Effectiveness of robot-assisted therapy on ankle rehabilitation--a systematic review

Mingming Zhang, T Claire Davies, Shane Xie, Mingming Zhang, T Claire Davies, Shane Xie

Abstract

Objective: The aim of this study was to provide a systematic review of studies that investigated the effectiveness of robot-assisted therapy on ankle motor and function recovery from musculoskeletal or neurologic ankle injuries.

Methods: Thirteen electronic databases of articles published from January, 1980 to June, 2012 were searched using keywords 'ankle*', 'robot*', 'rehabilitat*' or 'treat*' and a free search in Google Scholar based on effects of ankle rehabilitation robots was also conducted. References listed in relevant publications were further screened. Eventually, twenty-nine articles were selected for review and they focused on effects of robot-assisted ankle rehabilitation.

Results: Twenty-nine studies met the inclusion criteria and a total of 164 patients and 24 healthy subjects participated in these trials. Ankle performance and gait function were the main outcome measures used to assess the therapeutic effects of robot-assisted ankle rehabilitation. The protocols and therapy treatments were varied, which made comparison among different studies difficult or impossible. Few comparative trials were conducted among different devices or control strategies. Moreover, the majority of study designs met levels of evidence that were no higher than American Academy for Cerebral Palsy (CP) and Developmental Medicine (AACPDM) level IV. Only one study used a Randomized Control Trial (RCT) approach with the evidence level being II.

Conclusion: All the selected studies showed improvements in terms of ankle performance or gait function after a period of robot-assisted ankle rehabilitation training. The most effective robot-assisted intervention cannot be determined due to the lack of universal evaluation criteria for various devices and control strategies. Future research into the effects of robot-assisted ankle rehabilitation should be carried out based on universal evaluation criteria, which could determine the most effective method of intervention. It is also essential to conduct trials to analyse the differences among different devices or control strategies.

Figures

Figure 1
Figure 1
Flow diagram of selection process for final review.

