Neurorehabilitation Technology - V. Dietz, et. al., (Springer, 2012) WW.pdf - Bio Med 18 - hilakku

Neurorehabilitation Technology

Volker Dietz • Tobias Nef

William Zev Rymer

Editors

Neurorehabilitation

Technology

Editors

Volker Dietz, M.D., FRCP

Spinal Cord Injury Center

University Hospital Balgrist

Zurich

Switzerland

Tobias Nef, Ph.D.

Gerontology and Rehabilitation Group

ARTORG Center for Biomedical

Engineering Research

University of Bern

Switzerland

William Zev Rymer, M.B.B.S., Ph.D.

Searle Research Center

Rehabilitation Institute of Chicago

Chicago, Illinois

USA

ISBN 978-1-4471-2276-0

e-ISBN 978-1-4471-2277-7

DOI 10.1007/978-1-4471-2277-7

Springer London Dordrecht Heidelberg New York

British Library Cataloguing in Publication Data

A catalogue record for this book is available from the British Library

Library of Congress Control Number: 2011944229

Apart from any fair dealing for the purposes of research or private study, or criticism or review,

as permitted under the Copyright, Designs and Patents Act 1988, this publication may only be

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outside those terms should be sent to the publishers.

The use of registered names, trademarks, etc., in this publication does not imply, even in the

absence of a speciﬁ c statement, that such names are exempt from the relevant laws and regula-

tions and therefore free for general use.

Product liability: The publisher can give no guarantee for information about drug dosage and

application thereof contained in this book. In every individual case the respective user must

check its accuracy by consulting other pharmaceutical literature.

Printed on acid-free paper

Springer is part of Springer Science+Business Media (www.springer.com)

Foreword

Physical therapy is hard work. For the person undergoing neurorehabilitation,

many factors, including frustration and the seemingly slow pace of visible

improvement, stand in the way of neuromuscular recovery and functional

gain. But what are the most effective rehabilitation strategies? What combi-

nation of these strategies provides the best overall outcome? What clinical

scales offer the most accurate representation of functional change and quality

of life? And, perhaps most important for the forward-looking clinician, is

healthcare research addressing and funding this complex domain adequately?

How could we develop effective techniques faster and deploy them with more

conﬁ dence? If therapy is hard work for the patient, then navigating therapy

research is similarly challenging to the practitioner. Then there is the infuriat-

ing corollary to the inherently slow pace of neurologic recovery: rehabilita-

tion research studies depend on human-subjects testing, which is rate-limited,

of course, by that same, slow pace of neural system recovery. We can’t win!

Or can we? Three factors stand in our favor. First, the value of effective

rehabilitation to society is increasingly being acknowledged, from a quality of

life perspective, as the sheer number of people with disabilities is increasing in

most of the world’s cultures today and as medical advances in, for example,

acute-phase stroke management and spinal cord injury repair are thankfully

saving lives yet increasing the number of people living with a disability.

Secondly, on par with global warming, the economics of healthcare are fright-

ening futurists (and our children) to consider seriously the long-term progno-

sis of our species. These two factors are the “push” to drive toward better

solutions. The third is a “pull”: mechatronics technology. As the costs of com-

putational power and MEMS-based sensing/actuating/control components

decrease, we can focus more on effective, robust therapy and less on ﬂ aky,

bulky, expensive hardware. The end result is that rehabilitation research has

been signiﬁ cantly empowered in recent years to expand its horizons. In the

past decade, as a result, robots have for the ﬁ rst time actually been deployed in

the clinic, not just in surgery, but in rehabilitation as well. Whereas in the past,

researchers were focused on replicating therapist interventions with robot

assistants, today we are moving on to envisioning interventions that therapists

can design and guide, but that only robots can perform, due to the complex

adaptive control interactions between sensors, the interface, and actuators. We

have come a long way in the past 30 pioneering years of rehabilitation

robotics.

Neurorehabilitation Technology - V. Dietz, et. al., (Springer, 2012) WW.pdf

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