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Pournajaf S, Goffredo M, Pellicciari L, Piscitelli D, Criscuolo S, Le Pera D, Damiani C, Franceschini M. Effect of balance training using virtual reality-based serious games in individuals with total knee replacement: A randomized controlled trial. Ann Phys Rehabil Med 2022; 65:101609. [PMID: 34839056 DOI: 10.1016/j.rehab.2021.101609] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 10/25/2021] [Accepted: 11/03/2021] [Indexed: 10/14/2022]
Abstract
BACKGROUND Virtual reality (VR) and serious games (SGs) are widespread in rehabilitation for many orthopedic and neurological diseases. However, few studies have addressed the effects of rehabilitation with VR-based SGs on clinical, gait, and postural outcomes in individuals with total knee replacement (TKR). OBJECTIVE The primary objective was the efficacy of balance training using non-immersive VR-based SGs compared to conventional therapy in TKR patients on the Time Up and Go test. Secondary objectives included the efficacy on clinical, gait, and postural outcomes. METHODS We randomly allocated 56 individuals with unilateral TKR to the experimental group (EG) or control group (CG) for 15 sessions (45 min; 5 times per week) of non-immersive VR-based SGs or conventional balance training, respectively. The primary outcome was functional mobility measured by the Timed Up and Go test; secondary outcomes were walking speed, pain intensity, lower-limb muscular strength, independence in activities of daily living as well as gait and postural parameters. RESULTS We found significant within-group differences in all clinical outcomes and in a subset of gait (p<0.0001) and postural (p ≤ 0.05) parameters. Analysis of the stance time of the affected limb revealed significant between-group differences (p = 0.022): post-hoc analysis revealed within-group differences in the EG (p = 0.002) but not CG (p = 0.834). We found no significant between-group differences in other outcomes. CONCLUSIONS Balance training with non-immersive VR-based SGs can improve clinical, gait, and postural outcomes in TKR patients. It was not superior to the CG findings but could be considered an alternative to the conventional approach and can be added to a regular rehabilitation program in TKR patients. The EG had a more physiological duration of the gait stance phase at the end of the treatment than the CG. CLINICALTRIALS GOV: NCT03454256.
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Affiliation(s)
- Sanaz Pournajaf
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Michela Goffredo
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Leonardo Pellicciari
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy.
| | - Daniele Piscitelli
- School of Physical and Occupational Therapy, McGill University, Montreal, Canada; School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
| | - Simone Criscuolo
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Domenica Le Pera
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Carlo Damiani
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Marco Franceschini
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy; Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, Rome, Italy
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Defi IR, Iskandar S, Charismawati S, Turnip A, Novita D. Healthcare Workers’ Point of View on Medical Robotics During COVID-19 Pandemic – A Scoping Review. Int J Gen Med 2022; 15:3767-3777. [PMID: 35418776 PMCID: PMC8995177 DOI: 10.2147/ijgm.s355734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/25/2022] [Indexed: 11/26/2022] Open
Abstract
COVID-19 affected how healthcare workers interact with patients. Medical technology and robotics are developed in hospital settings to limit human contact. The aim of this review is to elucidate what kind of medical robotics is required for healthcare workers during COVID-19 pandemic. This review was obtained from electronic databases such as Google Scholar, PubMed, EBSCO, and Cochrane reviews were searched for articles using keywords such as “healthcare professional” OR “health worker” AND “COVID-19” AND “robot application” OR “robotics” OR “health technology” AND “needs assessment” OR “expectation” OR “perception” published during 2020 to 2021. Inclusion criteria were full-text articles related to assessment of healthcare workers’ need for medical robotics during COVID-19 pandemics. Exclusion criteria included abstracts, duplicate articles, blogs, news articles, promotional brochures, and conference proceedings. A total of 13,692 articles were identified through the search engines (PubMed 179, Cochrane Library 1300, EBSCO 13, Google Scholar 12,200). Five full-text articles fulfilled the inclusion criteria. Determining robotic functions is important to healthcare workers who will be user of such medical technology. This review divided robotic functions into medical, operational, movement, and social functions. Healthcare workers’ demands for robotics were also influenced by the types of robots, such as examination robots, robot-based sample test and medicine production, surgery and rehabilitation robots, disinfection and cleaning robots, delivery and logistic robot, telemedicine, and telepresence robots. Medical robotics is required for healthcare workers during the COVID-19 pandemic. The highest demands for medical robotics functions include cardiac measurements and oxygen saturation monitoring (medical functions); examination record delivery, video and image play, and medical information delivery (operational functions); and the ability to recognize and avoid obstacles (movement functions). Disinfection and cleaning robots were the type of robots with the highest demand among healthcare workers.
