Role of Robotics in Neurorehabilitation

Abstract

Over the past decade, rehabilitation hospitals have begun to incorporate robotics technologies into the daily treatment schedule of many patients. These interventions hold greater promise than simply replicating traditional therapy, because they allow therapists an unprecedented ability to specify and monitor movement features such as speed, direction, amplitude, and joint coordination patterns and to introduce controlled perturbations into therapy. We argue that to fully realize the potential of robotic devices in neurorehabilitation, it is necessary to better understand the specific aspects of movement that should be facilitated in rehabilitation. In this article, we first discuss neurorecovery in the context of motor control and learning principles that can provide guidelines to rehabilitation professionals for enhancing recovery of motor function. We then discuss how robotic devices can be used to support such activities.

Figure 1

The motor control system after stroke or spinal cord injury is altered so that the internal model is no longer appropriate to the postinjury sensory-motor system. As a result, predicted motor commands are likely to be inaccurate in achieving a desired movement trajectory.

Figure 2

(A) Lokomat robotic exoskeleton (Hocoma AG, Volketswil, Switzerland) assists patients as they walk on a treadmill. (B) ZeroG overground gait and balance training system (Aretech, LLC, Ashburn, Virginia).