The Use of Modern Technologies in Neurorehabilitation

The Vibramoov device (Techno Concept, France) will be used in the rehabilitation program. Before starting the training session, each subject will undergo a diagnosis in order to qualify for the use of Functional Proprioceptive Vibration. Before starting the therapy, pads are placed on the patient's body to fix the vibrating modules in the places to be treated (lower limbs, left upper limb or right upper limb). Then the vibrating modules are attached to the supports. The therapy carried out with the use of the Vibramoov device consists in the targeted and individualized stimulation of the nervous system, as in the course of natural movements of the upper or lower limbs with the use of visual biofeedback. Therapy with the use of the Vibramoov device will be carried out 4 times a week for 50 minutes a day. Additionally, individual physiotherapy (50 minutes) and upright standing (50 minutes) will be conducted 5 times a week.

The Ekso GT ™ exoskeleton (Ekso Bionics, Inc. Richmond, CA, USA) used in the rehabilitation program has been approved by the Food and Drug Administration (FDA). Before starting the training session, each subject will undergo a thorough diagnosis to individually adjust the bionic skeleton. After entering the patient's data into the device's software, the physiotherapist selects the optimal training parameters. As the patient progresses during the training unit, the therapist will update the exoskeleton settings on an ongoing basis, so that the training is best suited to the current capabilities of the subject. Therapy with the use of the exoskeleton device will be carried out 4 times a week for 50 minutes a day. Additionally, individual physiotherapy (50 minutes) and upright standing (50 minutes) will be conducted 5 times a week.

The RoboGait stationary robot (Bama technologist, Turkey) will be used in the rehabilitation program. Before starting the training session, each subject will undergo detailed diagnostics in order to individually adjust the orthoses. The next step will be to put on a vest and inguinal straps on a wheelchair or standing, and then lift it up with the device, then attach it to the Robogait orthoses. After entering the patient's data into the software of the device, the physiotherapist selects the optimal training parameters. During the session, biofeedback is also displayed informing the patient and the therapist about the patient's activity level in the transfer phase and the support during walking for both lower limbs. Therapy with the use of the RoboGait device will be carried out 4 times a week for 50 minutes a day. Additionally, individual physiotherapy (50 minutes) and upright standing (50 minutes) will be conducted 5 times a week.

The Zebris FDM-T treadmill will be used in the rehabilitation program for gait analysis. Before each session, patients will be equipped with a harness for safety reasons. The need for a handrail will be assessed prior to each session and patients will be encouraged to support their hands as little as possible. Before starting the training session, each subject will undergo a thorough diagnosis in order to individually adjust the training parameters. Therapy with the use of the Zebris FDM-T treadmill will be carried out 4 times a week for 50 minutes a day. Additionally, individual physiotherapy (50 minutes) and upright standing (50 minutes) will be conducted 5 times a week.

The Pablo (Tyromotion) device will be used in the rehabilitation program. Before the start of the training session, each subject will undergo detailed diagnostics assessing the range of mobility in the shoulder, radiocarpal (frontal and sagittal plane), elbow (sagittal plane), and explosive strength of the cylindrical, pinch and lateral and three-point grip. The Force Control Index will also be designated. The next stage will be training on the Pablo device using visual and auditory biofeedback. The physiotherapist selects the optimal training parameters (type of pad, type of game, level of the game). Each training session will be stored in the software and recorded in the patient's medical records. Therapy with the use of the Pablo device will be carried out 4 times a week for 50 minutes a day. Additionally, individual physiotherapy (50 minutes) and upright standing (50 minutes) will be conducted 5 times a week.

In control Group the rehabilitation program will be carried out for a period of 4 weeks. In each of the studied groups, the rehabilitation program will include conventional physiotherapy sessions performed 5 times a week, consisting of 50 minutes a day of individual physiotherapy and 50 minutes a day of standing upright.