Motor Neurorehabilitation in Patients with Hemiplegia

In recent decades, progress has been observed in motor rehabilitation interventions, based on repetitive practice of coordinated motor activities that are efficient and aim to improve movement functions, resulting in an improvement in quality of life of the patients. Robotic rehabilitation is a computer-software connected orthosis, which focuses on performing certain coordinated movements, aimed at restoring damaged sensory, motor and cognitive skills. Robotic rehabilitation is experiencing its rise by attaching sensors for the purpose of multimedia sensing, and the most applied and used are visual and auditory sensors. Visual feedback is an important factor in human-robot interaction, one of the most widely used open feedback models is visual feedback. Visual feedback is delivered through an additional computer screen, its purpose is cognitive training. The visual part of the training is closely correlated with the auditory information that makes the computerized rehabilitation unique. Combining cognitive training with the help of robots and together with virtual reality techniques offers us a new and significant effective alternative to the traditional way of training, gamification (the use of games with robotic rehabilitation) is becoming a more popular way of motivating in cognitive training. The incorporation of virtual reality allows us to repeat tasks, exercises, movement in a more comfortable and convenient way of motor rehabilitation. The aim of this study is to presents a unique case with hemiplegia where, in addition to all kinesitherapy and a physical plan, the rehabilitation includes robotic therapy of the lower extremities, where a robot-assisted exoskeleton (locomat) is used. Materials and methods: The robotic therapy together with the comprehensive rehabilitation treatment is carried out within twenty days with a rest on the 10th day of one week to show the patient's progress between the two treatments of 10 days each and to determine how much the robotic therapy has effect on motor neurorehabilitation in hemiplegic patients. In order to determine the independence and mobility of the patient at the beginning, on the 10th day and on the 20th day, the Barthel index test and the Fugl-Meyer assessment test were performed. Results: According to the analysis and processing of the results obtained from the robot-assisted exoskeleton itself and after their statistical processing, they show a significant improvement in the results in the second period of rehabilitation compared to the first rehabilitation, which means that the patient took a significant part in the movement itself with the robot-assisted exoskeleton and a significant patient improvement in terms of walking distance, meters walked, treadmill speed, driving force and body weight support. The overall result also results in an improvement in coordination and the establishment of a straight pattern of walking, which only hinders further rehabilitation. The results of the Bartel index test shows the progress of the patient and the improvement of his mobility, while the Fugl-Meyer assessment test shows the improvement of motor function and sensitivity. Conclusion: Robotic therapy, although it is still being developed and despite its inaccessibility in terms of the price of treatments, shows a significant improvement in motor function and in motor neurorehabilitation in patients with hemiplegia. Keywords: Robotic therapy, Robotic assisted exoskeleton, motor function, lower extremities