Wrist Rehabilitation Assisted by an Electromyography-Driven Neuromuscular Electrical Stimulation Robot After Stroke

Hu, Xiao; Tong, Kai-Yu; Ho, Newmen S.K.; Xue, Jingjing; Wei, Rong; Li, Leonard S.W.

doi:10.1177/1545968314565510

Cited by 84 publications

(112 citation statements)

References 39 publications

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“…However, for FMW/H distal-component, both groups showed signi cant improvement but RG showed signi cantly higher improvement of ~ 72% over 32% in CG (p = 0.012) because of intensive and repetitive-training of wrist and MCP. Similar improvement has also been re ected in proximal-joints in along with distal-joints robotic-training possibly because of compensatory muscle-activities from proximal-joints (12).…”

Section: Comparison Of Clinical-scales Of Robotic-therapy Group With supporting

confidence: 56%

“…Patients in RG showed more participation in ADL, re ected by an increase in BI and AROM of the wrist (23). Among the available wrist rehabilitative-devices and dose-matched conventional-intervention for rehabilitation of wrist in stroke, the reported gain in FMW/H is < 4 on a scale of 24 (12), (8), (26)(27)(28). In our study, the improvement in the FM score was ~ 14.…”

Section: Comparison Of Clinical-scales Of Robotic-therapy Group With mentioning

confidence: 43%

“…Although rehabilitation with neuro-rehabilitation robots has shown encouraging clinical-results (5,6,15,(7)(8)(9)(10)(11)(12)(13)(14), it is currently limited to a very few hospitals and not widely used because of associated high-cost and an infrastructural-requirement to station, size, complexity, set-up time, safety and usability restricting its success (16), (17), (18). Rehabilitation-strategies need to take into account the multifaceted nature of disability, which itself changes with time elapsed post-stroke and address with a multimodal-approach.…”

Section: Introductionmentioning

confidence: 99%

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Evidence of Neuroplasticity: A Robotic Hand Exoskeleton Study for Post-Stroke Rehabilitation

Singh¹,

Saini²,

Kumar³

et al. 2020

Preprint

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Background: A novel electromechanical robotic-exoskeleton was designed in-house for rehabilitation of wrist joint and Metacarpophalangeal (MCP) joint. Objective: The objective was to compare the rehabilitation effectiveness (clinical-scales and neurophysiological-measures) of robotic-therapy training-sessions with dose-matched control in patients with stroke. Methods: An observational pilot study was designed with patients within 2 years of chronicity. Patients received an intervention of 20 sessions of 45-minutes each, five days a week for four-weeks) in Robotic-therapy Group (RG) (n=12) and conventional upper-limb rehabilitation in Control-Group (CG) (n=11). Clinical-scales– Modified Ashworth Scale, Active Range of Motion, Barthel-Index, Brunstrom-stage and Fugl-Meyer scale (Shoulder/Elbow and Wrist/Hand component), and neurophysiological-measures of cortical-excitability (using Transcranial Magnetic Stimulation) –Motor Evoked Potential and Resting Motor-threshold, were acquired pre and post-therapy. Results: RG and CG showed significant improvement in all clinical motor-outcomes (p<0.05) except Modified Ashworth Scale in CG. RG showed significantly higher improvement over CG in Modified Ashworth Scale, Active Range of Motion and Fugl-Meyer (FM) scale and FM Wrist-/Hand component) (p<0.05). Increase in cortical-excitability in ipsilesional-hemisphere was found to be statistically significant in RG over CG, as indexed by decrease in Resting Motor-Threshold and increase in amplitude of Motor Evoked Potential (p<0.05). No significant changes were shown by the contralesional-hemisphere. Interhemispheric RMT-asymmetry evidenced significant changes in RG over CG (p<0.05) indicating increased cortical-excitability in ipsilesional-hemisphere along with interhemispheric changes.Conclusion: Neurophysiological-changes in RG could be most likely a consequence of plastic-reorganization and use-dependent plasticity. Robotic-exoskeleton training could significantly improve motor-outcomes and cortical-excitability in patients with stroke.Registry number: IEC/NP-99/13.03.2015

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Section: Comparison Of Clinical-scales Of Robotic-therapy Group With supporting

confidence: 56%

Section: Comparison Of Clinical-scales Of Robotic-therapy Group With mentioning

confidence: 43%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Evidence of Neuroplasticity: A Robotic Hand Exoskeleton Study for Post-Stroke Rehabilitation