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Affiliation(s)
- Irma Ruslina Defi
- Department of Physical Medicine and Rehabilitation, Hasan Sadikin General Hospital/Faculty of Medicine, Universitas Padjadjaran, Bandung, Jawa Barat, Indonesia
- Correspondence: Irma Ruslina Defi, Department of Physical Medicine and Rehabilitation, Hasan Sadikin General Hospital/Faculty of Medicine, Universitas Padjadjaran, Jl. Pasteur No. 38, Bandung, Jawa Barat, 40161, Indonesia, Tel +62 (22) 203 4989, Email
| | - Shelly Iskandar
- Department of Psychiatry, Hasan Sadikin General Hospital/Faculty of Medicine, Universitas Padjadjaran, Bandung, Jawa Barat, Indonesia
| | - Septiana Charismawati
- Department of Physical Medicine and Rehabilitation, Hasan Sadikin General Hospital/Faculty of Medicine, Universitas Padjadjaran, Bandung, Jawa Barat, Indonesia
| | - Arjon Turnip
- Department of Electrical Engineering, Faculty of Mathematics and Natural Sciences, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
| | - Dessy Novita
- Department of Electrical Engineering, Faculty of Mathematics and Natural Sciences, Universitas Padjadjaran, Sumedang, Jawa Barat, Indonesia
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Goffredo M, Pournajaf S, Proietti S, Gison A, Posteraro F, Franceschini M. Retrospective Robot-Measured Upper Limb Kinematic Data From Stroke Patients Are Novel Biomarkers. Front Neurol 2022; 12:803901. [PMID: 34992576 PMCID: PMC8725786 DOI: 10.3389/fneur.2021.803901] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 11/17/2021] [Indexed: 02/06/2023] Open
Abstract
Background: The efficacy of upper-limb Robot-assisted Therapy (ulRT) in stroke subjects is well-established. The robot-measured kinematic data can assess the biomechanical changes induced by ulRT and the progress of patient over time. However, literature on the analysis of pre-treatment kinematic parameters as predictive biomarkers of upper limb recovery is limited. Objective: The aim of this study was to calculate pre-treatment kinematic parameters from point-to-point reaching movements in different directions and to identify biomarkers of upper-limb motor recovery in subacute stroke subjects after ulRT. Methods: An observational retrospective study was conducted on 66 subacute stroke subjects who underwent ulRT with an end-effector robot. Kinematic parameters were calculated from the robot-measured trajectories during movements in different directions. A Generalized Linear Model (GLM) was applied considering the post-treatment Upper Limb Motricity Index and the kinematic parameters (from demanding directions of movement) as dependent variables, and the pre-treatment kinematic parameters as independent variables. Results: A subset of kinematic parameters significantly predicted the motor impairment after ulRT: the accuracy in adduction and internal rotation movements of the shoulder was the major predictor of post-treatment Upper Limb Motricity Index. The post-treatment kinematic parameters of the most demanding directions of movement significantly depended on the ability to execute elbow flexion-extension and abduction and external rotation movements of the shoulder at baseline. Conclusions: The multidirectional analysis of robot-measured kinematic data predicts motor recovery in subacute stroke survivors and paves the way in identifying subjects who may benefit more from ulRT.
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Affiliation(s)
- Michela Goffredo
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Sanaz Pournajaf
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Stefania Proietti
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Annalisa Gison
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy
| | - Federico Posteraro
- Rehabilitation Department, Versilia Hospital, Azienda Unità Sanitaria Locale (AUSL) Northwest Tuscany, Camaiore, Italy
| | - Marco Franceschini
- Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Roma, Rome, Italy.,Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, Rome, Italy
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Ghosh M, Nosaka K, Whitehead L, Nosaka K. Identifying key elements to assess patient's acceptability of neurorehabilitation in stroke survivors - a Delphi method. Disabil Rehabil 2021; 44:6258-6266. [PMID: 34383623 DOI: 10.1080/09638288.2021.1960438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Assessing patient acceptability of treatment is a clinical concern. No guidance exists to determine the best way to measure acceptability in stroke neurorehabilitation. This study identifies key elements to measure patient's acceptance of stroke neurorehabilitation by establishing expert consensus. MATERIALS AND METHODS A four-phase Delphi method with a three-round electronic-based survey was conducted. Experts were considered as stroke survivors or their caregivers and professionals in stroke neurorehabilitation. A twenty-five-item list was sourced from a literature review and discussion with a consumer panel (n = 22). In Round-1 (n = 118) and Round-2 (n = 80), experts ranked the items on a five-point scale. Consensus levels were validated by a Validation group in Round-3 (n = 50). Validity of the results was considered if consensus reached ≥70%, a non-bimodal pattern of response central tendency, SD in Round-2 was lower than that in Round-1, and the agreement scores of responses were similar between all rounds. RESULTS In Round-1&2 and Round-3, 77.5% (n = 62) and 74.0% (n = 37) respectively, of the respondents were professionals, 20.0% (n = 16, n = 10 respectively) were either stroke survivors or caregivers, and 2.57% (n = 2) and 6.0% (n = 3) respectively were professionals who themselves were stroke survivors or caregivers. The key elements which met all priori criteria are: Goal setting, Measurable progress, Functional improvement, Challenging, Motivation, Interactive, Communications with health professionals, Knowledge of treatment, and No risks. CONCLUSIONS Patient's acceptance is crucial to developing the appropriate neurorehabilitation interventions. Future clinical trials should consider these items when measuring patient's acceptance of stroke neurorehabilitation interventions during the development and evaluation phases.Implications for rehabilitationAssessing patient acceptability of treatment is a clinical concern in stroke neurorehabilitation.This study has identified nine key elements to assess patient acceptability of stroke neurorehabilitation. These key elements are: Goal setting, Measurable progress, Functional improvement, Challenging, Motivation, Interactive, Communications with health professionals, Knowledge of treatment, and No risks.Professionals should consider these elements when measuring patient's acceptance of an intervention during the development, piloting, evaluation, and implementation phases.These findings provide a framework in designing neurorehabilitation programs and clinical trials on acceptance of and adherence to treatment in stroke survivors.
