Towards Minimally-Supervised, Technology-Assisted Neurorehabilitation in the Clinic and at Home

Routine rehabilitation after a neurological injury such as stroke is typically limited to a few weeks or months following the insult, and recovery is strongly dependent on the therapy intensity, compliance and motivation of the individual patient. Following their return home, many individuals perform activities of daily living with their unaffected upper limb, leading to a phenomenon termed “learned non-use”, and potentially resulting in a functional decline. To date, little is known about the transfer of rehabilitation therapies into activities of daily living in the home environment, nor about the potential of technology to prevent functional decline or even further promote recovery following discharge from the clinic. In this talk I will present assessment, therapy and assistive technologies we are developing for minimally-supervised use in the clinic and in the home environment to promote upper limb function following neurological injury. This involves robot-assisted assessments of both motor and somatosensory deficits, enabling independent assessment-driven therapy of hand function that is both engaging and challenging from the very first session, and continuously adapts to the current abilities of the user. This concept has been successfully integrated into the daily routine of a rehabilitation clinic. For less severely impaired patients, we have developed a sensor-based arm therapy system which selects reaching targets based on integrated assessments, and prevents compensatory movements. This system was evaluated in 11 chronic stroke survivors in the home environment over a period of 6 weeks, and resulted in motivating and intense training. Finally, I will present our efforts to integrate wearable robotics and sensing with the aim of fusing the concepts of therapy and assistance to promote independence in everyday activities.

Bio:
Roger Gassert is Associate Professor of Rehabilitation Engineering at ETH Zurich. He received an M.Sc. degree in microengineering and a PhD degree in neuroscience robotics from the Ecole Polytechnique Fédérale de Lausanne (EPFL), Switzerland, in 2002 and 2006, respectively. Following postdoctoral positions at Imperial College London, UK, Simon Fraser University, Canada, and ATR International, Japan, he was appointed Assistant Professor of Rehabilitation Engineering at ETH Zurich in 2008. His research is concerned with the development and application of robotics, wearable sensor technologies and non-invasive neuroimaging to assess, explore and restore human sensorimotor function after neurological injury.
Roger Gassert is vice-president of the strategic advisory board of the CYBATHLON, a championship for people with disabilities competing with advanced assistive devices, and founding member of the International Consortium for Rehabilitation Robotics. He is a member of the foundation board of Access for all and the Cereneo center for interdisciplinary research in telerehabilitation, and member of the advisory board of the Innovation Centre for Assistive Technology of the Swiss Paraplegic Foundation.