Novel integrative rehabilitation system for the upper extremity: Design and usability evaluation

Purpose Design and test the usability of a novel virtual rehabilitation system for bimanual training of gravity supported arms, pronation/supination, grasp strengthening, and finger extension. Methods A robotic rehabilitation table, therapeutic game controllers, and adaptive rehabilitation games were developed. The rehabilitation table lifted/lowered and tilted up/down to modulate gravity loading. Arms movement was measured simultaneously, allowing bilateral training. Therapeutic games adapted through a baseline process. Four healthy adults performed four usability evaluation sessions each, and provided feedback using the USE questionnaire and custom questions. Participant’s game play performance was sampled and analyzed, and system modifications made between sessions. Results Participants played four sessions of about 50 minutes each, with training difficulty gradually increasing. Participants averaged a total of 6,300 arm repetitions, 2,200 grasp counts, and 2,100 finger extensions when adding counts for each upper extremity. USE questionnaire data averaged 5.1/7 rating, indicative of usefulness, ease of use, ease of learning, and satisfaction with the system. Subjective feedback on the custom evaluation form was 84% favorable. Conclusions The novel system was well-accepted, induced high repetition counts, and the usability study helped optimize it and achieve satisfaction. Future studies include examining effectiveness of the novel system when training patients acute post-stroke.

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Adaptation of Rehabilitation System Based on User’s Mental Engagement

Volume 3: 17th International Conference on Advanced Vehicle Technologies; 12th International Conference on Design Education; 8th Frontiers in Biomedical Devices ◽

10.1115/detc2015-47720 ◽

2015 ◽

Cited By ~ 1

Author(s):

Ehsan T. Esfahani ◽

Shrey Pareek ◽

Pramod Chembrammel ◽

Mostafa Ghobadi ◽

Thenkurussi Kesavadas

Keyword(s):

Brain Activity ◽

Difficulty Level ◽

The Novel ◽

Theta Band ◽

Robotic Rehabilitation ◽

Designed Experiments ◽

Power Spectral ◽

Rehabilitation System ◽

Alpha Beta ◽

The Brain

Recognition of user’s mental engagement is imperative to the success of robotic rehabilitation. The paper explores the novel paradigm in robotic rehabilitation of using Passive BCI as opposed to the conventional Active ones. We have designed experiments to determine a user’s level of mental engagement. In our experimental study, we record the brain activity of 3 healthy subjects during multiple sessions where subjects need to navigate through a maze using a haptic system with variable resistance/assistance. Using the data obtained through the experiments we highlight the drawbacks of using conventional workload metrics as indicators of human engagement, thus asserting that Motor and Cognitive Workloads be differentiated. Additionally we propose a new set of features: differential PSD of Cz-Poz at alpha, Beta and Sigma band, (Mental engagement) and relative C3-C4 at beta (Motor Workload) to distinguish Normal Cases from those instances when haptic where applied with an accuracy of 92.93%. Mental engagement is calculated using the power spectral density of the Theta band (4–7 Hz) in the parietal-midline (Pz) with respect to the central midline (Cz). The above information can be used to adjust robotic rehabilitation parameters I accordance with the user’s needs. The adjustment may be in the force levels, difficulty level of the task or increasing the speed of the task.

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Robotic Table and Serious Games for Integrative Rehabilitation Early Post-Stroke: Two Case Reports (Preprint)

10.2196/preprints.26990 ◽

2021 ◽

Author(s):

Grigore Burdea ◽

Nam H. Kim ◽

Kevin Polistico ◽

Ashwin Kadaru ◽

Namrata Grampurohit ◽

...

