Upper and lower extremity robotic devices to promote motor recovery after stroke -recent developments

Abstract

Successful motor rehabilitation of stroke, TBI and SCI subjects requires an intensive and task-specific therapy approach. Budget constrains limit a hand-to-hand therapy approach, so that intelligent machines may offer a solution to further promote motor recovery and to better understand motor control. This new field of automated or robot-assisted motor rehabilitation has emerged since the nineties. The article presents clinically viable devices for the upper and lower extremity rehabilitation, which have been developed by our group. The Bi-Manu-Track, enables the bilateral practice of a forearm and wrist movement, and is currently tested. For gait rehabilitation after stroke, the electromechanical gait trainer GT I has proven effective as compared to treadmill training with body weight support (BWS). The latest development is the HapticWalker, a robotic walking simulator for gait training, which allows the training of arbitrary daily life foot trajectories. The foot trajectories can be individually adjusted to each patient, in addition the machine will offer a sophisticated patient-machine-interaction. A prototype of the machine has been designed and built succesfully and is being evaluated at present. Technical possibilities are one aspect, but multi-centre trials and the consideration of unsubstantiated fears among therapists of being replaced by the machines will decide on the successful implementation of this most promising field to the benefit of patients.