Brain Injury Center

Development and Integration of Medicine-Engineering in TBI Rehabilitation-2

Posted on December 18, 2022

Robotic-Assisted Rehabilitation Training

In the past decades, rehabilitation robots have been rapid and vast developments. As a relatively young and rapidly developing field, rehabilitation robots are increasingly infiltrating the clinical environment. An increasing number of patients are suffering from limb motor dysfunction, which may be caused by stroke-related nerve damage, traumatic brain injury, or multiple sclerosis. The robotic-assisted rehabilitation therapy can deliver high-quality training to enhance the recovery process and promote the recovery of limb function.

One study presented the application of novel self-feeding robots in TBI rehabilitation, and the self-feeding robots improved the activities of daily living of patients with TBI. In another study, a collaborative wheelchair assistant system (CWAS) in cerebral palsy and traumatic brain injury users showed that it improved the patients' motor function.

Meanwhile, robotic gait training is applied in gait impairment after TBI widely. This assistive technology is beneficial for the rehabilitation of participants with TBI. Another study also confirmed that robotic-assisted locomotor training could improve the locomotor performance of patients with TBI. A study of 16 participants with TBI receiving 18 robotic gait training duration of six weeks demonstrated that robotic-assisted treadmill training (RATT) improves step length over manually assisted treadmill training (MATT).

Configurable Arm Rehabilitation Games for patients with chronic upper limb impairment after TBI.

The gamified rehabilitation platform using tangible robots can promote the rehabilitation of limb function, a model called visual feedback distortion for rehabilitating patients with TBI. Two patients were enrolled in a six-week rehabilitation program. In this case, patients who are physically capable of advancing in rehabilitation did not prevent them because they had reached habitual or self-imposed limits. Each patient followed the level of visual feedback distortion higher than her performance predicted in the initial evaluation.

The above shows us that robotic-assisted rehabilitation training pays more attention to limb motor dysfunction after TBI. We should focus on future robot research of fine hand motion rehabilitation.

The advantages and disadvantages of robotic-assisted rehabilitation training are:

Advantages

The increase in mobility is beneficial to learning, communication, motivation, and social interaction
Better steerability
Higher-intensity gait therapy

Disadvantages

Lack of personalized robot-assisted training (e.g., speed parameter)

Virtual Reality- (VR-) Based Training

Virtual reality (VR) is a new and developing technology that combines the characteristics of VR technology, such as autonomy, interactivity, and existence, with rehabilitation training. VR is described as "an advanced human-computer interaction mode that allows users to interact in a natural way with a computer-based environment for training and full immersion.". VR is now offering more new treatment measures for patients with TBI.

A study of 33 TBI patients examined the usability of a virtual reality driving simulator. All patients were asked to perform a VR driver rehabilitation (VR-DR) system and complete the related User Feedback Questionnaire. The result found that the VR-DR system could be well applied to the rehabilitation training of TBI patients.

Another study tested the availability and efficacy of a newly developed virtual reality- (VR-) based community living skills training program for people with TBI, and the result suggested the produced positive changes in TBI subjects. The study of 18 patients with severe TBI found that through two consecutive days of 3D cancellation in an interactive virtual environment, VR and robotics technology improved attention impairment in patients with TBI.

Similarly, a study also showed that rehabilitation training in an interactive visuo-haptic environment might be beneficial to the early recovery of attention in patients with TBI. Additionally, virtual reality (VR) has been used with robotics, biofeedback training, and modern multitouch technology.

Using multitouch-multiuser tabletop (MMT) devices: Snowflake MultiTeach (MT) and Diamond Touch Table (DTT), coupled with MediqVR virtual reality (VR) platform and computer-based interactive applications were applied in rehabilitation design; the research found that MediqVR training improves the patients' intuition, communication, and expression ability, enable them to carry out social activities naturally and reduce the patients' social anxiety.