This project will develop a lightweight, unobtrusive system of wearable sensors capable of monitoring an individual's motion in the home setting, and providing real-time feedback of motion quality. This system will help clinicians monitor changes in functional ability in home settings, and will help patients with neuro-motor de?cits t take a more active role in self-care. Such a system is particularly useful for determining if individuals are using compensatory motions after stroke. Compensation describes the use of new limbs and strategies to accomplish tasks previously performed with the stroke affected limb. Such compensation is thought to be maladaptive and may lead to further injury and depressed quality of life. Compensatory strategies likely evolve and are af?rmed in the absence of a clinical observer (e.g., at home). Thus, this project aims to (1) develop a technique for quantifying such compensation in the home setting using wearable sensors and (2) evaluate the relative ef?cacy of two biofeedback-based interventions designed to reduce the use of compensatory strategies at home. These interventions provide the participant with feedback regarding their movement quality, but differ in the style of delivery - one provides internally directed feedback regarding the person's body, and the other provides externally directed feedback regarding the person's environment. If successful, this project may bene?t many of the seven million people living with chronic stroke in the United States. Our methodology will utilize a prospective experimental design, and a between-groups human subjects study. We anticipate that both biofeedback based interventions will bene?t the participant, but that the internally directed feedback will signi?cantly reduce the use of compensation. The methodology developed and validated in this project may eventually bene?t other individuals living with chronic motor de?cits.
Almost seven million people in the US are living with the chronic after-effects of hemi paretic stroke; when these individuals return home after discharge, the lack of direct supervision may result in the use of compensatory movements. These movements differ from those used before stroke onset, and can result in injury and further disability. The use of novel wearable technologies and computational tools may facilitate the monitoring and subsequent rehabilitation of individuals living in the home with chronic motor de?cits, reducing injuries and improving quality of life for the millions of individuals living wth these conditions.