scholarly journals Devices and Protocols for Upper Limb Robot-Assisted Rehabilitation of Children with Neuromotor Disorders

2019 ◽  
Vol 9 (13) ◽  
pp. 2689 ◽  
Author(s):  
Valeria Falzarano ◽  
Francesca Marini ◽  
Pietro Morasso ◽  
Jacopo Zenzeri
Keyword(s):  
Upper Limb ◽  
Pediatric Population ◽  
Recovery Process ◽  
Key Factors ◽  
Robot Assisted ◽  
Robotic Therapy ◽  
Rehabilitation Protocols ◽  
Potential Benefits ◽  
Robotic Devices ◽  
Sensorimotor Recovery

Neuromotor disorders negatively affect the sensorimotor system, limiting the ability to perform daily activities autonomously. Rehabilitation of upper limb impairments is therefore essential to improve independence and quality of life. In the last two decades, there has been a growing interest in robot-assisted rehabilitation as a beneficial way to promote children recovery process. However, a common understanding of the best drivers of an effective intervention has not been reached yet. With this aim, the current study reviewed the existing literature on robot-assisted rehabilitation protocols for upper extremities in children, with the goal of examining the effects of robotic therapy on their sensorimotor recovery process. A literature search was conducted in several electronic database to identify the studies related to the application of robotic therapy on upper limbs in the pediatric population. We analyzed three reviews and 35 studies that used 14 different robotic devices, and an overview of their characteristics, applications in the clinical setting and results is provided. Besides, the potential benefits of robot-assisted assessment and therapy are discussed to identify the key factors yielding positive outcomes in children. Finally, this review aim to lay the foundations for more effective neuroplasticity-enhancement protocols and elicit insights into robot-based approaches.

Combined transcranial Direct Current Stimulation and robot-assisted arm training in patients with stroke: a systematic review

2021 ◽  
Vol 39 (6) ◽  
pp. 435-446
Author(s):  
Cristina Fonte ◽  
Valentina Varalta ◽  
Arianna Rocco ◽  
Daniele Munari ◽  
Mirko Filippetti ◽  
...  
Keyword(s):  
Upper Limb ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Cochrane Library ◽  
Motor Deficits ◽  
Robot Assisted ◽  
Robotic Training ◽  
Direct Current Stimulation ◽  
Robotic Therapy ◽  
Mesh Terms

Background: Upper limb motor deficits in patients with severe stroke often remain unresolved over time. Combining transcranial Direct Current Stimulation with robotic therapy is an innovative neurorehabilitation approach that holds promise to improve upper limb impairment after stroke. Objective: To investigate the effects of robotic training in combination with transcranial Direct Current Stimulation for treating poststroke upper limb impairment. Methods: PubMed, MEDLINE, Cochrane Library, and EMBASE electronic databases were searched using keywords, MeSH terms, and strings: “Stroke”[MeSH] AND (“Upper Extremity”[MeSH] OR “upper limb”) AND (“Transcranial Direct Current Stimulation” [MeSH] OR “tDCS”) AND (“robotics” OR “robotic therapy”). Full-text articles published in English up to October 2020 were included. Each was rated for quality according to the Physiotherapy Database (PEDro) score: eight out of eleven scored more than 8 points; their results were considered reliable for this review. Results: Of the total of 171 publications retrieved, 11 met the inclusion criteria. The results of studies that examined the same outcome measures were pooled to draw conclusions on the effectiveness of transcranial Direct Current Stimulation and robot-assisted training in corticomotor excitability, upper limb kinematics, muscle strength and tone, function, disability, and quality of life after stroke. Conclusions: To date, there is insufficient evidence to support the hypothesis that transcranial Direct Current Stimulation enhances the effects of robot-assisted arm training in poststroke patients. Further studies with more accurate, comparable and standardized methodology are needed in order to better define the effects of robotic training in combination with transcranial Direct Current Stimulation on poststroke upper limb impairment. Therefore, given the scarce resources available to rehabilitation researches, other, more promising approaches should be given attention.

