Effects of assistive systems in neurorehabilitation: recovery of sensory-motor functions

Background. Central nervous system (CNS) injury/disease (e.g., stroke) leads to disability that greatly decreases the quality of life. Research and clinical practice suggest that the recovery of sensorimotor (SM) functions in humans with CNS lesions can be enhanced and speeded up with the timely and effective application of assistive systems (AS) such as neural prostheses (NP) and haptic robots (HR). Objective. Quantification of effects of NP and HR integrated into the therapy, and design of new therapy modalities that combine AS into intensive and task oriented exercise. Methods. Quantification of: synergies before and after use of AS; carry over effects of AS related to clinical measures of disability; and changes in SM systems (central pattern generator, reflexes, cortical excitability) related to the function and lesion based on motion sensors, EMG and evoked potentials, and clinical scales. The AS will include: NP based on functional electrical stimulation (FES) for activation of afferent/efferent pathways; assistive robots that guide movement; HR that provide controlled both interaction and patient participation in movement; integrated HR and FES. All modalities will consider motivation (virtual reality, biofeedback). The target group: hemiplegic patients. Expected results. 1) Knowledge about immediate-, short-, and long-term effects of AS on the functioning. 2) New optimized therapies (time to start, duration, dosage, assessment methods, follow up) in stroke patients.