Evolution on Cognitive Rehabilitation after Stroke: from Traditional Techniques to Smart and Personalised ICT Home-based Systems

Or maybe you blithering idiots should focus on stopping the neuronal cascade of death by these 5 causes in the first week resulting in fewer dead and damaged neurons. Since you seem to have no clue on how to cognitively rehab someone after the damage is done. 

Evolution on Cognitive Rehabilitation after Stroke: from Traditional Techniques to Smart and Personalised ICT Home-based Systems

José M. Cogollor1, PhD; Javier Rojo2, PhD; Joachim Hermsdörfer3, Prof.; Manuel Ferre1, Prof.; Maria Teresa Arredondo2, Prof.; Christos Giachritsis4, PhD; Alan Armstrong3, PhD; Jose Breñosa1, PhD; Doris Bautista1, PhD; José Maria Sebastián1, Prof.

1 Centre for Automation and Robotics (CAR) UPM-CSIC, Universidad Politécnica de Madrid, Madrid, Spain.
2 Life Supporting Technologies, Universidad Politécnica de Madrid, Madrid, Spain.
3 Institute of Movement Science, Department of Sport and Health Science, Technische Universität München, Munich, Germany.
4 BMT Group Ltd, London, United Kingdom.

Corresponding Author:
Manuel Ferre
Centre for Automation and Robotics (CAR) UPM-CSIC, Universidad Politécnica de Madrid
Calle José Gutiérrez Abascal, 2. 28006 Madrid
Spain
Phone: 0034 91 336 30 61
Fax: 0034 91 336 30 10
Email: m.ferre@upm.es
Abstract
Background: Neurological patients after stroke usually present cognitive deficits which impose a dependency in their daily living. These deficits mainly affect the performance of some daily activities which can be dangerous if no supervision is provided. For that reason, stroke patients need long-term processes for their cognitive rehabilitation. Considering that classical techniques are focused on acting as a guide, teaching by repetition and they depend on the help of therapists, big efforts are being made to improve current methodologies and get benefits from e-health and web-based architectures to implement ICT systems that achieve reliable, personalized and home-based platforms to increase efficiency and level of attractiveness for patients and carers.

Objective: The goal of this work is to provide a wide swept in the practices implemented for the assessment of stroke patients and cognitive rehabilitation. The article puts together traditional methods and the most recent personalised platforms based on ICT technologies and even Internet of Things in order to show the evolution and improvements in the field of cognitive rehabilitation.

Methods: A literature review has been distributed to a multidisciplinary team of researchers from engineering, psychology and sport science fields. The systematic review has been focused on scientific published research, other European projects and the most current innovative large-scale initiatives in the area. 3,469 results were managed from the Web of Science, 284 articles from JMIR Publications were obtained and finally, 15 research European projects from CORDIS during the last fifteen years were reviewed for classification and selection regarding their relevance.

Results: The analysis of evolution on the techniques gave evidence on the improvements in the implementation of traditional techniques. In that sense, 7 relevant studies on the screening of stroke patients have been presented with 6 additional methods for the analysis of kinematics and 9 works on the execution of goal-oriented activities. Meanwhile, the classical methods to provide cognitive rehabilitation have been classified in the 5 main techniques implemented. Finally, the review has finalised with the selection of 8 different ICT-based approaches found in scientific-technical articles; 9 European projects funded by the European Commission that offer e-health architectures; and other large-scale activities such as smart houses and the initiative City4Age.

Conclusions: Stroke is one of the main causes that most negatively affect countries in the socio-economic aspect. The design of new ICT-based systems should provide 4 main features for an efficient and personalised cognitive rehabilitation: support in the execution of complex daily tasks, automatic error detection, home-based performance, and accessibility. Only 33% of the European projects presented fulfilled those requirements at the same time. For this reason, current and future large-scale initiatives focused on e-health and smart environments try to solve this situation by providing more complete and sophisticated platforms.