Technologies and combination therapies for enhancing movement training for people with a disability

David J Reinkensmeyer, Michael L Boninger, David J Reinkensmeyer, Michael L Boninger

Abstract

There has been a dramatic increase over the last decade in research on technologies for enhancing movement training and exercise for people with a disability. This paper reviews some of the recent developments in this area, using examples from a National Science Foundation initiated study of mobility research projects in Europe to illustrate important themes and key directions for future research. This paper also reviews several recent studies aimed at combining movement training with plasticity or regeneration therapies, again drawing in part from European research examples. Such combination therapies will likely involve complex interactions with motor training that must be understood in order to achieve the goal of eliminating severe motor impairment.

Figures

Figure 1
Figure 1
The spectrum of complexity in rehabilitation theraphy technology, ranging from simple rehabilitation devices (left) to complex robotic systems (right) (courtesy of Dr. Etienne Burdet, Imperial College, London).
Figure 2
Figure 2
Example upper extremity exoskeletons with at least four degrees of freedom, including ARMIn from ETH Zurich (left, 27), the L-Exos from Scuola Superiore Sant'Anna, Pisa, Italy (middle, 28), and the Able Exoskeleton from CEA/ISIR/Haption in France (right, 29).
Figure 3
Figure 3
Conceptual diagram of competition of task-related motor circuits for new neural resources made available with a plasticity treatment. Neural resources, such as synaptic connections, are represented by blocks. Pre-injury, there are ample resources to support motor control of multiple tasks. Following a neural injury, there are fewer resources and they are disordered. Following a plasticity treatment, there are more resources, but they are still disordered. Training on motor Task A results in ordering of blocks for that task, but leaves no blocks for building a controller for Task B.

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