New technology in rehabilitation: Possibilities and limitations

Abstract

Increasing evidence within the last 20 years has shown that the injured central nervous system (CNS) has the ability to reorganize. Reorganization in a functional meaningful way is dependent on motor activity as executed during rehabilitative training, and is followed by functional improvements. Robots for neurorehabilitation were designed as possible tools for therapists to automate labor-intensive training techniques, especially at an early stage where patients require a high amount of support. Because of their programmable force-producing ability, robotic devices can support the patient during task oriented movements, thereby providing correct afferent feedback while reducing the physical effort for the therapist. Robots can replicate some features of a therapist’s manual assistance, allowing patients to semi-autonomously perform their movement training. Novel therapy devices can furthermore increase the duration and number of training sessions while reducing the number of therapists required for each patient. Augmented Performance Feedback scenarios increase patients’ motivation and compliance thereby increasing active participation. Besides enhancing the rehabilitation process and improving therapeutic outcome, new technologies have the potential to support clinical evaluation, precisely control and measure therapy and implement novel forms of mechanical manipulation impossible for therapists to simulate.