Robotic Systems that Rehabilitate as well as Motivate: Three Strategies for Motivating Impaired Arm Use

Despite motor reduction due to rehabilitation training, whether robot-mediated or otherwise, many stroke patients with hemiplegia have learn non-use and lack motivation to use their impaired arm in real life. Therefore, other factors besides motor impairment and strength levels are critical to recovery of function on real activities. This paper discusses barriers to impaired arm use in the real world and presents a definition of motivation that is relevant to robot-assisted therapy. Three case studies highlighting three strategies to create robotic systems that are more motivating are discussed. The strategies are 1: embed therapy within a framework that provides patients with monitoring and interaction with therapists, 2: embed therapy into fun, video game like activities, and 3: embed therapy within patient-centered real-life functional activities

[1]  D C Good,et al.  Rehabilitation of the stroke patient. , 1995, Current opinion in neurology.

[2]  N. Miller,et al.  An operant approach to rehabilitation medicine: overcoming learned nonuse by shaping. , 1994, Journal of the experimental analysis of behavior.

[3]  P. Pound,et al.  A critical review of the concept of patient motivation in the literature on physical rehabilitation. , 2000, Social science & medicine.

[4]  P. Bach-y-Rita.  Theoretical and Practical Considerations in the Restoration of Function After Stroke , 2001, Topics in stroke rehabilitation.

[5]  Hui-ing Ma,et al.  A synthesis of the effects of occupational therapy for persons with stroke, Part II: Remediation of impairments. , 2002, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[6]  E. Taub,et al.  Constraint-Induced Movement Therapy: a new family of techniques with broad application to physical rehabilitation--a clinical review. , 1999, Journal of rehabilitation research and development.

[7]  M.J. Johnson,et al.  TheraDrive: a new stroke therapy concept for home-based, computer-assisted motivating rehabilitation , 2004, The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[8]  J A Hastings,et al.  A method of residual limb stiffness distribution measurement. , 1999, Journal of rehabilitation research and development.

[9]  William Harwin,et al.  A Gentle/S approach to robot assisted neuro-rehabilitation , 2004 .

[10]  M.J. Johnson,et al.  Kinematic implications of learned non-use for robotic therapy , 2005, 9th International Conference on Rehabilitation Robotics, 2005. ICORR 2005..

[11]  M.J. Johnson,et al.  A Suite of Computer-Assisted Techniques for Assessing Upper-Extremity Motor Impairments , 2005, 2005 IEEE Engineering in Medicine and Biology 27th Annual Conference.

[12]  J. Winters.  Telerehabilitation research: emerging opportunities. , 2002, Annual review of biomedical engineering.

[13]  N. Hogan,et al.  Effects of robotic therapy on motor impairment and recovery in chronic stroke. , 2003, Archives of physical medicine and rehabilitation.

[14]  C. Wolfe,et al.  Qualitative analysis of stroke patients' motivation for rehabilitation , 2000, BMJ : British Medical Journal.

[15]  P. Pohl,et al.  Therapeutic interventions to improve upper extremity recovery and function. , 1999, Clinics in geriatric medicine.

[16]  C. A. Trombly,et al.  Occupational Therapy for Physical Dysfunction , 1989 .

[17]  P. Bach-y-Rita,et al.  Computer-Assisted Motivating Rehabilitation (CAMR) for Institutional, Home, and Educational Late Stroke Programs , 2002, Topics in stroke rehabilitation.

[18]  Annette Sterr,et al.  Neurobehavioral aspects of recovery: assessment of the learned nonuse phenomenon in hemiparetic adolescents. , 2002, Archives of physical medicine and rehabilitation.

[19]  M. Dacso,et al.  Rehabilitation of the stroke patient. , 1968, Modern treatment.

[20]  Hui-ing Ma,et al.  A synthesis of the effects of occupational therapy for persons with stroke, Part I: Restoration of roles, tasks, and activities. , 2002, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[21]  M.J. Johnson,et al.  Development of ADLER: The Activities of Daily Living Exercise Robot , 2006, The First IEEE/RAS-EMBS International Conference on Biomedical Robotics and Biomechatronics, 2006. BioRob 2006..

[22]  J. Schaechter.  Motor rehabilitation and brain plasticity after hemiparetic stroke , 2004, Progress in Neurobiology.

[23]  K J Sullivan,et al.  Activity-Dependent Factors Affecting Poststroke Functional Outcomes , 2001, Topics in stroke rehabilitation.

[24]  P. Duncan,et al.  Post-Stroke Rehabilitation , 2004 .

[25]  H. F. Machiel Van der Loos,et al.  Design and evaluation of Driver's SEAT: A car steering simulation environment for upper limb stroke therapy , 2003, Robotica.