Abstract
Stroke is a major cause of disability in the world. The activities of upper limb segments are often compromised following a stroke, impairing most daily tasks. Robotic training is now considered amongst the rehabilitation methods applied to promote functional recovery. However, the implementation of robotic devices remains a major challenge for the bioengineering and clinical community. Latest exoskeletons with multiple degrees of freedom (DOF) may become particularly attractive, because of their low apparent inertia, the multiple actuators generating large torques, and the fact that patients can move the arm in the normal wide workspace. A recent study published in JNER by Milot and colleagues underlines that training with a 6-DOF exoskeleton impacts positively on motor function in patients being in stable phase of recovery after a stroke. Also, multi-joint robotic training was not found to be superior to single-joint robotic training. Although it is often considered that rehabilitation should start from simple movements to complex functional movements as the recovery evolves, this study challenges this widespread notion whose scientific basis has remained uncertain.
Highlights
Stroke is a major cause of disability in the world
There is a great hope that robotic devices will replace and/or assist efficiently physiotherapists, the implementation of rehabilitation based on robotic devices remains a major challenge for the bioengineering and clinical community [6,7]
Patients were in a stable phase of recovery after the stroke, so that the possible functional gains were attributed to the robotic training itself
Summary
Stroke is a major cause of disability in the world. The activities of upper limb segments are often compromised following a stroke, impairing most daily tasks. Most rehabilitation centers provide training and rehabilitation programs based on repetitive tasks [4], often with a functional feature [5]. There is a great hope that robotic devices will replace and/or assist efficiently physiotherapists, the implementation of rehabilitation based on robotic devices remains a major challenge for the bioengineering and clinical community [6,7]. The use of robotic devices has not clearly demonstrated that it impacts positively on the functional status of neurological patients, as compared to a conventional rehabilitation program handled by well trained and experienced physiotherapists [9].
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