Experimental Study on Upper-Limb Rehabilitation Training of Stroke Patients Based on Adaptive Task Level: A Preliminary Study

The Use of Sports Rehabilitation Robotics to Assist in the Recovery of Physical Abilities in Elderly Patients with Degenerative Diseases: A Literature Review

The increase in the number of elderly patients with degenerative diseases has brought additional medical and financial pressures, which are adding to the burden on society. The development of sports rehabilitation robotics (SRR) is becoming increasingly sophisticated at the technical level of its application; however, few studies have analyzed how it works and how effective it is in aiding rehabilitation, and fewer individualized exercise rehabilitation programs have been developed for elderly patients. The purpose of this study was to analyze the working methods and the effects of different types of SRR and then to suggest the feasibility of applying SRR to enhance the physical abilities of elderly patients with degenerative diseases. The researcher's team searched 633 English-language journal articles, which had been published over the past five years, and they selected 38 of them for a narrative literature review. Our summary found the following: (1) The current types of SRR are generally classified as end-effector robots, smart walkers, intelligent robotic rollators, and exoskeleton robots-exoskeleton robots were found to be the most widely used. (2) The current working methods include assistant tools as the main intermediaries-i.e., robots assist patients to participate; patients as the main intermediaries-i.e., patients dominate the assistant tools to participate; and sensors as the intermediaries-i.e., myoelectric-driven robots promote patient participation. (3) Better recovery was perceived for elderly patients when using SRR than is generally achieved through the traditional single-movement recovery methods, especially in strength, balance, endurance, and coordination. However, there was no significant improvement in their speed or agility after using SRR.

Robot-assisted therapy for upper limb paresis after stroke: Use of robotic algorithms in advanced practice

BACKGROUND

Rehabilitation of stroke-related upper limb paresis is a major public health issue.

OBJECTIVE

Robotic systems have been developed to facilitate neurorehabilitation by providing key elements required to stimulate brain plasticity and motor recovery, namely repetitive, intensive, adaptative training with feedback. Although the positive effect of robot-assisted therapy on motor impairments has been well demonstrated, the effect on functional capacity is less certain.

METHOD

This narrative review outlines the principles of robot-assisted therapy for the rehabilitation of post-stroke upper limb paresis.

RESULTS

A paradigm is proposed to promote not only recovery of impairment but also function.

CONCLUSION

Further studies that would integrate some principles of the paradigm described in this paper are needed.

The Effect of Applying Robot-Assisted Task-Oriented Training Using Human-Robot Collaborative Interaction Force Control Technology on Upper Limb Function in Stroke Patients: Preliminary Findings

Stroke is one of the leading causes of death and the primary cause of acquired disability worldwide. Many stroke survivors have difficulty using their upper limbs, which have important functional roles in the performance of daily life activities. Consequently, the independence and quality of life of most stroke patients are reduced. Robot-assisted therapy is an effective intervention for improving the upper limb function of individuals with stroke. Human-robot collaborative interaction force control technology is critical for improving the flexibility and followability of the robot's motion, thereby improving rehabilitation training outcomes. However, there are few reports on the effect of robot-assisted rehabilitative training on upper limb function. We applied this technology using a robot to assist patients with task-oriented training. Posttreatment changes in Fugl-Meyer and modified Barthel index (MBI) scores were assessed to determine whether this technology could improve the upper limb function of stroke patients. One healthy adult and five stroke patients, respectively, participated in functional and clinical experiments. The MBI and Fugl-Meyer scores of the five patients in the clinical experiments showed significant improvements after the intervention. The experimental results indicate that human-robot collaborative interaction force control technology is valuable for improving robots' properties and patients' recovery. This trial was registered in the Chinese clinical trial registry (ChiCTR2000038676).

Motivational Strategies for Stroke Rehabilitation: A Delphi Study

OBJECTIVES

The primary objective was to provide a list of effective motivational strategies based on consensus among rehabilitation experts, generated using the Delphi technique. The secondary objective was to identify the types of information that are important when selecting motivational strategies.

