Abstract
In this study, we developed a novel robotic system with a muscle-to-muscle interface to enhance rehabilitation of post-stroke patients. The developed robotic rehabilitation system was designed to provide patients with stage appropriate physical rehabilitation exercise and muscular stimulation. Unlike the position-based control of conventional bimanual robotic therapies, the developed system stimulates the activities of the target muscles, as well as the joint movements of the paretic limb. The robot-assisted motion and the electrical stimulation on the muscles of the paretic side are controlled by on-line comparison of the motion and the muscle activities between the paretic and unaffected sides. With the developed system, the rehabilitation exercise can be customized and modulated depending on the patient’s stage of motor recovery after stroke. The system can be operated in three different modes allowing both passive and active exercises. The effectiveness of the developed system was verified with healthy human subjects, where the subjects were paired to serve as the unaffected side and the paretic side of a hemiplegic patient.
Highlights
A large number of patients suffer from lower limb hemiplegia after experiencing a stroke
We aim to develop a robot-assisted rehabilitation system combined with the application of functional electrical stimulation (FES) on the muscles in the lower limb to enhance the recovery process for hemiplegic stroke patients
The differences in the integrated EMG (iEMG) values were statically significant between the two active modes for all the subjects except for subject B. These results show that volitional muscle activity or active engagement of the subjects on the paretic side can be effectively controlled by the operation modes of the developed hybrid robotic rehabilitation systems (HRRS)
Summary
A large number of patients suffer from lower limb hemiplegia after experiencing a stroke. Poststroke hemiplegic patients have impaired gait pattern and must undergo rehabilitation exercises to restore their normal gait pattern. Intensive rehabilitation exercises must be conducted within a golden period, between 3 and 6 months following the stroke within which most functional restoration takes place. Rehabilitation processes often do not begin in a timely manner due to the limited number of therapists available to conduct the exercises. The process of rehabilitation requires significant time and effort for the therapists and the number and duration of rehabilitation sessions hardly meet the demand. It is crucial that this problem be addressed as studies have indicated that increasing the amount of physiotherapy has a positive effect on functional recovery (Kwakkel et al, 2008; Huang and Krakauer, 2009; Kollen et al, 2009; Kwakkel, 2009; Marchal-Crespo and Reinkensmeyer, 2009)
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