© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).Peer reviewedFinal Published versio

Anwer, Saba

Gilani, Syed Omer

Iqbal, Javaid

Niazi, Imran Khan

Pujari, Amit N.

Shaikh, Nusratnaaz

Waris, Asim

Healthcare

English

PubMed

© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).Peer reviewe

University of Hertfordshire Research Archive

Citation: Anwer, S.; Waris, A.; Gilani,S.O.; Iqbal, J.; Shaikh, N.; Pujari, A.N.;Niazi, I.K. Reply to Morone, G.;Giansanti, D. Comment on “Anweret al. Rehabilitation of Upper LimbMotor Impairment in Stroke: ANarrative Review on the Prevalence,Risk Factors, and Economic Statisticsof Stroke and State of the ArtTherapies. Healthcare 2022, 10, 190”.Healthcare 2022, 10, 847. https://doi.org/10.3390/healthcare10050847Academic Editor: José CarmeloAdsuar SalaReceived: 21 April 2022Accepted: 29 April 2022Published: 5 May 2022Publisher’s Note: MDPI stays neutralwith regard to jurisdictional claims inpublished maps and institutional affil-iations.Copyright: © 2022 by the authors.Licensee MDPI, Basel, Switzerland.This article is an open access articledistributed under the terms andconditions of the Creative CommonsAttribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).healthcareReplyReply to Morone, G.; Giansanti, D. Comment on “Anwer et al.Rehabilitation of Upper Limb Motor Impairment in Stroke: ANarrative Review on the Prevalence, Risk Factors, andEconomic Statistics of Stroke and State of the Art Therapies.Healthcare 2022, 10, 190”Saba Anwer 1, Asim Waris 1 , Syed Omer Gilani 1 , Javaid Iqbal 1 , Nusratnaaz Shaikh 2 , Amit N. Pujari 3,4and Imran Khan Niazi 2,5,6,*1 School of Mechanical & Manufacturing Engineering, National University of Sciences and Technology (NUST),Islamabad 45200, Pakistan; sanwer.bmes19smme@student.nust.edu.pk (S.A.);asim.waris@smme.nust.edu.pk (A.W.); omer@smme.nust.edu.pk (S.O.G.); j.iqbal@ceme.nust.edu.pk (J.I.)2 Faculty of Health & Environmental Sciences, Health & Rehabilitation Research Institute, AUT University,Auckland 0627, New Zealand; nusrat.shaikh@aut.ac.nz3 School of Physics, Engineering and Computer Science, University of Hertfordshire, Hatfield AL10 9AB, UK;amit.pujari@ieee.org4 School of Engineering, University of Aberdeen, Aberdeen AB24 3FX, UK5 Center of Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand6 Center for Sensory-Motor Interaction, Department of Health Science & Technology, Aalborg University,9000 Alborg, Denmark* Correspondence: imran.niazi@nzchiro.co.nzThank you so much for your kind remarks. We really appreciate your detailed anal-ysis [1] of this review study [2]. The use of robotics based on the concept of artificialintelligence in the field of rehabilitation is really an interesting subject, and it will be apleasure for us to give an opinion on this issue.Firstly, it is very important to understand that, with the increasing rate of stroke-relateddisability, it will be difficult to provide stroke survivors with post-stroke care (PSC) servicesbecause of their unbearable economic consequences, which raises the need to minimizethe role of physical therapists and move towards adopting self-rehabilitative home-basedtherapies to facilitate healthcare for those living in remote areas.Secondly, the rehabilitation field is shifting from conventional approaches to new andtechnologically advanced therapeutic strategies in which virtual reality, telerehabilitation,robotics, and invasive and non-invasive stimulations are top of the list.For the use of artificial intelligence to fabricate modern medical equipment such asprosthetic limbs, robotic machinery is inevitable. Such systems are strongly bound withthe commitment to making rehabilitation systems more comfortable, with a significantlyincreased degree of freedom for stroke patients or victims of limb amputations.As An example, I will mention a commercially available system of Saebo-VR (https://www.saebo.com/virtual-reality/) (accessed on 28 March 2022) which is an interactive,multisensory computer-based simulation environment providing the patients with anopportunity to perform different activities in the real world. Saebo also provides a cutting-edge Saeb Glove (https://uk.saebo.com/shop/saeboglove/) (accessed on 28 March 2022)which helps its users suffering from different orthopedic and neurological injuries toincorporate with their motor therapy for assistance at home. This proprietary tensionsystem assists patients to perform finger extension following a grasp action. This fullyfunctional, commercially available setup is a bewildering example of AI-based robot-assisted system for patients with motor disabilities.Healthcare 2022, 10, 847. https://doi.org/10.3390/healthcare10050847 https://www.mdpi.com/journal/healthcareHealthcare 2022, 10, 847 2 of 2Moreover, systems such as Microsoft Kinect play significant roles in physiotherapy and re-habilitation of stroke patients. Microsoft Kinect device (https://www.physio-pedia.com/The_emerging_role_of_Microsoft_Kinect_in_physiotherapy_rehabilitation_for_stroke_patients) (ac-cessed on 28 March 2022) offers exciting and innovative ways of rehabilitation that makethe treatment, and thus the subsequent adherence and motivation, more interactive andenjoyable. Microsoft Kinect allows stroke survivors suffering from motor disabilities tointeract with an environment where they can perform different movement combinationswithout any need for a controller or attached device.This review article provides an overview of, and deep insights into, modern alternativerehabilitation technologies. Moreover, the review article focuses on the importance of strokerehabilitation while narratively explaining the socio-economic burden of this disease andrelated risk factors. Considering the increasing popularity and evidence of the benefitsof technology-aided rehabilitation approaches, some commonly used stroke therapiesto regain muscle activity are discussed. The reader can refer to the cited articles formore information.Despite all presented discussions, we cannot deny the fact that the future is stronglyassociated with excess use of artificial intelligence in the field of rehabilitation—whether itis telerehabilitation, virtual reality, robot-assisted therapies, or participatory involvementof multiple techniques. Hopefully, I have answered the question. For more details, pleaserefer to the cited article [2–5].Author Contributions: S.A. and A.W. presented the concept and design of the paper. S.O.G., J.I.,I.K.N. and N.S. helped in the authentic data collection from different research databases. A.W.,S.A. and A.N.P. drafted the manuscript. All the authors thoroughly studied and approved the finalmanuscript. All authors have read and agreed to the published version of the manuscript.Funding: This research received no external funding.Institutional Review Board Statement: Not applicable.Informed Consent Statement: Not applicable.Data Availability Statement: Data presented in the paper is extracted from published work. Theauthors of the current study do not have the raw data.Conflicts of Interest: Authors declare no conflict of interest.References1. Morone, G.; Giansanti, D. Comment on Anwer et al. Rehabilitation of Upper Limb Motor Impairment in Stroke: A NarrativeReview on the Prevalence, Risk Factors, and Economic Statistics of Stroke and State of the Art Therapies. Healthcare 2022, 10, 190.Healthcare 2022, 10, 846. [CrossRef]2. Anwer, S.; Waris, A.; Gilani, S.O.; Iqbal, J.; Shaikh, N.; Pujari, A.N.; Niazi, I.K. Rehabilitation of Upper Limb Motor Impairment inStroke: A Narrative Review on the Prevalence, Risk Factors, and Economic Statistics of Stroke and State of the Art Therapies.Healthcare 2022, 10, 190. [CrossRef] [PubMed]3. Masiero, S.; Poli, P.; Rosati, G.; Zanotto, D.; Iosa, M.; Paolucci, S.; Morone, G. The value of robotic systems in stroke rehabilitation.Expert Rev. Med. Devices 2014, 11, 187–198. [CrossRef] [PubMed]4. Veerbeek, J.M.; Langbroek-Amersfoort, A.C.; VanWegen, E.E.; Meskers, C.G.; Kwakkel, G. Effects of robot-assisted therapy forthe upper limb after stroke: A systematic review and meta-analysis. Neurorehabilit. Neural Repair. 2017, 31, 107–121. [CrossRef][PubMed]5. Vélez-Guerrero, M.A.; Callejas-Cuervo, M.; Mazzoleni, S. Artificial intelligence-based wearable robotic exoskeletons for upperlimb rehabilitation: A review. Sensors 2021, 21, 2146. [CrossRef] [PubMed]

