Robotic Rehabilitation and Spinal Cord Injury: a Narrative Review

Abstract

Mobility after spinal cord injury (SCI) is among the top goals of recovery and improvement in quality of life. Those with tetraplegia rank hand function as the most important area of recovery in their lives, and those with paraplegia, walking. Without hand function, emphasis in rehabilitation is placed on accessing one's environment through technology. However, there is still much reliance on caretakers for many activities of daily living. For those with paraplegia, if incomplete, orthoses exist to augment walking function, but they require a significant amount of baseline strength and significant energy expenditure to use. Options for those with motor complete paraplegia have traditionally been limited to the wheelchair. While wheelchairs provide a modified level of independence, wheelchair users continue to face difficulties in access and mobility. In the past decade, research in SCI rehabilitation has expanded to include external motorized or robotic devices that initiate or augment movement. These robotic devices are used with 2 goals: to enhance recovery through repetitive, functional movement and increased neural plasticity and to act as a mobility aid beyond orthoses and wheelchairs. In addition, lower extremity exoskeletons have been shown to provide benefits to the secondary medical conditions after SCI such as pain, spasticity, decreased bone density, and neurogenic bowel. In this review, we discuss advances in robot-guided rehabilitation after SCI for the upper and lower extremities, as well as potential adjuncts to robotics.

A Smart Terrain Identification Technique Based on Electromyography, Ground Reaction Force, and Machine Learning for Lower Limb Rehabilitation

“…Applying intelligent rehabilitation techniques, such as rehabilitation robots [1][2][3][4][5][6][7] or in-home rehabilitation systems based on wearable sensors [8][9][10][11][12], to help people suffering from limited mobile ability to perform physical rehabilitation is of significance. Such intelligent techniques alleviate the shortage of physical therapists and realize data monitoring for more accurate evaluations on patients [13][14][15][16], and thus have become a new trend in recent years.…”

Effects of robotic-assisted gait training on the central vascular health of individuals with spinal cord injury: A pilot study

“…8 The physiological demand of such exoskeleton-assisted walking programs are comparable to self-reported exertion of an able-bodied person walking at 3 miles per hour and can elicit improvements in spasticity, without any serious adverse events. 8,9 Robotic exoskeletons may decrease seated time, increase standing and walking time, 10,11 thus, potentially ameliorating several of the chronic health-related consequences that negatively impact this population. 12,13 As RGT enables practitioners to increase the intensity and total duration of physical activity whilst maintaining a physiological gait pattern, 14 there may be a significant benefit for people with SCI to manage their risk of cardiovascular disease (CVD).…”

Spinal kord hasarlı hastanın rehabilitasyonu

“…Nörorehabilitasyonda hastanın rehabilitasyon sırasında katılım düzeyinin kortikal plastisiteyi arttırdığı bilinmektedir [1] . Son dekadlarda omuriliğin sadece üst merkezlerden gelen emirleri ekstremitelere ileten bir sistem olmadığı, supraspinal kontrol olmadan da yürüme ve ayakta durma sırasındaki karmaşık propriyoseptif girdilerin omurilikte işlendiği saptanmıştır.…”

“…Tüm dünyada, kesin veriler olmamakla birlikte, her yıl 250.000-500.000 kişinin OY olduğu tahmin edilmektedir. [1] Türkiye genelinde 2000 yılında yapılmış bir çalışmada, yıllık insidans milyonda 12,7 olarak tahmin edilmekte, ülke çapında kullanılan veri tabanının olmaması nedeni ile çok kesin rakamlara ulaşılamamaktadır. [2] Amerika'da ise yıllık insidans ortalama 17,500 olgudur.…”

“…Berrin Gündüz1 , Işıl Turna 2İstanbul Fizik Tedavi Rehabilitasyon Eğitim ve Araştırma Hastanesi, İstanbulSpinal kord hasarı kişinin, aile ve yakınlarının yaşamını aniden, tamamen değiştiren kötü bir nörolojik tablodur. Hasar sonrasında birçok nörolojik ve tıbbi sorun ortaya çıkar; hastanın neredeyse tüm vücut fonksiyonları etkilenir.…”