Adaptive wrist robot training in pediatric rehabilitation

Several studies support the hypothesis that robot assisted therapy for adult subjects with motor impairments resulting from neurological damages can be beneficial in promoting the recovery process when conveyed in conjunction to conventional rehabilitation. Robotic therapy has been mainly applied to adult subjects and little is known about children or youth. This study presents the results of a robot-assisted rehabilitation training protocol applied to two young subjects suffering of hemiparesis. Robotic therapy was applied to the distal portion of the affected upper limb, through a fully backdrivable exoskeleton that allows full range of motion over the three degrees of freedom of the wrist. The training protocol consisted of ten therapy sessions and two days of robotic and clinical assessment pre and post training. With the main purpose of reducing the degree of motor impairment and promoting recovery, a control scheme was implemented which is characterized by an adaptive assistance delivered to the subjects as to help them completing the therapeutic task. The implementation of the new haptic controller is discussed in details and results are reported comparing the effect of robotic therapy for both dynamic and kinematic changes at the beginning and at end of the experiment. The results show that robot-assisted training successfully improved hand and wrist movement ability and promoted upper extremity functional recovery, thus highlighting the effectiveness of robotic therapy for both dynamic and kinematic motor performance.