Review Article

A Review of Robotics in Neurorehabilitation: Towards an Automated Process for Upper Limb

Table 1

Review of robot-aided system for upper limb neurorehabilitation.

SystemAssessmentAssignmentIntervention
Automatic assessmentAssessment methodProvided outcomeFunctional assessmentTherapy planning supportMethodRehabilitation targetTask-specific trainingMethodInteractionMeasurements

End-effector-type system
ACT-3D [61]NoOffline data analysisDifference between sessionsFMANoN/AShoulder; elbowYesReach (payload simulation)VR; haptic; auditoryKinematic data; force
ARM GUIDE [62, 63]NoOffline data analysisDifference between sessionsCM; RLAFTNoN/AShoulder; elbowYesPassive; active assisted; active resistanceVR; hapticKinematic data; force; straightness; smoothness
BRACCIO DI FERRO [64, 65]NoOffline data analysisDifference between sessionsFMA; MASNoN/AShoulder; elbowYesActive assisted; active resistance; gravity compensationVR; hapticKinematic data; force; smoothness; accuracy
GENTLE/S [66, 67]NoOffline data analysisVisual comparison of data trends (slopes)FMA; MoAS; MAS; NSA; SCTYesHaptic Master software allows the therapist to define the exercise pathShoulder; elbowYesPassive; assisted; active; trajectory correctionVR; hapticKinematic data; force
INMOTION ARM [59, 68]YesINMOTION EVAL software; 5 evaluation tests, robot generates 4 evaluation reportsRobot calculates 13 evidence-based measures of motor control that are highly correlated with traditional scalesFIM; FMA; MP; NIHSSYesSelection of the therapeutic exercise games; progress measurement of determined medical necessity; assesses treatment based upon measurable gainsShoulder; elbowYesPassive; active assisted; active resistance; gravity compensationVR; hapticKinematic and kinetic data (position, direction, distance, area, time, force, smoothness, accuracy); performance measures
IPAM [69, 70]YesIPAM softwareVirtual environment feedbackFMAYesAutomatically generated exercises based on a clinical assessment of the patient (automated tasks)Shoulder; elbowYesPassive; active resistance; active; reachVR; hapticKinematic data; force
MEMOS [71, 72]YesOnline data analysisScore proportional to the voluntary motor activity developed during the taskFMA; MSS; MRC; MPNoN/AARM: not a specific jointYesPassive; active resistance; activeVR; hapticKinematic data; force
MINE [73]NoOffline data analysisDifference between sessionsFMA; MSS; BI; FIM; MP; MASNoN/AShoulder; elbowYesPassive; active assisted; active resistance; bilateralVR; hapticKinematic data; force [bimanual]
NEREBOT [74, 75]YesOnline data analysisFeedback based on patient’s effortFMA; MRC; FIM; MAS; FAT; BBTNoTherapist defines the exercise by choosing via points and adjusts robot parameters according to the type of exerciseShoulder; elbow; forearmNoPassive; active assisted; activeVR; auditoryKinematic data; patient effort (cable tension based)
REHAROB [76, 77]YesOnline data analysisFeedback based on patient’s effortFMA; FIM; MAS; RMA; BI; BMRYesTherapist can choose exercises from any therapeutic school (Bobath, Kabat, etc.)Shoulder; elbow; forearmNoPassiveN/AKinematic data
AMADEO TYROMOTION [7880]YesTyroS softwareDifference between sessionsFMA; MRC; MI; MAS; FIM; COPMYesTyroS software creates a therapy report and therapy progressHand: prehensionYesPassive; active assisted; activeVRKinematic data; force; tonus; spasticity
BIMANUTRACK [81, 82]NoOffline data analysisDifference between sessionsFMA; WMFT; RMA; MASYesProgramming of individually adjusted natural gait trajectories; real-timesimulation of the programmed foot trajectoryForearm; wristNoActive; passive [bilateral]N/AKinematic data; force [bimanual]
HWARD [83, 84]NoOffline data analysisDifference between sessionsARAT; BBT; FMA; NIHSS; GDS; NSA; 9-HPT;SIS; MASNoN/AWrist; handYesPassive; active assisted; active resistanceVRKinematic data; force
REOGO [85, 86]YesAdvanced management softwareEvolution of measurementsFMA; MFTYesLibrary with a wide range of engaging exercises and games for various rehabilitation objectivesShoulder; elbow; wrist; handYesPassive; active; guided; freeVR; hapticKinematic data; accuracy; smoothness; force; muscle tone
