Autonomous Robots

, 19:271 | Cite as

A Simple Robotic System for Neurorehabilitation

  • S. Micera
  • M. C. Carrozza
  • E. Guglielmelli
  • G. Cappiello
  • F. Zaccone
  • C. Freschi
  • R. Colombo
  • A. Mazzone
  • C. Delconte
  • F. Pisano
  • G. Minuco
  • P. Dario
Article

Abstract

In the recent past, several researchers have shown that important variables in relearning motor skills and in changing the underlying neural architecture after stroke are the quantity, duration, content, and intensity of training sessions. Unfortunately, when traditional therapy is provided in a hospital or rehabilitation center, the patient is usually seen for few hours a week. Robot-mediated therapies could improve this situation but even if interesting results have been achieved by several groups, the use of robot-mediated therapy has not become very common in clinical practice. This is due to many different reasons (e.g., the “technophobia” of some clinicians, the need for more extensive clinical trials) but one of the more important is the cost and the complexity of these devices which make them difficult to be purchased and used in all the clinical centers.

The aim of this work was to verify the possibility of improving motor recovery of hemiparetic subjects by using a simple mechatronic system. To achieve this goal, our system (named “MEchatronic system for MOtor recovery after Stroke” (MEMOS)) has been designed with the aim of using mainly “off-the-shelf products” with only few parts simply manufactured with standard technology, when commercial parts were not available. Moreover, the prototype has been developed taking into account the requirements related to the clinical applicability such as robustness and safety.

The MEMOSsystem has been used during clinical trials with subjects affected by chronic hemiparesis (<6 months from the cerebrovascular accident). The results obtained during these experiments seem to showthat notwithstanding the simple mechatronic structure characterizing theMEMOSsystem, it is able to help chronic hemiparetics to reduce their level of impairment.

Further clinical experiments with acute and chronic subjects will be carried out in order to confirm these preliminary findings. Moreover, experiments for tele-rehabilitation of patients will be also carried out.

