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Novel Technology Application for Clinical Neurorehabilitation
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Novel Technology Application for Clinical Neurorehabilitation

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 25955

Special Issue Editor

Prof. Dr. Won-Seok Kim

E-Mail Website
Guest Editor
Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam-si 13620, Gyeonggi-do, Korea
Interests: neurorehabilitation; neuromodulation; virtual reality; robotic rehabilitation; clinical epidemiology; neuroimaging; cardiac rehabilitation

Special Issue Information

Dear Colleagues,

Neurorehabilitation for various diseases affecting the central nervous system is important for recovery. Conventional rehabilitation such as physical or occupational therapy has been provided, but the effect is usually limited. Novel technologies are expected to open up new opportunities for better recovery. In this Special Issue, we aim to present recent advances in the clinical application of novel technologies for neurorehabilitation. The novel technologies may include virtual/augmented/mixed reality, neuromodulation, robotics, the brain–computer interface, wearable devices, and so on. Submissions of clinical trials with sound methodologies are encouraged. Pilot feasibility trials with new therapeutic approaches and neurophysiological outcomes (e.g., parameters from biosensors or imaging (EEG, EMG, fNIRS, fMRI, and so on)) and review studies can also be considered. Preclinical studies using animal models and case reports are not considered for review.

Prof. Dr. Won-Seok Kim
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • neurological rehabilitation
  • recovery of function
  • stroke
  • Parkinson’s disease
  • multiple sclerosis
  • technology
  • virtual reality
  • neuromodulation
  • robotics
  • brain–computer interface

Published Papers (4 papers)

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Research

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12 pages, 819 KiB  
Article
Robot-Assisted Training for Upper Limb in Stroke (ROBOTAS): An Observational, Multicenter Study to Identify Determinants of Efficacy
by Rocco Salvatore Calabrò, Giovanni Morone, Antonino Naro, Marialuisa Gandolfi, Vitalma Liotti, Carlo D’aurizio, Sofia Straudi, Antonella Focacci, Sanaz Pournajaf, Irene Aprile, Serena Filoni, Claudia Zanetti, Maria Rosaria Leo, Lucia Tedesco, Vincenzo Spina, Carmelo Chisari, Giovanni Taveggia, Stefano Mazzoleni, Nicola Smania, Stefano Paolucci, Marco Franceschini and Donatella Bonaiutiadd Show full author list remove Hide full author list
J. Clin. Med. 2021, 10(22), 5245; https://doi.org/10.3390/jcm10225245 - 11 Nov 2021
Cited by 9 | Viewed by 2763
Abstract
Background: The loss of arm function is a common and disabling outcome after stroke. Robot-assisted upper limb (UL) training may improve outcomes. The aim of this study was to explore the effect of robot-assisted training using end-effector and exoskeleton robots on UL function [...] Read more.
Background: The loss of arm function is a common and disabling outcome after stroke. Robot-assisted upper limb (UL) training may improve outcomes. The aim of this study was to explore the effect of robot-assisted training using end-effector and exoskeleton robots on UL function following a stroke in real-life clinical practice. Methods: A total of 105 patients affected by a first-ever supratentorial stroke were enrolled in 18 neurorehabilitation centers and treated with electromechanically assisted arm training as an add-on to conventional therapy. Both interventions provided either an exoskeleton or an end-effector device (as per clinical practice) and consisted of 20 sessions (3/5 times per week; 6–8 weeks). Patients were assessed by validated UL scales at baseline (T0), post-treatment (T1), and at three-month follow-up (T2). The primary outcome was the Fugl-Meyer Assessment for the upper extremity (FMA-UE). Results: FMA-UE improved at T1 by 6 points on average in the end-effector group and 11 points on average in the exoskeleton group (p < 0.0001). Exoskeletons were more effective in the subacute phase, whereas the end-effectors were more effective in the chronic phase (p < 0.0001). Conclusions: robot-assisted training might help improve UL function in stroke patients as an add-on treatment in both subacute and chronic stages. Pragmatic and highmethodological studies are needed to confirm the showed effectiveness of the exoskeleton and end-effector devices. Full article
(This article belongs to the Special Issue Novel Technology Application for Clinical Neurorehabilitation)
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18 pages, 1569 KiB  
Article
Photo-Realistic Interactive Virtual Environments for Neurorehabilitation in Mild Cognitive Impairment (NeuroVRehab.PT): A Participatory Design and Proof-of-Concept Study
by Filipa Ferreira-Brito, Sérgio Alves, Osvaldo Santos, Tiago Guerreiro, Cátia Caneiras, Luís Carriço and Ana Verdelho
J. Clin. Med. 2020, 9(12), 3821; https://doi.org/10.3390/jcm9123821 - 26 Nov 2020
Cited by 7 | Viewed by 3440
Abstract
Mild cognitive impairment (MCI) is characterized by cognitive, psychological, and functional impairments. Digital interventions typically focus on cognitive deficits, neglecting the difficulties that patients experience in instrumental activities of daily living (IADL). The global conjecture created by COVID-19 has highlighted the seminal importance [...] Read more.
Mild cognitive impairment (MCI) is characterized by cognitive, psychological, and functional impairments. Digital interventions typically focus on cognitive deficits, neglecting the difficulties that patients experience in instrumental activities of daily living (IADL). The global conjecture created by COVID-19 has highlighted the seminal importance of digital interventions for the provision of healthcare services. Here, we investigated the feasibility and rehabilitation potential of a new design approach for creating highly realistic interactive virtual environments for MCI patients’ neurorehabilitation. Through a participatory design protocol, a neurorehabilitation digital platform was developed using images captured from a Portuguese supermarket (NeuroVRehab.PT). NeuroVRehab.PT’s main features (e.g., medium-sized supermarket, the use of shopping lists) were established according to a shopping behavior questionnaire filled in by 110 older adults. Seven health professionals used the platform and assessed its rehabilitation potential, clinical applicability, and user experience. Interviews were conducted using the think-aloud method and semi-structured scripts, and four main themes were derived from an inductive semantic thematic analysis. Our findings support NeuroVRehab.PT as an ecologically valid instrument with clinical applicability in MCI neurorehabilitation. Our design approach, together with a comprehensive analysis of the patients’ past experiences with IADL, is a promising technique to develop effective digital interventions to promote real-world functioning. Full article
(This article belongs to the Special Issue Novel Technology Application for Clinical Neurorehabilitation)
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Review

