Comparison of Therapeutic Exercise Accuracy During Completion of a Home Exercise Program Using the Exercise Tutor Versus a Written Home Exercise Program

Exercise is powerful in rehabilitation and prevention of disability; however, patient adherence to home exercises is difficult, learning new movements requires a great deal of practice, and incorrectly performed exercises are ineffective or even dangerous. We have developed a system comprised of a Kinect device with wearable inertial sensors to capture, record, and process the exerciser’s movement while concurrently providing targeted feedback to guide correct exercise completion. This pilot study allowed us to perform initial testing of this system, specifically, the effectiveness of this system in improving exercise accuracy, with and without the addition of inertial sensors to the Kinect camera feedback, as compared to a traditional written home exercise program. Twenty-four participants (18-48 years old, 14 female) completed one of three training types: a written exercise program, Kinect feedback only, or combined inertial sensor and Kinect feedback. All subjects completed a pre-test, three training sessions, and a post-test with the assigned feedback type, with movement accuracy as the outcome. These data are in analysis; therefore, previous data from the pilot for this project are presented here. Initial analysis indicates that kinect and inertial sensor feedback are better for different movement types, and are superior to a written program.https://engagedscholarship.csuohio.edu/u_poster_2014/1010/thumbnail.jp

ENGAGE: Guided Activity-Based Gaming in Neurorehabilitation after Stroke: A Pilot Study

Introduction. Stroke is a leading cause of disability in healthy adults. The purpose of this pilot study was to assess the feasibility and outcomes of a novel video gaming repetitive practice paradigm, (ENGAGE) enhanced neurorehabilitation: guided activity-based gaming exercise. Methods. Sixteen individuals at least three months after stroke served as participants. All participants received concurrent outpatient therapy or took part in a stroke exercise class and completed at least 500 minutes of gaming. Primary baseline and posttest outcome measures included the Wolf motor function test (WMFT) and the Fugl-Meyer assessment (FMA). ENGAGE uses a game selection algorithm providing focused, graded activity-based repetitive practice that is highly individualized and directed. The Wilcoxon signed ranks test was used to determine statistical significance. Results. There were improvements in the WMFT (=0.003) and the FMA (=0.002) that exceeded established values of minimal clinically important difference. Conclusions. ENGAGE was feasible and an effective adjunct to concurrent therapy after stroke

On the Location of the Gamma-ray Emission in the 2008 Outburst in the BL Lacertae Object AO 0235+164 through Observations across the Electromagnetic Spectrum

We present observations of a major outburst at centimeter, millimeter, optical, X-ray, and gamma-ray wavelengths of the BL Lacertae object AO 0235+164. We analyze the timing of multi-waveband variations in the flux and linear polarization, as well as changes in Very Long Baseline Array (VLBA) images at 7mm with 0.15 milliarcsecond resolution. The association of the events at different wavebands is confirmed at high statistical significance by probability arguments and Monte-Carlo simulations. A series of sharp peaks in optical linear polarization, as well as a pronounced maximum in the 7 mm polarization of a superluminal jet knot, indicate rapid fluctuations in the degree of ordering of the magnetic field. These results lead us to conclude that the outburst occurred in the jet both in the quasi-stationary "core" and in the superluminal knot, both parsecs downstream of the supermassive black hole. We interpret the outburst as a consequence of the propagation of a disturbance, elongated along the line of sight by light-travel time delays, that passes through a standing recollimation shock in the core and propagates down the jet to create the superluminal knot. The multi-wavelength light curves vary together on long time-scales (months/years), but the correspondence is poorer on shorter time-scales. This, as well as the variability of the polarization and the dual location of the outburst, agrees with the expectations of a multi-zone emission model in which turbulence plays a major role in modulating the synchrotron and inverse Compton fluxes.Comment: Accepted for Publication in the Astrophysical Journal Letters. 7 pages (including 5 figures). Minor corrections with regard to previous version, as proposed by the refere

Interactive Feedforward for Improving Performance and Maintaining Intrinsic Motivation in VR Exergaming

Exergames commonly use low to moderate intensity exercise protocols. Their effectiveness in implementing high intensity protocols remains uncertain. We propose a method for improving performance while maintaining intrinsic motivation in high intensity VR exergaming. Our method is based on an interactive adaptation of the feedforward method: a psychophysical training technique achieving rapid improvement in performance by exposing participants to self models showing previously unachieved performance levels. We evaluated our method in a cycling-based exergame. Participants competed against (i) a self model which represented their previous speed; (ii) a self model representing their previous speed but increased resistance therefore requiring higher performance to keep up; or (iii) a virtual competitor at the same two levels of performance. We varied participants' awareness of these differences. Interactive feedforward led to improved performance while maintaining intrinsic motivation even when participants were aware of the interventions, and was superior to competing against a virtual competitor

