Krebs H I, Volpe B T
Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
Handb Clin Neurol. 2013;110:283-94. doi: 10.1016/B978-0-444-52901-5.00023-X.
This chapter focuses on rehabilitation robotics which can be used to augment the clinician's toolbox in order to deliver meaningful restorative therapy for an aging population, as well as on advances in orthotics to augment an individual's functional abilities beyond neurorestoration potential. The interest in rehabilitation robotics and orthotics is increasing steadily with marked growth in the last 10 years. This growth is understandable in view of the increased demand for caregivers and rehabilitation services escalating apace with the graying of the population. We provide an overview on improving function in people with a weak limb due to a neurological disorder who cannot properly control it to interact with the environment (orthotics); we then focus on tools to assist the clinician in promoting rehabilitation of an individual so that s/he can interact with the environment unassisted (rehabilitation robotics). We present a few clinical results occurring immediately poststroke as well as during the chronic phase that demonstrate superior gains for the upper extremity when employing rehabilitation robotics instead of usual care. These include the landmark VA-ROBOTICS multisite, randomized clinical study which demonstrates clinical gains for chronic stroke that go beyond usual care at no additional cost.
本章重点介绍康复机器人技术，其可用于扩充临床医生的工具库，以便为老年人群提供有意义的恢复性治疗；同时还介绍矫形器的进展，以增强个体的功能能力，使其超越神经恢复潜力。过去10年，对康复机器人技术和矫形器的兴趣稳步增长，显著发展。鉴于人口老龄化导致对护理人员和康复服务的需求迅速增加，这种增长是可以理解的。我们概述了如何改善因神经系统疾病而肢体无力、无法正常控制肢体与环境互动的患者的功能（矫形器）；然后我们重点介绍帮助临床医生促进个体康复的工具，使患者能够在无辅助的情况下与环境互动（康复机器人技术）。我们展示了一些中风后即刻以及慢性期的临床结果，这些结果表明，使用康复机器人技术而非常规护理时，上肢功能改善更为显著。其中包括具有里程碑意义的退伍军人事务部机器人技术多中心随机临床研究，该研究表明，慢性中风患者采用康复机器人技术可获得超出常规护理的临床改善，且无需额外费用。