References

    1. Tejima N. Rehabilitation robotics: a review. Advanced Robotics. 2000;14:551–564.
    1. Hertel J. Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train. 2002;37:364–375.
    1. Brukner P, Khan K. Clinical sports medicine. 3. Sydney: McGraw Hill; 2006.
    1. ACC898 Managing soft tissue ankle injuries: a summary of recent research. +cost.
    1. Williams GR, Jiang JG, Matchar DB, Samsa GP. Incidence and occurrence of total (first-ever and recurrent) stroke. Stroke. 1999;30:2523–2528. doi: 10.1161/01.STR.30.12.2523.
    1. Dettori J, Basmania C. Early ankle mobilization, part II: a one-year follow-up of acute, lateral ankle sprains (a randomized clinical trial) Mil Med. 1994;159:15–20.
    1. Trevino S, Davis P, Hecht P. Management of acute and chronic lateral ligament injuries of the ankle. Orthop Clin North Am. 1994;25:1–16.
    1. Braun BL. Effects of ankle sprain in a general clinic population 6 to 18 months after medical evaluation. Arch Fam Med. 1999;8:143–148. doi: 10.1001/archfami.8.2.143.
    1. Jamwal PK. Design analysis and control of wearable ankle rehabilitation robot. The University of Auckland, Mechanical Engineering Department: PHD thesis; 2011.
    1. Krebs HI, Palazzolo JJ, Dipietro L, Ferraro M, Krol J, Rannekleiv K, Volpe BT, Hogan N. Rehabilitation robotics: performance-based progressive robot-assisted therapy. Autonomous Robots. 2003;15:7–20. doi: 10.1023/A:1024494031121.
    1. Wheeler JW, Krebs HI, Hogan N. 2004 IEEE/RSJ international conference on intelligent robots and systems; 28 september-2 October. Sendai, Japan: IEEE; 2004. An ankle robot for a modular gait rehabilitation system; pp. 1680–1684.
    1. Tsoi YH, Xie SQ. Design and control of a parallel robot for ankle rehabilitation. International Journal of Intelligent Systems Technologies and Applications. 2010;8:100–113. doi: 10.1504/IJISTA.2010.030193.
    1. Yoon J, Ryu J, Lim K-B. Reconfigurable ankle rehabilitation robot for various exercises. Journal of Robotic Systems. 2006;22(Supplement):15–3.
    1. Mohammed S, Amirat Y, Rifai H. Lower-limb movement assistance through wearable robots: state of the Art and challenges. Advanced Robotics. 2012;26:1–22. doi: 10.1163/016918611X607356.
    1. Hesse S, Schmidt H, Werner C, Bardeleben A. Upper and lower extremity robotic devices for rehabilitation and for studying motor control. Curr Opin Neurol. 2003;16:705–710. doi: 10.1097/00019052-200312000-00010.
    1. Senanayake C, Senanayake SMNA. EEE/ASME international conference on advanced intelligent mechatronics; July 14–17. Singapore: Institute of Electrical and Electronics Engineers Inc; 2009. Emerging robotics devices for therapeutic rehabilitation of the lower extremity; pp. 1142–1147.
    1. Kwakkel G, Kollen BJ, Krebs HI. Effects of robot-assisted therapy on upper limb recovery after stroke: a systematic review. Neurorehabil Neural Repair. 2008;22:111–121.
    1. American Heritage Publishing Company. The American heritage dictionary of the English language. 4. Boston: Houghton Mifflin, c2006: Houghton Mifflin Company; 2004.
    1. Critical review form – quantitative studies. .
    1. Guidelines for critical review form - quantitative studies. .
    1. AACPDM methodology to develop systematic reviews of treatment interventions (revision 1.2) .
    1. Saglia JA, Tsagarakis NG, Dai JS, Caldwell DG. International conference of the IEEE engineering in medicine and biology society. Buenos Aires, Argentina: IEEE; 2010. Assessment of the assistive performance of an ankle exerciser using electromyographic signals; pp. 5854–5858.
    1. Park Y-L, Chen B-R, Young D, Stirling L, Wood RJ, Goldfield E, Nagpal R. International conference on intelligent robots and systems: celebrating 50 years of robotics; 25–30 September. San Francisco, United states: Institute of Electrical and Electronics Engineers Inc; 2011. Bio-inspired active soft orthotic device for ankle foot pathologies; pp. 4488–4495.