Planar Robotic Systems for Upper-Limb Post-Stroke Rehabilitation

2008 ◽  
Author(s):  
Giulio Rosati ◽  
Riccardo Secoli ◽  
Damiano Zanotto ◽  
Aldo Rossi ◽  
Giovanni Boschetti
Keyword(s):  
Upper Limb ◽  
Leading Edge ◽  
Robotic Systems ◽  
Robot Arm ◽  
Chronic Patients ◽  
Upper Limb Rehabilitation ◽  
Post Stroke ◽  
Robotic Therapy ◽  
Robotic Devices ◽  
Limb Rehabilitation

Rehabilitation is the only way to promote recovery of lost function in post-stroke hemiplegic subjects, leading to independence and early reintegration into social and domestic life. In particular, upper limb rehabilitation is fundamental to regain ability in Activities of Daily Living (ADLs). Robot-aided rehabilitation is an emerging field seeking to employ leading-edge robotic systems to increase patient recovery in the rehabilitation treatment. Even though the effectiveness of robotic therapy is still being discussed, the use of robotic devices can increase therapists’ efficiency by alleviating the labor-intensive aspects of physical rehabilitation, and can produce a reduction in treatment costs. This paper presents a comparison between different planar robotic devices designed for upper-limb rehabilitation in chronic patients. A planar configuration of the workspace leads to straightforward mechanical and control system design, and allows to define very simple and understandable treatment exercises. Also, the graphical user interface becomes very intuitive for the patient, and a set of Cartesian-based measures of the patient’s performance can be defined easily. In the paper, SCARA (Selective Compliance Assembly Robot Arm) robots such as the MIT-Manus, Cartesian robots and cable-driven robots are considered and compared in terms of inertial properties and force exertion capabilities. Two cable-driven devices, designed at the Robotics Lab of the Department if Innovation In Mechanics and Management, University of Padua, Italy, are presented for the first time. The first robot employs four driven cables to produce a planar force on the end-effector, whereas the second one is based on a three-cable configuration plus a linear actuator to obtain better overall robot performance.

scholarly journals Upper limb motor improvement in chronic stroke after combining botulinum toxin A injection and multi-joints robot-assisted therapy: a case report

2019 ◽  
Vol 2019 (10) ◽  
Author(s):  
Alex Martino Cinnera ◽  
Alessandra Pucello ◽  
Alessandro Lupo ◽  
Francesca Gimigliano ◽  
Elisa Mammucari ◽  
...  
Keyword(s):  
Botulinum Toxin ◽  
Upper Limb ◽  
Daily Living ◽  
Botulinum Toxin A ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Chronic Stroke ◽  
Robot Assisted ◽  
Robotic Therapy ◽  
Motor Improvement

Abstract Spasticity is one of the major complications after stroke. Botulinum toxin type A (BoNT-A) injection is commonly used to manage focal spasticity. However, it is uncertain whether BoNT-A can improve activities of daily living function of paretic arm. The recovery of functions of the affected arm is also the aim of robotic upper limb (UL) therapy. The motorized exoskeleton assists the patient in a large 3D work environment by promoting movement for the UL (shoulder, elbow, wrist, hand). The combination of the BoNT-A injection and the robotic therapy might enhance functional recovery after stroke. We reported the case of a chronic stroke patient in which the injection of BoNT-A was combined with multi-joint exoskeleton training. The patient showed improvement in the motor control of the UL, supporting the feasibility of this approach.

Effects of Robotic Therapy Associated With Noninvasive Brain Stimulation on Upper-Limb Rehabilitation After Stroke: Systematic Review and Meta-analysis of Randomized Clinical Trials

2021 ◽  
pp. 154596832198935
Author(s):  
Suzana Bleckmann Reis ◽  
Wanderley Marques Bernardo ◽  
Carlos Andre Oshiro ◽  
Hermano Igo Krebs ◽  
Adriana Bastos Conforto
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Upper Limb ◽  
Brain Stimulation ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Body Structure ◽  
Robot Assisted ◽  
Noninvasive Brain Stimulation ◽  
Robotic Therapy

