The Neurorehabilitation Training Toolkit (NTT): A Novel Worldwide Accessible Motor Training Approach for At-Home Rehabilitation after Stroke

Sergi Bermúdez I Badia,M S Cameirão

doi:10.1155/2012/802157

Abstract

After stroke, enduring rehabilitation is required for maximum recovery, and ideally throughout life to prevent functional deterioration. Hence we developed a new concept for at-home low-cost motor rehabilitation, the NTT, an Internet-based interactive system for upper-limb rehabilitation. In this paper we present the NTT design concepts, its implementation and a proof of concept study with 10 healthy participants. The NTT brings together concepts of optimal learning, engagement, and storytelling to deliver a personalized training to its users. In this study we evaluate the feasibility of NTT as a tool capable of automatically assessing and adapting to its user. This is achieved by means of a psychometric study where we show that the NTT is able to assess movement kinematics—movement smoothness, range of motion, arm displacement and arm coordination—in healthy users. Subsequently, a modeling approach is presented to understand how the measured movement kinematics relate to training parameters, and how these can be modified to adapt the training to meet the needs of patients. Finally, an adaptive algorithm for the personalization of training considering motivational and performance aspects is proposed. In the next phase we will deploy and evaluate the NTT with stroke patients at their homes.

Highlights

There are about 16 million new strokes per year worldwide [1], and about 5 million of the survivors will sustain motor and/or cognitive impairments for the rest of their lives [2]
Using the data from our healthy participants, we have identified the training parameters, the first-order interactions, and the second-order parameters that contribute to the movement smoothness, range of motion, arm displacement, and arm coordination (Table 2)
In this paper we presented the Neurorehabilitation Training Toolkit (NTT), a low-cost neurorehabilitation system that aims at offering an alternative for continued at-home rehabilitation after stroke

Summary

Introduction

There are about 16 million new strokes per year worldwide [1], and about 5 million of the survivors will sustain motor and/or cognitive impairments for the rest of their lives [2]. Following stroke, enduring rehabilitation is needed for maximum recovery This requires long-term hospitalization or outpatient rehabilitation, a situation that is extremely demanding both for patients and national health systems. Despite outpatient rehabilitation programs, it is generally assumed that the full potential for recovery is reached in the first 6 months after stroke, with patients being discharged from rehabilitation [10]. There is a need to find solutions to provide patients with tools that allow them to have enduring rehabilitation at their homes

Methods

Results

Conclusion