Direct Drive Hand Exoskeleton for Robot-assisted Post Stroke Rehabilitation

Motor function deficit due to stroke is one of the leading causes for disability among working-age population. The most effective evidence-based treatment strategies are task oriented exercise approaches including constrained-induced movement therapy. Robot-assisted training provides high amount of repetitions and feedback to patient. Adjuvant therapies such as mirror therapy and motor imagery show their effectiveness if used in combination with basic neurorehabilitation methods and are treatment of choice for patients with severe motor impairment. Brain-computer interfaces allow to control motor imagery as a process by giving different type of feedback (e.g. kinesthetic via exoskeleton) during training sessions. It is poorly known if kinesthetic motor imagery is more effective comparing to robot-assisted training as a part of post-stroke rehabilitation. Materials and methods: 55 patients with arm paresis >1 month after stroke were enrolled in the current study. Screening and randomization were performed. Participants underwent rehabilitation treatment where BCI controlled motor imagery training in main group and robot-assisted training in control group were included. Motor function of the paretic arm was assessed using Action Research Arm Test (ARAT) and Fugl-Meyer Assessment (FMA) before and after intervention. Results: Recovery of upper extremity motor function did not correlate with time since stroke and age of participants neither in main group, nor in control group. Correlations between change in motor scales scores and initial severity of motor deficit was shown in both groups (p

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Improving of the Effectiveness of Motor-Imagery Training With BCI Technology in Hand Exoskeleton in Post-Stroke Rehabilitation

International Journal of Psychophysiology ◽

10.1016/j.ijpsycho.2021.07.360 ◽

2021 ◽

Vol 168 ◽

pp. S124

Author(s):

Alexandra Rubakova ◽

Galina Ivanova ◽

Boris Polyaev ◽

Maria Bulatova

Keyword(s):

Motor Imagery ◽

Stroke Rehabilitation ◽

Post Stroke ◽

Imagery Training ◽

Hand Exoskeleton

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Detecting Compensatory Motions and Providing Informative Feedback During a Tangible Robot Assisted Game for Post-Stroke Rehabilitation

10.1109/ro-man50785.2021.9515325 ◽

2021 ◽

Author(s):

Arzu Guneysu Ozgur ◽

Hala Khodr ◽

Barbara Bruno ◽

Nicolas Gandar ◽

Maximilian J. Wessel ◽

...

Keyword(s):

Stroke Rehabilitation ◽

Robot Assisted ◽

Informative Feedback ◽

Post Stroke

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Abstract WMP47: Robot-assisted Mechanical Therapy Protects Against Stroke-induced Skeletal Muscle Injury

Stroke ◽

10.1161/str.48.suppl_1.wmp47 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Maria H Balch ◽

Chandan K Sen ◽

Savita Khanna ◽

Hallie Harris ◽

Surya Gnyawali ◽

...

Keyword(s):

Skeletal Muscle ◽

Stroke Rehabilitation ◽

Muscle Injury ◽

Muscle Physiology ◽

Robot Assisted ◽

Track Width ◽

Muscle Perfusion ◽

Skeletal Muscle Injury ◽

Post Stroke ◽

Mechanical Therapy

Introduction: A growing body of literature supports acute changes to skeletal muscle physiology in response to stroke-induced central nervous system injury. While stroke survivors depend on rehabilitation to facilitate functional recovery, study of post-stroke rehabilitation and mechanisms of recovery remains limited. The current work addresses development of a Robot-Assisted Mechanical Therapy (RAMT) device and facilitation of reproducible, objective analysis of post-stroke rehabilitation. We hypothesize that RAMT permits systematic study of post-stroke mechano-physiotherapy and restores hindlimb function after stroke by protecting against skeletal muscle injury. Methods: Wistar rats (male, N=26) were subjected to middle cerebral artery occlusion (MCAO), after which they received daily RAMT (RAMT+; 0.5N force, 1Hz frequency, 10mm linear motion over medial stroke-affected gastrocnemius) or none (RAMT-; anesthesia only) for 14 days. Assessment of gait, sensorimotor behavior, and muscle perfusion quantified effects of RAMT on post-stroke function, while skeletal muscle analysis (RT-PCR, immunohistochemistry) evaluated expression of myostatin, a molecular target of stroke. Results: Compared to RAMT- controls, RAMT+ rats benefited from higher perfusion in stroke-affected gastrocnemius (47.7%, p<0.05). RAMT+ improved post-stroke gait and sensorimotor behavior, evidenced by better track width (11.9%, p<0.05), less time in quad support (54.4%, p<0.05), greater travel distance (60.5%, p<0.05), and more time mobile (41.7%, p<0.05). Additionally, RAMT+ protected from post-stroke induction of myostatin, decreasing mRNA and protein expression (39.1% and 88.6% respectively, p<0.05). Conclusion: RAMT facilitates reproducible, objective, pre-clinical study of post-stroke mechano-physiotherapy. RAMT successfully improves muscle perfusion, rescues gait deficits, preserves sensorimotor behavior, and attenuates the stroke-induced rise in myostatin. Ongoing efforts focus to characterize the mechano-sensitive miRNA transcriptome in skeletal muscle and employ electrophysiology to quantitatively map post-stroke neuroplasticity in response to RAMT.

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