Robot-aided assessment of lower extremity functions: a review

Abstract

The assessment of sensorimotor functions is extremely important to understand the health status of a patient and its change over time. Assessments are necessary to plan and adjust the therapy in order to maximize the chances of individual recovery. Nowadays, however, assessments are seldom used in clinical practice due to administrative constraints or to inadequate validity, reliability and responsiveness. In clinical trials, more sensitive and reliable measurement scales could unmask changes in physiological variables that would not be visible with existing clinical scores.In the last decades robotic devices have become available for neurorehabilitation training in clinical centers. Besides training, robotic devices can overcome some of the limitations in traditional clinical assessments by providing more objective, sensitive, reliable and time-efficient measurements. However, it is necessary to understand the clinical needs to be able to develop novel robot-aided assessment methods that can be integrated in clinical practice.This paper aims at providing researchers and developers in the field of robotic neurorehabilitation with a comprehensive review of assessment methods for the lower extremities. Among the ICF domains, we included those related to lower extremities sensorimotor functions and walking; for each chapter we present and discuss existing assessments used in routine clinical practice and contrast those to state-of-the-art instrumented and robot-aided technologies. Based on the shortcomings of current assessments, on the identified clinical needs and on the opportunities offered by robotic devices, we propose future directions for research in rehabilitation robotics. The review and recommendations provided in this paper aim to guide the design of the next generation of robot-aided functional assessments, their validation and their translation to clinical practice.

Perspectives and Challenges in Robotic Neurorehabilitation

“…Therefore, in addition to the kinematic and kinetic monitoring during gait, balance, or upper limb control, it is also necessary to assess the outcomes and the potential long-term retention of a neurorehabilitation protocol. As reported by Maggioni et al [165], providing a reliable assessment of the sensorimotor components is important in order to optimize the patient's chance of recovery. Despite this well-established evidence, these quantitative assessments by means of robotic devices are not continuously performed during clinical practice.…”

A review of computational approaches for evaluation of rehabilitation exercises

“…In the context of objective evaluation of patient movements in rehabilitation programs, it is important to note that a large number of robotic and mechanical devices have been designed and are commonly used for quantitative movement evaluation. Accordingly, multiple review papers have provided overviews of related works in the literature [15], [65]- [70]. The review of rehabilitation assessment using robotic and mechanical devices is beyond the scope of this work, and we place emphasis on quantitative evaluation using computational approaches for analysis of movement data collected with motion capture sensors.…”

Bioinspired approach toward molecular electrets: synthetic proteome for materials

“…At an organism-size level, examples for walking machines, which do not utilize wheels or roller, may seem somewhat impractical for the "optimal practical usage" of the current state of robotics. The process of designing and developing such walkers, however, plays a key role in advancing biomechanics and demonstrating its potential utility for rehabilitation medicine [66][67][68][69][70], and outside of biology [71][72][73][74][75][76][77]. Examples of taking structural features from nature and attaining the targeted functionalities include: (1) the invention of Velcro, for which George de Mestral used concepts from the burrs of the burdock plant [78,79], and (2) superhydrophobic surfaces, which copy nanostructures of plant leaves capable of repelling water droplets [80][81][82][83][84][85].…”