Neurophysiology of robot-mediated training and therapy: a perspective for future use in clinical populations

Frontiers in Neurology, 2013 · DOI: 10.3389/fneur.2013.00184 · Published: November 13, 2013

Assistive Technology Neuroplasticity Neurorehabilitation

Simple Explanation

The recovery of functional movements following injury to the central nervous system (CNS) is multifaceted and is accompanied by processes occurring in the injured and non-injured hemispheres of the brain or above/below a spinal cord lesion. Recovery of movement can be enhanced by intensive, repetitive, variable, and rewarding motor practice. To this end, robots that enable or facilitate repetitive movements have been developed to assist recovery and rehabilitation. Robots could thus open up a wider choice of options for delivering movement rehabilitation grounded on the principles underpinning neuroplasticity in the human CNS.

Study Duration

Not specified

Participants

Healthy subjects and neurological populations

Evidence Level

Review Article

Key Findings

1
Performing motor tasks with robot-mediated assistance can modulate neural activity compared to un-assisted or active voluntary movements in healthy subjects and stroke patients.
2
Adding VR to robot-mediated therapy remains to be explored both in terms of neuroplasticity and clinical application. Additionally, the type of visual stimuli used in VR-robot environments requires further investigation.
3
Using brain signals to drive a robot device directly to undertake everyday tasks and to induce motor rehabilitation is feasible following severe stroke.

Research Summary

The recovery of functional movements following injury to the central nervous system (CNS) is multifaceted and is accompanied by processes occurring in the injured and non-injured hemispheres of the brain or above/below a spinal cord lesion. To this end, robots that enable or facilitate repetitive movements have been developed to assist recovery and rehabilitation. Here, we suggest that some elements of robot-mediated training such as assistance and perturbation may have the potential to enhance neuroplasticity. From a technical perspective, robots can be excellent research tools, because they provide ways to standardize rehabilitative training, to precisely monitor recovery of motor function in patients and to control protocols for subjective human inﬂuence.

Practical Implications

Enhancing Neuroplasticity

Robot-mediated training elements like assistance and perturbation can potentially enhance neuroplasticity, aiding in the recovery of functional movements after CNS injury.

Wider Rehabilitation Options

Robots offer a broader range of options for delivering movement rehabilitation, based on neuroplasticity principles in the human CNS.

Personalized Training

Combining multiple concepts such as tDCS and robot-mediated therapy can provide individualized training delivered in a repetitive and standardized fashion, optimizing neuroplastic processes and learning.

Study Limitations

1
Limited knowledge on the neural correlates of robot-assisted movement and whether assistance control strategies induce neuroplasticity.
2
Rare use of robot-mediated perturbations in neurological therapy, despite understanding the neural correlates of motor learning induced by such perturbations in healthy subjects.
3
Lack of knowledge on the impact of motivation/reward on neuroplasticity during robot-based motor adaptation in healthy subjects and neurological patients.

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