Robotic Therapy and the Paradox of the Diminishing Number of Degrees of Freedom - 31/10/15

Doi : 10.1016/j.pmr.2015.06.003

Hermano Igo Krebs, PhD ^a,^b,^c,^d,^e,^⁎ , Eiichi Saitoh, MD ^c, Neville Hogan, PhD ^a,^f
^a Department of Mechanical Engineering, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA
^b Department of Neurology, University of Maryland, School of Medicine, 620 W Lexington St, Baltimore, MD 21201, USA
^c Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
^d Institute of Neuroscience, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4HH, UK
^e Department of Mechanical Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka 565-0871, Japan
^f Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, 77 Massachusetts Avenue, Cambridge, MA 02139, USA

^∗Corresponding author.

Riassunto

There has been remarkable growth in the development and application of robotics to ameliorate or remediate impairment. This growth is associated with a) the understanding that plasticity is a fundamental property of the adult human brain and might be harnessed to remap or create new neural pathways and b) that robots that can safely interact with humans and assist human performance. This article discusses whether robotic therapy has achieved a level of maturity to justify its broad adoption as a rehabilitative tool. How to improve outcomes further and how to select degrees of freedom to optimize care to particular patients is also discussed.

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Keywords : Robotic therapy, Rehabilitation robotics, Stroke, Impairment-based therapy, Functional-based therapy, Degrees of freedom

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Key points

Introduction: disruptive technology

Upper extremity robotic therapy: the tipping point

Results

Cost outcomes

Lower extremity robotic therapy: in its infancy

Defining success in robotic rehabilitation

Beyond the tipping point: functional rehabilitation

The paradox of the diminishing number of degrees of freedom

Summary

Disclosures: This work was supported in part by grants from the NIH R01 HD069776 to H.I. Krebs and the Eric P. and Evelyn E. Newman Fund. H.I. Krebs and N. Hogan are co-inventors of several Massachusetts Institute of Technology (MIT)–held patents for the robotic technology. They hold equity positions in Interactive Motion Technologies (Watertown, Massachusetts, US) the company that manufactures this type of technology under license to MIT.

Esportazione

Vol 26 - N° 4

P. 691-702 - Novembre 2015 Ritorno al numero

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Robotic Therapy and the Paradox of the Diminishing Number of Degrees of Freedom - 31/10/15

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