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Aprile, Cruciani, Germanotta, et al. "Upper Limb Robotics in Rehabilitation: An Approach to Select the Devices, Based on Rehabilitation Aims, and Their Evaluation in a Feasibility Study." Applied Sciences 9, no. 18 (2019): 3920. http://dx.doi.org/10.3390/app9183920.
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Robot-mediated therapy is a viable approach for upper limb rehabilitation. The upper limb is a highly complex segment and the identification of the appropriate devices capable of rehabilitating it globally (from the shoulder to the hand) in clinical practice is crucial. In this work, we aimed: (i) to describe an approach used in identifying a set of technological and robotic devices to globally treat the upper limb, and (ii) to evaluate the feasibility of the identified set in clinical practice. Using an ad-hoc form, a multidisciplinary team identified a set of four robotic and sensor-based devices to treat globally the upper limb. Then, 30 stroke patients were enrolled and assigned to two groups: the robotic group (RG), where patients were treated with the robotic set, or the conventional group (CG). All patients were evaluated before and after the treatment. In the RG the patients used all the devices (one in each rehabilitation session); the treatment was well accepted, without drop-outs or adverse events. Using a multidisciplinary approach, we identified a set of technological and robotic devices to treat the upper limb globally, and then we experimented to ascertain its feasibility, in a pilot study. Robotics offers a considerable number of devices for rehabilitation that should be selected according to rehabilitation aims and feasibility in clinical practice.
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Pausic, Vesna, Grigorije Jovanovic, and Svetlana Simic. "Robotics in physical medicine and neurorehabilitation." Medical review 74, no. 1-2 (2021): 50–53. http://dx.doi.org/10.2298/mpns2102050p.
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Introduction. Robots have been used for rehabilitation purposes since the 1960s. The aim of this paper is to present the application of robotics in physical medicine and rehabilitation with special reference to robotic devices used in rehabilitation. Material and Methods. The paper uses literature related to the application of robotics in medicine and rehabilitation. The literature review was conducted using the following databases: Serbian Library Consortium for Coordinated Acquisition, Medical Literature Analysis and Retrieval System, Google Scholar, Science Citation Index, and portal of Croatian scientific journals ?Hrcak?. Development of robotics in rehabilitation. Nowadays, there are a great number of different robotic systems for rehabilitation. Robotics in rehabilitation is of utter importance because it works on the principle of neuroplasticity. Robots for lower limb rehabilitation. These robotic systems are most often in the form of exoskeletons. Robots for upper limb rehabilitation. Upper limb rehabilitation robots are therapeutic devices that help or provide support for arm or hand movements. Robot for upper body rehabilitation. Robot ?Tymo?. Conclusion. By using robots in physical medicine and neurorehabilitation, a faster and more complete functional recovery of the patient can be achieved.
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Kiyono, Kei, Shigeo Tanabe, Satoshi Hirano, et al. "Effectiveness of Robotic Devices for Medical Rehabilitation: An Umbrella Review." Journal of Clinical Medicine 13, no. 21 (2024): 6616. http://dx.doi.org/10.3390/jcm13216616.
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Background/Objectives: Clinical trials have investigated the efficacy of rehabilitation robotics for various pathological conditions, but the overall impact on rehabilitation practice remains unclear. We comprehensively examined and analyzed systematic reviews (SRs) of randomized controlled trials (RCTs) investigating rehabilitative interventions with robotic devices. Methods: Four databases were searched using term combinations of keywords related to robotic devices, rehabilitation, and SRs. The SR meta-analyses were categorized into “convincing”, “highly suggestive”, “suggestive”, “weak”, or “non-significant” depending on evidence strength and validity. Results: Overall, 62 SRs of 341 RCTs involving 14,522 participants were identified. Stroke was most frequently reported (40 SRs), followed by spinal cord injury (eight SRs), multiple sclerosis (four SRs), cerebral palsy (four SRs), Parkinson’s disease (three SRs), and neurological disease (any disease causing limited upper- and lower-limb functioning; three SRs). Furthermore, 38, 21, and 3 SRs focused on lower-limb devices, upper-limb devices, and both upper- and lower-limb devices, respectively. Quantitative synthesis of robotic intervention effects was performed by 51 of 62 SRs. Robot-assisted training was effective for various outcome measures per disease. Meta-analyses offering suggestive evidence were limited to studies on stroke. Upper-limb devices were effective for motor control and activities of daily living, and lower-limb devices for walking independence in stroke. Conclusions: Robotic devices are useful for improving impairments and disabilities in several diseases. Further high-quality SRs including RCTs with large sample sizes and meta-analyses of these RCTs, particularly on non-stroke-related diseases, are required. Further research should also ascertain which type of robotic device is the most effective for improving each specific impairment or disability.
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Colovic, Hristina, Lidija Dimitrijevic, Vanja Djuric, and Sonja Jankovic. "Upper limb robotic neurorehabilitation after pediatric stroke." Srpski arhiv za celokupno lekarstvo 148, no. 5-6 (2020): 368–71. http://dx.doi.org/10.2298/sarh200104015c.
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Introduction. Pediatric brain stroke is a rare condition, with the incidence of 1.2?13/100,000. The most common consequence is hemiparesis with unilateral hand impairment. There is level 4 evidence that robotics may improve the function of upper limbs. In this paper, we present the effect of combined robotic rehabilitation and kinesitherapy on the distal portion of the arm in the chronic phase of hemiparesis in childhood. Case outline. In a 7.5-year-old girl the treatment with robotic neurorehabilitation was administered in the chronic phase of post-stroke rehabilitation, 18 months after the stroke, involving individualized kinesitherapy for 30 minutes, and virtual reality-based rehabilitation using the robotic Smart Glove for 30 minutes. The rehabilitation protocol was administered for 12 weeks (five times a week). The results of therapeutic evaluation showed that the level 2 of Manual Ability Classification System remained unchanged until the end of treatment, while the grade assigned for the spasticity of flexors in the forearm and fingers was 2 at the treatment onset, 1+ after four weeks of therapy, and 1 after eight and 12 weeks of therapy. Qualitative improvement of arm function through the increase of the overall value of the Quality of Upper Extremity Skills Test was evidenced at each evaluation testing, being the greatest after the first four weeks of rehabilitation (4.83%). Conclusion. The result of our study suggests that combined robotic rehabilitation and kinesitherapy can improve the functional motor performance of the arm involved in the chronic recovery phase after a pediatric stroke.
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Zhang, Kai, Xiaofeng Chen, Fei Liu, Haili Tang, Jing Wang, and Weina Wen. "System Framework of Robotics in Upper Limb Rehabilitation on Poststroke Motor Recovery." Behavioural Neurology 2018 (December 13, 2018): 1–14. http://dx.doi.org/10.1155/2018/6737056.
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Neurological impairments such as stroke cause damage to the functional mobility of survivors and affect their ability to perform activities of daily living. Recently, robotic treatment for upper limb stroke rehabilitation has received significant attention because it can provide high-intensity and repetitive movement therapy. In this review, the current status of upper limb rehabilitation robots is explored. Firstly, an overview of mechanical design of robotics for upper-limb rehabilitation and clinical effects of part robots are provided. Then, the comparisons of human-machine interactions, control strategies, driving modes, and training modes are described. Finally, the development and the possible future directions of the upper limb rehabilitation robot are discussed.
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Ferreira, Fernanda Márcia Rodrigues Martins, Guilherme de Paula Rúbio, Fabrício Henrique de Lisboa Brandão, et al. "Robotic Orthosis for Upper Limb Rehabilitation." Proceedings 64, no. 1 (2020): 10. http://dx.doi.org/10.3390/iecat2020-08519.
