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Robotic Therapy Stroke

Ji-Eun Cho, Jun Sang Yoo, Kyoung Eun Kim, Sung Tae Cho, Woo Seok Jang, Ki Hun Cho, Wan-Hee Lee
The purpose of this study was to critically evaluate the effects of robot-assisted gait training (RAGT) on gait-related function in patients with acute/subacute stroke. We conducted a systematic review of randomized controlled trials published between May 2012 and April 2016. This search included 334 articles (Cochrane, 51 articles; Embase, 175 articles; PubMed, 108 articles). Based on the inclusion and exclusion criteria, 7 studies were selected for this review. We performed a quality evaluation using the PEDro scale...
2018: BioMed Research International
Giuseppe Placidi, Luigi Cinque, Matteo Polsinelli, Matteo Spezialetti
Hand rehabilitation is fundamental after stroke or surgery. Traditional rehabilitation requires a therapist and implies high costs, stress for the patient, and subjective evaluation of the therapy effectiveness. Alternative approaches, based on mechanical and tracking-based gloves, can be really effective when used in virtual reality (VR) environments. Mechanical devices are often expensive, cumbersome, patient specific and hand specific, while tracking-based devices are not affected by these limitations but, especially if based on a single tracking sensor, could suffer from occlusions...
March 10, 2018: Sensors
Giovanni Morone, Stefano Masiero, Paola Coiro, Domenico De Angelis, Vincenzo Venturiero, Stefano Paolucci, Marco Iosa
BACKGROUND: Robotic walking training improves probability to reach an autonomous walking in non-ambulant patients affected by subacute stroke. However, little information is available regarding the prognostic factors for identifying best responder patients. The purpose of the present study is therefore to investigate the clinical features of patients with subacute stroke that might benefit more from robotic walking therapy. METHODS: One hundred subacute inpatients randomized in robotic or conventional gait training were assessed at baseline and after 4 weeks of training performed 5 times per week...
2018: Restorative Neurology and Neuroscience
Michael D Ellis, Carolina Carmona, Justin Drogos, Julius P A Dewald
Background: Progressive abduction loading therapy has emerged as a promising exercise therapy in stroke rehabilitation to systematically target the loss of independent joint control (flexion synergy) in individuals with chronic moderate/severe upper-extremity impairment. Preclinical investigations have identified abduction loading during reaching exercise as a key therapeutic factor to improve reaching function. An augmentative approach may be to additionally target weakness by incorporating resistance training to increase constitutive joint torques of reaching with the goal of improving reaching function by "overpowering" flexion synergy...
2018: Frontiers in Neurology
Jose L Contreras-Vidal, Magdo Bortole, Fangshi Zhu, Kevin Nathan, Anusha Venkatakrishnan, Gerard E Francisco, Rogelio Soto, Jose L Pons
OBJECTIVE: Advancements in robot-assisted gait rehabilitation and brain-machine interfaces (BMI) may enhance stroke physiotherapy by engaging patients while providing information about robot-induced cortical adaptations. We investigate the feasibility of decoding walking from brain activity in stroke survivors during therapy using a powered exoskeleton integrated with an electroencephalography (EEG)-based BMI. DESIGN: The H2 powered exoskeleton was designed for overground gait training with actuated hip, knee and ankle joints...
February 23, 2018: American Journal of Physical Medicine & Rehabilitation
Marco Franceschini, Michela Goffredo, Sanaz Pournajaf, Stefano Paravati, Maurizio Agosti, Francesco De Pisi, Daniele Galafate, Federico Posteraro
BACKGROUND: Upper limb recovery is one of the main goals of post-stroke rehabilitation due to its importance for autonomy in Activities of Daily Living (ADL). Although the efficacy of upper limb Robot-assisted Therapy (RT) is well established in literature, the impact of the initial status of the patient on the effects of RT is still understudied. This paper aims to identify whether demographic, clinical and motor characteristics of stroke patients may influence the ability to independently perform ADL after RT...
2018: PloS One
Ildikó Nagy, Dániel Fabó
Neurophysiological methods are gaining ground in the diagnosis and therapy of cerebrovascular disease. While the role of the EEG (electroencephalography) in the diagnosis of post-stroke epilepsy is constant, quantitative EEG para-meters, as new indicators of early efficiency after thrombolysis or in prognosis of patient's condition have proved their effectiveness in several clinical studies. In intensive care units, continuous EEG monitoring of critically ill patients became part of neurointenzive care protocols...
