Abstract

The goal of this project is to develop a means for individuals with stroke to practice arm movement therapy at home with remote monitoring. We previously developed a Web-based system for repetitive movement training (Java Therapy). This paper describes a new input device for the system that measures and assists in naturalistic arm movement, as well as software enhancements. The new input device is an instrumented, adult-sized version of Wilmington robotic exoskeleton (WREX), which is a five degrees-of-freedom orthosis that counterbalances the weight of the arm using elastic bands. To test the ability of the new device (Training-WREX or "T-WREX") to measure and assist in functional arm movements, we measured five chronic stroke subjects' movement ability while wearing the orthosis without gravity balance compared to wearing the orthosis with gravity balance. T-WREX's gravity balance function improved a clinical measure of arm movement (Fugl-Meyer Score), range of motion of reaching movements, and accuracy of drawing movements. Coupled with an enhanced version of Java Therapy, T-WREX will thus provide a means to assist functional arm movement training at home, either over the Web in real-time, or stand-alone with periodic communication with a remote site.

Highlights

  • Each year in the U.S over 400,000 people survive a stroke [1]

  • The goal of the present project is to develop an input device that allows a broader range of functional arm movements to be practiced and monitored

  • This paper describes the modifications to Wilmington Robotic Exoskeleton (WREX), software enhancements to Java Therapy, and initial testing of the system with five stroke subjects

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Summary

Introduction

80% of acute stroke survivors lose arm and hand movement skills [2]. Movement impairments are typically treated with intensive, hands-on physical and occupational therapy for several weeks after the initial injury. Due to economic pressures on the U.S health care system, stroke patients are receiving less therapy and going home sooner. The ensuing home rehabilitation is often self-directed with little professional or quantitative feedback. Even as formal therapy declines, a growing body of evidence suggests that both acute and chronic stroke survivors can improve movement ability with intensive, supervised training [3]. An important goal for rehabilitation engineering is to develop technology that allows the burgeoning U.S stroke population to practice intensive movement training without the expense of a supervising therapist.

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