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Clinical application of robotics and technology in the restoration of walking


Esquenazi, Alberto; Maier, Irin C; Schuler, Tabea Aurich; Beer, Serafin M; Borggraefe, Ingo; Campen, Katrin; Luft, Andreas R; Manoglou, Dimitrios; Meyer-Heim, Andreas; Spiess, Martina R; Wirz, Markus (2016). Clinical application of robotics and technology in the restoration of walking. In: Reinkensmeyer, David; Dietz, Volker. Neurorehabilitation Technology. Springer International: Springer International Publishing, 223-248.

Abstract

Robots for neurorehabilitation have been designed principally to automate repetitive labor-intensive training and to support therapists and patients during different stages of rehabilitation. Devices designed for body weight-supported treadmill training are promising task-oriented tools intended to assist in the restoration of gait. In early rehabilitation, robots provide a safe environment through the use of a suspension harness and assistance in achieving a more physiological gait pattern while promoting a high number of repetitions. In the later stages of rehabilitation, more sophisticated control strategies, virtual environment scenarios, or the possibility to address specific gait deficits by modulating different parameters extends their application. Scientific and clinical evidence for the effectiveness, safety, and tolerability of these devices exists; however documentation of their comparative advantages to conventional therapies is limited.

This might be due to the lack of appropriate selection parameters of locomotor training interventions based on functional impairments. Despite this shortcoming, robotic devices are being integrated into clinical settings with promising results. Appropriate use is dependent on the clinicians’ knowledge of different robotic devices as well as the ability to utilize the devices’ technical features, thereby allowing patients to benefit from robot-aided gait training throughout the rehabilitation continuum with the ultimate goal of safe and efficient overground walking.

This chapter will provide an overview on the rationales of introducing robots into the clinic and discuss their value in various neurological diagnoses. In addition, recommendations for goal setting and practice of robot-assisted training based on disease-related symptoms and functional impairment are summarized.

Abstract

Robots for neurorehabilitation have been designed principally to automate repetitive labor-intensive training and to support therapists and patients during different stages of rehabilitation. Devices designed for body weight-supported treadmill training are promising task-oriented tools intended to assist in the restoration of gait. In early rehabilitation, robots provide a safe environment through the use of a suspension harness and assistance in achieving a more physiological gait pattern while promoting a high number of repetitions. In the later stages of rehabilitation, more sophisticated control strategies, virtual environment scenarios, or the possibility to address specific gait deficits by modulating different parameters extends their application. Scientific and clinical evidence for the effectiveness, safety, and tolerability of these devices exists; however documentation of their comparative advantages to conventional therapies is limited.

This might be due to the lack of appropriate selection parameters of locomotor training interventions based on functional impairments. Despite this shortcoming, robotic devices are being integrated into clinical settings with promising results. Appropriate use is dependent on the clinicians’ knowledge of different robotic devices as well as the ability to utilize the devices’ technical features, thereby allowing patients to benefit from robot-aided gait training throughout the rehabilitation continuum with the ultimate goal of safe and efficient overground walking.

This chapter will provide an overview on the rationales of introducing robots into the clinic and discuss their value in various neurological diagnoses. In addition, recommendations for goal setting and practice of robot-assisted training based on disease-related symptoms and functional impairment are summarized.

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Additional indexing

Item Type:Book Section, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2016
Deposited On:03 Feb 2017 10:37
Last Modified:03 Feb 2017 10:40
Publisher:Springer International Publishing
ISBN:978-3-319-28601-3
Publisher DOI:https://doi.org/10.1007/978-3-319-28603-7_12
Related URLs:https://doi.org/10.1007/978-3-319-28603-7 (Publisher)

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