A systematic literature review of the use and effectiveness of the Computer Assisted Rehabilitation Environment for research and rehabilitation as it relates to the wounded warrior.

Abstract

Several U.S. military treatment and research facilities employ a Computer Assisted Rehabilitation Environment (CAREN) [Motek Medical BV, Amsterdam, The Netherlands] for research and rehabilitation of complex injuries exhibited by Wounded Warriors. There has been little scientific evidence of the effectiveness of this type of system for rehabilitation. A systematic review of the literature was completed to determine what type of work has been performed on the CAREN and report findings of clinical significance. Specific terms were searched on electronic databases to include journal articles, abstracts, and peer-reviewed conference proceedings related to the CAREN. Twenty-six publications were elicited that met our criteria. These were divided by their primary focus: rehabilitation, clinical research, and technical reports. Results from published articles have determined that the system is a capable tool for both assessment and rehabilitation, but little has currently been published, particularly on patient populations. More research needs to be performed to evaluate its effectiveness as a rehabilitation tool compared to other rehabilitation methods. It is expected that a system, such as the CAREN, will challenge patients multifactorially (e.g. physically and cognitively) and provide biofeedback while decreasing rehabilitation time and increasing effectiveness of treatment.