Systematic review of the effect of robot-aided therapy on recovery of the hemiparetic arm after stroke

Department of Signals and Systems (SAS), University of Twente, Enschede, Overijssel, Netherlands
The Journal of Rehabilitation Research and Development (Impact Factor: 1.43). 03/2006; 43(2):171-84. DOI: 10.1682/JRRD.2005.04.0076
Source: PubMed


A limited number of clinical studies have examined the effect of poststroke rehabilitation with robotic devices on hemiparetic arm function. We systematically reviewed the literature to assess the effect of robot-aided therapy on stroke patients' upper-limb motor control and functional abilities. Eight clinical trials were identified and reviewed. For four of these studies, we also pooled short-term mean changes in Fugl-Meyer scores before and after robot-aided therapy. We found that robot-aided therapy of the proximal upper limb improves short- and long-term motor control of the paretic shoulder and elbow in subacute and chronic patients; however, we found no consistent influence on functional abilities. In addition, robot-aided therapy appears to improve motor control more than conventional therapy.

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Available from: Maarten Ijzerman
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    • "Several systematic literature reviews have shown the effectiveness of rehabilitation robotics for the hemiparetic arm [6] [7] [8] [9] [10]. The first developed robotic devices mostly focused on training of the proximal arm only [6] [11] [12]. However, in recent years a growing number of studies describe interventions involving the distal arm and hand [13- 16]. "
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    ABSTRACT: Many stroke patients have impaired arm and hand function. Distal arm and hand devices may support functional use of the upper extremity in activities in daily life. The present study assessed the direct effects of a passive dynamic wrist and hand orthosis on hand and arm movements during the performance of a reach and grasp task in ten mildly to moderately impaired chronic stroke patients. The use of the orthosis resulted in an increase in hand opening, increase in trunk displacement and decrease in elbow ROM during the performance of the reach and grasp task. Therefore, the use of an additional device supporting the arm against gravity should be considered when using such an orthosis in future research, to counteract potential compensatory trunk movements. The findings obtained in this study are being taken into consideration for a longitudinal feasibility study using this orthosis in combination with a computerized gaming environment in chronic stroke at home. Keywords: Stroke, Dynamic orthosis, Hand, Wrist, Upper extremity, Rehabiltation, Kinematics, Performance evaluation.
    Full-text · Conference Paper · Aug 2015
    • "In recent years, design methodologies for rehabilitation robots have matured and robotic systems for rehabilitation have become ubiquitous. Clinical trials on robotic rehabilitation provide evidence that robotic therapy is effective for motor recovery and possesses high potential for improving the functional independence of patients [1]–[3]. To increase the efficacy of robot assisted therapies, there is still a pressing need for evidence based therapy protocols and novel systematic approaches to safely deliver these therapies. "
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    ABSTRACT: We advocate online modification of robot-Assisted task speed, based on continuously inferred motor imagery as an effective rehabilitation protocol for increasing the involvement levels of the patients in physical rehabilitation exercises. To study efficacy of such Brain-Computer Interface (BCI) based physical rehabilitation protocols, we conduct human subject experiments on healthy volunteers, comparing several BCI-based protocols with haptic and visual feedback with each other and with conventional robot-Assisted rehabilitation protocols, in terms of intensity and sustainability of motor imagery. Our results provide evidence that the online adjusted BCI-based robotic protocol helps subjects produce stronger and more sustained motor imagery throughout the motor task, compared to other BCI-based protocols. We also show that BCI-Assisted robotic therapy can enable a level of motor cortical activity that is similar to a scenario in which the subjects could actually execute the motion. These results suggest that BCI-Assisted rehabilitation methods that provide online modification of the task speed based on continuously inferred motor imagery have potential in increasing the level of involvement of patients during exercises and may lead to more effective recovery.
    No preview · Conference Paper · Aug 2015
    • "However, the exercises should be meaningful, personalised and goal-directed [3]. Robotic technology has the potential to provide people with stroke with the opportunity to independently perform intensive and repetitive exercises [4] [5]. One of the major advantages of technology-supported rehabilitation interventions such as those provided through robotics is that the technology enables users to perform exercises in their own homes thereby assisting them to have more active roles in their care. "
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    ABSTRACT: We drew on an interdisciplinary research design to examine stroke survivors' experiences of living with stroke and with technology in order to provide technology developers with insight into values, thoughts and feelings of the potential users of a to-be-designed robotic technology for home-based rehabilitation of the hand and wrist. Ten stroke survivors and their family carers were purposefully selected. On the first home visit, they were introduced to cultural probe. On the second visit, the content of the probe packs were used as prompt to conduct one-to-one interviews with them. The data generated was analysed using thematic analysis. A third home visit was conducted to evaluate the early prototype. User requirements were categorised into their network of relationships, their attitude towards technology, their skills, their goals and motivations. The user requirements were used to envision the requirements of the system including providing feedback on performance, motivational aspects and usability of the system. Participants' views on the system requirements were obtained during a participatory evaluation. This study showed that prior to the development of technology, it is important to engage with potential users to identify user requirements and subsequently envision system requirements based on users' views. Implications for Rehabilitation An understanding of how stroke survivors make sense of their experiences of living with stroke is needed to design home-based rehabilitation technologies. Linking stroke survivors' goals, motivations, behaviour, feelings and attitude to user requirements prior to technology development has a significant impact on improving the design.
    No preview · Article · Apr 2015 · Disability and rehabilitation. Assistive technology
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