Posts Tagged App

[WEB SITE] Mental Fatigue – University of Gothenburg, Sweden

Mental fatigue or brain fatigue

Mental fatigue can be a disabling consequence of traumatic brain injury, stroke, infection or inflammation in the Central Nervous System (CNS). The condition is characterized by pronounced mental fatigue after moderate mental activity. Pronounced fatigue can appear very rapidly and, when it does, it is not possible for the affected person to continue the activity. Typical for this kind of fatigue is a profound, long recovery time to get one’s mental energy back. Attention cannot be maintained for more than short periods. Other common associated symptoms are: irritability, tearfulness, sound and light sensitivity as well as headaches.

Read more under About Mental Fatigue.

Measure mental fatigue with an app.  Androids and Windows. Coming soon for iPhone.

Android

Windows 10

Contact information

Lars Rönnbäck, professor and senior physician in neurology

Birgitta Johansson, Ph.D., specialist in neuropsychology

Institute of neuroscience and physiology
Department of clinical neuroscience and rehabilitation
Sahlgrenska Academy
University of Gothenburg Sweden

mf@gu.se

Source: Mental Fatigue – Mental Fatigue, University of Gothenburg, Sweden

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[WEB SITE] A New Way for Therapists to Get Inside Heads: Virtual Reality – The New York Times

Myla Fay, a product designer for Limbix, testing the start-up company’s virtual-reality therapy software with a headset in its offices in Palo Alto, Calif. Psychologists can use virtual reality to provide exposure therapy to patients confronting anxiety. Credit: Jason Henry for The New York Times

SAN FRANCISCO — Dawn Jewell recently treated a patient haunted by a car crash. The patient had developed acute anxiety over the cross streets where the crash occurred, unable to drive a route that carried so many painful memories.

So Dr. Jewell, a psychologist in Colorado, treated the patient through a technique called exposure therapy, providing emotional guidance as they revisited the intersection together.

But they did not physically return to the site. They revisited it through virtual reality.

Dr. Jewell is among a handful of psychologists testing a new service from a Silicon Valley start-up called Limbix that offers exposure therapy through Daydream View, the Google headset that works in tandem with a smartphone.

“It provides exposure in a way that patients feel safe,” she said. “We can go to a location together, and the patient can tell me what they’re feeling and what they’re thinking.”

The service recreates outdoor locations by tapping into another Google product, Street View, a vast online database of photos that delivers panoramic scenes of roadways and other locations around the world. Using these virtual street scenes, Dr. Jewell has treated a second patient who struggled with anxiety after being injured by another person outside a local building.

A virtual reality therapy test using Limbix to simulate driving over a bridge. Credit: Limbix

The service is also designed to provide treatment in other ways, like taking patients to the top of a virtual skyscraper so they can face a fear of heights or to a virtual bar so they can address an alcohol addiction.

Backed by the venture capital firm Sequoia Capital, Limbix is less than a year old. The creators of its new service, including its chief executive and co-founder, Benjamin Lewis, worked in the seminal virtual reality efforts at Google and Facebook.

The hardware and software they are working with is still very young, but Limbix builds on more than two decades of research and clinical trials involving virtual reality and exposure therapy. At a time when much-hyped headsets like the Daydream and Facebook’s Oculus are still struggling to find a wide audience in the world of gaming — let alone other markets — psychology is an area where technology and medical experts believe this technology can be a benefit.

As far back as the mid-1990s, clinical trials showed that this kind of technology could help treat phobias and other conditions, like post-traumatic stress disorder.

Virtual reality cameras at Limbix. The creators of the service worked on virtual reality efforts at Facebook and Google. Credit: Jason Henry for The New York Times

Traditionally, psychologists have treated such conditions by helping patients imagine they are facing a fear, mentally creating a situation where they can address their anxieties. Virtual reality takes this a step further.

“We feel pretty confident that exposure therapy using V.R. can supplement what a patient’s imagination alone can do,” said Skip Rizzo, a clinical psychologist at the University of Southern California who has explored such technology over the past 20 years.

