The 3Ts of the new millennium neurorehabilitation gym: therapy, technology, translationality

Rehabilitation has been defined as the ‘sleeping giant’ of medicine, thus further efforts to improve its quality care standards are required [1]. Accordingly, there is on one side a need to optimize the trade-off between the number of people treated, the intensity and length of treatment, and the healthcare costs on the other. As such, this objective is not easy to achieve, especially when considering the complexity of neurological disorders like stroke, traumatic brain injuries, Parkinson’s disease, and multiple sclerosis. To obtain an increment in efficacy, a deeper knowledge of the involved complex neural mechanisms is needed. In addition to pathophysiological mechanisms, also biopsychosocial factors, biological and genetic expression factors related to the recovery of the independency of a person should be explored. Over the last 20 years, the neurorehabilitation theory has undergone a revolution due to the influence of advancements in neuroscience and neurotechnology. These gave rise to the introduction of some principles like the massed task practice, the top–down approach, and to the diffusion of new technologies like virtual reality systems, neurorobots, muscle and neural electromagnetic stimulators, and wearable devices [2]. We recently had the opportunity to redesign a neurorehabilitation gymnasium in accordancewith themost recent and important neuroscientific findings and technological solutions. Being inspired by virtual systems’ design which is based on the 3I principles of immersion, interaction, and imagination [3] and by the design in robotics usually defining the 3Ds, dull, dirty, and/or dangerouswork performed by robots [4], we also implemented an approach based on 3 Ts: therapy, technology, and translationality.