Balance disorders are a common problem following stroke, and the restoration of balance represents a key return to normalcy that can make the critical difference between returning home and remaining in long-term care. Current balance rehabilitation practice in the acute phase of recovery, however, is often driven by subjective feedback and experience, rather than by objective observation/analysis because of cost and time constraints. This study plans to investigate how gaming peripherals can be used as an inexpensive means to enhance balance rehabilitation by providing real-time, quantitative visual feedback to both the patient and the therapist. Specifically, the project is planning to 1) develop a low-cost instrumentation and visualization platform centered around the Nintendo Wii Balance Board, 2) use this platform to quantify the effects of visual feedback on both patients and therapists during balance retraining, and 3) develop the ability to predict patient functional outcomes in real time from data collected during typical rehabilitation activities. The effort includes the development of a clinically appropriate control interface and quantification of the performance of a system consisting of multiple Wii Balance Boards, multiple web cams, and other devices to provide real-time visual feedback based on fused data from all of these sources.
Balance recovery is assessed between matched groups who receive therapy with and without feedback. Comparisons of self-awareness in the same groups is used to examine the role of feedback in developing a patient?s metacognitive knowledge. Therapists? interaction styles and treatment plans are compared between the groups to identify the effects of the feedback on their work. Finally, the investigators plan to identify which instrumented activities provide data that best predict a patient?s score on established functional assessment tools. Ultimately, this project seeks to enhance quality of life post-stroke by helping to optimize therapy during the acute phase, which is the most critical stage of recovery. The results will also be directly applicable to balance rehabilitation in chronic stroke and other neurotrauma and more broadly applicable to amputees and sports medicine patients. Most critically, the low cost of the instrumentation platform is designed to remove financial adoption barriers, allowing virtually any rehabilitation facility to leverage the results of the research.