Reply to Morone, G.; Giansanti, D. Comment on “Anwer et al. Rehabilitation of Upper Limb Motor Impairment in Stroke: A Narrative Review on the Prevalence, Risk Factors, and Economic Statistics of Stroke and State of the Art Therapies. Healthcare 2022, 10, 190”

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Aberdeen University Research

Reply to Morone, G.; Giansanti, D. Comment on “Anwer et al. Rehabilitation of Upper Limb Motor Impairment in Stroke : A Narrative Review on the Prevalence, Risk Factors, and Economic Statistics of Stroke and State of the Art Therapies. Healthcare 2022, 10, 190”

Thank you so much for your kind remarks [...].</p

Pujari, Amit N

Reply to Morone, G.; Giansanti, D. Comment on "Anwer et al. Rehabilitation of Upper Limb Motor Impairment in Stroke:A Narrative Review on the Prevalence, Risk Factors, and Economic Statistics of Stroke and State of the Art Therapies. Healthcare 2022, 10, 190"

Thank you so much for your kind remarks [...

Saba Anwer

Multidisciplinary Digital Publishing Institute

Reply to Morone, G.; Giansanti, D. Comment on &ldquo;Anwer et al. Rehabilitation of Upper Limb Motor Impairment in Stroke: A Narrative Review on the Prevalence, Risk Factors, and Economic Statistics of Stroke and State of the Art Therapies. Healthcare 2022, 10, 190&rdquo;

Asim Waris

Syed Omer Gilani

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Nusratnaaz Shaikh

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Reply to Morone, G.; Giansanti, D. Comment on “Anwer et al. Rehabilitation of Upper Limb Motor Impairment in Stroke: A Narrative Review on the Prevalence, Risk Factors, and Economic Statistics of Stroke and State of the Art Therapies. <i>Healthcare</i> 2022, <i>10</i>, 190”

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Reply to Morone, G.; Giansanti, D. Comment on “Anwer et al. Rehabilitation of Upper Limb Motor Impairment in Stroke: A Narrative Review on the Prevalence, Risk Factors, and Economic Statistics of Stroke and State of the Art Therapies. Healthcare 2022, 10, 190”

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