Rehabilitation technologies and interventions for individuals with spinal cord injury: translational potential of current trends

Journal of NeuroEngineering and Rehabilitation, 2018 · DOI: https://doi.org/10.1186/s12984-018-0386-7 · Published: May 10, 2018

Spinal Cord Injury Neurorehabilitation Rehabilitation

Simple Explanation

Neurorehabilitation for SCI has shifted from compensatory movements to functional neurorecovery, using technologies like robotics and electrical stimulation. An environmental scan was completed to identify emerging physical interventions that aim to promote neurorecovery among the SCI population and to evaluate the strengths and gaps of the current direction of SCI rehabilitation research using the FAME framework. The FAME framework (Feasibility, Appropriateness, Meaningfulness, Effectiveness, Economic Evidence) was used to evaluate the likelihood of clinical implementation of SCI rehabilitation research.

Study Duration

June 8–July 5 2017

Participants

Individuals with SCI (traumatic or non-traumatic cause) aged ≥16 years

Evidence Level

Not specified

Key Findings

1
Strengths in SCI rehabilitation research include Feasibility (practical application), Appropriateness (alignment with motor learning), and Effectiveness (evaluation of clinical outcomes).
2
Gaps exist in Feasibility (clinical implementation of emerging technologies), Appropriateness (alignment with clinician/patient preferences), Meaningfulness (patient perceptions), and Economic Evidence.
3
Two thirds of the research involved electrical stimulation, robotics, virtual reality, or a combination of these technologies, all of which require specialized equipment and knowledge.

Research Summary

Current SCI rehabilitation research focuses on technology-augmented physical interventions but faces challenges in clinical implementation due to feasibility, appropriateness, meaningfulness, and economic impact. Future research should adopt a staged approach, incorporating the FAME framework throughout the development, evaluation, and implementation of novel rehabilitation interventions. Ongoing dialogues between clinicians and researchers can ensure that new technologies and ideas are vetted rigorously while informing changes to practice that will maximize outcomes for individuals with SCI.

Practical Implications

Improve Clinical Uptake

Address the feasibility, appropriateness, meaningfulness, and economic impact of technology-based interventions to enhance their adoption in clinical practice.

Enhance Research Design

Incorporate the FAME framework into research design to ensure that interventions are practical, patient-centered, and economically viable.

Facilitate Collaboration

Promote ongoing dialogues between clinicians and researchers to ensure that new technologies are rigorously vetted and align with clinical needs and patient priorities.

Study Limitations

1
Bias towards the western world likely reflects the sources of information accessed for the environmental scan.
2
Few studies documented the participants’ perspectives on the effects of an intervention.
3
The clinical uptake of these technologies into SCI rehabilitation has received little study to-date

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