Rehabilitation Robotics

Krebs, Hermano Igo; Volpe, Bruce T.

doi:10.1016/b978-0-444-52901-5.00023-x

Cited by 95 publications

(45 citation statements)

References 50 publications

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“…Clinical scales were applied to evaluate the subjects before and after the robot-aided rehabilitation training by the same physical therapist who was blinded from the study protocol. These scales included the Fugl-Meyer scale (range 0–66) [17] and was further derived into shoulder/elbow (42/66) and wrist/hand (24/66) subscales [18] for the evaluation of motor function and the modified Ashworth scale (range 0–4) [19] for the muscle tone at the wrist joint. In each session, the MIVF and MIVE torques were used to reflect muscle strength; the active range of motion and accuracy in the evaluation trial of each session can be measured, which can also be applied to evaluate the motor function improvement [15].…”

Section: Methodsmentioning

confidence: 99%

Myoelectrically controlled wrist robot for stroke rehabilitation

Song

Tong

et al. 2013

J NeuroEngineering Rehabil

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BackgroundRobot-assisted rehabilitation is an advanced new technology in stroke rehabilitation to provide intensive training. Post-stroke motor recovery depends on active rehabilitation by voluntary participation of patient’s paretic motor system as early as possible in order to promote reorganization of brain. However, voluntary residual motor efforts to the affected limb have not been involved enough in most robot-assisted rehabilitation for patients after stroke. The objective of this study is to evaluate the feasibility of robot-assisted rehabilitation using myoelectric control on upper limb motor recovery.MethodsIn the present study, an exoskeleton-type rehabilitation robotic system was designed to provide voluntarily controlled assisted torque to the affected wrist. Voluntary intention was involved by using the residual surface electromyography (EMG) from flexor carpi radialis(FCR) and extensor carpi radialis (ECR)on the affected limb to control the mechanical assistance provided by the robotic system during wrist flexion and extension in a 20-session training. The system also applied constant resistant torque to the affected wrist during the training. Sixteen subjects after stroke had been recruited for evaluating the tracking performance and therapeutical effects of myoelectrically controlled robotic system.ResultsWith the myoelectrically-controlled assistive torque, stroke survivors could reach a larger range of motion with a significant decrease in the EMG signal from the agonist muscles. The stroke survivors could be trained in the unreached range with their voluntary residual EMG on the paretic side. After 20-session rehabilitation training, there was a non-significant increase in the range of motion and a significant decrease in the root mean square error (RMSE) between the actual wrist angle and target angle. Significant improvements also could be found in muscle strength and clinical scales.ConclusionsThese results indicate that robot-aided therapy with voluntary participation of patient’s paretic motor system using myoelectric control might have positive effect on upper limb motor recovery.

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Section: Methodsmentioning

confidence: 99%

Myoelectrically controlled wrist robot for stroke rehabilitation

Song

Tong

et al. 2013

J NeuroEngineering Rehabil

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“…Robotic devices and virtual reality are increasingly used and assessed in rehabilitation and research [9, 10]. This second-generation devices are probably much more expensive than standard mirror therapy: they often present a technological complexity that requires investment, constant maintenance, and highly qualified operators [11].…”

Section: Introductionmentioning

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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“…The enormous personal and societal burden caused by diseases of the brain and spinal cord make imperative innovative attempts to reduce illness and alter permanent disability. Colleagues at MIT, HI Krebs and N Hogan, developed an array of interactive robotic devices that we have used to aid and abet treatment programs for neurological recovery of motor function of the limbs in patients who have had a stroke (1)(2)(3)(4). These interactive robots move a patient's paretic arm and when the patient begins to move, these robots "get out of the way" so the patient can execute the movement with very little resistance from the device.…”

Section: Introductionmentioning

confidence: 99%

Bioelectronic Medicine and the Dawn of Robotic Training to Improve Motor Outcome in Chronic Stroke

Volpe

2014

Bioelectron Med

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Engineers and clinicians have cooperated to produce and test new classes of bioelectronics that have altered motor impairment that occurs after stroke. The rationale that increased intensity of training alters outcome derives from past clinical and preclinical work. Now several studies have demonstrated that interactive robotic devices are a potent tool for the therapist to deliver effortlessly, reproducible high intensity movement training. These robots are safe and can provide a platform so that recovery might be influenced by a combination of noninvasive novel treatment programs. Also, these robotic devices provide a continuous objective history of movement parameters that will open the horizon for their use in generating novel movement biomarkers to understand, predict and measure the influence of new treatments on motor outcome after neurological injury.

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Rehabilitation Robotics

Cited by 95 publications

References 50 publications

Myoelectrically controlled wrist robot for stroke rehabilitation

Myoelectrically controlled wrist robot for stroke rehabilitation

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

Bioelectronic Medicine and the Dawn of Robotic Training to Improve Motor Outcome in Chronic Stroke

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