A comparative analysis of haptic and EEG devices for evaluation and training of post-stroke patients within a virtual environment

Virtual Rehabilitation benefits from the usage of interfaces other than the mouse and keyboard, but also possess disadvantages: haptic peripherals can utilize the subject\u27s hand to provide position information or joint angles, and allow direct training for specific movements; but can also place unneeded strain on the limbs; brain-machine interfaces (BMI) can provide direct connections from the user to external hardware or software, but are currently inaccurate for the full diversity of user movements in daily life and require invasive surgery to implement. A compromise between these two extremes is a BMI that can be adapted to specific users, can function with a wide range of hardware and software, and is both noninvasive and convenient to wear for extended periods of time. A suitable BMI using Electroencephalography (EEG) input, known as the Emotiv EPOC™ by Emotiv Systems was evaluated using multiple input specializations and tested with an external robotic arm to determine if it was suitable for control of peripherals. Users were given a preset periodicity to follow in order to evaluate their ability to translate specific facial movements into commands as well as their responsiveness to change the robot arm\u27s direction. Within 2 weeks of training, they maintained or improved axial control of the robot arm, and reduced their overall performance time. Although the EPOC™ does require further testing and development, its adaptability to multiple software programs, users and peripherals allows it to serve both Virtual Rehabilitation and device control in the immediate future

Design of a complex virtual reality simulation to train finger motion for persons with hemiparesis: a proof of concept study

<p>Abstract</p> <p>Background</p> <p>Current neuroscience has identified rehabilitation approaches with the potential to stimulate adaptive changes in the brains of persons with hemiparesis. These approaches include, intensive task-oriented training, bimanual activities and balancing proximal and distal upper extremity interventions to reduce competition between these segments for neural territory.</p> <p>Methods</p> <p>This paper describes the design and feasibility testing of a robotic/virtual environment system designed to train the hand and arm of persons with hemiparesis. The system employs a simulated piano that presents visual, auditory and tactile feedback comparable to an actual piano. Arm tracking allows patients to train both the arm and hand as a coordinated unit, emphasizing the integration of both transport and manipulation phases. The piano trainer includes songs and scales that can be performed with one or both hands. Adaptable haptic assistance is available for more involved subjects. An algorithm adjusts task difficulty in proportion to subject performance. A proof of concept study was performed on four subjects with upper extremity hemiparesis secondary to chronic stroke to establish: a) the safety and feasibility of this system and b) the concurrent validity of robotically measured kinematic and performance measures to behavioral measures of upper extremity function.</p> <p>Results</p> <p>None of the subjects experienced adverse events or responses during or after training. As a group, the subjects improved in both performance time and key press accuracy. Three of the four subjects demonstrated improvements in fractionation, the ability to move each finger individually. Two subjects improved their aggregate time on the Jebsen Test of Hand Function and three of the four subjects improved in Wolf Motor Function Test aggregate time.</p> <p>Conclusion</p> <p>The system designed in this paper has proven to be safe and feasible for the training of hand function for persons with hemiparesis. It features a flexible design that allows for the use and further study of adjustments in point of view, bilateral and unimanual treatment modes, adaptive training algorithms and haptically rendered collisions in the context of rehabilitation of the hemiparetic hand.</p

Device to rehabilitate one’s Physical and Learning Abilities

This article presents an innovative device to rehabilitate people’s physical and learning abilities. We aim to substantiate the subject, review existing solutions, and explain the most important issues connected with rehabilitation. We describe the CAD-based conceptual design of the device, its dedicated software, selection of actuators, and construction of the device’s prototype, including its first tests. The device includes an original set of exercises, which can be individually set for every patient to improve his physical abilities, memory (both visual and auditory) and reflexes (i.e. reaction time to a stimulus). Rehabilitation exercises, which are performed in virtual reality and shown on a display screen, are additionally enhanced in real life by introducing obstacles and space restrictions, which the user faces while performing his tasks. Deliberate restrictions of one’s space in which to perform exercises is made possible not only due to the device’s original design, that is a four-frames construction, but also due to connectors with adjustable installation points, which enables positioning of obstacles to suit the current state of a patient. The prototype device and its original software have been designed to suit stroke convalescents and preschool children. First tests were carried out with preschool children and this article highlights the results of these tests. They included exercises, which were custom-made for children, such as a quiz, exercise to train one’s reflexes, visual memory, auditory memory and games involving music. Since the rehabilitation device utilizes unique technical solutions, a patent application has been filed for it

