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The use of videogames and motion capture systems in rehabilitation contributes to the recovery of the patient. This systematic review aimed to explore the works related to these technologies. The PRISMA method (Preferred Reporting Items for Systematic reviews and Meta-Analyses) was used to search the databases Scopus, PubMed, IEEE Xplore, and Web of Science, taking into consideration four aspects: physical rehabilitation, the use of videogames, motion capture technologies, and upper limb rehabilitation. The literature selection was limited to open access works published between 2015 and 2020, obtaining 19 articles that met the inclusion criteria. The works reported the use of inertial measurement units (37%), a Kinect sensor (48%), and other technologies (15%). It was identified that 26% used commercial products, while 74% were developed independently. Another finding was that 47% of the works focus on post-stroke motor recovery. Finally, diverse studies sought to support physical rehabilitation using motion capture systems incorporating inertial units, which offer precision and accessibility at a low cost. There is a clear need to continue generating proposals that confront the challenges of rehabilitation with technologies which offer precision and healthcare coverage, and which, additionally, integrate elements that foster the patient's motivation and participation.

This paper presents a novel kinematic reconstruction of the human arm chain with five degrees of freedom and the estimation of the shoulder location during rehabilitation therapy assisted by end-effector robotic devices. This algorithm is based on the pseudoinverse of the Jacobian through the acceleration of the upper arm, measured using an accelerometer, and the orientation of the shoulder, estimated with a magnetic angular rate and gravity (MARG) device. The results show a high accuracy in terms of arm joints and shoulder movement with respect to the real arm measured through an optoelectronic system. Furthermore, the range of motion (ROM) of 50 healthy subjects is studied from two different trials, one trying to avoid shoulder movements and the second one forcing them. Moreover, the shoulder movement in the second trial is also estimated accurately. Besides the fact that the posture of the patient can be corrected during the exercise, the therapist could use the presented algorithm as an objective assessment tool. In conclusion, the joints' estimation enables a better adjustment of the therapy, taking into account the needs of the patient, and consequently, the arm motion improves faster.

Given the widespread debate on the definition of the terms "Body Schema" and "Body Image", this article presents a broad overview of the studies that have investigated the nature of these types of body representations, especially focusing on the innovative information about these two representations that could be useful for the rehabilitation of patients with different neurological disorders with motor deficits (especially those affecting the upper limbs). In particular, we analyzed (i) the different definitions and explicative models proposed, (ii) the empirical settings used to test them and (iii) the clinical and rehabilitative implications derived from the application of interventions on specific case reports. The growing number of neurological diseases with motor impairment in the general population has required the development of new rehabilitation techniques and a new phenomenological paradigm placing body schema as fundamental and intrinsic parts for action in space. In this narrative review, the focus was placed on evidence from the application of innovative rehabilitation techniques and case reports involving the upper limbs, as body parts particularly involved in finalistic voluntary actions in everyday life, discussing body representations and their functional role. [ABSTRACT FROM AUTHOR]

Recently, significant efforts have been made to develop prostheses, soft rehabilitation, and assistive devices that enhance the quality of life of limb amputees and the activities of daily living (ADL) of stroke patients. Therefore, this present study provides a general overview of the current prosthetic, assistive, and rehabilitative devices with a focus on actuators that provide actuation via shape-memory alloys (SMA). Shape-memory alloy (SMA)-based actuators are the subject of considerable research as they possess high force-to-weight ratio, quiet operation, muscular mobility, bio-compatibility, and accessible design options, all of which can potentially be used to develop inventive actuating systems. Several studies have examined the use of SMA-actuated devices in the medical and engineering industry. They have also, more recently, been used to develop soft robotic systems. This present review primarily focuses on the characterization, number, type of actuator, degrees of freedom (DOF), weight, cooling technique, control strategies, and applications as well as the advantages and disadvantages of plate, spring, and wire-based SMA actuators. Composite-based upper limb SMA actuators were also reviewed and compared in terms of the matrix, reinforcing materials, SMA configuration actuator dimensions, and manufacturing method as well as their advantages and disadvantages. The findings indicate that, in the last few years, more studies have examined developing novel intelligent materials with which to improve hand flexibility. Therefore, SMA materials have a promising future in the development of intelligent designs for hand-robots. They may also be used to improve control robustness as well as the accuracy of hand functions for ADL and effective rehabilitation.