January 30, 2018: Ideggyógyászati Szemle
Arturo Bertomeu-Motos, Andrea Blanco, Francisco J Badesa, Juan A Barios, Loredana Zollo, Nicolas Garcia-Aracil
BACKGROUND: End-effector robots are commonly used in robot-assisted neuro-rehabilitation therapies for upper limbs where the patient's hand can be easily attached to a splint. Nevertheless, they are not able to estimate and control the kinematic configuration of the upper limb during the therapy. However, the Range of Motion (ROM) together with the clinical assessment scales offers a comprehensive assessment to the therapist. Our aim is to present a robust and stable kinematic reconstruction algorithm to accurately measure the upper limb joints using only an accelerometer placed onto the upper arm...
February 20, 2018: Journal of Neuroengineering and Rehabilitation
Stéphanie Dehem, Maxime Gilliaux, Thierry Lejeune, Emmanuelle Delaunois, Paul Mbonda, Yves Vandermeeren, Christine Detrembleur, Gaëtan Stoquart
The impact of transcranial direct current stimulation (tDCS) is controversial in the neurorehabilitation literature. It has been suggested that tDCS should be combined with other therapy to improve their efficacy. To assess the effectiveness of a single session of upper limb robotic-assisted therapy (RAT) combined with real or sham-tDCS in chronic stroke patients. Twenty-one hemiparetic chronic stroke patients were included in a randomized, controlled, cross-over double-blind study. Each patient underwent two sessions 7 days apart in a randomized order: (a) 20 min of real dual-tDCS associated with RAT (REAL+RAT) and (b) 20 min of sham dual-tDCS associated with RAT (SHAM+RAT)...
February 7, 2018: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
Ying Xuan Zhi, Michelle Lukasik, Michael H Li, Elham Dolatabadi, Rosalie H Wang, Babak Taati
Robotic stroke rehabilitation therapy can greatly increase the efficiency of therapy delivery. However, when left unsupervised, users often compensate for limitations in affected muscles and joints by recruiting unaffected muscles and joints, leading to undesirable rehabilitation outcomes. This paper aims to develop a computer vision system that augments robotic stroke rehabilitation therapy by automatically detecting such compensatory motions. Nine stroke survivors and ten healthy adults participated in this study...
2018: IEEE Journal of Translational Engineering in Health and Medicine
Steven C Cramer
Stroke remains a major cause of human disability worldwide. In parallel with advances in acute stroke interventions, new therapies are under development that target restorative processes. Such therapies have a treatment time window measured in days, weeks, or longer and so have the advantage that they may be accessible by a majority of patients. Several categories of restorative therapy have been studied and are reviewed herein, including drugs, growth factors, monoclonal antibodies, activity-related therapies including telerehabilitation, and a host of devices such as those related to brain stimulation or robotics...
January 2018: Journal of Stroke
Wujing Cao, Fei Zhang, Hongliu Yu, Bingshan Hu, Qiaoling Meng
BACKGROUND: Loss of upper limb function often appears after stroke. Robot-assisted systems are becoming increasingly common in upper extremity rehabilitation. Rehabilitation robot provides intensive motor therapy, which can be performed in a repetitive, accurate and controllable manner. OBJECTIVE: This study aims to propose a novel center-driven robot for upper extremity rehabilitation. METHODS: A new power transmission mechanism is designed to transfer the power to elbow and shoulder joints from three motors located on the base...
January 19, 2018: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
S Mazzoleni, E Battini, R Crecchi, P Dario, F Posteraro
BACKGROUND: Significant results have been shown when an upper limb robot-assisted rehabilitation is delivered to stroke patients. OBJECTIVE: To evaluate the effects of upper limb robot-assisted rehabilitation on motor recovery in stroke patients who underwent a treatment based on a haptic device. METHODS: Thirty-nine stroke patients (twenty-three subacute and sixteen chronic) underwent rehabilitation training by using MOTORE/Armotion haptic system...
