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Application of Robotic Devices for Neurologic Rehabilitation

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 December 2019) | Viewed by 14368

Special Issue Editor


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Guest Editor
1. IRCCS Fondazione Don Carlo Gnocchi, 50143 Florence, Italy
2. Department of Clinical and Experimental Medicine, University of Florence, 50134 Florence, Italy
Interests: stroke rehabilitation; neurological rehabilitation; exercise therapy; technologies for rehabilitation; musculoskeletal disorders; geriatric rehabilitation; healthy ageing; rehabilitation outcome measures; rehabilitation outcome prediction
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Special Issue Information

Dear Colleagues,

The application of robotic devices to rehabilitation of sensorimotor deficits after central nervous system lesions has greatly developed in the last few decades. Interdisciplinary cooperation between neurophysiologists, medical specialists, physiotherapists, and engineers to develop more adaptable, clinically usable, and effective devices is constantly improving, but the implementation of robotic rehabilitation into clinical practice is still limited.

Indeed, robotic rehabilitation has the potential to provide many advantages in terms of standardization of tasks, real-time measurements and feedback, relief of a physiotherapist’s physical burden, and, most importantly, intensity of training, which seems to be highly correlated to the promotion of neuroplasticity and neurophysiological recovery. To enhance the effects on motor learning, brain–machine interfaces are becoming more and more sophisticated, and new rehabilitation paradigms, including advanced robot-mediated training strategies, are also being developed and studied.

Research is currently being carried out on the potential benefits of robotic rehabilitation for many neurologic conditions, but moderate to high quality evidence has already been provided for the application of robotic rehabilitation to stroke patients, combined with conventional physiotherapy. As to stroke, robot-assisted gait training has moderate quality evidence of effectiveness to promote recovery of independent walking, and high-quality evidence commends robotic upper limb training to improve activities of daily living, and paretic arm strength and function.

However, specific questions about the type of device and exercises, the timing, frequency, and duration of robot‐assisted lower and upper limb training, as well as translational models of implementing robotic rehabilitation into clinical practice must yet be clarified.

Another potentially relevant advantage of robotic rehabilitation is the possibility to detect real-time measures of the patient’s performance, but the correlation of these device-derived measures to validated clinical tools for assessing clinically significant changes in patients’ sensorimotor impairments and functioning has not been fully explored.

Finally, robotic rehabilitation is often integrated with serious games and virtual reality. The ratio is to increase a patient’s engagement and motivation, by playing an active role in exercises simultaneously involving body and mind. Training sometimes allows experiencing simulated real-life tasks, while maintaining a safe, monitored, and supervised environment. In this regard, the tackled cognitive processes need further investigation, along with the potential effects of a specifically designed, combined training of motor and cognitive functions, as, for instance, attention, concentration, spatial attention, and executive functions.

This Special Issue aims to cover the abovementioned items, focusing on advances in the development of robotic devices, on neurophysiological mechanisms implied in robotic rehabilitation, including cognitive processes, and on translational research models of implementation, sustainability, and effects of robotic rehabilitation, applied to stroke and to other neurologic conditions.


Dr. Francesca Cecchi
Guest Editor

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Keywords

  • Robotic rehabilitation
  • Robotic assessment
  • Robot-assisted therapy
  • Robot design
  • Robot-aided cognitive rehabilitation
  • Robotics for neurorehabilitation
  • Brain-machine interfaces in neurorehabilitation
  • Neurologic rehabilitation
  • Rehabilitation neurophysiology
  • Stroke rehabilitation

Published Papers (3 papers)