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Individuals with impaired upper limbs have motor limitations that interfere with functionality. An alternative to rehabilitation is robot-assisted therapy, a method that increases the effectiveness of treatment. New robotic actuators have been developed to assist in the rehabilitation of the upper limb. One of them aims to actively perform finger extension and flexion passively, using a servo motor coupled to a rope system. At the elbow, a direct current (DC) motor combined with a gearbox was coupled to a system of pulleys and ropes designed to actively perform flexion and extension movements. To activate the system, an Arduino-NANO® and a mobile application for Android were used. The performance of the prototype was evaluated in four post-stroke volunteers. The ability to perform the proposed movements with the device was observed. Structural reinforcement was necessary, after twisting the elbow support structure, with pronation of the forearm, resulting in increased component weight. This work presented new robotic devices that can assist in the rehabilitation of post-stroke individuals.
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Scano, M. Caimmi, M. Malosio, et al. "Upper limb robotic rehabilitation: Treatment customization." Gait & Posture 37 (April 2013): S13—S14. http://dx.doi.org/10.1016/j.gaitpost.2012.12.038.
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Aprile, Irene, Marco Germanotta, Arianna Cruciani, et al. "Upper Limb Robotic Rehabilitation After Stroke." Journal of Neurologic Physical Therapy 44, no. 1 (2020): 3–14. http://dx.doi.org/10.1097/npt.0000000000000295.
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van Delden, A. (Lex) E. Q., C. (Lieke) E. Peper, Gert Kwakkel, and Peter J. Beek. "A Systematic Review of Bilateral Upper Limb Training Devices for Poststroke Rehabilitation." Stroke Research and Treatment 2012 (2012): 1–17. http://dx.doi.org/10.1155/2012/972069.
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Introduction. In stroke rehabilitation, bilateral upper limb training is gaining ground. As a result, a growing number of mechanical and robotic bilateral upper limb training devices have been proposed.Objective. To provide an overview and qualitative evaluation of the clinical applicability of bilateral upper limb training devices.Methods. Potentially relevant literature was searched in the PubMed, Web of Science, and Google Scholar databases from 1990 onwards. Devices were categorized as mechanical or robotic (according to the PubMed MeSH term of robotics).Results. In total, 6 mechanical and 14 robotic bilateral upper limb training devices were evaluated in terms of mechanical and electromechanical characteristics, supported movement patterns, targeted part and active involvement of the upper limb, training protocols, outcomes of clinical trials, and commercial availability.Conclusion. Initial clinical results are not yet of such caliber that the devices in question and the concepts on which they are based are firmly established. However, the clinical outcomes do not rule out the possibility that the concept of bilateral training and the accompanied devices may provide a useful extension of currently available forms of therapy. To actually demonstrate their (surplus) value, more research with adequate experimental, dose-matched designs, and sufficient statistical power are required.
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Simonetti, Davide, Loredana Zollo, Luca Vollero, Giulio Iannello, and Eugenio Guglielmelli. "A modular telerehabilitation architecture for upper limb robotic therapy." Advances in Mechanical Engineering 9, no. 2 (2017): 168781401668725. http://dx.doi.org/10.1177/1687814016687252.
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Several factors may prevent post-stroke subjects from participating in rehabilitation protocols, for example, geographical location of rehabilitation centres, socioeconomic status, economic burden and lack of logistics surrounding transportation. Early supported discharge from hospitals with continued rehabilitation at home represents a well-defined regimen of post-stroke treatment. Information-based technologies coupled with robotics have promoted the development of new technologies for telerehabilitation. In this article, the design and development of a modular architecture for delivering upper limb robotic telerehabilitation with the CBM-Motus, a planar unilateral robotic machine that allows performing state-of-the-art rehabilitation tasks, have been presented. The proposed architecture allows a therapist to set a therapy session on his or her side and send it to the patient’s side with a standardized communication protocol; the user interacts with the robot that provides an adaptive assistance during the rehabilitation tasks. Patient’s performance is evaluated by means of performance indicators, which are also used to update robot behaviour during assistance. The implementation of the architecture is described and a set of validation tests on seven healthy subjects are presented. Results show the reliability of the novel architecture and the capability to be easily tailored to the user’s needs with the chosen robotic device.
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Bogue, Robert. "Rehabilitation robots." Industrial Robot: An International Journal 45, no. 3 (2018): 301–6. http://dx.doi.org/10.1108/ir-03-2018-0046.
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Purpose This paper aims to provide an insight into the emerging use of robots in the rehabilitation of sufferers from strokes and other neurological impediments. Design/methodology/approach This considers research, clinical trials and commercial products. Following an introduction, it explains brain neuroplasticity and its role in rehabilitation and then discusses the use of robots in the restoration of upper limb and hand movement in stroke and traumatic injury patients. Robotic techniques aimed at restoring ambulatory ability are then discussed, followed by examples of the application of brain–computer interface technology to robotic rehabilitation. Finally, concluding comments are drawn. Findings Research has shown that robotic techniques can assist in the restoration of functionality to partially or fully paralysed upper and lower limbs. A growing number of commercial exoskeleton and end-effector robotic products have been launched which are augmenting conventional rehabilitation therapies. These systems frequently include interactive computer games and tasks which encourage repetitive use and allow patients to monitor their progress. Trials which combine robotics with brain–computer interface technology have yielded encouraging and unexpectedly positive results. Originality/value This provides details of the increasingly important role played by robots in the rehabilitation of patients suffering from strokes and other neurological disorders.
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Chockalingam, Manigandan, Lenny Thinagaran Vasanthan, Sivakumar Balasubramanian, and Vimal Sriram. "Experiences of patients who had a stroke and rehabilitation professionals with upper limb rehabilitation robots: a qualitative systematic review protocol." BMJ Open 12, no. 9 (2022): e065177. http://dx.doi.org/10.1136/bmjopen-2022-065177.
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IntroductionEmerging evidence suggests that robotic devices for upper limb rehabilitation after a stroke may improve upper limb function. For robotic upper limb rehabilitation in stroke to be successful, patients’ experiences and those of the rehabilitation professionals must be considered. Therefore, this review aims to synthesise the available evidence on experiences of patients after a stroke with rehabilitation robots for upper limb rehabilitation and the experiences of rehabilitation professionals with rehabilitation robots for upper limb stroke rehabilitation.Methods and analysisDatabase search will include MEDLINE (Ovid), EMBASE (Elsevier), Cochrane CENTRAL, PsycINFO, Scopus, Web of Science, IEEE and CINAHL (EBSCOhost). Grey literature from Open Grey, PsyArXiv, bioRxiv, medRxiv and Google Scholar will also be searched. Qualitative studies or results from mixed-method studies that include adult patients after a stroke who use upper limb rehabilitation robots, either supervised by rehabilitation professionals or by patients themselves, at any stage of their rehabilitation and/or stroke professionals who use upper limb rehabilitation robots will be included. Robotic upper limb rehabilitation provided by students, healthcare assistants, technicians, non-professional caregivers, family caregivers, volunteer caregivers or other informal caregivers will be excluded. Articles published in English will be considered regardless of date of publication. Studies will be screened and critically appraised for methodological quality by two independent reviewers. A standardised tool from JBI System for the Unified Management, Assessment and Review of Information for data extraction, the meta-aggregation approach for data synthesis and the ConQual approach for confidence evaluation will be followed.Ethics and disseminationAs this systematic review is based on previously published research, no informed consent or ethical approval is required. It is anticipated that this systematic review will highlight the experiences of patients after a stroke and perceived facilitators and barriers for rehabilitation professionals on this topic, which will be disseminated through peer-reviewed publications and national and international conferences.PROSPERO registration numberCRD42022321402.
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Morales, Ricardo, Francisco Javier Badesa, Nicolás García-Aracil, José María Sabater, and Carlos Pérez-Vidal. "Pneumatic robotic systems for upper limb rehabilitation." Medical & Biological Engineering & Computing 49, no. 10 (2011): 1145–56. http://dx.doi.org/10.1007/s11517-011-0814-3.
