Stroke Awareness Month: Technology for Recovery

May is Stroke Awareness Month, organized by the American Heart Association. Every 40 seconds, someone in the US has a stroke. Stroke is a leading cause of disability in America and reduces mobility in more than half of stroke survivors 65 and older. Stroke survivors may experience paralysis, trouble thinking, problems understanding or forming speech, problems with bowel and bladder control, and other long-term disabilities. New research is developing and testing technology that may help stroke survivors regain their independence, even if some of these conditions persist. These are some of the current NIDILRR-funded projects working in the areas of robotics, web-based rehabilitation, sensors for effective measurement of disability and recovery, and tech for mobility and participation.

Tech to Recover at Home

Efficacy of an Interactive Web-Based Home Therapy Program in the Recovery of Arm and Hand Following Stroke: A Randomized Trial investigates the efficacy and feasibility of using a free, easy-to-use, interactive web-based upper extremity stroke rehabilitation program on individuals with stroke who have been discharged from rehabilitation.

Robotics for Recovery

Rehabilitation Engineering Research Center (RERC) on Wearable Robots for Independent Living conducts research and development activities focused on wearable robots for independent mobility and manipulation. Among the activities of this center is a project to study the possible improvement in gait after stroke caused by using exoskeletons early in the rehabilitation process. Another project studies the benefit of home-based robotic rehabilitation of the upper extremities in persons who have had a stroke, employing the new upper extremity exoskeleton being developed by the New Jersey Institute for Technology.

RERC on Patient-Centered, Home-Based Technologies to Assess and Treat Motor Impairment in Individuals with Neurologic Injury promotes rehabilitation engineering-based devices, strategies, techniques, and interventions that can facilitate activity and mobility following neurologic injuries, specifically home-based technologies for treating motor impairments. Among its development projects is a study to develop wearable upper extremity exoskeletons that can be integrated into activities of daily living for individuals with stroke.

Collaborative Machines Enhancing Therapies (COMET) focuses on advancing technologies that work in partnership with patients and clinicians to enhance gait and dexterity outcomes for individuals with stroke and spinal cord injury and other people with disabilities in a real-life rehabilitation setting. This includes a project to evaluate a novel soft wearable robot (exosuit) suitable for in-patient rehabilitation. The device increases walking and functional mobility capacity through the unique use of force-transmitting conformal textiles that anchor to the body, proximally-mounted cable-based actuation systems, and adaptive control algorithms that use the minimum number of sensors. A second research project leverages the knowledge gained from developing a complex robotic treadmill, the KineAssist MX, in order to refine and rigorously test a simpler, clinically-viable collaborative machine —the ResistX S/B — focused specifically on re-training force generation in the paretic limb.

Measuring for Effective Rehab

Sensor Technology Applied to Rehabilitation in Stroke – STARS designs, develops, and tests sensors suitable for measure of impairment in stroke survivors, and conducts studies to determine the feasibility of implementing these devices in routine practice. The goal of this project is to enhance the capacity of clinicians to provide evidence-based, individualized, and precise therapy, and to measure impairment by developing and testing a range of sensors suitable for clinical use, understanding that these clinicians play a pivotal role in implementing routine rehabilitation care.

Rehabilitation Interventions Based on Accurate Assessments with Combined Home-Hospital Rehabilitation champions innovative technologies/approaches for assessment-based rehabilitation with combined hospital-home rehabilitation that will improve therapeutic outcomes among individuals with neurologic disorders and older adults with disabilities. Many rehabilitation technologies including rehabilitation robots have been developed and applied to rehabilitation successfully. However, there is a lack of combined accurate assessment and treatment protocols and devices that evaluate and treat specific impairments. This RERC develops and tests devices and techniques that may increase the volume and effectiveness of impairment-specific therapies.

RERC on Patient-Centered, Home-Based Technologies to Assess and Treat Motor Impairment in Individuals with Neurologic Injury, described above, studies clinically-accepted, objective methods of assessing spontaneous use of impaired limbs in the home and community, including machine learning algorithms and wrist worn accelerometry for objectively measuring the amount of functional arm use in persons with stroke.

Tech for Mobility and Participation

MiGo Plus: The First Activity-Based, Peer-Supported Social Network for Improving Quality of Life After Stroke is in the early development stages. MiGo Plus aims to improve motor capacity and performance as well as provide support for individuals with stroke throughout their recovery and improve their quality of life. MiGo Plus uses custom wrist and hip-worn sensors developed and validated for individuals with stroke to monitor their arm and walking activity, along with a smartphone app to connect users with other stroke survivors for encouragement and collaboration.

Comparative Effectiveness of Off-the-Shelf (OTS) Versus Custom-Made Ankle-Foot Orthosis in Individuals with Stroke compares the effectiveness of two commonly used ankle-foot orthoses (AFOs) types: (1) prefabricated, OTS semi-rigid polypropylene, and (2) a custom-made polypropylene articulating AFO with a dorsiflexion stop and dorsiflexion spring assistance for individuals with intermediary deficits in walking function post-stroke. AFOs are frequently prescribed for patients with hemiplegia to enhance walking function.

Technologies to Evaluate and Advance Mobility and Manipulation (TEAMM) Rehabilitation Engineering Research Center develops technologies to evaluate and advance mobility and manipulation for people with movement disabilities, including stroke survivors. Among its development projects is a study to modify a smart, wearable airbag system with custom smartphone application to sense falls in stroke survivors, and evaluate whether use of this system can mitigate fall injuries and improve walking confidence.

The Center for Enhancing Neurocognitive Health, Abilities, Networks, and Community Engagement (ENHANCE) conducts research and development to support the ability of older adults with cognitive disabilities to live independently in the community. The Center includes a research project to develop and evaluate an adaptive intelligent software system that supports memory, everyday skills, and social engagement. A development project focuses on an instructional support aid for community mobility, and a second development project focuses on a cognitive aid to support prospective memory activities such as remembering medication schedules.

These are just a few of the projects NIDILRR has funded to support recovery and rehabilitation of stroke survivors. Explore more current and completed project descriptions in the NIDILRR Program Database. NARIC’s REHABDATA database has thousands of articles related to stroke recovery. Here are some abstracts of research from the NIDILRR grantee community

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