Rehabilitation Of Neurological Disorders Research Articles

Classroom-ready open-source educational exoskeleton for biomedical and control engineering

Abstract In recent years, robotic arm exoskeletons have emerged as promising tools, finding widespread application in the rehabilitation of neurological disorders and as assistive devices for everyday activities, even alleviating the physical strain on labor-intensive tasks. Despite the growing prominence of exoskeletons in everyday life, a notable knowledge gap exists in the availability of open-source platforms for classroom-ready usage in educational settings. To address this deficiency, we introduce an open-source educational exoskeleton platform aimed at Science, Technology, Engineering, and Mathematics (STEM) education. This platform represents an enhancement of the commercial EduExo Pro by AUXIVO, tailored to serve as an educational resource for control engineering and biomedical engineering courses.

Impact of AI-Powered Solutions in Rehabilitation Process: Recent Improvements and Future Trends.

Rehabilitation is an important and necessary part of local and global healthcare services along with treatment and palliative care, prevention of disease, and promotion of good health. The rehabilitation process helps older and young adults even children to become as independent as possible in activities of daily life and enables participation in useful living activities, recreation, work, and education. The technology of Artificial Intelligence (AI) has evolved significantly in recent years. Many activities related to rehabilitation have been getting benefits from using AI techniques. The objective of this review study is to explore the advantages of AI for rehabilitation and how AI is impacting the rehabilitation process. This study aims at the most critical aspects of the rehabilitation process that could potentially take advantage of AI techniques including personalized rehabilitation apps, rehabilitation through assistance, rehabilitation for neurological disorders, rehabilitation for developmental disorders, virtual reality rehabilitation, rehabilitation of neurodegenerative diseases and Telerehabilitation of Cardiovascular. We presented a survey on the newest empirical studies available in the literature including the AI-based technology helpful in the Rehabilitation process. The novelty feature included but was not limited to an overview of the technological solutions useful in rehabilitation. Seven different categories were identified. Illustrative examples of practical applications were detailed. Implications of the findings for both research and practice were critically discussed. Most of the AI applications in these rehabilitation types are in their infancy and continue to grow while exploring new opportunities. Therefore, we investigate the role of AI technology in rehabilitation processes. In addition, we do statistical analysis of the selected studies to highlight the significance of this review work. In the end, we also present a discussion on some challenges, and future research directions.

Rehabilitation of Neurological Disorders Using Body Weight Supported Treadmill Training - A Brief Review

Treadmill walking with the help of body weight support or without body weight support through a harness connected to an overhead support system, is a method of rehabilitating locomotor impairments in patients suffering from various disorders which affect normal gait/locomotion and is becoming increasingly popular. Body weight supported treadmill training (BWSTT) is a recent therapeutic training / technique that is being used for rehabilitation of patients with neurological walking disorders such as stroke, spinal cord injuries and cerebral palsy and parkinson’s disease. Further research to be carried out for establishing a definitive treatment protocol for BWSTT in these disease states Keywords: Body weight supported treadmill training, stroke, spinal cord injuries, cerebral palsy.

Classification of gait phases based on a machine learning approach using muscle synergy.

The accurate detection of the gait phase is crucial for monitoring and diagnosing neurological and musculoskeletal disorders and for the precise control of lower limb assistive devices. In studying locomotion mode identification and rehabilitation of neurological disorders, the concept of modular organization, which involves the co-activation of muscle groups to generate various motor behaviors, has proven to be useful. This study aimed to investigate whether muscle synergy features could provide a more accurate and robust classification of gait events compared to traditional features such as time-domain and wavelet features. For this purpose, eight healthy individuals participated in this study, and wireless electromyography sensors were attached to four muscles in each lower extremity to measure electromyography (EMG) signals during walking. EMG signals were segmented and labeled as 2-class (stance and swing) and 3-class (weight acceptance, single limb support, and limb advancement) gait phases. Non-negative matrix factorization (NNMF) was used to identify specific muscle groups that contribute to gait and to provide an analysis of the functional organization of the movement system. Gait phases were classified using four different machine learning algorithms: decision tree (DT), k-nearest neighbors (KNN), support vector machine (SVM), and neural network (NN). The results showed that the muscle synergy features had a better classification accuracy than the other EMG features. This finding supported the hypothesis that muscle synergy enables accurate gait phase classification. Overall, the study presents a novel approach to gait analysis and highlights the potential of muscle synergy as a tool for gait phase detection.

