Motor disability is a key feature of many neurological diseases, influencing the social roles of affected patients and their ability to perform daily life activities. Current rehabilitation capacities are overwhelmed by the age-related increase of motor dysfunctions seen, for example, in stroke, extrapyramidal or neuromuscular diseases. As the patient to rehabilitation personnel ration increases, robotic solutions might establish the possibility to rapidly satisfy the increasing demand for rehabilitation. This paper presents an inaugural exploratory study which investigates the interchangeability of a novel experimental robotic rehabilitation device system with classical physical therapy, using a multimodal neurophysiological assessment of the motor system—quantitative electroencephalogram (EEG), motor conduction times and turn/amplitude analysis. Preliminary results show no significant difference between the two methods; however, a significant effect of the therapy was found on different pathologies (beneficial for vascular and extrapyramidal, or limited, and only on preventing reduction of joint movements in neuromuscular).

Hepatic cancers represent an important worldwide health issue where surgery alone in most cases is not a feasible therapeutic solution since most tumors are non-resectable. Despite targeted therapies showing positive results in other areas of cancer treatment, in the case of liver tumors, no low-risk delivery methods have been identified. Based on a risk assessment approach, this paper proposes a technical solution in the form of a robotic system capable of achieving a reliable delivery method for targeted treatment, focusing on the patient safety and therapeutic efficiency. The design of the robotic system starts from the definition of the design constraints with respect to the medical protocol. An analytical hierarchy process is used to prioritize the data correlated with the technical characteristics of a new robotic system, aiming to minimize risks associated with the medical procedure. In a four-phase quality function deployment, the technical solution is evaluated with respect to the quality characteristics, functions, subsystems, and components aiming to achieve a safe and reliable system with high therapeutic efficiency. The results lead to the concept of HeRo, a parallel robotic system for the reliable targeted treatment of non-resectable liver tumors.

Background: Cerebrovascular accident, commonly known as stroke, Parkinson’s disease, and multiple sclerosis represent significant neurological conditions affecting millions globally. Stroke remains the third leading cause of death worldwide and significantly impacts patients’ hand functionality, making hand rehabilitation crucial for improving quality of life. Methods: A comprehensive literature review was conducted analyzing over 300 papers, and categorizing them based on mechanical design, mobility, and actuation systems. To evaluate each device, a database with 45 distinct criteria was developed to systematically assess their characteristics. Results: The analysis revealed three main categories of devices: rigid exoskeletons, soft exoskeletons, and hybrid devices. Electric actuation represents the most common source of power. The dorsal placement of the mechanism is predominant, followed by glove-based, lateral, and palmar configurations. A correlation between mass and functionality was observed during the analysis; an increase in the number of actuated fingers or in functionality automatically increases the mass of the device. The research shows significant technological evolution with considerable variation in design complexity, with 29.4% of devices using five or more actuators while 24.8% employ one or two actuators. Conclusions: While substantial progress has been made in recent years, several challenges persist, including missing information or incomplete data from source papers and a limited number of clinical studies to evaluate device effectiveness. Significant opportunities remain to improve device functionality, usability, and therapeutic effectiveness, as well as to implement advanced power systems for portable devices.

The use of robotic systems in physical rehabilitation protocols has become increasingly attractive and has been given more focus in the last decade as a result of the high prevalence of motor deficits in the population, which is linked to an overburdened healthcare system. In accordance with current trends, three robotic devices have been designed, called ParReEx Elbow, ParReEx Wrist, and ASPIRE, which were designed to improve upper-limb medical recovery (shoulder, elbow, forearm, and wrist). The three automated systems were tested in a hospital setting with 23 patients (12 men and 11 women) suffering from motor deficits caused by various neurological diseases such as stroke, Parkinson’s disease, and amyotrophic lateral sclerosis (ALS). The patients were divided into three groups based on their pathology (vascular, extrapyramidal, and neuromuscular). Objective clinical measures, such as the Medical Research Council (MRC) scale, goniometry, and dynamometry, were used to compare pre- and post-rehabilitation assessments for both robotic-aided and manual physical rehabilitation therapy. The results of these tests showed that, with the exception of a few minor differences in muscular strength recovery, the robotic-assisted rehabilitation methods performed equally as well as the manual techniques, though only minor improvements were validated during short-term rehabilitation. The greatest achievements were obtained in the goniometric analysis where some rehabilitation amplitudes increased by over 40% in the vascular group, but the same analysis returned regressions in the neuromuscular group. The MRC scale analysis returned no significant differences, with most regressions occurring in the neuromuscular group. The dynamometric analysis mostly returned improvements, but the highest value evolution was 19.07%, which also in the vascular group. While the results were encouraging, more research is needed with a larger sample size and a longer study period in order to provide more information regarding the efficacy of both rehabilitation methods in neurological illnesses.

The paper presents the design optimization of the ASPIRE spherical parallel robot for shoulder rehabilitation following clinical evaluation and clinicians’ feedback. After the development of the robotic structure and the implementation of the control system, ASPIRE was prepared for clinical evaluation. A set of clinical trials was performed on 24 patients with different neurological disorders to obtain the patient and clinician acceptance of the rehabilitation system. During the clinical trials, the behavior of the robotic system was closely monitored and analyzed in order to improve its reliability and overall efficiency. Along with its reliability and efficiency, special attention was given to the safety characteristics during the rehabilitation task.

Stroke, amyotrophic lateral sclerosis (ALS), and Parkinson’s disease are some of the conditions that can lead to neuromotor disabilities requiring rehabilitation. To address the socio-economic burden that is amplified by the rapidly increasing elderly population, traditional rehabilitation techniques have recently been complemented by technological advancements, particularly Robot-Assisted Therapy (RAT). RAT enhances motor learning by improving both accuracy and consistency. This study proposes an innovative rehabilitation system that combines serious gaming and augmented reality (AR) with the LegUp parallel robot, developed for the spatial rehabilitation of the hip, knee, and ankle in bed-ridden patients. The system aims to improve patient outcomes and actively involve patients in their therapy. Electro-goniometers and a HoloLens 2 device are used to provide immediate feedback about the position of the patient’s joints, forming the basis of an interactive game in which the patient moves their leg to reach various targets. Two game modes were developed, each targeting different aspects of neuromotor rehabilitation, such as coordination, strength, and flexibility. Preliminary findings suggest that combining RAT with augmented reality-based serious gaming can increase patient motivation and engagement. Furthermore, the personalized and interactive nature of the therapy holds the potential to improve rehabilitation outcomes by fostering sustained engagement and effort.