Barbara Rothbaum helped pioneer the practice at the Emory University School of Medicine in Atlanta, and her work spawned a company called Virtually Better, which has long offered virtual reality exposure therapy tools to some doctors and hospitals through an older breed of headset. According to one clinical trial she helped build, virtual reality was just as effective as trips to airports in treating the fear of flying, with 90 percent of patients eventually conquering their anxieties.

Such technology has also been effective in treating post-traumatic stress disorder among veterans. Unlike treatments built solely on imagination, Dr. Rothbaum said, virtual reality can force patients to face their past traumas.

“PTSD is a disorder of avoidance. People don’t want to think about it,” she said. “We need them to be engaged emotionally, and with virtual reality, it’s harder for them to avoid that.”

The founder of Oculus, Palmer Luckey, demonstrating the Oculus Rift virtual-reality headset and Oculus Touch hand controllers in 2015. Credit: Ramin Talaie for The New York Times

Now, headsets like Google’s Daydream, which works in tandem with common smartphones, and Facebook’s Oculus, the self-contained $400 headset that sparked the recent resurgence in virtual reality technologies, could potentially bring this kind of therapy to a much wider audience.

Virtually Better built its technology for virtual reality hardware that sold for several thousands of dollars. Today, Limbix and other companies, including a Spanish start-up called Psious, can offer services that are far less expensive. This week, Limbix is beginning to offer its tools to psychologists and other therapists outside its initial test. The service is free for now, with the company planning to sell more advanced tools at some point.

The Limbix mobile app for virtual-reality therapy. The service is free for now, and the company plans to sell more advanced tools in the future. Credit: Limbix

After testing the Limbix offering, Dr. Jewell said it allowed patients to face their anxieties in more controlled ways than they otherwise could. At the same time, such a tool can truly give patients the feeling that they are being transported to a different locations — at least in some cases.

Standing atop a virtual skyscraper, for instance, can cause anxiety even in those who are relatively comfortable with heights. Experts warn that a service like the one offered by Limbix requires the guiding hand of trained psychologists while still in development.

Limbix combines technical and medical expertise. One key employee, Scott Satkin, is a robotics and artificial intelligence researcher who worked on the Daydream project at Google. Limbix also works with its own psychologist, Sean Sullivan, who continues to run a therapy practice in San Francisco.

Dr. Sullivan is using the new service to treat patients, including a young man who recently developed a fear of flying, something that causes anxiety simply when he talks about it. Using the service alongside Dr. Sullivan, the young man, who asked that his name be withheld for privacy reasons spent several sessions visiting a virtual airport and, eventually, flying on a virtual plane.

In some ways, the young man said, the service is still less than perfect. Like the Street View scenes Dr. Jewell uses in treating her patients, some of this virtual reality is static, built from still images. But like the rest of the virtual reality market, these tools are still evolving toward more realistic scenes.

And even in its current form, the service can be convincing. The young man recently took a flight across the country — here in the real world.

The New York Times

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[WEB SITE] Caregiving Issues and Strategies

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Whether you’re trying to work out a care plan for your aging parents with  your siblings, or searching online for the latest app to assist you with your ill spouse’s medication reminders, FCA’s resources on Caregiving Issues and Strategies offer a wealth of information. This section provides you with practical care strategies, stress relief, available community resources, how to handle family issues, as well as hands-on care.

Source: Family Caregiver Alliance

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[Cochrane Review] Activity monitors for increasing physical activity in adult stroke survivors – Full Text

Cochrane library logo

Abstract

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows:

To summarise the available evidence regarding the effectiveness of commercially available wearable devices and smart phone applications for increasing physical activity levels for people with stroke.

