Robotics for Lower Limb Rehabilitation.

Improving walking function is a desirable outcome in rehabilitation and of high importance for social and vocational reintegration for persons with neurologic-related gait impairment. Robots for lower limb gait rehabilitation are designed principally to help automate repetitive labor-intensive training during neurorehabilitation. These include tethered exoskeletons, end-effector devices, untethered exoskeletons, and patient-guided suspension systems. This article reviews the first 3 categories and briefly mentions the fourth. Research is needed to further define the therapeutic applications of these devices. Additional technical improvements are expected regarding device size, controls, and battery life for untethered devices.

[1]  S. Hesse,et al.  A mechanized gait trainer for restoring gait in nonambulatory subjects. , 2000, Archives of physical medicine and rehabilitation.

[2]  Michael Peshkin,et al.  KineAssist: Design and Development of a Robotic Overground Gait and Balance Therapy Device , 2008, Topics in stroke rehabilitation.

[3]  Alberto Esquenazi,et al.  Robotic-Assisted Gait Training and Restoration , 2012, American journal of physical medicine & rehabilitation.

[4]  E. Rocon,et al.  A robot-based gait training therapy for pediatric population with cerebral palsy: goal setting, proposal and preliminary clinical implementation , 2018, Journal of NeuroEngineering and Rehabilitation.

[5]  Markus Wirz,et al.  Clinical application of robotics and technology in the restoration of walking , 2016 .

[6]  K. H. Low,et al.  Initial System Evaluation of an Overground Rehabilitation Gait Training Robot (NaTUre-gaits) , 2011, Adv. Robotics.

[7]  Stefan Hesse,et al.  Innovative gait robot for the repetitive practice of floor walking and stair climbing up and down in stroke patients , 2010, Journal of NeuroEngineering and Rehabilitation.

[8]  G. Kwakkel,et al.  Intensity of leg and arm training after primary middle-cerebral-artery stroke: a randomised trial , 1999, The Lancet.

[9]  Placido Bramanti,et al.  Can robot-assisted movement training (Lokomat) improve functional recovery and psychological well-being in chronic stroke? Promising findings from a case study. , 2014, Functional neurology.

[10]  V R Edgerton,et al.  Use-dependent plasticity in spinal stepping and standing. , 1997, Advances in neurology.

[11]  Thomas W. J. Janssen,et al.  Recovery of walking ability using a robotic device , 2013 .

[12]  Bram Koopman,et al.  The effect of impedance-controlled robotic gait training on walking ability and quality in individuals with chronic incomplete spinal cord injury: an explorative study , 2014, Journal of NeuroEngineering and Rehabilitation.

[13]  L. Lucas,et al.  Robot-Assisted Gait Training for Patients with Hemiparesis Due to Stroke , 2011, Topics in stroke rehabilitation.

[14]  Roger Hilfiker,et al.  Robotic-Assisted Step Training (Lokomat) Not Superior to Equal Intensity of Over-Ground Rehabilitation in Patients With Multiple Sclerosis , 2012, Neurorehabilitation and neural repair.

[15]  Martin E Schwab,et al.  Sprouting, regeneration and circuit formation in the injured spinal cord: factors and activity , 2006, Philosophical Transactions of the Royal Society B: Biological Sciences.

[16]  T. Demott,et al.  Enhanced Gait-Related Improvements After Therapist- Versus Robotic-Assisted Locomotor Training in Subjects With Chronic Stroke: A Randomized Controlled Study , 2008, Stroke.

[17]  J. Krakauer,et al.  Getting Neurorehabilitation Right , 2012, Neurorehabilitation and neural repair.

[18]  Robert Riener,et al.  Virtual reality for enhancement of robot-assisted gait training in children with central gait disorders. , 2011, Journal of rehabilitation medicine.

[19]  D. Chagas,et al.  Robotic Gait Training for Individuals With Cerebral Palsy: A Systematic Review and Meta-Analysis. , 2017, Archives of physical medicine and rehabilitation.

[20]  J. Kleim,et al.  Principles of experience-dependent neural plasticity: implications for rehabilitation after brain damage. , 2008, Journal of speech, language, and hearing research : JSLHR.

[21]  Giovanni Cannaviello,et al.  Wearable robotic exoskeleton for overground gait training in sub-acute and chronic hemiparetic stroke patients: preliminary results. , 2017, European journal of physical and rehabilitation medicine.

[22]  Alberto Esquenazi,et al.  A Randomized Comparative Study of Manually Assisted Versus Robotic‐Assisted Body Weight Supported Treadmill Training in Persons With a Traumatic Brain Injury , 2013, PM & R : the journal of injury, function, and rehabilitation.

[23]  B. Kwon,et al.  Effects of Electromechanical Exoskeleton-Assisted Gait Training on Walking Ability of Stroke Patients: A Randomized Controlled Trial. , 2019, Archives of physical medicine and rehabilitation.

[24]  Kelly P Westlake,et al.  Pilot study of Lokomat versus manual-assisted treadmill training for locomotor recovery post-stroke , 2009, Journal of NeuroEngineering and Rehabilitation.

[25]  Ju-Jang Lee,et al.  The Development of Two Mobile Gait Rehabilitation Systems , 2009, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[26]  Alberto Esquenazi,et al.  A Comparison of Locomotor Therapy Interventions: Partial‐Body Weight−Supported Treadmill, Lokomat, and G‐EO Training in People With Traumatic Brain Injury , 2017, PM & R : the journal of injury, function, and rehabilitation.

