Intervention to enhance skilled arm and hand movements after stroke: A feasibility study using a new virtual reality system

<p>Abstract</p> <p>Background</p> <p>Rehabilitation programs designed to develop skill in upper extremity (UE) function after stroke require progressive practice that engage and challenge the learner. Virtual realty (VR) provides a unique environment where the presentation of stimuli can be controlled systematically for optimal challenge by adapting task difficulty as performance improves. We describe four VR tasks that were developed and tested to improve arm and hand movement skills for individuals with hemiparesis.</p> <p>Methods</p> <p>Two participants with chronic post-stroke paresis and different levels of motor severity attended 12 training sessions lasting 1 to 2 hours each over a 3-week period. Behavior measures and questionnaires were administered pre-, mid-, and post-training.</p> <p>Results</p> <p>Both participants improved VR task performance across sessions. The less impaired participant averaged more time on task, practiced a greater number of blocks per session, and progressed at a faster rate over sessions than the more impaired participant. Impairment level did not change but both participants improved functional ability after training. The less impaired participant increased the number of blocks moved on the Box & Blocks test while the more impaired participant achieved 4 more items on the Functional Test of the Hemiparetic UE.</p> <p>Conclusion</p> <p>Two participants with differing motor severity were able to engage in VR based practice and improve performance over 12 training sessions. We were able to successfully provide individualized, progressive practice based on each participant's level of movement ability and rate of performance improvement.</p

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

Who takes music? Investigating access to high school music as a function of social and school factors.

Music is one of the opportunities offered in most American high schools and, in theory, all high school students should be able to elect music where it is offered. Using a theoretical and methodological framework grounded in the sociology of education, this study employs nationally representative data from High School and Beyond to investigate how characteristics of students and their schools function to influence access to high school music as determined by student election of music courses. Bivariate analyses provide descriptive information about characteristics of schools that offer music and students who take it. Multivariate analyses estimate direct influences of student background, school characteristics, and student high school behaviors on the probability of enrolling in any music and in selected types of performance and non-performance classes. Path analysis models estimate direct and indirect effects of these constructs on enrollment probability and on the amount of music that students take. Important findings of the study are that (1) students who are socially and academically advantaged are more likely to take music--especially performance classes; (2) students who take music lessons before entering high school have a higher probability of taking any type of music during high school and take more units of music than students without prior lessons; (3) schools with highly academic curricula (i.e., Catholic schools, schools with more affluent student populations, and schools with high proportions of college-bound students) appear to discourage music course-taking; (4) minority students (Black and Hispanic) are systematically restricted from music course-taking because they are more likely to attend schools that do not promote music coursework and because they exhibit the academic characteristics of students who generally take fewer units of music. The major conclusion is that, in spite of efforts spawned during the 1960s to provide musical experiences for all teenagers in our pluralistic society, high school music education serves a relatively select population. While the voluntary nature of music in American high schools makes it appear that all students have equal access to music, the choice to elect music is limited for some students by social factors and factors related to school organization.Ph.D.Communication and the ArtsEducationEducational sociologyMusicMusic educationUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/128840/2/9208660.pd

Planning and adjustments for the control of reach extent in a virtual environment

Abstract Background Skilled performance of reach actions includes both anticipatory planning and compensatory adjustments made while moving. The execution of reach actions in a virtual environment (VE) demonstrates similar characteristics to reaches performed in the real-world, however, it is unclear whether the VE itself significantly impacts movement planning or compensatory adjustments. The purpose of this study was to directly compare the use of planning and adjustments to control extent for unconstrained reach actions performed in an immersive VE to those performed in an analogous real-world environment (RWE). Methods Five non-disabled adults (29 ± 5 years) reached with the dominant, right arm to six targets presented in two directions (+45°, -45°) and three distances (8, 16, 24 cm) in a VE and an analogous RWE. Position data were sampled at 120 Hz from an electromagnetic marker on the index finger and differentiated to determine velocity and acceleration. The control of reach extent was compared between the two environments (paired t-test) as to the use of planning (correlation of peak acceleration with movement distance), compensatory adjustments prior to peak velocity (correlation of time to peak velocity with movement distance), and compensatory adjustments after peak velocity (variance in movement distance accounted for by deterministic statistical model). Results Reach movements were relatively fast (&lt;400 msec) and scaled to target distance in both the VE and RWE. Overall, the control of reach extent was similar in all respects between the two environments. In both environments, a hybrid control pattern was observed. That is, individuals utilized a combined strategy that relied on both planning and compensatory adjustments to capture the target. Adjustments to the reach were evident prior to peak velocity through changes in acceleration duration as well as after peak velocity based on target information. The two factor deterministic statistical model (peak velocity, target distance) explained &gt;92% of the variance in movement distance across participants and environments. Conclusions The VE did not impact movement planning or subsequent compensatory adjustments for the control of reach extent when directly compared to an analogous RWE. An immersive VE is a valid environment for the study of unconstrained reach actions

Girls learning computer science principles with after school games

Encouraging middle school girls to become interested in Computer Science has been a concern in the Computer Science Education community for many years. Although many girls do play digital games[4], this has not led to further interest in computer science. We believe this is caused by many factors. We are researching the effect of teaching (non-programming) computer science principles embedded in after school games, to encourage girls to study computer science in their future. We maintain that the experience of learning these principles will increase their confidence that they can enjoy learning more about computer science. This on-going NSF sponsored AISL research project is described for discussion