Middle East region: Israel

Stroke is the fifth cause of death and the primary cause of neurological disability in adults in Israel. In 2019, there were 19,244 stroke cases in Israel; of those, 65.5% were ischemic, 26.4% were transient ischemic attacks (TIAs), and 8.2% were hemorrhagic strokes. The rehabilitation process is long and arduous, and while rehabilitation technologies have the potential to assist patients, their family members, and the clinical team, the use of such technologies has not yet reached its full potential in terms of being in routine clinical usage, or what is referred to as the “plateau” on Gartner’s hype cycle. The reasons are varied and include human resources, cost, setup time, institutional infrastructure, and skeptical and apprehensive attitudes of clinicians (and some patients) toward the use of technology. Robotic technology is used mainly in several large rehabilitation centers, and the devices used are mostly of the passive-assist type. Clinicians from these centers indicated that their use of robotic devices in rehabilitation programs was often due to explicit policies and practices of institutional management. In this chapter, we provide an overview of the healthcare structure in Israel, with a focus on the neurorehabilitation process. We report the results of two focus groups with a total of 13 participants, including clinicians, researchers, and rehabilitation technology developers and distributors who considered a range of factors that contribute to and detract from technology adoption in rehabilitation. We conclude with an analysis of the threats and opportunities over the next 5 years for using rehabilitation technologies in general as well as a more specific consideration of robotic devices. We conclude with a set of emergent guidelines for the effective implementation of technology—with a focus on robotic technology—in the neurorehabilitation setting.