    1. Saglia JA, Tsagarakis NG, Dai JS, Caldwell DG. International conference on robotics and automation; 3–8 May. Anchorage, Alaska: IEEE; 2010. Control strategies for ankle rehabilitation using a high performance ankle exerciser; pp. 2221–2227.
    1. Bharadwaj K, Sugar TG, Koeneman JB, Koeneman EJ. Design of a robotic gait trainer using spring over muscle actuators for ankle stroke rehabilitation. J Biomech Eng. 2005;127:1009–1013. doi: 10.1115/1.2049333.
    1. Pan B-W, Lin C-C K, Ju M-S, Ju M-S. Development of a Robot for Ankle Rehabilitation of Stroke Patients. J Biomech. 2007;40:S648.
    1. Yoshizawa N. International conference on rehabilitation robotics; 23–26 June. Kyoto, Japan: IEEE Computer Society; 2009. Gait trials of an active AFO for Achilles tendon ruptures; pp. 253–256.
    1. Ferris DP, Gordon KE, Sawicki GS, Peethambaran A. An improved powered ankle-foot orthosis using proportional myoelectric control. Gait Posture. 2006;23:425–428. doi: 10.1016/j.gaitpost.2005.05.004.
    1. Bucca G, Bezzolato A, Bruni S, Molteni F. A mechatronic device for the rehabilitation of ankle motor function. J Biomech Eng. 2009;131:125001.125001–125001.125007.
    1. Krebs HI, Rossi S, Kim S, Artemiadis PK, Williams D, Castelli E, Cappa P, Krebs HI, Rossi S, Kim S, Artemiadis PK, Williams D, Castelli E, Cappa P. International conference on rehabilitation robotics; June 29-july 1. Switzerland: ETH Zurich Science City; 2011. Pediatric anklebot; pp. 1–5.
    1. Norris JA, Marsh AP, Granata KP, Ross SD. International design engineering technical conferences & computers and information in engineering conference; September 4–7. Las Vegas, USA: ASME; 2007. Positive feedback in powered exoskeletons: improved metabolic efficiency at the cost of reduced stability.
    1. Sawicki GS, Gordon KE, Ferris DP. Int C rehab robot; 28 june-1 July. Chicago, USA: IEEE; 2005. Powered lower limb orthoses: applications in motor adaptation and rehabilitation; pp. 206–211.
    1. Roy A, Krebs HI, Williams DJ, Bever CT, Forrester LW, Macko RM, Hogan N. Robot-aided neurorehabilitation: a novel robot for ankle rehabilitation. IEEE Transactions on Robotics. 2009;25:569–582.
    1. Miyoshi T, Hiramatsu K, Yamamoto S-I, Nakazawa K, Akai M. Robotic gait trainer in water: development of an underwater gait-training orthosis. Disabil Rehabil. 2008;30:81–87. doi: 10.1080/09638280701191826.
    1. Lin C-CK JM-S, Chen S-M, Pan B-W. A specialized robot for ankle rehabilitation and evaluation. Journal of Medical and Biological Engineering. 2008;28:79–86.
    1. Blanchette A, Lambert S, Richards CL, Bouyer LJ. Walking while resisting a perturbation: effects on ankle dorsiflexor activation during swing and potential for rehabilitation. Gait Posture. 2011;34:358–363. doi: 10.1016/j.gaitpost.2011.06.001.
    1. Tsoi YH. Modelling and adaptive interaction control of a parallel robot for ankle rehabilitation. The University of Auckland, Department of Mechanical Engineering: PHD thesis; 2011.
    1. Syrseloudis CE, Emiris IZ, Lilas T, Maglara A. Design of a simple and modular 2-DOF ankle physiotherapy device relying on a hybrid serial-parallel robotic architecture. Applied Bionics and Biomechanics. 2011;8:101–114.
    1. Sun H, Zhang L, Li C. 2009 IEEE international conference on intelligent computing and intelligent systems; 20–22 November. Shanghai, China: IEEE; 2009. Dynamic analysis of horizontal lower limbs rehabilitative robot; pp. 656–660.
    1. Pengju S, Ligang Y, Zhifeng L, Huayang Y, Dai JS. 2009 IEEE international conference on robotics and biomimetics; 19–23 December. Guilin, China: IEEE; 2009. Analysis and synthesis of ankle motion and rehabilitation robots; pp. 2533–2538.
    1. Au SK, Weber J, Herr H, Au SK, Weber J, Herr H. 2007 IEEE 10th international conference on rehabilitation robotics; 12–15 June. Noordwijk, Netherlands: IEEE Computer Society; 2007. Biomechanical design of a powered ankle-foot prosthesis; pp. 298–303.
