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Mixed Reality Rehabilitation of Stroke Survivors
A stroke survivor in a therapy session using the Mixed Reality Rehabilitation system
Achievement/Results
The experiential media NSF IGERT award at the Arts, Media and Engineering (AME) program of Arizona State University is supporting cutting edge research in Mixed Reality Rehabilitation for stroke survivors. An interdisciplinary team headed by five IGERT faculty members (Rikakis, Sundaram, He, Qian, Ingalls) has developed a novel mixed reality rehabilitation system targeted to help improve the reaching movements of people who have hemiparesis resulting from stroke. The research team includes eight IGERT trainees and associates. The system developed provides real-time, multimodal, customizable, adaptive feedback generated in response to the movement patterns of the patient’s affected arm and torso during reaching to grasp. The generation of the feedback follows principles from the performing and visuals arts as well as film to provide patients with intuitive assessment of their performance as well as direction for improvement. The result is a stimulating and enriched environment in which to train the patients and promote multimodal sensory-motor integration and active learning. The development of the system requires the lengthy and deep collaboration of engineers, medical experts, scientists and artists. The IGERT award has made this extensive collaboration possible. Results from the use of the system are highly promising. The fast advancing research promises outcomes of significant societal impact by the end of the IGERT award.
In the spring of 2008 a pilot study was conducted to test the system function, adaptation algorithms and its feasibility for stroke rehabilitation. Three chronic stroke survivors underwent training using our system for six 75-minute sessions over two weeks. The data from the study was analyzed and submitted for publication in Fall 2009. It shows that even after this relatively short time, all three subjects made significant improvements in the movement parameters that were targeted during training. Improvements included faster and smoother movement of reach, better joint coordination and reduced compensatory use of the torso and shoulder. The system was accepted by the patients and shows great promise as a tool for physical and occupational therapists to enhance stroke rehabilitation.
During the 08-09 year, the team also started the development of novel computational approaches and tools for assessing the different outcomes of mediated rehabilitation and informing the adaption of the rehabilitation process so as to better fit a patient’s needs and progress. Our approach relies on the computational extraction of correlations between standard clinical measures, self-reported data by the patients, detailed kinematics from motion capture data and media mappings used during the therapy.
During the past year, the team also developed a scaled version of the system for use in a clinical setting. The first version (lab version) of the system cost approximately $500,000 and required 5 operators and a therapist. The scaled version costs $25,000 and requires only one operator and a physical therapist trained in the use of the system. The scaled system was installed in the Rhodes Rehabilitation Institute of Banner Baywood Medical Center. A study with 30 stroke survivors started in April 2009. Five interdisciplinary teams of IGERT trainees are working with physical therapists and medical doctors from Rhodes on the mediated rehabilitation training of the stroke survivors. Each team includes three IGERT trainees (a bioengineering student, a media computing/engineering student and a media arts and sciences student) a physical therapist and a medical doctor. Each team will treat six subjects over a period of 45 days. This experience allows IGERT trainees to explore in a real world context the application of experiential media in rehabilitation. They get first hand knowledge of the challenges in working with stroke survivors. They need to communicate across multiple disciplines on a daily basis to better solve the challenges of each rehabilitation treatment and customize the therapy to its subject’s needs and progress. We are already witnessing a broadening of views by all trainees and the realization that the application of media computing and engineering to health challenges requires the innovative combination of multiple types of expertise and the development of strategies that transcend disciplines. The first team is already completing its work. Preliminary results from the first team show that use of the system can significantly increase the recovery of stroke survivors especially in the areas of sensory motor integration, development of generalizable movement strategies and self-correction.
Finally, the team has started the development of a portable low-cost platform that patients can use in their homes. Some of the stroke survivors involved in the Banner study will have the opportunity to take home a prototype home-training system. The home system will give the patients freedom to continue their rehabilitation training on their own on a daily basis, in combination with sessions with the therapists. The therapists will also be able to remotely monitor a patient’s work with the home system. This can help reduce the number of trips a patient needs to take to a hospital for physical therapy, significantly lengthened the time a patient can received therapy, while also controlling cost.
Address Goals
This activity contributes to the development of innovative computing technologies that can advance health services, improve quality of life while also controlling cost. It focuses on health technologies that can benefit primarily the elderly; a growing part of our population that will increasingly require healthcare resources. Stroke is the leading cause of adult disability in the United States. Four of five families in the United States are affected by stroke and 21% of adults provide unpaid care to friends or family members who have survived a stroke.
This activity also contributes significant knowledge to the development of cyber-physical systems of societal impact which has been identified by the NSF as a key research area for computing and engineering.
This activity also trains scientist and engineers that can work across disciplines to develop innovative technologies for health care and in general collaborate towards solving complex problems. It prepares scientists that can integrate a great range of view points spanning medicine, engineering, science, humanities and the arts. Finally, it proposes models of education where cutting edge research and education is embedded in real world contexts for solving real world problems. This approach promotes relevance of the education and societal impact of the research.