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16 pages, 6453 KiB  
Article
Low-Cost Robotic Guide Based on a Motor Imagery Brain–Computer Interface for Arm Assisted Rehabilitation
by Eduardo Quiles, Ferran Suay, Gemma Candela, Nayibe Chio, Manuel Jiménez and Leandro Álvarez-Kurogi
Int. J. Environ. Res. Public Health 2020, 17(3), 699; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17030699 - 21 Jan 2020
Cited by 13 | Viewed by 3976
Abstract
Motor imagery has been suggested as an efficient alternative to improve the rehabilitation process of affected limbs. In this study, a low-cost robotic guide is implemented so that linear position can be controlled via the user’s motor imagination of movement intention. The patient [...] Read more.
Motor imagery has been suggested as an efficient alternative to improve the rehabilitation process of affected limbs. In this study, a low-cost robotic guide is implemented so that linear position can be controlled via the user’s motor imagination of movement intention. The patient can use this device to move the arm attached to the guide according to their own intentions. The first objective of this study was to check the feasibility and safety of the designed robotic guide controlled via a motor imagery (MI)-based brain–computer interface (MI-BCI) in healthy individuals, with the ultimate aim to apply it to rehabilitation patients. The second objective was to determine which are the most convenient MI strategies to control the different assisted rehabilitation arm movements. The results of this study show a better performance when the BCI task is controlled with an action–action MI strategy versus an action–relaxation one. No statistically significant difference was found between the two action–action MI strategies. Full article
(This article belongs to the Special Issue Application of Robotic Devices for Neurologic Rehabilitation)
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22 pages, 3694 KiB  
Article
Fuzzy Logic-Based Risk Assessment of a Parallel Robot for Elbow and Wrist Rehabilitation
by Paul Tucan, Bogdan Gherman, Kinga Major, Calin Vaida, Zoltan Major, Nicolae Plitea, Giuseppe Carbone and Doina Pisla
Int. J. Environ. Res. Public Health 2020, 17(2), 654; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17020654 - 19 Jan 2020
Cited by 31 | Viewed by 4526
Abstract
A few decades ago, robotics started to be implemented in the medical field, especially in the rehabilitation of patients with different neurological diseases that have led to neuromuscular disorders. The main concern regarding medical robots is their safety assurance in the medical environment. [...] Read more.
A few decades ago, robotics started to be implemented in the medical field, especially in the rehabilitation of patients with different neurological diseases that have led to neuromuscular disorders. The main concern regarding medical robots is their safety assurance in the medical environment. The goal of this paper is to assess the risk of a medical robotic system for elbow and wrist rehabilitation in terms of robot and patient safety. The approached risk assessment follows the ISO12100:2010 risk management chart in order to determine, identify, estimate, and evaluate the possible risk that can occur during the use of the robotic system. The result of the risk assessment process is further analyzed using a fuzzy logic system in order to determine the safety degree conferred during the use of the robotic system. The innovative process concerning the risk assessment allows the achievement of a reliable medical robotic system both for the patient and the clinicians as well. The clinical trials performed on a group of 18 patients validated the functionality and the safe behavior of the robotic system. Full article
(This article belongs to the Special Issue Application of Robotic Devices for Neurologic Rehabilitation)
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Review

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13 pages, 1145 KiB  
Review
Effectiveness of Mechanical Horse-Riding Simulators on Postural Balance in Neurological Rehabilitation: Systematic Review and Meta-Analysis
by Juan G. Dominguez-Romero, Assumpta Molina-Aroca, Jose A. Moral-Munoz, Carlos Luque-Moreno and David Lucena-Anton
Int. J. Environ. Res. Public Health 2020, 17(1), 165; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17010165 - 25 Dec 2019
Cited by 18 | Viewed by 5425
Abstract
Mechanical horse-riding simulators consist of a device that mimics the movement of a real horse, generating between 50 and 100 three-dimensional physical movements (forward and back, left and right, up and down). The main objective of this study is to analyze the effectiveness [...] Read more.
Mechanical horse-riding simulators consist of a device that mimics the movement of a real horse, generating between 50 and 100 three-dimensional physical movements (forward and back, left and right, up and down). The main objective of this study is to analyze the effectiveness of mechanical horse-riding simulators to improve postural balance in subjects with neurological disorders. The search was conducted during January–March 2019 in PubMed, Physiotherapy Evidence Database (PEDro), Cochrane, Web of Science, CINAHL, and Scopus. The methodological quality of the studies was evaluated through the PEDro scale. A total of seven articles were included in this systematic review, of which four contributed information to the meta-analysis. Statistical analysis showed favorable results for balance in stroke patients, measured by the Berg Balance Scale (standardized mean difference (SMD) = 3.24; 95%; confidence interval (CI): 1.66–4.83). Not conclusive results were found in sitting postural balance, measured using the Gross Motor Function Measure-66 (GMFM-66) Sitting Dimension, in patients with cerebral palsy. Most studies have shown beneficial effects on postural balance compared with conventional physical therapy. However, due to the limited number of articles and their low methodological quality, no solid conclusions can be drawn about the effectiveness of this therapy. Full article
(This article belongs to the Special Issue Application of Robotic Devices for Neurologic Rehabilitation)
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