Affordable Robotics for Upper Limb Stroke Rehabilitation in Developing Countries: A Systematic Review

Stroke incidence is increasing more rapidly in Low- and Middle-Income Countries (LMICs) than in High-Income Countries (HICs), but LMICs are not well organized to provide adequate post-stroke rehabilitation because of physical, financial and personal barriers. The use of rehabilitation robotics can help bridge in healthcare disparities but they are available in LMICs in limited number due to their high cost and this limits the number of patients that can benefit from them. This article presents a literature review on the affordable robots for upper limb stroke rehabilitation that could be suitable in low-resources clinical settings with a focus on the different techniques implemented to reduce production costs. Different approaches can be carried out: i) developing end-effector and exoskeleton robots for the rehabilitation of proximal and distal joints respectively; ii) reducing the number of degrees of freedom of the robots at minimum (one or two) allowing the rehabilitation in a planar workspace; iii) avoiding the use of conventional materials that could make the robot bulky, expensive and difficult to transport. According to the mechanical properties required by the task, stell or metal alloys could be substituted for wood, aluminum, plastic, 3D-printed materials and by the adaptation of off-the-shelf elements.

I. Introduction

In 2011 the United Nations recognized non-communicable diseases, especially cardiovascular ones (CVDs), as a global health problem and defined an ambitious plan to reduce their effects worldwide [1].