Robotic Home-Based Rehabilitation Systems Design: From a Literature Review to a Conceptual Framework for Community-Based Remote Therapy During COVID-19 Pandemic

During the COVID-19 pandemic, the higher susceptibility of post-stroke patients to infection calls for extra safety precautions. Despite the imposed restrictions, early neurorehabilitation cannot be postponed due to its paramount importance for improving motor and functional recovery chances. Utilizing accessible state-of-the-art technologies, home-based rehabilitation devices are proposed as a sustainable solution in the current crisis. In this paper, a comprehensive review on developed home-based rehabilitation technologies of the last 10 years (2011–2020), categorizing them into upper and lower limb devices and considering both commercialized and state-of-the-art realms. Mechatronic, control, and software aspects of the system are discussed to provide a classified roadmap for home-based systems development. Subsequently, a conceptual framework on the development of smart and intelligent community-based home rehabilitation systems based on novel mechatronic technologies is proposed. In this framework, each rehabilitation device acts as an agent in the network, using the internet of things (IoT) technologies, which facilitates learning from the recorded data of the other agents, as well as the tele-supervision of the treatment by an expert. The presented design paradigm based on the above-mentioned leading technologies could lead to the development of promising home rehabilitation systems, which encourage stroke survivors to engage in under-supervised or unsupervised therapeutic activities

Принципы и опыт применения роботизированных реабилитационных технологий у пациентов после инсульта

This literature review is devoted to the study of recent advances in the field of neurorehabilitation using robotic technologies. Objective: to study best practices of applying robotic rehabilitation technologies in stroke patients, its clinical efficacy and influence on the molecular mechanisms of neuroplasticity. Keywords were searched in the Web of Science, Core Collection, Scopus and PubMed databases. Results. Robotic neurorehabilitation occupies a certain place in the comprehensive rehabilitation of patients with motor deficiency after stroke. An interdisciplinary patient-oriented approach and consistency at all stages of medical rehabilitation are especially important when using rehabilitation methods that implement advances in robotics and information technologies in patients after stroke. Rehabilitation with the use of high-tech computerized rehabilitation systems operating in the biofeedback mode is one of the promising areas and requires further neurophysiological and laboratory studies to create scientifically based methodological approaches. It will have great social significance and tangible economic effects from improving the quality of neurorehabilitation and reducing its duration.Обзор литературы посвящен изучению последних достижений в области нейрореабилитации с использованием роботизированных технологий. Цель – изучить опыт применения, клиническую эффективность и влияние на молекулярные механизмы нейропластичности роботизированных реабилитационных технологий у пациентов с острыми нарушениями мозгового кровообращения. Осуществлялся поиск по ключевым словам в базах данных Web of Science, Core Collection, Scopus, Pubmed по зарубежным журналам. Роботизированная нейрореабилитация занимает определенное место в комплексной реабилитации больных с моторным дефицитом после острых нарушений мозгового кровообращения. Особенно важными в использовании реабилитационных методов, имплементирующих передовые достижения робототехники и информационных технологий, являются междисциплинарный пациент-ориентированный подход и преемственность на всех этапах лечебно-восстановительного лечения больных после инсульта. Реабилитация с применением высокотехнологичных компьютеризированных реабилитационных комплексов, работающих в режиме биологической обратной связи, является одним из перспективных направлений и требует дальнейшего проведения нейрофизиологических и лабораторных исследований для создания научно обоснованных методических подходов, что позволит добиться ощутимого экономического эффекта от повышения качества нейрореабилитации, уменьшения времени на ее проведение и будет иметь огромную социальную значимость

A Wearable Arm and Wrist Rehabilitation Exercise Device Equipped with Monitoring System for Post Stroke Rehabilitation

An analysis of rehabilitation activity for paralyzed patient. Monitoring rehabilitation activity for post-stroke patients have increasingly common in hospitals and rehabilitation center worldwide. To develop home based and low cost device for post-stroke patients activity monitoring is challenging in rehabilitation engineering. Many technological devices have been developed like a Wearable Arm and Wrist Rehabilitation Exercise device equipped with monitoring system for post stroke rehabilitation were designed for and proposed.  In this article, we identify several functional activities of arm and wrist motoring defect is achieved by the exoskeleton system. This system is controlled by the Arduino UNO Microcontroller and the LCD is acting as monitoring unit. This allows investigating patterns of patient’s arm and wrist monitoring functional activity. These studies investigated the activation patterns in different experimental conditions such as water bottle take off, wrist stretching and grasp force. Furthermore, findings attained from this project may enable us to contribute towards the development of new arm rehabilitation monitoring device which can benefit human lives

Wearable Robotics for Impaired Upper-Limb Assistance and Rehabilitation: State of the Art and Future Perspectives

Despite more than thirty-five years of research on wearable technologies to assist the upper-limb and a multitude of promising preliminary results, the goal of restoring pre-impairment quality of life of people with physical disabilities has not been fully reached yet. Whether it is for rehabilitation or for assistance, nowadays robotics is still only used in a few high-tech clinics and hospitals, limiting the access to a small amount of people. This work provides a description of the three major 'revolutions' occurred in the field (end-effector robots, rigid exoskeletons, and soft exosuits), reviewing forty-eight systems for the upper-limb (excluding hand-only devices) used in eighty-nine studies enrolling a clinical population before June 2022. The review critically discusses the state of the art, analyzes the different technologies, and compares the clinical outcomes, with the goal of determine new potential directions to follow

Enhancing Biomechanical Function through Development and Testing of Assistive Devices for Shoulder Impairment and Total Limb Amputation

Assistive devices serve as a potential for restoring sensorimotor function to impaired individuals. My research focuses on two assistive devices: a passive shoulder exoskeleton and a muscle-driven endoprosthesis (MDE). Previous passive shoulder exoskeletons have focused on testing during static loading conditions in the shoulder. However, activities of daily living are based on dynamic tasks. My research for passive shoulder exoskeletons analyzes the effect that a continuous passive assistance has on shoulder biomechanics. In my research I showed that passive assistance decreases the muscular activation in muscles responsible for positive shoulder exoskeleton. An MDE has the potential to have accurate and precise control of movement as well as restore a sense of proprioception to the user. Such a transformative and invasive device has never previously been tested. Therefore, my research focused on analyzing fundamental principles of the MDE in an in-vivo rabbit model. The two concepts I tested in my research were the feasibility of implanting an orthopedic device underneath the skin at the distal end of a limb following amputation and the locomotor restorative capabilities of an artificial tendon used for muscle-device connection. In my work I proved the feasibility of implanting fully-footed rigid endoprostheses underneath the skin and isolated the primary factors for a successful surgery and recovery. In addition, my research showed that although artificial tendons have the potential to restore locomotor function, proper in-situ tendon lengths must be achieved for optimal movement. This research informed the design and testing of a fully jointed muscle-driven endoprosthesis prototype