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Affiliation(s)
- Manonita Ghosh
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.,School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia
| | - Kaoru Nosaka
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia.,School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia
| | - Lisa Whitehead
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Australia
| | - Kazunori Nosaka
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
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Kayabinar B, Alemdaroğlu-Gürbüz İ, Yilmaz Ö. The effects of virtual reality augmented robot-assisted gait training on dual-task performance and functional measures in chronic stroke: a randomized controlled single-blind trial. Eur J Phys Rehabil Med 2021; 57:227-237. [PMID: 33541040 DOI: 10.23736/s1973-9087.21.06441-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Many studies have demonstrated positive effects of virtual reality (VR) and robot-assisted gait training (RAGT) on balance, gait skills, functional capacity, active participation, and motivation in stroke patients, previously. However, the effects of VR augmented RAGT on dual-task performance which requires simultaneous use of motor and cognitive parameters have not been investigated. AIM To primarily investigate the effects of virtual reality (VR) augmented robot-assisted gait training (RAGT) on dual-task performance and secondarily, functional measurements in chronic stroke patients. DESIGN A randomized, single-blind trial. SETTING Inpatient rehabilitation center. POPULATION The study included 30 chronic stroke patients aged between 40-65 with the level of ≥3 from Functional Ambulation Classification and ≥24 from the Standardized Mini Mental State Examination. METHODS Fifteen patients in the study group received VR augmented RAGT and 15 patients in the control group received only RAGT during 12 sessions (six weeks). All patients received neurodevelopmental therapy in addition to their treatments, simultaneously. To evaluate dual-task performance, motor and cognitive tasks were given in addition to the 10 Meter Walk (first motor task), and durations were recorded in seconds. Functional measures such as Functional Gait Assessment, Rivermead Mobility Index, Berg Balance Scale, Fall Activity Scale International, and the Functional Independence Measure for gait, mobility, balance, fear of falling, and independence in daily living activities were also applied, consecutively. RESULTS The mean age of the study population was 57.93±5.91. After the treatment, single and dual-task gait speeds and cognitive dual-task performance increased in the study group (P<0.05), while no change was observed in the control group (P>0.05). No significant difference was detected between the groups in terms of all assessments after the treatment (P>0.05). CONCLUSIONS This study demonstrated that VR augmented RAGT improved dual-task gait speeds and dual-task performance of chronic stroke patients; however, there were no difference between the two groups after the treatment. Although functional improvements were determined with VR combined RAGT approach, it was not superior to RAGT only treatment. CLINICAL REHABILITATION IMPACT The results of current study suggest the simultaneous use of VR as an adjunct therapy method to the functional training to obtain functional gains in ambulant patients with chronic stroke.
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Affiliation(s)
- Büşra Kayabinar
- Department of Therapy and Rehabilitation, Kozaklı Vocational School, Nevşehir Hacı Bektaş Veli University, Nevşehir, Turkey -
| | - İpek Alemdaroğlu-Gürbüz
- Department of Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Öznur Yilmaz
- Department of Physiotherapy and Rehabilitation, Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
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Gait Recovery with an Overground Powered Exoskeleton: A Randomized Controlled Trial on Subacute Stroke Subjects. Brain Sci 2021; 11:brainsci11010104. [PMID: 33466749 PMCID: PMC7830339 DOI: 10.3390/brainsci11010104] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/09/2021] [Accepted: 01/11/2021] [Indexed: 12/26/2022] Open
Abstract
Background: Overground Robot-Assisted Gait Training (o-RAGT) provides intensive gait rehabilitation. This study investigated the efficacy of o-RAGT in subacute stroke subjects, compared to conventional gait training. Methods: A multicenter randomized controlled trial was conducted on 75 subacute stroke subjects (38 in the Experimental Group (EG) and 37 in the Control Group (CG)). Both groups received 15 sessions of gait training (5 sessions/week for 60 min) and daily conventional rehabilitation. The subjects were assessed at the beginning (T1) and end (T2) of the training period with the primary outcome of a 6 Minutes Walking Test (6MWT), the Modified Ashworth Scale of the Affected lower Limb (MAS-AL), the Motricity Index of the Affected lower Limb (MI-AL), the Trunk Control Test (TCT), Functional Ambulation Classification (FAC), a 10 Meters Walking Test (10MWT), the modified Barthel Index (mBI), and the Walking Handicap Scale (WHS). Results: The 6MWT increased in both groups, which was confirmed by both frequentist and Bayesian analyses. Similar outcomes were registered in the MI-AL, 10MWT, mBI, and MAS-AL. The FAC and WHS showed a significant number of subjects improving in functional and community ambulation in both groups at T2. Conclusions: The clinical effects of o-RAGT were similar to conventional gait training in subacute stroke subjects. The results obtained in this study are encouraging and suggest future clinical trials on the topic.
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ÇEKMECE Ç, SADE I. İnmeli Hastalarda Robotik Rehabilitasyonun El Fonksiyonları ve Günlük Yaşam Aktiviteleri Üzerine Etkisi. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2021. [DOI: 10.30934/kusbed.756705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Jang SM, Hong YJ, Lee K, Kim S, Chiến BV, Kim J. Assessment of User Needs for Telemedicine Robots in a Developing Nation Hospital Setting. Telemed J E Health 2020; 27:670-678. [PMID: 33095109 DOI: 10.1089/tmj.2020.0215] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: This study aimed to investigate the needs of medical users of telemedicine robots to encourage international cooperation and development. Introduction: As the use of telemedicine expands, it is necessary to develop new systems, including robots, which consider the perceived needs of end users to ensure quality of care and positive user experience. Materials and Methods: A survey of medical staff was conducted at a hospital in Vietnam to investigate users' needs for a telemedicine robot system. Results: A total of 117 medical staff participated in the survey, comprising 74 nurses and 43 doctors. The most preferred type of robot was the humanoid type, female version, and the preferred mobility type was walking. The most requested functions were "heart rate measurement," "recognition and avoidance of obstacles," "oxygen saturation measurement," "Transmitting Medical Information," and "wireless system." In addition, the most important considerations in developing a robot system were "cleaning the robot to prevent infection," followed by "convenience of operation." Discussion: The results of this study largely supported those of similar previous studies. However, some differences may reflect the cultural variation or differences in the level of medical development across contexts. Conclusion: To apply robotic systems to help develop telemedicine internationally, it is essential to develop a robot that reflects actual users' needs. If relevant matters such as legal issues are considered and addressed, an appropriate robotic telemedicine system can be successfully developed. Consequently, telemedicine can improve the quality of local medical care, strengthen practitioner capacity, and improve outcomes.
