Home-based upper limb stroke rehabilitation mechatronics: challenges and opportunities

Area of Science:

• Biomedical Engineering
• Rehabilitation Technology
• Mechatronics

Background:

• Interest in home-based stroke rehabilitation mechatronics has grown, driven by increased need post-COVID-19.
• Home environments present unique challenges for stroke rehabilitation devices compared to clinical settings.
• Existing devices often lack specific user-centered design considerations and clear links to rehabilitation practices.

Purpose of the Study:

• To conduct a scoping review of at-home upper limb stroke rehabilitation mechatronic device designs.
• To identify key design principles and areas for improvement in current mechatronic rehabilitation devices.
• To analyze device features, target anatomy, therapy tasks, and cost-effectiveness.

Main Methods:

• A systematic search of online databases for papers published between 2010 and 2021.
• Selection of 59 publications describing 38 unique home-based upper limb stroke rehabilitation mechatronic device designs.
• Categorization of devices based on target anatomy, therapy tasks, structure, features, and cost.

Main Results:

• Twenty-two devices targeted proximal anatomy, 13 targeted distal anatomy; cost increased with more actuators.
• Many designs lacked specificity regarding target users, impairments, or therapy activities (26/38).
• Few devices incorporated safety features like compliant structures (most common) or compensation detection (3/38); stakeholder consultation was minimal (6/38).

Conclusions:

• Combining actuated and unactuated degrees of freedom offers task variety and complexity at reduced cost.
• Future mechatronic designs should prioritize user needs, posture monitoring, and clear functional links.
• Enhanced stakeholder involvement, especially patient consultation, is crucial for effective home-based rehabilitation device development.