Given the widespread debate on the definition of the terms “Body Schema” and “Body Image”, this article presents a broad overview of the studies that have investigated the nature of these types of body representations, especially focusing on the innovative information about these two representations that could be useful for the rehabilitation of patients with different neurological disorders with motor deficits (especially those affecting the upper limbs). In particular, we analyzed (i) the different definitions and explicative models proposed, (ii) the empirical settings used to test them and (iii) the clinical and rehabilitative implications derived from the application of interventions on specific case reports. The growing number of neurological diseases with motor impairment in the general population has required the development of new rehabilitation techniques and a new phenomenological paradigm placing body schema as fundamental and intrinsic parts for action in space. In this narrative review, the focus was placed on evidence from the application of innovative rehabilitation techniques and case reports involving the upper limbs, as body parts particularly involved in finalistic voluntary actions in everyday life, discussing body representations and their functional role.

Robotic exoskeletons are active devices that assist or counteract the movements of the body limbs in a variety of tasks, including in industrial environments or rehabilitation processes. With the introduction of textile and soft materials in these devices, the effective motion transmission, mechanical support of the limbs, and resistance to physical disturbances are some of the most desirable structural features. This paper proposes an evaluation protocol and assesses the mechanical support properties of a servo-controlled robotic exoskeleton prototype for rehabilitation in upper limbs. Since this prototype was built from soft materials, it is necessary to evaluate the mechanical behavior in the areas that support the arm. Some of the rehabilitation-supporting movements such as elbow flexion and extension, as well as increased muscle tone (spasticity), are emulated. Measurements are taken using the reference supplied to the system's control stage and then compared with an external high-precision optical tracking system. As a result, it is evidenced that the use of soft materials provides satisfactory outcomes in the motion transfer and support to the limb. In addition, this study lays the groundwork for a future assessment of the prototype in a controlled laboratory environment using human test subjects. [ABSTRACT FROM AUTHOR]

An exoskeleton is an external cast which can be used to maneuver, protect or even provide a greater magnitude of strength to the upper limb allowing for heightened efficiency and performance. The limb may be weakened due to so many diseases or reasons such as paralysis, stroke, muscular atrophy, and different kinds of injuries. Numerous designs and manufactured prototypes of pneumatic exoskeletons have been reviewed--their pros and cons weighed against each other. This paper covers the fundamental concepts of various prototypes that have been designed and developed over the years. The best mechanism has been highlighted, although the design of a fully efficient exoskeleton comes with its set of drawbacks. Types of energy used for the driver unit, types of actuators, materials used, design concepts, and overall weight and manufacturing cost of every prototype has been contrasted with the others to conclude what an ideal exo-skeleton for rehabilitation purposes must look like and the principles and features of the prototype must be decided upon by keeping aesthetics and ergonomics in mind. [ABSTRACT FROM AUTHOR]

Robotic exoskeletons are active devices that assist or counteract the movements of the body limbs in a variety of tasks, including in industrial environments or rehabilitation processes. With the introduction of textile and soft materials in these devices, the effective motion transmission, mechanical support of the limbs, and resistance to physical disturbances are some of the most desirable structural features. This paper proposes an evaluation protocol and assesses the mechanical support properties of a servo-controlled robotic exoskeleton prototype for rehabilitation in upper limbs. Since this prototype was built from soft materials, it is necessary to evaluate the mechanical behavior in the areas that support the arm. Some of the rehabilitation-supporting movements such as elbow flexion and extension, as well as increased muscle tone (spasticity), are emulated. Measurements are taken using the reference supplied to the system’s control stage and then compared with an external high-precision optical tracking system. As a result, it is evidenced that the use of soft materials provides satisfactory outcomes in the motion transfer and support to the limb. In addition, this study lays the groundwork for a future assessment of the prototype in a controlled laboratory environment using human test subjects.

