A Novel Approach for Upper Limb Robotic Rehabilitation for Stroke Patients
This paper presents a novel neuro-rehabilitation system for recovery of arm and hand motor functions involved in reaching and grasping. The system provides arm weight support and robotic assistance of the hand closing/opening within specific exercises in
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Abstract. This paper presents a novel neuro-rehabilitation system for recovery of arm and hand motor functions involved in reaching and grasping. The system provides arm weight support and robotic assistance of the hand closing/opening within specific exercises in virtual reality. A user interface allows the clinicians to perform an easy parametrization of the virtual scenario, customizing the exercises and the robotic assistance to the needs of the patient and encouraging training of the hand with proper recruitment of the residual motor functions. Feasibility of the proposed rehabilitation system was evaluated through an experimental rehabilitation session, conducted by clinicians with 4 healthy participants and 2 stroke patients. All subjects were able to perform the proposed exercises with parameters adapted to their specific motor capabilities. All patients were able to use the proposed system and to accomplishing the rehabilitation tasks following the suggestion of the clinicians. The effectiveness of the proposed neuro-rehabilitation will be evaluated in an imminent prolonged clinical study involving more stroke patients. Keywords: Robotic rehabilitation · Stroke · Virtual reality · Exoskeleton · Neurorheabilitation · Haptic feedback
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Introduction
Upper limb motor impairment is one of the most frequent causes of long term disability following stroke. It includes muscle weakness, spasms, disturbed muscle timing and a reduced ability to selectively activate muscles. Recently, clinical trials provided evidence that the robotic therapy is effective for motor recovery and possesses high potential for improving functional independence [8,12,15]. The use of a robotic device permits to perform active and highly repetitive movements and it has been demonstrated to improve motor recovery after stroke compared to traditional therapy [2,3,7,13]. Robot-assisted rehabilitation devices c Springer International Publishing Switzerland 2016 F. Bello et al. (Eds.): EuroHaptics 2016, Part II, LNCS 9775, pp. 459–469, 2016. DOI: 10.1007/978-3-319-42324-1 45
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are usually combined with Virtual Reality (VR) environment, providing physical assistance to the patients while increasing the reliability and accuracy of the treatment. The combination of robot and VR allows therapists to adjust the exercises to the specific need of each patient and to monitoring the improvements through recorded kinematics data. In order to reduce the complexity and cost issues, the robotic devices can be designed in a passive manner, only to assist the patients by gravity compensation [4]. These devices support the weight of the arm such that the patients can focus on performing the VR tasks. Recently, Comani and colleagues [5] conducted a preliminary clinical study to investigate the electroencephalography (EEG) correlating of VR exercise, using the gravity compensation provided by a passive robot. In their study motor recovery was assessed through kinematic data, clinical scales and high-density electroencephalography. However, t
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