    1. ChunMan T, ZhenYang W, WeyYew T, Yu Zheng C. 2012 International conference on biomedical engineering; 27–28 feburary. Penang, Malaysia: IEEE; 2012. Design and development of inexpensive pneumatically-powered assisted knee-ankle-foot orthosis for gait rehabilitation-preliminary finding; pp. 28–32.
    1. Gengqian L, Jinlian G, Hong Y, Xiaojun Z, Guangda L. 2006 IEEE/RSJ international conference on intelligent robots and systems; 9–15 October. Beijing, China: IEEE; 2006. Design and kinematics analysis of parallel robots for ankle rehabilitation; pp. 253–258.
    1. Syrseloudis CE, Emiris IZ, Maganaris CN, Lilas TE. 30th Annual international conference of the IEEE engineering in medicine and biology society; 20–25 august. Vancouver, Canada: IEEE; 2008. Design framework for a simple robotic ankle evaluation and rehabilitation device; pp. 4310–4313.
    1. Allemand Y, Stauffer Y, Clavel R, Brodard R, Allemand Y, Stauffer Y, Clavel R, Brodard R. 2009 IEEE 11th International Conference on Rehabilitation Robotics; 23–26 June. Kyoto, Japan: IEEE Computer Society; 2009. Design of a new lower extremity orthosis for overground gait training with the WalkTrainer; pp. 550–555.
    1. Satici AC, Erdogan A, Patoglu V. 2009 IEEE International Conference on Rehabilitation Robotics; 23–26 June. Kyoto, Japan: IEEE Computer Society; 2009. Design of a reconfigurable ankle rehabilitation robot and its use for the estimation of the ankle impedance; pp. 257–264.
    1. Erdogan A, Satici AC, Patoglu V. 2009 ASME/IFToMM international conference on reconfigurable mechanisms and robots; 22–24 June. London, United Kingdom: IEEE Computer Society; 2009. Design of a reconfigurable force feedback ankle exoskeleton for physical therapy; pp. 400–408.
    1. Agrawal A, Banala SK, Agrawal SK, Binder-Macleod SA. Int C rehab robot; June 28-july 1. Chicago, United States: IEEE Computer Society; 2005. Design of a two degree-of-freedom ankle-foot orthosis for robotic rehabilitation; pp. 41–44.
    1. Tsoi YH, Xie SQ, Graham AE. Design, modeling and control of an ankle rehabilitation robot. Studies in Computational Intelligence. 2009;177:377–399. doi: 10.1007/978-3-540-89933-4_18.
    1. Hitt J, Oymagil AM, Sugar T, Hollander K, Boehler A, Fleeger J. 2007 IEEE international conference on robotics and automation; 10–14 April. Roma, Italy: IEEE; 2007. Dynamically controlled ankle-foot orthosis (DCO) with regenerative kinetics: incrementally attaining user portability; pp. 1541–1546.
    1. Cullell A, Moreno JC, Pons JL. 2007 IEEE international conference on robotics and automation 10–14 April. Roma, Italy: IEEE; 2007. The gait orthosis. A robotic system for functional compensation and biomechanical evaluation; pp. 3136–3137.
    1. Veneva I. 7th IASTED international conference on biomedical engineering; 17–19 feburary. Innsbruck, Austria: Acta Press; 2010. Intelligent device for control of active ankle-foot orthosis; pp. 100–105.
    1. Jamwal PK, Xie S, Aw KC. Kinematic design optimization of a parallel ankle rehabilitation robot using modified genetic algorithm. Robotics & Autonomous Systems. 2009;57:1018–1027. doi: 10.1016/j.robot.2009.07.017.
    1. Dai JS, Zhao T, Nester C. Sprained ankle physiotherapy based mechanism synthesis and stiffness analysis of a robotic rehabilitation device. Autonomous Robots. 2004;16:207–218.
    1. Mohammed S, Amirat Y. 2008 IEEE international conference on robotics and biomimetics; 22–25 feburary. Bangkok, Thailand: IEEE; 2009. Towards intelligent lower limb wearable robots: challenges and perspectives - state of the Art; pp. 312–317.
    1. Yoon J, Ryu J. 2005 IEEE international conference on robotics and automation; 18–22 April. Barcelona, Spain: IEEE; 2005. A novel reconfigurable ankle/foot rehabilitation robot; pp. 2290–2295.
