As mortality from stroke drops by 60%, the optimization of recovery following stroke has become even more essential

Author:

Dr. Natalee Takasumi

Clinical Applications Manager

Each year, nearly 800,000 people, will experience a stroke in the United States.1 Thankfully, the survival rate has improved, and over the last 40 years, there has been over a 60% decline in age-adjusted mortality from stroke.2 It is now the nation’s fifth-leading cause of death, down three spots from 2003.3

The Burden of Stroke

As these survival rates have continued to improve, the optimization of recovery following stroke has become even more essential. For survivors, stroke often leads to the severe long-term disability with secondary complications that can leave them unable to work or perform daily living activities without assistance. The direct and indirect costs of stroke in 2014 to 2015 was $45.5 billion, including health care services, medication and lost productivity.4
65% of survivors will receive post-stroke rehabilitation services with the overarching goal of returning patients to their communities. The likelihood of improvement after stroke varies greatly; approximately 35% of survivors with initial paralysis of the leg do not regain useful functions, and 20-25% are unable to walk without full assistance.5 Furthermore, 65% of survivors that initially have flaccid paralysis of the upper extremity are unable to incorporate their affected hand into their usual activities.6

The necessity for Intense Therapy

Starting rehabilitation as soon as possible is necessary to improve patient outcomes.7 During this critical time, there should be a focus on motor learning principles to maximize recovery and function.8

With Robotics, Increase Outcomes and Decrease Effort

Robotic devices are well-suited to address patient impairments seen in the acute and subacute phases of stroke recovery. They can deliver consistent, high-intensity motor therapy, that is programmable by the therapist to meet the specific needs of the patient. Patients with more severe impairments show even more significant benefit of motor function recovery for upper and lower extremities.9-11

Robotic devices also allow therapists to pass off the burden of care and decrease the physical strain and risk of falls to the patients. This will enable therapists to treat more patients efficiently, effectively, and earlier in the course of recovery.

Read more about robotic rehabilitation solutions that can help you tackle this challenge.

References

1 Benjamin EJ, Blaha MJ, Chiuve SE, et al. On behalf of the American Heart Association Statistics Committee and Stroke Statistics subcommittee. Heart disease and stroke statistics – 2017 update: a report from the American Heart Association. Circulation. 2017;135:e229-3445.
2 Chobanian AV, Bakris GL, Black HR, et al. National Heart, Lung and Blood Institute Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003; 289:2560-2572.
3 Heron MP, Smith BL. Deaths: Leading causes for 2003. National vital statistics reports, Hyattsville, MD. National Center for Health Statistics.
4 America’s Health Rankings analysis of CDC, Behavioral Risk Factor Surveillance System, United Health Foundation, AmericasHealthRankings.org. Accessed 2020.
5 Hendricks HT, van Limbeek J, Geurts AC, Zwarts MJ. Arch Phys Med Rehabil. 2002;83(11):1629-37.
6 Kwakkel G, Kollen BJ, van der Grond J, Prevo AJ. Probability of regaining dexterity in the flaccid upper limb: impact of severity of paresis and time since onset in acute stroke. Stroke. 2003;34(9):2181-6.
7 Flick CL. Stroke rehabilitation. Stroke Outcome and psychosocial consequences. Arch Phys Med Rehabil. 1999;80(5 Suppl 1):S21-6.
8 Kleim JA, Jones TA. Principles of expirience-dependent neural plasticity: Implications for rehabilitation after brain injury. J Speech Lang Hear Res. 2008;51:S225-239.
9 Lo K, Stephenson M, Lockwood C. Effectiveness of robotic assisted rehabilitation for mobility and functional ability in adult stroke patients: a systematic review. JBI Database System Rev Implement Rep. 2017 Dec;15(12):3049-3091. doi: 10.11124/JBISRIR-2017-003456. Review. PubMed PMID: 29219877.
10 Mehrholz J, Thomas S, Werner C, Kugler J, Pohl M, Elsner B. Electromechanical-assisted training for walking after stroke. Cochrane Database of Systematic Reviews 2017, Issue 5. Art. No.: CD006185. DOI: 10.1002/14651858.CD006185.pub4.
11 Klamroth-Marganska V, Blanco J, Campen K, et al. Three-dimensional, task-specific robot therapy of the arm after stroke: a multicentre, parallel-group randomised trial. Lancet Neurol. 2014; 13(2):159-66.

Originally published on 9.6.2020

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