http://jneuroengrehab.biomedcentral.com/articles/10.1186/1743-0003-11-3
- Paweł Maciejasz,
- Jörg EschweilerEmail author,
- Kurt Gerlach-Hahn,
- Arne Jansen-Troy and
- Steffen Leonhardt
Journal of NeuroEngineering and Rehabilitation201411:3
DOI: 10.1186/1743-0003-11-3
© Maciejasz et al.; licensee BioMed Central Ltd. 2014
Received: 25 October 2012
Accepted: 3 January 2014
Published: 9 January 2014
Abstract
The
existing shortage of therapists and caregivers assisting physically
disabled individuals at home is expected to increase and become serious
problem in the near future. The patient population needing physical
rehabilitation of the upper extremity is also constantly increasing.
Robotic devices have the potential to address this problem as noted by
the results of recent research studies. However, the availability of
these devices in clinical settings is limited, leaving plenty of room
for improvement. The purpose of this paper is to document a review of
robotic devices for upper limb rehabilitation including those in
developing phase in order to provide a comprehensive reference about
existing solutions and facilitate the development of new and improved
devices. In particular the following issues are discussed: application
field, target group, type of assistance, mechanical design, control
strategy and clinical evaluation. This paper also includes a
comprehensive, tabulated comparison of technical solutions implemented
in various systems.
Introduction
An
individual’s capacity to move is necessary to perform basic activities
of daily living (ADL). Movement disorders significantly reduce a
patient’s quality of life. Disorders of the upper extremities
specifically limit the independence of affected subjects. Fortunately,
there are various approaches to restore the functionality of the upper
extremity, e.g., orthoses, functional electrical stimulation, and
physical therapy. Positive outcome of physical rehabilitation, in the
case of neurologically based disorders, depends heavily on: onset,
duration, intensity and task-orientation of the training [1, 2], as well as the patient’s health condition, attention and effort [3].
Intense repetitions of coordinated motor activities constitute a
significant burden for the therapists assisting patients. In addition
and due to economical reasons, the duration of primary rehabilitation is
getting shorter and shorter [4].
These problems will probably exacerbate in the future as life
expectancy continues to increase accompanied by the prevalence of both
moderate and severe motor disabilities in the elderly population [5]
and consequently increasing their need of physical assistance. To
counteract these problems, prevailing research studies present a wide
variety of devices specifically assisting physical rehabilitation.
Robotic devices with the ability to perform repetitive tasks on patients
are among these technically advanced devices. In fact, robotic devices
are already used in clinical practice as well as clinical evaluation.
However, considering the number of devices described in the literature,
so far only a few of them have succeeded to target the subject group —
for more details see Table 1. Furthermore, it seems that the outcome of the use of devices already in clinical practice is not as positive as expected [3].
New solutions are being considered. Most of the literature reviews on
robotic devices for upper extremity rehabilitation (e.g. [6, 7]) concentrate on devices that have already undergone clinical evaluation. Gopura and Kiguchi [8]
compared the mechanical design of selected robotic devices for upper
extremity rehabilitation. However, no other publication presents a
summary of different robotic solutions for upper extremity
rehabilitation, including those being in the development phase. An
assessment of different technical solutions would provide developers of
robotic devices for upper limb rehabilitation an evaluation of solutions
that have already been considered, and thus learn from successes as
well as shortfalls from other research teams. Hence, a comparison of
various robotic devices would facilitate the development of new and
improved devices for robotic upper limb rehabilitation. The aim of this
paper is to summarize existing technical solutions for physical therapy
of the upper limb.
No comments:
Post a Comment