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Affiliation(s)
- Seon Mi Jang
- Health Management Division, Korea Armed Forces Nursing Academy, Daejeon, South Korea
| | - Yeong-Joo Hong
- Korea Health Industry Development Institute, Chungcheongbuk-do, South Korea
| | - Kyounga Lee
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, South Korea
| | - Sukwha Kim
- Department of Reconstructive Plastic Surgery, College of Medicine, Seoul National University, Seoul, South Korea
| | - Bùi Văn Chiến
- Department of International Relations, HaiPhong Children's Hospital, Hai Phong, Vietnam
| | - Jeongeun Kim
- College of Nursing, Seoul National University, Seoul, South Korea.,Research Institute of Nursing Science, Seoul National University, Seoul, South Korea
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Summa S, Schirinzi T, Bernava GM, Romano A, Favetta M, Valente EM, Bertini E, Castelli E, Petrarca M, Pioggia G, Vasco G. Development of SaraHome: A novel, well-accepted, technology-based assessment tool for patients with ataxia. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 188:105257. [PMID: 31846831 DOI: 10.1016/j.cmpb.2019.105257] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/20/2019] [Accepted: 11/30/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Early onset ataxias (EOAs) are a heterogeneous group of neurological conditions, responsible for severe motor disability in paediatric age, which still lack reliable outcome measures. Available scales to assess ataxia, such as the Scale for Assessment and Rating of Ataxia (SARA), are based on subjective assessment of specific motor and language tasks by an examiner, and therefore is age dependent and lacks accuracy in detecting small variations in disease severity. In last years, novel technologies, including computer interfaces and videogames, have emerged for clinical applications and the advent of Internet of Medical Things and of Information Communication Technology have allowed the remote control of such technologies. This pilot study describes a newly developed tool (SaraHome) for the assessment at home of EOA evaluating its feasibility and acceptability on a small sample of children. METHODS Ten EOA children and ten caregivers have been enrolled for a preliminary outpatient evaluation. The Microsoft Kinect 2.0 and Leap Motion Controller (LMC) connected to a personal computer with an ad hoc software have been set-up, for the acquisition of standardized motor tasks performed by the patients with the caregivers' assistance. Acceptance and practicability have been tested by QUEST 2.0 and IMI questionnaires in caregivers and patients respectively. RESULTS The SaraHome software was developed, based on a collection of services provided by a complex architecture that consists of a Restful interface, which enables to access a series of plugins for the execution of different tasks. A graphical user interface allows the acquisition of the patient movements while performing a motor task. A protocol of standard tasks inspired by SARA was established, and a system of video-assisted instruction provided. The set-up for the optimal acquisition of such protocol by Kinect and LMC has been defined. Both patients and caregivers accomplished the SaraHome assessment with good feedback at the technology acceptance questionnaires. CONCLUSIONS SaraHome represents a newly developed tool for the assessment of ataxia in patients, resulting from the integration of low-cost and easy-accessible technologies. This pilot application highlighted the feasibility and the acceptability of the system, suggesting the potential use in clinical practice.
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Affiliation(s)
- Susanna Summa
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.
| | - Tommaso Schirinzi
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy; Department of Systems Medicine, University of Roma Tor Vergata, Rome, Italy.
| | - Giuseppe Massimo Bernava
- Institute for Biomedical Research and Innovation (IRIB-CNR), Via Torre Bianca, Mortelle, Istituto Marino, 98164 Messina, Italy.
| | - Alberto Romano
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.
| | - Martina Favetta
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.
| | - Enza Maria Valente
- Department of Molecular Medicine, Unit of Genetics, Università degli studi di Pavia, Pavia, Italy; IRCCS Mondino Foundation, Pavia, Italy.
| | - Enrico Bertini
- Unit of Neuromuscolar and Neurodegenerative Diseases, Department of Neurosciences, IRCCS Bambino Gesù Children's Hospital, Rome, Italy.
| | - Enrico Castelli
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.
| | - Maurizio Petrarca
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB-CNR), Via Torre Bianca, Mortelle, Istituto Marino, 98164 Messina, Italy.
| | - Gessica Vasco
- MARlab, Neuroscience and Neurorehabilitation Department, Bambino Gesù Children's Hospital - IRCCS, Rome, Italy.
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Isaković MS, Savić AM, Konstantinović LM, Popović MB. Validation of computerized square-drawing based evaluation of motor function in patients with stroke. Med Eng Phys 2019; 71:114-120. [PMID: 31345670 DOI: 10.1016/j.medengphy.2019.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 04/04/2019] [Accepted: 06/07/2019] [Indexed: 12/01/2022]
Abstract
Human-administered clinical scales are commonly used for quantifying motor performance and determining the course of therapy in post-stroke individuals. Computerized methods aim to improve consistency, resolution and duration of patients' evaluation. The objective of this study was to test the validity of computerized square-drawing test (DT) for assessment of shoulder and elbow function by using novel set of DT-based kinematic measures and explore their relation with Wolf Motor Function Test (WMFT) scoring. Forty-seven stroke survivors were tested before and after the rehabilitation program. DT involved drawing a square in horizontal plane using a mechanical manipulandum and a digitizing board. Depending on the initial classification of patients into low or high performance groups, the two different outcome metrics were derived from DT kinematic data for evaluation of each group. Linear regression models applied to map DT outcome values to WMFT scores for both groups resulted with high correlation coefficients and low mean absolute prediction error. In conclusion, we have identified a set of kinematic measures suitable for fast and objective motor function evaluation and functional classification, strongly correlating with WMFT score in post-stroke individuals. The results support validation of square-drawing motor function assessment, encouraging its use in clinical settings.
