Hakim Renée M, Tunis Brandon G, Ross Michael D
a Department of Physical Therapy , University of Scranton , Scranton , PA , USA.
b Department of Physical Therapy , Daemen College , Amherst , NY , USA.
Disabil Rehabil Assist Technol. 2017 Nov;12(8):765-771. doi: 10.1080/17483107.2016.1269211. Epub 2016 Dec 30.
The focus of research using technological innovations such as robotic devices has been on interventions to improve upper extremity function in neurologic populations, particularly patients with stroke. There is a growing body of evidence describing rehabilitation programs using various types of supportive/assistive and/or resistive robotic and virtual reality-enhanced devices to improve outcomes for patients with neurologic disorders. The most promising approaches are task-oriented, based on current concepts of motor control/learning and practice-induced neuroplasticity. Based on this evidence, we describe application and feasibility of virtual reality-enhanced robotics integrated with current concepts in orthopaedic rehabilitation shifting from an impairment-based focus to inclusion of more intense, task-specific training for patients with upper extremity disorders, specifically emphasizing the wrist and hand. The purpose of this paper is to describe virtual reality-enhanced rehabilitation robotic devices, review evidence of application in patients with upper extremity deficits related to neurologic disorders, and suggest how this technology and task-oriented rehabilitation approach can also benefit patients with orthopaedic disorders of the wrist and hand. We will also discuss areas for further research and development using a task-oriented approach and a commercially available haptic robotic device to focus on training of grasp and manipulation tasks. Implications for Rehabilitation There is a growing body of evidence describing rehabilitation programs using various types of supportive/assistive and/or resistive robotic and virtual reality-enhanced devices to improve outcomes for patients with neurologic disorders. The most promising approaches using rehabilitation robotics are task-oriented, based on current concepts of motor control/learning and practice-induced neuroplasticity. Based on the evidence in neurologic populations, virtual reality-enhanced robotics may be integrated with current concepts in orthopaedic rehabilitation shifting from an impairment-based focus to inclusion of more intense, task-specific training for patients with UE disorders, specifically emphasizing the wrist and hand. Clinical application of a task-oriented approach may be accomplished using commercially available haptic robotic device to focus on training of grasp and manipulation tasks.
使用机器人设备等技术创新的研究重点一直是改善神经疾病人群，尤其是中风患者的上肢功能的干预措施。越来越多的证据描述了使用各种类型的支持性/辅助性和/或抵抗性机器人及虚拟现实增强设备的康复计划，以改善神经疾病患者的治疗效果。最有前景的方法是以任务为导向的，基于当前的运动控制/学习概念和练习诱导的神经可塑性。基于这一证据，我们描述了虚拟现实增强机器人技术与当前骨科康复概念相结合的应用和可行性，从基于损伤的重点转向为上肢疾病患者提供更强化、特定任务的训练，特别强调手腕和手部。本文的目的是描述虚拟现实增强康复机器人设备，回顾其在与神经疾病相关的上肢功能缺陷患者中的应用证据，并提出这种技术和以任务为导向的康复方法如何也能使手腕和手部骨科疾病患者受益。我们还将讨论使用以任务为导向的方法和市售触觉机器人设备进行进一步研究和开发的领域，重点是抓握和操作任务的训练。
对康复的启示 越来越多的证据描述了使用各种类型的支持性/辅助性和/或抵抗性机器人及虚拟现实增强设备的康复计划，以改善神经疾病患者的治疗效果。使用康复机器人最有前景的方法是以任务为导向的，基于当前的运动控制/学习概念和练习诱导的神经可塑性。基于神经疾病人群的证据，虚拟现实增强机器人技术可与当前骨科康复概念相结合，从基于损伤的重点转向为上肢疾病患者提供更强化、特定任务的训练，特别强调手腕和手部。以任务为导向的方法的临床应用可以使用市售触觉机器人设备来完成，重点是抓握和操作任务的训练。
