Michmizos Konstantinos P, Krebs Hermano Igo
Department of Computer Science, Rutgers University, Piscataway, NJ, USA.
Department of Mechanical Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
NeuroRehabilitation. 2017;41(1):69-76. doi: 10.3233/NRE-171458.
Robot-aided sensorimotor therapy imposes highly repetitive tasks that can translate to substantial improvement when patients remain cognitively engaged into the clinical procedure, a goal that most children find hard to pursue. Knowing that the child's brain is much more plastic than an adult's, it is reasonable to expect that the clinical gains observed in the adult population during the last two decades would be followed up by even greater gains in children. Nonetheless, and despite the multitude of adult studies, in children we are just getting started: There is scarcity of pediatric robotic rehabilitation devices that are currently available and the number of clinical studies that employ them is also very limited.
We have recently developed the MIT's pedi-Anklebot, an adaptive habilitation robotic device that continuously motivates physically impaired children to do their best by tracking the child's performance and modifying their therapy accordingly. The robot's design is based on a multitude of studies we conducted focusing on the ankle sensorimotor control. In this paper, we briefly describe the device and the adaptive environment we built around the impaired children, present the initial clinical results and discuss how they could steer future trends in pediatric robotic therapy.
The results support the potential for future interventions to account for the differences in the sensorimotor control of the targeted limbs and their functional use (rhythmic vs. discrete movements and mechanical impedance training) and explore how the new technological advancements such as the augmented reality would employ new knowledge from neuroscience.
机器人辅助感觉运动疗法施加高度重复的任务，当患者在临床过程中保持认知参与时，这些任务可转化为显著改善，而这一目标大多数儿童难以达成。鉴于儿童大脑比成人大脑更具可塑性，有理由预期在过去二十年中在成人中观察到的临床收益在儿童中会有更大收益。尽管如此，尽管有大量成人研究，但在儿童方面我们才刚刚起步：目前可用的儿科机器人康复设备稀缺，使用这些设备的临床研究数量也非常有限。
我们最近开发了麻省理工学院的小儿脚踝机器人，这是一种适应性康复机器人设备，通过跟踪儿童的表现并相应调整治疗，持续激励身体有障碍的儿童尽最大努力。该机器人的设计基于我们针对脚踝感觉运动控制进行的大量研究。在本文中，我们简要描述该设备以及我们围绕残疾儿童构建的自适应环境，展示初步临床结果，并讨论这些结果如何引领儿科机器人治疗的未来趋势。
结果支持未来干预措施考虑目标肢体感觉运动控制差异及其功能使用（节律性与离散运动以及机械阻抗训练）的潜力，并探索诸如增强现实等新技术进步如何利用神经科学的新知识。