Keyword(s):

Upper Extremity ◽

Serious Games ◽

Case Reports ◽

Upper Extremities ◽

Pinch Strength ◽

Robotic Rehabilitation ◽

Standardized Measures ◽

Post Stroke ◽

Active Flexion ◽

Rehabilitation System

BACKGROUND BrightArm Compact is a new rehabilitation system for upper extremities. It provides bimanual training with gradated gravity loading and mediates interactions with serious games. OBJECTIVE To design and test a robotic rehabilitation table-based virtual rehabilitation system for training upper extremities early post-stroke. METHODS A new robotic rehabilitation table, controllers and adaptive games were developed. Participants underwent 12 experimental sessions in addition to the standard of care. Standardized measures of upper extremity motor impairment and function, depression severity, and cognitive function were administered pre- and post-intervention. Non-standardized measures included game variables and subjective evaluations. RESULTS Two case study participants attained high total arm repetitions per session (504 and 957, respectively), and achieved high grasp and finger extension counts. Training intensity contributed to marked improvements in affected arm shoulder strength (225% and 100%, respectively), grasp strength (27% and 16% increase), 3-finger pinch strength (31% and 15% increase). Shoulder active flexion range increased 17% and 18%, respectively, and elbow active supination was larger by 75% and 58%, respectively. Improvements in motor function were at/above Minimal Clinically Important Difference for Fugl-Meyer Assessment (11 and 10 points), Chedoke Inventory (11 and 14 points) and Upper Extremity Functional Index (19 and 23 points). Cognitive/emotive outcomes were mixed. CONCLUSIONS The design of the robotic rehabilitation table was successfully tested on two participants early post-stroke. Results are encouraging. CLINICALTRIAL ClinicalTrials.gov NCT04252170

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Development of the Home based Virtual Rehabilitation System (HoVRS) to remotely deliver an intense and customized upper extremity training

Journal of NeuroEngineering and Rehabilitation ◽

10.1186/s12984-020-00789-w ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Qinyin Qiu ◽

Amanda Cronce ◽

Jigna Patel ◽

Gerard G. Fluet ◽

Ashley J. Mont ◽

...

Keyword(s):

Upper Extremity ◽

Chronic Stroke ◽

Hand Rehabilitation ◽

Kinematic Data ◽

Virtual Rehabilitation ◽

Home Based ◽

Rehabilitation System ◽

Kinematic Measures ◽

And Training ◽

Training Protocol

Abstract Background After stroke, sustained hand rehabilitation training is required for continuous improvement and maintenance of distal function. Methods In this paper, we present a system designed and implemented in our lab: the Home based Virtual Rehabilitation System (HoVRS). Fifteen subjects with chronic stroke were recruited to test the feasibility of the system as well as to refine the design and training protocol to prepare for a future efficacy study. HoVRS was placed in subjects’ homes, and subjects were asked to use the system at least 15 min every weekday for 3 months (12 weeks) with limited technical support and remote clinical monitoring. Results All subjects completed the study without any adverse events. Subjects on average spent 13.5 h using the system. Clinical and kinematic data were collected pre and post study in the subject’s home. Subjects demonstrated a mean increase of 5.2 (SEM = 0.69) on the Upper Extremity Fugl-Meyer Assessment (UEFMA). They also demonstrated improvements in six measurements of hand kinematics. In addition, a combination of these kinematic measures was able to predict a substantial portion of the variability in the subjects’ UEFMA score. Conclusion Persons with chronic stroke were able to use the system safely and productively with minimal supervision resulting in measurable improvements in upper extremity function.

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Usability evaluation of e-motion: A virtual rehabilitation system designed to demonstrate, instruct and monitor a therapeutic exercise programme

2008 Virtual Rehabilitation ◽

10.1109/icvr.2008.4625151 ◽

2008 ◽

Cited By ~ 10

Author(s):

Diarmaid Fitzgerald ◽

Dan Kelly ◽

Tomas Ward ◽

Charles Markham ◽

Brian Caulfield

Keyword(s):

Exercise Programme ◽

Usability Evaluation ◽

Therapeutic Exercise ◽

Virtual Rehabilitation ◽

Rehabilitation System

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Development of a Compensation-aware Virtual Rehabilitation System for Upper Extremity Rehabilitation in Community-Dwelling Older Adults with Stroke

10.21203/rs.3.rs-511925/v1 ◽

2021 ◽

Author(s):

Zhiqiang Luo ◽

Audrey Ei-Ping Lim ◽

Ponraj Durairaj ◽

Kim Kiow Tan ◽

Verawaty Verawaty

Keyword(s):

