Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Neurotherapeutics
Published in: Neurotherapeutics 3/2011

01-07-2011 | Review

Rehabilitation—Emerging Technologies, Innovative Therapies, and Future Objectives

Authors: Nneka L. Ifejika-Jones, Anna M. Barrett

Published in: Neurotherapeutics | Issue 3/2011

Login to get access

Abstract

Stroke is the leading cause of long-term disability. The goal of stroke rehabilitation is to improve recovery in the years after a stroke and to decrease long-term disability. This article, titled “Rehabilitation—Emerging Technologies, Innovative Therapies, and Future Objectives” gives evidence-based information on the type of rehabilitation approaches that are effective to improve functional mobility and to address cognitive impairments. We review the importance of taking a translational approach to neurorehabilitation, considering the interaction of motor and cognitive systems, skilled learned purposeful limb movement, and spatial navigation ability. Known biologic mechanisms of neurorecovery are targeted in relation to technology implemented by members of the multidisciplinary team. Results from proof-of-concept, within subjects, and randomized controlled trials are presented, and the implications for optimal stroke rehabilitation strategies are discussed. Developing clinical practices are highlighted and future research directions are proposed with goals to provide insight on what the next steps are for this burgeoning discipline.
Appendix
Available only for authorised users
Literature
1.
Taylor TN, Davis PH, Torner JC, Holmes J, Meyer JW, Jacobson MF. Lifetime cost of stroke in the United States. Stroke 1996;27:1459–1466.PubMedCrossRef
2.
Hargraves JL, Hadley J. The contribution of insurance coverage and community resources to reducing racial/ethnic disparities in access to care. Health Serv Res 2003;38:809–829.PubMedCrossRef
3.
Hachinski V, Donnan GA, Gorelick PB, et al. Stroke: working toward a prioritized world agenda. Cerebrovas Dis 2010;30:127–147.CrossRef
4.
DeLisa JA, Currie DM, Martin GM. Rehabilitation medicine: past, present and future. In: Rehabilitation Medicine: Principles and Practice. DeLisa JA, Gans BM, 1988:3–32.
5.
Barrett AM, Rothi LJG. Treatment innovation in behavioral rehabilitation of stroke: removing limits on recovery. J Rehabil Res Dev 2006;43:vii-x.PubMedCrossRef
6.
Barrett AM, Levy CE, Rothi LJG. Treatment innovation in rehabilitation of cognitive motor deficits after stroke and brain injury: psychological adjunctive treatments. Am J Phys Med Rehabil 2007;86:423–425.
7.
Barrett AM, Levy CE, Rothi LJG. Pharmaceuticals for post-stroke and brain injury rehabilitation. Am J Phys Med Rehabil 2007;86:603–604.CrossRef
8.
Rothi LJG. Cognitive rehabilitation: the role of theoretical rationales and respect for the maturationalprocess needed for our evidence. J Head Trauma Rehabil 2006;21:194–197.
9.
Van Peppen RP, Kwakkel G, Wood-Dauphinee S, Hendriks HJ, Van der Wees PJ, Dekker J. The impact of physical therapy on functional outcomes after stroke: what’s the evidence? Clin Rehabil 2004;18:833–862.PubMedCrossRef
10.
Kwakkel G, Kollen BJ, Lindeman E. Understanding the pattern of functional recovery after stroke: facts and theories. Restor Neurol Neurosci 2004;22:281–299.PubMed
11.
Knapp HD, Taub E and Berman AJ. Effect of deafferentation on a conditioned avoidance response. Science 1958;128:842–843.PubMedCrossRef
12.
Knapp HD, Taub E, Berman AJ. Movements in monkeys with deafferented forelimbs. Exp Neurol 1963;7:305–315.PubMedCrossRef