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Hyakutake, Koichi, Takashi Morishita, Kazuya Saita, et al. "Effects of Home-Based Robotic Therapy Involving the Single-Joint Hybrid Assistive Limb Robotic Suit in the Chronic Phase of Stroke: A Pilot Study." BioMed Research International 2019 (March 18, 2019): 1–9. http://dx.doi.org/10.1155/2019/5462694.
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Introduction. Robotic therapy has drawn attention in the rehabilitation field including home-based rehabilitation. A previous study has reported that home-based therapy could be more effective for increasing upper limb activity than facility-based therapy. The single-joint hybrid assistive limb (HAL-SJ) is an exoskeleton robot developed according to the interactive biofeedback theory, and several studies have shown its effectiveness for upper limb function in stroke patients. A study of home-based robotic therapy has shown to enhance rehabilitation effectiveness for stroke patient with a paretic upper limb. However, home-based therapy involving a HAL-SJ in stroke patients with paretic upper limbs has not been investigated. The present study aimed to investigate paretic upper limb activity and function with home-based robotic therapy involving a HAL-SJ in stroke patients. Materials and Methods. A home-based robotic therapy program involving a HAL-SJ was performed for 30 min per session followed by standard therapy for 30 min per session, 2 times a week, for 4 weeks (i.e., completion of all 8 sessions involved 8 h of rehabilitation), at home. After the intervention, patients were followed up by telephone and home visits for 8 weeks. The paretic upper limb activity and function were assessed using the Motor Activity Log (MAL; amount of use (AOU)), arm triaxial accelerometry (laterality index (LI)), the Fugl–Meyer assessment (FMA), and the action research arm test (ARAT), at baseline and week 4 and week 12 after the start of training. Results. The study included 10 stroke patients (5 men; mean age, 61.1 ± 7.1 years). The AOU scores and LI significantly improved at week 4 after the start of training (p<0.05). However, no significant changes were observed in the LI at week 12 (p=0.161) and the FMA scores at both week 4 and week 12 (p=0.059 and p=0.083, respectively). The ARAT scores significantly improved at both week 4 and week 12 (p<0.05). Conclusion. Home-based robotic therapy combined with conventional therapy could be a valuable approach for increasing paretic upper limb activity and maintaining paretic upper limb function in the chronic phase of stroke.
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Germanotta, Marco, Laura Cortellini, Sabina Insalaco, and Irene Aprile. "Effects of Upper Limb Robot-Assisted Rehabilitation Compared with Conventional Therapy in Patients with Stroke: Preliminary Results on a Daily Task Assessed Using Motion Analysis." Sensors 23, no. 6 (2023): 3089. http://dx.doi.org/10.3390/s23063089.
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Robotic rehabilitation of the upper limb has demonstrated promising results in terms of the improvement of arm function in post-stroke patients. The current literature suggests that robot-assisted therapy (RAT) is comparable to traditional approaches when clinical scales are used as outcome measures. Instead, the effects of RAT on the capacity to execute a daily life task with the affected upper limb are unknown, as measured using kinematic indices. Through kinematic analysis of a drinking task, we examined the improvement in upper limb performance between patients following a robotic or conventional 30-session rehabilitation intervention. In particular, we analyzed data from nineteen patients with subacute stroke (less than six months following stroke), nine of whom treated with a set of four robotic and sensor-based devices and ten with a traditional approach. According to our findings, the patients increased their movement efficiency and smoothness regardless of the rehabilitative approach. After the treatment (either robotic or conventional), no differences were found in terms of movement accuracy, planning, speed, or spatial posture. This research seems to demonstrate that the two investigated approaches have a comparable impact and may give insight into the design of rehabilitation therapy.
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Gao, Baofeng, Chao Wei, Hongdao Ma, Shu Yang, Xu Ma, and Songyuan Zhang. "Real-Time Evaluation of the Signal Processing of sEMG Used in Limb Exoskeleton Rehabilitation System." Applied Bionics and Biomechanics 2018 (October 14, 2018): 1–6. http://dx.doi.org/10.1155/2018/1391032.
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As an important branch of medical robotics, a rehabilitation training robot for the hemiplegic upper limbs is a research hotspot of rehabilitation training. Based on the motion relearning program, rehabilitation technology, human anatomy, mechanics, computer science, robotics, and other fields of technology are covered. Based on an sEMG real-time training system for rehabilitation, the exoskeleton robot still has some problems that need to be solved in this field. Most of the existing rehabilitation exoskeleton robotic systems are heavy, and it is difficult to ensure the accuracy and real-time performance of sEMG signals. In this paper, we design a real-time training system for the upper limb exoskeleton robot based on the EMG signal. It has four main characteristics: light weight, portability, high precision, and low delay. This work includes the structure of the rehabilitation robotic system and the method of signal processing of the sEMG. An experiment on the accuracy and time delay of the sEMG signal processing has been done. In the experimental results, the recognition accuracy of the sEMG is 94%, and the average delay time is 300 ms, which meets the accuracy and real-time requirements.
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Pană, Cristina Floriana, Dorin Popescu, and Virginia Maria Rădulescu. "Patent Review of Lower Limb Rehabilitation Robotic Systems by Sensors and Actuation Systems Used." Sensors 23, no. 13 (2023): 6237. http://dx.doi.org/10.3390/s23136237.
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Robotic systems for lower limb rehabilitation are essential for improving patients’ physical conditions in lower limb rehabilitation and assisting patients with various locomotor dysfunctions. These robotic systems mainly integrate sensors, actuation, and control systems and combine features from bionics, robotics, control, medicine, and other interdisciplinary fields. Several lower limb robotic systems have been proposed in the patent literature; some are commercially available. This review is an in-depth study of the patents related to robotic rehabilitation systems for lower limbs from the point of view of the sensors and actuation systems used. The patents awarded and published between 2013 and 2023 were investigated, and the temporal distribution of these patents is presented. Our results were obtained by examining the analyzed information from the three public patent databases. The patents were selected so that there were no duplicates after several filters were used in this review. For each patent database, the patents were analyzed according to the category of sensors and the number of sensors used. Additionally, for the main categories of sensors, an analysis was conducted depending on the type of sensors used. Afterwards, the actuation solutions for robotic rehabilitation systems for upper limbs described in the patents were analyzed, highlighting the main trends in their use. The results are presented with a schematic approach so that any user can easily find patents that use a specific type of sensor or a particular type of actuation system, and the sensors or actuation systems recommended to be used in some instances are highlighted.
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Rusinowska, Barbara, Balbina Tybulczuk, and Patrycja Białowąs. "Clinical outcomes in post-stroke rehabilitation using upper-limb exoskeletons: review of latest reports. (Exoskeletons in post-stroke rehabilitation)." Medical Science Pulse 18, no. 4 (2024): 53–67. https://doi.org/10.5604/01.3001.0054.9895.
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Background: Stroke is one of the main source of chronic disability in adults and affects motor dysfunction including paresis of upper limb. Currently, the use of new technologies is becoming more and more widespread and supports the effects of physical rehabilitation. The Fugl-Meyer Assessment of Upper Extremity (FMA-UE) is widely used gold standard in assessing motor functions of the upper limbs in stroke patients. Aim of the study: The purpose of this review is to present the results of upper limb rehabilitation using an exoskeleton on patients' motor functions based on FMA-UE.Material and methods: All relevant publications were retrieved from the PubMed, with key words such as “exoskeleton stroke” (PubMed – 212 results), “upper limb exoskeleton” (PubMed – 221 results), “stroke rehabilitation physiotherapy” (PubMed – 1191 results), and 35 papers were selected. Results: The results of research conducted on patients in subacute and chronic phase of stroke using various models of upper limb exoskeletons are introduced. We described the constructed exoskeletons and presented clinical outcomes after therapy using FMA-UE.Conclusions: Our analysis shows that rehabilitation of the upper limb using robotic exoskeletons significantly improves the movement of the proximal joints of the upper limb in post-stroke patients, regardless of the recovery phase.
