Motor Rehabilitation Program and Robotics

Abstract

The Brain Injury Association of America (BIAA) defines TBI as brain injury, neither degenerative nor congenital, caused by external physical force. TBI is normally caused by a dynamic impact to the head, resulted from localized shock or from sudden movements produced by shock in other parts of the body. This can result in a combination of compression, expansion, acceleration, deceleration, and rotation of the brain inside the cranium. The complex pathophysiology of TBI includes secondary pathologic processes in the brain as inflammation, ischemia, edema, oxidative stress, apoptosis, excitotoxicity, mitochondrial dysfunction, and many chronic secondary changes [1]. In general the lesion site after TBI may be more diffuse than after stroke and the common region of lesions differ among TBI patients. So TBI lesion can produce altered or diminished state of conscience and disabilities on cognitive, behavioral, emotional, or physical performance. There are also several common neurobehavioral complications after TBI [2]. Moreover behavioral symptoms such as depression and anxiety can overlap with cognitive and motor symptoms. Apathy, fatigue, and attention also modify the clinical pattern of motor, cognitive, and mood clinical complications [3–5]. TBI involves a gradual reactivation of brain function as compensatory and associative circuits. The entire recovery process is in itself dynamic and can be significantly altered by external events, stimulation, and training. But while cognitive dysfunction after TBI is the most common claim cited by caregivers, the extent of injury to the motor system and to motor-related cognitive circuits often overlaps. So rehabilitation includes all four function domains: physical, mental, affective, and social [6].