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Affiliation(s)
- Milica S Isaković
- School of Electrical Engineering, University of Belgrade, Bulevar kralja Aleksandra 73, 11000 Belgrade, Serbia; Tecnalia, Health Division, Mikeletegi Pasealekua 1-3, 20009 Donostia-San Sebastian, Spain.
| | - Andrej M Savić
- School of Electrical Engineering, University of Belgrade, Bulevar kralja Aleksandra 73, 11000 Belgrade, Serbia; Tecnalia, Health Division, Mikeletegi Pasealekua 1-3, 20009 Donostia-San Sebastian, Spain
| | - Ljubica M Konstantinović
- Faculty of Medicine, University of Belgrade, Dr Subotića 8, 11000 Belgrade, Serbia; Clinic for Rehabilitation "Dr Miroslav Zotović", Sokobanjska 13, 11000 Belgrade, Serbia
| | - Mirjana B Popović
- School of Electrical Engineering, University of Belgrade, Bulevar kralja Aleksandra 73, 11000 Belgrade, Serbia; Institute for Medical Research, University of Belgrade, Dr Subotića 4, 11000 Belgrade, Serbia
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Alvarez-Perez MG, Garcia-Murillo MA, Cervantes-Sánchez JJ. Robot-assisted ankle rehabilitation: a review. Disabil Rehabil Assist Technol 2019; 15:394-408. [PMID: 30856032 DOI: 10.1080/17483107.2019.1578424] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Aim: The aim of this review paper is to summarize recent developments and research in robotics, relevant to the field of ankle rehabilitation, to overview new findings and determine the actual state of the art.Method: The literature search was performed using scientific and medical databases (Scopus, PubMed and Web of Science) and other websites related to robots used in the area of ankle rehabilitation, analysing studies from 1950s to present. Information about the mechanical and kinematic specifications, actuation and stage of development was extracted from the selected literature.Results: Several types of rehabilitation robots have been considered, and they were classified depending on their architecture and design features. We we found that, regardless of the differences in architectures, only a few of them have been commercialized. The majority of rehabilitation robots designs allows plantarflexion-dorsiflexion movements. Unless some exceptions, most of the wearable robots do not allow the adduction-abduction movement. Neither the physical appearance of the robot nor the user's perception towards it has not regularly been taken into account in the design stage. This limits the possibility of successful commercialization.Conclusions: Up to the present moment, the main challenges in the field of robot rehabilitation are the lack of unique rehabilitation protocols capable to fulfil the needs of all types of patients and the additional resources to measure the effectiveness of proposals that have not yet been commercialized. Nonetheless, we have mentioned above three areas were the challenges in design are more pressing. The first one is the robot architecture, which still presents some incommodities nowadays to emulate the ankle joint movement in a natural way. Thus, the displacements experienced by the axes in the joint must be adaptable to each patient and a wide range of pathologies. Moreover, many proposals are not been conceived to the purpose of commercialization, and even less to become an object of personal use.Implications for rehabilitationThis review states that the use of robotic devices for ankle rehabilitation is a consolidated paradigm in the ankle's rehabilitation.Platform-based robots allow to do complex and specialized spatial movements and these architectures endow the device with high stiffness, a balanced force distribution and better adaptability to the mechanical properties of human ankle joints. Unless some exceptions, most of the wearable robots do not allow the adduction-abduction movement.For a full integration of these technologies in the ankle's rehabilitation field, more clinical evaluations are needed.Regardless of the potential of robotic devices in rehabilitation, only a few of them have been commercialized.
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Affiliation(s)
- Marian G Alvarez-Perez
- Mechanical Engineering Department, DICIS, University of Guanajuato, Salamanca, Mexico GTO
| | - Mario A Garcia-Murillo
- Mechanical Engineering Department, DICIS, University of Guanajuato, Salamanca, Mexico GTO
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Goffredo M, Guanziroli E, Pournajaf S, Gaffuri M, Gasperini G, Filoni S, Baratta S, Damiani C, Franceschini M, Molteni F. Overground wearable powered exoskeleton for gait training in subacute stroke subjects: clinical and gait assessments. Eur J Phys Rehabil Med 2019; 55:710-721. [PMID: 30723189 DOI: 10.23736/s1973-9087.19.05574-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Wearable powered exoskeletons provide intensive overground gait training with patient's active participation: these features promote a successful active motor relearning of ambulation in stroke survivors. AIM The aim of this study was to investigate the feasibility and the clinical effects of an overground exoskeleton-assisted gait training (OEAGT) in subacute stroke patients. DESIGN Prospective, pilot pre-post, open label, non-randomized experimental study. SETTING Four Italian neurological rehabilitation centers. POPULATION Forty-eight subacute stroke patients were enrolled. Two patients dropped out because of medical problems. Data analysis was conducted on 46 subjects (56.84±14.29 years; 27 male; 29 ischemic; 24 left hemiparesis). METHODS Patients underwent 15±2 sessions (60 min/session, 3-5 times/week) of OEAGT. Clinical and gait assessments were performed at the beginning (T1) and at the end (T2) of the training period: modified Barthel Index (BI), modified Ashworth Scale at Hip (MAS-H), Knee (MAS-K), and Ankle (MAS-A) level, Motricity Index (MI), Trunk Control Test (TCT), Functional Ambulation Classification (FAC), Walking Handicap Scale (WHS), 10-Meter Walking Test (10MWT), 6-Minute Walking Test (6mWT), Timed Up-and-Go test (TUG). The Technology Acceptance Model (TAM) questionnaire evaluated the acceptance of OEAGT by patients. Data stratification was performed using the time post the acute event and the onset of rehabilitation treatment, and the MI at T1. Wilcoxon's test (P<0.05) was used. RESULTS All clinical scales significantly improved at T2; no statistically significant changes were reported for MAS-H, MAS-K, MAS-A. The 69.57% patients were able to walk at T1; 17.39% were not able to walk at T1 but regained ambulation at T2; and 13.04% were not able to walk at either T1 or T2. The ambulant patients showed a statistical improvement in speed measured during the 10MWT and in the distance covered over a time of 6 minutes (6mWT). The results from the TAM questionnaire showed that all subjects perceived the OEAGT positively. The data stratification analysis suggests that the OEAGT does not have any restriction of use. CONCLUSIONS The OEAGT improved the clinical and gait outcomes in subacute patients. Randomized studies on larger samples are needed to confirm these data and to assess the efficacy of OEAGT. CLINICAL REHABILITATION IMPACT Introduce innovative rehabilitation strategies based on customized OEAGT.