Singh¹,

Saini²,

Kumar³

et al. 2020

Preprint

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“…Neuroprosthetic FES aims at promoting movement relearning by its ability to bypass lesions and restore function (2). Neuroprostheses proposed in the past provided meaningful upper limb movements, and could produce pre-defined muscles activation sequences upon triggering by patients or therapists (4,8,9). A special class of FES neuroprostheses enabled the control of FES at will by continuously detecting EMG activity, and promoted a significant reduction of impairment (8).…”

mentioning

confidence: 99%

Electrically Assisted Movement Therapy in Chronic Stroke Patients With Severe Upper Limb Paresis: A Pilot, Single-Blind, Randomized Crossover Study

Carda

Biasiucci²,

Maesani³

et al. 2017

Archives of Physical Medicine and Rehabilitation

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“…In a rehabilitation protocol, usually, the adduction-abduction movement is skipped (except for the thumb), and thus it generates a 2D and more simple workspace, as it is pointed out by [7] . The use of robotic devices is increasing, the motor therapy is showing a great potential, some benefits of the rehabilitation with robots include the ability to develop precise and repeatable therapeutic exercises [8] , a safe and intensive training [9,10] , a significant improvement in the behavior of the affected limbs [11] and an intensive motor improvement in chronic stroke [12] .…”

Section: Introductionmentioning

confidence: 99%

Design of a twelve-bar planar mechanism for finger orthosis

Montes

Vilchis-González

Ávila-Vilchis

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In the last years, a considerable number of patients with hand mobility problems has been reported; in most of these cases, the patients must spend time in a specialized center to carry out a therapy to rehabilitate damaged parts. This paper presents the design of an orthosis for finger rehabilitation. The novelty of this proposal is that the design is formed by rigid links and three semicircular sliders with a center of rotation coincident with the finger joints; moreover, the synthesis of these sliders is realized in a new and simple way. The mechanism is designed to be compact enough to be used by a person during a whole day; it is formed by twelve links and allows the three finger phalanxes to be flexed simultaneously. The mechanism is coupled only to the dorsal side of the hand and has no interference when grasping objects, in such a way that the orthosis presented in this paper enables the patient to perform the Activities of Daily Living. The synthesis of the mechanism presented in this paper focuses on the middle finger, nevertheless, it is possible to use the same configuration for the others fingers only by scaling. RESUMENEn los últimos años un considerable número de pacientes con problemas de movilidad en las manos ha sido reportado; en la mayoría de los casos, los pacientes deben pasar un tiempo determinado en un centro especializado para llevar a cabo una terapia para rehabilitar las partes afectadas. En este artículo se presenta el diseño de una ortesis para rehabilitación de un dedo. La novedad de esta propuesta es que el diseño está formado por eslabones rígidos y tres correderas semicirculares, cuyo centro de rotación coincide con el centro de rotación de los dedos; además, la síntesis de estas correderas se realizó de una manera sencilla y nueva. El mecanismo diseñado es suficientemente compacto para ser utilizado por una persona durante un día entero; está formado por doce eslabones y permite que las tres falanges se muevan simultáneamente. El mecanismo es acoplado al dorso de la mano para no interferir con la sujeción de objetos, y por tanto permitir el desarrollo de las actividades de la vida diaria. La síntesis del mecanismo presentada en este artículo se enfoca en el dedo medio, sin embargo es posible usar la misma configuración para los otros dedos, solo escalando el mecanismo.

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Wrist Rehabilitation Assisted by an Electromyography-Driven Neuromuscular Electrical Stimulation Robot After Stroke

Abstract: The NMES robot-assisted wrist training was more effective than the pure robot. The additional NMES application in the treatment could bring more improvements in the distal motor functions and faster rehabilitation progress.

Cited by 84 publications

References 39 publications

Evidence of Neuroplasticity: A Robotic Hand Exoskeleton Study for Post-Stroke Rehabilitation

Evidence of Neuroplasticity: A Robotic Hand Exoskeleton Study for Post-Stroke Rehabilitation

Electrically Assisted Movement Therapy in Chronic Stroke Patients With Severe Upper Limb Paresis: A Pilot, Single-Blind, Randomized Crossover Study

Design of a twelve-bar planar mechanism for finger orthosis

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