Earlier robotic physiotherapy was constricted to specifically gait and movement training, but with recent advancement, it is expanded to dexterous hand and robotic limbs, which are not only improving patient recovery outcomes but also building maximum functional ability. Paradigm shift to incorporating robot assisted physiotherapy in practice requires a comprehensive and detailed knowledge about the same. This chapter embarks on an expedition into the convergence of robotics and physiotherapy, meticulously navigating through the avant-garde technologies and methodologies that are orchestrating a paradigmatic shift in patient care, thereby fostering a person's enhanced outcomes. By illuminating the dynamic interplay of these two domains, this chapter elucidates the transformative potential they hold in revolutionizing patient care, invigorating the trajectory of recovery, and sculpting a landscape of holistic wellness.
Top1. Introduction To Robotic-Assisted Physiotherapy
Robotic-assisted gait training (RAGT), a new rehabilitation technology, has been introduced in an effort to enhance stability, balance, and posture. Because the brain and spinal cord are malleable, RAGT may use forced, high-intensity walking to activate neural pathways and improve gait. According to some publications, RAGT can help adults with neurological problems regain their balance. It also appears to aid in the rehabilitation of young children with physical disabilities. However, the precise function and implications of this therapy were yet unknown (Calabrò et al., 2021).
Exoskeletons or end-effector robots combined with virtual reality (VR) serious games have shown benefits for the neuromotor rehabilitation of the upper limbs, including higher intensity of the training, higher level of motor control of the joints, longer duration, and more sessions with the ability to give variable assistance or resistance force feedback and possibly provide kinesiology information of the patient performance that facilitates the evaluation during the treatment (Molteni et al., 2018).
Robotic-assisted gait training is often employed for patients with other neurological illnesses, such as Parkinson's syndrome or post-stroke conditions as shown in figure 1.1, but there are still questions about this training. The methods by which robotically assisted training enhances gait as well as the gait metrics that may be in charge of the changes are of interest (Calabrò et al., 2021).
Over-ground robotic-assisted gait training devices (O-RAGT) allow the patient to walk in a real-world environment, allowing for significant kinematic flexibility while assuring task success. Because people can use O-RAGT at home in a comfortable environment, it may help people build habits that result in long-term behaviour modification. in the form of a wearable robotic knee orthosis for patients with recurrent stroke. In addition, there was an increase in PA (steps taken) after completing the O-RAGT program that persisted for an additional three months. It is known that O-RAGT improved PA and physical function over time, but it is not known if these effects extend to measures of cardiovascular health like blood pressure and arterial stiffness. This is significant in light of the significant independent risk that arterial stiffness poses for cardiovascular disease (Wright et al., 2021).
Unfortunately, the use of robotics for orthopaedic rehabilitation remains largely unexplored and the research in this area is quite sparse, compared to neurorehabilitation systems, despite the potential advantages, the high incidence of musculoskeletal injuries, and the current demand for faster and better physical therapies (Padilla-Castañeda et al., 2018).
Figure 1.
Gait Training Using Robotics