You'll have to have your doctor analyze this to see what can be used to get you recovered. Doesn't do that. YOU DON'T HAVE A FUNCTIONING STROKE DOCTOR! Run away.
Robot-assisted rehabilitation of hand function
2010, Current opinion in …
Robot-assisted rehabilitation of hand function
Sivakumar Balasubramanian
, Julius Klein
and Etienne Burdet
Hand impairments following stroke
The human hand is an elaborate sensorimotor apparatus:a 21 degrees-of-freedom (DOF) skeleton (including the wrist)actuated by 29skeletalmuscles,and equipped with muscle sensors as well as high density of cutaneous mechano receptors (especially on the palmar side) [1].However, the main determinant of the hand’s dexterity is the intricate and highly developed neural system that senses and controls hand movements [2]. The large allocation of cortical resources for the management of the human hand is evident from the motor and sensory homunculae. The control of hand functions is distributed among various cortical (e.g. primary motor cortex, premotor cortex, parietal cortex) and subcortical (e.g.cerebellum, basal ganglia) structures [3]. Additionally,neurons in the primary motor cortex have direct projec-tions to the spinal motor neuron pools, allowing them to rapidly access hand skeletal muscles through monosynaptic connections to spinal motor neurons. The major downfall of this strong cortical dependence of hand function is loss of dexterity and the severe impairments that result from a lesion to the associated cortical structures or the corticospinal tract.Impairment of the hand function is one of the most common deficits after a stroke: approximately 60% of the stroke survivors suffer from some form of sensorimotor impairment associated with their hand [3]. The different motor impairments of the hand can be viewed
Department of Bioengineering, Imperial College of Science, Technology and Medicine, London, UK Correspondence to Etienne Burdet, PhD, South Kensington Campus, Imperial College London, LondonSW7 2AZ, UK E-mail: e.burdet@imperial.ac.uk
Sivakumar Balasubramanian and Julius Kleincontributed equally to the writing of this article.
Current Opinion in Neurology
2010, 23:000–000
Purpose of review
Initial work on robot-assisted neurorehabilitation for the upper extremity aimed primarily at training, reaching movements with the proximal sections of the upper extremity.However, recent years have seen a surge in devices dedicated to hand function. This review describes the state of the art and the promises of this novel therapeutic approach.
Recent findings
Numerous robotic devices for hand function with various levels of complexity and functionality have been developed over the last 10 years. These devices range from simple mechanisms that support single joint movements to mechanisms with as many as 18 degrees-of-freedom (DOF) that can support multijoint movements at the wrist and fingers. The results from clinical studies carried out with eight out of 30 reported devices indicate that robot-assisted hand rehabilitation reduces motor impairments of the affected hand and the arm, and improves the functional use of the affected hand.
Summary
The current evidence in support of the robot-assisted hand rehabilitation is preliminary but very promising, and provides a strong rationale for more systematic investigations in the future.
Sivakumar Balasubramanian
, Julius Klein
and Etienne Burdet
Introduction
Robot assisted neurorehabilitation has been an active area of scientific investigation for the last 15 years.Various robotic devices for the upper extremity have been developed and tested on acute and chronic stroke survivors. The initial work in this field had focused on the proximal sections of the upper extremity with devices specifically designed to assist and train, reaching movements involving the shoulder and elbow joints. Since2003, there has been a steady increase in the number of devices that assist and train distal upper extremity movements such as wrist and/or finger movements. The purpose of this article is to review the existing literature on robot-assisted rehabilitation of hand functions. It will start with a brief presentation of the different hand motor impairments resulting from a stroke, followed by a review of the design aspects of hand rehabilitation robots, and a discussion on the current status of robotic therapy for hand functions and the potential avenues for future investigations.Hand impairments following stroke
The human hand is an elaborate sensorimotor apparatus:a 21 degrees-of-freedom (DOF) skeleton (including the wrist)actuated by 29skeletalmuscles,and equipped with muscle sensors as well as high density of cutaneous mechano receptors (especially on the palmar side) [1].However, the main determinant of the hand’s dexterity is the intricate and highly developed neural system that senses and controls hand movements [2]. The large allocation of cortical resources for the management of the human hand is evident from the motor and sensory homunculae. The control of hand functions is distributed among various cortical (e.g. primary motor cortex, premotor cortex, parietal cortex) and subcortical (e.g.cerebellum, basal ganglia) structures [3]. Additionally,neurons in the primary motor cortex have direct projec-tions to the spinal motor neuron pools, allowing them to rapidly access hand skeletal muscles through monosynaptic connections to spinal motor neurons. The major downfall of this strong cortical dependence of hand function is loss of dexterity and the severe impairments that result from a lesion to the associated cortical structures or the corticospinal tract.Impairment of the hand function is one of the most common deficits after a stroke: approximately 60% of the stroke survivors suffer from some form of sensorimotor impairment associated with their hand [3]. The different motor impairments of the hand can be viewed
Department of Bioengineering, Imperial College of Science, Technology and Medicine, London, UK Correspondence to Etienne Burdet, PhD, South Kensington Campus, Imperial College London, LondonSW7 2AZ, UK E-mail: e.burdet@imperial.ac.uk
Sivakumar Balasubramanian and Julius Kleincontributed equally to the writing of this article.
Current Opinion in Neurology
2010, 23:000–000
Purpose of review
Initial work on robot-assisted neurorehabilitation for the upper extremity aimed primarily at training, reaching movements with the proximal sections of the upper extremity.However, recent years have seen a surge in devices dedicated to hand function. This review describes the state of the art and the promises of this novel therapeutic approach.
Recent findings
Numerous robotic devices for hand function with various levels of complexity and functionality have been developed over the last 10 years. These devices range from simple mechanisms that support single joint movements to mechanisms with as many as 18 degrees-of-freedom (DOF) that can support multijoint movements at the wrist and fingers. The results from clinical studies carried out with eight out of 30 reported devices indicate that robot-assisted hand rehabilitation reduces motor impairments of the affected hand and the arm, and improves the functional use of the affected hand.
Summary
The current evidence in support of the robot-assisted hand rehabilitation is preliminary but very promising, and provides a strong rationale for more systematic investigations in the future.
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