13.
Ostendorf CG, Wolf SL. Effect of forced use of the upper extremity of a hemiplegic patient on changes in function. A single-case design. Phys Ther 1981;61:1022–1028.PubMed
14.
Wolf SL, Lecraw DE, Barton LA, Jann BB. Forced use of hemiplegic upper extremities to reverse the effect of learned nonuse among chronic stroke and head-injured patients. Exp Neurol 1989;104:125–132.PubMedCrossRef
15.
Boake C, Noser EA, Ro T, et al. Constraint induced movement therapy during early stroke rehabilitation. Neurorehabil Neural Repair 2007;21:14–24.PubMedCrossRef
16.
Bonifer N, Anderson KM. Application of constraint-induced movement therapy for an individual with severe chronic upper-extremity hemiplegia. Phys Ther 2003;83:384–398.PubMed
17.
Koyama T, Sano K, Tanaka S, Hatanaka T, Domen K. Effective targets for constraint induced movement therapy for patients with upper-extremity impairment after stroke. NeuroRehabilitation 2007;22:287–293.PubMed
18.
Taub E, Uswatte G, King DK, Morris D, Crago JE, Chatterjee A. A placebo-controlled trial of constraint-induced movement therapy for upper extremity after stroke. Stroke 2006;37:1045–1049.PubMedCrossRef
19.
Dromerick AW, Edwards DF, Hahn M. Does the application of constraint-induced movement therapy during acute rehabilitation reduce arm impairment after ischemic stroke? Stroke 2000;31:2984–2988.PubMedCrossRef
20.
Lin KC, Chang YF, Wu CY, Chen YA. Effects of constraint-induced therapy versus bilateral arm training on motor performance, daily functions, and quality of life in stroke survivors. Neurorehabil Neural Repair 2009;23:441–448.PubMedCrossRef
21.
Wolf SL, Winstein CJ, Miller JP, et al. Effect of constraint-induced movement therapy on upper extremity function 3 to 9 months after stroke: the EXCITE randomized clinical trial. JAMA 2006;296:2095–2104.PubMedCrossRef
22.
Hakkennes S, eating JL. Constraint-induced movement therapy following stroke: a systematic review of randomised controlled trials. Aust J Physiother 2005;51:221–231.PubMedCrossRef
23.
Lllie R, Mateer CA. Constraint-based therapies as a proposed model for cognitive rehabilitation. J Head Trauma Rehabil 2006;21:119–130.CrossRef
24.
Taub E, Uswatte G, Pidikiti R. Constraint-induced movement therapy: a new family of techniques with broad application to physical rehabilitation--a clinical review. J Rehabil Res Dev 1999;36:237–251.PubMed
25.
Morris DM, Taub E, Mark VW. Constraint induced movement therapy: characterizing the intervention protocol. Eura Medicophys 2006;42:257–268.PubMed
26.
Underwood J, Clark PC, Blanton S, Aycock DM, Wolf SL. Pain, fatigue, and intensity of practice in people with stroke who are receiving constraint-induced movement therapy. Phys Ther 2006;86:1241–1250.PubMedCrossRef
27.
Sterr A, Elbert T, Berthold I, Kolbel S, Rockstroh B, Taub E. Longer versus shorter daily constraint-induced movement therapy of chronic hemiparesis: an exploratory study. Arch Phys Med Rehabil 2002;83:1374–1377.PubMedCrossRef
28.
Blanton S, Wilsey H, Wolf SL. Constraint induced movement therapy in stroke rehabilitation: perspectives on future clinical applications. NeuroRehabilitation 2008;23:15–28.PubMed
29.
Eng J, Tang PF. Gait training strategies to optimize walking ability in people with stroke: a synthesis of the evidence. Expert Rev. Neurother 2007;7:1417–36.PubMedCrossRef
30.
Chen G, Patten C. Treadmill training with harness support: selection of parameters for individuals with poststroke hemiparesis. J Rehabil Res Dev 2006;43:485–98.PubMedCrossRef
31.
