Full-text articles available at http://www.rehab.research.va.gov/jour/11s/4834contents.html
Manuscripts featured in this issue include—
ZeroG: Overground gait and balance training system, pg. 287
This article evaluates the ZeroG, a new overground body-weight support system that allows patients to practice gait and balance activities safely following neurological and orthopedic injuries. Unlike existing overground gait training technologies, the ZeroG offers both dynamic and static body-weight support and an actively driven trolley system that minimizes the horizontal forces felt by a subject. This article reports on the performance of ZeroG’s unloading system and the trolley tracking system based on benchtop and human-subject testing.
Retraining of interjoint arm coordination after stroke using robot-assisted time-independent functional training, pg. 299
This article describes the initial validation of time-independent functional training, a new haptic-based therapy for retraining interjoint coordination following stroke. For the study, the training module was coupled with the ARMin III robotic exoskeleton, whereby arm movements of a patient were maintained within the proper kinematic trajectory without use of compensatory strategies. The study results show little variation between test groups, suggesting that haptic information may not improve learning of a complex trajectory above what is possible with visual information alone.
Variable structure pantograph mechanism with spring suspension system for comprehensive upper-limb haptic movement training, pg. 317
This article describes testing of the Universal Haptic Pantograph (UHP), a multifunction device developed for movement training of the shoulder, elbow, and wrist. This third-generation prototype comprises 7 joints, 11 joint axes, and 3 configurable joint locks that limit the system’s degrees of freedom thereby offering an increased number of functional training modes, smoother transitions between modes, and improved means of gravity compensation over its predecessor. The clinical test results show that upper-limb function improved significantly following training sessions, suggesting that the UHP may be as effective as single-function devices while significantly reducing the cost of robotic rehabilitation hardware.
Potential of robots as next-generation technology for clinical assessment of neurological disordersand upper-limb therapy, pg. 335
This review describes how robotic technologies combined with virtual/augmented reality systems can support a broad range of behavioral tasks to quantify brain function objectively. It also highlights the potential benefits of robots in providing upper-limb therapy.
Upper-limb robot-assisted therapy in rehabilitation of acute stroke patients: Focused review and results of new randomized controlled trial, pg. 355
This article reports on a randomized clinical trial of the Neuro-Rehabilitation-roBot (NeReBot), a device with three degrees of freedom for the treatment of post-stroke upper-limb impairments. The results of NeReBot training when substituted for conventional proximal upper-limb exercise are discussed. The results suggest that robot-assisted rehabilitation can be as effective as conventional therapy.
Psychological state estimation from physiological recordings during robot-assisted gait rehabilitation, pg. 367
This study evaluates the feasibility of adapting gait training in real time based on a subject’s level of mental engagement (e.g., boredom, excitement, or stress). Researchers recorded psychophysiological measurements such as heart rate and skin temperature as an objective measure of engagement while participants navigated a virtual reality environment collecting items and performed locomotor treadmill training. The study results confirm the feasibility of real-time objective assessment of mental engagement to maximize an individual’s motor learning during rehabilitation.
Efficacy of rehabilitation robotics for walking training in neurological disorders: A review, pg. 387
This literature review examines the effects of robotics-based locomotor training on individuals with such neurological disorders as stroke, spinal cord injury, multiple sclerosis, traumatic brain injury, and Parkinson disease. Based on a review of 30 articles, the findings support the use of robotics-based locomotor training for improving walking function in individuals with stroke and spinal cord injury. Evidence on the use of locomotor training with the other conditions is limited or insufficient to suggest benefits to these populations.
Short-term ankle motor performance with ankle robotics training in chronic hemiparetic stroke, pg. 417
This article discusses the training effects of a new ankle robot on people with stroke. Study participants trained for 1 hour using an ankle-controlled video game first without and then with the help of a robot. The results show that the training increased accuracy, speed, and smoothness of ankle movements in participants with stroke. Participants had retained the benefits at 48 hours.
Pilot study to test effectiveness of video game on reaching performance in stroke, pg. 431
This study investigates user preferences and outcomes of functional reach training with two forms of feedback in subjects with unilateral hemiparetic stroke. Researchers compared the reaching distances achieved by participants who had completed training using the Arm Coordination Training 3D system with visual feedback in the forms of an avatar and a simulated air hockey game. The results show that subjects achieved greater reaching distances with the avatar feedback but unanimously preferred the air hockey simulation as feedback during training.
Robot-assisted upper-limb therapy in acute rehabilitation setting following stroke: Department of Veterans Affairs multisite clinical trial, pg. 445
This study evaluates the efficacy of robot-assisted upper-limb therapy with the Mirror Image Movement Enabler (MIME) in the acute stroke rehabilitation setting. The aims of the study were to evaluate whether MIME could facilitate similar or greater motor recovery as early hands-on therapy and to investigate the dose-response effect of robot-assisted therapy. The results demonstrate a trend toward greater upper-limb function in groups that received robot-assisted training than in those that received an equal amount of conventional therapy. Additionally, the results demonstrate a strong dose-response effect between intensity of training and Fugl-Meyer assessment scores at the completion of training and at follow-up.
A portable powered ankle-foot orthosis for rehabilitation, pg. 459
This article presents a novel portable powered ankle-foot orthosis that provides untethered assistance for potential at-home daily rehabilitation. The study results demonstrate that the ankle-foot orthosis provided appropriately timed powered assistance during walking. Pilot data from subjects with and without disabilities demonstrated the potential of the orthosis to provide both plantar flexor and dorsiflexor assistance during walking.
Quantitative evaluations of ankle spasticity and stiffness in neurological disorders using manual spasticity evaluator, pg. 473
This article describes a new manual spasticity evaluator (MSE) for quantitatively and conveniently measuring spasticity or contracture in the ankle joint. The study evaluated the capability of MSE to measure ankle range of motion at controlled low velocity, elastic stiffness, spasticity, and Tardieu catch angle at higher velocities in children with and without cerebral palsy. The results show that the Tardieu angle, range of motion, and stiffness in the spastic ankle can be quantitatively and conveniently determined with the MSE.
Effect of robot-assisted versus conventional body-weight-supported treadmill training on quality of life for people with multiple sclerosis, pg. 483
Researchers compared the results of robot-assisted and unassisted body-weight-supported treadmill training (BWSTT) on the quality of life for patients with multiple sclerosis. The results suggest that task repetitive gait training with both types of BWSTT may improve quality of life for people with MS-related gait dysfunction. No significant quantifiable differences were found between the two forms of BWSTT.
JRRD is a peer-reviewed, scientifically indexed journal providing comprehensive coverage of all rehabilitation disciplines. It provides researchers and other rehabilitation professionals with the ideal venue for publishing original research papers for exposure to a global audience. For more information about JRRD, please visit www.rehab.research.va.gov/jrrd.
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