A 3D-Printed Soft Haptic Device with Built-in Force Sensing Delivering Bio-Mimicked Feedback.

Haptics plays a significant role not only in the rehabilitation of neurological disorders, such as stroke, by substituting necessary cognitive information but also in human-computer interfaces (HCIs), which are now an integral part of the recently launched metaverse. This study proposes a unique, soft, monolithic haptic feedback device (SoHapS) that was directly manufactured using a low-cost and open-source fused deposition modeling (FDM) 3D printer by employing a combination of soft conductive and nonconductive thermoplastic polyurethane (TPU) materials (NinjaTek, USA). SoHapS consists of a soft bellow actuator and a soft resistive force sensor, which are optimized using finite element modeling (FEM). SoHapS was characterized both mechanically and electrically to assess its performance, and a dynamic model was developed to predict its force output with given pressure inputs. We demonstrated the efficacy of SoHapS in substituting biofeedback with tactile feedback, such as gripping force, and proprioceptive feedback, such as finger flexion-extension positions, in the context of teleoperation. With its intrinsic properties, SoHapS can be integrated into rehabilitation robots and robotic prostheses, as well as augmented, virtual, and mixed reality (AR/VR/MR) systems, to induce various types of bio-mimicked feedback.

A Hybrid Knee Exoskeleton Using Real-Time Ultrasound-Based Muscle Fatigue Assessment

Ultrasound-based state assessment of the human muscle during rehabilitation and its integration into a hybrid exoskeleton comprising an functional electrical stimulation (FES) system and a powered orthosis are emerging research areas. This article presents results from the first experimental demonstration of a hybrid knee exoskeleton that uses ultrasound-derived muscle state feedback to coordinate electrical motors and FES. A significant contribution of the article is to integrate a real-time ultrasound image acquisition and processing framework into a recently derived switching-based feedback control of the hybrid knee exoskeleton. As a result, the contractility response of the quadriceps muscle to the FES input can be monitored in vivo in real-time and estimate FES-induced muscle fatigue changes in the muscle. The switched controller’s decision-making process can then use the estimated muscle fatigue to compensate or replace the FES-stimulated muscle power with an electrical motor, thus avoiding extensive stimulation of the fatigued muscle. The experimental results suggest a potential application in the rehabilitation of neurological disorders like spinal cord injuries and stroke.

Effectiveness of Self-Action Observation Therapy as a Novel Method on Paretic Upper Limb and Cortical Excitability Post-Stroke: A Single-Subject Study

Background: Action Observation Therapy (AOT) is a top-down approach that has been recently introduced in the rehabilitation of neurological disorders mainly after stroke. The main goal of this study was to investigate the effects and feasibility of a new technique in AOT procedure (called self-AOT) following periods of no treatment and routine AOT intervention on upper limb motor function, occupational performance and neurophysiological changes in a stroke patient. Methods: A single-subject A-B-A-C design was used and a 58-year-old woman with a 3-year history of left hemiplegia poststroke participated in this study. In the baseline (A1, A2) phases, the patient received no treatment. In the first intervention (B phase), she received a 4-week AOT, and in the second intervention (C phase), a 4 week of Self-AOT was practiced. In all phases, upper limb motor recovery as a target outcome was evaluated on 4 occasions using the Fugl-Meyer assessment. Upper limb function, dexterity and spasticity were assessed using Action Research Arm Test, Box-Block Test and Modified Modified Ashworth Scale respectively. Occupational Performance/Satisfaction was assessed with Canadian Occupational Performance Measure and to assess neuroplasticity, Motor Evoked Potential was recorded by Transcranial Magnetic Stimulation. Visual analysis, slope, and percentage of non-overlapping data were used for assessing the changes between phases. Results: Percentage of non-overlapping data and slopes indicated that motor recovery had clinically relevant improvements after both interventions compared to baselines. Other outcomes also showed improvements except for spasticity of wrist/elbow flexors and Motor Evoked Potential of opponens indicis. Conclusion: Self-AOT may be as effective as other procedures of AOT for improving upper limb motor function, occupational performance/satisfaction, and cortical excitability post-stroke.

