{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T11:16:28Z","timestamp":1782126988384,"version":"3.54.5"},"reference-count":36,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,4,30]],"date-time":"2021-04-30T00:00:00Z","timestamp":1619740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>In the aging world population, the occurrence of neuromotor deficits arising from stroke and other medical conditions is expected to grow, demanding the design of new and more effective approaches to rehabilitation. In this paper, we show how the combination of robotic technologies with progress in exergaming methodologies may lead to the creation of new rehabilitation protocols favoring motor re-learning. To this end, we introduce the Track-Hold system for neuromotor rehabilitation based on a passive robotic arm and integrated software. A special configuration of weights on the robotic arm fully balances the weight of the patients\u2019 arm, allowing them to perform a purely neurological task, overcoming the muscular effort of similar free-hand exercises. A set of adaptive and configurable exercises are proposed to patients through a large display and a graphical user interface. Common everyday tasks are also proposed for patients to learn again the associated actions in a persistent way, thus improving life independence. A data analysis module was also designed to monitor progress and compute indices of post-stroke neurological damage and Parkinsonian-type disorders. The system was tested in the lab and in a pilot project involving five patients in the post-stroke chronic stage with partial paralysis of the right upper limb, showing encouraging preliminary results.<\/jats:p>","DOI":"10.3390\/s21093130","type":"journal-article","created":{"date-parts":[[2021,4,30]],"date-time":"2021-04-30T10:53:29Z","timestamp":1619780009000},"page":"3130","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A System for Neuromotor Based Rehabilitation on a Passive Robotic Aid"],"prefix":"10.3390","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1448-0960","authenticated-orcid":false,"given":"Marco","family":"Righi","sequence":"first","affiliation":[{"name":"National Research Council of Italy, ISTI Area della Ricerca CNR, Via G. Moruzzi 1, 56124 Pisa, Italy"},{"name":"Computer Science Department, University of Pisa, Lungarno Pacinotti, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0559-0607","authenticated-orcid":false,"given":"Massimo","family":"Magrini","sequence":"additional","affiliation":[{"name":"National Research Council of Italy, ISTI Area della Ricerca CNR, Via G. Moruzzi 1, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Dolciotti","sequence":"additional","affiliation":[{"name":"Department of Traslational Research and New Technologies in Medicine and Surgery, University of Pisa, Lungarno Pacinotti, 43, 56126 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5175-5126","authenticated-orcid":false,"given":"Davide","family":"Moroni","sequence":"additional","affiliation":[{"name":"National Research Council of Italy, ISTI Area della Ricerca CNR, Via G. Moruzzi 1, 56124 Pisa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"367","DOI":"10.3389\/fnagi.2019.00367","article-title":"Functional Near-Infrared Spectroscopy to Study Cerebral Hemodynamics in Older Adults During Cognitive and Motor Tasks: A Review","volume":"11","author":"Udina","year":"2020","journal-title":"Front. Aging Neurosci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"459","DOI":"10.3233\/NRE-192687","article-title":"Effectiveness of somatosensory interventions on somatosensory, motor and functional outcomes in the upper limb post-stroke: A systematic review and meta-analysis","volume":"44","author":"Yilmazer","year":"2019","journal-title":"NeuroRehabilitation"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Jiang, Y., Lu, H., Man, Q., Liu, Z., Wang, L., Wang, Y., Suo, C., Zhang, T., Jin, L., and Dong, Q. (2020). Stroke burden and mortality attributable to ambient fine particulate matter pollution in 195 countries and territories and trend analysis from 1990 to 2017. Environ. Res.","DOI":"10.1016\/j.envres.2020.109327"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Takahashi, J.C., Funaki, T., Houkin, K., Kuroda, S., Fujimura, M., Tomata, Y., and Miyamoto, S. (2020). Impact of cortical hemodynamic failure on both subsequent hemorrhagic stroke and effect of bypass surgery in hemorrhagic moyamoya disease: A supplementary analysis of the Japan Adult Moyamoya Trial. J. Neurosurg.","DOI":"10.3171\/2020.1.JNS192392"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Yasaka, M., Uchiyama, S., Atarashi, H., Okumura, K., Koretsune, Y., Yamashita, T., Taniguchi, A., Fukaya, T., and Inoue, H. (2020). J-Dabigatran Surveillance Investigators. Dabigatran for Japanese Patients with Atrial Fibrillation and Prior Stroke: A Subgroup Analysis of the J-Dabigatran Surveillance Program. J. Stroke Cerebrovasc. Dis., 9.","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.104717"},{"key":"ref_6","unstructured":"Bella, R., Bellisario, P., Bozzola, E., Bozzola, M., Carolei, A., Consoli, D., Ferri, C., Forleo, G., Galeone, D., and Gensini, G. (2019). Prevenzione delle malattie cerebrovascolari lungo il corso della vita. Minist. Della Salut. Ital., Available online: http:\/\/www.salute.gov.it\/imgs\/C_17_pubblicazioni_2896_allegato.pdf."