Adaptable videogame platform for interactive upper extremity rehabilitation

The primary objective of this work is to design a recreational rehabilitation videogame platform for customizing motivating games that interactively encourage purposeful upper extremity gross motor movements. Virtual reality (VR) technology is a popular application for rehabilitation therapies but there is a constant need for more accessible and affordable systems. We have developed a recreational VR game platform can be used as an independent therapy supplement without laboratory equipment and is inexpensive, motivating, and adaptable. The behaviors and interactive features can be easily modified and customized based on players\u27 limitations or progress. A real-time method of capturing hand movements using programmed color detection mechanisms to create the simulated virtual environments (VEs) is implemented. Color markers are tracked and simultaneously given coordinates in the VE where the player sees representations of their hands and other interacting objects whose behaviors can be customized and adapted to fit therapeutic objectives and players\u27 interests. After gross motor task repetition and involvement in the adaptable games, mobility of the upper extremities may improve. The videogame platform is expanded and optimized to allow modifications to base inputs and algorithms for object interactions through graphical user interfaces, thus providing the adaptable need in VR rehabilitation

Jogos usados na reabilitação após Acidente Vascular Cerebral: Scoping Review

Objectives: To explore the current state of scientific knowledge related to the use of games in the rehabilitation of individuals after stroke, with the objectives of mapping the games and identifying the areas of function rehabilitated. Method: Scoping review, based on Joanna Briggs Institute model. Search in MEDLINE®, CINAHL® and SPORTDiscus® databases. All types of scientific studies published in English, Spanish and Portuguese, without time limit, were considered. Results: In the 116 articles considered for analysis three major groupings of games were identified: Immersive / Non-Immersive Virtual Reality, Video Games and Traditional Games, which were associated with the rehabilitation of motor, proprioceptive, cognitive and cardiorespiratory functions. Conclusion: The use of games in rehabilitation has grown over the last few years. Games induce greater interactivity in intensive and repetitive training, adding more motivation and adherence to rehabilitation processes, which can be an important therapeutic resource.Objetivos: explorar el estado actual del conocimiento científico relacionado con el uso de juegos en la rehabilitación de individuos después de un accidente cerebrovascular, para mapear los juegos e identificar áreas de función rehabilitadas. Método: Revisión del alcance, basado en el modelo del Instituto Joanna Briggs. Busque en las bases de datos MEDLINE®, CINAHL® y SPORTDiscus®. Se consideraron todos los tipos de estudios científicos publicados en inglés, español y portugués, sin límite de tiempo. Resultados: En los 116 artículos considerados para el análisis se identificaron tres grandes grupos de juegos: Realidad virtual inmersiva / no inmersiva, Videojuegos y Juegos tradicionales, que se asociaron con la rehabilitación de las funciones motoras, propioceptivas, cognitivas y cardiorrespiratorias. Conclusión: El uso de juegos en rehabilitación ha crecido en los últimos años. Los juegos inducen una mayor interactividad en el entrenamiento intensivo y repetitivo, agregando más motivación y adherencia a los procesos de rehabilitación, que pueden ser un recurso terapéutico importante.Objetivos: explorar o estado atual do conhecimento científico relacionado com a utilização de jogos na reabilitação do indivíduo após Acidente Vascular Cerebral, para mapear os jogos e identificar as áreas de função reabilitadas. Método: revisão do tipo Scoping, com base no modelo do Joanna Briggs Institute. Realizada busca nas bases de dados MEDLINE®, CINAHL® e SPORTDiscus®. Foram considerados todos os tipos de estudos científicos publicados em inglês, espanhol e português, sem limite temporal. Resultados: Nos 116 artigos considerados para análise identificaram-se três grandes agrupamentos de jogos: Realidade Virtual imersiva/não imersiva, videojogos e Jogos Tradicionais, que se associaram à reabilitação das funções motora, propriocetiva, cognitiva e cardiorrespiratória. Conclusão: A utilização de jogos na reabilitação cresceu ao longo dos últimos anos. Os jogos induzem maior interatividade no treino intensivo e repetitivo, acrescentando mais motivação e adesão aos processos de reabilitação, podendo ser um importante recurso terapêutico

Gait sonification for rehabilitation: adjusting gait patterns by acoustic transformation of kinematic data

