Future and Impact of Rehabilitation Robotics on Post-stroke Care and Recovery

Abstract

The demand for rehabilitation services is growing apace with the graying of the population. This situation creates both a need and an opportunity to deploy technologies such as rehabilitation robotics, and in the last decade and half, several research groups have demonstrated variations of this technology. Results so far are mixed, with the available evidence demonstrating unequivocally that some forms of robotic therapy can be highly effective, even for patients many years post stroke, but other forms of robotic therapy have been singularly ineffective. The contrast is starkest when we compare upper-extremity (UE) and lower-extremity (LE) therapy. In fact, the 2010 Stroke Care Guidelines of the American Heart Association (AHA) and of the Veterans Administration/Department of Defense (VA/DoD) endorsed the use of rehabilitation robotics for UE post-stroke care, but concluded that lower-extremity robotic therapy is much less effective as compared to usual care practices in the US and declared “still in its infancy.” (Bates J et al., Rehabil Res Dev 47(9):1-43, 2010; Miller EL et al., Stroke 41(10):2402-2448, 2010). In this chapter we briefly describe what we are presently investigating to revert and work toward a future endorsement of the AHA and VA/DoD for rehabilitation robotics for LE post-stroke care.