Traditional forms of physical therapy and rehabilitation are often based on therapist observation and judgment, coincidentally this process oftentimes can be inaccurate, expensive, and non-timely. Modern immersive Virtual Reality systems provide a unique opportunity to make the therapy process smarter. In this paper, we present an immersive virtual reality stroke rehabilitation game based on a widely accepted therapy method, Constraint-Induced Therapy, that was evaluated by nine post-stroke participants. We implement our game as a dynamically adapting system that can account for the user’s motor abilities while recording real-time motion capture and behavioral data. The game also can be used for tele-rehabilitation, effectively allowing therapists to connect with the participant remotely while also having access to +90Hz real-time biofeedback data. Our quantitative and qualitative results suggest that our system is useful in increasing affordability, accuracy, and accessibility of post-stroke motor treatment.
via Towards an Immersive Virtual Reality Game for Smarter Post-Stroke Rehabilitation – IEEE Conference Publication
The applications of robotics to the rehabilitation training of neuromuscular impairments have received increasing attention due to their promising prospects. The effectiveness of robot-assisted training directly depends on the control strategy applied in the therapy program. This paper presents an upper extremity exoskeleton for the functional recovery training of disabled patients. A minimal-intervention-based admittance control strategy is developed to induce the active participation of patients and maximize the use of recovered motor functions during training. The proposed control strategy can transit among three control modes, including human-conduct mode, robot-assist mode, and motion-restricted mode, based on the real-time position tracking errors of the end-effector. The human-robot interaction in different working areas can be modulated according to the motion intention of patient. Graphical guidance developed in Unity-3-D environment is introduced to provide visual training instructions. Furthermore, to improve training performance, the controller parameters should be adjusted in accordance with the hemiplegia degree of patients. For the patients with severe paralysis, robotic assistance should be increased to guarantee the accomplishment of training. For the patients recovering parts of motor functions, robotic assistance should be reduced to enhance the training intensity of effected limb and improve therapeutic effectiveness. The feasibility and effectiveness of the proposed control scheme are validated via training experiments with two healthy subjects and six stroke patients with different degrees of hemiplegia.
via Development of a Minimal-Intervention-Based Admittance Control Strategy for Upper Extremity Rehabilitation Exoskeleton – IEEE Journals & Magazine
Long-term rehabilitation opportunities are critical for millions of individuals with chronic upper limb motor deficits striving to improve their motor performance through self-managed rehabilitation programs. However, there is minimal professional support of rehabilitation across the lifespan. In this paper, we introduce an upper extremity rehabilitation system, the Quality of Movement Feedback-Oriented Measurement System (QM-FOrMS), by integrating cost-effective portable sensors and clinically verified motion quality analysis towards individuals with upper limb motor deficits. Specifically, QM-FOrMS is comprised of an eTextile pressure sensitive mat, named Smart Mat, a sensory can, named Smart Can, and a mobile device. A personalizable and adaptive upper limb rehabilitation program is developed, including both unilateral and bilateral functional activities which can be selected from a list or custom designed to further tailor the program to the individual. Quantitative evaluation of the motor performance from the QM-FOrMS is derived from fine-grained kinematic measurements. We ran a pilot study with three groups, including five baseline subjects (i.e., healthy young adults), six older adults and four individuals with movement impairment. The experimental results show that QM-FOrMS can provide the detailed feature during the unattended rehabilitation exercise, and proposed metrics can distinguish the evaluation results across group.
Source: A portable and cost-effective upper extremity rehabilitation system for individuals with upper limb motor deficits – IEEE Xplore Document
This study investigates the effect of combining both mirror therapy with Electrical Stimulation (ES) on improvement of the function of lower extremity compared to conventional therapy. 18 stroke survivors (sub acute stage) were recruited, 9 of them were randomly assigned to receive conventional treatment and another 9 started the mirror therapy combined with ES treatment. Duration of each session in both interventions was 50 minutes, done 4 times per week over two weeks. After 2 weeks, subjects took one week rest before switching they type of treatment; those started with conventional therapy continued with mirror therapy combined with ES, and vice versa. The duration of this phase was 2 weeks with same schedule as the 1st one. Ankle dorsi-flexion range of motion, lower extremity sensory-motor function, and walking duration were measured at baseline, after 1st 2 weeks, and immediately after the last two weeks, and 4 weeks after end of training (retention test). Repeated Measures ANCOVA was done to compare outcome measures scores in both groups and between all testing days, and paired T-test was used measure the difference between groups. Significant increase in all outcome measures was found after the (MT+ES) training, which is higher than conventional therapy training (p<;0.0001). In conclusion, the results suggest that combination of mirror therapy and ES is more effective than conventional therapy in improving lower limb motor function after stroke.
Stroke is a sudden loss of the blood supply to brain tissues where a focal neurological disturbance of brain function rapidly develops. The symptoms of stroke last more than 24 hours and depend on the area of the brain that has been affected. Lower-extremity motor function after stroke is often impaired, causing restrictions in function, gait, and postural performance . Because ankle is one of the most important joints in gait, especially related to dorsiflexion movement , the gait performance is highly diminished as a result of ankle movement impairment . Recovery is most prominent within the first three to six months after stroke. Thus, implementation of intensive therapy within this duration post stroke can lead to faster improvement in activities . Conventional treatment approaches (like Brunnstrom’s approach or Bobath’s approach) for hemiplegic patients have been used for many years, even though they are not always evidence-based and their neurophysiologic background is poorly investigated. On the other hand, several promising rehabilitation approaches have been recently developed addressing the motor recovery and balance of lower extremity in stroke; such as virtual reality, mental imagery, robotic interactive therapy, electrical stimulation, and mirror therapy .
Source: Mirror therapy combined with functional electrical stimulation for rehabilitation of stroke survivors’ ankle dorsiflexion – IEEE Xplore Document