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Díaz, Iñaki, Jorge Juan Gil, and Emilio Sánchez. "Lower-Limb Robotic Rehabilitation: Literature Review and Challenges." Journal of Robotics 2011 (2011): 1–11. http://dx.doi.org/10.1155/2011/759764.
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This paper presents a survey of existing robotic systems for lower-limb rehabilitation. It is a general assumption that robotics will play an important role in therapy activities within rehabilitation treatment. In the last decade, the interest in the field has grown exponentially mainly due to the initial success of the early systems and the growing demand caused by increasing numbers of stroke patients and their associate rehabilitation costs. As a result, robot therapy systems have been developed worldwide for training of both the upper and lower extremities. This work reviews all current robotic systems to date for lower-limb rehabilitation, as well as main clinical tests performed with them, with the aim of showing a clear starting point in the field. It also remarks some challenges that current systems still have to meet in order to obtain a broad clinical and market acceptance.
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Yadav*, Dr Madhu. "Application of Technologies Robotic Rehabilitation in Children with Upper Limb Injury." International Journal of Preventive Medicine and Health 1, no. 4 (2021): 1–5. http://dx.doi.org/10.35940/ijpmh.b1005.091421.
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Robotic and advanced technology rehabilitation is useful for people with difficulties and deficits in arm and hand movements, walking problems and balance disorders. Robotic technologies are being introduced in the rehabilitation field to support the activity of specialists, doctors and physiotherapists; the future and the challenge of rehabilitation lies precisely in the development of robotics. Robot assists the therapist in administering the most appropriate motor therapy with precision and repeatability modulates the difficulty of the exercise. It allows repetitive task-oriented activities with augmentative feedback capable of inducing brain plasticity. It acquires quantitative information on movement and evaluates the services performed he first, “Arm and Hand”, is used to help the opening and closing movements of the hand. After entering it by hand and forearm, gently guides the patient's shoulder and elbow movements to reach and grasp objects. “Wrist”, on the other hand, interacts with the movements of the wrist and integrates functionally with the “Hand” module.
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Yadav, Dr Madhu. "Application of Technologies Robotic Rehabilitation in Children with Upper Limb Injury." International Journal of Preventive Medicine and Health 1, no. 4 (2021): 1–5. http://dx.doi.org/10.54105/ijpmh.b1005.091421.
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Robotic and advanced technology rehabilitation is useful for people with difficulties and deficits in arm and hand movements, walking problems and balance disorders. Robotic technologies are being introduced in the rehabilitation field to support the activity of specialists, doctors and physiotherapists; the future and the challenge of rehabilitation lies precisely in the development of robotics. Robot assists the therapist in administering the most appropriate motor therapy with precision and repeatability modulates the difficulty of the exercise. It allows repetitive task-oriented activities with augmentative feedback capable of inducing brain plasticity. It acquires quantitative information on movement and evaluates the services performed he first, “Arm and Hand”, is used to help the opening and closing movements of the hand. After entering it by hand and forearm, gently guides the patient’s shoulder and elbow movements to reach and grasp objects. “Wrist”, on the other hand, interacts with the movements of the wrist and integrates functionally with the “Hand” module.
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Madhu, Yadav. "Application of Technologies Robotic Rehabilitation in Children with Upper Limb Injury." International Journal of Preventive Medicine and Health (IJPMH) 1, no. 4 (2021): 1–5. https://doi.org/10.54105/ijpmh.B1005.091421.
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Robotic and advanced technology rehabilitation is useful for people with difficulties and deficits in arm and hand movements, walking problems and balance disorders. Robotic technologies are being introduced in the rehabilitation field to support the activity of specialists, doctors and physiotherapists; the future and the challenge of rehabilitation lies precisely in the development of robotics. Robot assists the therapist in administering the most appropriate motor therapy with precision and repeatability modulates the difficulty of the exercise. It allows repetitive task-oriented activities with augmentative feedback capable of inducing brain plasticity. It acquires quantitative information on movement and evaluates the services performed he first, “Arm and Hand”, is used to help the opening and closing movements of the hand. After entering it by hand and forearm, gently guides the patient's shoulder and elbow movements to reach and grasp objects. “Wrist”, on the other hand, interacts with the movements of the wrist and integrates functionally with the “Hand” module.
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Rzyman, Gustaw, Jacek Szkopek, Grzegorz Redlarski, and Aleksander Palkowski. "Upper Limb Bionic Orthoses: General Overview and Forecasting Changes." Applied Sciences 10, no. 15 (2020): 5323. http://dx.doi.org/10.3390/app10155323.
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Using robotics in modern medicine is slowly becoming a common practice. However, there are still important life science fields which are currently devoid of such advanced technology. A noteworthy example of a life sciences field which would benefit from process automation and advanced robotic technology is rehabilitation of the upper limb with the use of an orthosis. Here, we present the state-of-the-art and prospects for development of mechanical design, actuator technology, control systems, sensor systems, and machine learning methods in rehabilitation engineering. Moreover, current technical solutions, as well as forecasts on improvement, for exoskeletons are presented and reviewed. The overview presented might be the cornerstone for future research on advanced rehabilitation engineering technology, such as an upper limb bionic orthosis.
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Cortés, Camilo, Aitor Ardanza, F. Molina-Rueda, et al. "Upper Limb Posture Estimation in Robotic and Virtual Reality-Based Rehabilitation." BioMed Research International 2014 (2014): 1–18. http://dx.doi.org/10.1155/2014/821908.
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New motor rehabilitation therapies include virtual reality (VR) and robotic technologies. In limb rehabilitation, limb posture is required to (1) provide a limb realistic representation in VR games and (2) assess the patient improvement. When exoskeleton devices are used in the therapy, the measurements of their joint angles cannot be directly used to represent the posture of the patient limb, since the human and exoskeleton kinematic models differ. In response to this shortcoming, we propose a method to estimate the posture of the human limb attached to the exoskeleton. We use the exoskeleton joint angles measurements and the constraints of the exoskeleton on the limb to estimate the human limb joints angles. This paper presents (a) the mathematical formulation and solution to the problem, (b) the implementation of the proposed solution on a commercial exoskeleton system for the upper limb rehabilitation, (c) its integration into a rehabilitation VR game platform, and (d) the quantitative assessment of the method during elbow and wrist analytic training. Results show that this method properly estimates the limb posture to (i) animate avatars that represent the patient in VR games and (ii) obtain kinematic data for the patient assessment during elbow and wrist analytic rehabilitation.
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Nalongo J., Amina. "Robotics in Physical Therapy: Enhancing Patient Outcomes." Research Output Journal of Engineering and Scientific Research 4, no. 2 (2025): 87–94. https://doi.org/10.59298/rojesr/2025/4.2.8794.
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The integration of robotics into physical therapy represents a significant advancement in rehabilitation sciences, offering new pathways to enhance patient outcomes. This paper examines the evolution, benefits, challenges, and future directions of robotic systems in physical therapy. With a focus on upper extremity rehabilitation, robotic systems such as exoskeletons and virtual reality-integrated devices have demonstrated promising results in improving exercise adherence, therapy intensity, and functional recovery, especially in stroke patients. The review examines the design complexities of rehabilitation robots, including multi-degree-of-freedom mechanisms, user interaction challenges, and cost constraints. Case studies and clinical data support the effectiveness of robotic interventions while also emphasizing the importance of ethical considerations, safety standards, and user education. Although technical and financial challenges remain, ongoing innovations in robot-assisted therapy suggest a future where personalized, accessible, and efficient rehabilitation is increasingly feasible. Keywords: Robotic Rehabilitation, Physical Therapy, Exoskeletons, Neurorehabilitation, Upper Limb Therapy, Patient Outcomes, Virtual Reality.
