The value of robotic systems in stroke rehabilitation

Abstract

In this paper, we discuss robot-mediated neurorehabilitation as a significant emerging field in clinical medicine. Stroke rehabilitation is advancing toward more integrated processes, using robotics to facilitate this integration. Rehabilitation approaches have tremendous value in reducing long-term impairments in stroke patients during hospitalization and after discharge, of which robotic systems are a new modality that can provide more effective rehabilitation. The function of robotics in rehabilitative interventions has been examined extensively, generating positive yet not completely satisfactory clinical results. This article presents state-of-the-art robotic systems and their prospective function in poststroke rehabilitation of the upper and lower limbs.

Keywords::

• activities of daily living
• motor learning
• neurorehabilitation
• plasticity
• robot-assisted training
• stroke

Financial & competing interests disclosure

The authors have no relevant affiliation or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, and royalties.

Professional copyediting services courtesy of Blue Pencil Science.

Key issues

• Stroke (cerebrovascular disease) is the leading cause of long-term disability in developed countries.

• There is increasing evidence that the motor system is plastic following stroke and can be influenced by motor training.

• Due to population aging, the number of people who require rehabilitation training after stroke will rise in the coming decades.

• There is a need to reduce the social cost of stroke with regard to residual motor impairments in stroke survivors and direct (inpatient and treatment) and indirect costs.

• Robotic systems have the potential to improve clinical outcomes of rehabilitation treatments and decrease treatment costs.

• Compared with physical therapy, existing robotic therapy devices confer few benefits with regard to functional outcome.

• Future research should determine whether daily living-related tasks can be enhanced by robotic training through technical design and new treatment exercises and protocols.

• The use of existing and developing robotic technology in poststroke rehabilitation will continue to grow, and the first at-home rehabilitation devices are likely to be developed and brought to market.

• Tailoring the robotic approach to user needs (patients, therapist and clinicians) might improve outcomes.

• The robotic technology is used in various domains of rehabilitation, as the large family of neurodegeneration.