Rehabilitation techniques after stroke have dramatically evolved in the past two decades thanks to: - improvement of our knowledge of mechanisms underlying learning and adaptation after lesion of the central nervous system (brain plasticity); - generalization of evaluation process concerning rehabilitation procedures, leading to profound changes in current practice; - rapid evolutions in computer sciences, electronics and robotics which enrich our manual rehabilitation techniques with instrumental ones. Such evolutions should be considered in the light of: - changes in stroke epidemiology and patient's characteristics; - changes in several rehabilitation concepts: importance of intensity and repetition of exercises, self-rehabilitation, task-oriented rehabilitation. . .; - societal developments with high medico-economic pressure, enthusiasm for technology, increase of ambulatory treatments. . . The use of technology in rehabilitation after stroke has been worldwide proposed in the past three decades. Functional electrical stimulation, muscle strengthening devices (like isokinetic dynamometers), and static or dynamic posturology have proven their interest and are widely used. Since about 5 years, there is an increasing interest concerning video games and immersive virtual reality, underpinned by strongly suspected clinical efficacy documented in the medical literature. Current technologies and constant innovation in this sector allow the development of self-adaptative and engaging rehabilitation video games which are very promising in patient's care. In the same way, rehabilitation robotics (mechanical motorized interactive devices) have gradually improved, with a widely suspected benefit even if not fully established. Furthermore, all these devices offer a continuous monitoring of motor performance of patients, permitting optimal on-line adaptation and fine personalization of rehabilitation programs. On a more global point of view, the actual trend consists in the association of these technologies to enhance their complementarities. Using technologies for outpatients' rehabilitation (tele-rehabilitation) suggests new health system promising organizations. Finally, highly personalized rehabilitation programs based on these emerging technologies and enhanced by self-rehabilitation could lead to optimize, intensify and prolong patient's post-stroke treatments in order to promote functional recovery.
Laffont, I., Van Dokkum, L., Froger, J., Mottet, D., & Pelissier, J. (2012). Stroke patients: Emerging rehabilitation techniques. Annals of Physical and Rehabilitation Medicine, 55, e145–e146. https://doi.org/10.1016/j.rehab.2012.07.377