Engineering New Approaches to Rehabilitation

The population in the industrialized world is aging rapidly. Modest growth in national economies coupled with rapidly increasing expenditures for medical goods and services have strained the health care budgets for most of the industrialized world. This means that there will be an increased emphasis on maintaining a productive, older workforce, and that there will be an advantage for health systems that can develop strategies to reduce disabilities, maintain individuals' function and control costs. While there is increased competition for resources from other disciplines, neurorehabilitation has a new set of tools that can begin to create the kind of scientific excitement and major clinical advances that we have seen in other fields. These include functional imaging, gene therapies, tissue engineering, biomechanical modeling, to name just a few. We also are seeing a new generation of investigators and clinicians emerging that are taking on the challenge of developing effective treatments for stroke, brain injury and spinal cord injury. Science is rapidly moving away from the "cottage industry" of the individual investigator working in an isolated laboratory to the collaborative, multidisciplinary model of "big science". To survive, neurorehabilitation must maintain the pace of scientific and clinical innovation while also retaining the essential elements of successful clinical interaction