ANIMUS

A cerebrovascular accident or stroke is defined as a brain insult that occurs when the blood supply to a part of the brain is interrupted, which affects 120,000 individuals in Spain each year. Among its sequelae, upper limb impairments are specially common, as are present in more than 80% of stroke survivors, and specially disabling, due to the involvement of the upper limb in daily activities. Only 30-40% of patients recover moderate dexterity after six months, and only 5-20% achieve full recovery of arm function. Consequently, there is a great number of individuals who need therapeutic attention to recover or improve upper limb function after stroke. Several approaches are used or are being investigated, including conventional physical therapy, multisensory stimulation, non-invasive brain, nerve and muscle stimulation. Conventional physical therapy have been combined with only one of stimulation-based interventions, and the potential of combining more modes is, therefore, almost unexplored. Additionally, the vast majority of the studies evaluate recovery only at one functional, performance or neural level, and those studies that investigate more than one level do not properly explore the relationship between recovery at different levels, which would help to untangle clinical progress after stroke. This project represents a new paradigm in the rehabilitation and diagnosis of the upper limb function after stroke. Unlike the current approach, based on paradigms of conventional physiotherapy that, at best, are combined with multisensory, brain, nerve or muscle stimulation, the present project will combine all these modes of stimulation in a paradigm of active interaction, both for patients with moderate and mild hemiparesis, who present some mobility and functionality of the upper limbs, and for patients with severe hemiparesis, who do not present any movement. Through the combination of ocular, muscular and accelerometric activity, their movement intentionality will be detected and enable their interaction with rehabilitation exercises. The effectiveness of this new rehabilitation paradigm will be evaluated on the basis of functional, performance and neural progress, which also represents an innovative and comprehensive approach to the evaluation of recovery after stroke.