Upper limb robot-assisted therapy: A new option for children with hemiplegia¹

Issue title: State of the Science for Pediatric Rehabilitation Engineering

Guest editors: Richard Foulds and Sergei Adamovich

Article type: Research Article

Authors: Fasoli, Susan E.^{a; *} | Fragala-Pinkham, Maria^b | Hughes, Richard^c | Hogan, Neville^d | Stein, Joel^e | Krebs, Hermano Igo^{d; f; g}

Affiliations: [a] Newton Wellesley Hospital and Harvard Medical School, Department of Physical Medicine and Rehabilitation, Boston, MA, USA | [b] Franciscan Hospital for Children, Research Center for Children with Special Health Care Needs, Brighton, MA, USA | [c] Partners Home Care, Boston, MA, USA | [d] Massachusetts Institute of Technology, Department of Mechanical Engineering, Cambridge, MA, USA | [e] Columbia University College of Physicians and Surgeons, Weill Cornell Medical College, New York-Presbyterian Hospital, New York, NY, USA | [f] Weill Cornell Medical College, Department of Neurology and Neuroscience, Burke Medical Research Institute, White Plains, NY, USA | [g] University of Maryland School of Medicine, Department of Neurology, Baltimore, MD, USA | Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA

Correspondence: [*] Address for correspondence: Susan E. Fasoli, ScD OTR/L, Department of Rehabilitation Services, Newton Wellesley Hospital, 2014 Washington Street, Newton, MA 02462, USA. Tel.: +1 617 243 6403; Fax: +1 617 243 6651; E-mail: sfasoli@partners.org.

Note: [1] Portions of this material were published in the American Journal of Physical Medicine and Rehabilitation: S.E. Fasoli, M. Fragala-Pinkham, R. Hughes, N. Hogan, H.I. Krebs and J. Stein, Upper limb robotic therapy for children with hemiplegia, Am J Phys Med Rehabil 87 (2008), 929–936. S.E. Fasoli, M. Fragala-Pinkham, R. Hughes, H.I. Krebs, N. Hogan and J. Stein, Robotic therapy and botulinum toxin type A: A novel intervention approach for cerebral palsy, Am J Phys Med Rehabil 87 (2008), 1022–1025.

Abstract: Although a number of research studies have examined the effects of robot-assisted movement therapy for adults with motor impairments following stroke, use of this technology for children with neurologically-based movement disorders is just beginning. Conventional rehabilitation methods are insufficient in meeting children's needs for intensive motor learning experiences. Therapy for children with moderate to severe upper limb motor impairments is particularly challenging, because of their reluctance to engage in challenging and repetitive upper limb exercise and frequent developmental disregard for using the paretic arm during functional tasks. In an effort to adapt robot-assisted movement therapy for children with moderate to severe hemiplegia due to cerebral palsy (CP), we developed robotic therapy that was engaging and cognitively challenging for children, and that provided intensive sensorimotor practice during goal directed reaching activities. This is a review of how we adapted robotic therapy for children with hemiplegia, our selection of outcome measures, and a brief summary of study findings. Our initial work suggests that robot-assisted therapy can be readily adapted and has good potential for improving motor performance of children with hemiplegic cerebral palsy.

DOI: 10.3233/TAD-2010-0303

Journal: Technology and Disability, vol. 22, no. 4, pp. 193-198, 2010