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Affiliation(s)
- Michela Goffredo
- Department of Neurorehabilitation, IRCCS San Raffaele Pisana, Rome, Italy -
| | - Eleonora Guanziroli
- Villa Beretta Rehabilitation Center, Valduce Hospital, Costa Masnaga, Lecco, Italy
| | - Sanaz Pournajaf
- Department of Neurorehabilitation, IRCCS San Raffaele Pisana, Rome, Italy
| | - Marina Gaffuri
- Villa Beretta Rehabilitation Center, Valduce Hospital, Costa Masnaga, Lecco, Italy
| | - Giulio Gasperini
- Villa Beretta Rehabilitation Center, Valduce Hospital, Costa Masnaga, Lecco, Italy
| | - Serena Filoni
- Padre Pio Non-profit Foundation and Rehabilitation Centers, San Giovanni Rotondo, Foggia, Italy
| | - Silvano Baratta
- Department of Intensive Neuromotor Rehabilitation, USL Umbria 2, Trevi, Perugia, Italy
| | - Carlo Damiani
- Department of Neurorehabilitation, IRCCS San Raffaele Pisana, Rome, Italy
| | - Marco Franceschini
- Department of Neurorehabilitation, IRCCS San Raffaele Pisana, Rome, Italy.,San Raffaele University, Rome, Italy
| | - Franco Molteni
- Villa Beretta Rehabilitation Center, Valduce Hospital, Costa Masnaga, Lecco, Italy
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Ballantyne R, Rea PM. A Game Changer: 'The Use of Digital Technologies in the Management of Upper Limb Rehabilitation'. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2019; 1205:117-147. [PMID: 31894574 DOI: 10.1007/978-3-030-31904-5_9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Hemiparesis is a symptom of residual weakness in half of the body, including the upper extremity, which affects the majority of post stroke survivors. Upper limb function is essential for daily life and reduction in movements can lead to tremendous decline in quality of life and independence. Current treatments, such as physiotherapy, aim to improve motor functions, however due to increasing NHS pressure, growing recognition on mental health, and close scrutiny on disease spending there is an urgent need for new approaches to be developed rapidly and sufficient resources devoted to stroke disease. Fortunately, a range of digital technologies has led to revived rehabilitation techniques in captivating and stimulating environments. To gain further insight, a meta-analysis literature search was carried out using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) method. Articles were categorized and pooled into the following groups; pro/anti/neutral for the use of digital technology. Additionally, most literature is rationalised by quantitative and qualitative findings. Findings displayed, the majority of the inclusive literature is supportive of the use of digital technologies in the rehabilitation of upper extremity following stroke. Overall, the review highlights a wide understanding and promise directed into introducing devices into a clinical setting. Analysis of all four categories; (1) Digital Technology, (2) Virtual Reality, (3) Robotics and (4) Leap Motion displayed varying qualities both-pro and negative across each device. Prevailing developments on use of these technologies highlights an evolutionary and revolutionary step into utilizing digital technologies for rehabilitation purposes due to the vast functional gains and engagement levels experienced by patients. The influx of more commercialised and accessible devices could alter stroke recovery further with initial recommendations for combination therapy utilizing conventional and digital resources.
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Affiliation(s)
- Rachael Ballantyne
- Anatomy Facility, Thomson Building, School of Life Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Paul M Rea
- Anatomy Facility, Thomson Building, School of Life Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK.
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Xu G, Gao X, Pan L, Chen S, Wang Q, Zhu B, Li J. Anxiety detection and training task adaptation in robot-assisted active stroke rehabilitation. INT J ADV ROBOT SYST 2018. [DOI: 10.1177/1729881418806433] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In the therapist-centered rehabilitation program, the experienced therapists can observe emotional changes of stroke patients and make corresponding decisions on their intervention strategies. Likewise, robotic-assisted stroke rehabilitation systems will be more appreciated if they can also perceive emotional states of the stroke patients and enhance their engagements by exploring emotion-based dynamic difficulty adjustments. Nevertheless, few research have addressed this issue. A two-phase pilot study with anxiety as the target emotion state was conducted in this article. In phase I, the motor performances and the physiological responses to the stroke subject’s anxiety with high, medium, and low intensities were statistically analyzed, and anxiety models with three intensities were offline developed using support vector machine–based classifiers. In phase II, anxiety-based closed-loop robot-aided training task adaptation and its impacts on patient–robot interaction engagements were explored. As a comparison, a performance-based robotic behavior adaptation was also implemented. Experimental results with 12 recruited stroke patients conducted on the Barrett WAMTM manipulator verified that the rehabilitation robot can implicitly recognize the anxiety intensities of the stroke survivors and the anxiety-based real-time robotic behavior adaptation shows more engagements in the human–robot interactions.
