NeuroCimt / Counteract
A major goal in the rehabilitation of patients with central neurological disorders such as stroke and Multiple Sclerosis (MS) is to achieve optimal motor performance enabling patients to live independently with maximum freedom of movement. Loss of upper and lower extremity motor performance results in dependency in Activities of Daily Living (ADL), reduced self-efficacy, deconditioning, decrease of perceived health status, loss of societal participation and quality of life. Upper extremity function is a key ADL factor and seen as a high research priority in rehabilitation. Stroke patients show considerable non-use of their paretic arm in daily life. However, for each individual patient, it is unknown whether this is an optimal adaptive strategy (compensation with the non-paretic side) or maladaptation. In the same vein, loss of ambulation in terms of decreased upright activities of daily living, (upright ADLs) is heavily dependent on restoration of adequate balance control and motor function and may result in increased (fear of) falling and deterioration in mobility in chronic stroke, even in young strokes.
Understanding phenomena such as learned non-use and deterioration is a pre-requisite for the development of patient-tailored interventions targeting neurological repair through biofeedback, allowing patients to learn to adapt to existing deficits and to prevent learned non-use and maladaptive strategies. Future rehabilitation strategies should comprise continuous and repetitive monitoring of change in patients ‘real-world performance’ as well as the identification of patients who are susceptible for change. Biofeedback paradigms may be especially suitable to provide real-time feedback aimed at improving (mal) adaptive motor-performance. Currently, there is no paradigm for continuous monitoring or biofeedback.
To develop and evaluate an on-body sensing and real-time biofeedback system for optimal, patient-tailored motor rehabilitation in neurological disorders, aimed at optimizing adaptation and prevent maladaptation in motor performance of upper and lower extremities during daily life.
2016 – 2021