Background

Description of the condition

Between 1990 and 2010 absolute numbers of people living with stroke increased by 84% worldwide, and stroke is now the third leading cause of disability globally (Feigin 2014). As such, the disease burden of stroke is substantial. It has been estimated that 91% of the burden of stroke is attributable to modifiable risk factors such as smoking, poor diet, and low levels of physical activity (Feigin 2016). A low level of physical activity (less than four hours per week) is the second highest population-attributable risk factor for stroke, second only to hypertension (O’Donnell 2016). The promotion of physical activity, which has been defined as body movement produced by skeletal muscles resulting in energy expenditure (Caspersen 1985), is therefore an important health intervention for people with stroke.

The association between health and physical activity is well established. Prolonged, unbroken bouts of sitting is a distinct health risk independent of time engaged in regular exercise (Healy 2008). There is evidence from cross-sectional and longitudinal studies that high sitting time and low levels of physical activity contribute to poor glycaemic control (Owen 2010). Three systematic reviews and meta-analyses of observational studies have confirmed that, after adjusting for other demographic and behavioural risk factors, physical activity is inversely associated with all-cause mortality in men and women (Nocon 2008; Löllgen 2009; Woodcock 2011). Yet despite this knowledge, populations worldwide are becoming more sedentary, and physical inactivity has been labelled a global pandemic (Kohl 2012).

In addition to overcoming the sedentary lifestyles and habits prevalent in many modern societies, people with stroke have additional barriers to physical activity such as weakness, sensory dysfunction, reduced balance, and fatigue (Billinger 2014). Directly after a stroke, people should be admitted to hospital for co-ordinated care and commencement of rehabilitation (SUTC 2013). Early rehabilitation after stroke is frequently focused on the recovery of physical independence (Pollock 2014). Recovery after stroke is enhanced by active practice of specific tasks, and greater improvements are seen when people with stroke spend more time in active practice (Veerbeek 2014). Yet findings from research conducted around the world indicate that people in the first few weeks and months after stroke are physically inactive in hospital settings with around 80% of the day spent inactive (sitting or lying) (West 2012). These high levels of inactivity are concerning because recovering the ability to walk independently is an important goal of people with stroke. The reported paucity of standing and walking practice in the early phase after stroke potentially limits the opportunities of people with stroke to optimise functional recovery, particularly for standing and walking goals. Further, physical inactivity may lead to an increased risk of hospital-acquired complications, such as pressure ulcers, pneumonia, and cardiac compromise (Lindgren 2004).

Physical activity levels of people with stroke remain lower than their age-matched counterparts even when they return to living in the community (English 2016). Community-dwelling stroke survivors spend the vast majority of their waking time sitting down (English 2014). Promisingly, early research suggests that increasing physical activity in people with stroke is feasible, and that an increase in physical activity levels after stroke may have a positive impact on fatigue, mood, community participation, and quality of life (QoL) (Graven 2011; Duncan 2015).

Continue —> Activity monitors for increasing physical activity in adult stroke survivors – Lynch – 2017 – The Cochrane Library – Wiley Online Library

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[WEB SITE] Exercise Prescription Software – Physical Therapy Web

Any tool that can help people be more active and involved in their own rehabilitation is worthwhile. An increase in patient compliance can be achieved by making exercise programs easier to adhere to. Clear descriptions of how to perform exercises correctly is also critical to the success of any exercise program. Here is a list of software applications that allow physical therapists to create specific exercise programs for their patients. The list is not complete. If you know of a product that should be included or if you’d like to have your exercise prescription software reviewed, please let us know.

exercise prescription software - diagram

By Udrekeli [Public domain], via Wikimedia Commons

 

Arena Health Systems: Creators of Phys-X software

“Phys-X Advanced includes over 900 of the most often prescribed range of motion, stabilization and strengthening exercises (categories listed below) and includes Full Color Photographs for most exercises! Each exercise includes an illustration and specific easy to follow instructions that allow on-the-fly modification. The exercises can even be printed with Spanish instructions.”

BPM Rx: Exercise prescription for health and fitness professionals

“Whether you’re a personal trainer or physical therapist, exercise prescription is your life. BPM Rx is the ultimate PT Software that allows you to craft stunning exercise handouts that will inspire like never before! Try it out-the first week is free!”

