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On the Role of Auditory Feedback in Robot-Assisted Movement Training after Stroke: Review of the Literature

DOI: 10.1155/2013/586138

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Abstract:

The goal of this paper is to address a topic that is rarely investigated in the literature of technology-assisted motor rehabilitation, that is, the integration of auditory feedback in the rehabilitation device. After a brief introduction on rehabilitation robotics, the main concepts of auditory feedback are presented, together with relevant approaches, techniques, and technologies available in this domain. Current uses of auditory feedback in the context of technology-assisted rehabilitation are then reviewed. In particular, a comparative quantitative analysis over a large corpus of the recent literature suggests that the potential of auditory feedback in rehabilitation systems is currently and largely underexploited. Finally, several scenarios are proposed in which the use of auditory feedback may contribute to overcome some of the main limitations of current rehabilitation systems, in terms of user engagement, development of acute-phase and home rehabilitation devices, learning of more complex motor tasks, and improving activities of daily living. 1. Introduction Stroke is the leading cause of movement disability in the USA and Europe [1, 2]. In the EU, there are 200 to 300 stroke cases per 100,000 every year, and about 30% survive with major motor deficits [3]. These impressive numbers are increasing due to aging and lifestyle in developed countries. Improving the outcome of movement therapy after stroke is thus a major societal goal that received a lot of interest in the last decade from many researchers in the medical and engineering fields. After the acute phase, stroke patients require continuous medical care and rehabilitation treatment, the latter being usually delivered as both individual and group therapy. The rationale for doing motor rehabilitation is that the motor system is plastic following stroke and can be influenced by motor training [4]. Motor learning is a complex process and to date there is still a lack of knowledge on how the sensory motor system reorganizes in response to movement training [5]. Motor learning can be described as “a set of processes associated with practice or experience leading to relatively permanent changes in the capability for producing skilled action” [6]. Early after a stroke, the brain can undergo dramatic plastic changes [7, 8] that can be further enhanced by environmental stimulation. Animal studies have shown that an enriched poststroke recovery environment can induce structural plastic changes in the brain such as decreased infarct volume and increased dendritic branching, spine density, neurotrophic

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