Hesse S. Recovery of gait and other motor functions after stroke: novel physical and pharmacological treatment strategies. Restor Neurol Neurosci 2004;22:359–69.PubMed
32.
Enzinger C, Dawes H, Johansen-Berg H, et al. Brain activity changes associated with treadmill training after stroke. Stroke 2009;40:2460–2467.PubMedCrossRef
33.
Moseley AM, Stark A, Cameron ID, Pollock A. Treadmill training and body weight support for walking after stroke. Cochrane Stroke Group. Cochrane Database Syst Rev 2005;4:CD002840.
34.
Brandstater ME, de Bruin H, Gowland C, Clark MB. Hemiplegic gait: analysis of temporal variables. Arch Phys Med Rehabil 1983;64:583–87.PubMed
35.
Franceschini M, Carda S, Agosti M, et al. Walking after stroke: what does treadmill training with body weight support add to over ground gait training in patients early after stroke? A single-blind, randomized, controlled trial. Stroke 2009;40:3079–3085.PubMedCrossRef
36.
Ada L, Dean CM, Morris ME, Simpson JM, Katrak P. Randomized trial of treadmill walking with body weight support to establish walking in subacute stroke: the MOBILISE trial. Stroke 2010;41:1237–1242.PubMedCrossRef
37.
Pohl M, Werner C, Holzgraefe M, et al. Repetitive locomotor training and physiotherapy improve walking and basic activities of daily living after stroke: a single-blind, randomized multicentre trial. Clin Rehabil 2007;21:17–27.PubMedCrossRef
38.
Hefftner G, Zucchini W, Jaros G. The electromyogram as a control signal for functional neuromuscular stimulation — part I: autoregressive modeling as a mean of EMG signature discrimination. IEEE Trans Biomed Eng 1998;35:230–237.CrossRef
39.
Olney SJ, Richards C. Hemiparetic gait following stroke, part I: characteristics. Gait Posture 1996;4:136–148.CrossRef
40.
Richards CL, Malouin F, Dean C. Gait in stroke: assessment and rehabilitation. Clin Geriatr Med 1999;15:833–855.PubMed
41.
Pomeroy VM, Pollack A, Baily-Hallam A, et al. Electrostimulation for promoting recovery of movement or functional ability after stroke (review). Cochrane Sys Rev 2006;2:CD003241.
42.
Ring H, Treger I, Gruendlinger L, Hausdorff JM. Neuroprosthesis for foot drop compared with an ankle-foot orthosis: effects on postural control during walking. J Stroke Cerebrovasc Dis 2009;18:41–47.PubMedCrossRef
43.
Embrey DG, Holtz SL, Alon G, Brandsma BA, McCoy SW. Functional electrical stimulation to dorsiflexors and plantar flexors during gait to improve walking in adults with chronic hemiplegia. Arch Phys Med Rehabil 2010;91:687–696.PubMedCrossRef
44.
Powell J, Pandyan AD, Granat M, Cameron M, Stott DJ. Electrical stimulation of wrist extensors in poststroke hemiplegia. Stroke 1999;30:1384–1389.PubMedCrossRef
45.
Brewer BR, MacDowell SK, Worthen-Chaudhari LC. Poststroke upper extremity rehabilitation: a review of robotic systems and clinical results. Top Stroke Rehabil 2007:14:22–44.PubMedCrossRef
46.
Kwakkel G, Kollen B, Krebs HI. Effects of robot-assisted therapy on upper limb recovery after stroke: a systemic review. Neurorehabil Neural Repair 2008;22:111–121.PubMed
47.
Hidler J, Nichols D, Pelliccio M, et al. Advances in the understanding and treatments of stroke impairment using robotics devices. Top Stroke Rehabil 2005;12:22–23.PubMedCrossRef
48.
Krebs HI, Hogan N, Aisen ML, Volpe BT. Robot-aided neurorehabilitation. IEEE Trans Rehabil Eng 1998;6:75–87.PubMedCrossRef
49.
Lum PS, Burgar CG, Shor PC, Majmundar M, Van der Loos M. Robot-assisted movement training compared with conventional therapy techniques for the rehabilitation of upper-limb motor function after stroke. Arch Phys Med Rehabil 2002;83:952–959.PubMedCrossRef
