Applications of Rehabilitation Engineering Technologies for the Intervention of Neural and Motor Impairment Post Stroke

Stroke is the leading cause of disability worldwide. Stroke survivors often have motorimpairments which contribute to upper limbs dysfunctions, reduced balance, posturalcontrol and reduced mobility and proprioception. These physical symptoms lead toreduced social participation and poor quality of life. Over the past ten years, therehad been an enormous focus on the use of virtual reality (VR) and other technologiesto improve clinical outcomes for people with stroke. These technologies includelarge scale bespoke manufactured immersvie virtual reality system, or home basedrehabilitation device such as the commercially available device Nitendo Wii andMicrosoft XBox. The clinical efficacy of these rehabilitation technologies had beenstudied extensively but our understanding of the underlying mechanism of recoveryinduced by these technologies is poor. There are two aspects of “recovery” must beconsidered. One is the learning compensation strategies where patients acquired“new” skills to improve functional abilities. The other aspect is the neuroplasticitymechanism which leads to cortical map reorganisation. The patient is able to re-usethe same body segments in the same way as they did before the stroke. Publishedstudies generally reported improvement in upper limb function, lower limb function,balance and gait. This leads to the uncertainty whether these technologies areeffective in promoting “recovery” at neural level or functional level. With the advance in technology, monitoring techniques such as neural imaging,motion analysis, and EMGs devices have broad applications in the understandingof neural recovery post stroke. Studies that utilize functional outcome measuresor observational design may be more effective in identifying functional recovery.A combination of the two designs may be helpful to provide new insights on therecovery mechanism induced by rehabilitation devices.