Advances in Neurorehabilitation: Robotics, Virtual Reality and Beyond

A special issue of Medical Sciences (ISSN 2076-3271).

Deadline for manuscript submissions: closed (1 September 2022) | Viewed by 11063

Special Issue Editors

Prof. Dr. Rocco Salvatore Calabrò
E-Mail Website
Guest Editor
Prof. Dr. Alessandro Marco De Nunzio
E-Mail Website
Guest Editor
LUNEX International University of Health
Dr. Antonio Cerasa
E-Mail
Guest Editor
Consiglio Nazionale delle Ricerche, Rome, Italy

Special Issue Information

Advances in Neurorehabilitation: Robotics, Virtual Reality and Beyond

Over the last few decades, neurorehabilitation has witnessed the growing use and efficacy of innovation technology in patients with different neurological disorders, including stroke, traumatic brain injury and neurodegenerative diseases. The use of robots, virtual reality, innovative assistive devices, telerehabilitation and artificial intelligence has proven effective in improving patients' motor and cognitive outcomes as well as their quality of life. Nonetheless, no clear guidelines on the application of innovation technology in different patients and stages of disease exist, and no cost-effectiveness analysis has to date justified the extensive clinical use of such technology.

The aim of this Special Issue is to provide healthcare professionals and researchers with clear indications on the application of innovative technology in the neurorehabilitation field.

Papers dealing with new or combined advanced approaches (including neuromodulation) are particularly welcome.

Dr. Rocco Salvatore Calabrò
Prof. Dr. Alessandro Marco De Nunzio
Dr. Antonio Cerasa
Guest Editors

Manuscript Submission Information

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Keywords

  • robotic rehabilitation
  • virtual reality
  • rehabilitation outcomes
  • assistive devices
  • Brain Computer Interface (BCI)
  • telerehabilitation
  • cognitive rehabilitation
  • neuromodulation

Published Papers (4 papers)