    1. Wu Y-N, Ren Y, Hwang M, Gaebler-Spira DJ, Zhang L-Q. 32th Annual international conference of the IEEE engineering in medicine and biology society; august 31-september 4. Buenos Aires, Argentina; 2010. Efficacy of robotic rehabilitation of ankle impairments in children with cerebral palsy; pp. 4481–4484.
    1. Wu YN, Hwang M, Ren YP, Gaebler-Spira D, Zhang LQ. Combined passive stretching and active movement rehabilitation of lower-limb impairments in children with cerebral palsy using a portable robot. Neurorehabil Neural Repair. 2011;25:378–385. doi: 10.1177/1545968310388666.
    1. Ahn J. Feasibility of novel gait training with robotic assistance: dynamic entrainment to mechanical perturbation to the ankle. Massachusetts Institute of Technology, Dept of Mechanical Engineering: PHD thesis; 2011.
    1. Ahn J, Patterson T, Lee H, Klenk D, Lo A, Krebs HI, Hogan N. 2011 Annual international conference of the IEEE engineering in medicine and biology society; Aug 30-sept 3. Boston, USA: IEEE; 2011. Feasibility of entrainment with ankle mechanical perturbation to treat locomotor deficit of neurologically impaired patients; pp. 7474–7477.
    1. Maeshima S, Osawa A, Nishio D, Hirano Y, Takeda K, Kigawa H, Sankai Y. Efficacy of a hybrid assistive limb in post-stroke hemiplegic patients: a preliminary report. BMC Neurol. 2011;11:116–116. doi: 10.1186/1471-2377-11-116.
    1. Quintero HA, Farris RJ, Hartigan C, Clesson I, Goldfarb M. A powered lower limb orthosis for providing legged mobility in paraplegic individuals. Topics in Spinal Cord Injury Rehabilitation. 2011;17:25–33.
    1. Blaya JA, Herr H. Adaptive control of a variable-impedance ankle-foot orthosis to assist drop-foot gait. IEEE Trans Neural Syst Rehabil Eng. 2004;12:24–31. doi: 10.1109/TNSRE.2003.823266.
    1. Cioi D, Kale A, Burdea G, Engsberg J, Janes W, Ross S. 2011 IEEE international conference on rehabilitation robotics; June 29-july 1. ETH Zurich Science City, Switzerland: IEEE; 2011. Ankle control and strength training for children with cerebral palsy using the Rutgers ankle CP: a case study; pp. 654–659.
    1. McGehrin K, Roy A, Goodman R, Rietschel J, Forrester L, Bever C. Ankle robotics training in Sub-acute stroke survivors: concurrent within-session changes in ankle motor control and brain electrical activity. Neural Repair/Rehabilitation. 2012;78:01.175.
    1. Forrester LW, Roy A, Krebs HI, Macko RF. Ankle training with a robotic device improves hemiparetic gait after a stroke. Neurorehabil Neural Repair. 2011;25:369–377. doi: 10.1177/1545968310388291.
    1. Cordo P, Lutsep H, Cordo L, Wright WG, Cacciatore T, Skoss R. Assisted movement with enhanced sensation (AMES): coupling motor and sensory to remediate motor deficits in chronic stroke patients. Neurorehabil Neural Repair. 2009;23:67–77.
    1. Ren Y, Xu T, Wang L, Yang CY, Guo X, Harvey RL, Zhang L-Q. 33rd Annual international conference of the IEEE engineering in medicine and biology society; august 30-september 3. Boston, United states: Institute of Electrical and Electronics Engineers Inc; 2011. Develop a wearable ankle robot for in-bed acute stroke rehabilitation; pp. 7483–7486.
    1. Homma K, Usuba M. 2007 IEEE 10th international conference on rehabilitation robotics; 12–15 June. Noordwijk, Netherlands: IEEE Computer Society; 2007. Development of ankle dorsiflexion/plantarflexion exercise device with passive mechanical joint; pp. 292–297.
    1. Furusho J, Kikuchi T, Tokuda M, Kakehashi T, Ikeda K, Morimoto S, Hashimoto Y, Tomiyama H, Nakagawa A, Akazawa Y. 2007 IEEE 10th international conference on rehabilitation robotics; 12–15 June. Noordwijk, Netherlands: IEEE Computer Society; 2007. Development of shear type compact MR brake for the intelligent ankle-foot orthosis and its control; pp. 89–94.
    1. Sawicki GS, Domingo A, Ferris DP. The effects of powered ankle-foot orthoses on joint kinematics and muscle activation during walking in individuals with incomplete spinal cord injury. Journal of Neuro engineering and Rehabilitation. 2006;3:3. doi: 10.1186/1743-0003-3-3.