Cervical spinal cord injury is damage to the spinal cord that causes temporary or permanent changes in body functions below the site of the injury. In particular, the impairment of the upper limbs limits the patient's autonomy in the execution of activities of daily living. This paper illustrates the use of a low-cost robot with a virtual reality platform for upper limb rehabilitation of cervical spinal cord injury patients. Vibration and pressure haptic feedback sensations are provided thanks to a custom-made thimble feedback device. The virtual reality platform consists of three different virtual rehabilitation games developed in Unity. They provide the user with the opportunity to interact with the virtual scene using free hands thanks to the data collected by a hand tracking system. During the therapy session, quantitative data about the motor performance are collected. Each virtual reality environment can be modified in settings according to the patients' needs. A proof of concept was performed with both healthy subjects and spinal cord injured patients to evaluate the platform and its usability. The data saved during the sessions are analyzed to validate the importance of haptic feedback and stored both for patients and therapists to control the performance and the recovery process. [ABSTRACT FROM AUTHOR]

Introdution: Stroke causes several alterations, the more frequent are motor, physical and psychological. Since rehabilitation takes time and can become monotonous, the use of virtual reality can act as a stimulating way to involve the patient in the treatment, seeking to develop its functionality. Objective: The objective of this study was to verify in the available literature the effects of using virtual reality in the treatment of the sequelae of the Stroke, to gain functionality in the upper limbs. Methods: This literature review was based on the PICO strategy, carried out in the databases Lílacs, Pubmed, Scielo and PEDro, using the keywords "physiotherapy AND virtual reality OR exergame OR exergaming AND stroke AND upper limbs". Complete articles were published in English, Portuguese and Spanish, available and dated between 2015 and 2020, excluding those that were review articles, incomplete and that did not address the topic. Results: As a result, the search found 1,035 articles, of which only 14 met the imposed criteria. Most studies have shown that the use of virtual reality through games has proved to be an efficient resource in the functional rehabilitation of patients with stroke. Presenting itself as a competent complementary to physiotherapeutic treatment in improving fine motor skills, motor behavior of the limbs and cognitive performance, these gains directly influenced the gain in functionality of the samples. Conclusion: The use of virtual reality is useful to assist in the treatment and reduction of sequelae in the upper limbs of patients with stroke, as it promotes greater functional gain, range of motion and improves the dexterity of both the most and the least compromised hand. [ABSTRACT FROM AUTHOR]

Background and purpose: Limited research has been dedicated to upper limb (UL) rehabilitation in progressive multiple sclerosis (PMS). The objective in this pilot study was to investigate the effect of task‐oriented UL rehabilitation in PMS and to perform explorative analyses of the magnetic resonance imaging (MRI) correlates of changes in motor performance. Methods: Twenty‐six PMS patients with mild UL impairment were prospectively enrolled and randomized into two groups: an active treatment group (ATG, n = 13) and a passive treatment group (PTG, n = 13). At baseline and after training, patients underwent MRI scans with structural and functional imaging and were evaluated with the action research arm test, the nine‐hole peg test, the ABILHAND scale and the modified fatigue impact scale (MFIS). Measures of motor finger performance were obtained by engineered glove measuring. Results: After rehabilitation, the ATG improved in several finger motor tasks (0.001 ≤ P ≤ 0.03, 0.72 ≤ Cohen's d ≤ 1.22) and showed reduced MFIS scores compared with the PTG (P = 0.03). The ATG showed increased functional connectivity within the cerebellar and thalamic resting state networks compared with the PTG (P < 0.05). Correlations were found between several measures of motor improvement and thalamic and sensorimotor networks (0.87 ≤ r ≤ 0.93, 0.001 ≤ P ≤ 0.03). No changes in cerebral volumes and diffusion tensor imaging derived measures were detected. Conclusions: Progressive multiple sclerosis patients with mild UL dysfunction benefit from task‐oriented UL rehabilitation, which seems to be more efficient than simple passive mobilization. Despite a high burden of disability and brain damage, functional adaptive capacities seem to be preserved, thus providing a rationale for the use of rehabilitative treatments in late PMS. [ABSTRACT FROM AUTHOR]