DIEGO [78, 87]YesTyroS softwareEvolution of measurementN/AYesSelection of therapy gamesARM: not a specific joint; shoulderYesPassive; assistive; active; gravity compensation [uni- and bilateral]VR; hapticKinematic data; motoric function; force proprioception
Exoskeleton/Orthosis system
L-EXOSPERCRO [88]NoOffline data analysisDifference between sessionsFMA; MAS; BASYesSelection of different trajectories in the same virtual environmentShoulder; elbowYesActive; active assisted; gravity compensationVRKinematic data; force; accuracy
MYOPRO [8991]NoEMG signalsDifference between sessionsMAS; BBT; FMA; MAL-AOU;MAL-HWNoN/AElbowYesActive assistedHapticKinematic data; force
WREX [92]NoOffline data analysisDifference between sessionsN/ANoN/AShoulder; elbowYesActive assisted; gravity compensationN/AKinematic data; force
ARMEOSPRING (T-WREX) [9395]YesJava Therapy 2.0 softwareDifference between sessionsFMA; RFT: BBT: BBTDYesSelection of therapy gamesShoulder; elbow; forearmYesPassive; gravity compensationVR; hapticKinematic data; force
MENTOR PRO (hand) [9698]NoOffline data analysisMonitoring of patient’s progress in DLAN/ANoN/AWrist; hand; fingersNoActive (only extension)VRKinematic data
HEXORR [99]NoOffline data analysisDifference between sessionsARAT; FMA; MASNoN/AMetacarpus [interfalangica]YesPassive; active assisted; active; gravity compensationHapticKinematic data; force grasping patterns
RUTGERS MARTER II [100, 101]YesOnline data analysisPerformance meterJTHF; FMANoN/AHandYesN/AVR; haptic; auditoryKinematic data; force
SUPINATOR-EXTENDER [102]NoOffline data analysisDifference between sessionsN/ANoN/AForearm; wristYesActive assistedVR; hapticKinematic data; force; grasping patterns
T-WREX [95, 103]YesJava Therapy softwareMonitoring of a patient’s progress by skilled rehabilitation therapistFMA; RFT; BBTNoN/AShoulder; elbow; forearm; wrist; handYesPassive; gravity compensationVRKinematic data; force
WOTAS [104]NoOffline data analysisDifference between sessionsFTMTRSNoN/AElbow; forearm; wristYesTremor controlHapticKinematic data (voltage coming from gyroscopes)
ARMEOPOWER (ARM-IN III) [93, 105, 106]YesGIANTS game engineDifference between sessionsFMAYesChoose from several VR therapy tasksShoulder; elbow; forearm; wrist; handYesActive; passive; active assisted; active resistance; gravity compensationVRKinematic data; force
ARM-IN [107, 108]YesOnline data analysisDifference between sessionsN/AYesAllows different therapy modes, robot interface for patient (PRI) and therapist (TRI)Shoulder; elbow; forearm; wristYesPassive; active assisted; activeVR; hapticKinematic data; force
GENTLE/G [109]YesOnline data analysisPerformance meterN/AYesHMI module for interaction between the user and the Gentle robot; database for storing patient informationShoulder; elbow; handYesPassive; assisted; active; trajectory correctionVR; hapticKinematic data (position, direction, distance); force
Rupert [110, 111]NoOffline data analysisDifference between sessionsWMFT; FMANoN/AShoulder; elbow; forearm; wristYesPassive; active assisted; activeVR; hapticKinematic data; force; [motor activity; stroke impact scale; stroke recovery scale]

9-HPT: 9-Hole Peg Test; ARAT: Action Research Arm Test; BAS: Bimanual Activity Scale; BBT: Box and Blocks Test; BBTD: BBT (without picking up blocks); BI: Barthel Index; BMR: British Medical Research; CM: Chedoke-McMaster; COPM: Canadian Occupational Performance Measure; FAT: Frenchay Arm Test; FIM: Functional Independence Measure; FMA: Fugl-Meyer Assessment; FTMTRS: Fahn-Tolosa-Marin Tremor Rating Scale; GDS: Geriatric Depression Scale; JTHF: Jebsen Test of Hand Function; MAL-AOU: Activity Log-Amount of Use; MAL-HW: Motor Activity Log-How Well; MAS: Modified Ashworth Scale; MFT: Manual Functional Test; MI: Motricity Index; MoAS: Motor Assessment Scale; MP: Motor Power; MRC: Medical Research Council; MSS: Motor Status Score.