Robotic exoskeletons: a perspective for the rehabilitation of arm coordination in stroke patients.
Nathanaël Jarrassé,Nathanaël Jarrassé,Nathanaël Jarrassé,Tommaso Proietti,Tommaso Proietti,Tommaso Proietti,Vincent Crocher,Vincent Crocher,Vincent Crocher,Johanna Robertson,Anis Sahbani,Anis Sahbani,Anis Sahbani,Guillaume Morel,Guillaume Morel,Guillaume Morel,Agnès Roby-Brami +16 more
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TLDR
The aim of the present text is to analyze the potential of robotic exoskeletons to specifically rehabilitate joint motion and particularly inter-joint coordination in stroke patients.Abstract:
Upper-limb impairment after stroke is caused by weakness, loss of individual joint control, spasticity, and abnormal synergies. Upper-limb movement frequently involves abnormal, stereotyped, and fixed synergies, likely related to the increased use of sub-cortical networks following the stroke. The flexible coordination of the shoulder and elbow joints is also disrupted. New methods for motor learning, based on the stimulation of activity-dependent neural plasticity have been developed. These include robots that can adaptively assist active movements and generate many movement repetitions. However, most of these robots only control the movement of the hand in space. The aim of the present text is to analyze the potential of robotic exoskeletons to specifically rehabilitate joint motion and particularly inter-joint coordination. First, a review of studies on upper-limb coordination in stroke patients is presented and the potential for recovery of coordination is examined. Second, issues relating to the mechanical design of exoskeletons and the transmission of constraints between the robotic and human limbs are discussed. The third section considers the development of different methods to control exoskeletons: existing rehabilitation devices and approaches to the control and rehabilitation of joint coordinations are then reviewed, along with preliminary clinical results available. Finally, perspectives and future strategies for the design of control mechanisms for rehabilitation exoskeletons are discussed.read more
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Effects of a wearable exoskeleton stride management assist system (SMA®) on spatiotemporal gait characteristics in individuals after stroke: a randomized controlled trial.
Carolyn Buesing,Gabriela Fisch,Megan O’Donnell,Ida Shahidi,Lauren Thomas,Chaithanya K. Mummidisetty,Kenton J. Williams,Hideaki Takahashi,William Z. Rymer,Arun Jayaraman +9 more
TL;DR: SMA and FTST interventions provided similar, significant improvements in spatiotemporal gait parameters; however, the SMA group showed additional improvements across more parameters at various time points.
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Exoskeleton and End-Effector Robots for Upper and Lower Limbs Rehabilitation: Narrative Review.
TL;DR: An overview of literature published on exoskeleton devices for upper and lower limb rehabilitation in patients with upper motor neuron syndrome is provided; the available current research evidence is summarized and the new challenges that neurorehabilitation and bioengineering will have to face in the upcoming years are outlined.
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References
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TL;DR: In this paper, a unified approach to kinematically constrained motion, dynamic interaction, target acquisition and obstacle avoidance is presented, which results in a unified control of manipulator behaviour.
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TL;DR: There is evidence to support rehabilitation in well coordinated multidisciplinary stroke units or through provision of early supported provision of discharge teams and promising interventions that could be beneficial to improve aspects of gait include fitness training, high-intensity therapy, and repetitive-task training.
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Steven L. Wolf,Carolee J. Winstein,J. Philip Miller,Edward Taub,Gitendra Uswatte,David M. Morris,Carol Giuliani,Kathye E. Light,Deborah S. Nichols-Larsen +8 more
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