The aim of this study is to assess quantitatively the effects of a computer-assisted system (ARMEO Spring system) to improve upper extremity function in hemiplegic children due to Cerebral Palsy (CP), by means of clinical-functional scales and upper limb kinematics. Twenty-one children with hemiplegia were clinically assessed with Quality of Upper Extremities Skills Test and Melbourne Assessment and instrumentally by 3D movement analysis during reaching task. Data were collected before and after 4 weeks of treatment with the ARMEO Spring system. A control group of 15 healthy children was included as reference. After the ARMEO Spring training, the clinical scores improved significantly. In terms of kinematics, the affected limbs improved in terms of the movement duration and velocity, smoothness (Average Jerk) and Number of Movement Unit parameters. From these results, the ARMEO Spring training seems to be a promising intervention for improving upper limb function in hemiplegic children. [ABSTRACT FROM AUTHOR]

Background: The study aims to determine the effectiveness of robot-assisted training in the recovery of stroke-affected arms using an exoskeleton robot Armeo Spring.Objective: To identify the effect of robot training on functional recovery of the arm.Methods: A total of 34 stroke patients were divided into either an experimental group (EG; n= 17) or a control group (n= 17). EG was also trained to use the Armeo Spring during occupational therapy. Both groups were clinically assessed before and after treatment. Statistical comparison methods (i.e. one-tailed t-tests for differences between two independent means and the simplest test) were conducted to compare motor recovery using robot-assisted training or conventional therapy.Results: Patients assigned to the EG showed a statistically significant improvement in upper extremity motor function when compared to the CG by FIM (P< 0.05) and ACER (P< 0.05). The calculated treatment effect in the EG and CG was meaningful for shoulder and elbow kinematic parameters.Conclusions: The findings show the benefits of robot therapy in two areas of functional recovery. Task-oriented robotic training in rehabilitation setting facilitates recovery not only of the motor function of the paretic arm but also of the cognitive abilities in stroke patients. [ABSTRACT FROM AUTHOR]

Current physiotherapy services may not be effective or suitable for certain patients due to lack of motivation, poor adherence to exercises, insufficient supervision and feedback or, in the worst case, refusal to continue with the rehabilitation plan. This paper introduces a novel approach for rehabilitation of upper limbs through KineActiv, a platform based on Microsoft Kinect v2 and developed in Unity Engine. KineActiv proposes exergames to encourage patients to perform rehabilitation exercises prescribed by a specialist, controls the patient′s performance, and corrects execution errors on the fly. KineActiv comprises a web platform where the physiotherapist can review session results, monitor patient health, and adjust rehabilitation routines. We recruited 10 patients for assessing the system usability as well as the system performance. Results show that KineActiv is a usable, enjoyable and reliable system, that does not cause any negative feelings.

This study aimed to document and compare the decline of upper limb performance among adults with myotonic dystrophy type 1 according to phenotype and gender. A longitudinal descriptive design compared upper limb performance at baseline and follow-up of 70 women and 38 men with the late-onset or adult phenotypes. Grip strength and pinch strength as well as gross dexterity and fine dexterity were assessed. All four performance measures decreased significantly ( p  <   0.001). The decline over time was similar for individuals with the late-onset and adult-onset phenotypes, but differed according to gender. For late-onset and adult-onset phenotypes respectively, women lost less grip strength than men: 0.4 and minus 0.8 kg (2.0% and −9.4%) in women vs. minus 7.4 and minus 3.1 kg (−19.2% and −30.7%) in men. A similar situation was found for gross dexterity: minus 3.0 and minus 3.2 blocks (−4.6% and −5.9%) in women vs. minus 12.4 and minus 8.7 blocks (−19.4% and −16.6%) in men. Pinch gauge had the smallest standard deviations and was one of the only measurement tools with significant detectable changes in relation to the standard error of measurement. Given these results, health professionals and researchers should consider phenotype and gender differently when planning health services or future studies. Indeed, as their upper limb strength and dexterity differed, even if their decline was similar, the phenotypes should not be pooled. Finally, the use of the pinch gauge to assess long-term change in upper limb ability seems preferable to the three other measurements. [ABSTRACT FROM AUTHOR]