To enhance motor learning in both sport and rehabilitation, auditory feedback has emerged as an effective tool. Since it requires less attention than visual feedback and hardly affects the visually dominated orientation in space, it can be used safely and effectively in natural locomotion such as walking. One method for generating acoustic movement feedback is the direct mapping of kinematic data to sound (movement sonification). Using this method in orthopedic gait rehabilitation could make an important contribution to the prevention of falls and secondary diseases. This would not only reduce the individual suffering of the patients, but also medical treatment costs. To determine the possible applications of movement sonification in gait rehabilitation in the context of this work, a new gait sonification method based on inertial sensor technology was developed. Against the background of current scientific findings on sensorimotor function, feedback methods, and gait analysis, three studies published in scientific journals are presented in this thesis: The first study shows the applicability and acceptance of the feedback method in patients undergoing inpatient rehabilitation after unilateral total hip arthroplasty. In addition, the direct effect of gait sonification during ten gait training sessions on the patients’ gait pattern was revealed. In the second study, the immediate follow-up effect of gait sonification on the kinematics of the same patient group is examined at four measurement points after gait training. In this context, a significant influence of sonification on the gait pattern of the patients was shown, which, however, did not meet the previously expected effects. In view of this finding, the effect of the specific sound parameter loudness of gait sonification on the gait of healthy persons was analyzed in a third study. Thus, an impact of asymmetric loudness of gait sonification on the ground contact time could be detected. Considering this cause-effect relationship can be a component in improving gait sonfication in rehabilitation. Overall, the feasibility and effectiveness of movement sonification in gait rehabilitation of patients after unilateral hip arthroplasty becomes evident. The findings thus illustrate the potential of the method to efficiently support orthopedic gait rehabilitation in the future. On the basis of the results presented, this potential can be exploited in particular by an adequate mapping of movement to sound, a systematic modification of selected sound parameters, and a target-group-specific selection of the gait sonification mode. In addition to a detailed investigation of the three factors mentioned above, an optimization and refinement of gait analysis in patients after arthroplasty using inertial sensor technology will be beneficial in the future.Akustisches Feedback kann wirkungsvoll eingesetzt werden, um das Bewegungslernen sowohl im Sport als auch in der Rehabilitation zu erleichtern. Da es weniger Aufmerksamkeit als visuelles Feedback erfordert und die visuell dominierte Orientierung im Raum kaum beeinträchtigt, kann es während einer natürlichen Fortbewegung wie dem Gehen sicher und effektiv genutzt werden. Eine Methode zur Generierung akustischen Bewegungsfeedbacks ist die direkte Abbildung kinematischer Daten auf Sound (Bewegungssonifikation). Ein Einsatz dieser Methode in der orthopädischen Gangrehabilitation könnte einen wichtigen Beitrag zur Prävention von Stürzen und Folgeerkrankungen leisten. Neben dem individuellen Leid der Patienten ließen sich so auch medizinische Behandlungskosten erheblich reduzieren. Um im Rahmen dieser Arbeit die Einsatzmöglichkeiten der Bewegungssonifikation in der Gangrehabilitation zu bestimmen, wurde eine neue Gangsonifikationsmethodik auf Basis von Inertialsensorik entwickelt. Zu der entwickelten Methodik werden, vor dem Hintergrund aktueller wissenschaftlicher Erkenntnisse zur Sensomotorik, zu Feedbackmethoden und zur Ganganalyse, in dieser Thesis drei in Fachzeitschriften publizierte Studien vorgestellt. Die erste Studie beschreibt die Anwendbarkeit und Akzeptanz der Feedbackmethode bei Patienten in stationärer Rehabilitation nach unilateraler Hüftendoprothetik. Darüber hinaus wird der direkte Effekt der Gangsonifikation während eines zehnmaligen Gangtrainings auf das Gangmuster der Patienten deutlich. In der zweiten Studie wird der unmittelbare Nacheffekt der Gangsonifikation auf die Kinematik der gleichen Patientengruppe zu vier Messzeitpunkten nach dem Gangtraining untersucht. In diesem Zusammenhang zeigte sich ein signifikanter Einfluss der Sonifikation auf das Gangbild der Patienten, der allerdings nicht den zuvor erwarteten Effekten entsprach. Aufgrund dieses Ergebnisses wurde in einer dritten Studie die Wirkung des spezifischen Klangparameters Lautstärke der Gangsonifikation auf das Gangbild von gesunden Personen analysiert. Dabei konnte ein Einfluss von asymmetrischer Lautstärke der Gangsonifikation auf die Bodenkontaktzeit nachgewiesen werden. Die Berücksichtigung dieses Ursache-Wirkungs-Zusammenhangs kann einen Baustein bei der Verbesserung der Gangsonifikation in der Rehabilitation darstellen. Insgesamt wird die Anwendbarkeit und Wirksamkeit von Bewegungssonifikation in der Gangrehabilitation bei Patienten nach unilateraler Hüftendoprothetik evident. Die gewonnenen Erkenntnisse verdeutlichen das Potential der Methode, die orthopädische Gangrehabilitation zukünftig effizient zu unterstützen. Ausschöpfen lässt sich dieses Potential auf Grundlage der vorgestellten Ergebnisse insbesondere anhand einer adäquaten Zuordnung von Bewegung zu Sound, einer systematischen Modifikation ausgewählter Soundparameter sowie einer zielgruppenspezifischen Wahl des Modus der Sonifikation. Neben einer differenzierten Untersuchung der genannten Faktoren, erscheint zukünftig eine Optimierung und Verfeinerung der Ganganalyse bei Patienten nach Endoprothetik unter Einsatz von Inertialsensorik notwendig

ADEPT:Exploring the Design, Pedagogy, and Analysis of a Mixed Reality Application for Piano Training

(Abstract to follow