Converging Robotic Technologies in Targeted Neural Rehabilitation: A Review of Emerging Solutions and Challenges

Abstract

Recent advances in the field of neural rehabilitation, facilitated through technological innovation and improved neurophysiological knowledge of impaired motor control, have opened up new research directions. Such advances increase the relevance of existing interventions, as well as allow novel methodologies and technological synergies. New approaches attempt to partially overcome long-term disability caused by spinal cord injury, using either invasive bridging technologies or noninvasive human–machine interfaces. Muscular dystrophies benefit from electromyography and novel sensors that shed light on underlying neuromotor mechanisms in people with Duchenne. Novel wearable robotics devices are being tailored to specific patient populations, such as traumatic brain injury, stroke, and amputated individuals. In addition, developments in robot-assisted rehabilitation may enhance motor learning and generate movement repetitions by decoding the brain activity of patients during therapy. This is further facilitated by artificial intelligence algorithms coupled with faster electronics. The practical impact of integrating such technologies with neural rehabilitation treatment can be substantial. They can potentially empower nontechnically trained individuals—namely, family members and professional carers—to alter the programming of neural rehabilitation robotic setups, to actively get involved and intervene promptly at the point of care. This narrative review considers existing and emerging neural rehabilitation technologies through the perspective of replacing or restoring functions, enhancing, or improving natural neural output, as well as promoting or recruiting dormant neuroplasticity. Upon conclusion, we discuss the future directions for neural rehabilitation research, diagnosis, and treatment based on the discussed technologies and their major roadblocks. This future may eventually become possible through technological evolution and convergence of mutually beneficial technologies to create hybrid solutions.

XR (Extended Reality: Virtual Reality, Augmented Reality, Mixed Reality) Technology in Spine Medicine: Status Quo and Quo Vadis

“…XR's novelty and immersive nature have been proven to promote motivation, excitement, and task engagement, making virtual rehabilitation more effective than traditional rehabilitation [133]. VR technology has recently been implemented in various clinical settings, including physical, vocational, cognitive, and psychological rehabilitation [134].…”

“…Task-oriented training and treatment gamification also make rehabilitation enjoyable and motivate patients to carry out repetitive tasks. It has been widely adopted in many medical fields, especially in digital healthcare [133,134,136]. Therefore, XR-technology-based devices can improve analgesia, compliance, and the effectiveness of rehabilitation in spine medicine, including rehabilitation.…”

“…On the other hand, the lack of a systematic methodology in this review makes it impossible to obtain the highest level of current evidence for conditions and technologies. Another limitation of a narrative review is that it cannot seek out all the relevant literature and cover the scientific literature unbiasedly; instead, it discusses pivotal articles known to the authors [133]. It should also be noted that ongoing research may soon make it obsolete.…”

Psychological and Emotional Effects of Digital Technology on Children in COVID-19 Pandemic

“…VRT (virtual reality technology)-based rehabilitation is increasingly used to encourage patient recovery in the physical and cognitive domains [ 35 ]. The advantages of using VRT in neurorehabilitation are the possibility of recovering a compromised function as a way to stimulate [ 36 ] neuronal reorganization and the induction of neuroplasticity (to maximize motor learning and neuroplasticity) and regain functions and abilities (even partially) by interacting with a virtual reality environment (VRE). The reference literature suggests that the alleged danger of the use of smartphones [ 48 , 49 ], in particular as a risk factor for the development of brain tumors, is in fact still debated and, even if the fear can be justified, we have no evidence that the danger is real [ 50 , 51 , 52 ].…”

Neuromechanical Biomarkers for Robotic Neurorehabilitation

“…The combination of these technologies can be used to create a personalized rehabilitation training program ( Figure 2 , bottom panel). For a comprehensive review on the current robotic technologies applied on the neurorehabilitation see (Nizamis et al, 2021 ).…”