Evaluating the use of robotic and virtual reality rehabilitation technologies to improve function in stroke survivors: A narrative review

Clark, William E.; Sivan, Manoj; O’Connor, Rory J

doi:10.1177/2055668319863557

Cited by 43 publications

(46 citation statements)

References 53 publications

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“…We compared our research with the most similar studies performed in the last 6 years for VR- and robotics-based lower limb rehabilitation (Lee et al, 2014 ; Xiang et al, 2014 ; Givon et al, 2015 ; Ko et al, 2015 ; Song and Park, 2015 ; Gibbons et al, 2016 ; Lo et al, 2017 ; Darbois et al, 2018 ; Clark et al, 2019 ). These studies used the same clinical scales to measure the rehabilitation progress of lower limb function and/or were performed in the acute period of ischemic stroke.…”

Section: Discussion Conclusion and Further Workmentioning

confidence: 99%

Stroke Affected Lower Limbs Rehabilitation Combining Virtual Reality With Tactile Feedback

Захаров

Bulanov²,

Хивинцева

et al. 2020

Front. Robot. AI

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In our study, we tested a combination of virtual reality (VR) and robotics in the original adjuvant method of post-stroke lower limb walk restoration in acute phase using a simulation with visual and tactile biofeedback based on VR immersion and physical impact to the soles of patients. The duration of adjuvant therapy was 10 daily sessions of 15 min each. The study showed the following significant rehabilitation progress in Control ( N = 27) vs. Experimental ( N = 35) groups, respectively: 1.56 ± 0.29 (mean ± SD) and 2.51 ± 0.31 points by Rivermead Mobility Index ( p = 0.0286); 2.15 ± 0.84 and 6.29 ± 1.20 points by Fugl-Meyer Assessment Lower Extremities scale ( p = 0.0127); and 6.19 ± 1.36 and 13.49 ± 2.26 points by Berg Balance scale ( p = 0.0163). P -values were obtained by the Mann–Whitney U test. The simple and intuitive mechanism of rehabilitation, including through the use of sensory and semantic components, allows the therapy of a patient with diaschisis and afferent and motor aphasia. Safety of use allows one to apply the proposed method of therapy at the earliest stage of a stroke. We consider the main finding of this study that the application of rehabilitation with implicit interaction with VR environment produced by the robotics action has measurable significant influence on the restoration of the affected motor function of the lower limbs compared with standard rehabilitation therapy.

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Section: Discussion Conclusion and Further Workmentioning

confidence: 99%

Stroke Affected Lower Limbs Rehabilitation Combining Virtual Reality With Tactile Feedback

Захаров

Bulanov²,

Хивинцева

et al. 2020

Front. Robot. AI

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“…Very few studies ( 25 , 26 ) have attempted to assess the additional benefits of this combination of technologies. Patients #1 and #5 in our study showed marginal motor improvements on the FM UE scale ( 27 , 28 ).…”

Section: Discussionmentioning

confidence: 99%

Improving motor function after chronic stroke by interactive gaming with a redesigned MR‑compatible hand training device

et al. 2021

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New rehabilitation strategies enabled by technological developments are challenging the prevailing concept of there being a limited window for functional recovery after stroke. In this study, we examined the utility of a robot-assisted therapy used in combination with a serious game as a rehabilitation and motor assessment tool in patients with chronic stroke. We evaluated 928 game rounds from 386 training sessions of 8 patients who had suffered an ischemic stroke affecting middle cerebral artery territory that incurred at least 6 months prior. Motor function was assessed with clinical motor scales, including the Fugl-Meyer upper extremity (FM UE) scale, Action Research Arm Test, Modified Ashworth scale and the Box and Blocks test. Robotic device output measures (mean force, force-position correlation) and serious game score elements (collisions, rewards and total score) were calculated. A total of 2 patients exhibited a marginal improvement after a 10-week training protocol according to the FM UE scale and an additional patient exhibited a significant improvement according to Box and Blocks test. Motor scales showed strong associations of robotic device parameters and game metrics with clinical motor scale scores, with the strongest correlations observed for the mean force (0.677<Ρ<0.869), followed by the number of collisions (-0.670<Ρ<-0.585). Linear regression analysis showed that these indices were independent predictors of motor scale scores. In conclusion, a robotic device linked to a serious game can be used by patients with chronic stroke and induce at least some clinical improvements in motor performance. Robotic device output parameters and game score elements associate strongly with clinical motor scales and have the potential to be used as predictors in models of rehabilitation progress.

