Abstract
In the context of stroke rehabilitation, simple structures and user-intent driven actuation are relevant features to facilitate neuroplasticity as well as deliver a sufficient number of repetitions during a single therapy session. A novel robotic treatment device for distal upper limb rehabilitation in stroke patients was developed, and a usability test was performed to assess its clinical feasibility. The rehabilitation robot was designed as a two-axis exoskeleton actuated by electric motors, consisting of forearm supination/pronation and hand grasp/release, which were selected based on a kinematic analysis of essential daily activities. A vision-assisted algorithm was utilized for user-intent extraction in a human-in-the-loop concept. A usability test was performed on six physiatrists, five biomedical engineers, five rehabilitation therapists, two chronic stroke patients, and two caregivers of the patients. After sufficient instruction, all subjects tested the robot for a minimum of 10 min and completed the evaluation form using a 7-point Likert scale. The participants found the device interesting (5.7 ± 1.2), motivating (5.8 ± 0.9), and as having less possibility of causing injury or safety issues (6.1 ± 1.1); however, the appropriateness of difficulty (4.8 ± 1.9) and comfort level (4.9 ± 1.3) were found to be relatively low. Further development of the current device would provide a good treatment option as a simple, low-cost, and clinically feasible rehabilitation robot for stroke.
Highlights
The high incidence of stroke [1] and the recent trend toward developing rehabilitation robots have led to the development of several types of rehabilitation robots [2]
It is undeniable that more task-specific repetition of the paralyzed extremity would lead to better recovery in patients with limb paralysis caused by central nervous system (CNS) injuries or disorders
For overall satisfaction regarding the robot’s ability to help stroke rehabilitation, physiatrists rated with the highest score (6.0 ± 0.9), followed by robot engineers (5.4 ± 0.5), therapists (4.6 ± 0.5), and patients (4.0 ± 1.2)
Summary
The high incidence of stroke [1] and the recent trend toward developing rehabilitation robots have led to the development of several types of rehabilitation robots [2]. Not many types of neurorehabilitation robots have entered the developmental stage for large-scale randomized controlled clinical trials, nor have they been widely commercialized. Part of the reason for this would be the regulation issues pertaining to medical devices; a more important factor could be a lack of sustainable motivation to practically achieve sufficient “task-specific high repetition” throughout. Most of the rehabilitation robots focus on providing high repetitions and maintain motivation by applying virtual reality or gamification factors, such as providing disturbance during desired movements [6,7,8,9,10]. Robots that are developed as assistive devices, which interact with real objects, would primarily provide ultimate task-specific movements [11,12,13,14]
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