Background Robot-assisted therapy and noninvasive brain stimulation (NIBS) are promising strategies for stroke rehabilitation. Objective This systematic review and meta-analysis aims to evaluate the evidence of NIBS as an add-on intervention to robotic therapy in order to improve outcomes of upper-limb motor impairment or activity in individuals with stroke. Methods This study was performed according to the PRISMA Protocol and was previously registered on the PROSPERO Platform (CRD42017054563). Seven databases and gray literature were systematically searched by 2 reviewers, and 1176 registers were accessed. Eight randomized clinical trials with upper-limb body structure/function or activity limitation outcome measures were included. Subgroup analyses were performed according to phase poststroke, device characteristics (ie, arm support, joints involved, unimanual or bimanual training), NIBS paradigm, timing of stimulation, and number of sessions. The Grade-Pro Software was used to assess quality of the evidence. Results A nonsignificant homogeneous summary effect size was found both for body structure function domain (mean difference [MD] = 0.15; 95% CI = −3.10 to 3.40; P = 0.93; I2 = 0%) and activity limitation domain (standard MD = 0.03; 95% CI = −0.28 to 0.33; P = 0.87; I2 = 0%). Conclusions According to this systematic review and meta-analysis, at the moment, there are not enough data about the benefits of NIBS as an add-on intervention to robot-assisted therapy on upper-limb motor function or activity in individuals with stroke.

Electromagnetic field in Alzheimer’s disease: a literature review of recent preclinical and clinical studies

2020 ◽  
Vol 17 ◽  
Author(s):  
Reem Habib Mohamad Ali Ahmad ◽  
Marc Fakhoury ◽  
Nada Lawand
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Neurodegenerative Disorder ◽  
In Vivo Studies ◽  
Key Factors ◽  
Potential Benefits ◽  
Preclinical And Clinical Studies ◽  
The Brain

: Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by the progressive loss of neurons leading to cognitive and memory decay. The main signs of AD include the irregular extracellular accumulation of amyloidbeta (Aβ) protein in the brain and the hyper-phosphorylation of tau protein inside neurons. Changes in Aβ expression or aggregation are considered key factors in the pathophysiology of sporadic and early-onset AD and correlate with the cognitive decline seen in patients with AD. Despite decades of research, current approaches in the treatment of AD are only symptomatic in nature and are not effective in slowing or reversing the course of the disease. Encouragingly, recent evidence revealed that exposure to electromagnetic fields (EMF) can delay the development of AD and improve memory. This review paper discusses findings from in vitro and in vivo studies that investigate the link between EMF and AD at the cellular and behavioural level, and highlights the potential benefits of EMF as an innovative approach for the treatment of AD.

Sequentially applied myoelectrically controlled FES in a task-oriented approach and robotic therapy for the recovery of upper limb in post-stroke patients: A randomized controlled pilot study

2020 ◽  
pp. 1-11
Author(s):  
Gloria Perini ◽  
Rita Bertoni ◽  
Rune Thorsen ◽  
Ilaria Carpinella ◽  
Tiziana Lencioni ◽  
...  
Keyword(s):  
Upper Limb ◽  
Standard Care ◽  
Experimental Treatment ◽  
Stroke Patients ◽  
Rehabilitation Care ◽  
Post Stroke ◽  
Robotic Therapy ◽  
Arm Rehabilitation ◽  
Point Increase ◽  
Task Oriented

BACKGROUND: Functional recovery of the plegic upper limb in post-stroke patients may be enhanced by sequentially applying a myoelectrically controlled FES (MeCFES), which allows the patient to voluntarily control the muscle contraction during a functional movement and robotic therapy which allows many repetitions of movements. OBJECTIVE: Evaluate the efficacy of MeCFES followed by robotic therapy compared to standard care arm rehabilitation for post-stroke patients. METHODS: Eighteen stroke subjects (onset ⩾ 3 months, age 60.1 ± 15.5) were recruited and randomized to receive an experimental combination of MeCFES during task-oriented reaching followed by robot therapy (MRG) or same intensity conventional rehabilitation care (CG) aimed at the recovery of the upper limb (20 sessions/45 minutes). Change was evaluated through Fugl-Meyer upperextremity (FMA-UE), Reaching Performance Scale and Box and Block Test. RESULTS: The experimental treatment resulted in higher improvement on the FMA-UE compared with CG (P= 0.04), with a 10 point increase following intervention. Effect sizes were moderate in favor of the MRG group on FMA-UE, FMA-UE proximal and RPS (0.37–0.56). CONCLUSIONS: Preliminary findings indicate that a combination of MeCFES and robotic treatment may be more effective than standard care for recovery of the plegic arm in persons > 3 months after stroke. The mix of motor learning techniques may be important for successful rehabilitation of arm function.

scholarly journals Mechatronic Design of a Robot for Upper Limb Rehabilitation at Home

