So they came up with NO specific helps for getting survivors recovered! Useless! Keywords are specific and recovered.
A Review of Rehabilitation Devices to Promote Upper Limb Function Following Stroke
Jacob Brackenridge
1
, Lynley V. Bradnam
2,3
, Sheila Lennon
2
, John J. Costi
1
and David A. Hobbs
1,
*
1
Medical Device Research Institute, School of Computer Science, Engineer-ing and Mathematics, Flinders University, Adelaide, South Australia, Austra-lia;
2
Discipline of Physiotherapy, School of Health Sciences, Flinders Uni-versity, Adelaide, South Australia, Australia;
3
Discipline of Physiotherapy, Graduate School of Health, University of Technology, Sydney, NSW, Australia
Background:
Stroke is a major contributor to the reduced ability to carry out activities of daily living (ADL) post cerebral infarct. There has been a major focus on understanding and improving rehabilitation interventions in order to target cortical neural plasticity to support recovery of upper limb function. Conventional therapies delivered by therapists have been combined with the application of mechanical and robotic devices to provide controlled and assisted movement of the paretic upper limb. The ability to provide greater levels of intensity and reproducible repetitive task practice through the application of intervention devices are key mechanisms to support rehabilitation efficacy.
Results:
This review of literature published in the last decade identified 141 robotic or mechanical devices. These devices have been characterised and assessed by their individual characteristics to provide a review of current trends in rehabilitation device interventions. Correlation of factors identified to promote positive targeted neural plasticity has raised questions over the benefits of expensive robotic devices over simple mechanical ones.
Conclusion:
A mechanical device with appropriate functionality to support the promotion of neural plasticity after stroke may provide an effective solution for both patient recovery and to stimulate further research into the use of medical de-vices in stroke rehabilitation. These findings indicate that a focus on simple, cost effective and efficacious intervention solutions may improve rehabilitation outcomes.
Keywords:
Activities of daily living, exercise therapy, paresis, recovery of function, robotics, stroke, upper extremity, me-chanical devices, neural plasticity.
Received: December 12, 2015 Revised: February 12, 2016 Accepted: February 17, 2016
1. INTRODUCTION
Stroke is a cerebrovascular event in which the blood supply to the brain is interrupted causing either a cerebral infarct or a haemorrhage [1]. Damage caused by stroke to the brain most often leads to hemiparesis of the contralesional side of the body. A stroke can severely affect and limit the activities of daily living (ADL) leading to increasing dependence on external assistance. In Australia alone, over 430,000 people were living with the effects of stroke in 2014 and this number is expected to grow to over 700,000 by 2032. In 2012, the total financial cost of stroke in Australia was estimated at $5 billion and this figure is likely to increase [1]. The brain has its own inbuilt mechanism to deal with injury, known as cortical neural plasticity, which is the fundamental building block by which the human brain learns and adapts to environments [2]. It is through this process of neuronal growth and synaptic modification that spontaneous recovery of function is possible. However, actual spontaneous physical recovery of arm and hand function has been identified in less than 15% of the post stroke population [3].
1
, Lynley V. Bradnam
2,3
, Sheila Lennon
2
, John J. Costi
1
and David A. Hobbs
1,
*
1
Medical Device Research Institute, School of Computer Science, Engineer-ing and Mathematics, Flinders University, Adelaide, South Australia, Austra-lia;
2
Discipline of Physiotherapy, School of Health Sciences, Flinders Uni-versity, Adelaide, South Australia, Australia;
3
Discipline of Physiotherapy, Graduate School of Health, University of Technology, Sydney, NSW, Australia
Abstract:
Background:
Stroke is a major contributor to the reduced ability to carry out activities of daily living (ADL) post cerebral infarct. There has been a major focus on understanding and improving rehabilitation interventions in order to target cortical neural plasticity to support recovery of upper limb function. Conventional therapies delivered by therapists have been combined with the application of mechanical and robotic devices to provide controlled and assisted movement of the paretic upper limb. The ability to provide greater levels of intensity and reproducible repetitive task practice through the application of intervention devices are key mechanisms to support rehabilitation efficacy.
Results:
This review of literature published in the last decade identified 141 robotic or mechanical devices. These devices have been characterised and assessed by their individual characteristics to provide a review of current trends in rehabilitation device interventions. Correlation of factors identified to promote positive targeted neural plasticity has raised questions over the benefits of expensive robotic devices over simple mechanical ones.
Conclusion:
A mechanical device with appropriate functionality to support the promotion of neural plasticity after stroke may provide an effective solution for both patient recovery and to stimulate further research into the use of medical de-vices in stroke rehabilitation. These findings indicate that a focus on simple, cost effective and efficacious intervention solutions may improve rehabilitation outcomes.
Keywords:
Activities of daily living, exercise therapy, paresis, recovery of function, robotics, stroke, upper extremity, me-chanical devices, neural plasticity.
Received: December 12, 2015 Revised: February 12, 2016 Accepted: February 17, 2016
1. INTRODUCTION
Stroke is a cerebrovascular event in which the blood supply to the brain is interrupted causing either a cerebral infarct or a haemorrhage [1]. Damage caused by stroke to the brain most often leads to hemiparesis of the contralesional side of the body. A stroke can severely affect and limit the activities of daily living (ADL) leading to increasing dependence on external assistance. In Australia alone, over 430,000 people were living with the effects of stroke in 2014 and this number is expected to grow to over 700,000 by 2032. In 2012, the total financial cost of stroke in Australia was estimated at $5 billion and this figure is likely to increase [1]. The brain has its own inbuilt mechanism to deal with injury, known as cortical neural plasticity, which is the fundamental building block by which the human brain learns and adapts to environments [2]. It is through this process of neuronal growth and synaptic modification that spontaneous recovery of function is possible. However, actual spontaneous physical recovery of arm and hand function has been identified in less than 15% of the post stroke population [3].
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