BioEx Systems Inc.: Easy to use home exercise database

“Exercise, Fitness Assessment, Nutrition and Management software for Physical Therapists, Personal Trainers, Dietitians, Nutritionists and other professionals. Windows based software.”

Exercise Prescriber: Provide home exercises and information advice

“…an essential clinical tool for health professionals who routinely provide home exercises and information advice for their clients.”

Exercise Pro Live : Personalized Video and Printed Exercise Programs for Rehabilitation and Fitness

“…designed by physical therapists and other fitness professionals to provide video exercise programs with clear exercise instructions, proper exercise form and improved compliance and communication between health professionals and their clients.”

HEP2go.com: HEP for rehab pro’s

“For rehabilitation professionals such as physical therapists, occupational therapists, athletic trainers, etc. to create home exercise programs for patients and or clients.”

i-HEP.com: iHomeExerciseProgram

“Innovative Video + Web-based Platform = Better HEP Management & Better Patient Education

Mavenlive: Intelligent exercise prescription, customizable images, and documentation (free-trial available)

“Using Mavenlive will benefit you not only from a clinical standpoint, but it will help you improve relationships with your patients and your referral sources. Mavenlive clients tell us that physicians love getting professional correspondence. “

myclinicspace: High quality image and video exercises for patient rehabilitation

“myclinicspace is an online exercise prescription package for health professionals.”

MyPhysioRehab: A global community of therapists helping to speed your recovery (free-demo available)

“MyPhysioRehab allows you as a health professional to provide your patients with an injury profile and a rehabilitation programme to aid rapid recovery.”

PacPacs+: Online Rehabilitation Exercise and Client Management

“Manage your patient aftercare. Prescribe rehabilitation routines with multi-angle videos. Track consultation history and make notes for future sessions.”

Patient Care HEP: MedBridge

“Patient Care HEP is the fast, easy, comprehensive, and engaging home exercise program for rehabilitation professionals.”

Physiotec: Exercise and patient education database software

“Physiotec offers a health and fitness software with exercise programs for physiotherapy, rehabilitation and therapeutic exercises and distributes it across Canada, United-States (USA) and United-Kingdoms.”

PTX – PhysioTherapy eXercises: Create custom programs or choose ready made programs

“A free tool to create exercise programs for people with injuries and disabilities”

PhysioTools Software: Comprehensive and easy to use exercise software

“Exercise software for health and fitness professionals to print and email over 15,000 exercises for rehabilitation, physiotherapy, sports and education”

Physioview: Features professionally produced photographs, audio, video and text

“Physioview redefines the home exercise program from the fundamental to highly customized creation of rehabilitation exercise protocols. “

Physitrack: A mobile phone exclusively for practitioners

“Provides Physical Therapists with the ability to prescribe exercises, send messages to their patients”

The Rehab Lab: Online Exercise Prescription Software

“The Rehab Lab is an online exercise prescription software application that enables physiotherapists to create customised rehabilitation programmes for clients and patients.”

Simple Therapy: video exercise therapy that matches your needs, when and where you want it

“SimpleTherapy® offers more than 20 video-based exercise therapy programs designed by doctors.”

SimpleSet Pro: Advanced Exercise Prescription Software

“SimpleSet Pro is the ultimate online tool for professional exercise program design. With SimpleSet Pro you can create comprehensive exercise programs for your clients, and email or print them in minutes!”

SHAPES: Spatially and Human Aware Performance Evaluation System.

“SHAPES is an interactive, assistive technology (using the Microsoft Xbox Kinect) that enhances exercise routines.”

TheraVid: Connect. Discover. Recover.

“Use our expanding database of HD exercise videos and unique online interface to build better client relationships today. Free while in beta.”