Purpose state: The aim of this preliminary study was to test a data glove, CyberTouch™, combined with a virtual reality (VR) environment, for using in therapeutic training of reaching movements after spinal cord injury (SCI).Method: Nine patients with thoracic SCI were selected to perform a pilot study by comparing two treatments: patients in the intervention group (IG) conducted a VR training based on the use of a data glove, CyberTouch™ for 2 weeks, while patients in the control group (CG) only underwent the traditional rehabilitation. Furthermore, two functional parameters were implemented in order to assess patient’s performance of the sessions: normalized trajectory lengths and repeatability.Results: Although no statistical significance was found, the data glove group seemed to obtain clinical changes in the muscle balance (MB) and functional parameters, and in the dexterity, coordination and fine grip tests. Moreover, every patient showed variations in at least one of the functional parameters, either alongY-axis trajectory orZ-axis trajectory.Conclusions: This study might be a step forward for the investigation of new uses of motion capture systems in neurorehabilitation, making it possible to train activities of daily living (ADLs) in motivational environments while measuring objectively the patient’s functional evolution.Implications for RehabilitationKey findings: A motion capture application based on a data glove is presented, for being used as a virtual reality tool for rehabilitation. This application has provided objective data about patient’s functional performance.What the study has added: (1) This study allows to open new areas of research based on the use of different motion capture systems as rehabilitation tools, making it possible to train Activities of Daily Living in motivational environments. (2) Furthermore, this study could be a contribution for the development of clinical protocols to identify which types of patients will benefit most from the VR treatments, which interfaces are more suitable to be used in neurorehabilitation, and what types of virtual exercises will work best. [ABSTRACT FROM PUBLISHER]

Abstract: The purpose of this study was to investigate the effects of imposing different degrees of forward trunk flexion during sitting pivot transfers on electromyographic activity at the leading and trailing upper limb muscles and on dynamic stability requirements. Thirty-two individuals with a spinal cord injury performed three types of sitting pivot transfers: natural technique, exaggerated forward trunk flexion and upright trunk position. Ground reaction forces, trunk kinematics, and bilateral electromyographic activity of eight upper limb muscles were recorded. Electromyographic data were analyzed using the area under the curve of the muscular utilization ratio. Dynamic stability requirements of sitting pivot transfers were assess using a dynamic equilibrium model. Compared to the natural strategy, significantly greater muscle activities were found for the forward trunk flexion condition at the anterior deltoid and both heads of the pectorialis major, whereas the upright trunk strategy yielded greater muscle activity at the latissimus dorsii and the triceps. The forward flexed condition was found to be more dynamically stable, with a lower stabilizing force, increased area of base of support and greater distance traveled. Thus, transferring with a more forward trunk inclination, even though it increases work of few muscles, may be a beneficial trade-off because increased dynamic stability of this technique and versatility in terms of potential distance of the transfer. [Copyright &y& Elsevier]

Aims: Lateral body weight shifting tasks are used in rehabilitation programmes, particularly in programmes for patients with orthopaedic complaints or hemiparesis. In the present study, we aimed to identify the inherent factors that could lead to deterioration of performance in such tasks. Methodology: Twenty four healthy participants were asked to accurately load a target of one or two thirds of their body weight onto their left and right lower limbs. Results: Constant error showed a relative central tendency effect during body weight shifting. 'Central tendency' refers to people undershooting heavier target loads by a large extent, and undershooting lighter target loads by a small extent during body weight shifting. Overall accuracy (root-mean-squared error) and variability significantly differed for the two target loads during weight shift to the left but not during that to the right. Inter-limb weight adjustment between the upper and lower limbs deteriorated the weight adjustment for the target load. Conclusion: Having a central tendency can potentially deteriorate a person's performance of the task both in the early (when a lighter target is used) and late (when a heavier target is used) phases of rehabilitation. Lateral differences in both overall accuracy and consistency may occur while shifting heavy (rather than light) loads, particularly when the left lower limb is affected. Heavy reliance on the upper limb while attempting accurate loading on the target limb can also deteriorate loading accuracy. [ABSTRACT FROM AUTHOR]

