Chronic stroke is a common cerebrovascular disease consequence which frequently affects elderly. Most of the patients suffer from long term disability resulting in mental and various physical health problems. Currently, treatments of acute stroke are including medical method (rt-PA thrombolysis), endovascular method (clot retrieval) and decompressive surgery. Even though these several developed treatments have significantly reduced morbidity and mortality from stroke, a number of patients still have to face with some incurable impairments. Those patients need sustained and effective rehabilitation to help them capable for normal daily life.
Chronic stroke rehabilitation needs multidisciplinary expertise incorporated of physiatrist, physiotherapist and occupational therapist. Patient and family cooperations also play an important role in this process especially in severe disabilities whom desired long term treatment. Therefore, the utilization of innovative technologies for chronic stroke treatment such as robot-assisted therapy and transcranial magnetic stimulation can improve effectiveness of rehabilitation and expedite stroke recovery.
The robot-assisted arm and gait training are innovative medical devices for rehabilitating muscular weakness patients. The robot-assisted gait training device(Lokomat) stimulates somatosensory feedbacks from muscles, joints and vision to patient’s brain. These feedbacks enhance neuroplasticity which resulting in better recovery of balance and gait functions when compare to conventional rehabilitation. The robot-assisted arm training device(Armeo) virtually simulate the usage of patient’s arm in daily life activities. These robot-assisted therapies yield favorable outcome in acute and chronic stroke rehabilitation. Moreover, these can be used for rehabilitation in other neurological disorders such as spinal cord injury and Parkinson’s disease.
TMS is an innovative treatment for various neurological diseases. The magnetic field activates brain cortex which induce the production of neurotransmitters and neuroplasticity. This device has been approved by U.S. FDA for treatment of major depressive disorder and neuropathic pain. Furthermore, TMS can be combined with conventional treatments in chronic stroke rehabilitation for achieving better outcome.
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