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Jobbágy, Boris, Dušan Šimšík, Jiří Marek, Ján Karchňák, and Daniela Onofrejová. "Robotic Exoskeleton for Rehabilitation of the Upper Limb." American Journal of Mechanical Engineering 2, no. 7 (2014): 299–302. http://dx.doi.org/10.12691/ajme-2-7-27.
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ASAHINA, Atsushi. "Robotic Rehabilitation System for Upper Limb ReoGo^[○!R]." Journal of the Society of Mechanical Engineers 119, no. 1166 (2016): 29. http://dx.doi.org/10.1299/jsmemag.119.1166_29.
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Jakob, Iris, Alexander Kollreider, Marco Germanotta, et al. "Robotic and Sensor Technology for Upper Limb Rehabilitation." PM&R 10 (September 2018): S189—S197. http://dx.doi.org/10.1016/j.pmrj.2018.07.011.
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Torres Quezada, Mauricio, Roberto Sagaró Zamora, Leonardo Broche Vázquez, Denis Delisle Rodríguez, and Alberto Lopez Delis. "Robotic Training System for Upper Limb Rehabilitation1." Ingenieria y Universidad 18, no. 2 (2014): 235. http://dx.doi.org/10.11144/javeriana.iyu18-2.rtsu.
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IntroIntroducción: Un exoesqueleto se conceptualiza como un mecanismo estructural externo cuyos segmentos y articulaciones se corresponden con las del cuerpo humano y es capaz de coordinar y amplificar sus movimientos. El objetivo del trabajo se enfoca en desarrollar una tecnología de plataforma robótica de asistencia y métodos de cuantificación para la rehabilitación motora de miembros superiores en ambientes clínicos y ambulatorios para pacientes con afecciones motoras como resultados de enfermedades cerebrovasculares.Métodos: Se presenta a partir de una concepción integradora el diseño del prototipo de un exoesqueleto que permite al paciente realizar movimientos combinados a partir de los cuatro grados de libertad que provee el dispositivo de rehabilitación. El sistema es controlado por medio de una interfaz de usuario desarrollada en Labview que soporta el control e interacción del usuario con el exoesqueleto, lo cual posibilita que el terapeuta puede modificar la rutina que debe realizar el paciente incluyendo nuevas trayectorias y el número de repeticiones a seguir por el exoesqueleto en las articulaciones de hombro, codo y muñeca. Adicionalmente, posibilita la retroalimentación visual de la actividad electromiográfica del paciente durante la rehabilitación.Resultados: Se presenta el diseño mecánico de la armadura, implementación de los sistemas de potencia, el desarrollo del sistema de control y de la interfaz de usuario así como su integración con el sistema mecánico.Conclusiones: Se desarrolla y pone en funcionamiento una avanzada plataforma robótica capaz de desarrollar diversas rutinas terapéuticas combinando 4 grados de libertad en hombro, codo y muñeca, capaz de controlar a través de la interfaz desarrollada desplazamientos regulados, exactos y repetitivos, así como seguir cronológicamente la evolución del paciente registrando la actividad mioeléctrica durante el proceso de rehabilitación.<br /><br /><br /><br />Background: Robot-assisted therapy or exoskeleton is an active mechanical device that can be easily adjusted to fit a different patient limb length, and is able to coordinate and amplify movements. The aim of this study focuses on developing a robotic training system and quantification methods for upper limbs rehabilitation in clinic environments to be used in survivor stroke patients with motor disorders or loss of physical strength on one side of the body.Methods: From an integrated approach, a design of one exoskeleton is presented which allows patients perform complex movements in four degrees of freedom (DOF) rehabilitation system. The system is controlled by means of user interface developed with Lab view v8.6 software that supports control and user interaction with the exoskeleton; so it’s possible for therapist to modify the patient routine including new movements and a number of repetitions in articulating joints of shoulder, elbow and wrist. On other hand system permits bio- feedback of electromyogram patient activity during rehabilitation sessions.Results: Biomechanical analyses and structure design, implementation of power systems, the development of the control system and user interface as well as its integration with the mechanical system is presented.</p><p><br />Conclusions: A robot arm exoskeleton device with four DOF; able to develop complex, accurate and repetitive therapeutic routines for articulating joints of shoulder, elbow and wrist trough an interface is shown. The device permits to follow chronologically patient outcomes recording the electromyogram activity during rehabilitation progress.
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Abdallah, Ismail Ben, and Yassine Bouteraa. "An Optimized Stimulation Control System for Upper Limb Exoskeleton Robot-Assisted Rehabilitation Using a Fuzzy Logic-Based Pain Detection Approach." Sensors 24, no. 4 (2024): 1047. http://dx.doi.org/10.3390/s24041047.
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The utilization of robotic systems in upper limb rehabilitation has shown promising results in aiding individuals with motor impairments. This research introduces an innovative approach to enhance the efficiency and adaptability of upper limb exoskeleton robot-assisted rehabilitation through the development of an optimized stimulation control system (OSCS). The proposed OSCS integrates a fuzzy logic-based pain detection approach designed to accurately assess and respond to the patient’s pain threshold during rehabilitation sessions. By employing fuzzy logic algorithms, the system dynamically adjusts the stimulation levels and control parameters of the exoskeleton, ensuring personalized and optimized rehabilitation protocols. This research conducts comprehensive evaluations, including simulation studies and clinical trials, to validate the OSCS’s efficacy in improving rehabilitation outcomes while prioritizing patient comfort and safety. The findings demonstrate the potential of the OSCS to revolutionize upper limb exoskeleton-assisted rehabilitation by offering a customizable and adaptive framework tailored to individual patient needs, thereby advancing the field of robotic-assisted rehabilitation.
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Ribas Neto, Antonio, Julio Fajardo, Willian Hideak Arita da Silva, et al. "Design of Tendon-Actuated Robotic Glove Integrated with Optical Fiber Force Myography Sensor." Automation 2, no. 3 (2021): 187–201. http://dx.doi.org/10.3390/automation2030012.
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People taken by upper limb disorders caused by neurological diseases suffer from grip weakening, which affects their quality of life. Researches on soft wearable robotics and advances in sensor technology emerge as promising alternatives to develop assistive and rehabilitative technologies. However, current systems rely on surface electromyography and complex machine learning classifiers to retrieve the user intentions. In addition, the grasp assistance through electromechanical or fluidic actuators is passive and does not contribute to the rehabilitation of upper-limb muscles. Therefore, this paper presents a robotic glove integrated with a force myography sensor. The glove-like orthosis features tendon-driven actuation through servo motors, working as an assistive device for people with hand disabilities. The detection of user intentions employs an optical fiber force myography sensor, simplifying the operation beyond the usual electromyography approach. Moreover, the proposed system applies functional electrical stimulation to activate the grasp collaboratively with the tendon mechanism, providing motion support and assisting rehabilitation.
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Copilusi, Petre Cristian, Valentin Grecu, and Nicolae Dumitru. "Human Upper Limb Robotic System Experimental Analysis by Using CONTEMPLAS Motion Software." Applied Mechanics and Materials 325-326 (June 2013): 1062–66. http://dx.doi.org/10.4028/www.scientific.net/amm.325-326.1062.
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In this paper a human upper limb robotic system is analyzed through an experimental study. The experimental analysis aim is to validate this robotic system type in order to use it in some kinetotherapy programs for the human upper limb recovery. The robotic system experimental research was performed by using special equipment called CONTEMPLAS which enables to evaluate angular variations in 3D environment. The equipment used in this research has two high-speed cameras which can record and establish the angular variations developed at the robotic system joints level. This paper consists of three main parts. In the first part there is an actual study of the robotic systems specially designed for the human upper limb rehabilitation, where the robotic system proposed for this experimental research is described. The second part includes some literature aspects regarding the movements developed by the human upper limb, and in the third part the experimental research is described in detail.
