Ödemiş Erkan, Baysal Cabbar Veysel, İnci Mustafa
Department of Biomedical Engineering, Çukurova University, 01330, Sarıçam, Adana, Turkey.
Department of Mechatronics Engineering, İskenderun Technical University, 31200, Hatay, Turkey.
Med Biol Eng Comput. 2025 Feb 7. doi: 10.1007/s11517-025-03315-z.
This paper aims to comprehensively review patient performance assessment (PPA) methods used in assist-as-needed (AAN) robotic therapy for upper extremity rehabilitation. AAN strategies adjust robotic assistance according to the patient's performance, aiming to enhance engagement and recovery in individuals with motor impairments. This review categorizes the implemented PPA methods in the literature for the first time in such a wide scope and suggests future research directions to improve adaptive and personalized therapy. At first, the studies are examined to evaluate PPA methods, which are subsequently categorized according to their underlying implementation strategies: position error-based methods, force-based methods, electromyography (EMG), electroencephalography (EEG)-based methods, performance indicator-based methods, and physiological signal-based methods. The advantages and limitations of each method are discussed. In addition to the classification of PPA methods, the current study also examines clinically tested AAN strategies applied in upper extremity rehabilitation and their clinical outcomes. Clinical findings from these trials demonstrate the potential of AAN strategies in improving motor function and patient engagement. Nevertheless, more extensive clinical testing is necessary to establish the long-term benefits of these strategies over conventional therapies. Ultimately, this review aims to guide future developments in the field of robotic rehabilitation, providing researchers with insights into optimizing AAN strategies for enhanced patient outcomes.
本文旨在全面综述按需辅助（AAN）机器人疗法用于上肢康复时所采用的患者表现评估（PPA）方法。AAN策略根据患者的表现调整机器人辅助，旨在提高运动功能受损个体的参与度和康复效果。本综述首次在如此广泛的范围内对文献中已实施的PPA方法进行分类，并提出未来的研究方向，以改进适应性和个性化治疗。首先，对各项研究进行考察以评估PPA方法，随后根据其潜在的实施策略进行分类：基于位置误差的方法、基于力的方法、肌电图（EMG）、基于脑电图（EEG）的方法、基于性能指标的方法以及基于生理信号的方法。讨论了每种方法的优缺点。除了对PPA方法进行分类外，本研究还考察了应用于上肢康复的经过临床测试的AAN策略及其临床结果。这些试验的临床结果表明了AAN策略在改善运动功能和患者参与度方面的潜力。然而，需要更广泛的临床测试来确定这些策略相对于传统疗法的长期益处。最终，本综述旨在指导机器人康复领域的未来发展，为研究人员提供有关优化AAN策略以提高患者治疗效果的见解。
