Acquired brain damage (ABD) is a term that encompasses a range of injuries to the brain that typically manifest suddenly or unexpectedly. These injuries can lead to changes in a person’s independence, health, and autonomy, significantly impacting their quality of life. Common causes of ABD include strokes, both ischemic and hemorrhagic, and traumatic brain injuries (TBI), although there are other factors that can also trigger such injuries. In this context, neurorehabilitation emerges as a fundamental tool, and neuroplasticity plays an essential role in the recovery process.
The importance of early neurorehabilitation
When dealing with acquired brain damage, time is a critical factor. Patients who initiate the rehabilitation process during the first week after experiencing a stroke, for example, tend to have a lower degree of disability and a higher quality of life in the long run. Essentially, neurorehabilitation aims for three main objectives: maintaining existing skills, recovering lost skills, and learning new abilities. Scientific evidence supports the idea that regeneration, the recovery of lost function, and motor learning after brain injuries are largely due to the phenomenon of neuroplasticity.
Neuroplasticity, a capacity for reorganization
In simple terms, neuroplasticity is the ability of neuronal tissue to reorganize, assimilate, and modify the biological, biochemical, and physiological mechanisms involved in communication between nerve cells. This process is present throughout life, but there are key moments when it manifests more intensely. Particularly during the first year of life, puberty, gestation, and, significantly, immediately after an injury to the central nervous system (CNS).
Neuroplasticity is the mechanism that allows neurons to regenerate both anatomically and functionally and form new synaptic connections. In summary, it represents the brain’s ability to recover and restructure itself. At the same time, this provides the foundation for neurorehabilitation activity following a stroke or other brain injuries.
Types of neuroplasticity
There are three fundamental types of neuronal plasticity that are closely related. Each contributes to different aspects of brain reorganization:
- Structural Neuroplasticity: This form of plasticity refers to the nervous system’s ability to reorganize neuronal and synaptic connections. Experiences and learning can change these connections, influencing the overall activity of the brain and patterns of response to stimuli in neural circuits. Examples of structural neuroplasticity include neurogenesis, the formation of new neurons, and cell death.
- Functional Neuroplasticity: Functional neuroplasticity occurs when the functions of a damaged brain region are taken over by another region. This happens after an injury to the nervous system, where functions previously carried out by a damaged region are assumed by intact brain regions.
- Molecular Neuroplasticity: This type of plasticity operates at the biochemical level and refers to the ability of chemical molecules participating in synapses to change, aiming to reshape these connections. Molecular neuroplasticity can occur in the short or long term and is characterized by the strengthening or weakening of synaptic connections based on their use and relevance.
How to enhance neuronal plasticity after a brain injury?
In reality, training these neuroplastic processes in children and at younger ages is relatively straightforward. However, challenges arise when it comes to adults, especially after experiencing brain damage. Attention and motivation are key elements in increasing neuroplasticity and improving learning during rehabilitation. Additionally, physical exercise and performing repetitive tasks have also proven effective in increasing neuronal plasticity.
It is crucial to consider these aspects both in professional neurorehabilitation treatment and in the patient’s daily life. If not properly controlled, neuroplasticity mechanisms can become counterproductive to recovery. Therefore, the active collaboration of family members and caregivers in the rehabilitation process is essential.
On the other hand, technology also plays a critical role in enhancing neuroplasticity. For example, robotic systems allow continuous repetitive movements that improve the strength, endurance, and balance of patients, increasing their motivation and hope for recovery. Integrating technology into a comprehensive rehabilitation program can increase therapy intensity and frequency. This, in turn, promotes neuroplasticity and ultimately improves the quality of life for those who have experienced acquired brain damage.
Robotics and neuroplasticity, a promising link
Rehabilitation robotics has a history dating back to the 1980s when it was developed for research purposes. As technology advanced, these systems evolved into clinical tools that transformed the rehabilitation of various functions, including walking, arm and hand recovery, early verticalization, and balance rehabilitation. Today, robotics plays an integral role in assessing the motor ability of patients, providing intensive therapies with repetition and difficulty levels tailored to individual needs, and offering assistance or resistance during movements.
In particular, robot-assisted gait rehabilitation has proven highly effective in improving independence, gait quality, speed, strength, and quality of life in people who have suffered a stroke. A meta-analysis conducted in 2017 revealed that individuals who undergo electromechanically assisted gait training along with conventional physiotherapy are 48% more likely to regain the ability to walk independently.
Social Robotics and AI, a revolution in neurorehabilitation
An innovative aspect in the field of neurorehabilitation is the use of tools based on AI and social robotics. An example of this is the Inrobics Rehab platform developed in Spain. This resource is proving remarkably successful in rehabilitating patients with acquired brain damage, providing personalized and motivating sessions that address limitations in motor, cognitive, and social skills resulting from brain damage.
Inrobics Rehab is supported by an AI architecture complemented with a social robot and a sensor that monitors the patient’s movements. This allows therapists to design physical and cognitive rehabilitation sessions tailored to each patient’s needs and progress. The platform has been tested in the pediatric population with neuromotor problems, yielding promising results.
Some activity blocks of Inrobics Rehab
Inrobics Rehab offers six activity blocks that allow training motor and cognitive skills, equally promoting neuroplasticity:
- EVAL: In this activity, the patient performs different movements proposed by the robot Robic to assess the range of motion of the joints.
- WARM UP: Robic suggests movement sequences that the patient can perform simultaneously as a warm-up before the session.
- DYNAMIC: This block focuses on movement sequences designed to train strength and endurance through repetitions.
- ADL (Activities of Daily Living): Robic represents daily activities such as eating, grooming, and shopping, guiding the patient to perform them alongside him, providing verbal guidance.
- SYMBOLIC: In this activity, a series of simple movements is presented, which Robic then names, challenging the patient’s attention and memory.
- DANCE: A choreography with a song is taught, adding steps progressively until the patient can perform the complete choreography.
Results of studies at the National Hospital for Paraplegics in Toledo and at Ceadac
Inrobics Rehab underwent a pilot study at the National Hospital for Paraplegics in Toledo, working with children with spinal cord injuries. Additionally, a test was conducted at the State Reference Center for Brain Damage Care (Ceadac). Preliminary results from these studies indicate significant improvements in neuroplasticity and the quality of life of patients. Specifically, social robotics and AI solutions can provide:
- Improvement in adherence: These tools use playful social interactions to maintain patient motivation and increase adherence to treatments in the long term.
- Game-Based Therapy: Assistive social robotics incorporates gamification principles, making sessions more engaging and effective.
- Boost Neuroplasticity: These therapies are designed to promote the formation of new neuronal connections, contributing to functional recovery.
- Promotion of a Positive Attitude: By making rehabilitation more enjoyable, these tools validate the patient’s continuous effort and improve their attitude toward treatment.
- Increased Concentration and Motivation: Game mechanics integrated into sessions enhance the patient’s concentration and motivation.
But it doesn’t end here!
At Inrobics, we take pride in Inrobics Rehab being the only certified social robotics solution as a medical device in Europe. Hence, our commitment to its ongoing development and expansion.