[ARTICLE] Community-Based Neurorehabilitation in Underserved Populations – Full Text PDF


Despite the fact that stroke is the leading cause of long-term adult disability and a primary cause of death, one of the major problems in national healthcare systems is the inability to provide quality post-stroke rehabilitation. Geographical barriers, socioeconomic position, race, education, and cost all contribute to health care disparities. These disparities may not only obstruct access to the most appropriate rehabilitative care, but may contribute to psychological problems, reduced quality of life, and unsuccessful return to meaningful community participation. Information and communications technology (ICT) when combined with robotic technology can enhance the accessibility of rehabilitation in low-resource, capacity-constrained settings. In this paper we introduce a low cost, limited supervision, portable robot (H-Man) designed for upper extremity rehabilitation. A usability and feasibility study indicates that out-patient robotic treatment with the HMan leads to positive improvements in arm movement, and that the system is usable and well accepted by key stakeholders. This paper also introduces an implementation strategy to assess the effectiveness, benefits and barriers of using the H-Man robot for community-based neurorehabilitation in underserved populations, such as those that live in low income neighborhoods or in rural areas.


Stroke is the leading cause of disability in the United States, with 65% of the nearly four million people who have survived a stroke living with minor to severe impairments [1]. It has been estimated that among the 75% of patients who survive the first month after a stroke, more than half will require specialized rehabilitation. Individuals are left with a broad range of disabilities, from mild paresis to complete paralysis of both the upper and lower extremities, proprioceptive deficits, disordered movement organization, loss of range of motion, muscle weakness and abnormal muscle tone, and impaired force generation. Impaired arm and …..

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