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Bonanno M, Militi A, La Fauci Belponer F, De Luca R, Leonetti D, Quartarone A, Ciancarelli I, Morone G, Calabrò RS. Rehabilitation of Gait and Balance in Cerebral Palsy: A Scoping Review on the Use of Robotics with Biomechanical Implications. J Clin Med 2023; 12:jcm12093278. [PMID: 37176718 PMCID: PMC10179520 DOI: 10.3390/jcm12093278] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/22/2023] [Accepted: 04/29/2023] [Indexed: 05/15/2023] Open
Abstract
Cerebral palsy (CP) is a congenital and permanent neurological disorder due to non-progressive brain damage that affects gross motor functions, such as balance, trunk control and gait. CP gross motor impairments yield more challenging right foot placement during gait phases, as well as the correct direction of the whole-body center of mass with a stability reduction and an increase in falling and tripping. For these reasons, robotic devices, thanks to their biomechanical features, can adapt easily to CP children, allowing better motor recovery and enjoyment. In fact, physiotherapists should consider each pathological gait feature to provide the patient with the best possible rehabilitation strategy and reduce extra energy efforts and the risk of falling in children affected by CP.
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Affiliation(s)
- Mirjam Bonanno
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, SS 113, C. da Casazza, 98124 Messina, Italy
| | - Angela Militi
- Department of Biomedical and Dental Sciences and Morphological and Functional Imaging, University of Messina, 98125 Messina, Italy
| | - Francesca La Fauci Belponer
- Neuropsichiatria Infantile, Azienda Ospedaliera Universitaria (AOU), Policlinico "Gaetano Martino", 98125 Messina, Italy
| | - Rosaria De Luca
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, SS 113, C. da Casazza, 98124 Messina, Italy
| | - Danilo Leonetti
- Department of Biomedical, Dental and Morphological and Functional Images, Section of Orthopaedic and Traumatology, University of Messina, 98125 Messina, Italy
| | - Angelo Quartarone
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, SS 113, C. da Casazza, 98124 Messina, Italy
| | - Irene Ciancarelli
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
- ASL 1 Abruzzo (Avezzano-Sulmona-L'Aquila), 67100 L'Aquila, Italy
| | - Giovanni Morone
- Department of Life, Health and Environmental Sciences, University of L'Aquila, 67100 L'Aquila, Italy
- San Raffaele Institute of Sulmona, 67039 Sulmona, Italy
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi "Bonino-Pulejo", Via Palermo, SS 113, C. da Casazza, 98124 Messina, Italy
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Duret C, Grosmaire AG, Krebs HI. Robot-Assisted Therapy in Upper Extremity Hemiparesis: Overview of an Evidence-Based Approach. Front Neurol 2019; 10:412. [PMID: 31068898 PMCID: PMC6491567 DOI: 10.3389/fneur.2019.00412] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 04/04/2019] [Indexed: 01/15/2023] Open
Abstract
Robot-mediated therapy is an innovative form of rehabilitation that enables highly repetitive, intensive, adaptive, and quantifiable physical training. It has been increasingly used to restore loss of motor function, mainly in stroke survivors suffering from an upper limb paresis. Multiple studies collated in a growing number of review articles showed the positive effects on motor impairment, less clearly on functional limitations. After describing the current status of robotic therapy after upper limb paresis due to stroke, this overview addresses basic principles related to robotic therapy applied to upper limb paresis. We demonstrate how this innovation is an evidence-based approach in that it meets both the improved clinical and more fundamental knowledge-base about regaining effective motor function after stroke and the need of more objective, flexible and controlled therapeutic paradigms.
