Neuroengineering methods to support stroke rehabilitation and assessment: from clinical requirements toward new technologies and their clinical translation
Stroke is the main cause of acquired adult disability in high-income countries, with hemiparesis affecting about 80% of stroke survivors. Restoration of gait is one of the main goals of stroke rehabilitation, while the recovery of arm functions is crucial for the capability to perform activities of daily life, which increases independence and quality of life. Neuroplasticity is the basic mechanism for functional recovery after stroke. Rehabilitative interventions should make effective use of neuroplasticity, proposing high-intensity, repetitive, task-specific, interactive and individualized training. Neuroengineering methods, including Functional Electrical Stimulation (FES), robotic devices and muscle synergies analysis, may play a crucial role in the design of novel subject-specific and high-intense interventions, which allow the participants to progress in task difficulty during training, so as to increase their motivation. Specifically, FES increases the afference feedback provided to the central nervous system and, mainly when synchronized with the efferent signal produced by the subject’s residual muscle activation, may enhance neural plasticity. Robotic devices allow intensive and highly repetitive training of complex task-oriented movements, with a reduced effort for the therapists. Muscle synergies analysis provides a deep understanding of the subject-specific impairment of motor coordination and may contribute to the design of customized training. Neuroengineering methods, from neuroimaging to Transcranial Magnetic Stimulation and multi-channel surface EMG analysis, may help also the design of assessment tests which provides insights on neural reorganization and motor recovery after stroke. This seminar will present an overview of some of these methods supporting both the design of rehabilitative interventions based on neuroplasticity principles as well as the assessment of functional outcomes and neural correlates. Examples of clinical applications within randomized controlled studies aimed at demonstrating their effectiveness will be also provided.
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Monday, October 21st 2019, h14.30
Sala Lauree Psicologia, U6 Building, third floor
Free entry.
Info:
Prof. Maria Teresa Guasti