Alessandra Pedrocchi, Maria Bulgheroni, Emilia Ambrosini, and Walter Baccinelli
In the rehabilitation field, every year innovative high-tech research prototypes are developed and sometimes pilot-tested in small groups of patients but only few of them are really made available to patients with a proved demonstration of their efficacy. The most ambitious aim of the EU project RETRAINER is to propose a novel roadmap to translate research prototypes to bedside passing through randomized controlled trials (RCT) and industrial exploitation.
Starting from the results of a previous FP7 project, MUNDUS, the RETRAINER project developed two hybrid robotic systems for arm training (RETRAINER-S1) and for hand functions recovery (RETRAINER-S2) in stroke survivors. RETRAINER-S1 supports arm movements by the combined action of a passive exoskeleton for weight relief and Functional Electrical Stimulation (FES), which amplitude is controlled based on the residual EMG activities of the same stimulated muscles. Residual functionalities are thus trained and improved rather than replaced by the device. RETRAINER S2 consists of a wearable modular system with multiple electrode arrays, in which the stimulation patterns can be tuned to elicit functional grasp, to obtain whole muscle conditioning and to produce open-loop or closed-loop grasp control. Both systems benefit from the use of interactive objects, i.e. daily life objects equipped with RFID tags. A reader embedded in the robotic system recognizes the selected object or target among several ones and drives the rehabilitation exercises. Both RETRAINER-S1 and RETRAINER-S2 have been extensively tested in two parallel multi-center RCTs involving 68 stroke patients each.
The special session will describe the two RETRAINER systems, the preliminary results of the two RCTs and the perspectives of passive exoskeletons, upper limb FES, hand neuroprostheses and smart objects for upper limb stroke rehabilitation. Finally, the point of view of the big industry will be reported by Ottobock representatives.