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Oña, E. D., R. Cano-de la Cuerda, P. Sánchez-Herrera, C. Balaguer, and A. Jardón. "A Review of Robotics in Neurorehabilitation: Towards an Automated Process for Upper Limb." Journal of Healthcare Engineering 2018 (2018): 1–19. http://dx.doi.org/10.1155/2018/9758939.
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Robot-mediated neurorehabilitation is a growing field that seeks to incorporate advances in robotics combined with neuroscience and rehabilitation to define new methods for treating problems related with neurological diseases. In this paper, a systematic literature review is conducted to identify the contribution of robotics for upper limb neurorehabilitation, highlighting its relation with the rehabilitation cycle, and to clarify the prospective research directions in the development of more autonomous rehabilitation processes. With this aim, first, a study and definition of a general rehabilitation process are made, and then, it is particularized for the case of neurorehabilitation, identifying the components involved in the cycle and their degree of interaction between them. Next, this generic process is compared with the current literature in robotics focused on upper limb treatment, analyzing which components of this rehabilitation cycle are being investigated. Finally, the challenges and opportunities to obtain more autonomous rehabilitation processes are discussed. In addition, based on this study, a series of technical requirements that should be taken into account when designing and implementing autonomous robotic systems for rehabilitation is presented and discussed.
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Zhao, Shumi, Jianxun Liu, Zidan Gong, et al. "Wearable Physiological Monitoring System Based on Electrocardiography and Electromyography for Upper Limb Rehabilitation Training." Sensors 20, no. 17 (2020): 4861. http://dx.doi.org/10.3390/s20174861.
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Secondary injuries are common during upper limb rehabilitation training because of uncontrollable physical force and overexciting activities, and long-time training may cause fatigue and reduce the training effect. This study proposes a wearable monitoring device for upper limb rehabilitation by integrating electrocardiogram and electromyogram (ECG/EMG) sensors and using data acquisition boards to obtain accurate signals during robotic glove assisting training. The collected ECG/EMG signals were filtered, amplified, digitized, and then transmitted to a remote receiver (smart phone or laptop) via a low-energy Bluetooth module. A software platform was developed for data analysis to visualize ECG/EMG information, and integrated into the robotic glove control module. In the training progress, various hand activities (i.e., hand closing, forearm pronation, finger flexion, and wrist extension) were monitored by the EMG sensor, and the changes in the physiological status of people (from excited to fatigue) were monitored by the ECG sensor. The functionality and feasibility of the developed physiological monitoring system was demonstrated by the assisting robotic glove with an adaptive strategy for upper limb rehabilitation training improvement. The feasible results provided a novel technique to monitor individual ECG and EMG information holistically and practically, and a technical reference to improve upper limb rehabilitation according to specific treatment conditions and the users’ demands. On the basis of this wearable monitoring system prototype for upper limb rehabilitation, many ECG-/EMG-based mobile healthcare applications could be built avoiding some complicated implementation issues such as sensors management and feature extraction.
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Gu, Peigeng. "Modular Design and Control System Optimisation of an Upper Limb Rehabilitation Robot." Highlights in Science, Engineering and Technology 134 (March 30, 2025): 163–70. https://doi.org/10.54097/ebv9yx24.
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Stroke is one of the leading causes of disability and death worldwide, and upper limb dysfunction in particular seriously affects patients' daily life and self-care ability. Therefore, designing efficient and economical upper limb rehabilitation robots has become an urgent problem. In this paper, a modular and lightweight upper limb rehabilitation robot is proposed. The robot employs adaptive impedance control, model predictive control (MPC) and electromyogram (EMG)-based closed-loop control strategies to achieve personalized rehabilitation training support. Through simulation and experimentation, this paper verifies the significant effect of the robotic system in enhancing the upper limb function of stroke patients, especially in improving locomotor ability, enhancing the sense of active participation, and promoting the recovery of voluntary movement. The results show that the system has the ability of efficient and personalized rehabilitation training, and is expected to be widely applied in home and community rehabilitation to promote the popularity and development of upper limb rehabilitation technology. The analyses in this position can provide a reference for the development of upper limb rehabilitation robots.
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Fonte, Cristina, Valentina Varalta, Arianna Rocco, et al. "Combined transcranial Direct Current Stimulation and robot-assisted arm training in patients with stroke: a systematic review." Restorative Neurology and Neuroscience 39, no. 6 (2021): 435–46. http://dx.doi.org/10.3233/rnn-211218.
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Background: Upper limb motor deficits in patients with severe stroke often remain unresolved over time. Combining transcranial Direct Current Stimulation with robotic therapy is an innovative neurorehabilitation approach that holds promise to improve upper limb impairment after stroke. Objective: To investigate the effects of robotic training in combination with transcranial Direct Current Stimulation for treating poststroke upper limb impairment. Methods: PubMed, MEDLINE, Cochrane Library, and EMBASE electronic databases were searched using keywords, MeSH terms, and strings: “Stroke”[MeSH] AND (“Upper Extremity”[MeSH] OR “upper limb”) AND (“Transcranial Direct Current Stimulation” [MeSH] OR “tDCS”) AND (“robotics” OR “robotic therapy”). Full-text articles published in English up to October 2020 were included. Each was rated for quality according to the Physiotherapy Database (PEDro) score: eight out of eleven scored more than 8 points; their results were considered reliable for this review. Results: Of the total of 171 publications retrieved, 11 met the inclusion criteria. The results of studies that examined the same outcome measures were pooled to draw conclusions on the effectiveness of transcranial Direct Current Stimulation and robot-assisted training in corticomotor excitability, upper limb kinematics, muscle strength and tone, function, disability, and quality of life after stroke. Conclusions: To date, there is insufficient evidence to support the hypothesis that transcranial Direct Current Stimulation enhances the effects of robot-assisted arm training in poststroke patients. Further studies with more accurate, comparable and standardized methodology are needed in order to better define the effects of robotic training in combination with transcranial Direct Current Stimulation on poststroke upper limb impairment. Therefore, given the scarce resources available to rehabilitation researches, other, more promising approaches should be given attention.
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RAHMAN, MOHAMMAD HABIBUR, THIERRY KITTEL-OUIMET, MAAROUF SAAD, JEAN-PIERRE KENNÉ, and PHILIPPE S. ARCHAMBAULT. "DYNAMIC MODELING AND EVALUATION OF A ROBOTIC EXOSKELETON FOR UPPER-LIMB REHABILITATION." International Journal of Information Acquisition 08, no. 01 (2011): 83–102. http://dx.doi.org/10.1142/s0219878911002367.
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Proper functioning of the shoulder, elbow, and wrist movements play a vital role in the performance of essential daily activities. To assist physically disabled people with impaired upper-limb function, we have been developing an exoskeleton robot (ExoRob) to rehabilitate and to ease upper limb motion. The proposed ExoRob will be comprised of seven degrees of freedom (DOFs) to enable natural movements of the human upper-limb. This paper focuses on the kinematic and dynamic modeling of the proposed ExoRob that corresponds to human upper-limbs. For this purpose, a nonlinear computed torque control technique was employed. In simulations, trajectory tracking corresponding to typical rehabilitation exercises were carried out to evaluate the performances of the developed model and controller. For the experimental part, only 3DOFs (elbow, wrist flexion/extension, wrist abduction/adduction) were considered. Simulated and experimental results show that the controller was able to maneuver the proposed ExoRob efficiently in order to track the desired trajectories, which in this case consisted in passive arm movements. Such movements are widely used in therapy and were performed efficiently with the developed ExoRob and the controller.
