Neurorehabilitation of the hand using the cybergrasp[TM] and mirror image

In recent years, researchers have explored the use of a mirror image as a means of rehabilitation for individuals suffering from hemiparesis. Through neuroimaging and functional testing, neurological improvement has been demonstrated in those that engage in mirror therapy. Bilateral training, or simultaneous movement of both sides of the body, has also been studied as a treatment method to improve function after cerebral vascular accident. The development of robotic systems to assist movement of the human body has played a major role in the fabrication of bilateral training devices. In this experiment, the CyberGrasp™ robotic exoskeleton was used to assist the paretic hand in simultaneous bilateral movement in three subjects more than 1 year post stroke. While the bilateral motion took place, the subject viewed a mirror image of their unaffected hand superimposed on their impaired hand. Results at the end of 2 weeks showed no major change in active digit extension, but a noted decrease in the stretch reflex and clinically significant improvements on the Jebsen Test of Hand Function. The system resulted in no major side effects. In conclusion, robot-assisted bilateral training in conjunction with mirror therapy may be a helpful treatment in patients suffering from hemiparesis due to neurological impairment. The experiment conducted demonstrated the feasibility of the system to be used in further research