Table 3.
Summary of automatic systems for upper limb spasticity assessment.
| ID | Source | User’s Arm Behavior Modeling * | User’s Arm Motion & Response Capturing | Control Strategy | Morphology of Robotic Device | Characteristics of Robotic Device | User Interfaces (Patient; Therapist) | Approach of Evaluation | Outcome Provided | Correlation Study with | Sample Size | Rehab Mode | Target Human Joint | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| (1) | Norton, B. (1972) [43] | ✘ | 3 EMG electrodes | Passive-assisted | Exoskeleton (1 DOF) | Accuracy: Portability: Adaptability: |
✪✪ ✪✪ ✪✪ |
P: None T: None | Hysteresis loops (40 s) | Position, force and EMG recordings | None | 40 subjects + 3 patients | ✘ | Elbow (Hemiplegic) |
| (2) | Reinkensmeyer, D. (1999) [44] | ✔ | None | Active-assistive + passive | Exoskeleton (ARM Guide) (2 DOF) | Accuracy: Portability: Adaptability: |
✪✪ ✪✪ ✪✪ |
P: None T: A computer | FUGL motor performance exam (Post-processed) | Force patterns | None | 4 patients | ✔ | Shoulder + Elbow (Hemiplegic) |
| (3) | Pandyan, A. (2001) [45] | ✘ | None | Active | Exoskeleton | Accuracy: Portability: Adaptability: |
✪✪ ✪✪✪ ✪✪✪ |
P: None T: None | Correlation between observed and measured MAS and RTPM (7 min) | RTPM | MAS | 16 subjects | ✘ | Elbow (Poststroke) |
| (4) | Lee, H.M. (2004) [46] | ✔ | 1 differential pressure sensor 1 angular rate sensor 2 sensing air bags 1 gyroscope | Active | End-effector | Accuracy: Portability: Adaptability: |
✪✪✪ ✪✪✪ ✪ |
P: None T: None | Real-time | (Velocity-profile graphics) | MAS, UPDRS | 15 subjects + 15 patients | ✘ | Elbow (Poststroke) |
| (5) | Wu, Y.N. (2004) [47] | ✘ | 2 EMG electrodes | Active | Exoskeleton | Accuracy: Portability: Adaptability: |
✪✪ ✪✪✪ ✪✪ |
P: None T: None | Estimation of velocity-dependent viscous component | Biomechanical and neurophysiological data | MAS | 13 patients | ✘ | Elbow (Poststroke) |
| (6) | Chen, J.J.J (2005) [48] | ✔ | 1 differential pressure sensor 1 angular rate sensor 2 sensing air bags 1 gyroscope 2 EMG electrodes | Active | Endeffector | Accuracy: Portability: Adaptability: |
✪✪✪ ✪✪✪ ✪ |
P: None T: A computer | Estimation of velocity-dependent viscous component | Biomechanic parameters | MAS | 10 patients | ✘ | Elbow (Chronic stroke) |
| (7) | Kumar Raj.T.S (2006) [49] | ✘ | None | Active | Exoskeleton | Accuracy: Portability: Adaptability: |
✪✪ ✪✪✪ ✪✪ |
P: None T: None | Linear regression technique (10 min) | RTPM | MAS | 111 patients | ✘ | Elbow (Poststroke) |
| (8) | Fazekas, Gabor (2006) [50] | ✘ | None | Passive | Endeffector (REHAROB) (6 DOF + 6 DOF) | Accuracy: Portability: Adaptability: |
✪✪✪ ✪✪ ✪✪ |
P: Outer shell with handle T: Hardware Control Panel with predefine programming | Training sessions (30 min) | MAS and FIM score | MAS | 4 subjets + 8 patients | ✔ | Shoulder + Elbow (Hemiparetic) |
| (9) | Pandyan, A (2006) [51] | ✘ | 2 EMG electrodes | Active-assistive | Exoskeleton | Accuracy: Portability: Adaptability: |
✪✪ ✪✪ ✪✪ |
P: None T: None | Flexo-extensions (16.7 s) | MAS, RPE, FEMG | MAS, RPE, FEMG | 14 patients | ✘ | Elbow (Poststroke) |
| (10) | Nef and Riener (2007) [52] | ✔ | None | Passive-assistive | Exoskeleton (ARMin)(4 DOF) | Accuracy: Portability: Adaptability: |