50.
Lo AC, Guarino PD, Richards LG, et al. Robot-assisted therapy for long-term upper-limb impairment after stroke. N Engl J Med 2010;13;362:1772–1783.CrossRef
51.
Schwartz I, Sajin A, Fisher I, et al. The effectiveness of locomotor therapy using robotic-assisted gait training in subacute stroke patients: a randomized controlled trial. PM R 2009;1:516–523.PubMed
52.
Hidler J, Nichols D, Pelliccio M, et al. Multicenter randomized clinical trial evaluating the effectiveness of the Lokomat in subacute stroke. Neurorehabil Neural Repair 2009;23:5–13.PubMed
53.
Westlake KP, Patten C. Pilot study of Lokomat versus manual-assisted treadmill training for locomotor recovery post-stroke. J Neuroeng Rehabil 2009;6:18.PubMedCrossRef
54.
Neisser U. The cognitive approach. In: Cognitive Psychology. New York, NY: Prentice Hall, 1967:3.
55.
Cirstea CM, Ptito A, Levin MF. Feedback and cognition in arm motor skill reacquisition after stroke. Stroke 2006;37:1237–1242.PubMedCrossRef
56.
Malouin F, Belleville S, Richards CL, Desrosiers J, Doyon J. Working memory and mental practice outcomes after stroke. Arch Phys Med Rehabil 2004;85:177–183.PubMedCrossRef
57.
Eskes GA, Barrett AM. Neuropsychological Rehabilitation. In: Neurovascular Neuropsychology. Festa JR, Lazar RM, eds. New York: Springer Science Publications, 2009:281–306.
58.
Heilman KM. Neglect and related disorders. In: Clinical Neuropsychology. Heilman KM, Valenstein E, eds. New York: Oxford University Press, 2003:268–307.
59.
Barrett AM, Burkholder S. Monocular patching in subjects with right hemisphere stroke affects perceptual-attentional bias. J Rehab Res Dev 2006;43:337–346.CrossRef
60.
Riestra AR, Barrett AM. Rehabilitation of spatial neglect. In: Handbook of Clinical Neurology: Neurorehabilitation. Barnes M, Good D, eds. Lochcannon, Stratcannon, UK: Elsevier, 2011;(in press).
61.
Wade DT, Hewer RL, David RM, Enderby PM. Aphasia after stroke: natural history and associated deficits. J Neurol Neurosurg Psychiatry 1986;49:11–16.PubMedCrossRef
62.
Barrett AM, Foundas AL. Apraxia. In: Rizzo M, Eslinger PJ, eds. Principles and Practice of Behavioral Neurology and Neuropsychology Philadelphia: Saunders/Churchill Livingstone/Mosby, 2004:409–422.
63.
Jehkonen M, Laihosalo M, Kettunen JE. Impact of neglect on functional outcome after stroke--a review of methodological issues and recent research findings. Rest Neurol Neurosci 2006;24:209–215.
64.
Pulvermüller F. Brain mechanisms linking language and action. Nature Rev Neuroscience 2005;6:576–582.CrossRef
65.
Berthier M, Pulvermüller F. Neuroscience insights improve neurorehabilitation of poststroke aphasia. Nature Rev Neurol 2011;7:86–97.CrossRef
66.
Pulvermüller F, Neininger B, Elbert T, et al. Constraint-induced therapy of chronic aphasia following stroke. Stroke 2001;32:1621–1626.PubMedCrossRef
67.
Maher LM, Kendall D, Swearengin JA, et al. A pilot study of use-dependent learning in the context of Constraint Induced Language Therapy. J Int Neuropsychol Soc 2006;12:843–852.PubMedCrossRef
68.
Naeser MA, Martin PI, Nicholas M, et al. Improved picture naming in chronic aphasia after TMS to part of right Broca's area: an open-protocol study. Brain Lang 2005;93:95–105.PubMedCrossRef
69.
Weiduschat N, Thiel A, Rubi-Fessen I, et al. Effects of repetitive transcranial magnetic stimulation in aphasic stroke: a randomized controlled pilot study. Stroke 2010;42:409–415.PubMedCrossRef
70.
Galletta E, Rao P, Barrett AM. Transcranial magnetic stimulation: potential progress for language improvement in aphasia. Topics Stroke Rehabil 2011;18(2):87–91.
