Abstract:

Stroke is a significant socially important disease in Bulgaria. During last years, we observe a change of the paradigm of neurorehabilitation, due to the introduction of new technologies, especially mechanotherapy, robots and virtual reality.

Our goal was to introduce an electronic module on the topic “Robotic neurorehabilitation in post-stroke hemiparesis (including clinical cases)”. Our secondary aim was to test the interest of potential workers in the field.

We decided to prepare an electronic educational module on this topic, to introduce it in the education and to test the interest of potential professionals in this area.

The included learners were divided into three categories:
i) students in physiotherapy and in nursing – during their university education,
ii) medical doctors – during the specialization in “Physical and Rehabilitation medicine (PRM)”, and
iii) working healthcare professionals - physiotherapists and nurses (post-graduate training).

We prepared an educational module on the topic “Robotic neurorehabilitation in post-stroke hemiparesis” and we prepared electronic (e-) books on the topics “Robotic neurorehabilitation” and “Post-stroke rehabilitation”.

In the educational module and in the e-book we included detailed information on modern applications of robot, neuro-robot and virtual reality (VR) in neuro-rehabilitation (NR) of patients with cerebrovascular diseases. We clarified the potential of different types of neuro-robots for NR: for upper and for lower extremities, unilateral (for grasp training) and bilateral (for balance and gait training); exoskeletons and controllers of endpoint trajectories. We explained in details the effects of robotic NR with VR on neuroplasticity, especially on the activity-dependent plasticity of the human brain. We emphasized the potential of sensors of the neuro-robots for evaluation of the muscle force, stiffness (spasticity), active and passive range of motion; grasp capacity, gait velocity; and autonomy in every-day activities. We enlightened scientific studies, proving the efficacy of the application of neuro-robots – stimulation of neuroplasticity, clinical effects of acceleration of functional recovery and amelioration of the quality of life of patients with post-stroke hemiparesis. We presented our own clinical experience, including results and clinical cases, treated with neurorobots, as addition to the classical NR methods.

We evaluated the professional competencies of participants in the educational module – before and after the electronic modules and courses. Additionally, we investigated learners’ opinion of the educational courses and the provided educational materials, using a five-levels Likert scale.

We consider very important the introduction of the topic in the education of students and trainees – members of the multi-disciplinary NR-team: medical doctors – specialists and residents in Neurology and in Physical and Rehabilitation Medicine; nurses, physiotherapists, occupational therapists, and psychologists.

The application in NR of devices, using robots and virtual reality, stimulates functional recovery and autonomy of our patients in activities of daily living, and ameliorates their quality of life.

Keywords:

Online education, robot, virtual reality, neurorobotics, neurorehabilitation, activities of daily living.