✪✪✪ ✪✪ ✪✪ |
P: 1 graphic display for patient T: 1 graphic display for therapist | Mobilisation therapy and ball game therapy (60 min) | Recorded trajectories and 3D disturbance simulations | None | 11 patients | ✔ | Shoulder + Elbow (Hemiplegic and chronic stroke) |
| (11) | Takahashi Craig.D. (2008) [53] | ✘ | None | Active-assistive | Endeffector (HWARD) (3 DOF) | Accuracy: Portability: Adaptability: |
✪✪✪ ✪✪ ✪✪ |
P: Computer monitor and + 3 soft straps in hand T: Computer monitor with game difficulty adjusting | Nine different computer games (1.5 h) | MAS, FUGL, ROM, Stroke impact, grasp and pinch force | MAS, FUGL, ROM | 13 patients | ✔ | Hand-wrist (Poststroke) |
| (12) | Calota and Levin (2008) [54] | ✘ | 2 EMG electrodes | Active | Exoskeleton (Montreal Spasticity Measure) | Accuracy: Portability: Adaptability: |
✪✪ ✪✪ ✪✪ |
P: Not specified T: A Computer | Flexo extensions (5 min) | TSRT | MAS, Tardieu | 20 patients | ✘ | Elbow (Poststroke) |
| (13) | Bovolenta, F (2009) [55] | ✔ | None | Active and passive | Endeffector (ReoGo) | Accuracy: Portability: Adaptability: |
✪✪✪ ✪✪ ✪✪ |
P: Computer monitor T: Computer monitor | Nine different computer games (1.5 h) | MAS, FUGL, ROM, Stroke impact, grasp and pinch force | MAS, FUGL, Tardieu | 13 patients | ✘ | Shoulder + Elbow (Poststroke) |
| (14) | Posteraro, F (2009) [56] | ✔ | None | Active-assistive | Endeffector (MIT-MANUS) (2 DOF) | Accuracy: Portability: Adaptability: |
✪✪✪ ✪✪ ✪✪ |
P: A display T: Not specified | Robot-assisted therapy (60 min) | CM, MSS, MAS, FUGL, ROM | CM, MSS, MAS, FUGL, ROM | 14 patients | ✔ | Shoulder + Elbow (Hemiparetic) |
| (15) | Posteraro, F (2010) [57] | ✘ | None | Active-assistive | Endeffector (MIT-MANUS) (2 DOF) | Accuracy: Portability: Adaptability: |
✪✪ ✪✪ ✪✪ |
P: A display T: Not specified | Robot mediated therapies (45 min) | Motor status core, MAS, ROM | MAS, ROM | 34 patients | ✔ | Shoulder + Elbow (Chronic-hemiparetic) |
| (16) | Ferreira, J (2011) [58] | ✘ | 1 goniometer Unknown EMG electrodes | Active | Exoskeleton | Accuracy: Portability: Adaptability: |
✪✪✪ ✪✪ ✪✪ |
P: None T: A computer | Linear regression technique (Detection algorithm) | TSRT | None | 25 patients | ✘ | Elbow (Post-stroke + cerebral palsy) |
| (17) | Fazekas, Gabor (2011) [59] | ✘ | None | Passive | Endeffector (REHAROB) (6 DOF + 6 DOF) | Accuracy: Portability: Adaptability: |
✪✪✪ ✪✪ ✪✪ |
P: Outer shell with handle T: Hardware Control Panel with predefine programming | Training sessions (30 min) | RMA, MAS, ROM, FUGL and FIM score | RMA, MAS, ROM, FUGL and FIM score | 30 patients | ✔ | Shoulder + Elbow (Hemiparetic) |
| (18) | Kim, E.H (2011) [60] | ✘ | None | Active | Endeffector (Hand-stretching device) | Accuracy: Portability: Adaptability: |
✪✪ ✪✪✪ ✪✪ |
P: None T: Not specified | Finger Stretching (10 min) | Mean MAS | MAS | 15 patients | ✘ | Hand (Hemiparetic) |
| (19) | Hu, X (2013) [61] | ✘ | 4 EMG electrodes | Active | Exoskeleton (2 DOF) | Accuracy: Portability: Adaptability: |
✪✪✪ ✪✪✪ ✪✪ |
P: A table and a sponge T: Only technician Not developed yet | Training sessions (EMG-triggered algorithm) (30 min) | EMG samples and FUGL, MAS, ARAT and WMFT | FUGL, MAS, ARAT and WMFT | 10 patients | ✔ | Hand-wrist (Chronic-stroke) |
