A Robotic System with EMG-Triggered Functional Eletrical Stimulation for Restoring Arm Functions in Stroke Survivors

Ambrosini, Emilia; Gasperini, Giulio; Zajc, Johannes; Immick, Nancy; Augsten, Andreas; Rossini, Mauro; Ballarati, Roberto; Russold, Micheal; Ferrante, S.; Ferrigno, Giancarlo; Bulgheroni, Maria; Baccinelli, Walter; Schauer, Thomas; Wiesener, Constantin; Gfoehler, Margit; Puchinger, Markus; Weber, Max; Weber, Sebastian; Pedrocchi, Alessandra; Molteni, Franco; Krakow, Karsten

doi:10.1177/1545968321997769

Cited by 33 publications

(70 citation statements)

References 48 publications

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“…Supplementary Table 1 summarizes the characteristics of the included studies. According to the inclusion criteria, all reports are RCTs published between 2000 ( Volpe et al, 2000 ) and 2021 ( Ambrosini et al, 2021 ; Chinembiri et al, 2021 ; Doost et al, 2021 ; Gueye et al, 2021 ; H. C. Lee et al, 2021 ; Park, 2021 ).…”

Section: Resultsmentioning

confidence: 99%

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

Bressi

Cricenti

Campagnola

et al. 2022

NRE

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BACKGROUND: 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. OBJECTIVE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

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Section: Resultsmentioning

confidence: 99%

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

Bressi

Cricenti

Campagnola

et al. 2022

NRE

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“…This might apply, in particular, to NMES hybrid devices. Indeed, NMES used in combination with rigid exoskeletons has proven to bring beneficial effects in upper-limb rehabilitation [ 84 , 85 ]. We believe that, starting from the work of Nam and colleagues [ 45 ], this approach should be investigated with soft robotic suits as well.…”

Section: Discussionmentioning

confidence: 99%

Upper limb soft robotic wearable devices: a systematic review

Bardi

Gandolla

Braghin

et al. 2022

J NeuroEngineering Rehabil

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Introduction Soft robotic wearable devices, referred to as exosuits, can be a valid alternative to rigid exoskeletons when it comes to daily upper limb support. Indeed, their inherent flexibility improves comfort, usability, and portability while not constraining the user’s natural degrees of freedom. This review is meant to guide the reader in understanding the current approaches across all design and production steps that might be exploited when developing an upper limb robotic exosuit. Methods The literature research regarding such devices was conducted in PubMed, Scopus, and Web of Science. The investigated features are the intended scenario, type of actuation, supported degrees of freedom, low-level control, high-level control with a focus on intention detection, technology readiness level, and type of experiments conducted to evaluate the device. Results A total of 105 articles were collected, describing 69 different devices. Devices were grouped according to their actuation type. More than 80% of devices are meant either for rehabilitation, assistance, or both. The most exploited actuation types are pneumatic (52%) and DC motors with cable transmission (29%). Most devices actuate 1 (56%) or 2 (28%) degrees of freedom, and the most targeted joints are the elbow and the shoulder. Intention detection strategies are implemented in 33% of the suits and include the use of switches and buttons, IMUs, stretch and bending sensors, EMG and EEG measurements. Most devices (75%) score a technology readiness level of 4 or 5. Conclusion Although few devices can be considered ready to reach the market, exosuits show very high potential for the assistance of daily activities. Clinical trials exploiting shared evaluation metrics are needed to assess the effectiveness of upper limb exosuits on target users.

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“…The efficacity of robotic physical therapy was also tested in [ 6 , 7 , 8 , 9 ], with similar results: robotic physical therapy was as effective as conventional physical therapy.…”

Section: Introductionmentioning

confidence: 98%

Comparative Assessment of Robotic versus Classical Physical Therapy Using Muscle Strength and Ranges of Motion Testing in Neurological Diseases

Major

Vaida

Major

et al. 2021

JPM

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The use of robotic systems in physical rehabilitation protocols has become increasingly attractive and has been given more focus in the last decade as a result of the high prevalence of motor deficits in the population, which is linked to an overburdened healthcare system. In accordance with current trends, three robotic devices have been designed, called ParReEx Elbow, ParReEx Wrist, and ASPIRE, which were designed to improve upper-limb medical recovery (shoulder, elbow, forearm, and wrist). The three automated systems were tested in a hospital setting with 23 patients (12 men and 11 women) suffering from motor deficits caused by various neurological diseases such as stroke, Parkinson’s disease, and amyotrophic lateral sclerosis (ALS). The patients were divided into three groups based on their pathology (vascular, extrapyramidal, and neuromuscular). Objective clinical measures, such as the Medical Research Council (MRC) scale, goniometry, and dynamometry, were used to compare pre- and post-rehabilitation assessments for both robotic-aided and manual physical rehabilitation therapy. The results of these tests showed that, with the exception of a few minor differences in muscular strength recovery, the robotic-assisted rehabilitation methods performed equally as well as the manual techniques, though only minor improvements were validated during short-term rehabilitation. The greatest achievements were obtained in the goniometric analysis where some rehabilitation amplitudes increased by over 40% in the vascular group, but the same analysis returned regressions in the neuromuscular group. The MRC scale analysis returned no significant differences, with most regressions occurring in the neuromuscular group. The dynamometric analysis mostly returned improvements, but the highest value evolution was 19.07%, which also in the vascular group. While the results were encouraging, more research is needed with a larger sample size and a longer study period in order to provide more information regarding the efficacy of both rehabilitation methods in neurological illnesses.

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A Robotic System with EMG-Triggered Functional Eletrical Stimulation for Restoring Arm Functions in Stroke Survivors

Cited by 33 publications

References 48 publications

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

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

Upper limb soft robotic wearable devices: a systematic review

Comparative Assessment of Robotic versus Classical Physical Therapy Using Muscle Strength and Ranges of Motion Testing in Neurological Diseases

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