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The clinical applications and benefits of the use of a Robotic Exoskeleton for Rehabilitation (RER) in the elbow and hand are described because a RER is a high-quality alternative capable of restoring compromised functions and neurorehabilitation at the same time in post-stroke patients. Passive rehabilitation (PR) is usually applied in the early stages of post-stroke recovery. The responsibility of assisting Physical Medicine and Rehabilitation (PM&R) doctors and the patient with passive exercises is a robotic system (RS); while active rehabilitation (AR) is applied regularly in late stages, it is like PR and its implications but requires the strength and support of the person to perform the exercises voluntarily. The objective of the present study is to collect, synthesize, and report relevant scientific studies related to the implementation of exoskeleton systems for elbow-hand rehabilitation. Various scientific literature on the topic was reviewed in the main biomedical databases using the population, intervention, comparison, results, and context (PICOC) criteria. This study presents the potential and describes a comprehensive and updated vision of the consequences and improvements obtained with the use of the RER and its advances. In conclusion, the usefulness and importance of a RER in various applied clinical practices have found numerous advantages, such as a better evaluation of spasticity, neuromotor recuperation, promoting neuroplasticity, and much more, which is of global relevance since this study gives us a greater understanding of the potential of these new perspectives to improve the rehabilitation of compromised functions in post-stroke cases with the use of RER. Doi: 10.28991/HIJ-2024-05-04-020 Full Text: PDF

The World Health Organization (WHO) estimates that 15 million people are affected by stroke each year, causing deterioration of the upper limb, which is reflected in 70-80% of them, decreasing the performance of daily activities and quality of life, mainly affecting hand functions. Thus, the purpose of this study is to present a high-quality alternative to recover muscle tone and mobility, consisting of a hand-exoskeleton for passive rehabilitation. It covers a motion protocol for each finger and pressure sensors to give a safety pressure range during the gripping function. The bio-design method covers standards (ISO 13485 and VDI 2206) based on biomechanic and anthropometric fundamentals, where Fusion 360 was used for mechanical development and electrical-electronic circuit schematics. The prototyping process was based on 3D printing using polylactic acid (PLA); also, the actuators were servomotors DS3218, the pressure sensors were RP-C7.6-LT, and the microcontroller was Arduino Nano. The system has been validated by the Institute of Research in Biomedical Sciences (INICIB) at the Ricardo Palma University, where the novelty of this work lies in the introduction of a new mobile-prismatic joint mechanism. In conclusion, favorable results were achieved regarding the complete flexion and extension of the fingers (91.6% acceptance rate, tested in 100 subjects), so the next step proposes that the wearable device will be used in the Physical Medicine and Rehabilitation Departments of Medical Centers. Doi: 10.28991/ESJ-2024-08-06-02 Full Text: PDF

This Review Article is presented based on current scientific evidence on space medicine focused on human physiology and its countermeasures. Therefore, a non-systematic bibliographic search of scientific articles and research books in English-Spanish of the last 7 years was carried out, detailing their application in humans, murine models and in vitro experiments. The conditions of the space environment such as microgravity and radiation that produce considerable physiological changes in the cardiovascular system (redistribution of fluids, cardiovascular remodeling, arrhythmias) were taken into account; nervous (sensorimotor, neurosensory, neurovestibular); respiratory (volume and capacity changes); renal (lithiasis); musculoskeletal (muscular atrophy, osteoporosis); hematological (anemia); immunological (immune dysregulation) and digestive (intestinal microbiota disorder). In addition, there are biological, molecular and genetic processes still to be explored, in order to know and mitigate the uncertain mechanisms triggered in extreme and dangerous environments. Therefore, it is a priority to develop and implement countermeasures to reduce the harmful effects on health, with the aim of guaranteeing the astronaut's adaptation, safety and performance during future space flights.