2018: NeuroRehabilitation
So Young Lee, Young Tae Jeon, Bo Ryun Kim, Eun Young Han
RATIONALE: Spasticity is a major complication after stroke, and botulinumtoxin A (BoNT-A) injection is commonly used to manage focal spasticity. However, it is uncertain whether BoNT-A can improve voluntary motor control or activities of daily living function of paretic upper limbs. This study investigated whether BoNT-A injection combined with robot-assisted upper limb therapy improves voluntary motor control or functions of upper limbs after stroke. PATIENT CONCERNS: Two subacute stroke patients were transferred to the Department of Rehabilitation...
December 2017: Medicine (Baltimore)
Vi Do Tran, Paolo Dario, Stefano Mazzoleni
AIM OF THE STUDY: This review classifies the kinematic measures used to evaluate post-stroke motor impairment following upper limb robot-assisted rehabilitation and investigates their correlations with clinical outcome measures. METHODS: An online literature search was carried out in PubMed, MEDLINE, Scopus and IEEE-Xplore databases. Kinematic parameters mentioned in the studies included were categorized into the International Classification of Functioning, Disability and Health (ICF) domains...
January 17, 2018: Medical Engineering & Physics
Marian Suarez-Escobar, Elizabeth Rendon-Velez
PURPOSE: This article aims to clarify the current state-of-the-art of robotic/mechanical devices for post-stroke thumb rehabilitation as well as the anatomical characteristics and motions of the thumb that are crucial for the development of any device that aims to support its motion. METHODS: A systematic literature search was conducted to identify robotic/mechanical devices for post-stroke thumb rehabilitation. Specific electronic databases and well-defined search terms and inclusion/exclusion criteria were used for such purpose...
January 15, 2018: Disability and Rehabilitation. Assistive Technology
Estelle Raffin, Friedhelm C Hummel
More than 1.5 million people suffer a stroke in Europe per year and more than 70% of stroke survivors experience limited functional recovery of their upper limb, resulting in diminished quality of life. Therefore, interventions to address upper-limb impairment are a priority for stroke survivors and clinicians. While a significant body of evidence supports the use of conventional treatments, such as intensive motor training or constraint-induced movement therapy, the limited and heterogeneous improvements they allow are, for most patients, usually not sufficient to return to full autonomy...
November 1, 2017: Neuroscientist: a Review Journal Bringing Neurobiology, Neurology and Psychiatry
Cristina Spalletti, Claudia Alia, Stefano Lai, Alessandro Panarese, Sara Conti, Silvestro Micera, Matteo Caleo
Focal cortical stroke often leads to persistent motor deficits, prompting the need for more effective interventions. The efficacy of rehabilitation can be increased by 'plasticity-stimulating' treatments that enhance experience-dependent modifications in spared areas. Transcallosal pathways represent a promising therapeutic target, but their role in post-stroke recovery remains controversial. Here, we demonstrate that the contralesional cortex exerts an enhanced interhemispheric inhibition over the perilesional tissue after focal cortical stroke in mouse forelimb motor cortex...
December 27, 2017: ELife
Zan Yue, Xue Zhang, Jing Wang
The recovery of hand function is one of the most challenging topics in stroke rehabilitation. Although the robot-assisted therapy has got some good results in the latest decades, the development of hand rehabilitation robotics is left behind. Existing reviews of hand rehabilitation robotics focus either on the mechanical design on designers' view or on the training paradigms on the clinicians' view, while these two parts are interconnected and both important for designers and clinicians. In this review, we explore the current literature surrounding hand rehabilitation robots, to help designers make better choices among varied components and thus promoting the application of hand rehabilitation robots...
2017: Behavioural Neurology
Orna Rosenthal, Alan M Wing, Jeremy L Wyatt, David Punt, R Chris Miall
BACKGROUND: Chronic upper limb motor impairment is a common outcome of stroke. Therapeutic training can reduce motor impairment. Recently, a growing interest in evaluating motor training provided by robotic assistive devices has emerged. Robot-assisted therapy is attractive because it provides a means of increasing practice intensity without increasing the workload of physical therapists. However, movements practised through robotic assistive devices are commonly pre-defined and fixed across individuals...
December 6, 2017: Journal of Neuroengineering and Rehabilitation
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