Training modalities in robot-mediated upper limb rehabilitation in stroke: a framework for classification based on a systematic review

A doctor/therapist question. Is this framework better than the previous ones? Which one is your therapist using?

Framework for rehabilitation decisions after stroke - 1997 version

 

Optimal Strategies of Upper Limb Motor Rehabilitation after Stroke

 

The clinician's voice of brain and heart: A biopsycho-ecological framework for merging the biomedical and holistic

The newest one here:

http://www.jneuroengrehab.com/content/11/1/111/abstract 

Angelo Basteris, Sharon M Nijenhuis, Arno HA Stienen, Jaap H Buurke, Gerdienke B Prange and Farshid Amirabdollahian

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Journal of NeuroEngineering and Rehabilitation 2014, 11:111  doi:10.1186/1743-0003-11-111
Published: 10 July 2014

Abstract (provisional)

Robot-mediated post-stroke therapy for the upper-extremity dates back to the 1990s. Since then, a number of robotic devices have become commercially available. There is clear evidence that robotic interventions improve upper limb motor scores and strength, but these improvements are often not transferred to performance of activities of daily living. We wish to better understand why. Our systematic review of 74 papers focuses on the targeted stage of recovery, the part of the limb trained, the different modalities used, and the effectiveness of each. The review shows that most of the studies so far focus on training of the proximal arm for chronic stroke patients. About the training modalities, studies typically refer to active, active-assisted and passive interaction. Robot-therapy in active assisted mode was associated with consistent improvements in arm function. More specifically, the use of HRI features stressing active contribution by the patient, such as EMG-modulated forces or a pushing force in combination with spring-damper guidance, may be beneficial.Our work also highlights that current literature frequently lacks information regarding the mechanism about the physical human-robot interaction (HRI). It is often unclear how the different modalities are implemented by different research groups (using different robots and platforms). In order to have a better and more reliable evidence of usefulness for these technologies, it is recommended that the HRI is better described and documented so that work of various teams can be considered in the same group and categories, allowing to infer for more suitable approaches. We propose a framework for categorisation of HRI modalities and features that will allow comparing their therapeutic benefits.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

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