Monitoring patients during neurorehabilitation following central or peripheral nervous system injury: Dynamic difficulty adaptation

Brain injuries including stroke often require extensive cognitive and physical rehabilitation.Active mental engagement and a positive emotional state are prerequisites for optimal learning in the rehabilitation of stroke patients. Stroke often affects aspects of gait requiring balance and gait therapy using robot-assisted devices. Ideal cognitive and physical training conditions are an important prerequisite to obtain optimal robot-assisted therapeutic outcomes. Key factors for successful therapy include design of the rehabilitation task, attention to stress, and the psychological state of patients during robot-assisted gait therapy. Although the latter is difficult to gauge in real time, patient stress or anxiety can be inferred from heart rate variability (HRV). This chapter examines the design of robot assisted therapy and the effect on HRV of increasing task difficulty.