Robot-assisted gait training for stroke patients: current state of the art and perspectives of robotics

Morone, Giovanni; Paolucci, Stefano; Cherubini, Andrea; Angelis, Domenico De; Venturiero, Vincenzo; Coiro, Paola; Iosa, Marco

doi:10.2147/ndt.s114102

Cited by 214 publications

(177 citation statements)

References 64 publications

(74 reference statements)

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“…Robotic systems are well suited to produce intensive, task‐oriented motor training for moving the patient's limbs under the supervision/help of a therapist. In this context, robots would enhance conventional rehabilitation via intense and task‐oriented training [42].…”

Section: Discussionmentioning

confidence: 99%

Exoskeleton and End‐Effector Robots for Upper and Lower Limbs Rehabilitation: Narrative Review

Molteni

Gasperini

Cannaviello

et al. 2018

PM&R

189

143

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Recovery of upper and lower limbs function is essential to reach independence in daily activities in patients with upper motor neuron syndrome (UMNS). Rehabilitation can provide a guide for motor recovery influencing the neurobiology of neuronal plasticity providing controlled, repetitive, and variable patterns. Increasing therapy dosage, intensity, number of repetition, execution of task‐oriented exercises, and combining top‐down and bottom‐up approaches can promote plasticity and functional recovery. Robotic exoskeletons for upper and lower limbs, based on the principle of motor learning, have been introduced in neurorehabilitation. In this narrative review, we provide an overview of literature published on exoskeleton devices for upper and lower limb rehabilitation in patients with UMNS; we summarized the available current research evidence and outlined the new challenges that neurorehabilitation and bioengineering will have to face in the upcoming years. Robotic treatment should be considered a rehabilitation tool useful to generate a more complex, controlled multisensory stimulation of the patient and useful to modify the plasticity of neural connections through the experience of movement. Efficacy and efficiency of robotic treatment should be defined starting from intensity, complexity, and specificity of the robotic exercise, that are related to human‐robot interaction in terms of motion, emotion, motivation, meaning of the task, feedback from the exoskeleton, and fine motion assistance. Duration of a single session, global period of the treatment, and the timing for beginning of robotic treatment are still open questions. There is the need to evaluate and individualize the treatment according to patient's characteristics. Robotic devices for upper and lower limbs open a window to define therapeutic modalities as possible beneficial drug, able to boost biological, neurobiological, and epigenetic changes in central nervous system. We need to implement large and innovative research programs to answer these issues in the near future.

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Section: Discussionmentioning

confidence: 99%

Exoskeleton and End‐Effector Robots for Upper and Lower Limbs Rehabilitation: Narrative Review

Molteni

Gasperini

Cannaviello

et al. 2018

PM&R

189

143

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“…Составление медико-технических требований к сложным медицинским изделиям, возможно только на основе совместной деятельности медицинских и технических специалистов [5], что обеспечит клиническую эффективность и безопасность разработки.…”

Section: выводыunclassified

“…Разработка и внедрение высокотехнологичных, в ряде случаев, инновационных медицинских и технических решений могут базироваться на логистической концепции сочетанного применения принципов комплексного управления материальными и нематериальными (финансовыми, энергетическими, трудовыми и т.п.) потоками с максимальным использованием интеграции и информационных технологий, что особо важно для обеспечения взаимодействия медицинских и технических специалистов [5]. исходя из того, что логистическая концепция предполагает анализ, синтез, и оптимизацию потоково-процессных производственно-сервисных, в том числе, медицинских структур, в статье рассмотрены некоторые вопросы информационных технологий, позволяющие более качественно обеспечивать как профессиональные лечебно-диагностические возможности разрабатываемых изделий, так и высокие требования по сохранению здоровья пациентов при их эксплуатации.…”

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Innovative Aspects of It-Technology Application in Medical Products for Rehabilitation

Gertsik

Генрихович²,

Ivanova³

et al. 2019

Physical and rehabilitation medicine, medical rehabilitation

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Currently, increasingly important in medical practice is given to methods and medical devices for rehabilitation. The use of new methods of rehabilitation using robotic mechanotherapy, exoskeleton, expansion of non-invasive stimulation techniques in the field of neuroscience requires more in-depth understanding of the possibilities and prospects for the development of such areas as remote sensing of physiological parameters and telemedicine technology. New information technologies and regulatory framework can significantly improve the efficiency of interaction between the doctor and patient. At the same time, it is necessary to take into account all requirements in the field of safety of operation of modern equipment for the rehabilitation and protection of personal data, as well as other requirements of national and international legislation.

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“…They also identify static and dynamic systems, from the respect of restricted defined space over free space for user walking. 32 In the following classifications, we excluded devices for one joint (two segments) movement training purpose (Kinnect, Rutger Ankle) and only systems developed for whole body gait training will be considered.…”

Section: Drive Modes and Control Strategies Of Gait Rehabilitation Tementioning

confidence: 99%

Advanced technology for gait rehabilitation: An overview

Mikołajczyk

Ciobanu

Badea

et al. 2018

Advances in Mechanical Engineering

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Most gait training systems are designed for acute and subacute neurological inpatients. Many systems are used for relearning gait movements (nonfunctional training) or gait cycle training (functional gait training). Each system presents its own advantages and disadvantages in terms of functional outcomes. However, training gait cycle movements is not sufficient for the rehabilitation of ambulation. There is a need for new solutions to overcome the limitations of existing systems in order to ensure individually tailored training conditions for each of the potential users, no matter the complexity of his or her condition. There is also a need for a new, integrative approach in gait rehabilitation, one that encompasses and addresses all aspects of physical as well as psychological aspects of ambulation in real-life multitasking situations. In this respect, a multidisciplinary multinational team performed an overview of the current technology for gait rehabilitation and reviewed the principles of ambulation training.

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Robot-assisted gait training for stroke patients: current state of the art and perspectives of robotics

Cited by 214 publications

References 64 publications

Exoskeleton and End‐Effector Robots for Upper and Lower Limbs Rehabilitation: Narrative Review

Exoskeleton and End‐Effector Robots for Upper and Lower Limbs Rehabilitation: Narrative Review

Innovative Aspects of It-Technology Application in Medical Products for Rehabilitation

Advanced technology for gait rehabilitation: An overview

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