Abstract: Background: Depending on the level and severity of the sensorimotor impairment in individuals with a spinal cord injury, the subsequent reduced seated postural stability and strength generating-capacity at the upper limbs could affect performance during sitting pivot transfer. This study aimed to determine the effects of sensorimotor impairments on head, trunk and upper limb movement and efforts during sitting pivot transfers. Methods: Twenty-six individuals with a spinal cord injury participated and were stratified in two subgroups: with (N=15) and without voluntary motor control (N=11) of their lower back and abdominal muscles. Kinematics and kinetics of sitting pivot transfer were collected using a transfer assessment system. Mean joint angles and movement amplitudes and peak and average joint moments were compared between subgroups using independent Student t-tests (P<0.05) for the weight-bearing sitting pivot transfer phases. Findings: The subgroup without voluntary control of their lower back and abdominal muscles had significantly greater forward trunk flexion compared to the other subgroup resulting in higher wrist extension and elbow flexion at both upper limbs. No significant joint moment difference was found between the subgroups. Interpretation: Individuals with spinal cord injury who have no voluntary motor control of their abdominal and lower back muscles increase forward trunk flexion during sitting pivot transfers 1) to increase stiffness of their spine that may optimize the strength-generating ability of their thoracohumeral muscles and 2) to lower their center of mass that may facilitate lift-off and enhance the overall stability during sitting pivot transfers. [Copyright &y& Elsevier]

The article discusses a study to quantify the movement limitation of upper limbs in hemiplegic children after traumatic brain injury (TBI) by using a clinical-functional scale and upper limb kinematics in order to evaluate the efficacy of constraint-induced movement therapy (CIMT) on upper limbs. 10 children with TBI were evaluated before and after the CIMT program. The study concluded that CIMT is effective in improving movement efficiency and upper limb function in children after TBI.

In this report we describe the effects of a virtual reality (VR) training addressed to the upper limb of a stroke patient. After 20 days of rehabilitation sessions consisting of physical therapy and VR rehabilitation, the subject was evaluated by means of kinematics and clinical scales. Results showed the improvement of paretic arm mobility, in terms of quantitative parameters and clinical scales, suggesting that VR training could represent a valuable tool to supplement the traditional rehabilitation provided by the physical therapist. [ABSTRACT FROM AUTHOR]

Early intervention and intensive therapy improve the outcome of neuromuscular rehabilitation. There are indications that where a patient is motivated and premeditates their movement, the recovery is more effective. Therefore, a strategy for patient-cooperative control of rehabilitation devices for upper extremities is proposed and evaluated. The strategy is based on the minimal intervention principle allowing an efficient exploitation of task space redundancies and resulting in user-driven movement trajectories. The patient's effort is taken into consideration by enabling the machine to comply with forces exerted by the user. The interaction is enhanced through a multimodal display and a virtually generated environment that includes haptic, visual and sound modalities. [ABSTRACT FROM AUTHOR]

Abstract: Messier S, Bourbonnais D, Desrosiers J, Roy Y. Kinematic analysis of upper limbs and trunk movement during bilateral movement after stroke. Objective: To compare the kinematics of the upper limbs and trunk during unilateral and parallel bilateral tasks in subjects with hemiparesis and control subjects. Design: Comparative study. Setting: Geriatric center offering rehabilitation services. Participants: Convenience sample of 15 persons (age, 69.4±12.0y; ≥3mo poststroke) recruited in a geriatric center with rehabilitation services, and 13 control persons (67.8±7.5y) participated in the study. Interventions: Not applicable. Main Outcome Measures: Unilateral and bilateral movements toward 1 or 2 targets located beyond arm’s length and positioned in 3 directions. Angular changes of both upper limbs and trunk were characterized in the sagittal, frontal, and horizontal planes. Results: During the bilateral task, the deficits of the kinematic joints of the paretic upper limb persisted in subjects with hemiparesis as compared with the corresponding upper limb in the control subjects (abduction shoulder: subjects with hemiparesis, 5.7°±5.3°; control subjects, 0.7°±4.8°; extension elbow: subjects with hemiparesis, 38.2°±14.2°; control subjects, 52.8°±12.5°) with a marked flexion of the trunk (subjects with hemiparesis, 33.7°±8.7°; control subjects, 26.8°±5.8°). The elbow extension of the nonparetic upper limb was reduced (subjects with hemiparesis, 41.0°±13.6°; control subjects, 52.8°±12.5°). Conclusions: The use of parallel bilateral reaching tasks and placing movements of the upper extremities in the subjects with hemiparesis contributed an increase in the trunk flexion rather than improve the motor performance of the paretic upper limb, especially with regard to increasing elbow extension. [Copyright &y& Elsevier]

