Opportunities for Innovation, and Survey of Ongoing R&D
- Classification for Innovation:
- Assessment
- intervention/therapy
- activity monitoring (e.g., wearable)
- Possibilities for technologies addressing multiple areas
- Roles for Technical Tools in Interventions
- Injections and surgery by physicians
- Technologies for incisions, surgery, EMG, injections, etc.
- Medications (e.g., baclofen, dantrium), motor point block (Botox, phenol), pharmacologic agents (e.g., amphetamines)
- Examples of Augments for Conventional Allied Health Therapy
- Physical therapy equipment
- Externally-powered isokinetic/isotonic exercise
- Occupational therapy equipment
- Computer interfaces / assistive technologies
- Speech/language therapy
- Therapeutic software to practice language understanding, speech, communication
- Example of a Rehab Clinic Trying Innovative Technologies: Sister Kenny Rehab Institute
"Semi-Automated" Robotic Therapy
- "Robots and Therapy" info from stroke site
- "Robotic" therapy
- Discussed more fully in Dr. Michelle Johnson's class.
- MIT-Manus clinical trials, updates
- InMotion products
- InMotion2 - planar shoulder-arm robotic
- Mostly tracking tasks, somewhat like games
- Stanford / Palo Alto VA
- MIME (Mirror Image Motion Enabler)
- 3D robot for Rehab Therapy (e.g., summary paper)
- Passive and active assist, repeatable movement patterns
- E-stim/FES therapy (muscle, nerve, brain areas) & EMG biofeedback
- Computer-Assisted Motivating Therapy (CAMR) approaches
- Palanca, joysticks, TheraJoy, TheraDrive, etc.
- "Virtual-reality" therapy
- Driving simulators
- Ranging/exercise protocols (e.g., Rutgers)
- Gait / walk-over protocols
- Neurocognitive
Example: UniTherapy Software for Assistive/Remote Therapy and Teleassessment
- Structural organization of package
- Telerehab capabilities: Telepractitioner and Patient Terminals
- Accessibility features (e.g., mapping to user-space via range-of-motion)
- Systems Identification Manager
- Tracking Manager
- Impedance Manager
Innovations in Mobile Systems and Intelligent Agents
- Roles for Technical Tools in Activity Monitoring / Mobile Assessment
- Technical Motivation
- wireless technologies
- wearable sensor and computing technologies
- intelligent systems
- Practical Motivation
- New rehab classification model includes "activity" and "participation"
- Many rehab "scales" are trying to estimate daily activity - better would be to measure directly
- Frequency of activity
- Quality of activity (e.g., quality of movement)
- Desire for timely assessments
- Key functions:
- Activity documentation
- Task-assistance
- Decision-support
- Greatest challenge: intelligent management of information
- Intelligent agents - observes (senses) on the user’s behalf
- Is empowered to do something once triggered, subject to rules that are under the user’s control or supervision.
- Works mostly in the background, performing simple tasks (e.g., event recognition causing data collection) that require minimal attentional resources, and
- Negotiate with other agents (e.g., storage media), with lower-level decision-making capabilities.
- Intelligent assistants - interacts with user to help the user complete a specific type of task
- Ex: reminders related to a certain assessment or therapeutic protocol, performance monitoring to change settings during exercise tasks
- Functions as an assistive technology.
- Rules are typically driven by a combination of both a user-event (e.g., input to PocketPC screen) and a sensor-event.
- Possibilities
Figure. Classification scheme for types of sensors of interest in rehabilitation. Along the left is the sampling frequency (“med” implies rates from about 10-1000 total samples/sec, “low” is under 10 samples/sec), and an indication of frequency of collection (“often” it generally refers to continuous monitoring). “Med” applications require significant planning for data reduction and storage unless “events” can be reliably obtained on-the-fly, or a mechanism exists for direct wireless data transfer to the environment (e.g., Bluetooth). Data from “low” and “single measurement” applications can generally be stored on a mobile device, and if necessary transferred when convenient. Wellness sensors are included within physiologic measurement. ECG: electrocardiogram, EMG: electromyogram, HR: heart rate, SPO2, EADLs (electronic aids to daily living).
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