    1. Mirbagheri MM, Ness LL, Patel CP, Quiney K, Rymer WZ. 2011 IEEE international conference on rehabilitation robotics; June 29-july 1. ETH Zurich Science City, Switzerland: IEEE; 2011. The effects of robotic-assisted locomotor training on spasticity and volitional control.
    1. Mirelman A, Bonato P, Deutsch JE. Effects of training with a robot-virtual reality system compared with a robot alone on the gait of individuals after stroke. Stroke. 2008;40:169–174.
    1. Chin LF, Lim WS, Kong KH. Evaluation of robotic-assisted locomotor training outcomes at a rehabilitation centre in singapore. Singapore Med J. 2010;51:709–715.
    1. Selles RW, Li X, Lin F, Chung SG, Roth EJ, Zhang L-Q. Feedback-controlled and programmed stretching of the ankle plantarflexors and dorsiflexors in stroke: effects of a 4-week intervention program. Arch Phys Med Rehabil. 2005;86:2330–2336. doi: 10.1016/j.apmr.2005.07.305.
    1. Boian RF, Deutsch JE, Lee CS, Burdea GC, Lewis J. 11th Symposium on haptic interfaces for virtual environment and teleoperator systems; 22–23 march. Los Angeles, USA: IEEE; 2003. Haptic effects for virtual reality-based post-stroke rehabilitation; pp. 247–253.
    1. Deutsch JE, Pasercllia C, Vecchione C, Mirelman A, Lewis JA, Doian R, Burclca G. Improved gait and elevation speed of individuals poststroke after lower extremity training in virtual environments. Journal of Neurological Physical Therapy. 2004;28:185–186.
    1. Zhang L-Q, Chung SG, Bai Z, Xu D, Rey EMT, Rogers MW, Johnson ME, Roth EJ. Intelligent stretching of ankle joints with contracture spasticity. IEEE Trans Neural Syst Rehabil Eng. 2002;10:149–157. doi: 10.1109/TNSRE.2002.802857.
    1. Tanida S, Kikuchi T, Kakehashi T, Otsuki K, Ozawa T, Fujikawa T, Yasuda T, Furusho J, Morimoto S, Hashimoto Y. 2009 IEEE international conference on rehabilitation robotics, ICORR 2009, June 23, 2009 - June 26, 2009. Kyoto, Japan: IEEE Computer Society; 2009. Intelligently controllable ankle foot orthosis (I-AFO) and its application for a patient of guillain-barre syndrome; pp. 857–862.
    1. Girone M, Burdea G, Bouzit M, Popescu V. Virtual reality meets Med. Amsterdam, The Netherlands: Ios Press; 2000. Orthopedic rehabilitation using the “Rutgers ankle” interface; pp. 89–95.
    1. Shorter KA, Kogler GF, Loth E, Durfee WK, Hsiao-Wecksler ET. A portable powered ankle-foot orthosis for rehabilitation. J Rehabil Res Dev. 2011;48:459–472. doi: 10.1682/JRRD.2010.04.0054.
    1. Deutsch JE, Latonio J, Burdea GC, Boian R. Post-stroke rehabilitation with the rutgers ankle system: a case study. Presence. 2001;10:416–430. doi: 10.1162/1054746011470262.
    1. Deutsch JE, Latonio J, Burdea GC, Boian R. Eurohaptics conference. Birmingham, UK: ; 2001. Rehabilitation of musculoskeletal injuries using the Rutgers ankle haptic interface: three case reports; pp. 11–16.
    1. Burdea GC, Cioi D, Angad K, Janes WE, Ross SA, Engsberg JR. Robotics and gaming to improve ankle strength, motor control and function in children with cerebral palsy-a case study series. IEEE Transaction on Neural System and Rehabilitation Engineering. 2012;PP(99):1.
    1. Roy A, Forrester LW, Macko RF. Short-term ankle motor performance with ankle robotics training in chronic hemiparetic stroke. J Rehabil Res Dev. 2011;48:417–430. doi: 10.1682/JRRD.2010.04.0078.
    1. Waldman G, Wu YN, Ren Y, Li Y, Guo X, Roth EJ, Wang L, Zhang LQ. International stroke conference and nursing symposium poster presentations. Los Angeles, USA: The American Heart Association; 2011. Stroke rehabilitation using a portable robot improves biomechanical and clinical outcome measures; p. e128.
    1. Ward J, Sugar T, Standeven J, Engsberg JR. 2010 IEEE international conference on robotics and automation; 3–8 May. Anchorage, USA: IEEE; 2010. Stroke survivor gait adaptation and performance after training on a powered ankle foot orthosis; pp. 211–216.
