BIEN 167 - Rehabilitation Engineering (3)

Course description: Principles and applications of rehabilitative assessment and therapy, with special focus on the use of technology to enhance access to independent living and to optimize the delivery of rehabilitative healthcare services. Overview of sensorimotor systems, as related to human performance and human-technology interface analysis. Rehabilitation biomechanics of physical interfaces, including seating/positing, prosthetics, and manual interfaces. Approaches for access engineering and telerehabilitation, including accessible design strategies, roles of standards, teletherapy, and augmentative communication. Innovations in assessment and intervention strategies for neurorehabilitation, including rehabilitation robotics. Approaches and technologies used in prosthetics and orthotics. Includes demonstrations and a final project.

Instructor:

Prof. Jack Winters (8-6640, jack.winters@mu.edu), Office Hours: Tues-Thurs 10:00-11:30, Wed 1:30-3:00, or by appt.

Reading Material:

An extensive web site for content for each module at www.eng.mu.edu/wintersj/rehab/rehab167/, with assignments and discussions via D2L

Aims / Learning Objectives / Desired Outcomes:

• You will develop a strong "systems" understanding of the continuum of care for clinical rehabilitation, including from the context of optimizing outcomes.
• You will understand key terminology used by various medical rehabilitation professionals and within the disability community, the infrastructure that exists for clinical rehabilitation services, and roles for rehabilitation engineers.
• You will understand key aspects of sensorimotor systems as related to human performance and design/evaluation of human-technology interfaces.
• You will gain a conceptual understanding of some basic principles of biomechanics of physical human-technology interfaces, with applications to seatingpositioning, prosthetics, and manual interfaces.
• You will gain an understanding of technical approaches for breaking down access barriers, especially in the context of access technologies in modern telecommunications and information technologies, telerehabilitation and the roles of consensus standards.
• You will gain an conceptual understanding of key challenges and innovations in neurorehab, and some of the emerging uses of technology for therapeutic intervention and assessment.
• You will gain a basic understanding of approaches and technologies used in prosthetics and orthotics.
• Through a project and a presentation, you will have the opportunity to share experiences and knowledge with your classmates.
• You will get practice in applied problem-solving, and integrating professional/ethical responsibilities with contemporary societal challenges in healthcare. 

Grading:

• 30% Module Interaction/Homeworks (through D2L/IM, one per module, 6 @ 5% each)
• 30% Module Quizzes (1 per module, often oral with 1 retake, best 5 of 6 @ 6% each, must take 1-3)
• 5 % Presentation (15 min plus 5 min discussion, for one of Modules 2-6)
• 35% Final Presentation (10%) and Report (25%)

Modules (each 2-3 weeks):

1. Clinical Rehabilitation Science & Engineering: Principles, Terminology & Models

• Rehabilitative science foundations: healing biodynamics at the cell-tissue-organ-person levels, and understanding effects of interventions
• Existing infrastructure for the field of clinical rehabilitation and physical medicine
• Consensus terminology and models for the rehabilitation/disability field
• Clinical rehab engineering and the Human Activity / Assistive Technology (HAAT) model
• Rehabilitative continuum of care as a optimization problem
• Concepts in tele-access within the context of continuum of care

2. Sensorimotor Systems and Human Performance Assessment

• Conceptual Models of Human Performance and Interface Design
  • Terminology and approaches in rehabilitation and ergonomics
  • Basics of sensorimotor control (feedback, feedforward)
• Components of Sensory Performance and Relation to Technology
  • Vision, gazing, seeing ... and video codes, resolution and sampling
  • Hearing, speaking ... and audio codecs, frequency content, volume
  • Reflexes, spasticity, positioning ... and measurement sampling
  • Arms, reaching, tracking ... and robotic manipulators
  • Hands, grasping, manually manipulating ... and computer interface devices
  • Example: Virtual reality/environments
• Tools for Integrative Task Analysis
  • Approaches to task analysis in rehabilitation
  • Relation to fields of ergonomics, human factors and usability engineering
  • Human-computer interface analysis (e.g., augmentative communication)

3. Rehab Biomechanics of Physical Contact Interfaces

• Brief overview of biomechanics behind mobility and manipulation technologies
  • Statics, solids, materials, kinematics, dynamics
• Principles of bi-causal mechanical interfaces
• Seated mobility devices
  • General wheelchair considerations
  • Seating considerations
  • Positioning considerations
  • Sports wheelchairs
• Physical interfaces for Prosthetics and Orthotics
  • interfaces to lower extremity stumps
  • interfaces to upper extremity stumps
• Hand manipulation and device assisting manipulation tasks
  • Degrees of freedom for interfaces to hands and fingers
  • Concept of Extended Physiological Proprioception (EPP)

4. Access Engineering: Accessible Interfaces and Telerehabilitation

• Foundations: Access to information and services through accessible interfaces and telecommunications
• Accessible design regulations Related to Section 508 of Rehab Act and other regulations/standards
• Accessible Design
• Universal Access Concepts
• Principles of Universal Design
• Usability analysis and user-centered analysis
• Use of Mobile Usability and Accessibility Lab (MUA-Lab) for analysis
• Accessibility Guidance for Medical Devices
• Models for Telerehabilitation
  • Process models (teleconsultation, telehomecare, telemonitoring, teletherapy, ...)
  • Telehealth conceptual model (science of rehab bioprocess, human-technology interfaces, behavior/compliance)
  • Optimization modeling framework
• Telehealth Technologies
  • ITU's videoconferencing standards: H.320, H.324, H.323
  • IP-based multimedia conferencing (e.g., H.323 vs SIP, MPEG, streaming, multicast)
  • Wireless standards (e.g., IEEE 802.a/b/g, Bluetooth)
  • Other technologies (e.g., vitals, activity monitoring, exercise)
  • Challenges of compliance, access to information/services; roles for tele-assessment

5. Neurorehabilitation: Innovation in Therapeutic Strategies

• Model of Rehabilitation Plan of Care (e.g., Neurorehab from Traumatic Event)
  • Conceptual framework: diagnosis, prognosis, intervention, assessment, outcomes
  • "Systems" analysis of this framework, as an optimization problem
• Conventional Approaches to Diagnosis, Intervention and Outcomes Assessment
  • Scales ("instruments" "forms" "measures") - by trained observer and/or self-report
  • Objective (sensor-based) measures (not common, but examples from physical therapy, speech, gait)
• Innovative Approaches in Neurorehab
  • Classification: Assessment, intervention/therapy, activity monitoring (e.g., wearable)
  • Interventions: E-stim, Constraint-Induced Movement Therapy, rehab robotics, computer-assisted motivating therapy
  • Examples from stroke rehab
• UniTherapy Software for Assistive/Remote Therapy and Teleassessment
  • Structural organization of package
  • Hands-on examples (tracking tasks, systems identification, telerehab tools)

6. Prosthetics and Orthotics: Approaches and Technologies

• Prosthetics fabrication methods
• Lower extremity orthotic systems
• Lower extremetry prosthetics, below knee
• Lower extremity prosthetics, above knee
• Spinal, trunk and neck orthotic systems
• Upper extremity orthotic systems
• Upper extremity prosthetics: body-powered
• Upper extremity prosthetics: externally-powered
• Joysticks (mainstream, customized)
• Therapeutic and assistive robotics

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