Progress in sensorimotor rehabilitative physical therapy programs for stroke patients

Abstract

Impaired motor and functional activity following stroke often has negative impacts on the patient, the family and society. The available rehabilitation programs for stroke patients are reviewed. Conventional rehabilitation strategies (Bobath, Brunnstrom, proprioception neuromuscular facilitation, motor relearning and function-based principles) are the mainstream tactics in clinical practices. Numerous advanced strategies for sensory-motor functional enhancement, including electrical stimulation, electromyographic biofeedback, constraint-induced movement therapy, robotics-aided systems, virtual reality, intermittent compression, partial body weight supported treadmill training and thermal stimulation, are being developed and incorporated into conventional rehabilitation programs. The concept of combining valuable rehabilitative procedures into "a training package", based on the patient's functional status during different recovery phases after stroke is proposed. Integrated sensorimotor rehabilitation programs with appropriate temporal arrangements might provide great functional benefits for stroke patients.

Keywords: Rehabilitation; Sensory stimulation; Stroke; Thermal stimulation.

Figures

Figure 1

Schematic flowchart for selecting from the available rehabilitation strategies for stroke patients with impairments of various severity levels during different stroke phases. Functional recovery from a severe to moderate and mild condition after stroke is indicated by arrows with indications of the progression of recovery and unrecovery. Appropriate advanced rehabilitation technique(s) combined with conventional rehabilitation are selected to maximize the patient’s functional recovery according to his/her initial motor function (mild, moderate or severe) in the clinic. ADLs: Activities of daily living; CIMT: Constraint induced movement therapy; ES: Electrical stimulation; PBWSTT: Partial body weight supported treadmill training; PNF: Proprioceptive neuromuscular facilitation; TS: Thermal stimulation.