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1089\/cpb.2005.8.187","article-title":"Virtual environments for motor rehabilitation: Review","volume":"8","author":"Holden","year":"2005","journal-title":"Cyberpsychol. Behav."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1177\/0269215512444631","article-title":"A randomized controlled trial of Cognitive Sensory Motor Training Therapy on the recovery of arm function in acute stroke patients","volume":"26","author":"Chanubol","year":"2012","journal-title":"Clin. Rehabil."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2035","DOI":"10.1016\/S0140-6736(99)00920-4","article-title":"Rehabilitation of hemiparesis after stroke with a mirror","volume":"353","author":"Altshuler","year":"1999","journal-title":"Lancet"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1097\/WCO.0b013e32835c5ba0","article-title":"Promoting neuroplasticity and recovery after stroke: Future directions for rehabilitation clinical trials","volume":"26","author":"Bowden","year":"2013","journal-title":"Curr. Opin. Neurol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1161\/STROKEAHA.108.533828","article-title":"The effectiveness of the Bobath concept in stroke rehabilitation: What is the evidence?","volume":"40","author":"Kollen","year":"2009","journal-title":"Stroke"},{"key":"ref_12","first-page":"306","article-title":"Spasticity; its nature and treatment","volume":"80","author":"Levine","year":"1954","journal-title":"Calif Med."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Villepinte, C., Verma, A., Dimeglio, C., De Boissezon, X., and Gasq, D. (2020). Responsiveness of kinematic and clinical measures of upper-limb motor function after stroke: A systematic review and meta-analysis. Ann. Phys. Rehabil. Med.","DOI":"10.1016\/j.rehab.2020.02.005"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Thieme, H., Morkisch, N., Mehrholz, J., Pohl, M., Behrens, J., Borgetto, B., and Dohle, C. (2018). Mirror therapy for improving motor function after stroke. Cochrane Database Syst. Rev., 7.","DOI":"10.1002\/14651858.CD008449.pub3"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1001\/archneur.1997.00550160075019","article-title":"The effect of robot-assisted therapy and rehabilitative training on motor recovery following stroke","volume":"54","author":"Aisen","year":"1997","journal-title":"Arch. Neurol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"477","DOI":"10.1053\/apmr.2003.50110","article-title":"Effects of robotic therapy on motor impairment and recovery in chronic stroke","volume":"84","author":"Fasoli","year":"2003","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Adinolfi, F., Caggianese, G., Gallo, L., Grosso, J., Infarinato, F., Marchese, N., Sale, P., and Spaltro, E. (2016). SmartCARE\u2014 An ICT Platform in the Domain of Stroke Pathology to Manage Rehabilitation Treatment and Telemonitoring at Home. Intelligent Interactive Multimedia Systems and Services 2016, Springer.","DOI":"10.1007\/978-3-319-39345-2_4"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Delmastro, F., Dolciotti, C., La Rosa, D., Di Martino, F., Magrini, M., Coscetti, S., and Palumbo, F. (2019). Experimenting mobile and e-health services with frail MCI older people. Information, 10.","DOI":"10.3390\/info10080253"},{"key":"ref_19","unstructured":"Magrini, M., Coscetti, S., Barcaro, U., and Dolciotti, S. (2021, April 20). A System for Motor and Cognitive Activities for People with Mild Or moderate Cognitive Impairment. Available online: https:\/\/openportal.isti.cnr.it\/doc?id=people______::37298caaff9a7daa511362bce80cb561."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Verri Lucca, A., Augusto Silva, L., Luchtenberg, R., Garcez, L., Mao, X., Garc\u00eda Ovejero, R., Miguel Pires, O., Vict\u00f3ria Barbosa, J.L., and Leithardt, V.R.Q. (2020). A Case Study on the Development of a Data Privacy Management Solution Based on Patient Information. Sensors, 20.","DOI":"10.3390\/s20216030"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Cikajlo, I., Huki\u0107, A., and Zajc, D. (2021). Exergaming as Part of the Telerehabilitation Can Be Adequate to the Outpatient Training: Preliminary Findings of a Non-randomized Pilot Study in Parkinson \u2019s Disease. Front. Neurol.","DOI":"10.3389\/fneur.2021.625225"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Norouzi-gheidari, N., Hernandez, A., Archambault, P.S., Higgins, J., Poissant, L., and Kairy, D. (2019). Feasibility, Safety and E ffi cacy of a Virtual Reality Exergame System to Supplement Upper Extremity Rehabilitation Post-Stroke: A Pilot Randomized Clinical Trial and Proof of Principle. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17010113"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Lacorte, E., Bellomo, G., Nuovo, S., Corbo, M., Vanacore, N., and Piscopo, P. (2020). The Use of New Mobile and Gaming Technologies for the Assessment and Rehabilitation of People with Ataxia: A Systematic Review and Meta-analysis. Cerebellum.","DOI":"10.1007\/s12311-020-01210-x"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Pacheco, T., de Medeiros, C.S.P., de Oliveira, V.H.B., Vieira, E.R., and de Cavalcanti, F.A.C. (2020). Effectiveness of exergames for improving mobility and balance in older adults: A systematic review and meta-analysis. Syst. Rev.","DOI":"10.21203\/rs.3.rs-19993\/v1"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.jht.2015.11.006","article-title":"Robot training for hand motor recovery in subacute stroke patients: A randomized controlled trial","volume":"29","author":"Palafox","year":"2016","journal-title":"J. Hand Ther."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1080\/00222895.2019.1639608","article-title":"Effect of tDCS on Fine Motor Control of Patients in Subacute and Chronic Post-Stroke Stages","volume":"52","author":"Pavlova","year":"2020","journal-title":"J. Mot. Behav."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Paillard, T. (2020). Cross-Education Related to the Ipsilateral Limb Activity on Monopedal Postural Control of the Contralateral Limb: A Review. Front. Physiol., 11.","DOI":"10.3389\/fphys.2020.00496"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Qassim, H., and Hasan, W.Z.W. (2020). A Review on Upper Limb Rehabilitation Robots. Appl. Sci., 10.","DOI":"10.3390\/app10196976"},{"key":"ref_29","first-page":"1","article-title":"Neurocognitive robot-assisted rehabilitation of hand function: A randomized control trial on motor recovery in subacute stroke","volume":"7","author":"Ranzani","year":"2020","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Keeling, A.B., Piitz, M., Semrau, J.A., Hill, M.D., Scott, S.H., and Dukelow, S.P. (2021). Robot enhanced stroke therapy optimizes rehabilitation: A pilot study. J. Neuroeng. Rehabil.","DOI":"10.1186\/s12984-021-00804-8"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Lee, S.H., Park, G., Cho, D.Y., Kim, H.Y., Lee, J.-Y., Kim, S., Park, S.-B., and Shin, J.-H. (2020). Comparisons between end-effector and exoskeleton rehabilitation robots regarding upper extremity function among chronic stroke patients with moderate-to-severe upper limb impairment. Sci. Rep.","DOI":"10.1038\/s41598-020-58630-2"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Baniqued, P.D.E., Stanyer, E.C., Awais, M., Alazmani, A., Jackson, A.E., Mon-Williams, M.A., Mushtaq, F., and Holt, R.J. (2021). Brain\u2014Computer interface robotics for hand rehabilitation after stroke: A Systematic review. J. Neuroeng. Rehabil.","DOI":"10.1186\/s12984-021-00820-8"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1097\/01.PHM.0000137313.14480.CE","article-title":"Comparison of two techniques of robot-aided upper limb exercise training after stroke","volume":"83","author":"Stein","year":"2004","journal-title":"Am. J. Phys. Med. Rehabil."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Rovini, E., Maremmani, C., and Cavallo, F. (2020). A wearable system to objectify assessment of motor tasks for supporting parkinson\u2019s disease diagnosis. Sensors, 20.","DOI":"10.3390\/s20092630"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12938-018-0600-7","article-title":"Objective and automatic classification of Parkinson disease with Leap Motion controller","volume":"17","author":"Butt","year":"2018","journal-title":"Biomed. Eng. Online"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1109\/TITB.2011.2182616","article-title":"Assessment of tremor activity in the Parkinson\u2019s disease using a set of wearable sensors","volume":"16","author":"Rigas","year":"2012","journal-title":"IEEE Trans. Inf. Technol. Biomed."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/9\/3130\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:56:03Z","timestamp":1760162163000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/21\/9\/3130"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,30]]},"references-count":36,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["s21093130"],"URL":"https:\/\/doi.org\/10.3390\/s21093130","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,30]]}}}