Older Adults ◽

Upper Extremity ◽

Community Dwelling ◽

Virtual Rehabilitation ◽

Motor Practice ◽

Significant Difference ◽

Rehabilitation System ◽

Before And After ◽

Upper Extremity Rehabilitation ◽

Community Dwelling Older Adults

Abstract Background: Compensatory movements are commonly observed in older adults with stroke when they take motor practice for rehabilitation, which could limit their motor recovery.Aim: This study aims to develop one virtual rehabilitation system (VRS) that can detect and reduce compensatory movements to improve the quality of upper extremity (UE) movements and hence the outcome of rehabilitation in community-dwelling older adults with stroke. Method: To design and validate the algorithm of compensation detection equipped in VRS, a study was first conducted to recruit 17 healthy and 6 stroke participants to identify and quantify compensatory movements when they played rehabilitation games provided by the VRS. Then a pilot study was conducted to test the feasibility and efficacy of the VRS deployed in community, where 18 stroke participants were assigned to either virtual reality (VR) group or conventional treatment (CT) group, and each participant underwent 10 sessions of an additional 6 minutes of VR games or CT respectively, on top of their usual rehabilitation programme. Participants were assessed before and after interventions using Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Wolf Motor Function Test(WMFT), Stroke Rehabilitation Motivation Scale (SRMS), Range of Motion (ROM) measurements and the number of compensatory movements.Results: VR group demonstrated a trend in reduction of trunk and upper-extremity compensations, increased intrinsic motivation scores, and statistically significant improvements in FMA-UE (p=0.045) and WMFT (p=0.009, p=0.0355) scores. There was, however, no significant difference in all outcome measures between two groups. Conclusion: The compensation-aware VRS demonstrates a trend towards reduced compensation and higher motivation level, which could be an effective adjunct to the conventional therapy with less supervision from a therapist as well as be potentially deployed in a community center or at an elder adult’s home.

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Game-based virtual rehabilitation system for upper extremity using low-cost camera

2015 8th Biomedical Engineering International Conference (BMEiCON) ◽

10.1109/bmeicon.2015.7399505 ◽

2015 ◽

Cited By ~ 4

Author(s):

Ngoc Bien Pham ◽

Van Thang Phan ◽

Van Binh Nguyen ◽

Viet Dung Nguyen

Keyword(s):

Upper Extremity ◽

Low Cost ◽

Virtual Rehabilitation ◽

Rehabilitation System

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Development of the Home based Virtual Rehabilitation System (HoVRS) to remotely deliver an intense and customized upper extremity training

10.21203/rs.3.rs-64042/v2 ◽

2020 ◽

Author(s):

Qinyin Qiu ◽

Amanda Cronce ◽

Jigna Patel ◽

Gerard G Fluet ◽

Ashley Mont ◽

...

Keyword(s):

Upper Extremity ◽

Chronic Stroke ◽

Hand Rehabilitation ◽

Kinematic Data ◽

Virtual Rehabilitation ◽

Home Based ◽

Rehabilitation System ◽

Kinematic Measures ◽

And Training ◽

Training Protocol

Abstract Background: After stroke, sustained hand rehabilitation training is required for continuous improvement and maintenance of distal function. Methods: In this paper, we present a system designed and implemented in our lab: the Home based Virtual Rehabilitation System (HoVRS). Fifteen subjects with chronic stroke were recruited to test the feasibility of the system as well as to refine the design and training protocol to prepare for a future efficacy study. HoVRS was placed in subjects’ homes, and subjects were asked to use the system at least 15 minutes every weekday for 3 months (12 weeks) with limited technical support and remote clinical monitoring. Results: All subjects completed the study without any adverse events. Subjects on average spent 13.5 hours using the system. Clinical and kinematic data were collected pre and post study in the subject’s home. Subjects demonstrated a mean increase of 5.2 (SEM=0.69) on the Upper Extremity Fugl-Meyer Assessment (UEFMA). They also demonstrated improvements in six measurements of hand kinematics. In addition, a combination of these kinematic measures was able to predict a substantial portion of the variability in the subjects’ UEFMA score. Conclusion: Persons with chronic stroke were able to use the system safely and productively with minimal supervision resulting in measurable improvements in upper extremity function.

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