Topics in NeuroRehabilitation – Episode 18. Dr. Alberto Esquenazi, MD, CMO of MossRehab Elkins Park, provides an introduction to clinic-based uses of robotic devices for gait rehabilitation after stroke. Dr. Esquenazi describes different types of robotic devices available, and the various roles each can play in augmenting the therapist's ability to increase the intensity, repetition, and task-specificity of gait training, while adapting the assistance to the specific needs of each patient. Dr. Esquenazi also provides a look at the results from his work with the ReWalk ReStore, and some of the observed impacts on patients’ walking symmetry and velocity. Lastly, Dr. Esquenazi details the framework created by team members at Moss Rehab to evaluate available robotic technologies and prescribe their use with patients of various clinical presentations, according to patient goals and needs.
To request a demo of the ReWalk ReStore, please visit us at https://rewalk.com/contact/
In case you missed last month’s episode, click here to watch Topics in NeuroRehab Ep 17: https://www.youtube.com/watch?v=jw_zAGLmBIQ
To learn more about Dr. Esquenazi and his research, please visit the links below:
MossRehab at Elkins Park: https://www.mossrehab.com/locations/elkins-park
Sheerr Gait and Motion Analysis Laboratory: https://www.mossrehab.com/gaitlab
Relevant publications from Dr. Esquenazi
Esquenazi, Alberto, and Andrew Packel. "Robotic-assisted gait training and restoration." American journal of physical medicine & rehabilitation 91.11 (2012): S217-S231. https://journals.lww.com/ajpmr/Abstract/2012/11003/Robotic_Assisted_Gait_Training_and_Restoration.3.aspx
Esquenazi, Alberto, and Mukul Talaty. "Robotics for lower limb rehabilitation." Physical Medicine and Rehabilitation Clinics 30, no. 2 (2019): 385-397. https://www.pmr.theclinics.com/article/S1047-9651(18)30876-3/abstract
Esquenazi, Alberto, Mukul Talaty, and Arun Jayaraman. "Powered exoskeletons for walking assistance in persons with central nervous system injuries: a narrative review." PM&R 9.1 (2017): 46-62. https://www.sciencedirect.com/science/article/abs/pii/S1934148216308796
Awad, Louis N., et al. "The ReWalk ReStore™ soft robotic exosuit: a multi-site clinical trial of the safety, reliability, and feasibility of exosuit-augmented post-stroke gait rehabilitation." Journal of neuroengineering and rehabilitation 17.1 (2020): 1-11. https://link.springer.com/article/10.1186/s12984-020-00702-5?utm_source=researcher_app
Esquenazi, Alberto, et al. "A comparison of locomotor therapy interventions: partial-body weight− supported treadmill, Lokomat, and G-EO training in people with traumatic brain injury." PM&R 9.9 (2017): 839-846. https://www.sciencedirect.com/science/article/abs/pii/S1934148217300308
Esquenazi, Alberto, et al. "A randomized comparative study of manually assisted versus robotic-assisted body weight supported treadmill training in persons with a traumatic brain injury." PM&R 5.4 (2013): 280-290. https://www.sciencedirect.com/science/article/abs/pii/S1934148212016516
Talaty, Mukul, Alberto Esquenazi, and Jorge E. Briceno. "Differentiating ability in users of the ReWalk TM powered exoskeleton: An analysis of walking kinematics." 2013 IEEE 13th international conference on rehabilitation robotics (ICORR). IEEE, 2013. https://ieeexplore.ieee.org/abstract/document/6650469
Esquenazi, Alberto, et al. "Clinical application of robotics and technology in the restoration of walking." Neurorehabilitation technology. Springer, Cham, 2016. 223-248. https://link.springer.com/chapter/10.1007/978-3-319-28603-7_12
Additional references:
Sommerfeld, Disa K., et al. "Spasticity after stroke: its occurrence and association with motor impairments and activity limitations." Stroke 35.1 (2004): 134-139.https://www.ahajournals.org/doi/full/10.1161/01.str.0000105386.05173.5e
Watkins, C. L., et al. "Prevalence of spasticity post stroke." Clinical rehabilitation 16.5 (2002): 515-522. https://journals.sagepub.com/doi/abs/10.1191/0269215502cr512oa
Harkema, Susan J. "Neural plasticity after human spinal cord injury: application of locomotor training to the rehabilitation of walking." The Neuroscientist 7.5 (2001): 455-468. https://journals.sagepub.com/doi/abs/10.1177/107385840100700514
Bohannon RW, Horton MG, Wikholm JB. Importance of four variables of walking to patients with stroke. Int J Rehabil Res. 1991;14(3):246-50. doi: 10.1097/00004356-199109000-00010. PMID: 1938039. https://pubmed.ncbi.nlm.nih.gov/1938039/
Dimyan, Michael A., and Leonardo G. Cohen. "Neuroplasticity in the context of motor rehabilitation after stroke." Nature Reviews Neurology 7, no. 2 (2011): 76-85. https://www.nature.com/articles/nrneurol.2010.200
Sheffler, Lynne R., and John Chae. "Technological advances in interventions to enhance poststroke gait." Physical Medicine and Rehabilitation Clinics 24, no. 2 (2013): 305-323. https://www.pmr.theclinics.com/article/S1047-9651(12)00136-2/abstract