A physical therapy system for encouraging specific motion in wrist rehabilitation exercises

The objective this research is to design a passive therapy device with rehabilitation gaming suite that employs an adaptive algorithm that alters game play in order to best fit the needs of the user. The goal of physical therapeutic exercises is to increase proficiency of a motor skill. Physical therapeutic exercises are commonly prescribed to individuals with motor disabilities. During the physical therapy process, individuals will usually practice once a week with the assistance of a clinician and six days a week in isolation. When practicing exercises in the presence of a skilled clinician, an individual receives several benefits including: (1) real-time feedback on accuracy of motions; (2) real-time adaptations to an exercise plan that accommodates the client's skill level and performance; (3) social interactions that increase engagement; and (4) positive feedback that increases morale. These benefits are not realized by the client when practicing exercises in isolation, causing clients to struggle to comply with therapeutic regimens at home. To create this system, first, we designed a passive exoskeleton with a rehabilitation gaming suite that encourages therapeutic motions. Then, we verified its ability to increase participant engagement while completing therapeutic exercises. Next, we verified the ability of our system to encourage accurate therapeutic motions. We then used machine learning techniques to process data from popular video games in order to classify task difficulty and make the rehabilitation game adaptive, so it has the capability to learn and grow with users. A final experiment was conducted with elderly adults and stroke survivors that suggests that adaptive user experiences help promote expedited learning of the task.Ph.D

Visualization and Interaction Technologies in Serious and Exergames for Cognitive Assessment and Training: A Survey on Available Solutions and Their Validation

Exergames and serious games, based on standard personal computers, mobile devices and gaming consoles or on novel immersive Virtual and Augmented Reality techniques, have become popular in the last few years and are now applied in various research fields, among which cognitive assessment and training of heterogeneous target populations. Moreover, the adoption of Web based solutions together with the integration of Artificial Intelligence and Machine Learning algorithms could bring countless advantages, both for the patients and the clinical personnel, as allowing the early detection of some pathological conditions, improving the efficacy and adherence to rehabilitation processes, through the personalisation of training sessions, and optimizing the allocation of resources by the healthcare system. The current work proposes a systematic survey of existing solutions in the field of cognitive assessment and training. We evaluate the visualization and interaction technologies commonly adopted and the measures taken to fulfil the need of the pathological target populations. Moreover, we analyze how implemented solutions are validated, i.e. The chosen experimental designs, data collection and analysis. Finally, we consider the availability of the applications and raw data to the large community of researchers and medical professionals and the actual application of proposed solutions in the standard clinical practice. Despite the potential of these technologies, research is still at an early stage. Although the recent release of accessible immersive virtual reality headsets and the increasing interest on vision-based techniques for tracking body and hands movements, many studies still rely on non-immersive virtual reality (67.2%), mainly mobile and personal computers, and standard gaming tools for interactions (41.5%). Finally, we highlight that although the interest of research community in this field is increasingly higher, the sharing of dataset (10.6%) and implemented applications (3.8%) should be promoted and the number of healthcare structures which have successfully introduced the new technological approaches in the treatment of their host patients is limited (10.2%)

A usability study in patients with stroke using MERLIN, a robotic system based on serious games for upper limb rehabilitation in the home setting

Neuroscience and neurotechnology are transforming stroke rehabilitation. Robotic devices, in addition to telerehabilitation, are increasingly being used to train the upper limbs after stroke, and their use at home allows us to extend institutional rehabilitation by increasing and prolonging therapy. The aim of this study is to assess the usability of the MERLIN robotic system based on serious games for upper limb rehabilitation in people with stroke in the home environment.This research is part of a MERLIN project, which has received funding from EIT Health (Grant no. 20649). EIT Health is supported by the European Institute of Innovation and Technology (EIT), a body of the European Union which receives support from the European Union’s Horizon 2020 Research and innovation programme

How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program

Technologies used to facilitate remote rehabilitation of adults with deconditioning, musculoskeletal conditions, stroke, or traumatic brain injury: an umbrella review

Objective: The objective of this review was to provide an overview of technologies (devices, tools, or software applications) used to facilitate remote rehabilitation of adults with deconditioning, musculoskeletal conditions, stroke, or traumatic brain injury, and to summarize the quantitative evidence of their efficacy. Introduction: Health care providers are considering how to meet longer-term rehabilitation needs of people whose health or level of activity and participation has been impacted directly or indirectly by the COVID-19 pandemic. Demands on rehabilitation services are increasing, driving a need for more services to be delivered in homes and communities. This review will identify the effectiveness of health care technologies to facilitate remote rehabilitation. Inclusion criteria: This review included quantitative systematic reviews where participants were adults requiring rehabilitation for musculoskeletal conditions, stroke, or traumatic brain injury, or older adults requiring rehabilitation for deconditioning. Interventions included a technology and focused on recovery or rehabilitation with one of the following primary outcomes: physical activity levels, balance and/or gait, physical performance (mobility), or functional performance. Secondary outcomes included levels of pain, cognitive function, health-related quality of life, and adverse effects. Methods: Five databases were searched from 2016 to 2020 to identify English-language publications. Critical appraisal of five systematic reviews was conducted independently by two reviewers. Data extraction was performed independently by two reviewers. Data were summarized using a tabular format with supporting text. Results: Despite the large number of systematic reviews found in the initial search, only five met the inclusion criteria. Of these, each explored a different technology, including wearable activity trackers, computer-based activities, non-immersive virtual reality, mobile apps, web-based rehabilitation interventions, and electronic health-based interventions (web-based or app-based with a wearable activity tracker). Computer-based activities were beneficial for improving cognitive function but showed no benefit on quality of life in post-stroke rehabilitation. Interventions that included wearable activity trackers showed mixed findings for increasing levels of physical activity for community-dwelling older adults with deconditioning. Mobile apps were beneficial for increasing levels of physical activity and physical or functional performance for post-stroke rehabilitation. Web-based rehabilitation that contained a variety of components to support home exercise was not effective in improving physical performance or QoL, reducing pain, or increasing levels of physical activity among individuals with rheumatoid arthritis. Electronic health-based interventions (web-based or app-based with a wearable activity tracker) were effective in improving physical performance and reducing pain in individuals with osteoarthritis of the knee or hip. Therapy in the form of screen-based, non-immersive virtual reality could be successfully transferred to the home environment for improving the balance/gait of individuals with stroke. Conclusions: The small number of heterogeneous systematic reviews included in this umbrella review and the very low quality of evidence, mostly from single small primary studies, make it difficult to draw overall conclusions that differ from the original review findings. This highlights a paucity of strong, high-quality evidence underpinning technologies that can be used to facilitate remote rehabilitation in the wake of the COVID-19 pandemic

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