Emerging Technologies for Improving Access to Movement Therapy following Neurologic Injury

A disturbing paradox has developed between rehabilitation research and practice in the last decade. On the one hand, scientific evidence has accumulated that therapy improves movement recovery following stroke and spinal cord injury. On the other hand, the duration of reimbursed therapy has decreased due to economic pressures on the U.S. health care system. If intensive therapy stimulates recovery, an important goal is to develop technology that allows people with neurologic injuries to practice therapy without always requiring one-on-one interactions with clinicians. In this chapter, we first discuss key elements of this paradox and how technology may help address those elements. We then review several recent attempts to automate movement therapy for both upper and lower extremity rehabilitation. In conclusion, we pose three questions that we believe will shape the future development and use of this technology.