Neurorobotic and hybrid management of lower limb motor disorders: a review

In the past 9 years, DID YOUR HOSPITAL DO ONE DAMN THING WITH THIS? Or did the board of directors allow the cesspools of incompetence to infect the whole hospital?  Why would you want to go to a hospital that DOES NOTHING with stroke research? 

Neurorobotic and hybrid management of lower limb motor disorders: a review

  Received: 22 February 2011/Accepted: 30 July 2011
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 International Federation for Medical and Biological Engineering 2011

Abstract

 A neurobot (NR) is a mechatronic wearable robot that can be applied to drive a paralyzed limb.Through the application of controllable forces, a NR can assist, replace, or retrain a certain motor function. Robotic intervention in rehabilitation of motor disorders has a potential to improve traditional therapeutic interventions.Because of its flexibility, repeatability and quantifiability, NRs have been more and more applied in neurorehabilitation. Furthermore, combination of NRs with functional electrical stimulation/therapy constitutes a trend to over-come a number of practical limitations to widespread the application of NRs in clinical settings and motor control studies. In this review, we examine the motor learning principles, robotic control approaches and novel developments from studies with NRs and hybrid systems, with a focus on rehabilitation of the lower limbs.

Introduction

Loss of motor function is a hallmark consequences of neurological diseases. A study compiles the 12 most common neurological diseases in the U.S. Among them,those neurological diseases that can affect lower limb motor function are cerebral palsy in children, sclerosis,Parkinson, Stroke, amyotrophic lateral sclerosis, and spinal cord injury (SCI). Estimated prevalence for cerebral palsy was 2.4 per 1,000 children. In the general population, per1,000, the 1-year prevalence for multiple sclerosis was 0.9.Among the elderly, the prevalence of Parkinson disease was 9.5. For diseases best described by annual incidence per 100,000, the rate for stroke was 183,101 for major traumatic brain injury, 4.5 for spinal cord injury, and 1.6for amyotrophic lateral sclerosis [45]. Some others studies have been focused on one of those neurologic diseases, the ones with more incidence. For example, stroke prevalence has been estimated in other review in 2.9%, estimating that a new stroke attack occurs every 40 s [28]. Another study done in SCI showed that world annual incidence rates intraumatic SCI varied from 12.1 to 57.8 per million [94]. In the case of Parkinson disease, the world incidence has been established in 10–18 cases per million, with a prevalence of among 0.3–3% [35], mainly in the elderly population.Neurologic motor rehabilitation is directed toward there-learning of motor skills. Behavioral experience can cause dendrites to grow and regress, synapses to change inefficacy, vasculature and glia to be modified, and, some-times, neurons to be added or lost [56]. Task-oriented repetitive movements can improve muscular strength and movement coordination in patients with impairments dueto neurological disorder that leads to motor control abnormalities, weakness and spasticity. During the last decades, there is a trend in rehabilitation practices among practitioners that focus on the functional movements torecover gait [62, 95]: task specific physiotherapy (standing on parallel bars, training of equilibrium), bracing, manual supported over ground gait training, manual body weight supported treadmill training and robotic treadmill training,among others.