Robotic Upper Limb Rehabilitation Research Articles

Effects of robotic upper limb treatment after stroke on cognitive patterns: A systematic review.

Robotic therapy (RT) has been internationally recognized for the motor rehabilitation of the upper limb. Although it seems that RT can stimulate and promote neuroplasticity, the effectiveness of robotics in restoring cognitive deficits has been considered only in a few recent studies. To verify whether, in the current state of the literature, cognitive measures are used as inclusion or exclusion criteria and/or outcomes measures in robotic upper limb rehabilitation in stroke patients. The systematic review was conducted according to PRISMA guidelines. Studies eligible were identified through PubMed/MEDLINE and Web of Science from inception to March 2021. Eighty-one studies were considered in this systematic review. Seventy-three studies have at least a cognitive inclusion or exclusion criteria, while only seven studies assessed cognitive outcomes. Despite the high presence of cognitive instruments used for inclusion/exclusion criteria their heterogeneity did not allow the identification of a guideline for the evaluation of patients in different stroke stages. Therefore, although the heterogeneity and the low percentage of studies that included cognitive outcomes, seemed that the latter were positively influenced by RT in post-stroke rehabilitation. Future larger RCTs are needed to outline which cognitive scales are most suitable and their cut-off, as well as what cognitive outcome measures to use in the various stages of post-stroke rehabilitation.

Haptic feedback system for postural adaptation during robotic rehabilitation of upper limb.

Although trunk compensation during stroke rehabilitation is widely studied, the proposed solutions primarily include a trunk constraint, which has several disadvantages. In this study, we have proposed a haptic feedback-based system for postural training during upper-limb motor rehabilitation. We have tested the proposed system on six healthy people in this preliminary study. Participants performed a simple 1-dimensional reaching task while their posture was being monitored. They received haptic feedback based on their trunk posture. Preliminary results revealed a significant decline in postural error (p<0.05) after the haptic-based training. The reduction in error was maintained even after haptic feedback was turned off. This study shows that haptic feedback could be a viable alternative to the traditional constraint-based methods for postural adaptation. Additional studies need to be conducted to further evaluate the influence of using such feedback strategies.

A randomized controlled trial on the effects induced by robot-assisted and usual-care rehabilitation on upper limb muscle synergies in post-stroke subjects

Muscle synergies are hypothesized to reflect connections among motoneurons in the spinal cord activated by central commands and sensory feedback. Robotic rehabilitation of upper limb in post-stroke subjects has shown promising results in terms of improvement of arm function and motor control achieved by reassembling muscle synergies into a set more similar to that of healthy people. However, in stroke survivors the potentially neurophysiological changes induced by robot-mediated learning versus usual care have not yet been investigated. We quantified upper limb motor deficits and the changes induced by rehabilitation in 32 post-stroke subjects through the movement analysis of two virtual untrained tasks of object placing and pronation. The sample analyzed in this study is part of a larger bi-center study and included all subjects who underwent kinematic analysis and were randomized into robot and usual care groups. Post-stroke subjects who followed robotic rehabilitation showed larger improvements in axial-to-proximal muscle synergies with respect to those who underwent usual care. This was associated to a significant improvement of the proximal kinematics. Both treatments had negative effects in muscle synergies controlling the distal district. This study supports the definition of new rehabilitative treatments for improving the neurophysiological recovery after stroke.

Robotic Rehabilitation of Upper Limb in PD

Robotic Rehabilitation of Upper Limb in PD

Planar robotic rehabilitation of upper limb in post-stroke subjects: Transfer of training effects to a non-trained 3D functional task

Planar robotic rehabilitation of upper limb in post-stroke subjects: Transfer of training effects to a non-trained 3D functional task

Robotic upper limb rehabilitation after acute stroke by NeReBot: evaluation of treatment costs.

Stroke is the first cause of disability. Several robotic devices have been developed for stroke rehabilitation. Robot therapy by NeReBot is demonstrated to be an effective tool for the treatment of poststroke paretic upper limbs, able to improve the activities of daily living of stroke survivors when used both as additional treatment and in partial substitution of conventional rehabilitation therapy in the acute and subacute phases poststroke. This study presents the evaluation of the costs related to delivering such therapy, in comparison with conventional rehabilitation treatment. By comparing several NeReBot treatment protocols, made of different combinations of robotic and nonrobotic exercises, we show that robotic technology can be a valuable and economically sustainable aid in the management of poststroke patient rehabilitation.

New Technologies for Stroke Rehabilitation

New Technologies for Stroke Rehabilitation