Robot-assisted Therapy in Stroke Rehabilitation

Abstract

Research into rehabilitation robotics has grown rapidly and the number of therapeutic rehabilitation robots has expanded dramatically during the last two decades. Robotic rehabilitation therapy can deliver high-dosage and high-intensity training, making it useful for patients with motor disorders caused by stroke or spinal cord disease. Robotic devices used for motor rehabilitation include end-effector and exoskeleton types; herein, we review the clinical use of both types. One application of robot-assisted therapy is improvement of gait function in patients with stroke. Both end-effector and the exoskeleton devices have proven to be effective complements to conventional physiotherapy in patients with subacute stroke, but there is no clear evidence that robotic gait training is superior to conventional physiotherapy in patients with chronic stroke or when delivered alone. In another application, upper limb motor function training in patients recovering from stroke, robot-assisted therapy was comparable or superior to conventional therapy in patients with subacute stroke. With end-effector devices, the intensity of therapy was the most important determinant of upper limb motor recovery. However, there is insufficient evidence for the use of exoskeleton devices for upper limb motor function in patients with stroke. For rehabilitation of hand motor function, either end-effector and exoskeleton devices showed similar or additive effects relative to conventional therapy in patients with chronic stroke. The present evidence supports the use of robot-assisted therapy for improving motor function in stroke patients as an additional therapeutic intervention in combination with the conventional rehabilitation therapies. Nevertheless, there will be substantial opportunities for technical development in near future.

Dreaming of the future of stroke: translation of bench to bed

“…Wearable devices that measure easily quantifiable data have been or are being devel- Advancements in robotics and neuroscience can promote the improvement of functional impairment in patients with stroke through therapeutic assisting robots [38]. Therapeutic robot can improve the effects of stroke rehabilitation to provide more intensive, longer, and more repetitive tasks with more challenging and motivating components.…”

Improved walking ability with wearable robot-assisted training in patients suffering chronic stroke

“…Six infrared 100 Hz cameras recorded the data, which were subsequently analyzed using Vicon Nexus(version 1.7.1) The kinetic data were collected by two force plates (AMTI, Watertown, MA, USA) with a sampling frequency of 1,000Hz embedded in the walkway [16].…”

The role of evidence-based medicine in the neurorehabilitation: the innovative technologies (a review)

“…Анализ иссле-дований показывает (уровень доказательности 1а), что роботизированная механотерапия способствует восстановлению функции ходьбы. В то же время, преимущества роботизированной механотерапии по сравнению с методами лечебной физкультуры не доказаны [6].…”

“…Роботизированная механотерапия значимо (1а) улучшает мышечную силу проксимальных (но не дистальных) отделов руки и функциональные исхо-ды верхней конечности [6]. Результаты исследова-ний могут объясняться трудностью тренировки точ-ных движений руки без специальных механизиро-ванных устройств.…”