Toward the integration of novel wearable step-counters in gait telerehabilitation after stroke.

In the management of stroke, after the first critical care period at the hospital, it is important for the subjects to plan a neural and motion rehabilitation program at home. Telerehabilitation could represent a valid aid for subjects involved in a rehabilitation process at home. Motion and neural rehabilitation are strictly correlated. Prompt motion rehabilitation is essential to ensure good recovery performance from the stroke defect. Remote therapy, which involves a telerehabilitation program, should monitor daily motion activity. An optimal telerehabilitation program should be capable of monitoring patient activity starting from a high disability of imbalance, when there is the need for properly designed aids or prosthesis. The program should continue when the patient improves his or her condition, and progressively changes or abandons aids or prosthesis. New home care for remote activity monitoring has been proposed. It includes a sensorized-codivilla-spring and a gastrocnemius expansion measurement unit to allow activity monitoring in terms of step-counting for the continuity of care at home. This home care has been integrated in a telerehabilitation process. Preliminary clinical trials have shown the effectiveness and the high degree of client satisfaction (patient and therapist). The next phase will be the integration with other units to allow the monitoring of other physiological parameters (blood pressure, heart rate, blood glucose) useful to investigate in stroke telerehabilitation.