Stroke: Virtual Reality and "smart" sensors for the therapies of the future

The latest invention was made public this week. Called ORTHOMONiTOR, it is a device that monitors the use of orthopaedic devices, which patients recovering from a stroke normally use. “The users themselves can understand if they are using the device at the right time and in a correct way, and can compare those data with how they feel. Clinicians and therapists can establish short and medium term goals and easily understand if they can be achieved”, describes Miguel Oliveira, scientific coordinator of Kinematix, a spin-off from INESC TEC and the Faculty of Engineering of the University of Porto that is responsible for the project.

The device will be integrated in orthopaedic devices in order to collect information, using accelerometers, oscillometres and capacitive sensors, about the gait, number of steps, and walking speed of the patient. The information obtained can be stored on the device for three months, or can be downloaded through a USB connection.

Moreover, a mobile application is being developed which will allow the users to quickly monitor their activity using a mobile phone. Miguel Oliveira stresses that “the patients’ involvement in their healing process, where they are active agents in the process of rehabilitation”, is the future’s trend. Furthermore, the possibility of having continuous feedback is an important motivational effect for recovery.

The ORTHOMONiTOR is now concluded and has been tested in several case studies with different devices. In the next phase, Kinematix will market the device targeting “orthopaedics and prosthetics assistants in the United States and in several European companies,” he adds.

Bursting soap bubbles to train arm movements

Project ExerGames was also presented this month. Antonio Santos, at Fraunhofer Portugal, an applied research organisation based in the University of Porto’s Science and Technology Park (UPTEC), explains that the project includes several “interactive computer games that aid motor rehabilitation in stroke patients.” “The upper limbs are usually the most affected, and their rehabilitation is made possible through repetitive movements. These games encourage those exercises, providing a more motivating setting and with different goals.”

According to the indications of a group of physical therapists who collaborated on the project, basic games has been created, with simple environments that are accessible to anyone. For working on the arm, for example, the patient will have to burst a set of soap bubbles that appear on a screen. The difficulty increases when the bubbles begin to appear more frequently on the edge of the screen, forcing the patient to move the arm more noticeably. For exercising the opening hand movement, the user must pick an apple and put it in a basket

The user can be monitored with sensors during the games. For larger movements, sensors are used in order to monitor the entire body. Leapmotion sensors are used to measure the movement of each finger, and to measure the rotation of the hand there is a sphere the size of a tennis ball, equipped with an accelerometer and a gyroscope.

So far, the researchers conducted usability tests on the system both with patients and therapists, and the next step will be “testing the system for several months to assess the rehabilitation progress, comparing patients who use the games in the ExerGames with those who do not.”

Rehabilitation to live independently through a virtual city

The Madeira Interactive Technologies Institute (M-ITI) at the University of Madeira is developing a project that, in addition to motor skills, promises to assist in the rehabilitation of cognitive abilities. The NeuroRehab Lab combines virtual scenarios with interactive tools to simulate daily life activities and to train memory, language and attention.

“In the first months after the stroke, patients may have very large motor deficits, and so for them the outside world is a huge challenge. The project recreates scenarios to cognitively enable the patients to be independent”, explains neuroscientist Sergi Bermudez Badia. “We have created a virtual city where the user can navigate. For example, the patient can go out to do certain tasks, such as shopping”, he adds. The user has to understand where the grocery store is, and start selecting foods according to the predefined shopping list.

The same lab is currently developing an electrode helmet where the goal is “to understand the electrical activity in different parts of the brain, so that it is possible to decode the patient’s movement intentions.” This equipment is connected to a virtual environment that encourages motor intention and represents its feedback. For example, the device prompts the user to move the arm, and after receiving indication of intention, shows a puppet moving the arm.

These are some examples of Portuguese projects that put the latest cutting-edge technology at the service of rehabilitation after a stroke, similarly to what has been happening all over the world. It is important to remember that a stroke is a neurological disease caused by the sudden decrease in the blood supply to a particular region of the brain. In Portugal, it is the leading cause of death, and, in case of survival, it can cause motor and cognitive disabilities.

Ciência 2.0, 29 October 2014