Robot-assisted gait training for stroke patients: current state of the art and perspectives of robotics

Giovanni Morone, Stefano Paolucci, Andrea Cherubini, Domenico De Angelis, Vincenzo Venturiero, Paola Coiro, Marco Iosa, Giovanni Morone, Stefano Paolucci, Andrea Cherubini, Domenico De Angelis, Vincenzo Venturiero, Paola Coiro, Marco Iosa

Abstract

In this review, we give a brief outline of robot-mediated gait training for stroke patients, as an important emerging field in rehabilitation. Technological innovations are allowing rehabilitation to move toward more integrated processes, with improved efficiency and less long-term impairments. In particular, robot-mediated neurorehabilitation is a rapidly advancing field, which uses robotic systems to define new methods for treating neurological injuries, especially stroke. The use of robots in gait training can enhance rehabilitation, but it needs to be used according to well-defined neuroscientific principles. The field of robot-mediated neurorehabilitation brings challenges to both bioengineering and clinical practice. This article reviews the state of the art (including commercially available systems) and perspectives of robotics in poststroke rehabilitation for walking recovery. A critical revision, including the problems at stake regarding robotic clinical use, is also presented.

Keywords: activities of daily living; exoskeleton; motor learning; neurorehabilitation; plasticity; robot-assisted walking training; wearable robot.

Conflict of interest statement

Disclosure The authors have no relevant affiliation or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject, matter, or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants, or patents, received or pending, or royalties. The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The determinants of gait and balance by multisystem rehabilitation of patients with stroke who may benefit from robotic training.
Figure 2
Figure 2
Theoretical schema combining patient’s level of ability defined by functional classification of ambulation (FAC) with best possible solution in terms of walking training and machine constriction. Abbreviation: BWS-TT, body weight-supported treadmill training.
Figure 3
Figure 3
Examples of robotic devices with different approaches.

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