Haptic Neurorehabilitation and Virtual Reality for Upper Limb Paralysis: A Review.

Motor and sensory loss or dysfunction affects the quality of life for thousands of individuals daily. The upper limb, and especially the hand, are important for a person's ability to complete activities of daily living. Traditional therapy methods focus on motor recovery, but future methods should include sensory recovery and should promote the use of the affected limb(s) at home. In this review, we highlight the current state-of-art robotic devices for the upper limb, and we discuss benefits of including haptic feedback and virtual reality environments during neurorehabilitation. Robotic devices, such as end-effector devices, grounded and ungrounded exoskeletons, have been developed to assist with various functions including individual finger, whole hand, and shoulder movements. Many robots highlighted in this paper are inexpensive and are small enough to be in a patient's home, or allow for telerehabilitation. Virtual reality creates safe environments for patients to practice motor movements and interactive games improve enjoyment of therapy. Haptic feedback creates more immersive virtual reality, and contributes to the recovery of sensory function. Physiological studies conducted after brain trauma and with robotic devices contribute to the understanding of brain plasticity, and illustrate the efficacy of these technologies. We conclude by addressing the future direction of neurorehabilitation research.