ÖGBMT Jahrestagung 2021

Over the last decade, technology plays an increasing role in the motor rehabilitation of people with spinal cord injury (SCI). Particularly in the early phase after incomplete SCI, robotic locomotion training devices are nowadays routinely used as part of a task-oriented, training program. These trainings aim at restoration of ambulation by inducing neuroplasticity in the central nervous system including the spinal neural network. With robots, the physical workload of therapists can be effectively reduced allowing for longer training sessions, and continuation of an intensive training after the inpatient phase becomes possible. However, even with the most complex exoskeletons, no significantly better outcomes can be achieved compared to traditional physical therapy of the same intensity. Novel neuromodulation therapies such as spinal cord stimulation in combination with intense task-specific therapies hold promise to boost the outcomes beyond the current limits. But still, all restorative therapies rely on preserved connections which are not present in people with complete SCI. A complete loss of arm and hand function in people with high SCI can be compensated by neuroprostheses or robotic arms controlled by brain-computer interfaces. A key for successful application of these assistive devices is their individualization to the needs and priorities of the end users. The main challenge of these complex systems is that they have to prove their usability and usefulness in everyday settings. For an efficient development of rehabilitation technology an early involvement of end users is mandatory. However, the current legal constraints introduced with the Medial Device Regulation represent a major barrier for systematically collecting feedback from clinical and end users participating in pilot experiments and evaluations.