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Ch. 22: Rehabilitation Technologies to Promote Upper Limb Recovery after Stroke (in progress)
Terms in this set (18)
-Can provide quantifiable and repeatable treatment interventions
-Can allow us to better measure the impact of our interventions on impairments of motor function
-Are not expected to replace OTs and PTs, but will become a part of their treatment repertoire to optimize functional performance after a disabling event
-Is predicted to help to reduce or control rehab costs by providing intensive movement therapies with minimal supervision by a therapist
-May help shorten inpatient hospitalizations and potentially improve long-term functional outcomes
What principles have influenced the development of rehabilitation technology?
-Motor learning principles, particularly massed practice and explicit learning paradigms
How have motor learning approaches to conventional stroke rehab evolved?
-Motor learning approaches have evolved to emphasize task-oriented training to improve upper limb function and pt. participation in valued roles and routines.
What have been the results of task-oriented approaches in which motor skills are practiced in natural contexts?
-Task-oriented approach, in which motor skills are practiced in natural contexts, has resulted in faster and better treatment outcomes than traditional methods.
Studies have shown that the training of virtual tasks can lead to significant gains in motor performance during real world activities. (True or False?)
What are the two main classes of rehabilitation robotics that have been developed?
-Class 1= Robots that allow the user to compensate for lost skills when the potential for motor recovery is poor.
-Class 2= Provide repetitive, task specific training to help restore lost motor function.
This chapter focuses on the 2nd class of robots
How is robot-assisted technologies different from constraint-induced movement therapy (CIMT)?
-Unlike CIMT, robot-assisted technologies are appropriate for persons with moderate to severe motor impairments.
3 types of robots for the upper limb
1. Active systems
2. Passive systems
3. Interactive systems
Have actuators that provide movement assistance along a defined trajectory
Support the limb during movement attempts
Actuators or motors are combined with impedance and control strategies that allow the robot to react to the pt. movement attempts
Low-impedance interactive robots (i.e.- the InMotion ARM)
-Are highly "backdrivable" and compliant to a client's attempts to move
-Allows precise and objective measures of motor performance
Active robots that use pneumatic actuators or "muscles" to power the device (i.e.- Hand Mentor)
-Are not as responsive to the pt. movement attempts, because the mechanics of the robot create a more viscous response, similar to moving through honey.
Passive robotics systems (i.e.- T-WREX and Armeo Spring devices)
-Offer varied forms of nonpowered assistance with elastic bands or springs that support the limb against gravity during movement attempts.
End-effector robots (i.e.- the InMotion ARM and Mirror Image Motion Enabler (MIME))
-Are typically attached to the person's hand or forearm at a single point of contact
-Are easily adjusted to different arm lengths but do not control movement torques at individual joints
-Structure more closely resembles human anatomy
-Allows separate control of torques applied at each joint
-Some require more effort when adapting them to different body sizes because each robot link must be adjusted to match the length of the user's upper and lower arm.
-Are used to visually direct the pt. movement attempts during robot-assisted therapy
-Vary in degree of complexity, ranging from simple stimuli to simulation of functional task performance
MIT MANUS and InMotionARM Robots
-The most widely studied rehab robots (along w/ the InMotion2)
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