WebExercises: Exercise Prescription Made Easy™

“WebExercises® will promote more frequent and proper form of all prescribed rehabilitation and corrective exercises – resulting in improved recovery and stronger happier patients and clients.”

wellpepper: gives your health a kick

“Wellpepper for iPad and iPhone enables healthcare professionals to prescribe physical therapy exercises and encourages people to complete exercises at home to help speed recovery”

Source: Exercise Prescription Software – Physical Therapy Web

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[WEB SITE] Bioness Receives FDA Clearance for the L300 Go™ System.

VALENCIA, Calif., Feb. 07, 2017 /PRNewswire/

Bioness, Inc., the leading provider of cutting-edge, clinically supported rehabilitation therapies, today announced that it received clearance from the U.S. Food and Drug Administration (FDA) for the L300 Go System. The L300 Go builds upon the global success of the company’s NESS L300® Foot Drop System and NESS L300 Plus® System with numerous advancements, including the introduction of 3D motion detection of gait events, multi-channel stimulation and a mobile iOS application to track user activity.

Gait movement disorders, such as foot drop and knee instability, are often associated with an upper motor neuron disease such as stroke and multiple sclerosis as well as injuries to the brain and spinal cord. Individuals with an impaired gait have less control over their lower extremity muscles and are at an increased risk for falls. The L300 Go is the first functional electrical stimulation (FES) system to offer 3D motion detection of gait events and muscle activation using data from a 3-axis gyroscope and accelerometer.  Patient movement is monitored in all three kinematic planes and stimulation is deployed precisely when needed during the gait cycle.  An adaptive, learning algorithm accommodates changes in gait dynamics, and a high speed processor that deploys stimulation within 10 milliseconds of detecting a valid gait event.  This rapid, reliable response is critical and supports user confidence.

The new myBioness™ mobile iOS application allows home users of the system to track activity, set personal goals and review their progress over time using dynamic reporting capabilities. The app has been designed to keep users engaged in the rehabilitation process and motivated to meet their recovery goals.

Multi-channel stimulation is an additional noteworthy L300 Go feature that allows clinicians to precisely control the amount of dorsiflexion and inversion/eversion the system provides. Using a new, proprietary electrode, medial and lateral stimulation can be adjusted independently. This more efficient fitting process saves valuable time and facilitates more productive therapy sessions.

“The healthcare system is being challenged to objectively document and improve functional capabilities. To help meet these demands, clinicians are turning to technologies that speed up rehabilitation timelines and provide a personalized recovery plan,” said Todd Cushman, President and CEO of Bioness. “Technological innovations including 3D motion detection and multi-channel stimulation work together to improve treatment efficiency and promote patient mobility. At Bioness, we are focused on improving the lives of patients through technology and are proud to add the L300 Go into our growing portfolio of products.”

The L300 Go System was cleared by the U.S. Food and Drug Administration on January 27, 2017.  The system is indicated to provide ankle dorsiflexion in adult and pediatric individuals with foot drop and/or assist knee flexion or extension in adult individuals with muscle weakness related to upper motor neuron disease/injury (e.g., stroke, damage to pathways to the spinal cord). The L300 Go System electrically stimulates muscles in the affected leg to provide ankle dorsiflexion of the foot and/or knee flexion or extension; thus, it also may improve the individual’s gait.

Bioness will begin commercial release of the L300 Go in the spring of 2017. Initially, the system will only be available to healthcare professionals for clinic use. Home user availability is targeted for the later part of 2017. Current users of the L300 Foot Drop System and L300 Plus System will be eligible for a Customer Loyalty Upgrade Program which is designed to make the new technology more accessible for users in the clinic and community.

About Bioness, Inc.
Bioness is the leading provider of innovative technologies helping people regain mobility and independence. Bioness solutions include implantable and external neuromodulation systems, robotic systems and software based therapy programs providing functional and therapeutic benefits for individuals affected by pain, central nervous system disorders and orthopedic injuries. Currently, Bioness offers six medical devices within its commercial portfolio which are distributed and sold on five continents and in over 25 countries worldwide. Our technologies have been implemented in the most prestigious and well-respected institutions around the globe with approximately 90% of the top rehabilitation hospitals in the United States currently using one or more Bioness solution.  Bioness has a singular focus on aiding large, undeserved customer groups with innovative, evidence-based solutions and we will continue to develop and make commercially available new products that address the growing and changing needs of our customers. Individual results vary. Consult with a qualified physician to determine if this product is right for you. Contraindications, adverse reactions and precautions are available online at www.bioness.com.