Exercise Tutor: A System for In-home Therapeutic Exercise Guidance

The Exercise Tutor (ET) is a system that uses a Kinect camera motion sensor in conjunction with a number of wearable inertial sensors to monitor home exercise performance. Its purpose is to decrease healthcare costs while concurrently improving clinical outcomes. A clinician programs this system with the particular exercise(s) that a client is to perform, along with several critical parameters for its correct and safe completion. The client then takes the system home and exercises using the ET, which keeps track of the regularity and quantity as well as quality of exercise performance for the clinician. The system also provides real-time feedback to the client while performing the exercise to ensure correct and safe execution. This summer we completed initial ET feasibility testing and planned the next phase of pilot clinical studies. Initial feasibility testing included task analysis for prototype exercises (identifying joints of interest, velocities, critical angles, etc.), identifying relevant parameters for front end programming, determining error tolerance levels for the exercises, and identifying home usability features (screen size, control features, and avatar characteristics). Finally, two initial clinical trials were planned to assess the ET’s effectiveness as a feedback modality during exercise as well as its in-home usability

Design, Implementation, and Field Testing of a Privacy-Aware Compliance Tracking System for Bedside Care in Nursing Homes

Lower back musculoskeletal disorders are pervasive in workplaces. In the United States alone, the total cost of such injuries exceed $100 billion a year. The lower-back injury rate in the healthcare sector is one of the highest among all industry sectors. A main risk factor for lower-back injuries is the use of improper body mechanics when doing lifting and pulling activities. In healthcare venues, nursing homes in particular, nursing assistants are on the front line to take care of patients. Even in places where ceiling-mounted lifting equipment is installed, they are still required to handle the patient for bedside care, such as sliding the sling underneath the patient, scooping up the patient, putting on compression socks, etc. To help nursing assistants get into the habit of using proper body mechanics, we designed and implemented a privacy-aware compliance tracking system (PACTS). PACTS can track a nursing assistant for possible violation of proper body mechanics while doing bedside care and provide realtime feedback via a smart wearable device such as a smart watch worn by the nursing assistant. The system was deployed in a local nursing home for an 80-day field study in six rooms with seven participating nursing assistants. The test exposed several issues with the original design of the system. The primary issue is how to balance the privacy requirement and the usability of the system. Over-emphasizing the former would negatively impact the latter. This issue is partially resolved with a leasing mechanism where the system would automatically register a nursing assistant within the lease period once she or he has manually registered with the system

Comparison of Therapeutic Exercise Accuracy During Completion of a Home Exercise Program Using the Exercise Tutor Versus a Written Home Exercise Program

Exercise is powerful in rehabilitation and prevention of disability; however, patient adherence to home exercises is difficult, learning new movements requires a great deal of practice, and incorrectly performed exercises are ineffective or even dangerous. We have developed a system comprised of a Kinect device with wearable inertial sensors to capture, record, and process the exerciser’s movement while concurrently providing targeted feedback to guide correct exercise completion. This pilot study allowed us to perform initial testing of this system, specifically, the effectiveness of this system in improving exercise accuracy, with and without the addition of inertial sensors to the Kinect camera feedback, as compared to a traditional written home exercise program. Twenty-four participants (18-48 years old, 14 female) completed one of three training types: a written exercise program, Kinect feedback only, or combined inertial sensor and Kinect feedback. All subjects completed a pre-test, three training sessions, and a post-test with the assigned feedback type, with movement accuracy as the outcome. These data are in analysis; therefore, previous data from the pilot for this project are presented here. Initial analysis indicates that kinect and inertial sensor feedback are better for different movement types, and are superior to a written program.https://engagedscholarship.csuohio.edu/u_poster_2014/1010/thumbnail.jp

Rule Based Realtime Motion Assessment for Rehabilitation Exercises

In this paper, we describe a rule based approach to realtime motion assessment of rehabilitation exercises. We use three types of rules to define each exercise: (1) dynamic rules, with each rule specifying a sequence of monotonic segments of the moving joint or body segment, (2) static rules for stationary joints or body segments, and (3) invariance rules that dictate the requirements of moving joints or body segments. A finite state machine based approach is used in dynamic rule specification and realtime assessment. In addition to the typical advantages of the rule based approach, such as realtime motion assessment with specific feedback, our approach has the following advantages: (1) increased reusability of the defined rules as well as the rule assessment engine facilitated by a set of generic rule elements; (2) increased customizability of the rules for each exercise enabled by the use of a set of generic rule elements and the use of extensible rule encoding method; and (3) increased robustness without relying on expensive statistical algorithms to tolerate motion sensing errors and subtle patient errors