2021 ◽  
Vol 18 (4) ◽  
pp. 857-871
Author(s):  
Elio Matteo Curcio ◽  
Giuseppe Carbone
Keyword(s):  
Design Process ◽  
Upper Limb ◽  
Experimental Tests ◽  
Design Solution ◽  
Upper Limb Rehabilitation ◽  
Potential Benefits ◽  
Significant Cost Reduction ◽  
Dynamics Models ◽  
Limb Rehabilitation ◽  
At Home

AbstractThis paper addresses the design of a novel bionic robotic device for upper limb rehabilitation tasks at home. The main goal of the design process has been to obtain a rehabilitation device, which can be easily portable and can be managed remotely by a professional therapist. This allows to treat people also in regions that are not easily reachable with a significant cost reduction. Other potential benefits can be envisaged, for instance, in the possibility to keep social distancing while allowing rehabilitation treatments even during a pandemic spread. Specific attention has been devoted to design the main mechatronic components by developing specific kinematics and dynamics models. The design process includes the implementation of a specific control hardware and software. Preliminary experimental tests are reported to show the effectiveness and feasibility of the proposed design solution.

scholarly journals Tools and Techniques Used With Robotic Devices to Quantify Upper-Limb Function in Typically Developing Children: A Systematic Review

2020 ◽  
Vol 9 ◽  
pp. 117957272097901
Author(s):  
Stephan CD Dobri ◽  
Hana M Ready ◽  
Theresa Claire Davies
Keyword(s):  
Systematic Review ◽  
Outcome Measures ◽  
Motor Function ◽  
Upper Limb ◽  
Rate Of Change ◽  
Typically Developing ◽  
Typically Developing Children ◽  
Upper Limb Function ◽  
Robotic Devices ◽  
Tools And Techniques

Background: Robotic devices have been used to quantify function, identify impairment, and rehabilitate motor function extensively in adults, but less-so in younger populations. The ability to perform motor actions improves as children grow. It is important to quantify this rate of change of the neurotypical population before attempting to identify impairment and target rehabilitation techniques. Objectives: For a population of typically developing children, this systematic review identifies and analyzes tools and techniques used with robotic devices to quantify upper-limb motor function. Since most of the papers also used robotic devices to compare function of neurotypical to pathological populations, a secondary objective was introduced to relate clinical outcome measures to identified robotic tools and techniques. Methods: Five databases were searched between February 2019 and August 2020, and 226 articles were found, 19 of which are included in the review. Results: Robotic devices, tasks, outcome measures, and clinical assessments were not consistent among studies from different settings but were consistent within laboratory groups. Fifteen of the 19 articles evaluated both typically developing and pathological populations. Conclusion: To optimize universally comparable outcomes in future work, it is recommended that a standard set of tasks and measures is used to assess upper-limb motor function. Standardized tasks and measures will facilitate effective rehabilitation.

Outcomes of complex robot-assisted extravesical ureteral reimplantation in the pediatric population

2016 ◽  
Vol 12 (3) ◽  
pp. 169.e1-169.e6 ◽  
Author(s):  
Angela M. Arlen ◽  
Kristin M. Broderick ◽  
Curtis Travers ◽  
Edwin A. Smith ◽  
James M. Elmore ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Ureteral Reimplantation ◽  
Robot Assisted

Robot Assisted Neurological Rehabilitation at Home: Motivational Aspects and Concepts for Tele-Rehabilitation

2009 ◽  
Vol 17 (4) ◽  
pp. 8-10 ◽  
Author(s):  
Michelle J. Johnson ◽  
Henning Schmidt
Keyword(s):  
New Technology ◽  
Neurological Rehabilitation ◽  
Motor Rehabilitation ◽  
Robot Assisted ◽  
Robotic Training ◽  
Training Systems ◽  
Rehabilitation Concepts ◽  
Potential Benefits ◽  
High Level ◽  
Therapy Robots

SummaryNumerous clinical studies have proved the efficacy of therapy robots in Neurological Motor Rehabilitation and their potential benefits for clinical outcome results. A major challenge of current technological and clinical research is the transfer of this new technology from the rehab hospital to the patient's home, thus enabling him to continue high level rehab training for further improvement of motor control of the affected limbs. This article focuses on motivational aspects and tele-rehabilitation concepts, which play an important role in the development of robotic training systems for home rehabilitation.

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