Upper Limb Robot-Assisted Therapy: A New Option for Children With Hemiplegia
By Fasoli, Susan E.; Fragala-Pinkham, Maria; Hughes, Richard; Hogan, Neville; Stein, Joel; Krebs, Hermano Igo; Technology and Disability, Vol. 22, No. 4, pp. 193-198Publication Date: 2010
Article outlines the development of robot assisted movement therapy for children with moderate to severe hemiplegia due to cerebral palsy (CP). Thirteen children aged 4 to 12 years with hemiplegia due to CP or stroke participated in two related studies. Therapeutic games, the work station of the InMotion2 robot, and a therapy protocol were adapted for pediatric upper limb therapy. The robot, being an end effector type with a single point of contact between the client and robot handle and with a “one size fits all” design, required little modification for pediatric use. In addition to a focus on control of paretic shoulder and elbow movements, elicitation of distal activation of the wrist and hand during reaching games was also desired; therefore, grasping mitts or Velcro strapping were used or the size of the handle was altered to meet participants’ needs. Visual display targets of the adaptive therapy game used were child friendly images of animals, spaceships, and so on, with bright starbursts providing visual feedback of successful reaches. Reaches involved moving to and from a central target and 8 peripheral compass point targets. The robot controller adapted the amount of assistance and guidance provided, based on the child’s motor abilities. Outcome measures used were the Quality of Upper Extremity Skills Test (QUEST), the Fugl-Meyer Assessment (FMA), the Modified Ashworth Scale (MAS), and a parent questionnaire. Gains in upper limb coordination and quality of movement were statistically significant on all measures. Parents reported that they would recommend robotic therapy to others and would pursue other robot assisted therapies if available. Implications for further expansion of this therapy to children with diagnoses such as spastic quadriplegia or acquired brain injury are discussed.
Published by: IOS Press (Website:http://www.iospress.nl)
Association for the Advancement of Assistive Technology in Europe (AAATE) (Web Site: http://www.aaate.net )
