Wearable technology in stroke rehabilitation: towards improved diagnosis and treatment of upper-limb motor impairment

Pablo Maceira-Elvira, Traian Popa, Anne-Christine Schmid, Friedhelm C Hummel, Pablo Maceira-Elvira, Traian Popa, Anne-Christine Schmid, Friedhelm C Hummel

Abstract

Stroke is one of the main causes of long-term disability worldwide, placing a large burden on individuals and society. Rehabilitation after stroke consists of an iterative process involving assessments and specialized training, aspects often constrained by limited resources of healthcare centers. Wearable technology has the potential to objectively assess and monitor patients inside and outside clinical environments, enabling a more detailed evaluation of the impairment and allowing the individualization of rehabilitation therapies. The present review aims to provide an overview of wearable sensors used in stroke rehabilitation research, with a particular focus on the upper extremity. We summarize results obtained by current research using a variety of wearable sensors and use them to critically discuss challenges and opportunities in the ongoing effort towards reliable and accessible tools for stroke rehabilitation. Finally, suggestions concerning data acquisition and processing to guide future studies performed by clinicians and engineers alike are provided.

Keywords: Home-based; Monitor; Motor function; Rehabilitation; Remote; Stroke; Telemedicine; Wearable technology.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
IMU sensors (orange) used to track arm movements. Sensors placed on the back of the hands, forearms and upper arms capture acceleration (linear and angular) and orientation of each segment, allowing kinematic reconstruction or movement characterization
Fig. 2
Fig. 2
EMG sensors (green) placed over biceps and flexor digitorum superficialis muscles, involved in elbow and wrist flexion, respectively. Electrodes placed asymmetrically with respect to the neuromuscular plaques allow capturing the electrical potential difference as the depolarization wave travels along the muscle cells’ membranes. Resulting signal (top left) is filtered and amplified for further processing
Fig. 3
Fig. 3
Encoder (blue) mounted on a hand orthosis, aligned with the rotation axis of the index finger. This configuration allows tracking angular displacement of fingers supported by the orthosis
Fig. 4
Fig. 4
Flexible sensors (red) laid along the fingers. Their flexion results in piezo-resistive changes in the conducting material (e.g. silver nanoparticles), which map directly to different finger positions. Prototype IMU sensor glove by Noitom [84]

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Source: PubMed

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