71.
Fregni F, Boggio PS, Mansur CG, et al. Transcranial direct current stimulation of the unaffected hemisphere in stroke patients. Neuroreport 2005;16:1551–1555.PubMedCrossRef
72.
Iyer MB, Mattu U, Grafman J, Lomarev M, Sato S, Wassermann EM. Safety and cognitive effect of frontal DC brain polarization in healthy individuals. Neurology 2005;64:872–875.PubMedCrossRef
73.
Fregni F, Boggio PS, Nitsche MA, Marcolin MA, Rigonatti SP, Pascual-Leone A. Treatment of major depression with transcranial direct current stimulation. Bipolar Disord 2006;8:203–204.PubMedCrossRef
74.
Baker J, Rorden C, Fridriksson J. Using transcranial direct current stimulation (tDCS) to treat stroke patients with aphasia. Stroke 2010;41:1229–1236.PubMedCrossRef
75.
Hesse S, Werner C, Schonhardt EM, Bardeleben A, Jenrich W, Kirker SG. Combined transcranial direct current stimulation and robot-assisted arm training in subacute stroke patients: a pilot study. Restor Neurol Neurosci 2007;25:9–15.PubMed
76.
Kagan A, Simmons-Mackie N, Rowland A, et al. Counting what counts: A framework for capturing real-life outcomes of aphasia intervention. Aphasiology 2008;22:258–280.CrossRef
77.
Barrett AM, Rothi LJG. Theoretical bases for neuropsychological interventions. In: Eslinger PJ, ed. Neuropsychological interventions: emerging treatment and management models for neuropsychological impairments. New York: Guilford, 2002:16–37.
78.
Raymer AM, Singletary F, Rodriguez A, Ciampitti M, Heilman KM, Rothi LJ. Effects of gesture + verbal treatment for noun and verb retrieval in aphasia J Int Neuropsychol Soc 2006;12:867–882.PubMedCrossRef
79.
Rodriguez A, Raymer AM, Rothi LG. Effects of gesture and semantic-phonologic treatments for verb retrieval. Aphasiology 2006;20:286–297.CrossRef
80.
Richards K, Singletary F, Rothi LJ, Koehler S, Crosson B. Activation of intentional mechanisms through utilization of nonsymbolic movements in aphasia rehabilitation. J Rehabil Res Dev 2002;39:445–454.PubMed
81.
Parkinson, BR, Raymer A, Chang YL, Fitzgerald DB, Crosson B. Lesion characteristics related to treatment improvement in object and action naming for patients with chronic aphasia. Brain Lang 2009;110:61–70.PubMedCrossRef
82.
Buxbaum LJ, Haaland KY, Hallett M, et al. Treatment of limb apraxia: moving forward to improved action. Am J Phys Med Rehabil 2008;87:149–161.PubMedCrossRef
83.
Ochipa C, Rapcsak SZ, Maher LM, Rothi LJ, Bowers D, Heilman KM. Selective deficit of praxis imagery in ideomotor apraxia. Neurology 1997;49:474–480.PubMed
84.
Bowen A, Lincoln NB, Dewey M. Cognitive rehabilitation for spatial neglect following stroke. The Cochrane Database of Systematic Reviews 2002, Issue 2. Art. No. CD003586. doi:10.​1002/​14651858.​CD003586.
85.
Lincoln NB, Bowen A. The need for randomised treatment studies in neglect research. Restor Neurol Neurosci 2006;24:401–408.PubMed
86.
Bowen A, Lincoln N. Rehabilitation for spatial neglect improves test performance but not disability. Stroke 2007;38:2869–2870.CrossRef
87.
Jutai JW, Bhogal SK, Foley NC, Bayley M, Teasell RW, Speechley MR. Treatment of visual perceptual disorders post stroke. Top Stroke Rehabil 2003;10:77–106.PubMedCrossRef
88.
Cappa SF, Benke T, Clarke S, Rossi B, Stemmer B, van Heugten CM. EFNS guidelines on cognitive rehabilitation: report of an EFNS task force. Eur J Neurol 2005;12:665–680.PubMedCrossRef
89.
Cicerone KD, Dahlberg C, Kalmar K, et al. Evidence-based cognitive rehabilitation: recommendations for clinical practice. Arch Phys Med Rehabil 2000;81:1596–1615.PubMedCrossRef
