Review Article
Volume 12 Issue 6 - 2020
Stroke Rehabilitation: A Role for the New Technologies?
Madalena Bettencourt1 and João Casaca-Carreira2*
1Physiotherapist, Insurance Company, Fidelidade, Portugal
2Physiotherapy Department, Portuguese Red Cross Health School, Lisbon and Physiotherapy Department, School of Health, Setúbal Polytechnic Institute, Portugal
*Corresponding Author: João Casaca-Carreira, Physiotherapy Department, Portuguese Red Cross Health School, Lisbon and Physiotherapy Department, School of Health, Setúbal Polytechnic Institute, Portugal.
Received: April 16, 2020; Published: May 15, 2020


Background: Stroke is a disease of the central nervous system caused by the reduction or interruption of a vessel on the brain. The prevalence of stroke consequences, not only physical but also psychological and social, tend to increase in the years after stroke, being rehabilitation the most important part of the process. With the emergence of new technologies, stroke rehabilitation benefited from important improvements.

Purpose: The purpose of this study is to understand the role of new interventions on the rehabilitation of stroke patients with hemiplegia and body asymmetry.

Results: Standard therapy, Bobath concept, Induced Constraint Movement Therapy, Mirror Therapy, Force Plate Feedback, Virtual Reality and Robot Therapy are described and the evidence supporting each approach is presented. Based on the studies mentioned above, the new approaches that have been more studied and shown more results are the Virtual Reality and the Robot Therapy.

Conclusion: In summary, these studies reveal that the new therapeutic approaches should be used as a complement of the standard therapy.