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Affiliation(s)
- Guozheng Xu
- Robotics Information Sensing and Control Research Institute, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Xiang Gao
- Robotics Information Sensing and Control Research Institute, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Lizheng Pan
- School of Mechanical Engineering, Changzhou University, Changzhou, China
| | - Sheng Chen
- Robotics Information Sensing and Control Research Institute, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Qiang Wang
- Robotics Information Sensing and Control Research Institute, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Bo Zhu
- Robotics Information Sensing and Control Research Institute, Nanjing University of Posts and Telecommunications, Nanjing, China
| | - Jinfei Li
- Department of Rehabilitation Medicine, Nanjing Tongren Hospital, Nanjing, China
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15
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A Systematic Review on Existing Measures for the Subjective Assessment of Rehabilitation and Assistive Robot Devices. JOURNAL OF HEALTHCARE ENGINEERING 2018; 2016:1048964. [PMID: 27196802 PMCID: PMC5058569 DOI: 10.1155/2016/1048964] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2016] [Accepted: 04/06/2016] [Indexed: 11/29/2022]
Abstract
The objective of the current study is to identify and classify outcome measures currently used for the assessment of rehabilitation or assistive robot devices. We conducted a systematic review of the literature using PubMed, MEDLINE, CIRRIE, and Scopus databases for studies that assessed rehabilitation or assistive robot devices from 1980 through January 2016. In all, 31 articles met all inclusion criteria. Tailor-made questionnaires were the most commonly used tool at 66.7%, while the great majority (93.9%) of the studies used nonvalidated instruments. The study reveals the absence of a standard scale which makes it difficult to compare the results from different researchers. There is a great need, therefore, for a valid and reliable instrument to be available for use by the intended end users for the subjective assessment of robot devices. The study concludes by identifying two scales that have been validated in general assistive technology devices and could support the scope of subjective assessment in rehabilitation or assistive robots (however, with limited coverage) and a new one called PYTHEIA, recently published. The latter intends to close the gap and help researchers and developers to evaluate, assess, and produce products that satisfy the real needs of the end users.
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Mazzoleni S, Battini E, Crecchi R, Dario P, Posteraro F. Upper limb robot-assisted therapy in subacute and chronic stroke patients using an innovative end-effector haptic device: A pilot study. NeuroRehabilitation 2018; 42:43-52. [PMID: 29400670 DOI: 10.3233/nre-172166] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Significant results have been shown when an upper limb robot-assisted rehabilitation is delivered to stroke patients. OBJECTIVE To evaluate the effects of upper limb robot-assisted rehabilitation on motor recovery in stroke patients who underwent a treatment based on a haptic device. METHODS Thirty-nine stroke patients (twenty-three subacute and sixteen chronic) underwent rehabilitation training by using MOTORE/Armotion haptic system. Thirteen healthy subjects were recruited for comparison purpose.The following clinical outcome measures were used: Chedoke-McMaster Stroke Assessment, Modified Ashworth Scale (MAS), Fugl-Meyer Assessment (FM), Medical Research Council, Motricity Index (MI), Box and Block Test (B&B) and Modified Barthel Index (mBI).The following parameters were computed: mean speed, maximum speed, mean time, path length, normalized jerk, mean force, mean error, mean energy expenditure and active patient-robot interaction percentage.The assessments were carried-out before and after treatment. RESULTS Significant changes were observed in both groups in the FM, MI, B&B and mean speed. Significant changes were observed in mBI, mean time, mean force, mean energy expenditure and active patient-robot interaction percentage in subacute stroke patients. In chronic stroke patients significant changes were found on the MAS-elbow. CONCLUSIONS The haptic device used is at least as effective as an existing device used in similar studies.
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Affiliation(s)
- S Mazzoleni
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Polo Sant'Anna Valdera, Pontedera (Pisa), Italy.,Rehabilitation Bioengineering Laboratory, Auxilium Vitae Rehabilitation Center, Volterra, Italy
| | - E Battini
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Polo Sant'Anna Valdera, Pontedera (Pisa), Italy.,Rehabilitation Bioengineering Laboratory, Auxilium Vitae Rehabilitation Center, Volterra, Italy
| | - R Crecchi
- Rehabilitation Bioengineering Laboratory, Auxilium Vitae Rehabilitation Center, Volterra, Italy
| | - P Dario
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Polo Sant'Anna Valdera, Pontedera (Pisa), Italy
| | - F Posteraro
- Rehabilitation Bioengineering Laboratory, Auxilium Vitae Rehabilitation Center, Volterra, Italy.,Rehabilitation Department, Versilia Hospital, Azienda USL Toscana Nord Ovest, Italy
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18
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Chua KSG, Kuah CWK. Innovating With Rehabilitation Technology in the Real World: Promises, Potentials, and Perspectives. Am J Phys Med Rehabil 2017; 96:S150-S156. [PMID: 28708632 PMCID: PMC5598910 DOI: 10.1097/phm.0000000000000799] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
In this article, we discuss robotic-assisted therapy as an emerging and significant field of clinical rehabilitation and its value proposition for innovating rehabilitation clinical practice. Attempts to achieve integration among clinicians' practices and bioengineers' machines often generate new challenges and controversies. To date, the literature is indicative of a sizeable number and variety of robotic devices in the field of clinical rehabilitation, some are commercially available; however, large-scale clinical outcomes are less positive than expected. The following main themes related to integrating rehabilitation technology in real-world clinical practice will be discussed: the application of current evidence-based practice and knowledge in relation to treatment in the rehabilitation clinic, perspectives from rehabilitation professionals using robotic-aided therapy with regard to challenges, and strategies for problem solving. Lastly, we present innovation philosophies with regard to sustainability of clinical rehabilitation technologies.