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Ridremont, Tanguy, Inderjeet Singh, Baptiste Bruzek, et al. "Soft Robotic Bilateral Rehabilitation System for Hand and Wrist Joints." Machines 12, no. 5 (2024): 288. http://dx.doi.org/10.3390/machines12050288.
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Upper limb functionality is essential to perform activities of daily living. It is critical to investigate neurorehabilitation therapies in order to improve upper limb functionality in post-stroke patients. This paper presents a soft-robotic bilateral system to provide rehabilitation therapy for hand and wrist joints. A sensorized glove that tracks finger and wrist joint movements is worn on the healthy limb, which guides the movement of the paretic limb. The input of sensors from the healthy limb is provided to the soft robotic exoskeleton attached to the paretic limb to mimic the motion. A proportional derivative flow-based control algorithm is used to perform bilateral therapy. To test the feasibility of the developed system, two different applications are performed experimentally: (1) Wrist exercise with a dumbbell, and (2) Object pick-and-place task. The initial tests of the developed system verified its capability to perform bilateral therapy.
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Dimante, Dace, Ināra Logina, Marco Sinisi, and Angelika Krūmiņa. "Sensory Feedback in Upper Limb Prostheses." Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences. 74, no. 5 (2020): 308–17. http://dx.doi.org/10.2478/prolas-2020-0047.
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Abstract Loss of an arm is a devastating condition that can cross all socioeconomic groups. A major step forward in rehabilitation of amputees has been the development of myoelectric prostheses. Current robotic arms allow voluntary movements by using residual muscle contraction. However, a significant issue is lack of movement control and sensory feedback. These factors play an important role in integration and embodiment of a robotic arm. Without feedback, users rely on visual cues and experience overwhelming cognitive demand that results in poorer use of a prosthesis. The complexity of the afferent system presents a great challenge of creating a closed-loop hand prosthesis. Several groups have shown progress providing sensory feedback for upper limb amputees using robotic arms. Feedback, although still limited, is achieved through direct implantation of intraneural electrodes as well as through non-invasive methods. Moreover, evidence shows that over time some amputees develop a phantom sensation of the missing limb on their stump. This phenomenon can occur spontaneously as well as after non-invasive nerve stimulation, suggesting the possibility of recreating a sensory homunculus of the hand on the stump. Furthermore, virtual reality simulation in combination with mechanical stimulation of skin could augment the sensation phenomenon, leading to better interface between human and robotic arms.
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Aprile, Irene, Giulia Guardati, Valeria Cipollini, et al. "Influence of Cognitive Impairment on the Recovery of Subjects with Subacute Stroke Undergoing Upper Limb Robotic Rehabilitation." Brain Sciences 11, no. 5 (2021): 587. http://dx.doi.org/10.3390/brainsci11050587.
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Cognitive decline is often present in stroke survivors, with a significant impact on motor recovery. However, how specific cognitive domains could impact motor recovery after robotic rehabilitation in patients with stroke is still not well understood. In this study, we analyzed the relationship between cognitive impairment and the outcome of a robot-mediated upper limb rehabilitation intervention in a sample of 51 subacute stroke patients. Participants were enrolled and treated with a set of robotic and sensor-based devices. Before the intervention, patients underwent a cognitive assessment by means of the Oxford Cognitive Screen. To assess the effect of the 30-session rehabilitation intervention, patients were assessed twice with the following outcome measures: the Fugl-Meyer Assessment for Upper Extremity (FMA-UE), to evaluate motor function; the Upper limb Motricity Index (MI), to evaluate upper limb muscle strength; the Modified Barthel Index (mBI), to evaluate activities of daily living and mobility. We found that deficits in spatial attention and executive functions impacted the mBI improvement, while language, number processing, and spatial attention deficits reduced the gains in the FMA-UE. These results suggest the importance to evaluate the cognitive functions using an adequate tool in patients with stroke undergoing a robotic rehabilitation intervention.
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Bulboaca, Angelo, Ioana Stanescu, Gabriela Dogaru, Paul-Mihai Boarescu, and Adriana Elena Bulboaca. "The importance of visuo-motor coordination in upper limb rehabilitation after ischemic stroke by robotic therapy." Balneo Research Journal 10, no. 10.2 (2019): 82–89. http://dx.doi.org/10.12680/balneo.2019.244.
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Abstract Stroke is an acute hypoperfusion of cerebral parenchyma that most often leads to outstanding motor deficits that can last for the rest of the patient’s life. The purpose of the neurorehabilitation process is to limit, as far is possible for the motor deficits and to bring the patient to an independent life. A modern method consists in robotic neurorehabilitation which is more and more used, associated with functional electrical stimulation (FES). At the lower limb, the use of robotic rehabilitation associated with FES is already considered a success due to relatively stereotypical movements of the lower limb. In opposition, the upper limb is more difficult to rehabilitate due to its more complex movements. Therefore, eye-hand coordination (EHC) constitutes an important factor that is conditioning the rehabilitation progress. The eye-hand coordination can be brutally disturbed by stroke with critical consequences on motor-executive component. The EHC development depends on the interaction between a feedback complex and the prediction of the upper limb motility in the space, and requires the association between visual system, oculomotor system and hand motor system. We analyzed the stroke impact on this sensorial-motor functional integration and looked for a possible solution for the interruption of coordination between eyes and the movements of the superior limb. We consider that our study can contribute to a better understanding and to a faster rehabilitation of the motor deficit in the upper limb after stroke. Key words: stroke, rehabilitation, eye-hand coordination, robotic neurorehabilitation,
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Iosa, Marco, Alex Martino Cinnera, Fioravante Capone, et al. "Clinical Interpretation of Working Volume and Weight Support in Upper Limb Robotic Neurorehabilitation after Stroke." Applied Sciences 11, no. 24 (2021): 12123. http://dx.doi.org/10.3390/app112412123.
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In the past two decades, many studies reported the efficacy of upper limb robotic rehabilitation in patients after stroke, also in its chronic phase. Among the possible advantages of robotic therapy over conventional therapy are the objective measurements of kinematic and kinetic parameters during therapy, such as the spatial volume covered by the patient’s upper limb and the weight support provided by the robot. However, the clinical meaning and the usability of this information is still questioned. Forty patients with chronic stroke were enrolled in this study and assessed at the beginning of upper limb robotic therapy (Armeo® Power) and after two weeks (ten sessions) of therapy by recording the working volume and weight support provided by the robot and by administering six clinical scales to assess upper limb mobility, strength, spasticity, pain, neurological deficits, and independency. At baseline, the working volume significantly correlated with spasticity, whereas weight support significantly correlated with upper limb strength, pain, spasticity, and neurological deficits. After two weeks of robotic rehabilitation, all the clinical scores as well as the two parameters improved. However, the percentage changes in the working volume and weight support did not significantly correlate with any of the changes in clinical scores. These results suggest caution in using the robotic parameters as outcome measures because they could follow the general improvement of the patient, but complex relationships with clinical features are possible. Robotic parameters should be analyzed in combination with the clinical scores or other objective measures because they may be informative about therapy progression, and there is a need to combine their clinical, neuroscientific, and biomechanical results to avoid misleading interpretations.
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Ochi, Mitsuhiro, and Satoru Saeki. "Current Status and Issues on Upper Limb Robotic Rehabilitation." Japanese Journal of Rehabilitation Medicine 59, no. 4 (2022): 372–76. http://dx.doi.org/10.2490/jjrmc.59.372.
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Maciejasz, Paweł, Jörg Eschweiler, Kurt Gerlach-Hahn, Arne Jansen-Troy, and Steffen Leonhardt. "A survey on robotic devices for upper limb rehabilitation." Journal of NeuroEngineering and Rehabilitation 11, no. 1 (2014): 3. http://dx.doi.org/10.1186/1743-0003-11-3.