Keywords: Stroke; New Technologies; Rehabilitation


  1. Lee D., et al. “Asymmetric training using virtual reality reflection equipment and the enhancement of upper limb function in stroke patients: A randomized controlled trial”. Journal of Stroke and Cerebrovascular Diseases 6 (2014): 1319-1326.
  2. Stroke, Cerebrovascular accident. Who, Health Topics.
  3. Tadi P LF. “Acute Stroke (Cerebrovascular Accident)”. Stat Pearls (FL) TI (2020).
  4. Norouzi-Gheidari N., et al. “Effects of robot-assisted therapy on stroke rehabilitation in upper limbs: Systematic review and meta-analysis of the literature”. Journal of Rehabilitation Research and Development 4 (2012): 479-496.
  5. I Badia SB., et al. “Combining virtual reality and a myoelectric limb orthosis to restore active movement after stroke”. International Journal on Disability and Human Development3 (2014):153-166.
  6. Kauhanen M-L. “Quality of life after stroke: Clinical, functional, psychosocial and cognitive correlates” (1999): 88.
  7. S SDBKCTG. Middle Cerebral Artery Stroke. Med Scape.
  8. Meretoja A., et al. “Trends in treatment and outcome of stroke patients in Finland from 1999 to 2007. PERFECT Stroke, a nationwide register study”. Annals of Medicine (2011): 43.
  9. Högg S., et al. “Upper limb strength training in subacute stroke patients: Study protocol of a randomised controlled trial”. Trials1 (2019): 1-11.
  10. Kim J., et al. “Kinematic analysis of head, trunk, and pelvic motion during mirror therapy for stroke patients”. The Journal of Physical Therapy Science 10 (2017): 1793-1799.
  11. Recovery Stroke (2019).
  12. Díaz-Arribas MJ., et al. “Effectiveness of the Bobath concept in the treatment of stroke: a systematic review”. Disability and Rehabilitation (2019): 1-14.
  13. Levin MF., et al. “Emergence of Virtual Reality as a Tool for Upper Limb Rehabilitation: Incorporation of Motor Control and Motor Learning Principles”. Physical Therapy 3 (2015): 415-425.
  14. Güçlü Gündüz A., et al. “The effects of early neurodevelopmental bobath approach and mobilizatioquadriceps muscle thickness in stroke patients”. Turkish Journal of Medical Sciences 1 (2019): 318-326.
  15. M Rsmll-E. “Bobath Concept - Theory and Clinical Practice in Neurological Rehabilitation”. Blackwell Publishing (2009).
  16. Pumprasart T., et al. “The effect of the Bobath therapy programme on upper limb and hand function in chronic stroke individuals with moderate to severe deficits”. International Journal of Therapy and Rehabilitation 10 (2019).
  17. Taub E and Uswatte G. “Constraint-Induced Movement therapy: Answers and questions after two decades of research”. Neuro Rehabilitation 2 (2006): 93-95.
  18. Morris DM., et al. “Constraint-induced movement therapy: characterizing the intervention protocol”. Europa Medicophysica 3 (2006): 257-268.
  19. Ju Y and Yoon IJ. “The effects of modified constraint-induced movement therapy and mirror therapy on upper extremity function and its influence on activities of daily living”. The Journal of Physical Therapy Science 1 (2018): 77-81.
  20. Barzel A., et al. “Comparison of two types of Constraint-Induced Movement Therapy in chronic stroke patients: A pilot study”. Restorative Neurology and Neuroscience 6 (2009): 673-680.
  21. Szaflarski JP., et al. “Cortical Reorganization Following Modified Constraint-Induced Movement Therapy: A Study of 4 Patients with Chronic Stroke”. Archives of Physical Medicine and Rehabilitation 8 (2006): 1052-1058.
  22. Fuentes MA., et al. “Combined Transcranial Direct Current Stimulation and Virtual Reality-Based Paradigm for Upper Limb Rehabilitation in Individuals with Restricted Movements. A Feasibility Study with a Chronic Stroke Survivor with Severe Hemiparesis”. The Journal of Medical Systems 5 (2018): 87.
  23. Henderson A., et al. “Virtual reality in stroke rehabilitation: A systematic review of its effectiveness for upper limb motor recovery”. Topics in Stroke Rehabilitation 2 (2007): 52-61.
  24. Van Peppen RPS., et al. “Effects of visual feedback therapy on postural control in bilateral standing after stroke: A systematic review”. Journal of Rehabilitation Medicine 1 (2006): 3-9.
  25. Hsieh HC. “Use of a Gaming Platform for Balance Training After a Stroke: A Randomized Trial”. Archives of Physical Medicine and Rehabilitation 4 (2019): 591-597.
  26. Barclay-Goddard R., et al. “Force platform feedback for standing balance training after stroke”. Stroke 2 (2005): 412-413.
  27. Silva MG., et al. “Development of a low cost force platform for biomechanical parameters analysis”. Research on Biomedical Engineering 3 (2017): 259-268.
  28. Saposnik G and Levin M. “Virtual reality in stroke rehabilitation: A meta-analysis and implications for clinicians”. Stroke5 (2011): 1380-1386.
  29. Holden MK and Dyar T. “Virtual environment training: A New Tool for Neurorehabilitation”. Reports in Neurological 2 (2002): 62-71.
  30. Tieri G., et al. “Virtual reality in cognitive and motor rehabilitation: facts, fiction and fallaciesv”. Expert Review of Medical Devices 2 (2018): 107-117.
  31. Turolla A., et al. “Virtual reality for the rehabilitation of the upper limb motor function after stroke: A prospective controlled trial”. Journal of NeuroEngineering and Rehabilitation 1 (2013): 1-9.
  32. Laver KE., et al. “Virtual reality for stroke rehabilitation”. Cochrane Database Syst Rev 11 (2017).
  33. Bryce TN., et al. “Framework for assessment of the usability of lower-extremity robotic exoskeletal orthoses”. American Journal of Physical Medicine and Rehabilitation 11 (2015): 1000-1014.
  34. Kwakkel G., et al. “Effects of robot-assisted therapy on upper limb recovery after stroke: A systematic review”. Neurorehabilitation and Neural Repair 2 (2008): 111-121.
  35. Lo AC., et al. “Robot-assisted therapy for long-term upper-limb impairment after stroke”. The New England Journal of Medicine 19 (2010): 1772-1783.
  36. Hadjidj A., et al. “Wireless Sensor Networks for Rehabilitation Applications: Challenges and Opportunities”. To cite this version: HAL Id: hal-00762929 Wireless Sensor Networks for Rehabilitation Applications: Challenges and Opportunities (2013).
  37. Yoo DH and Kim SY. “Effects of upper limb robot-assisted therapy in the rehabilitation of stroke patients”. The Journal of Physical Therapy Science 3 (2015): 677-679.
  38. Uivarosan D., et al. “Effects of combining modern recovery techniques with neurotrophic medication and standard treatment in stroke patients”. Science of the Total Environment 679 (2019): 80-87.
  39. Todd H Wagner., et al. “An Economic Analysis of Robot-Assisted Therapy for Long Term Upper-Limb Impairment After Stroke”. Stroke9 (2011): 2630-2632.
Citation: Madalena Bettencourt and João Casaca-Carreira. “Stroke Rehabilitation: A Role for the New Technologies?”. EC Neurology 12.6 (2020): 33-39.

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