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Research

8 pages, 440 KiB  
Communication
Improvement of Gait after Robotic-Assisted Training in Children with Cerebral Palsy: Are We Heading in the Right Direction?
Med. Sci. 2022, 10(4), 59; https://doi.org/10.3390/medsci10040059 - 13 Oct 2022
Cited by 2 | Viewed by 1668
Abstract
Cerebral palsy (CP) is a non-progressive congenital neurological disorder that affects different physical and cognitive functions in children. In addition to standard rehabilitation, advanced robotic gait devices are novel tools that are becoming progressively more common as part of the treatment of CP. [...] Read more.
Cerebral palsy (CP) is a non-progressive congenital neurological disorder that affects different physical and cognitive functions in children. In addition to standard rehabilitation, advanced robotic gait devices are novel tools that are becoming progressively more common as part of the treatment of CP. The aim of this study is to evaluate the effects of Lokomat training, in addition to conventional rehabilitation, on the motor function and quality of life of children with ataxic-spastic CP (ASCP). Ten children with ASCP who attended the Robotic Rehabilitation OutClinic of the IRCCS Centro Neurolesi “Bonino Pulejo”, from April to June 2019, were enrolled in this study. They received twenty-four robotic rehabilitation sessions, twice a week for three months, each session lasting about 45 min. They were also provided with conventional physical and occupational therapy. After the innovative training, we found significant changes in the children’s outcomes, i.e., in GMFM (p < 0.001), with significant improvements in sitting (p < 0.03) and walking (p < 0.03). Moreover, the quality of life of the young patients, evaluated by their parents, significantly improved (p < 0.005). The use of robotic systems could be considered to be an effective complementary treatment to improve gait, as well as quality of life, in children with CP. Full article
(This article belongs to the Special Issue Advances in Neurorehabilitation: Robotics, Virtual Reality and Beyond)
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12 pages, 1375 KiB  
Article
Training-Induced Muscle Fatigue with a Powered Lower-Limb Exoskeleton: A Preliminary Study on Healthy Subjects
Med. Sci. 2022, 10(4), 55; https://doi.org/10.3390/medsci10040055 - 26 Sep 2022
Viewed by 2129
Abstract
Powered lower-limb exoskeletons represent a promising technology for helping the upright stance and gait of people with lower-body paralysis or severe paresis from spinal cord injury. The powered lower-limb exoskeleton assistance can reduce the development of lower-limb muscular fatigue as a risk factor [...] Read more.
Powered lower-limb exoskeletons represent a promising technology for helping the upright stance and gait of people with lower-body paralysis or severe paresis from spinal cord injury. The powered lower-limb exoskeleton assistance can reduce the development of lower-limb muscular fatigue as a risk factor for spasticity. Therefore, measuring powered lower-limb exoskeleton training-induced fatigue is relevant to guiding and improving such technology’s development. In this preliminary study, thirty healthy subjects (age 23.2 ± 2.7 years) performed three motor tasks: (i) walking overground (WO), (ii) treadmill walking (WT), (iii) standing and sitting (STS) in three separate exoskeleton-based training sessions of 60 min each. The changes in the production of lower-limb maximal voluntary isometric contraction (MVIC) were assessed for knee and ankle dorsiflexion and extension before and after the three exoskeleton-based trained motor tasks. The MVIC forces decreased significantly after the three trained motor tasks except for the ankle dorsiflexion. However, no significant interaction was found between time (before-, and after-training) and the training sessions except for the knee flexion, where significant fatigue was induced by WO and WT trained motor tasks. The results of this study pose the basis to generate data useful for a better approach to the exoskeleton-based training. The STS task leads to a lower level of muscular fatigue, especially for the knee flexor muscles. Full article
(This article belongs to the Special Issue Advances in Neurorehabilitation: Robotics, Virtual Reality and Beyond)
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14 pages, 1088 KiB  
Article
Recent Considerations on Gaming Console Based Training for Multiple Sclerosis Rehabilitation
Med. Sci. 2022, 10(1), 13; https://doi.org/10.3390/medsci10010013 - 11 Feb 2022
Cited by 7 | Viewed by 3221
Abstract
Multiple Sclerosis (MS) is a well-known, chronic demyelinating disease of the Central Nervous System (CNS) and one of the most common causes of disability in young adults. In this context, one of the major challenges in patients’ rehabilitation is to maintain the gained [...] Read more.
Multiple Sclerosis (MS) is a well-known, chronic demyelinating disease of the Central Nervous System (CNS) and one of the most common causes of disability in young adults. In this context, one of the major challenges in patients’ rehabilitation is to maintain the gained motor abilities in terms of functional independence. This could be partially obtained by applying new emerging and cutting-edge virtual/augmented reality and serious game technologies for a playful, noninvasive treatment that was demonstrated to be quite efficient and effective in enhancing the clinical status of patients and their (re)integration into society. Recently, Cloud computing and Internet of Things (IoT) emerged as technologies that can potentially revolutionize patients’ care. To achieve such a goal, a system that on one hand gathers patients’ clinical parameters through a network of medical IoT devices equipped with sensors and that, on the other hand, sends the collected data to a hospital Cloud for processing and analytics is required. In this paper, we assess the effectiveness of a Nintendo Wii Fit® Plus Balance Board (WFBB) used as an IoT medical device adopted in a rehabilitation training program aimed at improving the physical abilities of MS patients (pwMS). In particular, the main scientific contribution of this paper is twofold: (i) to present a preliminary new pilot study investigating whether exercises based on the Nintendo Wii Fit® balance board included in a rehabilitation training program could improve physical abilities and Quality of Life (QoL) of patients compared to that of a conventional four-week rehabilitation training program; (ii) to discuss how such a rehabilitation training program could be adopted in the perspective of near future networks of medical IoT-based rehabilitation devices, interconnected with a hospital Cloud system for big data processing to improve patients’ therapies and support the scientific research about motor rehabilitation. Results demonstrate the advantages of our approach from both health and technological points of view. Full article
(This article belongs to the Special Issue Advances in Neurorehabilitation: Robotics, Virtual Reality and Beyond)
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10 pages, 1093 KiB  
Article
The Route of Motor Recovery in Stroke Patients Driven by Exoskeleton-Robot-Assisted Therapy: A Path-Analysis
Med. Sci. 2021, 9(4), 64; https://doi.org/10.3390/medsci9040064 - 26 Oct 2021
Cited by 1 | Viewed by 2622
Abstract
Background: Exoskeleton-robot-assisted therapy is known to positively affect the recovery of arm functions in stroke patients. However, there is a lack of evidence regarding which variables might favor a better outcome and how this can be modulated by other factors. Methods: [...] Read more.
Background: Exoskeleton-robot-assisted therapy is known to positively affect the recovery of arm functions in stroke patients. However, there is a lack of evidence regarding which variables might favor a better outcome and how this can be modulated by other factors. Methods: In this within-subject study, we evaluated the efficacy of a robot-assisted rehabilitation system in the recovery of upper limb functions. We performed a path analysis using a structural equation modeling approach in a large sample of 102 stroke patients (age 63.6 ± 13.1 years; 61% men) in the post-acute phase. They underwent 7 weeks of bilateral arm training assisted by an exoskeleton robot combined with a conventional treatment (consisting of simple physical activity together with occupational therapy). The upper extremity section of the Fugl–Meyer (FM-UE) scale at admission was used as a predictor of outcome, whereas age, gender, side of the lesion, days from the event, pain scale, duration of treatment, and number of sessions as mediators. Results: FM-UE at admission was a direct predictor of outcome, as measured by the motricity index of the contralateral upper limb and trunk control test, without any other mediating factors. Age, gender, days from the event, side of lesion, and pain scales were independently associated with outcomes. Conclusions: To the best of our knowledge, this is the first study assessing the relationship between clinical variables and outcomes induced by robot-assisted rehabilitation with a path-analysis model. We define a new route for motor recovery of stroke patients driven by exoskeleton-robot-assisted therapy, highlighting the role of FM-UE at admission as a useful predictor of outcome, although other variables need to be considered in the time-course of disease. Full article
(This article belongs to the Special Issue Advances in Neurorehabilitation: Robotics, Virtual Reality and Beyond)
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