90.
Cicerone KD, Dahlberg C, Malec JF, et al. Evidence-based cognitive rehabilitation: updated review of the literature from 1998 through 2002. Arch Phys Med Rehabil 2005;86(8):1681–92.PubMedCrossRef
91.
Luaute J, Michel C, Rode G, et al. Functional anatomy of the therapeutic effects of prism adaptation on left neglect. Neurology 2006;66:1859–1867.PubMedCrossRef
92.
Teasell R, Salter K, Bitensky J, et al. Perceptual disorders. In: Evidence-Based Review of Stroke Rehabilitation. Available at: www.​ebrsr.​com. Accessed May 2010.
93.
94.
Weinberg J, Diller L, Gordon WA, et al. Visual scanning training effect on reading-related tasks in acquired right brain damage. Arch Phys Med Rehabil 1977;58:479–486.PubMed
95.
Weinberg J, Diller L, Gordon WA, et al. Training sensory awareness and spatial organization in people with right brain damage. Arch Phys Med Rehabil 1979;60:491–496.PubMed
96.
Robertson IH, North N. Active and passive activation of left limbs: influence on visual and sensory neglect. Neuropsychologia 1993;31:293–300.PubMedCrossRef
97.
Kalra L, Perez I, Gupta S, Wittink M. The influence of visual neglect on stroke rehabilitation. Stroke 1997;28:1386–91.PubMedCrossRef
98.
Eskes GA, Butler B, McDonald A, Harrison ER, Phillips SJ. Limb activation effects in hemispatial neglect. Arch Phys Med Rehabil 2003;84:323–8.PubMedCrossRef
99.
Rossi PW, Kheyfets S, Reding MJ. Frensel prisms improve visual perception in stroke patients with homonymous hemianopia or unilateral visual neglect. Neurology 1990;40:1597–9.PubMed
100.
Rossetti Y, Rode G, Pisella L, Fame A, Li L, Boisson D, Perenin MT. Prism adaptation to a rightward optical deviation rehabilitates left hemispatial neglect. Nature 1998;395:166–9.PubMedCrossRef
101.
Serino A, Barbiani M, Rinaldesi ML, Ladavas E. Effectiveness of prism adaptation in neglect rehabilitation: a controlled trial. Stroke 2009;40:1392–1398.PubMedCrossRef
102.
Nys GM, de Haan EH, Kunneman A, de Kort PL, Dijkerman HC. Acute neglect rehabilitation using repetitive prism adaptation: a randomized placebo-controlled trial. Restor Neurol Neurosci 2008;26:1–12.PubMed
103.
Turton A, O’Leary K, Gabb J, Woodward R, Gilchrist I. A single blinded randomized controlled pilot trial of prism adaptation for improving self-care in stroke patients with neglect. Neuropsychol Rehabil 2010;20:180–196.PubMedCrossRef
104.
Fortis P, Kornitzer J, Goedert KM, Barrett AM. Effect of prism adaptation on “aiming” spatial bias and functional abilities. Neurology 2009;72(suppl 1):A332.
105.
Robertson IH, Ridgeway V, Greenfield E, Parr A. Motor recovery after stroke depends on intact sustained attention: a 2-year follow-up study. Neuropsychology 1997;11:29029–5.
Metadata
Title
Rehabilitation—Emerging Technologies, Innovative Therapies, and Future Objectives
Authors
Nneka L. Ifejika-Jones
Anna M. Barrett
Publication date
01-07-2011
Publisher
Springer-Verlag
Published in
Neurotherapeutics / Issue 3/2011
Print ISSN: 1933-7213
Electronic ISSN: 1878-7479
DOI
https://doi.org/10.1007/s13311-011-0057-x

Other articles of this Issue 3/2011

Neurotherapeutics 3/2011 Go to the issue

Review

Treatment of Risk Factors to Prevent Stroke

Review

Treatment Targets in Intracerebral Hemorrhage

Review

Investigational Therapies for Ischemic Stroke: Neuroprotection and Neurorecovery

Review

Intra-arterial Therapy for Acute Ischemic Stroke

Review

Treatment of Acute Ischemic Stroke: Beyond Thrombolysis and Supportive Care

ReviewPaper

Antiplatelet Agents for Stroke Prevention