Reviewing Clinical Effectiveness of Active Training Strategies of Platform-Based Ankle Rehabilitation Robots

Abstract

Objective This review aims to provide a systematical investigation of clinical effectiveness of active training strategies applied in platform-based ankle robots. Method English-language studies published from Jan 1980 to Aug 2017 were searched from four databases using key words of “Ankle∗” AND “Robot∗” AND “Effect∗ OR Improv∗ OR Increas∗.” Following an initial screening, three rounds of discrimination were successively conducted based on the title, the abstract, and the full paper. Result A total of 21 studies were selected with 311 patients involved; of them, 13 studies applied a single group while another eight studies used different groups for comparison to verify the therapeutic effect. Virtual-reality (VR) game training was applied in 19 studies, while two studies used proprioceptive neuromuscular facilitation (PNF) training. Conclusion Active training techniques delivered by platform ankle rehabilitation robots have been demonstrated with great potential for clinical applications. Training strategies are mostly combined with one another by considering rehabilitation schemes and motion ability of ankle joints. VR game environment has been commonly used with active ankle training. Bioelectrical signals integrated with VR game training can implement intelligent identification of movement intention and assessment. These further provide the foundation for advanced interactive training strategies that can lead to enhanced training safety and confidence for patients and better treatment efficacy.

State of the art in parallel ankle rehabilitation robot: a systematic review

“…Based on a report from the American Heart Association, approximately 795,000 people experience stroke in the United States each year [ 2 ]; stroke has poor prognosis and is associated with a high proportion of patients with drop foot, becoming the leading cause of permanent disabilities worldwide, with over 15 million new cases each year and 50 million stroke survivors [ 3 ]. An important factor in ankle dysfunction is damage to the central nervous system (CNS), which needs to be stimulated for reorganization and compensation and to promote the recovery of the motor system’s motor perception function [ 4 ]. Therefore, physiotherapy becomes essential for patients under this circumstance [ 5 , 6 ].…”

Wearable Ankle Robots in Post-stroke Rehabilitation of Gait: A Systematic Review

“…On the other hand, wearable ankle rehabilitation robots are applied to the lower limb to offer plantar flexion/dorsiflexion, adduction/abduction, and inversion/eversion to perform gait training. In recent years, platform-based ankle robots were reviewed in studies (Miao et al, 2018; Zeng et al, 2018), as well as both platform-based ankle rehabilitation robots, and wearable ankle rehabilitation robots (Zhang et al, 2013; Jamwal et al, 2015; Khalid et al, 2015). However, they only discussed different designs, and control aspects of a few wearable ankle robots.…”

A Feasibility Study of Robot-Assisted Ankle Training Triggered by Combination of SSVEP Recognition and Motion Characteristics

“…In order to address those limitations, various ankle robots have been developed to substitute partial functions of traditional therapy, and some robots have been in commercial stage [4]. There have two kinds of ankle robots, one of which is platform based robots, and the other is wearable devices [5]. Platform based robots is suitable to subjects with weak motion ability of ankle joints, while wearable ankle robots are designed to exercise those subjects, whose motion ability of ankle joints are strong enough to walk, but gait needs to be rebuilt [6].…”

“…Although there have many kinds of training strategies applied to active training, its basic function is to provide necessary assistance for subjects to accomplish the training targets within the predefined time, and its advanced function is to enhance the difficulty of the training to challenge the motion ability of ankle joints [5]. Assist-as-needed is a typical training strategy, which will provide necessary torque to assist subject to accomplish the training if they cannot touch the targets within the predefined time [5]. In other words, under the assist-as-needed strategy, subjects can accomplish the training successfully only if they can trigger the robot.…”