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Affiliation(s)
- Karen Sui Geok Chua
- From the Tan Tock Seng Hospital Rehabilitation Center, Center for Advanced Rehabilitation Therapeutics, Singapore
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19
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Stampacchia G, Rustici A, Bigazzi S, Gerini A, Tombini T, Mazzoleni S. Walking with a powered robotic exoskeleton: Subjective experience, spasticity and pain in spinal cord injured persons. NeuroRehabilitation 2017; 39:277-83. [PMID: 27372363 DOI: 10.3233/nre-161358] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Powered robotic exoskeletons represent an emerging technology for the gait training of Spinal Cord Injured (SCI) persons. The analysis of the psychological and physical impact of such technology on the patient is crucial in terms of clinical appropriateness of such rehabilitation intervention for SCI persons. OBJECTIVE To investigate the acceptability of overground robot-assisted walking and its effect on pain and spasticity. METHODS Twenty-one SCI persons participated in a walking session assisted by a powered robotic exoskeleton. Pain assessed using a Numeric Rating Scale (NRS) and muscle spasticity, assessed as subjective perception using an NRS scale and as objective assessment using the Modified Ashworth scale and the Penn scale, were evaluated before and after the walking experience. Positive and negative sensations were investigated using a questionnaire. The patient's global impression of change (PGIC) scale was administrated as well. RESULTS After the walking session a significant decrease in the muscle spasticity and pain intensity was observed. The SCI persons recruited in this study reported (i) a global change after the walking session, (ii) high scores on the positive and (iii) low scores on the negative sensations, thus indicating a good acceptability of the robot-assisted walking. CONCLUSIONS The overground robot-assisted walking is well accepted by SCI persons and has positive effects in terms of spasticity and pain reduction.
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Affiliation(s)
- Giulia Stampacchia
- Center for Spinal Cord Injured Persons, Pisa University Hospital, Pisa, Italy
| | - Alessandro Rustici
- Center for Spinal Cord Injured Persons, Pisa University Hospital, Pisa, Italy
| | - Samuele Bigazzi
- Center for Spinal Cord Injured Persons, Pisa University Hospital, Pisa, Italy
| | - Adriana Gerini
- Center for Spinal Cord Injured Persons, Pisa University Hospital, Pisa, Italy
| | - Tullia Tombini
- Center for Spinal Cord Injured Persons, Pisa University Hospital, Pisa, Italy
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Stephenson A, Stephens J. An exploration of physiotherapists’ experiences of robotic therapy in upper limb rehabilitation within a stroke rehabilitation centre. Disabil Rehabil Assist Technol 2017; 13:245-252. [DOI: 10.1080/17483107.2017.1306593] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Andrew Stephenson
- Northumbria Healthcare NHS Foundation Trust, Northumbria Specialist Emergency Care Hospital, Cramlington, UK
| | - John Stephens
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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Xu G, Guo X, Zhai Y, Li H. An intelligent control framework for robot-aided resistance training using hybrid system modeling and impedance estimation. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2016; 2015:3602-6. [PMID: 26737072 DOI: 10.1109/embc.2015.7319172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This study presents a novel therapy control method for robot-assisted resistance training using the hybrid system modeling technology and the estimated patient's bio-impedance changes. A new intelligent control framework based on hybrid system theory is developed, to automatically generate the desired resistive force and to make accommodating emergency behavior, when monitoring the changes of the impaired limb's muscle strength or the unpredictable safety-related occurrences during the execution of the training task. The impaired limb's muscle strength progress is online evaluated using its bio-damping and bio-stiffness estimation results. The proposed method is verified with a custom constructed therapeutic robot system featuring a Barrett WAM™ compliant manipulator. A typical inpatient stroke subject was recruited and enrolled in a ten-week resistance training program. Preliminary results show that the proposed therapeutic strategy can enhance the impaired limb's muscle strength and has practicability for robot-aided rehabilitation training.
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Garcia-Aracil N, Zollo L, Casals A, Sabater-Navarro J. New methods of human-robot interaction in medical practice. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2014; 116:49-51. [PMID: 24862653 DOI: 10.1016/j.cmpb.2014.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Mazzoleni S, Montagnani G, Vagheggini G, Buono L, Moretti F, Dario P, Ambrosino N. Interactive videogame as rehabilitation tool of patients with chronic respiratory diseases: preliminary results of a feasibility study. Respir Med 2014; 108:1516-24. [PMID: 25087837 DOI: 10.1016/j.rmed.2014.07.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 07/03/2014] [Accepted: 07/07/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of an interactive videogame (IV) system in addition to a supervised pulmonary rehabilitation programme (PRP) in patients with chronic respiratory diseases. DESIGN Randomised Controlled Trial comparing standard PRP (20 patients, control group: CG), and PRP + sessions of interactive videogame-aided exercises (20 patients, experimental group: EG). Lung and respiratory muscle function, arterial blood gases, exercise capacity, dyspnoea, health status and health-related quality of life (HRQL) and emotional response were measured before and after PRP. A questionnaire on acceptability of the PRP was administered. RESULTS Exercise capacity, dyspnoea and HRQL significantly improved in both groups after the PRP, whereas the EG showed a greater improvement in six-minute walk test and transitional dyspnoea index than the CG. No difference in psychological status or acceptability of PRP was observed between the two groups. CONCLUSIONS The addition of IV training was more effective for improving some parameters of exercise tolerance and dyspnoea, although did not result in better psychological status nor it was better accepted than the standard PRP in patients with chronic respiratory diseases.
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Affiliation(s)
- Stefano Mazzoleni
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy; Rehabilitation Bioengineering Laboratory, Volterra, Italy.
| | - Giulia Montagnani
- Rehabilitation Bioengineering Laboratory, Volterra, Italy; Weaning and Rehabilitation Unit, Auxilium Vitae Rehabilitation Centre, Volterra, Italy
| | - Guido Vagheggini
- Rehabilitation Bioengineering Laboratory, Volterra, Italy; Weaning and Rehabilitation Unit, Auxilium Vitae Rehabilitation Centre, Volterra, Italy
| | - Lorenzo Buono
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy; Rehabilitation Bioengineering Laboratory, Volterra, Italy
| | - Francesca Moretti
- Rehabilitation Bioengineering Laboratory, Volterra, Italy; Weaning and Rehabilitation Unit, Auxilium Vitae Rehabilitation Centre, Volterra, Italy
| | - Paolo Dario
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Nicolino Ambrosino
- Rehabilitation Bioengineering Laboratory, Volterra, Italy; Weaning and Rehabilitation Unit, Auxilium Vitae Rehabilitation Centre, Volterra, Italy
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