Clinical Application of Virtual Reality for Upper Limb Motor Rehabilitation in Stroke: Review of Technologies and Clinical Evidence

Journal of Clinical Medicine, Journal Year: 2020, Volume and Issue: 9(10), P. 3369 - 3369

Published: Oct. 21, 2020

Neurorehabilitation for stroke is important upper limb motor recovery. Conventional rehabilitation such as occupational therapy has been used, but novel technologies are expected to open new opportunities better Virtual reality (VR) a technology with set of informatics that provides interactive environments patients. VR can enhance neuroplasticity and recovery after by providing more intensive, repetitive, engaging training due several advantages, including: (1) tasks various difficulty levels rehabilitation, (2) augmented real-time feedback, (3) immersive experiences, (4) standardized (5) safe simulation real-world activities daily living. In this comprehensive narrative review the application in stroke, mainly limbs, we cover: used including sensors; clinical evidence rehabilitation; considerations rehabilitation. Meta-analyses were identified an online search Ovid-MEDLINE, Ovid-EMBASE, Cochrane Library, KoreaMed. We expect will provide insights into successful applications or trials stroke.

Language: Английский

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Artificial intelligence in elderly healthcare: A scoping review

Ageing Research Reviews, Journal Year: 2022, Volume and Issue: 83, P. 101808 - 101808

Published: Nov. 23, 2022

Language: Английский

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Robot-Assisted Therapy for Upper Extremity Motor Impairment After Stroke: A Systematic Review and Meta-Analysis

Physical Therapy, Journal Year: 2021, Volume and Issue: 101(4)

Published: Jan. 17, 2021

Abstract Objective The purpose of this study was to review the effects robot-assisted therapy (RT) for improving poststroke upper extremity motor impairment. Methods PubMed, Embase, Medline, and Web Science databases were searched from inception April 8, 2020. Randomized controlled trials that conducted evaluate RT on impairment used Fugl-Meyer assessment scores as an outcome included. Two authors independently screened articles, extracted data, assessed methodological quality included studies using Physiotherapy Evidence Database (PEDro) scale. A random-effects meta-analysis performed pool effect sizes across studies. Results Forty-one randomized with 1916 stroke patients Compared dose-matched conventional rehabilitation, significantly improved stroke, a small size (Hedges g = 0.25; 95% CI, 0.11-0.38; I2 45.9%). subgroup analysis revealed unilateral RT, but not bilateral superior rehabilitation 0.32; 0.15-0.50; 55.9%). Regarding type robot devices, end effector device 0.22; 0.09–0.36; 35.4%), exoskeleton device, rehabilitation. stage, between-group difference (ie, vs convention rehabilitation) significant only people late subacute or chronic 0.33; 0.16-0.50; 34.2%). Conclusion might be in after notable hemiplegia limited potential spontaneous recovery.

Language: Английский

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Tailoring robot-assisted arm training to individuals with stroke: bridging neuroscience principles and clinical practice

Frontiers in Neurology, Journal Year: 2025, Volume and Issue: 16

Published: Jan. 29, 2025

Robot-assisted arm training (RAAT) has demonstrated promising potential in improving rehabilitation outcomes for individuals with neurological conditions, particularly stroke. Despite 20 years of their use clinical and research settings, there are still significant needs to be made concerning indications. In the present perspective manuscript, we provide some hypotheses suitability different RAAT according features available devices characteristics, showing limitations strengths. Several factors were considered optimization intervention, including technological characteristics (e.g., support constriction), residual upper limb motor function, phase Finally, outline key areas improvement advance field near future neuroscientific bases tailored improve outcome robotic rehabilitation.

Language: Английский

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Reliability, validity and discriminant ability of a robotic device for finger training in patients with subacute stroke

Journal of NeuroEngineering and Rehabilitation, Journal Year: 2020, Volume and Issue: 17(1)

Published: Jan. 3, 2020

Abstract Background The majority of stroke survivors experiences significant hand impairments, as weakness and spasticity, with a severe impact on the activity daily living. To objectively evaluate deficits, quantitative measures are needed. aim this study is to assess reliability, validity discriminant ability instrumental provided by robotic device for rehabilitation, in sample patients subacute stroke. Material methods In study, 120 40 controls were enrolled. Clinical evaluation included finger flexion extension strength (using Medical Research Council, MRC), spasticity Modified Ashworth Scale, MAS) motor control dexterity during ADL performance (by means Frenchay Arm Test, FAT). Robotic evaluations strength, muscle tone at rest, instrumented MAS Tardieu Scale. Subjects evaluated twice, one day apart, test-retest reliability measures, using Intraclass Correlation Coefficient (ICC). estimate response stability, standard errors measurement minimum detectable change (MDC) also calculated. Validity was assessed analyzing correlations between metrics clinical scales, Spearman’s (r). Finally, we investigated distinguish healthy subjects, Mann-Whitney U tests. Results All able discriminate from subjects ( p < 0.001). Test-retest found be excellent (in both extension) tone, ICCs higher than 0.9. MDCs equal 10.6 N flexion, 3.4 extension, 14.3 tone. Conversely, poor. correlated scales (r about 0.7 MRC, 0.5 Discussion Finger reliable sensitive measures. Moreover, strongly scales. Changes obtained MDC these could considered clinically relevant used effect rehabilitation treatment

Language: Английский

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Exoskeleton versus end-effector robot-assisted therapy for finger-hand motor recovery in stroke survivors: systematic review and meta-analysis

Topics in Stroke Rehabilitation, Journal Year: 2021, Volume and Issue: 29(8), P. 539 - 550

