Computer Vision for Gait Assessment in Cerebral Palsy: Metric Learning and Confidence Estimation.

Assessing the motor impairments of individuals with neurological disorders holds significant importance in clinical practice. Currently, these clinical assessments are time-intensive and depend on qualitative scales administered by trained healthcare professionals at the clinic. These evaluations provide only coarse snapshots of a person's abilities, failing to track quantitatively the detail and minutiae of recovery over time.

Biomarkers for rhythmic and discrete dynamic primitives in locomotion.

Rehabilitation can promote brain plasticity and improve motor control after central nervous system injuries. Our working model is that motor control is encoded using dynamic primitives: submovements, oscillations, and mechanical impedances. We hypothesize that therapies focusing on these primitives can achieve greater motor recovery.

Inter-limb Asymmetry of Equilibrium Regulation in the Legs of 10-11-Year-Old Boys during Overground Sprinting.

Short-distance running at top speed is important in field sports. Previous studies have analyzed kinematic and kinetic properties of sprinting in adults, but equivalent knowledge in children is underexplored. Quantifying relevant aspects of children's sprinting is useful for classifying their running skills and providing effective coaching based on motor control theory.

Multivariable passive ankle impedance in stroke patients: A preliminary study.

Multivariable ankle mechanical impedance was estimated in four stroke survivors, in coupled dorsi- plantarflexion and inversion-eversion. We applied external torque perturbation with an ankle robot and used multi-input, multi-output stochastic system identification methods to estimate impedance, in both paretic and nonparetic limbs. Subjects were instructed to remain at rest throughout the four trials performed on each leg.

Sleep deprivation affects gait control.

Different levels of sleep restriction affect human performance in multiple aspects. However, it is unclear how sleep deprivation affects gait control. We applied a paced gait paradigm that included subliminal rhythm changes to analyze the effects of different sleep restriction levels (acute, chronic and control) on performance.

Effects of Robotic Therapy Associated With Noninvasive Brain Stimulation on Upper-Limb Rehabilitation After Stroke: Systematic Review and Meta-analysis of Randomized Clinical Trials.

Background: Robot-assisted therapy and noninvasive brain stimulation (NIBS) are promising strategies for stroke rehabilitation.

Objective: This systematic review and meta-analysis aims to evaluate the evidence of NIBS as an add-on intervention to robotic therapy in order to improve outcomes of upper-limb motor impairment or activity in individuals with stroke.

Methods: This study was performed according to the PRISMA Protocol and was previously registered on the PROSPERO Platform (CRD42017054563).

Effects of innovative hip-knee-ankle interlimb coordinated robot training on ambulation, cardiopulmonary function, depression, and fall confidence in acute hemiplegia.

Background: While Walkbot-assisted locomotor training (WLT) provided ample evidence on balance and gait improvements, the therapeutic effects on cardiopulmonary and psychological elements as well as fall confidence are unknown in stroke survivors.

Objective: The present study aimed to compare the effects of Walkbot locomotor training (WLT) with conventional locomotor training (CLT) on balance and gait, cardiopulmonary and psychological functions and fall confidence in acute hemiparetic stroke.

Methods: Fourteen patients with acute hemiparetic stroke were randomized into either the WLT (60 min physical therapy + 30 min Walkbot-assisted gait training) or CLT (60 min physical therapy + 30 min gait training) groups, 7 days/week over 2 weeks.

Effects of supraspinal feedback on human gait: rhythmic auditory distortion.

Background: Different types of sound cues have been used to adapt the human gait rhythm. We investigated whether young healthy volunteers followed subliminal metronome rhythm changes during gait.

Methods: Twenty-two healthy adults walked at constant speed on a treadmill following a metronome sound cue (period 566 msec).

Exploiting the Invariant Structure for Controlling Multiple Muscles in Anthropomorphic Legs: III. Reproducing Hemiparetic Walking from Equilibrium Point- Based Synergies.

In the development of a robotic therapy system, tests must be first run to guarantee safety and performance of the system before actual human trials. Lower-limb robotic therapy system has an inherit injury risk and a human-like stunt robot is desirable. This study proposes such an alternative: anthropomorphic legs with a bio-inspired control method affording a human-like test bench for the robotic therapy system.

Robot-Assisted Therapy in Upper Extremity Hemiparesis: Overview of an Evidence-Based Approach.

Robot-mediated therapy is an innovative form of rehabilitation that enables highly repetitive, intensive, adaptive, and quantifiable physical training. It has been increasingly used to restore loss of motor function, mainly in stroke survivors suffering from an upper limb paresis. Multiple studies collated in a growing number of review articles showed the positive effects on motor impairment, less clearly on functional limitations.

Robotic Arm Rehabilitation in Chronic Stroke Patients With Aphasia May Promote Speech and Language Recovery (but Effect Is Not Enhanced by Supplementary tDCS).

This study aimed to determine the extent to which robotic arm rehabilitation for chronic stroke may promote recovery of speech and language function in individuals with aphasia. We prospectively enrolled 17 individuals from a hemiparesis rehabilitation study pairing intensive robot assisted therapy with sham or active tDCS and evaluated their speech ( = 17) and language ( = 9) performance before and after a 12-week (36 session) treatment regimen. Performance changes were evaluated with paired -tests comparing pre- and post-test measures.

Passive Wrist Stiffness: The Influence of Handedness.