    1. Deutsch JE, Lewis JA, Burdea G. Technical and patient performance using a virtual reality-integrated telerehabilitation system: preliminary finding. IEEE Trans Neural Syst Rehabil Eng. 2007;15:30–35.
    1. Mirbagheri MM, Tsao C, Pelosin E, Rymer WZ. Int C rehab robot; 28 june-1 July. Chicago, USA: IEEE; 2005. Therapeutic effects of robotic-assisted locomotor training on neuromuscular properties; pp. 561–564.
    1. Boian RF, Lee CS, Deutsch JE, Burdea GC, Lewis JA. International workshop on virtual reality rehabilitation (mental health, neurological, physical, vocational) VRMHR 2002 . Lausanne, Switzerland: ; 2002. Virtual reality-based system for ankle rehabilitation post stroke; pp. 77–86.
    1. Mirbagheri MM, Patel C, Quiney K. Engineering in medicine and biology society,EMBC, 2011 annual international conference of the IEEE; Aug. 30 2011-Sept. 3 2011. Boston, Massachusetts USA: ; 2011. Robotic-assisted locomotor training impact on neuromuscular properties and muscle strength in spinal cord injury; pp. 4132–4135.
    1. International classification of functioning, disability and health. ,_Disability_and_Health.
    1. Mudge S, Stott NS. Timed walking tests correlate with daily step activity in persons with stroke. Arch Phys Med Rehabil. 2009;90:296–301. doi: 10.1016/j.apmr.2008.07.025.
    1. Nadeau S, Gravel D, Arsenault AB, Bourbonnais D. Plantarflexor weakness as a limiting factor of gait speed in stroke subjects and the compensating role of hip flexors. Clin Biomech. 1999;14:125–135. doi: 10.1016/S0268-0033(98)00062-X.
    1. Ross SA, Engsberg JR. Relationships between spasticity, strength, gait, and the GMFM-66 in persons with spastic diplegia cerebral palsy. Arch Phys Med Rehabil. 2007;88:1114–1120. doi: 10.1016/j.apmr.2007.06.011.
    1. Lin SI. Motor function and joint position sense in relation to gait performance in chronic stroke patients. Arch Phys Med Rehabil. 2005;86:197–203. doi: 10.1016/j.apmr.2004.05.009.
    1. Kim CM, Eng JJ. The relationship of lower-extremity muscle torque to locomotor performance in people with stroke. Phys Ther. 2003;83:49–57.
    1. Lin PY, Yang YR, Cheng SJ, Wang RY. The relation between ankle impairments and gait velocity and symmetry in people with stroke. Arch Phys Med Rehabil. 2006;87:562–568. doi: 10.1016/j.apmr.2005.12.042.
    1. Stein J, Hughes R, Fasoli S, Krebs HI, Hogan N. Clinical applications of robots in rehabilitation. Physical and Rehabilitation Medicine. 2005;17:217–230.
    1. Marchal-Crespo L, Reinkensmeyer DJ. Review of control strategies for robotic movement training after neurologic injury. J Neuroeng Rehabil. 2009;6:20. doi: 10.1186/1743-0003-6-20.
    1. Lim H-O, Tanie K. Human safety mechanisms of human-friendly robots: passive viscoelastic trunk and passively movable base. The International Journal of Robotics Research. 2000;19:307–335. doi: 10.1177/02783640022066888.
    1. Santis AD, Siciliano B, Luca AD, Bicchi A. An atlas of physical human–robot interaction. Mechanism and Machine Theory. 2008;43:253–270. doi: 10.1016/j.mechmachtheory.2007.03.003.
    1. Hogan N, Krebs HI, Rohrer B, Palazzolo JJ, Dipietro L, Fasoli SE, Stein J, Hughs R, Frontera WR, Lynch D, Volpe BT. Motions or muscles? some behavioral factors underlying robotic assistance of motor recovery. J Rehabil Res Dev. 2006;43:605–618. doi: 10.1682/JRRD.2005.06.0103.
    1. Radomski MV, Latham CAT. Occupational therapy for physical dysfunction. 6. Philadelphia, USA: Lippincott Williams & Wilkins; 2008.
    1. Siegler S, Chen J, Schneck CD. The three-dimensional kinematics and flexibility characteristics of the human ankle and subtalar joints—part I Kinematics1. J Biomech Eng. 1988;110:364–373. doi: 10.1115/1.3108455.

Source: PubMed

Sponsorit ja yhteistyökumppanit

Sairaudet

Huumeiden interventiot

3
Tilaa