title: Robot-aided assessment of lower extremity functions: a review.
abstract: The assessment of sensorimotor functions is extremely important to understand the health status of a patient and its change over time. Assessments are necessary to plan and adjust the therapy in order to maximize the chances of individual recovery. Nowadays, however, assessments are seldom used in clinical practice due to administrative constraints or to inadequate validity, reliability and responsiveness. In clinical trials, more sensitive and reliable measurement scales could unmask changes in physiological variables that would not be visible with existing clinical scores.In the last decades robotic devices have become available for neurorehabilitation training in clinical centers. Besides training, robotic devices can overcome some of the limitations in traditional clinical assessments by providing more objective, sensitive, reliable and time-efficient measurements. However, it is necessary to understand the clinical needs to be able to develop novel robot-aided assessment methods that can be integrated in clinical practice.This paper aims at providing researchers and developers in the field of robotic neurorehabilitation with a comprehensive review of assessment methods for the lower extremities. Among the ICF domains, we included those related to lower extremities sensorimotor functions and walking; for each chapter we present and discuss existing assessments used in routine clinical practice and contrast those to state-of-the-art instrumented and robot-aided technologies. Based on the shortcomings of current assessments, on the identified clinical needs and on the opportunities offered by robotic devices, we propose future directions for research in rehabilitation robotics. The review and recommendations provided in this paper aim to guide the design of the next generation of robot-aided functional assessments, their validation and their translation to clinical practice.
authors.affiliation: Sensory-Motor Systems (SMS) Lab, Institute of Robotics and Intelligent Systems (IRIS), Department of Health Sciences and Technology (D-HEST), ETH Zürich, Zürich, Switzerland. serenam@ethz.ch.|Hocoma AG, Volketswil, Switzerland. serenam@ethz.ch.|Spinal Cord Injury Center, Balgrist University Hospital, University Zürich, Zürich, Switzerland. serenam@ethz.ch.
authors.forename: Serena
authors.identifier: 0000-0002-0416-1229
authors.initials: S
authors.lastname: Maggioni
authors.affiliation: Hocoma AG, Volketswil, Switzerland.|Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, IL, USA.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Melendez-Calderon
authors.affiliation: Laboratory of Biomechanical Engineering, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.
authors.forename: Edwin
authors.initials: E
authors.lastname: van Asseldonk
authors.affiliation: Sensory-Motor Systems (SMS) Lab, Institute of Robotics and Intelligent Systems (IRIS), Department of Health Sciences and Technology (D-HEST), ETH Zürich, Zürich, Switzerland.|Spinal Cord Injury Center, Balgrist University Hospital, University Zürich, Zürich, Switzerland.
authors.forename: Verena
authors.initials: V
authors.lastname: Klamroth-Marganska
authors.affiliation: Hocoma AG, Volketswil, Switzerland.
authors.forename: Lars
authors.initials: L
authors.lastname: Lünenburger
authors.affiliation: Sensory-Motor Systems (SMS) Lab, Institute of Robotics and Intelligent Systems (IRIS), Department of Health Sciences and Technology (D-HEST), ETH Zürich, Zürich, Switzerland.|Spinal Cord Injury Center, Balgrist University Hospital, University Zürich, Zürich, Switzerland.
authors.forename: Robert
authors.initials: R
authors.lastname: Riener
authors.affiliation: Laboratory of Biomechanical Engineering, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, The Netherlands.|Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands.
authors.forename: Herman
authors.initials: H
authors.lastname: van der Kooij
mesh_terms: D005684:Gait; D020233:Gait Disorders, Neurologic / Q000534:rehabilitation*; D006801:Humans; D035002:Lower Extremity; D015203:Reproducibility of Results; D012371:Robotics; D057170:Translational Research, Biomedical; D016138:Walking
keywords: Assessment; Exoskeleton; Gait; ICF; Joint impedance; Muscle force; Proprioception; Range of motion; Reliability; Responsiveness; Robotic rehabilitation; Synergies; Translational research; Validity; Walking