Roboter- und gerätegestützte Rehabilitation der oberen Extremität

Zusammenfassung

Eine standardisierte Therapie der oberen Extremität bei Patienten mit einer Störung des zentralen Nervensystems (ZNS) liegt bisher nicht vor. In der letzten Dekade hat die roboter- und gerätegestützte Therapie die Behandlung der motorischen Funktionsstörungen der oberen Extremität nach Schlaganfall in der Neurorehabilitation deutlich beeinflusst. Die vorliegende Arbeit gibt einen Überblick zu den technischen Grundlagen und zur Differenzierung der verschiedenen Gerätetypen. Unter Einbeziehung ausgewählter Studien wird die Praxis der roboter- und gerätegestützten Rehabilitation der oberen Extremität dargestellt. Die Effektivität der gerätegestützten Therapie der oberen Extremität ist, im Vergleich zu einer gleichwertig intensiven konventionellen Therapie, weiterhin diskutabel, nicht zuletzt auch aufgrund der recht heterogenen Studienlage. Dennoch weisen die Entwicklung und der Einsatz roboter- und gerätegestützter Therapieformen der oberen Extremität in eine vielversprechende Zukunft. Sie können das Personal entlasten und stellen aktuell eine sinnvolle Ergänzung zur konventionellen Therapie dar.

Abstract

Neurorehabilitation of patients with long-term upper limb motor dysfunction due to central nervous system damage still lacks adequate standardization. During the last decade, robot- and device-assisted rehabilitation has become more feasible for the treatment of the functional disorders of the upper limb after stroke. Here we present an overview on technological aspects and differential use of devices for upper limb rehabilitation and review relevant clinical studies. We also discuss the potential for standardized evaluation in relation to limited health care resources. While the effectiveness of device-assisted versus conventional therapy is still a matter of debate, largely due to the heterogeneous design of the available clinical studies, we strongly believe that technological progress and a better understanding of the timing, intensity and quality of upper limb rehabilitation will enable a central role for robot- and device-assisted rehabilitation in the next decade.

Schlüsselwörter

robotergestützte Rehabilitation - gerätegestützte Rehabilitation - obere Extremität - Robotik - Neurorehabilitation

Key words

robot-assisted rehabilitation - device-based rehabilitation - upper extremity - robotics - neurorehabilitation

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