Technology-assisted training of arm-hand skills in stroke: concepts on reacquisition of motor control and therapist guidelines for rehabilitation technology design.
BACKGROUND
It is the purpose of this article to identify and review criteria that rehabilitation technology should meet in order to offer arm-hand training to stroke patients, based on recent principles of motor learning.


METHODS
A literature search was conducted in PubMed, MEDLINE, CINAHL, and EMBASE (1997-2007).


RESULTS
One hundred and eighty seven scientific papers/book references were identified as being relevant. Rehabilitation approaches for upper limb training after stroke show to have shifted in the last decade from being analytical towards being focussed on environmentally contextual skill training (task-oriented training). Training programmes for enhancing motor skills use patient and goal-tailored exercise schedules and individual feedback on exercise performance. Therapist criteria for upper limb rehabilitation technology are suggested which are used to evaluate the strengths and weaknesses of a number of current technological systems.


CONCLUSIONS
This review shows that technology for supporting upper limb training after stroke needs to align with the evolution in rehabilitation training approaches of the last decade. A major challenge for related technological developments is to provide engaging patient-tailored task oriented arm-hand training in natural environments with patient-tailored feedback to support (re) learning of motor skills.
Timmermans
Annick A A
AA
Faculty of Biomedical Technology, Technical University Eindhoven, Eindhoven, the Netherlands. A.Timmermans@srl.nl
Seelen
Henk A M
HA
Willmann
Richard D
RD
Kingma
Herman
H
D001132:Arm / Q000502:physiology*; D004867:Equipment Design; D005081:Exercise Therapy; D005246:Feedback; D006040:Goals; D006801:Humans; D007858:Learning; D008503:Medical Staff; D009043:Motor Activity; D019957:Motor Skills Disorders / Q000534:rehabilitation*; D009068:Movement; D010361:Patients / Q000523:psychology; D017410:Practice Guidelines as Topic; D012371:Robotics; D012944:Social Support; D020521:Stroke / Q000628:therapy; D000071939:Stroke Rehabilitation