Published: Aug. 21, 2021

Introduction The growing number of stroke survivors with residual hand disabilities requires the development efficient recovery therapy, and robotic rehabilitation can play an important role.Objective study aims to compare relative effects end-effector (EE) exoskeleton (EXO) devices in motor patients finger-hand impairment stroke.Methods We identified randomized controlled trials (RCTs) through search database on PubMed, Embase, MEDLINE, Cochrane library until October 2020. included as outcomes: motricity index (MI), quick version arm, shoulder, (QuickDASH) questionnaire, Fugl-Meyer assessment for upper extremity (FMAUE). performed a systematic review, meta-analysis, surface under cumulative ranking analysis (SUCRA).Results five RTCs 149 subjects. MI showed signifìcant improvement (p < .05) intervention group compared control (effect size, ES: 9.47; confidence interval, CI: 3.91, 15.03). QuickDASH reported significant reduction EXO (ES: −6.71; −9.17, −4.25). FMAUE EE (ES:3; CI:1.97, 4.04). SUCRA demonstrated that interventions are more likely be best option (97.3% probability EXO; 48.3% EE; 4.4% control).Conclusion Despite limited studies included, might better than treatment fingers patients. Further still needed confirm findings should focus direct comparison two devices.

Language: Английский

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Immersive virtual reality for upper limb rehabilitation: comparing hand and controller interaction

Virtual Reality, Journal Year: 2022, Volume and Issue: 27(2), P. 1157 - 1171

Published: Dec. 2, 2022

Virtual reality shows great potential as an alternative to traditional therapies for motor rehabilitation given its ability immerse the user in engaging scenarios that abstract them from medical facilities and tedious exercises. This paper presents a virtual application includes three serious games was developed rehabilitation. It uses standalone headset user's hands without need any controller interaction. Interacting with immersive environment using only natural hand gestures involves interaction is similar of real life, which would be especially desirable patients problems. A study involving 28 participants (4 problems) carried out compare two types (hands vs. controllers). All completed No significant differences were found number attempts necessary complete The group used controllers required less time exercise. performance outcomes independent gender age participants. subjective assessment problems not significantly different rest With regard type, mostly preferred their (78.5%). four These results suggest together headsets could improve motivation, well accepted by patients, help exercise therapy at home.

Language: Английский

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Short and long-term effects of robot-assisted therapy on upper limb motor function and activity of daily living in patients post-stroke: a meta-analysis of randomized controlled trials

Journal of NeuroEngineering and Rehabilitation, Journal Year: 2022, Volume and Issue: 19(1)

Published: July 21, 2022

Abstract Objective To investigate the effect of robot-assisted therapy (RAT) on upper limb motor control and activity function in poststroke patients compared with that non-robotic therapy. Methods We searched PubMed, EMBASE, Cochrane Library, Google Scholar Scopus. Randomized controlled trials published from 2010 to nowadays comparing RAT treatment aged 18 or older were included. Researchers extracted all relevant data included studies, assessed heterogeneity inconsistency statistics (I 2 statistics), evaluated risk bias individual studies performed analysis. Result Forty-six Meta-analysis showed outcome Fugl-Meyer Upper Extremity assessment (FM-UE) (SMD = 0.20, P 0.001) post intervention was significantly higher 0.32, < group than group. Differences outcomes FM-UE between observed at end not found follow-up. Additionally, 0.15, 0.005) 0.002) different groups only a total training time more 15 h. Moreover, differences significant when arm robots applied severe impairments (FM-UE: SMD 0.14, 0.08; activity: 0.21, 0.06) provided patient-passive − 0.09, 0.85; 0.70, 0.16). Conclusion has immediate benefits for hemiparetic after stroke controls, but there is no evidence support its long-term additional benefits. The superiority improving limited by amount patients' active participation.

Language: Английский

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Upper limb intelligent feedback robot training significantly activates the cerebral cortex and promotes the functional connectivity of the cerebral cortex in patients with stroke: A functional near-infrared spectroscopy study

Frontiers in Neurology, Journal Year: 2023, Volume and Issue: 14

Published: Feb. 6, 2023

Background Upper limb intelligence robots are widely used to improve the upper function of patients with stroke, but treatment mechanism is still not clear. In this study, functional near-infrared spectroscopy (fNIRS) was evaluate concentration changes oxygenated hemoglobin (oxy-Hb) and deoxyhemoglobin (deoxy-Hb) in different brain regions connectivity (FC) cerebral cortex stroke. Method Twenty post-stroke dysfunction were included study. They all received three types shoulder joint training, namely, active intelligent feedback robot training (ACT), suspension (SUS), passive (PAS). During activation detected by fNIRS obtain FC cortex. The signals recorded over eight ROIs: bilateral prefrontal cortices (PFC), primary motor (M1), somatosensory (S1), premotor supplementary (PM). For easy comparison, we defined right hemisphere as ipsilesional flipped lesional Nirspark. Result Compared other two groups, stronger observed during ACT. One-way repeated measures ANOVA revealed significant differences mean oxy-Hb among conditions four contralesional PFC [F (2, 48) = 6,798, p &lt; 0.01], M1 6.733, S1 4,392, 0.05], PM 3.658, 0.05]. Oxy-Hb responses region ACT than SUS ( 0.01) PAS 0.05). Cortical significantly greater 0.05) higher PAS, there no difference deoxy-Hb conditions. SUS, increased ACT, which characterized enhanced 0.05), between PAS. Conclusion study found that cortical PFC, showed tighter cortices. FC. Our research helps understand rehabilitation provides an objective basis for further application field stroke rehabilitation.

Language: Английский

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Beyond motor recovery after stroke: The role of hand robotic rehabilitation plus virtual reality in improving cognitive function

Journal of Clinical Neuroscience, Journal Year: 2021, Volume and Issue: 92, P. 11 - 16

Published: July 31, 2021

Language: Английский

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