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20 pages, 749 KiB  
Review
Clinical Application of Virtual Reality for Upper Limb Motor Rehabilitation in Stroke: Review of Technologies and Clinical Evidence
by Won-Seok Kim, Sungmin Cho, Jeonghun Ku, Yuhee Kim, Kiwon Lee, Han-Jeong Hwang and Nam-Jong Paik
J. Clin. Med. 2020, 9(10), 3369; https://doi.org/10.3390/jcm9103369 - 21 Oct 2020
Cited by 96 | Viewed by 13970
Abstract
Neurorehabilitation for stroke is important for upper limb motor recovery. Conventional rehabilitation such as occupational therapy has been used, but novel technologies are expected to open new opportunities for better recovery. Virtual reality (VR) is a technology with a set of informatics that [...] Read more.
Neurorehabilitation for stroke is important for upper limb motor recovery. Conventional rehabilitation such as occupational therapy has been used, but novel technologies are expected to open new opportunities for better recovery. Virtual reality (VR) is a technology with a set of informatics that provides interactive environments to patients. VR can enhance neuroplasticity and recovery after a stroke by providing more intensive, repetitive, and engaging training due to several advantages, including: (1) tasks with various difficulty levels for rehabilitation, (2) augmented real-time feedback, (3) more immersive and engaging experiences, (4) more standardized rehabilitation, and (5) safe simulation of real-world activities of daily living. In this comprehensive narrative review of the application of VR in motor rehabilitation after stroke, mainly for the upper limbs, we cover: (1) the technologies used in VR rehabilitation, including sensors; (2) the clinical application of and evidence for VR in stroke rehabilitation; and (3) considerations for VR application in stroke rehabilitation. Meta-analyses for upper limb VR rehabilitation after stroke were identified by an online search of Ovid-MEDLINE, Ovid-EMBASE, the Cochrane Library, and KoreaMed. We expect that this review will provide insights into successful clinical applications or trials of VR for motor rehabilitation after stroke. Full article
(This article belongs to the Special Issue Novel Technology Application for Clinical Neurorehabilitation)
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15 pages, 2175 KiB  
Review
Effectiveness of Virtual Reality on Functional Performance after Spinal Cord Injury: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Amaranta De Miguel-Rubio, M. Dolores Rubio, Alejandro Salazar, Rocio Camacho and David Lucena-Anton
J. Clin. Med. 2020, 9(7), 2065; https://doi.org/10.3390/jcm9072065 - 1 Jul 2020
Cited by 16 | Viewed by 4516
Abstract
A spinal cord injury (SCI) usually results in a significant limitation in the functional outcomes, implying a challenge to the performance of activities of daily living. The main aim of this study is to analyze the effectiveness of virtual reality to improve functional [...] Read more.
A spinal cord injury (SCI) usually results in a significant limitation in the functional outcomes, implying a challenge to the performance of activities of daily living. The main aim of this study is to analyze the effectiveness of virtual reality to improve functional performance in patients with SCI. The search was performed between October and December 2019 in Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database (PEDro), PubMed, Scopus, Web of Science, and Embase. The methodological quality of the studies was evaluated through the PEDro scale, and the risk of bias was evaluated with the Cochrane collaboration’s tool. Seven articles were included in this systematic review, and five of them in the meta-analysis. Statistical analysis showed favorable results for functional performance in control group performing conventional therapy, measured by the functional independence measure (standardized mean difference (SMD)= −0.70; 95% confidence interval: −1.25 to −0.15). Results were inconclusive for other outcomes. Most studies have not shown beneficial effects on functional performance compared with conventional physical therapy. The results obtained showed that virtual reality may not be more effective than conventional physical therapy in improving functional performance in patients with SCI. Full article
(This article belongs to the Special Issue Novel Technology Application for Clinical Neurorehabilitation)
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