[27]  A. Esquenazi,et al.  The ReWalk Powered Exoskeleton to Restore Ambulatory Function to Individuals with Thoracic-Level Motor-Complete Spinal Cord Injury , 2012, American journal of physical medicine & rehabilitation.

[28]  N. Paker,et al.  Lokomat: a therapeutic chance for patients with chronic hemiplegia. , 2014, NeuroRehabilitation.

[29]  A. Mayr,et al.  Prospective, Blinded, Randomized Crossover Study of Gait Rehabilitation in Stroke Patients Using the Lokomat Gait Orthosis , 2007, Neurorehabilitation and neural repair.

[30]  S. Harkema,et al.  Locomotor activity in spinal cord-injured persons. , 2004, Journal of applied physiology.

[31]  Didier Pradon,et al.  Effect of a robotic restraint gait training versus robotic conventional gait training on gait parameters in stroke patients , 2013, Experimental Brain Research.

[32]  Aliasgar Morbi,et al.  Power Walker Helps a Child with Cerebral Palsy , 2016 .

[33]  Joseph Mantone.  Getting a leg up? Rehab patients get an assist from devices such as HealthSouth's AutoAmbulator, but the robots' clinical benefits are still in doubt. , 2006, Modern healthcare.

[34]  Steven C Cramer,et al.  Robotics, motor learning, and neurologic recovery. , 2004, Annual review of biomedical engineering.

[35]  V. Dietz,et al.  Treadmill training of paraplegic patients using a robotic orthosis. , 2000, Journal of rehabilitation research and development.

[36]  Mukul Talaty,et al.  Powered Exoskeletons for Walking Assistance in Persons with Central Nervous System Injuries: A Narrative Review , 2017, PM & R : the journal of injury, function, and rehabilitation.

[37]  S. Paolucci,et al.  Seven Capital Devices for the Future of Stroke Rehabilitation , 2012, Stroke research and treatment.

[38]  S. Hesse,et al.  Gait rehabilitation machines based on programmable footplates , 2007, Journal of NeuroEngineering and Rehabilitation.

[39]  Mónica Alcobendas-Maestro,et al.  Lokomat Robotic-Assisted Versus Overground Training Within 3 to 6 Months of Incomplete Spinal Cord Lesion , 2012, Neurorehabilitation and neural repair.

[40]  Volker Dietz,et al.  Neuronal plasticity after a human spinal cord injury: Positive and negative effects , 2012, Experimental Neurology.

[41]  Mukul Talaty,et al.  Differentiating ability in users of the ReWalkTM powered exoskeleton: An analysis of walking kinematics , 2013, 2013 IEEE 13th International Conference on Rehabilitation Robotics (ICORR).

[42]  Shin-ichiroh Yamamoto,et al.  Recent Trends in Lower-Limb Robotic Rehabilitation Orthosis: Control Scheme and Strategy for Pneumatic Muscle Actuated Gait Trainers , 2014, Robotics.

[43]  M. S. Huq,et al.  The Efficacy of State of the Art Overground Gait Rehabilitation Robotics , 2017 .

[44]  J. Hidler,et al.  Multicenter Randomized Clinical Trial Evaluating the Effectiveness of the Lokomat in Subacute Stroke , 2009, Neurorehabilitation and neural repair.

[45]  Rob den Otter,et al.  The Combined Effects of Body Weight Support and Gait Speed on Gait Related Muscle Activity: A Comparison between Walking in the Lokomat Exoskeleton and Regular Treadmill Walking , 2014, PloS one.

[46]  Paolo Bonato,et al.  Advanced Robotic Therapy Integrated Centers (ARTIC): an international collaboration facilitating the application of rehabilitation technologies , 2018, Journal of NeuroEngineering and Rehabilitation.

[47]  Alessia Bramanti,et al.  Robotic gait rehabilitation and substitution devices in neurological disorders: where are we now? , 2016, Neurological Sciences.

[48]  R. Calabró,et al.  Lokomat training in vascular dementia: motor improvement and beyond! , 2015, Aging Clinical and Experimental Research.

[49]  Joseph Hidler,et al.  Activity-based therapies , 2006, NeuroRX.

[50]  H. van der Kooij,et al.  Design and Evaluation of the LOPES Exoskeleton Robot for Interactive Gait Rehabilitation , 2007, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[51]  J. Chapman,et al.  Does treadmill training with Hybrid Assistive Limb (HAL) impact the quality of life? A first case series in the United States , 2018, Disability and rehabilitation. Assistive technology.

[52]  Qiming Chen,et al.  Dynamic Balance Gait for Walking Assistance Exoskeleton , 2018, Applied bionics and biomechanics.

[53]  E. Sierra.  Methodology to development to prior studies to the project in The Palacio del Infantado in Guadalajara , 2012 .

[54]  Nicolas Vuillerme,et al.  Effects of gait training using a robotic constraint (Lokomat®) on gait kinematics and kinetics in chronic stroke patients. , 2014, Journal of rehabilitation medicine.

[55]  Andreas Meyer-Heim,et al.  Requirements for and impact of a serious game for neuro-pediatric robot-assisted gait training. , 2013, Research in developmental disabilities.

[56]  V. Edgerton,et al.  Plasticity of the spinal neural circuitry after injury. , 2004, Annual review of neuroscience.

[57]  T. Murphy,et al.  Plasticity during stroke recovery: from synapse to behaviour , 2009, Nature Reviews Neuroscience.