Motions or muscles? Some behavioral factors underlying robotic assistance of motor recovery

Robotics and related technologies have begun to realize their promise to improve the delivery of rehabilitation therapy. However, the mechanism by which they enhance recovery remains unclear. Ultimately, recovery depends on biology, yet the details of the recovery process remain largely unknown; a d...

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Bibliographic Details
Published in:Journal of rehabilitation research and development 2006-08, Vol.43 (5), p.605-618
Main Authors: Hogan, Neville, Krebs, Hermano I, Rohrer, Brandon, Palazzolo, Jerome J, Dipietro, Laura, Fasoli, Susan E, Stein, Joel, Hughes, Richard, Frontera, Walter R, Lynch, Daniel, Volpe, Bruce T
Format: Article
Language:English
Subjects:
Behavior - physiology
Brain
Control algorithms
Exercise
Exercise Therapy
Humans
Intelligent systems
Medical research
Medical treatment
Motor ability
Movement
Muscle Weakness - etiology
Muscle Weakness - rehabilitation
Nervous system
Patients
Rehabilitation
Robotics
Robots
Stroke - complications
Stroke Rehabilitation
Systems integration
Technology application
Therapy
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Summary:Robotics and related technologies have begun to realize their promise to improve the delivery of rehabilitation therapy. However, the mechanism by which they enhance recovery remains unclear. Ultimately, recovery depends on biology, yet the details of the recovery process remain largely unknown; a deeper understanding is important to accelerate refinements of robotic therapy or suggest new approaches. Fortunately, robots provide an excellent instrument platform from which to study recovery at the behavioral level. This article reviews some initial insights about the process of upper-limb behavioral recovery that have emerged from our work. Evidence to date suggests that the form of therapy may be more important than its intensity: muscle strengthening offers no advantage over movement training. Passive movement is insufficient; active participation is required. Progressive training based on measures of movement coordination yields substantially improved outcomes. Together these results indicate that movement coordination rather than muscle activation may be the most appropriate focus for robotic therapy.
ISSN:0748-7711
1938-1352
DOI:10.1682/jrrd.2005.06.0103