| (20) | Ferreira, J (2013) [62] | ✘ | 1 electrogoniometer Unknown EMG electrodes | Active | Exoskeleton | Accuracy: Portability: Adaptability: |
✪✪✪ ✪✪ ✪✪ |
P: None T: A computer | Passive muscle stretch at different velocities (Detection algorithm) | TSRT | None | 11 patients | ✘ | Elbow (Post-stroke + cerebral palsy) |
| (21) | Sale and Posteraro (2014) [63] | ✘ | None | Active-assistive | Endeffector (MIT-MANUS) (2 DOF) | Accuracy: Portability: Adaptability: |
✪✪ ✪✪ ✪✪ |
P: A display T: Not specified | Robot-assisted therapy (45 min) | MAS-S, MAS-E, pROM | MAS-S, MAS-E, pROM | 53 patients | ✔ | Shoulder + Elbow (Subacute stroke) |
| (22) | Taveggia, G (2016) [64] | ✘ | None | Active-assitive and passive | Exoskeleton (ARMEO spring) | Accuracy: Portability: Adaptability: |
✪✪✪ ✪✪ ✪✪ |
P: A display T: A computer | Training sessions (SPSS software) (60 min) | Motricity index, MAS and NPRS | MAS | 54 patients | ✘ | Shoulder + Elbow + Wrist (Poststroke) |
| (23) | Pennati, G.V (2016) [65] | ✘ | None | Passive | Exoskeleton (NeuroFlexor) (1 DOF) | Accuracy: Portability: Adaptability: |
✪✪ ✪✪✪ ✪✪ |
P: A display T: A digital | Estimation of Neural and Viscous component | Cut-off values | MAS, FUGL | 107 patients | ✘ | Wrist (Poststroke) |
| (24) | Dehem, S (2017) [66] | ✘ | None | Passive | Endeffector (REAplan) | Accuracy: Portability: Adaptability: |
✪✪ ✪✪✪ ✪✪ |
P: A display T: Not specified | Correlation between velocity and RF | Velocity-force graphics | MAS | 12 patients | ✘ | Elbow (Chronic stroke) |
| (25) | Lee, D.J. (2017) [67] | ✘ | 1 dynamometer | Active | Exoskeleton (1 DOF) | Accuracy: Portability: Adaptability: |
✪✪ ✪✪ ✪✪ |
P: Not developed yet T: Computer monitor and a emergency switches to stop | Stretching sessions (90 s) | Force patterns | MAS | 9 patients | ✔ | Elbow + Hand-wrist (Poststroke) |
| (26) | Calabro, R.S (2017) [68] | ✘ | 3 EMG electrodes | Active-assistive | Exoskeleton (Armeo power) (6 DOF) | Accuracy: Portability: Adaptability: |
✪✪✪ ✪✪✪ ✪✪ |
P: A display T: Not specified | Training sessions (EMG Algorithm Shapiro-Wilk statistic) (60 min) | MAS, FUGL | MAS, FUGL | 20 patients | ✔ | Shoulder + Elbow (Ischemic stroke) |
| (27) | Posteraro, F (2018) [69] | ✘ | None | Active and passive | Exoskeleton (NEUROExos Elbow Module) (4 DOF) | Accuracy: Portability: Adaptability: |
✪✪✪ ✪✪ ✪✪ |
P: Not specified T: Not specified | Isokinetic passive mobilization (45 min) | MAS score | MAS | 5 patients | ✔ | Elbow (Poststroke) |
| (28) | Wang, H. (2019) [12] | ✘ | None | Active and Passive | End-effector (Humac Norm) (1 DOF) | Accuracy: Portability: Adaptability: |
✪✪ ✪✪ ✪✪ |
P: A display T: PC interface | Online | Peak torque; Keep time; Rise time | MAS | 14 patients (stroke) | ✘ | Elbow |
| (29) | Sin, M. (2019) [70] | ✘ | 1 EMG | Active and Passive | End-effector (1 DOF) | Accuracy: Portability: Adaptability: |
✪✪ ✪✪✪ ✪✪ |
P: Not specified T: Not specified | Manual and Isokinetic mobilization (37 min) | Intraclass correlation coefficient | MAS, MTS | 17 patients (stroke) | ✘ | Elbow |
* Considering the automatic administration of the test(✔ = Yes; ✘ = No); ★ Given in levels (Low: ✪, Medium: ✪✪, High:✪✪✪); ★★ Exoskeleton or Endeffector.