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Affiliation(s)
- Christophe Duret
- Centre de Rééducation Fonctionnelle Les Trois Soleils, Médecine Physique et de Réadaptation, Unité de Neurorééducation, Boissise-Le-Roi, France.,Centre Hospitalier Sud Francilien, Neurologie, Corbeil-Essonnes, France
| | - Anne-Gaëlle Grosmaire
- Centre de Rééducation Fonctionnelle Les Trois Soleils, Médecine Physique et de Réadaptation, Unité de Neurorééducation, Boissise-Le-Roi, France
| | - Hermano Igo Krebs
- Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, United States.,Department of Neurology, University of Maryland, Baltimore, MD, United States.,Department of Physical Medicine and Rehabilitation, Fujita Health University, Nagoya, Japan.,Institute of Neuroscience, University of Newcastle, Newcastle upon Tyne, United Kingdom.,Department of Mechanical Sciences and Bioengineering, Osaka University, Osaka, Japan.,Wolfson School of Mechanical, Electrical, and Manufacturing Engineering, Loughborough University, Loughborough, United Kingdom
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Munera M, Marroquin A, Jimenez L, Lara JS, Gomez C, Rodriguez S, Rodriguez LE, Cifuentes CA. Lokomat therapy in Colombia: Current state and cognitive aspects. IEEE Int Conf Rehabil Robot 2018; 2017:394-399. [PMID: 28813851 DOI: 10.1109/icorr.2017.8009279] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Neurological disorders frequently affect walking function which is one of the most fundamental skills to improve quality of life and autonomy, and Lokomat has been a key piece for gait's rehabilitation. In this study, a diagnosis about the development of the Robot-assisted therapy rehabilitation with Lokomat in Colombia is made. The study was performed by collecting some anthropometric and demographic data of the patients that use Lokomat, followed by a survey of cognitive aspects. With the purpose to compare the current state of the robotic therapies it was found that in Colombia the benefits of this treatment have not being fully exploited. Regarding the cognitive aspects, most of the patients that use Lokomat as a rehabilitation therapy feel comfortable (47%), very safe (68%) and have a perpective of significant results with the therapy (68%). However, when compared the number of patients in therapy with Lokomat with the number of the population that has gait disabilities, it is found that few Colombians have access to this type of therapy.
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Razumov AN, Rezchikov EA, Maistruk AV, Arkhipov MV, Golovin VF. [The safety of robotics for restorative medicine]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOĬ FIZICHESKOĬ KULTURY 2016; 92:54-56. [PMID: 26852504 DOI: 10.17116/kurort2015554-56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The present article is devoted to the peculiarities of the safety measures that need to be taken during the operation of the automated robots intended to perform noninvasive controlled deformations of the patient's soft tissues. The authors propose the use of the commercially available devices for nonmedical applications operated without enclosure for staff as basic robots.
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Affiliation(s)
- A N Razumov
- I.M.Sechenov First Moscow State Medical University, Russian Ministry of Health, Moscow, Russian Federation, 119991
| | - E A Rezchikov
- Federal state educational institution of higher professional education 'Moscow State Industrial University', 'Robototekhnika' Laboratory, Moscow, Russian Federation, 115280
| | - A V Maistruk
- Federal state educational institution of higher professional education 'Moscow State Industrial University', 'Robototekhnika' Laboratory, Moscow, Russian Federation, 115280
| | - M V Arkhipov
- Federal state educational institution of higher professional education 'Moscow State Industrial University', 'Robototekhnika' Laboratory, Moscow, Russian Federation, 115280
| | - V F Golovin
- Federal state educational institution of higher professional education 'Moscow State Industrial University', 'Robototekhnika' Laboratory, Moscow, Russian Federation, 115280
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Use of a robotic device for the rehabilitation of severe upper limb paresis in subacute stroke: exploration of patient/robot interactions and the motor recovery process. BIOMED RESEARCH INTERNATIONAL 2015; 2015:482389. [PMID: 25821804 PMCID: PMC4363505 DOI: 10.1155/2015/482389] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2014] [Revised: 09/28/2014] [Accepted: 10/04/2014] [Indexed: 01/19/2023]
Abstract
This pioneering observational study explored the interaction between subacute stroke inpatients and a rehabilitation robot during upper limb training. 25 stroke survivors (age 55 ± 17 years; time since stroke, 52 ± 21 days) with severe upper limb paresis carried out 16 sessions of robot-assisted shoulder/elbow training (InMotion 2.0, IMT, Inc., MA, USA) combined with standard therapy. The values of 3 patient/robot interaction parameters (a guidance parameter: Stiffness, a velocity-related parameter: Slottime, and Robotic Power) were compared between sessions 1 (S1), 4 (S4), 8 (S8), 12 (S12), and 16 (S16). Pre/post Fugl-Meyer Assessment (FMA) scores were compared in 18 patients. Correlations between interaction parameters and clinical and kinematic outcome measures were evaluated. Slottime decreased at S8 (P = 0.003), while Guidance decreased at S12 (P = 0.008). Robotic Power tended to decrease until S16. FMA scores improved from S1 to S16 (+49%, P = 0.002). Changes in FMA score were correlated with the Stiffness parameter (R = 0.4, P = 0.003). Slottime was correlated with movement velocity. This novel approach demonstrated that a robotic device is a useful and reliable tool for the quantification of interaction parameters. Moreover, changes in these parameters were correlated with clinical and kinematic changes. These results suggested that robot-based recordings can provide new insights into the motor recovery process.
