Abstract
Robot-mediated therapy is an innovative form of rehabilitation that enables highly repetitive, intensive, adaptive, and quantifiable physical training. It has been increasingly used to restore loss of motor function, mainly in stroke survivors suffering from an upper limb paresis. Multiple studies collated in a growing number of review articles showed the positive effects on motor impairment, less clearly on functional limitations. After describing the current status of robotic therapy after upper limb paresis due to stroke, this overview addresses basic principles related to robotic therapy applied to upper limb paresis. We demonstrate how this innovation is an evidence-based approach in that it meets both the improved clinical and more fundamental knowledge-base about regaining effective motor function after stroke and the need of more objective, flexible and controlled therapeutic paradigms.
Highlights
Robot-mediated rehabilitation is an innovative exercise-based therapy using robotic devices that enable the implementation of highly repetitive, intensive, adaptive, and quantifiable physical training
The use of some robots demonstrated that the higher dose of robot-assisted training improved the motor outcomes when compared to a lower dose; Hsieh et al [50] designed a clinical trial with 2 doses of robot-mediated rehabilitation in chronic stroke patients and showed that the higher dose resulted in the better motor outcomes
As Lynch et al have shown, one needs to be careful to select the appropriate robot controller and adaptive settings otherwise assistance may not be the treatment modality optimizing motor recovery [25, 52]. This is not limited to upper extremity; studies of robot-assisted gait training have demonstrated that such rehabilitation is more effective when the user actively participates in the movement
Summary
Robot-mediated rehabilitation is an innovative exercise-based therapy using robotic devices that enable the implementation of highly repetitive, intensive, adaptive, and quantifiable physical training. The use of some robots demonstrated that the higher dose of robot-assisted training improved the motor outcomes when compared to a lower dose; Hsieh et al [50] designed a clinical trial with 2 doses (number of repetitions) of robot-mediated rehabilitation in chronic stroke patients and showed that the higher dose resulted in the better motor outcomes. As Lynch et al have shown, one needs to be careful to select the appropriate robot controller and adaptive settings otherwise assistance may not be the treatment modality optimizing motor recovery [25, 52] This is not limited to upper extremity; studies of robot-assisted gait training have demonstrated that such rehabilitation is more effective when the user actively participates in the movement. In an era of constraint budget associated with decreasing length of hospital stays worldwide, robotics has the potential to increase the productivity and quality of care after stroke in all countries
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