Source: Bioness Receives FDA Clearance for the L300 Go™ System

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[Project Report] “Active on Wheels” INF2260/4060 H2016 – Full Text PDF

1. Introduction

The “Active on Wheels” project is done in collaboration with Matthijs Wouda at Sunnaas Sykehus HF, and our project statement is simply put to design a useful, inspiring, and motivating interface for the “Active on Wheels” app. The app combines a smartphone, fitness-armband, and a heart rate monitor belt to provide accurate energy expenditure (how many calories you use) for wheelchair users. The app exists today with a functional, but bare bones design (See Fig 1), which our task is to change. The goal of the app is to enable exercise measuring and tracking for disabled people outside of hospital settings, in order to motivate and support them to exercise and work out.

Full Text PDF

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[WEB SITE] RAPAEL Smart Glove Receives CES 2017 Innovation Award – Rehab Managment

The RAPAEL Smart Glove, a wearable device from NEOFECT, Burlingame, Calif, offers at-home game-based hand therapy for stroke patients who cannot visit a clinic due to economic or geographic reasons.

Simply wear the glove, connect to the “RAPAEL” app, and play the rehabilitation games.

The Smart Glove—a CES 2017 Innovation Awards Honoree for the hospital edition—leads the patient through games that stimulate daily activities, in one or two 30-minute sessions per day.

Built-in sensors capture the patient’s movement and positioning data, and transfer it via Bluetooth to a tablet, where it is analyzed. This analysis enables the games’ difficulty levels to be adjusted and the patient’s exercise schedule to be customized.

Training movements include forearm supination/pronation, wrist flexion/extension, wrist radial/ulnar deviation, and finger flexion/extension, per the company’s website.

[Source: NEOFECT]

Source: RAPAEL Smart Glove Receives CES 2017 Innovation Award – Rehab Managment

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[WEB SITE] “Selfie Pay”: Making Online Payments Via Selfies – Assistive Technology Blog

Selfies are all the rage these days. Using this popular technique of taking photos, Mastercard is trialing a new method of payment that may be helpful to people with disabilities. The company’s new mobile app, called “Identity Check Mobile” (and popularly known as Selfie Pay) allows shoppers to pay for their purchases online by taking a selfie.

This is how it works: The app, when first downloaded, takes a photo of the user, and stores a digitized photo of their face on Mastercard’s servers. When that user is shopping online on their computer, and is ready to pay, they get a notification on their phone to verify the purchase amount. Once they verify it (by simply tapping on the amount), the next screen asks them to take a selfie. The selfie is then matched with the digitized photo of that person’s face, and if there is a match, the purchase is approved. The app also asks the person to blink to ensure that a human is actually taking the selfie, and someone is not just holding a photo of the person in front of the phone camera.

This can be beneficial for people with not very good motor skills, amputees, people with vision impairment or anyone who would want to speed up the checkout process by not typing on the keyboard.

This app is already available in several countries in Europe, and Mastercard says it should be available across the globe starting sometime next year.

Source: “Selfie Pay”: Making Online Payments Via Selfies – Assistive Technology Blog

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[ARTICLE] Democratizing Neurorehabilitation: How Accessible are Low-Cost Mobile-Gaming Technologies for Self-Rehabilitation of Arm Disability in Stroke? – Full Text HTML