Neuromotor rehabilitation and recovery of upper limb functions are essential to improve the life quality of patients who have suffered injuries or have pathological sequels, where it is desirable to enhance the development of activities of daily living (ADLs). Modern approaches such as robotic-assisted rehabilitation provide decisive factors for effective motor recovery, such as objective assessment of the progress of the patient and the potential for the implementation of personalized training plans. This paper focuses on the design, development, and preliminary testing of a wearable robotic exoskeleton prototype with autonomous Artificial Intelligence-based control, processing, and safety algorithms that are fully embedded in the device. The proposed exoskeleton is a 1-DoF system that allows flexion-extension at the elbow joint, where the chosen materials render it compact. Different operation modes are supported by a hierarchical control strategy, allowing operation in autonomous mode, remote control mode, or in a leader-follower mode. Laboratory tests validate the proper operation of the integrated technologies, highlighting a low latency and reasonable accuracy. The experimental result shows that the device can be suitable for use in providing support for diagnostic and rehabilitation processes of neuromotor functions, although optimizations and rigorous clinical validation are required beforehand. [ABSTRACT FROM AUTHOR]

Processing and control systems based on artificial intelligence (AI) have progressively improved mobile robotic exoskeletons used in upper-limb motor rehabilitation. This systematic review presents the advances and trends of those technologies. A literature search was performed in Scopus, IEEE Xplore, Web of Science, and PubMed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology with three main inclusion criteria: (a) motor or neuromotor rehabilitation for upper limbs, (b) mobile robotic exoskeletons, and (c) AI. The period under investigation spanned from 2016 to 2020, resulting in 30 articles that met the criteria. The literature showed the use of artificial neural networks (40%), adaptive algorithms (20%), and other mixed AI techniques (40%). Additionally, it was found that in only 16% of the articles, developments focused on neuromotor rehabilitation. The main trend in the research is the development of wearable robotic exoskeletons (53%) and the fusion of data collected from multiple sensors that enrich the training of intelligent algorithms. There is a latent need to develop more reliable systems through clinical validation and improvement of technical characteristics, such as weight/dimensions of devices, in order to have positive impacts on the rehabilitation process and improve the interactions among patients, teams of health professionals, and technology. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to examine the effectiveness of botulinum toxin A (BoNT-A) therapy combined with rehabilitation on motor function in post-stroke patients. Methods: The following sources up to December 31, 2018, were searched from inception for articles in English: Pubmed, Scopus, CINAHL, Embase, PsycINFO, and CENTRAL. Trials using injections of BoNT-A for upper and lower limb rehabilitation were examined. We excluded studies that were not performed for rehabilitation or were not evaluated for motor function. Results: Twenty-six studies were included. In addition to rehabilitation, nine studies used adjuvant treatment to improve spasticity or improve motor function. In the upper limbs, two of 14 articles indicated that significant improvement in upper limb motor function was observed compared to the control group. In the lower limbs, seven of 14 articles indicated that significant improvement in lower limb motor function was observed compared to the control group. Conclusions: The effect of combined with rehabilitation is limited after stroke, and there is not sufficient evidence, but results suggest that BoNT-A may help to improve motor function. In future studies, the establishment of optimal rehabilitation and evaluation times of BoNT-A treatment will be necessary for improving motor function and spasticity. [ABSTRACT FROM AUTHOR]