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Jarrassé N, Proietti T, Crocher V, Robertson J, Sahbani A, Morel G, Roby-Brami A. Robotic exoskeletons: a perspective for the rehabilitation of arm coordination in stroke patients. Front Hum Neurosci 2014; 8:947. [PMID: 25520638 PMCID: PMC4249450 DOI: 10.3389/fnhum.2014.00947] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 11/06/2014] [Indexed: 11/13/2022] Open
Abstract
Upper-limb impairment after stroke is caused by weakness, loss of individual joint control, spasticity, and abnormal synergies. Upper-limb movement frequently involves abnormal, stereotyped, and fixed synergies, likely related to the increased use of sub-cortical networks following the stroke. The flexible coordination of the shoulder and elbow joints is also disrupted. New methods for motor learning, based on the stimulation of activity-dependent neural plasticity have been developed. These include robots that can adaptively assist active movements and generate many movement repetitions. However, most of these robots only control the movement of the hand in space. The aim of the present text is to analyze the potential of robotic exoskeletons to specifically rehabilitate joint motion and particularly inter-joint coordination. First, a review of studies on upper-limb coordination in stroke patients is presented and the potential for recovery of coordination is examined. Second, issues relating to the mechanical design of exoskeletons and the transmission of constraints between the robotic and human limbs are discussed. The third section considers the development of different methods to control exoskeletons: existing rehabilitation devices and approaches to the control and rehabilitation of joint coordinations are then reviewed, along with preliminary clinical results available. Finally, perspectives and future strategies for the design of control mechanisms for rehabilitation exoskeletons are discussed.
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Affiliation(s)
- Nathanaël Jarrassé
- UMR 7222, Center National de la Recherche Scientifique (CNRS), Institute of Intelligent Systems and Robotics (ISIR), Paris, France
- UMR 7222, Sorbonne Universités, UPMC Univ Paris, Paris, France
- U1150, Institut National de la Santé et de la Recherche Médicale (INSERM), Agathe-ISIR, Paris, France
| | - Tommaso Proietti
- UMR 7222, Center National de la Recherche Scientifique (CNRS), Institute of Intelligent Systems and Robotics (ISIR), Paris, France
- UMR 7222, Sorbonne Universités, UPMC Univ Paris, Paris, France
- U1150, Institut National de la Santé et de la Recherche Médicale (INSERM), Agathe-ISIR, Paris, France
| | - Vincent Crocher
- UMR 7222, Center National de la Recherche Scientifique (CNRS), Institute of Intelligent Systems and Robotics (ISIR), Paris, France
- UMR 7222, Sorbonne Universités, UPMC Univ Paris, Paris, France
- Department of Electrical and Electronic Engineering, University of Melbourne, Melbourne, VIC, Australia
| | - Johanna Robertson
- Department of Physical Medicine and Rehabilitation, Hôpital Raymond Poincaré, Garches, France
| | - Anis Sahbani
- UMR 7222, Center National de la Recherche Scientifique (CNRS), Institute of Intelligent Systems and Robotics (ISIR), Paris, France
- UMR 7222, Sorbonne Universités, UPMC Univ Paris, Paris, France
- U1150, Institut National de la Santé et de la Recherche Médicale (INSERM), Agathe-ISIR, Paris, France
| | - Guillaume Morel
- UMR 7222, Center National de la Recherche Scientifique (CNRS), Institute of Intelligent Systems and Robotics (ISIR), Paris, France
- UMR 7222, Sorbonne Universités, UPMC Univ Paris, Paris, France
- U1150, Institut National de la Santé et de la Recherche Médicale (INSERM), Agathe-ISIR, Paris, France
| | - Agnès Roby-Brami
- UMR 7222, Center National de la Recherche Scientifique (CNRS), Institute of Intelligent Systems and Robotics (ISIR), Paris, France
- UMR 7222, Sorbonne Universités, UPMC Univ Paris, Paris, France
- U1150, Institut National de la Santé et de la Recherche Médicale (INSERM), Agathe-ISIR, Paris, France
- Department of Physical Medicine and Rehabilitation, Hôpital Raymond Poincaré, Garches, France
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Asín Prieto G, Cano-de-la-Cuerda R, López-Larraz E, Metrot J, Molinari M, van Dokkum LEH. Emerging Perspectives in Stroke Rehabilitation. BIOSYSTEMS & BIOROBOTICS 2014. [DOI: 10.1007/978-3-642-38556-8_1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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