Objective: This paper reports on the quantification of passive wrist joint stiffness and investigates the potential influence of handedness and gender on stiffness estimates.

Methods: We evaluated the torque-angle relationship during passive wrist movements in 2 degrees of freedom (into flexion-extension and radial-ulnar deviation) in 13 healthy subjects using a wrist robot. Experimental results determined intrasubject differences between dominant and nondominant wrist and intersubject differences between male and female participants.

MIT-Skywalker: considerations on the Design of a Body Weight Support System.

Background: To provide body weight support during walking and balance training, one can employ two distinct embodiments: support through a harness hanging from an overhead system or support through a saddle/seat type. This paper presents a comparison of these two approaches. Ultimately, this comparison determined our selection of the body weight support system employed in the MIT-Skywalker, a robotic device developed for the rehabilitation/habilitation of gait and balance after a neurological injury.

Effects of partial body-weight support and functional electrical stimulation on gait characteristics during treadmill locomotion: Pros and cons of saddle-seat-type body-weight support.

Robotic therapy for rehabilitation of the lower extremity is currently in its early stage of development. Aiming at exploring an efficacious intervention for gait rehabilitation, we investigate the characteristics of an end-effector gait-training device that combines saddle-seat-type body-weight-supported treadmill training with functional electrical stimulation (FES). This is a task-oriented approach to restoring voluntary control of locomotion in patients with neuromuscular diseases.

Robot Assisted Training for the Upper Limb after Stroke (RATULS): study protocol for a randomised controlled trial.

Background: Loss of arm function is a common and distressing consequence of stroke. We describe the protocol for a pragmatic, multicentre randomised controlled trial to determine whether robot-assisted training improves upper limb function following stroke.

Methods/design: Study design: a pragmatic, three-arm, multicentre randomised controlled trial, economic analysis and process evaluation.

Pediatric robotic rehabilitation: Current knowledge and future trends in treating children with sensorimotor impairments.

Background: Robot-aided sensorimotor therapy imposes highly repetitive tasks that can translate to substantial improvement when patients remain cognitively engaged into the clinical procedure, a goal that most children find hard to pursue. Knowing that the child's brain is much more plastic than an adult's, it is reasonable to expect that the clinical gains observed in the adult population during the last two decades would be followed up by even greater gains in children. Nonetheless, and despite the multitude of adult studies, in children we are just getting started: There is scarcity of pediatric robotic rehabilitation devices that are currently available and the number of clinical studies that employ them is also very limited.

Intensive seated robotic training of the ankle in patients with chronic stroke differentially improves gait.

Background: Robotic driven treatment plans targeting isolated joints of the upper limb have improved the sensorimotor condition of patients with stroke. Similar intensive efforts to allay lower limb gait impairment have not been so successful. In patients with stroke, targeted robot assisted training of the ankle joint, in a seated position, has demonstrated significant alterations in ankle stiffness and foot-ankle orientation at foot strike which may provide a new treatment option for gait impairment.

Improved grasp function with transcranial direct current stimulation in chronic spinal cord injury.

Background: Recovering hand function has important implications for improving independence of patients with tetraplegia after traumatic spinal cord injury (SCI). Transcranial direct current stimulation (tDCS) is a noninvasive neuromodulation technique that has potential to improve motor function.

Objective: To investigate the effects of one session of 1 mA, 2 mA, and sham anodal tDCS (a-tDCS) in the upper extremity (hand) motor performance (grasp and lease) in patients with chronic cervical SCI.

Summary of Human Ankle Mechanical Impedance During Walking.

The human ankle joint plays a critical role during walking and understanding the biomechanical factors that govern ankle behavior and provides fundamental insight into normal and pathologically altered gait. Previous researchers have comprehensively studied ankle joint kinetics and kinematics during many biomechanical tasks, including locomotion; however, only recently have researchers been able to quantify how the mechanical impedance of the ankle varies during walking. The mechanical impedance describes the dynamic relationship between the joint position and the joint torque during perturbation, and is often represented in terms of stiffness, damping, and inertia.

MIT-Skywalker: A Novel Gait Neurorehabilitation Robot for Stroke and Cerebral Palsy.

The MIT-Skywalker is a novel robotic device developed for the rehabilitation or habilitation of gait and balance after a neurological injury. It represents an embodiment of the concept exhibited by passive walkers for rehabilitation training. Its novelty extends beyond the passive walker quintessence to the unparalleled versatility among lower extremity devices.

On the Origin of Muscle Synergies: Invariant Balance in the Co-activation of Agonist and Antagonist Muscle Pairs.

Investigation of neural representation of movement planning has attracted the attention of neuroscientists, as it may reveal the sensorimotor transformation essential to motor control. The analysis of muscle synergies based on the activity of agonist-antagonist (AA) muscle pairs may provide insight into such transformations, especially for a reference frame in the muscle space. In this study, we examined the AA concept using the following explanatory variables: the AA ratio, which is related to the equilibrium-joint angle, and the AA sum, which is associated with joint stiffness.

Robotic Therapy and the Paradox of the Diminishing Number of Degrees of Freedom.

There has been remarkable growth in the development and application of robotics to ameliorate or remediate impairment. This growth is associated with a) the understanding that plasticity is a fundamental property of the adult human brain and might be harnessed to remap or create new neural pathways and b) that robots that can safely interact with humans and assist human performance. This article discusses whether robotic therapy has achieved a level of maturity to justify its broad adoption as a rehabilitative tool.