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“…The main objective of rehabilitation technologies is to maintain or improve the functioning and independence of an individual, in addition to facilitating participation and improving general well-being. 10 In the last decade, the use of technological devices in the rehabilitation of patients affected by stroke has increased, which are developed to improve stroke results, due to the increase in intensity, repetitions, specificity and feedback during rehabilitation. 10,11 There is a wide range of technologies with applications in rehabilitation.…”

Section: Introductionmentioning

confidence: 99%

“…10 In the last decade, the use of technological devices in the rehabilitation of patients affected by stroke has increased, which are developed to improve stroke results, due to the increase in intensity, repetitions, specificity and feedback during rehabilitation. 10,11 There is a wide range of technologies with applications in rehabilitation. Iosa conducts a review describing the “Seven capital devices for the future of Stroke rehabilitation”: robots, brain computer interfaces, neuroprostheses, non-invasive brain stimulators, wearable devices, virtual reality and tablet-pc.…”

Section: Introductionmentioning

confidence: 99%

“…Virtual reality offers increased training intensity and repetitions, as well as reducing the therapist’s time. 10 Likewise, video games and virtual reality have the potential to increase participant participation by making repetitive exercises more engaging and motivating. 15 A Cochrane review finds that the use of virtual reality and interactive video games was not more beneficial than conventional therapy approaches to improve upper limb function.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of technological interventions to improve upper limb motor function in people with stroke in low- and middle-income countries: Protocol for a systematic review and meta-analysis

Mm¹,

Paredes²,

Sa³

et al. 2020

Preprint

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IntroductionStroke is one of the main causes of disability in low- and middle-income countries (LMIC), frequently presenting with upper extremity paresis and causing major functional dependence. It requires high dose and intense rehabilitation which implies high economic costs, consequently limiting this therapy in LMIC. There are multiple technological interventions that facilitate rehabilitation either in intensity, adherence and motor evaluation; or enable access to rehabilitation such as robots, games or virtual reality, sensors, electronic devices and tele-rehabilitation. Their efficacy has been mainly evaluated in high-income countries, hence the importance of conducting a systematic review in LMIC settings.ObjectivesTo measure the efficacy of technological interventions vs. classical physical rehabilitation in the upper extremity motor function in people who had suffered a first or recurrent episode of stroke in LMIC.Methods and analysisThis protocol is consistent with the methodology recommended by the PRISMA-P and the Cochrane handbook for systematic reviews of interventions. We propose to do a systematic review and meta-analysis. In order to do so, we will perform an electronic search in PubMed, Global Index Medicus and Physiotherapy Evidence Database. No date range parameters will be used. Randomized controlled trials (RCT) published in English, Spanish, French and Portuguese, with the primary outcome focusing on upper limb motor function, will be included. Two reviewers will screen all retrieved titles, abstracts and full texts, perform the evaluation of the risk of bias and extract all data independently. The risk of bias of the included RCT will be evaluated by the Cochrane Collaboration’s tool. A qualitative synthesis will be provided in text and tables, to summarize the main results of the selected publications.The heterogeneity between studies will be assessed through the I2 statistic. If there is sufficient homogeneity across outcomes, a meta-analysis will be considered. The outcomes to be evaluated will be motor functionality of the upper extremity, performance for activities of daily living and quality of life, through measurement scales.ConclusionsThis systematic review will provide evidence regarding the efficacy of multiple technological interventions to improve motor function of upper extremity in individuals with stroke in LMIC. Based on this analysis, we will be able to assess whether these interventions are also effective and feasible in the recovery of functionality after stroke in low- and middle-income countries, and thus offer recommendations in these areas.

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Evaluating the use of robotic and virtual reality rehabilitation technologies to improve function in stroke survivors: A narrative review

Cited by 43 publications

References 53 publications

Stroke Affected Lower Limbs Rehabilitation Combining Virtual Reality With Tactile Feedback

Stroke Affected Lower Limbs Rehabilitation Combining Virtual Reality With Tactile Feedback

Improving motor function after chronic stroke by interactive gaming with a redesigned MR‑compatible hand training device

Effectiveness of technological interventions to improve upper limb motor function in people with stroke in low- and middle-income countries: Protocol for a systematic review and meta-analysis

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