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

Damn it all, we don't need guidelines we need protocols. WHEN THE HELL are you going to provide protocols that lead to 100% recovery? This is just laziness, do your fucking job.  Well, this was way back in 2009, I bet nothing better has been done in the last 10 years. And if we had a public database of stroke research and protocols the 10 million yearly stroke survivors  could make damn sure our stroke medical 'professionals' are up-to-date on the latest.  If your doctor writes E.T.(Evaluate and Treat) prescriptions it means s/he knows absolutely nothing about stroke rehab and yet you continue to pay them for nada.

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

 AnnickAATimmermans*
1,2
, HenkAMSeelen
2
, RichardDWillmann
3
 and HermanKingma
1,4
 Address:
1
Faculty of Biomedical Technology, Technical University Eindhoven, Den Dolech 2, 5600 MB Eindhoven, the Netherlands,
2
Rehabilitation Foundation Limburg (SRL), Research Dept, Zandbergsweg 111, 6432 CC Hoensbroek, the Netherlands,
3
Philips Research Europe, Dept Medical Signal Processing, Weisshausstrasse 2, 52066 Aachen, Germany and
4
Department of ORL-HNS, Maastricht University Medical Center, PO Box 5800, 6202 AZ Maastricht, the NetherlandsEmail: AnnickAATimmermans*-A.Timmermans@srl.nl; HenkAMSeelen-H.Seelen@srl.nl; RichardDWillmann-Richard.Willmann@philips.com; HermanKingma-Herman.Kingma@MUMC.nl* Corresponding author

Abstract

Background:
It 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.
Methods:
A literature search was conducted in PubMed, MEDLINE, CINAHL, and EMBASE(1997–2007).
Results:
One 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.
Conclusion:
This 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.