Abstract
Reduced hand dexterity is a common component of sensorimotor impairments for individuals after stroke. To improve hand function, innovative rehabilitation interventions are constantly developed and tested. In this context, technology-based interventions for hand rehabilitation have been emerging rapidly. This paper offers an overview of basic knowledge on post lesion plasticity and sensorimotor integration processes in the context of augmented feedback and new rehabilitation technologies, in particular virtual reality and soft robotic gloves. We also discuss some factors to consider related to the incorporation of augmented feedback in the development of technology-based interventions in rehabilitation. This includes factors related to feedback delivery parameter design, task complexity and heterogeneity of sensory deficits in individuals affected by a stroke. In spite of the current limitations in our understanding of the mechanisms involved when using new rehabilitation technologies, the multimodal augmented feedback approach appears promising and may provide meaningful ways to optimize recovery after stroke. Moving forward, we argue that comparative studies allowing stratification of the augmented feedback delivery parameters based upon different biomarkers, lesion characteristics or impairments should be advocated (e.g., injured hemisphere, lesion location, lesion volume, sensorimotor impairments). Ultimately, we envision that treatment design should combine augmented feedback of multiple modalities, carefully adapted to the specific condition of the individuals affected by a stroke and that evolves along with recovery. This would better align with the new trend in stroke rehabilitation which challenges the popular idea of the existence of an ultimate good-for-all intervention.
Highlights
Stroke is defined as an interruption of blood supply in the brain that causes neural damages
Only 5 to 20% of individuals affected by a stroke regain satisfactory hand function while over 60% remain unable to use their paretic hand 6 months after stroke [14]
The objective of this paper is to review the basic knowledge on post lesion plasticity and sensorimotor integration processes in the context of augmented feedback in virtual reality and soft robotic gloves used for post-stroke rehabilitation of the hand
Summary
Stroke is defined as an interruption of blood supply in the brain that causes neural damages. Most individuals who sustain a stroke are challenged by a reduction of hand dexterity and hand-related functional capacities [2–5]. Successful sensorimotor training relies on task-specific practice in which individuals affected by a stroke engage in meaningful goal-directed tasks with the intention of acquiring new skills [6]. The tasks trained should be challenging enough to require learning [7], be adaptable in order to calibrate to the person’s progress, be intensive (e.g., elevated number of repetitions) and practiced rapidly after a stroke. These tasks should require attention and focus (i.e., active participation) from the subject [8–10]
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