Robot-aided intensive training in post-stroke recovery

Masiero, Stefano; Celia, Andrea; Armani, Mario; Rosati, Giulio; Tavolato, B.; Ferraro, Claudio; Ortolani, Marco

doi:10.1007/bf03324658

Cited by 10 publications

(10 citation statements)

References 44 publications

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“…However, there are little data on the true relationship between sensory information and patient engagement and effort, which should be examined to guide the design of novel robotic systems for rehabilitation. • The multiplanarity of the exercises that induce greater motor cortex excitation [35,100,101].…”

Section: Five-year Viewmentioning

confidence: 99%

The value of robotic systems in stroke rehabilitation

Masiero

Poli

Rosati

et al. 2014

Expert Review of Medical Devices

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135

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In this paper, we discuss robot-mediated neurorehabilitation as a significant emerging field in clinical medicine. Stroke rehabilitation is advancing toward more integrated processes, using robotics to facilitate this integration. Rehabilitation approaches have tremendous value in reducing long-term impairments in stroke patients during hospitalization and after discharge, of which robotic systems are a new modality that can provide more effective rehabilitation. The function of robotics in rehabilitative interventions has been examined extensively, generating positive yet not completely satisfactory clinical results. This article presents state-of-the-art robotic systems and their prospective function in poststroke rehabilitation of the upper and lower limbs.

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Section: Five-year Viewmentioning

confidence: 99%

The value of robotic systems in stroke rehabilitation

Masiero

Poli

Rosati

et al. 2014

Expert Review of Medical Devices

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135

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“…One domain to be explored is acute-phase robotic therapy. So far, many robotic devices have been designed to deliver arm therapy in individuals with stroke [24], but only a few of them-notably, the MIT-Manus [25][26], the Mirror Image Movement Enabler (MIME) [27][28], the Bi-Manu-Track [29], and the Neuro-RehabilitationroBot (NeReBot) [30][31][32]-have been tested in at least one randomized controlled trial (RCT) on patients during the acute or subacute phases of their stroke. * The results of those studies show that early robotic training of the upper limb can improve ADLs significantly more than chronic-phase training [22].…”

Section: Introductionmentioning

confidence: 99%

“…The authors attributed the greater improvements in the robot-trained group to the greater number of repetitions and the bilateral approach. At the University of Padua in Italy, we designed and developed the NeReBot, a device for treatment of poststroke upper-limb impairments in the acute and subacute phases of rehabilitation [30][31][32]. In the first NeReBot trial [21], the additional training delivered by NeReBot consisted of 25 daily interventions (starting within the first week poststroke) divided into 2 sessions a day for a total training time of 4 hours a week for 5 weeks, whereas the control group (CG) received similar exposure to the robot (two 30-minute sessions a week) except that the exercises were performed with the unimpaired limb.…”

Section: Introductionmentioning

confidence: 99%

Upper-limb robot-assisted therapy in rehabilitation of acute stroke patients: Focused review and results of new randomized controlled trial

Masiero¹,

Armani²,

Rosati³

2011

JRRD

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162

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Abstract-The successful motor rehabilitation of stroke patients requires early intensive and task-specific therapy. A recent Cochrane Review, although based on a limited number of randomized controlled trials (RCTs), showed that early robotic training of the upper limb (i.e., during acute or subacute phase) can enhance motor learning and improve functional abilities more than chronic-phase training. In this article, a new subacute-phase RCT with the Neuro-RehabilitationroBot (NeReBot) is presented. While in our first study we used the NeReBot in addition to conventional therapy, in this new trial we used the same device in substitution of standard proximal upper-limb rehabilitation. With this protocol, robot patients achieved similar reductions in motor impairment and enhancements in paretic upper-limb function to those gained by patients in a control group. By analyzing these results and those of previous studies, we hypothesize a new robotic protocol for acute and subacute stroke patients based on both treatment modalities (in addition and in substitution).Clinical Trial Registration: ClinicalTrials.gov; NCT01102309, "Robot-assisted rehabilitation of the upper limb in acute and subacute poststroke patients"; http://clinicaltrials.gov/ct2/show/ NCT01102309.

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“…A variety of assistive control strategies have been designed (see review [7]), including: robots that move limbs rigidly along fixed paths, robots that assist only if the patient’s performance fails to stay within some spatial or temporal boundary, and soft robots that form a model of the patient’s weakness. Mechanical devices for rehabilitation are, in fact, designed to interact with the human guiding the upper limb through repetitive exercises based on a stereotyped pattern, and providing force feedback for sensorimotor type rehabilitative training [8]. …”

Section: Introductionmentioning

confidence: 99%

Effect of task-related continuous auditory feedback during learning of tracking motion exercises

Rosati

Oscari

Spagnol

et al. 2012

J NeuroEngineering Rehabil

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BackgroundThis paper presents the results of a set of experiments in which we used continuous auditory feedback to augment motor training exercises. This feedback modality is mostly underexploited in current robotic rehabilitation systems, which usually implement only very basic auditory interfaces. Our hypothesis is that properly designed continuous auditory feedback could be used to represent temporal and spatial information that could in turn, improve performance and motor learning.MethodsWe implemented three different experiments on healthy subjects, who were asked to track a target on a screen by moving an input device (controller) with their hand. Different visual and auditory feedback modalities were envisaged. The first experiment investigated whether continuous task-related auditory feedback can help improve performance to a greater extent than error-related audio feedback, or visual feedback alone. In the second experiment we used sensory substitution to compare different types of auditory feedback with equivalent visual feedback, in order to find out whether mapping the same information on a different sensory channel (the visual channel) yielded comparable effects with those gained in the first experiment. The final experiment applied a continuously changing visuomotor transformation between the controller and the screen and mapped kinematic information, computed in either coordinate system (controller or video), to the audio channel, in order to investigate which information was more relevant to the user.ResultsTask-related audio feedback significantly improved performance with respect to visual feedback alone, whilst error-related feedback did not. Secondly, performance in audio tasks was significantly better with respect to the equivalent sensory-substituted visual tasks. Finally, with respect to visual feedback alone, video-task-related sound feedback decreased the tracking error during the learning of a novel visuomotor perturbation, whereas controller-task-related sound feedback did not. This result was particularly interesting, as the subjects relied more on auditory augmentation of the visualized target motion (which was altered with respect to arm motion by the visuomotor perturbation), rather than on sound feedback provided in the controller space, i.e., information directly related to the effective target motion of their arm.ConclusionsOur results indicate that auditory augmentation of visual feedback can be beneficial during the execution of upper limb movement exercises. In particular, we found that continuous task-related information provided through sound, in addition to visual feedback can improve not only performance but also the learning of a novel visuomotor perturbation. However, error-related information provided through sound did not improve performance and negatively affected learning in the presence of the visuomotor perturbation.

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Robot-aided intensive training in post-stroke recovery

Cited by 10 publications

References 44 publications

The value of robotic systems in stroke rehabilitation

The value of robotic systems in stroke rehabilitation

Upper-limb robot-assisted therapy in rehabilitation of acute stroke patients: Focused review and results of new randomized controlled trial

Effect of task-related continuous auditory feedback during learning of tracking motion exercises

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