Abstract

Motor-training software on tablets or smartphones (Apps) offer a low-cost, widely-available solution to supplement arm physiotherapy after stroke. We assessed the proportions of hemiplegic stroke patients who, with their plegic hand, could meaningfully engage with mobile-gaming devices using a range of standard control-methods, as well as by using a novel wireless grip-controller, adapted for neurodisability. We screened all newly-diagnosed hemiplegic stroke patients presenting to a stroke centre over 6 months. Subjects were compared on their ability to control a tablet or smartphone cursor using: finger-swipe, tap, joystick, screen-tilt, and an adapted handgrip. Cursor control was graded as: no movement (0); less than full-range movement (1); full-range movement (2); directed movement (3). In total, we screened 345 patients, of which 87 satisfied recruitment criteria and completed testing. The commonest reason for exclusion was cognitive impairment. Using conventional controls, the proportion of patients able to direct cursor movement was 38–48%; and to move it full-range was 55–67% (controller comparison: p>0.1). By comparison, handgrip enabled directed control in 75%, and full-range movement in 93% (controller comparison: p<0.001). This difference between controllers was most apparent amongst severely-disabled subjects, with 0% achieving directed or full-range control with conventional controls, compared to 58% and 83% achieving these two levels of movement, respectively, with handgrip. In conclusion, hand, or arm, training Apps played on conventional mobile devices are likely to be accessible only to mildly-disabled stroke patients. Technological adaptations such as grip-control can enable more severely affected subjects to engage with self-training software.

Introduction

The most important intervention shown to improve physical function after stroke is repetitive, task-directed exercises, supervised by a physiotherapist, with higher intensity leading to faster and greater recovery. In practice, access to physiotherapy is significantly limited by resource availability . For example, 55% of UK stroke in-patients receive less than half the recommended physiotherapy time of 45 minutes per day.

One solution to inadequate physiotherapy is robotic technology, that enables patients to self-practice, with mechanical assistance, via interaction with adapted computer games. While a range of rehabilitation robotics have been marketed over the last decade, and shown to be efficacious, they are not widely used due to factors such as high-cost (typically, $10,000–100,000), cumbersome size, and restriction to patients with high baseline performance, and who have access to specialist rehabilitation centres.

An alternative approach to self-rehabilitation, are medical applications (Apps), or gaming software, run on mobile media devices e.g. tablets or smartphones. Because such devices are low-cost ($200–500), and ubiquitous, they have the potential to democratize computerized-physiotherapy, especially in under-resourced settings, e.g. chronically-disabled in the community. Furthermore, their portability enables home use, while their employment of motivational gaming strategies can potentiate high-intensity motor practice. Accordingly, increasing numbers of motor-training Apps for mobile devices have been commercialised in recent years, and clinical trials are under way. However, since these devices are designed for able-person use, it is questionable as to how well disabled people can access them, and engage meaningfully and repeatedly with rehabilitation software.

This study assesses the degree of motor interaction that can be achieved by hemiplegic stroke patients using four types of conventional hand-control methods (finger swipe, tap, joystick and tilt) for mobile devices. An adapted controller of the same mobile devices, whose materials cost ~$100, was evaluated alongside. Since the latter interface exploits the fact that handgrip is relatively spared in stroke hemiplegia, and is sensitive to subtle forces, we expected that this would increase the range of arm-disability severities able to achieve meaningful computer-game control. In order to assess motor control, with minimal cognitive confounding (given that many softwares also have cognitive demands), we used a simple 1-dimensional motor assessment for all controller types.

Continue —> PLOS ONE: Democratizing Neurorehabilitation: How Accessible are Low-Cost Mobile-Gaming Technologies for Self-Rehabilitation of Arm Disability in Stroke?

Fig 1. Control methods and devices trialled. Conventional control mechanisms were trialled using standard tablet and smartphone (A, B). Subjects were required only to move a cursor along a single vertical path, full-range, and then to an indicated vertical level (they were not tested on playing the underlying game). B shows software used for assessing swipe, with varying cursor size. There was no improvement in accessibility using a larger cursor. The novel control mechanism (C) is a wireless grip-force sensor that detects both finger-flexion and extension movements, the latter assisted by a fingerstrap holding the device within a partially-extended hand. Control software for C entailed moving a circle in a vertical plane towards a target star. Cursor and target stimuli dimensions and contrast are similar between all methods.

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