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MacClellan, Leah R., Douglas D. Bradham, Jill Whitall, et al. "Robotic upper-limb neurorehabilitation in chronic stroke patients." Journal of Rehabilitation Research and Development 42, no. 6 (2005): 717. http://dx.doi.org/10.1682/jrrd.2004.06.0068.
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MacClellan, Leah R., Douglas D. Bradham, Jill Whitall, et al. "Robotic upper-limb neurorehabilitation in chronic stroke patients." Journal of Rehabilitation Research and Development 42, no. 6 (2005): 717. http://dx.doi.org/10.1682/jrrd.2004.606.0068.
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Huang, Helen J., and Daniel P. Ferris. "Neural coupling between upper and lower limbs during recumbent stepping." Journal of Applied Physiology 97, no. 4 (2004): 1299–308. http://dx.doi.org/10.1152/japplphysiol.01350.2003.
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During gait rehabilitation, therapists or robotic devices often supply physical assistance to a patient's lower limbs to aid stepping. The expensive equipment and intensive manual labor required for these therapies limit their availability to patients. One alternative solution is to design devices where patients could use their upper limbs to provide physical assistance to their lower limbs (i.e., self-assistance). To explore potential neural effects of coupling upper and lower limbs, we investigated neuromuscular recruitment during self-driven and externally driven lower limb motion. Healthy subjects exercised on a recumbent stepper using different combinations of upper and lower limb exertions. The recumbent stepper mechanically coupled the upper and lower limbs, allowing users to drive the stepping motion with upper and/or lower limbs. We instructed subjects to step with 1) active upper and lower limbs at an easy resistance level (active arms and legs); 2) active upper limbs and relaxed lower limbs at easy, medium, and hard resistance levels (self-driven); and 3) relaxed upper and lower limbs while another person drove the stepping motion (externally driven). We recorded surface electromyography (EMG) from six lower limb muscles. Self-driven EMG amplitudes were always higher than externally driven EMG amplitudes ( P < 0.05). As resistance and upper limb exertion increased, self-driven EMG amplitudes also increased. EMG bursts during self-driven and active arms and legs stepping occurred at similar times. These results indicate that active upper limb movement increases neuromuscular activation of the lower limbs during cyclic stepping motions. Neurologically impaired humans that actively engage their upper limbs during gait rehabilitation may increase neuromuscular activation and enhance activity-dependent plasticity.
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Frisoli, Antonio, Michele Barsotti, Edoardo Sotgiu, Giuseppe Lamola, Caterina Procopio, and Carmelo Chisari. "A randomized clinical control study on the efficacy of three-dimensional upper limb robotic exoskeleton training in chronic stroke." Journal of NeuroEngineering and Rehabilitation 19, no. 1 (2022): 14. https://doi.org/10.1186/s12984-022-00991-y.
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<strong>Background : </strong>Although robotics assisted rehabilitation has proven to be effective in stroke rehabilitation, a limited functional improvements in Activities of Daily Life has been also observed after the administration of robotic training. To this aim in this study we compare the efficacy in terms of both clinical and functional outcomes of a robotic training performed with a multi-joint functional exoskeleton in goal-oriented exercises compared to a conventional physical therapy program, equally matched in terms of intensity and time. As a secondary goal of the study, it was assessed the capability of kinesiologic measurements—extracted by the exoskeleton robotic system—of predicting the rehabilitation outcomes using a set of robotic biomarkers collected at the baseline. <strong>Methods : </strong>A parallel-group randomized clinical trial was conducted within a group of 26 chronic post-stroke patients. Patients were randomly assigned to two groups receiving robotic or manual therapy. The primary outcome was the change in score on the upper extremity section of the Fugl-Meyer Assessment (FMA) scale. As secondary outcome a specifically designed bimanual functional scale, Bimanual Activity Test (BAT), was used for upper limb functional evaluation. Two robotic performance indices were extracted with the purpose of monitoring the recovery process and investigating the interrelationship between pre-treatment robotic biomarkers and post-treatment clinical improvement in the robotic group.<strong>Results : </strong>A significant clinical and functional improvements in both groups (p < 0.01) was reported. More in detail a significantly higher improvement of the robotic group was observed in the proximal portion of the FMA (p < 0.05) and in the reduction of time needed for accomplishing the tasks of the BAT (p < 0.01). The multilinear-regression analysis pointed out a significant correlation between robotic biomarkers at the baseline and change in FMA score (R<sup>2</sup> = 0.91, p < 0.05), suggesting their potential ability of predicting clinical outcomes.<strong>Conclusion : </strong>Exoskeleton-based robotic upper limb treatment might lead to better functional outcomes, if compared to manual physical therapy. The extracted robotic performance could represent predictive indices of the recovery of the upper limb. These results are promising for their potential exploitation in implementing personalized robotic therapy. <i>Clinical Trial Registration</i> clinicaltrials.gov, NCT03319992 Unique Protocol ID: RH-UL-LEXOS-10. Registered 20.10.2017, https://clinicaltrials.gov/ct2/show/NCT03319992
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Cong, Junjun. "Analysis of PID Control and Impedance Control Based on Upper Limb Rehabilitation Training Robot." Highlights in Science, Engineering and Technology 134 (March 30, 2025): 139–45. https://doi.org/10.54097/zr523868.
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In the process of upper limb rehabilitation training robots assisting patients in the training of the affected limbs, a stable and sensitive control system is a prerequisite to ensure efficient training results. On the basis of traditional proportional-integral-derivative (PID) control and impedance control, this paper aims to explore the current status of the application of fuzzy PID, neural network and human-computer interaction in robotic rehabilitation training, and analyze the current research with examples. Finally, this paper proposes a method that integrates human-computer interaction, fuzzy PID, neural network and deep learning. The method uses sensors to analyze the neuroelectrical signals, human-computer interaction forces, and language systems, respectively and uses FNN controllers for control and reinforcement learning. The method can provide a more stable, efficient and personalized rehabilitation training system for upper limb rehabilitation training robots. The optimization method proposed in this paper is helpful for the subsequent improvement of the upper limb rehabilitation training robot. However, the method proposed in this paper has the limitation that it is difficult to optimize the superposition of specific functions.
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Biffi, Emilia, Cristina Maghini, Beatrice Cairo, et al. "Movement Velocity and Fluidity Improve after Armeo®Spring Rehabilitation in Children Affected by Acquired and Congenital Brain Diseases: An Observational Study." BioMed Research International 2018 (November 18, 2018): 1–8. http://dx.doi.org/10.1155/2018/1537170.
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Background. Children with cerebral palsy (CP) and acquired brain injury (ABI) often exhibit upper limb impairment, with repercussions in their daily activities. Robotic rehabilitation may promote their functional recovery, but evidence of its effectiveness is often based on qualitative functional scales. The primary aim of the present work was to assess movement precision, velocity, and smoothness using numerical indices from the endpoint trajectory of Armeo®Spring. Secondly, an investigation of the effectiveness of robotic rehabilitation in CP and ABI children was performed. Methods. Upper limb functional changes were evaluated in children with CP (N=21) or ABI (N=22) treated with Armeo®Spring (20 45-minute sessions over 4 weeks) using clinical scales and numerical indices computed from the exoskeleton trajectory. Results. Functional scales (i.e., QUEST and Melbourne) were sensitive to changes produced by the treatment for the whole study group and for the two etiology-based subgroups (improvements above Minimal Clinically Importance Difference). Significant improvement was also observed in terms of velocity, fluidity, and precision of the movement through the numerical indices of kinematic performance. Differences in the temporal evolution of the motor outcome were highlighted between the ABI and CP subgroups, pointing toward adopting different rehabilitative protocols in these two populations. Conclusions. Robot-assisted upper limb rehabilitation seems to be a promising tool to promote and assess rehabilitation in children affected by acquired and congenital brain diseases.