Music-based techniques and related devices in neurorehabilitation: a scoping review

Introduction The music as a powerful, and versatile stimulus for the brain, is at the date sometimes used in neurorehabilitation and proposed as a promising complementary strategy provided in combination with other therapy in individuals with neurological disorders. Different techniques and devices have been developed in the field of the music-based neurorehabilitation. Areas covered This scoping review analyzes the current scientific literature concerning the different techniques and devices used in the music-supported neurorehabilitation, also focusing on the devices used in music-based therapies in patients with neurological disorders: 46 studies met the inclusion criteria and were included. Expert Opinion Included studies, highlight the potentiality and the versatility of the music-based therapy in the rehabilitation of neurological disorders. The variety of existing techniques allow to applied the music-based therapy in different situations and conditions. Moreover, the wide range of used devices that ranging from the simple musical instruments to the more advanced technologies, allows to develop customized exercises based on the needs of the patient. This review may be considered as a starting point to better design future RCTs that would investigate the effectiveness of music therapy on neurological disorders.

Formação em Neurologia nos cursos de Terapia Ocupacional do Rio Grande do Sul

Os terapeutas ocupacionais atuam na reabilitação de disfunções neurológicas, para isso, durante a formação superior o Programa Político Pedagógico dos cursos contém disciplinas na área de Neurologia. Com o aumento da incidência de sequelas das disfunções neurológicas em adultos o terapeuta ocupacional deve estar apto para prestar assistência qualificada a esta clientela, tendo conhecimento dos aspectos neurológicos fundamentais para neuroreabilitação com vista em um cuidado integral em saúde. Assim, esta pesquisa objetivou analisar como os estudantes de Terapia Ocupacional, das Instituições de Ensino Superior (IES) do Rio Grande do Sul, avaliam o ensino em Neurologia proporcionado durante a graduação. Este estudo caracteriza-se por ser transversal, analítico-descritivo e quali-quantitativo. A coleta deu-se através de um questionário eletrônico com questões abertas e fechadas. A pesquisa contou com 25 estudantes, sendo em sua maioria das IES públicas. O estudo apontou uma insatisfação dos alunos quanto ao ensino em Neurologia ofertado, e dentre as justificativas relatadas estão: o aprendizado superficial, poucas disciplinas e o possível reflexo do despreparo na futura atuação profissional. Os dados deste estudo possibilitaram a visão da avaliação discente frente ao estudo ofertado em Neurologia que refletirá na atuação profissional dos futuros terapeutas ocupacionais.

Neurobiological Aspects of Neurologic Music Therapy.

Making music is a powerful way of engaging multisensory and motor networks, inducing changes within these networks and linking together distant brain regions. These multimodal effects of music making together with music’s ability to tap into the emotion and reward system in the brain can be used to facilitate therapy and rehabilitation of neurological disorders. In this article, we review short- and long-term effects of listening to music and making music on functional networks and structural components of the brain. The specific influence of music on the developing brain is emphasized and possible transfer effects on emotional and cognitive processes are discussed. Furthermore, we present data on the potential of music making to support and facilitate neurorehabilitation. We focus on interventions such as melodic intonation therapy and music-supported motor rehabilitation to showcase the effects of neurologic music therapies and discuss their underlying neural mechanisms.

Neurologic music therapy: The beneficial effects of music making on neurorehabilitation

Making music is a powerful way of engaging a multisensory and motor network and inducing changes and linking brain regions within this network. These multimodal effects of music making together with music's ability to tap into the emotion and reward system in the brain can be used to facilitate therapy and rehabilitation of neurological disorders. In this article, we review short- and long-term effects of listening to music and making music on functional networks and structural components of the brain. The specific influence of music on the developing brain is emphasized and possible transfer effects on emotional and cognitive processes are discussed. Furthermore we present data on the potential of music making to support and facilitate neurorehabilitation. We will focus on interventions such as rhythmic auditory stimulation, melodic intonation therapy, and music-supported motor rehabilitation to showcase the effects of neurologic music therapies and discuss their underlying neural mechanisms.