Richard Daniel Willmann

Technology-assisted training of arm-hand skills in stroke: concepts on reacquisition of motor control and therapist guidelines for rehabilitation technology design

BackgroundIt is the purpose of this article to identify and review criteria that rehabilitation technology should meet in order to offer arm-hand training to stroke patients, based on recent principles of motor learning.MethodsA literature search was conducted in PubMed, MEDLINE, CINAHL, and EMBASE (1997–2007).ResultsOne hundred and eighty seven scientific papers/book references were identified as being relevant. Rehabilitation approaches for upper limb training after stroke show to have shifted in the last decade from being analytical towards being focussed on environmentally contextual skill training (task-oriented training). Training programmes for enhancing motor skills use patient and goal-tailored exercise schedules and individual feedback on exercise performance. Therapist criteria for upper limb rehabilitation technology are suggested which are used to evaluate the strengths and weaknesses of a number of current technological systems.ConclusionThis review shows that technology for supporting upper limb training after stroke needs to align with the evolution in rehabilitation training approaches of the last decade. A major challenge for related technological developments is to provide engaging patient-tailored task oriented arm-hand training in natural environments with patient-tailored feedback to support (re) learning of motor skills.

Home Stroke Rehabilitation for the Upper Limbs

Philips Research is developing and clinically testing solutions to increase the efficiency and effectiveness of rehabilitation. The Stroke Rehabilitation Exerciser supports patients and therapists in the implementation and execution of a personalized neurological motor exercise plan at home. It enables an efficient therapy planning for the medical professional and increases the training intensity for the patient. The stroke rehabilitation exerciser coaches the patient through a sequence of neurological motor exercises, which are prescribed by the physiotherapist and uploaded to a patient unit. A wireless inertial sensor system records the patients movements. The data is automatically analyzed for deviations from a personal movement target and patient and therapist are provided with adequate feedback.

The Role of Technology for Non-Invasive Cardiovascular Monitoring in the Future Exemplified

The healthcare systems in the developed coun- tries are changing in order to deal with the challenges of the future. Patients will be monitored not only sporadically in the hospitals in acute phases, a clear trend can be identified to monitor in low acute settings also at home, where they are often unsupervised and ask to do reliable measurements them- selves. Technology will play a major role as enabler of this new paradigm. This paper discusses aspects on the new sensor requirements and provides Philips - specific examples.