This proposal describes a TeleRehabilitation system developed to provide motor retraining for stroke patients. The system allows a therapist in a remote location to conduct treatment sessions with a patient who is located at home. The patient and therapist are connected in real time via a network connection on a computer. Thus, the patient and therapist can see and hear each other in real time during the remotely operated treatment session. A special feature of the TeleRehabilitation system is the use of a virtual environment (VE) to provide augmented feedback to the patient during the motor retraining exercises which are displayed on the computer screen in the patient's home. The novel rehabilitation system includes training scenes (3-D """"""""pictures"""""""" that are designed to elicit movements in a natural way by creating an environmental context and task goal for that movement), a """"""""teacher"""""""" who shows the correct movement by representing the trajectory of the limb's end point (or entire arm), a scoring system, and multiple features which provide augmented feedback and knowledge of results. A therapeutic framework has been devised to group training tasks into functionally oriented movement categories. Treatment sessions will be tailored to each patient s motor recovery state and particular motor control problems through the selection of particular scenes (tasks) and difficulty levels within each category. Goals for this proposed project are: 1) to further develop the TeleRehabilitation prototype system, and to asses the feasibility of using it with stroke patients in their homes. Specifically, to conduct a pilot study with stroke patients in which to test the feasibility of using the system to provide instructions and motor training, to record the arm movements of patients, and to monitor patients' progress in their home, and 2) after feasibility has been established, to test the value of the system by conducting a single-blind, randomized controlled clinical trial with 44 stroke patients.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21HD040959-03
Application #
6607642
Study Section
Special Emphasis Panel (ZHD1-RRG-K (16))
Program Officer
Quatrano, Louis A
Project Start
2001-08-01
Project End
2005-07-31
Budget Start
2003-08-01
Budget End
2005-07-31
Support Year
3
Fiscal Year
2003
Total Cost
$386,154
Indirect Cost
Name
Massachusetts Institute of Technology
Department
Miscellaneous
Type
Other Domestic Higher Education
DUNS #
001425594
City
Cambridge
State
MA
Country
United States
Zip Code
02139
Holden, Maureen K; Dyar, Thomas A; Dayan-Cimadoro, Lilian (2007) Telerehabilitation using a virtual environment improves upper extremity function in patients with stroke. IEEE Trans Neural Syst Rehabil Eng 15:36-42
Holden, Maureen K (2005) Virtual environments for motor rehabilitation: review. Cyberpsychol Behav 8:187-211; discussion 212-9