Effects of control strategies on gait in robot-assisted post-stroke lower limb rehabilitation: a systematic review

Abstract Background Stroke related motor function deficits affect patients' likelihood of returning to professional activities, limit their participation in society and functionality in daily living. Hence, robot-aided gait rehabilitation needs to be fruitful and effective from a motor learning...

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Main Authors: Silvia Campagnini, Piergiuseppe Liuzzi, Andrea Mannini, Robert Riener, Maria Chiara Carrozza
Format: Article
Language:English
Published: BMC 2022-06-01
Series:Journal of NeuroEngineering and Rehabilitation
Subjects:
Online Access:https://doi.org/10.1186/s12984-022-01031-5
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author Silvia Campagnini
Piergiuseppe Liuzzi
Andrea Mannini
Robert Riener
Maria Chiara Carrozza
author_facet Silvia Campagnini
Piergiuseppe Liuzzi
Andrea Mannini
Robert Riener
Maria Chiara Carrozza
author_sort Silvia Campagnini
collection DOAJ
description Abstract Background Stroke related motor function deficits affect patients' likelihood of returning to professional activities, limit their participation in society and functionality in daily living. Hence, robot-aided gait rehabilitation needs to be fruitful and effective from a motor learning perspective. For this reason, optimal human–robot interaction strategies are necessary to foster neuroplastic shaping during therapy. Therefore, we performed a systematic search on the effects of different control algorithms on quantitative objective gait parameters of post-acute stroke patients. Methods We conducted a systematic search on four electronic databases using the Population Intervention Comparison and Outcome format. The heterogeneity of performance assessment, study designs and patients’ numerosity prevented the possibility to conduct a rigorous meta-analysis, thus, the results were presented through narrative synthesis. Results A total of 31 studies (out of 1036) met the inclusion criteria, without applying any temporal constraints. No controller preference with respect to gait parameters improvements was found. However, preferred solutions were encountered in the implementation of force control strategies mostly on rigid devices in therapeutic scenarios. Conversely, soft devices, which were all position-controlled, were found to be more commonly used in assistive scenarios. The effect of different controllers on gait could not be evaluated since conspicuous heterogeneity was found for both performance metrics and study designs. Conclusions Overall, due to the impossibility of performing a meta-analysis, this systematic review calls for an outcome standardisation in the evaluation of robot-aided gait rehabilitation. This could allow for the comparison of adaptive and human-dependent controllers with conventional ones, identifying the most suitable control strategies for specific pathologic gait patterns. This latter aspect could bolster individualized and personalized choices of control strategies during the therapeutic or assistive path.
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spelling doaj.art-c074dfad2e5245f48f1e4190703b33442022-12-22T00:24:12ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032022-06-0119111610.1186/s12984-022-01031-5Effects of control strategies on gait in robot-assisted post-stroke lower limb rehabilitation: a systematic reviewSilvia Campagnini0Piergiuseppe Liuzzi1Andrea Mannini2Robert Riener3Maria Chiara Carrozza4IRCCS Fondazione Don Carlo Gnocchi ONLUSIRCCS Fondazione Don Carlo Gnocchi ONLUSIRCCS Fondazione Don Carlo Gnocchi ONLUSETH ZurichIstituto di BioRobotica, Scuola Superiore Sant’AnnaAbstract Background Stroke related motor function deficits affect patients' likelihood of returning to professional activities, limit their participation in society and functionality in daily living. Hence, robot-aided gait rehabilitation needs to be fruitful and effective from a motor learning perspective. For this reason, optimal human–robot interaction strategies are necessary to foster neuroplastic shaping during therapy. Therefore, we performed a systematic search on the effects of different control algorithms on quantitative objective gait parameters of post-acute stroke patients. Methods We conducted a systematic search on four electronic databases using the Population Intervention Comparison and Outcome format. The heterogeneity of performance assessment, study designs and patients’ numerosity prevented the possibility to conduct a rigorous meta-analysis, thus, the results were presented through narrative synthesis. Results A total of 31 studies (out of 1036) met the inclusion criteria, without applying any temporal constraints. No controller preference with respect to gait parameters improvements was found. However, preferred solutions were encountered in the implementation of force control strategies mostly on rigid devices in therapeutic scenarios. Conversely, soft devices, which were all position-controlled, were found to be more commonly used in assistive scenarios. The effect of different controllers on gait could not be evaluated since conspicuous heterogeneity was found for both performance metrics and study designs. Conclusions Overall, due to the impossibility of performing a meta-analysis, this systematic review calls for an outcome standardisation in the evaluation of robot-aided gait rehabilitation. This could allow for the comparison of adaptive and human-dependent controllers with conventional ones, identifying the most suitable control strategies for specific pathologic gait patterns. This latter aspect could bolster individualized and personalized choices of control strategies during the therapeutic or assistive path.https://doi.org/10.1186/s12984-022-01031-5Robot-assisted rehabilitationControl LawStrokeNeurorehabilitationLower limbGait Determinants
spellingShingle Silvia Campagnini
Piergiuseppe Liuzzi
Andrea Mannini
Robert Riener
Maria Chiara Carrozza
Effects of control strategies on gait in robot-assisted post-stroke lower limb rehabilitation: a systematic review
Journal of NeuroEngineering and Rehabilitation
Robot-assisted rehabilitation
Control Law
Stroke
Neurorehabilitation
Lower limb
Gait Determinants
title Effects of control strategies on gait in robot-assisted post-stroke lower limb rehabilitation: a systematic review
title_full Effects of control strategies on gait in robot-assisted post-stroke lower limb rehabilitation: a systematic review
title_fullStr Effects of control strategies on gait in robot-assisted post-stroke lower limb rehabilitation: a systematic review
title_full_unstemmed Effects of control strategies on gait in robot-assisted post-stroke lower limb rehabilitation: a systematic review
title_short Effects of control strategies on gait in robot-assisted post-stroke lower limb rehabilitation: a systematic review
title_sort effects of control strategies on gait in robot assisted post stroke lower limb rehabilitation a systematic review
topic Robot-assisted rehabilitation
Control Law
Stroke
Neurorehabilitation
Lower limb
Gait Determinants
url https://doi.org/10.1186/s12984-022-01031-5
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