Rehabilitation--emerging technologies, innovative therapies, and future objectives

Abstract

Stroke is the leading cause of long-term disability. The goal of stroke rehabilitation is to improve recovery in the years after a stroke and to decrease long-term disability. This article, titled "Rehabilitation--Emerging Technologies, Innovative Therapies, and Future Objectives" gives evidence-based information on the type of rehabilitation approaches that are effective to improve functional mobility and to address cognitive impairments. We review the importance of taking a translational approach to neurorehabilitation, considering the interaction of motor and cognitive systems, skilled learned purposeful limb movement, and spatial navigation ability. Known biologic mechanisms of neurorecovery are targeted in relation to technology implemented by members of the multidisciplinary team. Results from proof-of-concept, within subjects, and randomized controlled trials are presented, and the implications for optimal stroke rehabilitation strategies are discussed. Developing clinical practices are highlighted and future research directions are proposed with goals to provide insight on what the next steps are for this burgeoning discipline.

Fig. 1

Body-Weight-Supported Gait Training (Robomedica, Mission Viejo, CA). In this example, the patient is suspended from above using a harness system, with two therapists providing facilitation of leg movement and one therapist assisting with core stabilization. [Courtesy of TIRR Memorial Hermann (The Institute for Rehabilitation and Research), photo by Stockyard Photos]

Fig. 2

Lokomat robotic-assisted therapy (LokoMat, Hocoma Ag, Volketswil, SZ, CH-8604). In this example, a patient is engaged in the robotic lower extremity device and suspended over a treadmill using a harness system. The patient can be unweighted for a percent of their body mass based on parameters set by the therapists. [Courtesy of John Lynch, Memorial Hermann Healthcare System]