Upper Extremity Rehabilitation using Robotics

 Description 

There are mainly two types of robotic devices for upper limb rehabilitation: the end-effector-based and the exoskeleton- based robots. The main advantage of the upper limb robot on the basis of the end-effector system is that it adapts to patients with different body sizes. In contrast, the exoskeleton upper limb robot required various modifications in different patients because they needed an optimal joint adaptation to work correctly (REFERENCE)

Indication 

The hand serves very important role with functionality. It is used in everyday activities such as eating, dressing, object manipulation and handwriting. Therefore re-training reach and grasping skills is critical to improving quality of life, hand therapy is used to relearn basic skills (REFERENCE). Rehabilitation robotic systems for upper extremities have the potential to deliver large doses of motor training in a cost-effective manner (REFERENCE) Clinical testing has be shown that robotic hand training can improve movement ability and performance on functional scales, in chronic stroke patients.

Key Evidence 

Amadeo Robotic System by Tyromotion 

The Amadeo Robotic System by Tyromotion is an end-effector based system that has five degrees of freedom and provides the motion of one or all five fingers through a passive rotational joint placed between the fingertip and an entity that moves laterally (the thumb has two passive rotational joints). All five translational degrees of freedom are independent and provide an almost entire coverage of the fingers’ workspace. The interface between the human hand and the machine is achieved thanks to elastic bands or plasters and the wrist is restrained from movement by a Velcro strap. (REFERENCE) 

 Acute- Stroke: 

A randomized control trial conducted on acute stroke patients looked at the effectiveness robot- assisted hand therapy using a device the Amadeo Robotic System by Tyromotion. The Amadeo treatment composed of 1) continuous passive therapy 2) assisted movement therapy 3) balloon training (active training in a virtual environment by carrying out target oriented tasks) (REFERENCE). Comparable to traditional Occupational Therapy methods, patients within the robotic therapy group made significant improvements in Fugl-Meyer Scale (FM), and Box and Block Test (BB) at the end of treatment (4/5 weeks) and maintained improvements after a 3-month follow-up. This result is very important because the gain achieved is not exercise or time dependent, but could be secondary to reorganization of brain structures (REFERENCE).