DESIGN

Delphi study.

SETTING

On-site survey at academic conferences and web-based survey.

PARTICIPANTS

Rehabilitation experts (N=198) including physicians, physical therapists, occupational therapists, and speech-language-hearing therapists who had worked in stroke rehabilitation for at least 5 years.

INTERVENTION

Not applicable.

MAIN OUTCOME MEASURES

Panelists were asked to rate the effectiveness of motivational strategies and to rate the importance of different types of information using a 5-point Likert scale. Consensus was defined as having been reached for items with an interquartile range of 1 or less.

RESULTS

A total of 116 experts (58.6%) completed the third round of the Delphi survey. Consensus was reached on all of the 26 presented strategies. Seven strategies, such as control of task difficulty and goal setting, were considered to be very effective in increasing patient motivation. In addition, all 11 of the presented types of information regarding patient health status, environmental factors, and personal factors were deemed very important or important in determining which motivational strategies to use.

CONCLUSIONS

We generated a list of effective motivational strategies for stroke rehabilitation based on expert consensus. Our results suggest that experts consider a comprehensive range of patient information when choosing motivational strategies. These findings represent a group of consensus-based recommendations for increasing patient adherence to stroke rehabilitation programs, which may be beneficial to many medical professionals working in stroke rehabilitation.

Motivational Strategies for Stroke Rehabilitation: A Descriptive Cross-Sectional Study

Background: The addition of motivational strategies to a rehabilitation program is thought to enhance patient adherence and improve outcomes. However, little is known about how rehabilitation professionals motivate stroke patients during rehabilitation. The primary objective of this study was to provide a comprehensive and quantitative list of motivational strategies for stroke rehabilitation. In addition, we aimed to examine (1) whether professionals with more clinical experience used a higher number of motivational strategies, (2) the purpose for using each strategy, and (3) the information considered when choosing strategies.

Methods: This descriptive, cross-sectional study was conducted using a web survey with a convenience sample of 407 rehabilitation professionals including physicians, nurses, physical therapists, occupational therapists, and speech-language-hearing therapists.

Results: We received data for 362 participants. Fifteen strategies were found to be used by more than 75% of the respondents to motivate their patients. Almost all of the respondents reported that they actively listened to and praised their patients to increase patient adherence to rehabilitation programs. Respondents with more clinical experience tended to use a higher number of motivational strategies (rho = 0.208, p < 0.001). For 11 of the 15 strategies selected by more than 75% of the respondents, the highest percentage of respondents reported that they used the strategies to make rehabilitation worthwhile for their patients. The majority of respondents reported that they decided which motivational strategy to use by considering comprehensive information regarding the patient health condition, environmental factors, and personal factors.

Conclusions: The comprehensive list of motivational strategies obtained may be useful for increasing patient adherence to rehabilitation, especially for professionals with less clinical experience. Furthermore, our findings regarding the purpose for using each strategy and the information considered when choose strategies might help rehabilitation professionals to optimally utilize the motivational strategy list.

A Novel Robot-Aided Upper Limb Rehabilitation Training System Based on Multimodal Feedback

During robot-aided rehabilitation exercises, monotonous, and repetitive actions can, to the subject, feel tedious and tiring, so improving the subject's motivation and active participation in the training is very important. A novel robot-aided upper limb rehabilitation training system, based on multimodal feedback, is proposed in this investigation. To increase the subject's interest and participation, a friendly graphical user interface and diversiform game-based rehabilitation training tasks incorporating multimodal feedback are designed, to provide the subject with colorful and engaging motor training. During this training, appropriate visual, auditory, and tactile feedback is employed to improve the subject's motivation via multi-sensory incentives relevant to the training performance. This approach is similar to methods applied by physiotherapists to keep the subject focused on motor training tasks. The experimental results verify the effectiveness of the designed multimodal feedback strategy in promoting the subject's participation and motivation.