Mubin Omar, Alnajjar Fady, Jishtu Nalini, Alsinglawi Belal, Al Mahmud Abdullah
School of Computing, Engineering and Mathematics, Western Sydney University, Rydalmere, Australia.
College of Information Technology, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates.
JMIR Rehabil Assist Technol. 2019 Sep 8;6(2):e12010. doi: 10.2196/12010.
Robot-assisted therapy has become a promising technology in the field of rehabilitation for poststroke patients with motor disorders. Motivation during the rehabilitation process is a top priority for most stroke survivors. With current advancements in technology there has been the introduction of virtual reality (VR), augmented reality (AR), customizable games, or a combination thereof, that aid robotic therapy in retaining, or increasing the interests of, patients so they keep performing their exercises. However, there are gaps in the evidence regarding the transition from clinical rehabilitation to home-based therapy which calls for an updated synthesis of the literature that showcases this trend. The present review proposes a categorization of these studies according to technologies used, and details research in both upper limb and lower limb applications.
The goal of this work was to review the practices and technologies implemented in the rehabilitation of poststroke patients. It aims to assess the effectiveness of exoskeleton robotics in conjunction with any of the three technologies (VR, AR, or gamification) in improving activity and participation in poststroke survivors.
A systematic search of the literature on exoskeleton robotics applied with any of the three technologies of interest (VR, AR, or gamification) was performed in the following databases: MEDLINE, EMBASE, Science Direct & The Cochrane Library. Exoskeleton-based studies that did not include any VR, AR or gamification elements were excluded, but publications from the years 2010 to 2017 were included. Results in the form of improvements in the patients' condition were also recorded and taken into consideration in determining the effectiveness of any of the therapies on the patients.
Thirty studies were identified based on the inclusion criteria, and this included randomized controlled trials as well as exploratory research pieces. There were a total of about 385 participants across the various studies. The use of technologies such as VR-, AR-, or gamification-based exoskeletons could fill the transition from the clinic to a home-based setting. Our analysis showed that there were general improvements in the motor function of patients using the novel interfacing techniques with exoskeletons. This categorization of studies helps with understanding the scope of rehabilitation therapies that can be successfully arranged for home-based rehabilitation.
Future studies are necessary to explore various types of customizable games required to retain or increase the motivation of patients going through the individual therapies.
机器人辅助治疗已成为中风后运动障碍患者康复领域一项很有前景的技术。康复过程中的积极性是大多数中风幸存者的首要任务。随着当前技术的进步，虚拟现实（VR）、增强现实（AR）、可定制游戏或它们的组合已被引入，以帮助机器人治疗保持或提高患者的兴趣，使他们持续进行锻炼。然而，关于从临床康复过渡到家庭治疗的证据存在空白，这需要对展示这一趋势的文献进行更新综合。本综述根据所使用的技术对这些研究进行分类，并详细介绍上肢和下肢应用方面的研究。
这项工作的目的是回顾中风后患者康复中实施的实践和技术。旨在评估外骨骼机器人与三种技术（VR、AR或游戏化）中的任何一种结合使用在改善中风幸存者的活动和参与度方面的有效性。
在以下数据库中对应用了三种相关技术（VR、AR或游戏化）中任何一种的外骨骼机器人相关文献进行系统检索：MEDLINE、EMBASE、科学Direct和Cochrane图书馆。排除未包括任何VR、AR或游戏化元素的基于外骨骼的研究，但纳入2010年至2017年的出版物。还记录了患者病情改善形式的结果，并在确定任何一种治疗方法对患者的有效性时予以考虑。
根据纳入标准确定了30项研究，包括随机对照试验以及探索性研究。各项研究共有约385名参与者。使用基于VR、AR或游戏化的外骨骼等技术可以填补从诊所到家庭环境的过渡。我们的分析表明，使用与外骨骼的新型接口技术后，患者的运动功能总体上有所改善。这种研究分类有助于理解可以成功安排用于家庭康复的康复治疗范围。
未来有必要开展研究，探索各种可定制游戏，以保持或提高接受个体治疗患者的积极性。