Keywords

biomedical robotics rehabilitation robotics stroke 

References

  1. Fasoli, S.E., Krebs, H.I., Stein, J., Frontera, W.R., and Hogan, N. 2003. Effects of robotic therapy on motor impairment and recovery in chronic stroke. Arch Phys Med Rehab, 84:477–482.Google Scholar
  2. Fasoli, S.E., Krebs, H.I., Stein, J., Frontera, W.R., Hughes, R., and Hogan, N. 2004. Robotic therapy for chronic motor impairments after stroke: Follow-up results. Arch Phys Med Rehabil, 85(7):1106–1111.CrossRefGoogle Scholar
  3. Ferraro, M., Hogan Demajo, J., Krol, J., Trudell, C., Rannekleiv, K., Edelstein, L., Christos, P., Aisen, M., England, J., Fasoli, S., Krebs, H.I., Hogan, N., and Volpe, B.T. 2002. Assessing the motor status score: a scale for the evaluation of upper limb motor outcomes in patient after stroke. Neurorehabilitation and Neuron Repair, 16:283–289.Google Scholar
  4. Fugl-Meyer, A.R., Jaasko, I., Leyman, I., Olssom, S., and Steglind, S. 1975. The post-stroke hemiplegic patient. a method for evaluation of physical performance. Scand J Rehab Med, 7:13–31.Google Scholar
  5. Gomez-Pinilla, F., Ying, Z., Roy, R.R., Molteni, R., and Edgerton, V.R. 2002. Voluntary exercise induces a bdnf-mediated mechanism that promotes neuroplasticity. J Neurophys, 88(5):2187–2195.Google Scholar
  6. Granger, C.V., Cotter, A.C., Hamilton, B.B., and Fiedler, R.C. 1993. Functional assessment scales: a study of persons after stroke. Arch Phys Med Rehabil, 74:133–138.Google Scholar
  7. Hesse, S., Schulte-Tigges, G., Konrad, M., Bardeleben, A., and Werner, C. 2003. Robot-assisted arm trainer for the passive and active practice of bilateral forearm and wrist movements in hemiparetic subjects. Arch Phys Med Rehab, 84:915–920.Google Scholar
  8. Jones, T.A., Chu, C.J., Grande, L.A., and Gregory, A.D. 1999. Motor skills training enhances lesion-induced structural plasticity in the motor cortex of adult rats. J Neurosci 19:10153–10163.Google Scholar
  9. Kempermann, G., Van Praag, H., and Gage, F.H. 2000. Activity-dependent regulation of neuronal plasticity and self repair. Prog Brain Res, 127:35–48.Google Scholar
  10. Kiguchi, K., Iwami, K., Yasuda, M., Watanabe, K., and Fukuda, T. 2003. An exoskeletal robot for human shoulder joint motion assis. IEEE/ASME Trans Mech, 8:126–136.CrossRefGoogle Scholar
  11. Louriero, R., Amirabdollahian, F., Topping, M., Driessen, B., and Harwin, W. 2003. Upper limb robot mediated stroke therapy using the gentle/s approach. Auton Robot, 15:35–51.Google Scholar
  12. Lum, P.S., Burger, C.G., and Shor, P. 2004. Evidence for improved muscle activation patterns after retraining of reaching movements with the mime robotic system in subjects with post-stroke hemiparesis. IEEE Tran Neural Sys Rehab Eng, 12(2):186–194.Google Scholar
  13. Lum, P.S., Burgar, C.G., Shor, P.C., Majmundar, M., and Van der Loos, M. 2002. Robot-assisted movement training compared with conventional therapy techniques for the rehabilitation of upper-limb motor function after stroke. Arch Phys Med Rehabil, 83(7):952–959.CrossRefGoogle Scholar
  14. Micera, S., Carpaneto, J., Posteraro, F., Cenciotti, L., Popovic, M., and Dario, P. (2005) Characterization of upper arm synergies during reaching tasks in subjects affected by neurological disorders. Clin Biomech, (accepted).Google Scholar
  15. Patton, J.L. and Mussa-Ivaldi, F.A. 2004. Robot-assisted adaptive training: Custom force fields for teaching movement patterns. IEEE Trans Biomed Eng., 51:636–646.CrossRefGoogle Scholar
  16. Reinkensmeyer, D., Dewald, P., and Rymer, W. Guidance-based quantification of arm impairment following brain injury: A pilot study. IEEE Tran Rehab Eng, 7:1–11.Google Scholar
  17. Reinkensmeyer, D.J., Pang, C.T., Nessler, J.A., and Painter, C.C. 2002. Web-based telerehabilitation for the upper extremity after stroke. IEEE Trans Neural Syst Rehabil Eng, 10(2):102–108.CrossRefGoogle Scholar
  18. Rosen, J., Brand, M., Fuchs, M.B., and Arcan, M. A myosignal-based powered exoskeleton system. IEEE Trans Sys Man Cyber—Part A, 31(3):210–222.Google Scholar
  19. Tsagarakis, N. and Caldwell, D.G. Development and control of a ‘soft-actuated’ exoskeleton for use in physiotherapy and training. Auton Robot, 15(1):21–33.Google Scholar
  20. Volpe, B., Krebs, H., Hogan, N., Edelsteinn, L., Diels, C., and Aisen, M. 1999. A novel approach to stroke rehabilitation: Robot-aided sensorimotor stimulation. Neurology, 54:1938–1944.Google Scholar
  21. Volpe, B.T., Krebs, H.I., Hogan, N., Edelsteinn, L., Diels, C.M., and Aisen, M.L. 1999. Robot training enhanced motor outcome in patients with stroke maintained over 3 years. Neurology, 53(8):1874–1876.Google Scholar
  22. Werry, I., Dautenhahn, K., and Harwin, W.S. 2001. Investigating a robot as a therapy partner for children with autism. In Proc AAATE 2001, 6th European Conference For The Advancement of Assistive Technology (AAATE 2001), Ljubljana/Slovenia, pp. 374–378.Google Scholar

Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  • S. Micera
    • 1
  • M. C. Carrozza
    • 1
  • E. Guglielmelli
    • 2
  • G. Cappiello
    • 3
  • F. Zaccone
    • 3
  • C. Freschi
    • 3
  • R. Colombo
    • 4
  • A. Mazzone
    • 4
  • C. Delconte
    • 5
  • F. Pisano
    • 5
  • G. Minuco
    • 6
  • P. Dario
    • 7
  1. 1.ARTS LabScuola Superiore Sant'AnnaPisaItaly
  2. 2.Campus Biomedico UniversityRomeItaly
  3. 3.ARTS LabScuola Superiore Sant'AnnaPisaItaly
  4. 4.IRCCS Salvatore Maugeri FoundationService of BioengineeringVeruno (NO)Italy
  5. 5.Division of NeurologyVeruno (NO)Italy
  6. 6.Service of BioengineeringVeruno (NO)Italy
  7. 7.ARTS LabScuola Superiore Sant'AnnaPisaItaly

Personalised recommendations