Background: Repetitive, active movement-based training promotes brain plasticity and motor recovery after stroke. Robotic therapy provides highly repetitive therapy that reduces motor impairment. However, the effect of assist-as-needed algorithms on patient participation and movement quality is not known.
Objective: To analyze patient participation and motor performance during highly repetitive assist-as-needed upper limb robotic therapy in a retrospective study.
Methods: Sixteen patients with sub-acute stroke carried out a 16-session upper limb robotic training program combined with usual care. The Fugl-Meyer Assessment (FMA) score was evaluated pre and post training. Robotic assistance parameters and Performance measures were compared within and across sessions.
Results: Robotic assistance did not change within-session and decreased between sessions during the training program. Motor performance did not decrease within-session and improved between sessions. Velocity-related assistance parameters improved more quickly than accuracy-related parameters.
Conclusions: An assist-as-needed-based upper limb robotic training provided intense and repetitive rehabilitation and promoted patient participation and motor performance, facilitating motor recovery.
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http://dx.doi.org/10.3233/NRE-171454 | DOI Listing |
JBJS Rev
November 2024
Division of Plastic and Reconstructive Surgery, University of Colorado School of Medicine, Anschutz Medical Center, Aurora, Colorado.
Background: Modern nerve-to-nerve transfers are a significant advancement in peripheral nerve surgery. Nerve transfers involve transferring donor nerves or branches to recipient nerves close to the motor end unit, leading to earlier reinnervation and preservation of the musculotendinous units in proximal nerve injuries. After nerve reinnervation, function may be superior to traditional tendon transfer techniques in terms of strength and independent motion.
View Article and Find Full Text PDFJ Bone Joint Surg Am
November 2024
Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY.
Background: An accurate knowledge of a patient's risk of cord-level intraoperative neuromonitoring (IONM) data loss is important for an informed decision-making process prior to deformity correction, but no prediction tool currently exists.
Methods: A total of 1,106 patients with spinal deformity and 205 perioperative variables were included. A stepwise machine-learning (ML) approach using random forest (RF) analysis and multivariable logistic regression was performed.
Sci Robot
January 2025
Department of Bioengineering, Imperial College of London, London, UK.
Despite the advances in bionic reconstruction of missing limbs, the control of robotic limbs is still limited and, in most cases, not felt to be as natural by users. In this study, we introduce a control approach that combines robotic design based on postural synergies and neural decoding of synergistic behavior of spinal motoneurons. We developed a soft prosthetic hand with two degrees of actuation that realizes postures in a two-dimensional linear manifold generated by two postural synergies.
View Article and Find Full Text PDFSci Robot
January 2025
Sony Computer Science Laboratories Inc. (Sony CSL), Tokyo, Japan.
For trained individuals such as athletes and musicians, learning often plateaus after extensive training, known as the "ceiling effect." One bottleneck to overcome it is having no prior physical experience with the skill to be learned. Here, we challenge this issue by exposing expert pianists to fast and complex finger movements that cannot be performed voluntarily, using a hand exoskeleton robot that can move individual fingers quickly and independently.
View Article and Find Full Text PDFArch Orthop Trauma Surg
January 2025
BG Klinikum Unfallkrankenhaus Berlin, Department of Hand-, Replantation- and Microsurgery and Chair of Hand-, Replantation- and Microsurgery, Charité Universitätsmedizin Berlin, Berlin, Germany.
Introduction: Rhizarthrosis, or osteoarthritis of the trapeziometacarpal joint, predominantly affects women over 50, with up to 30% experiencing some degree of arthritis in this joint. Traditional surgical approaches, such as trapeziectomy with ligament reconstruction, can result in some patients in persistent pain or limited functionality. TMC ball-in-socket arthroplasty, with a cup placed in the distal scaphoid, offers a promising alternative to traditional arthrodesis or resection-suspension arthroplasty.
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