No abstract

Passive movement is an important mean of rehabilitation for stroke survivors in the early stage or with greater paralysis. The upper extremity robot is required to assist therapists with passive movement during clinical rehabilitation, while customizing is one of the crucial issues for robot-assisted upper extremity training, which fits the patient-centeredness. Robot-assisted teaching training could address the need well. However, the existing control strategies of teaching training are usually commanded by position merely, having trouble to achieve the efficacy of treatment by therapists. And deficiency of flexibility and compliance comes to the training trajectory. This research presents a novel motion control strategy for customized robot-assisted passive neurorehabilitation. The teaching training mechanism is developed to coordinate the movement of the shoulder and elbow, ensuring the training trajectory correspondence with human kinematics. Furthermore, the motion trajectory is adjusted by arm strength to realize dexterity and flexibility. Meanwhile, the torque sensor employed in the human-robot interactive system identifies movement intention of human. The goal-directed games and feedbacks promote the motor positivity of stroke survivors. In addition, functional experiments and clinical experiments are investigated with a healthy adult and five recruited stroke survivors, respectively. The experimental results present that the suggested control strategy not only serves with safety training but also presents rehabilitation efficacy.

Objective: Robot-assisted neuro-rehabilitation therapy plays a central role in upper extremity recovery of stroke. Even though, the efficacy of robotic training on upper extremity is not yet well defined and scant attention has been devoted to its potential effect on lower extremity. In this paper, the aim was to compare efficacy on upper and lower extremities between robot-assisted training (RAT) and therapist-mediated enhanced upper extremity therapy (EUET).Methods: A  randomized clinical trial involving 172 stroke survivors was conducted in China. All participants received either RAT or EUET for 3 weeks. The Fugl-Meyer assessment upper extremity subscale (FMA-UE), Fugl-Meyer assessment lower extremity subscale (FMA-LE), and Modified Barthel Index (MBI) were administered at baseline, mid-treatment (one week after treatment start), and posttreatment.  Results: Participants in RAT group showed a significant improvement in hemiplegia extremity, which was non-inferior to EUET group in FMA-UE (p<0.05), while suggesting greater motor recovery of lower extremity in FMA-LE (p<0.05) compared with EUET group. A marked increase in MBI was observed within groups, however, no significant difference was detected between groups.Conclusion: RAT is non-inferior in reducing impairment of upper extremity and appears to be superior in that of lower extremity compared with EUET for stroke survivors.

Stroke is one of the leading causes of death and the primary cause of acquired disability worldwide. Many stroke survivors have difficulty using their upper limbs, which have important functional roles in the performance of daily life activities. Consequently, the independence and quality of life of most stroke patients are reduced. Robot-assisted therapy is an effective intervention for improving the upper limb function of individuals with stroke. Human-robot collaborative interaction force control technology is critical for improving the flexibility and followability of the robot’s motion, thereby improving rehabilitation training outcomes. However, there are few reports on the effect of robot-assisted rehabilitative training on upper limb function. We applied this technology using a robot to assist patients with task-oriented training. Posttreatment changes in Fugl-Meyer and modified Barthel index (MBI) scores were assessed to determine whether this technology could improve the upper limb function of stroke patients. One healthy adult and five stroke patients, respectively, participated in functional and clinical experiments. The MBI and Fugl-Meyer scores of the five patients in the clinical experiments showed significant improvements after the intervention. The experimental results indicate that human-robot collaborative interaction force control technology is valuable for improving robots’ properties and patients’ recovery. This trial was registered in the Chinese clinical trial registry (ChiCTR2000038676).