Electromechanical-assisted training for walking after stroke

Mehrholz, Jan; Thomas, Simone; Werner, Carsten; Kügler, Joachim; Pohl, Marcus; Elsner, Bernhard

doi:10.1002/14651858.cd006185.pub4

Cited by 297 publications

(183 citation statements)

References 76 publications

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“…As affirmed recently by Cochrane,35 it is imperative to define the characteristics of patients who may benefit the most from robotic therapy. According to the principle that overground training is the most physiological one, although not always possible, the more is the severity of stroke, the more should be the help and the constraint level provided by the device, as shown in Figure 2.…”

Section: From “Efficacy For All” To “All For Efficacy”mentioning

confidence: 99%

Robot-assisted gait training for stroke patients: current state of the art and perspectives of robotics

Morone¹,

Paolucci²,

Cherubini³

et al. 2017

NDT

217

141

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In this review, we give a brief outline of robot-mediated gait training for stroke patients, as an important emerging field in rehabilitation. Technological innovations are allowing rehabilitation to move toward more integrated processes, with improved efficiency and less long-term impairments. In particular, robot-mediated neurorehabilitation is a rapidly advancing field, which uses robotic systems to define new methods for treating neurological injuries, especially stroke. The use of robots in gait training can enhance rehabilitation, but it needs to be used according to well-defined neuroscientific principles. The field of robot-mediated neurorehabilitation brings challenges to both bioengineering and clinical practice. This article reviews the state of the art (including commercially available systems) and perspectives of robotics in poststroke rehabilitation for walking recovery. A critical revision, including the problems at stake regarding robotic clinical use, is also presented.

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Section: From “Efficacy For All” To “All For Efficacy”mentioning

confidence: 99%

Robot-assisted gait training for stroke patients: current state of the art and perspectives of robotics

Morone¹,

Paolucci²,

Cherubini³

et al. 2017

NDT

217

141

View full text Add to dashboard Cite

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“…Cochrane systematic reviews on this topic concluded that “ virtual reality and physiotherapy may have similar effects on gait, balance, and quality of life ” for Parkinson disease [14] or that “ the use of virtual reality and interactive video gaming was not more beneficial than conventional therapy approaches in improving upper limb function ” after stroke [101]. When there is effect of robot-assisted training, the quality of evidence is very low or low for improving arm functions after stroke [102] or moderate for improving independent walking in people after stroke [103]. Researchers who have conducted systematic reviews on the topic suggest that the effectiveness of robot-assisted therapy is more due to the high intensity of training than to the treatment modality [102–106]: “ it seems unlikely that therapy provided by robots will lead to better results than therapy provided by humans under the premise that intensity, amount and frequency of therapy are exactly comparable ” [104].…”

Section: Discussionmentioning

confidence: 99%

Do Robotics and Virtual Reality Add Real Progress to Mirror Therapy Rehabilitation? A Scoping Review

Darbois

Guillaud

Pinsault

2018

Rehabilitation Research and Practice

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Background Mirror therapy has been used in rehabilitation for multiple indications since the 1990s. Current evidence supports some of these indications, particularly for cerebrovascular accidents in adults and cerebral palsy in children. Since 2000s, computerized or robotic mirror therapy has been developed and marketed. Objectives To map the extent, nature, and rationale of research activity in robotic or computerized mirror therapy and the type of evidence available for any indication. To investigate the relevance of conducting a systematic review and meta-analysis on these therapies. Method Systematic scoping review. Searches were conducted (up to May 2018) in the Cochrane Library, Google Scholar, IEEE Xplore, Medline, Physiotherapy Evidence Database, and PsycINFO databases. References from identified studies were examined. Results In sum, 75 articles met the inclusion criteria. Most studies were publicly funded (57% of studies; n = 43), without disclosure of conflict of interest (59% of studies; n = 44). The main outcomes assessed were pain, satisfaction on the device, and body function and activity, mainly for stroke and amputees patients and healthy participants. Most design studies were case reports (67% of studies; n = 50), with only 12 randomized controlled trials with 5 comparing standard mirror therapy versus virtual mirror therapy, 5 comparing second-generation mirror therapy versus conventional rehabilitation, and 2 comparing other interventions. Conclusion Much of the research on second-generation mirror therapy is of very low quality. Evidence-based rationale to conduct such studies is missing. It is not relevant to recommend investment by rehabilitation professionals and institutions in such devices.

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“…It is likely that severely impaired individuals will not be able to tolerate this type of feedback. However, non-ambulatory individuals are currently better served by current forms of RAGT, than ambulatory individuals [10]. Damping fields are likely more appropriate for these higher functioning individuals.…”

Section: Discussionmentioning

confidence: 99%

“…Even with these benefits, there have been mixed results in terms of outcomes [1]–[10]. It should be noted for most studies that showed RAGT to have greater improvements over conventional therapy, RAGT was done in addition to conventional therapy and/or was used in sub-acute populations.…”

Section: Introductionmentioning

confidence: 99%

Variable Damping Force Tunnel for Gait Training Using ALEX III

Stegall

Zanotto

Agrawal

2017

IEEE Robot. Autom. Lett.

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Haptic feedback affects not only the quality of training but can also influence the physical design of robotic gait trainers by determining how much force needs to be applied to the user and the nature of the force. This paper presents the design of a variable damping force tunnel and explores the effect of the shape and strength of the damping field using ALEX III, a treadmill-based exoskeleton developed at Columbia University. The study consists of 32 healthy subjects who were trained for 40 minutes in the device. The subjects were trained to follow a footpath with a 50% increase in step height, so the foot would have 1.5 times the ground clearance. Subjects were assigned to one of four groups: linear high, linear low, parabolic high, and parabolic low. Linear or parabolic denotes the shape of the damping field, and high or low denotes the rate of change (strength) of the field based on error. It is shown that the new controller is capable of inducing gait adaptations in healthy individuals while walking in the device. All groups showed adaptations in step height, while only the high strength groups showed changes in normalized error area, a measure of how closely the desired path was followed.

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Electromechanical-assisted training for walking after stroke

Abstract: Analysis 1.2. Comparison 1 Electromechanical-and robotic-assisted gait training plus physiotherapy versus physiotherapy (or usual care), Outcome 2 Recovery of independent walking at follow-up a er study end.

Cited by 297 publications

References 76 publications

Robot-assisted gait training for stroke patients: current state of the art and perspectives of robotics

Robot-assisted gait training for stroke patients: current state of the art and perspectives of robotics

Do Robotics and Virtual Reality Add Real Progress to Mirror Therapy Rehabilitation? A Scoping Review

Variable Damping Force Tunnel for Gait Training Using ALEX III

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