pb2015 pm&r, harvard medical school spaulding rehabilitation hospital motion analysis laboratory...

PB2015

PM&R, Harvard Medical SchoolSpaulding Rehabilitation Hospital

Motion Analysis Laboratory

Wyss Institute forBiologically Inspired Engineering

Microsoft Surface Project

PB2015




Cerebral Palsy•Permanent, non-progressive physical disorders• Caused by disturbances to fetal/infant brain• Affects 1 in 303 children• Causes impairments in:

movementhearingvisionLearning• No cure

•Treatment: alleviation and maintenance of symptoms; Occupational and Physical Therapy.

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Therapy Services

• Help minimize contractures• Improve:

range of motioncoordinationquality of movement

• Provide tasks that engage and motivate

• We have designed a system based on Microsoft interactive touch screen surface to address these limitations in therapy sessions.

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The Platform

• Five interactive games that encourage repetitive motions

• Similar to iPad touch screen• Eight sensors on upper limbs• Record joint angles of

shoulders and elbows• Accelerometer embedded in vest

worn by the participant• Provides postural and

positional data

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Unique Features of the Tabletop

• Videogames allow for repeated practice

• Participants can move on their own…can lead to motor recovery

• Immediate auditory and visual feedback

• Progress shown in a concrete way

• Pain free range of motion

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• Children with auditory processing impairments often only learn through visual system.

• Mechanics of hi/lo table allow for adaptability: Gravity eliminated shoulder and elbow control Easel allows for help with visual scanning, wrist

extension and holding head in neutral Offers ability to play in sitting and standing Adjust height for functional body mechanics

• Games keep accurate record of performance and progress.

Unique Features of the Tabletop

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What Motor Skills do the Games Target?

• Active range of motion in gravity eliminated, against gravity and weight bearing (standing).

• Fine motor skills: SpeedPre-writing: finger isolationObject use: sustaining hold of adaptive tool

(adaptive stylus, ball, paddle with Butterfly game)

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What Motor Skills do the Games Target?• Bi-manual skills: Sub-divided

into 4 categories:Use of involved arm as stabilizer

(hold paper while writing)Ability to use involved arm

symmetrically or simultaneously (pushing/pulling)

Ability to differentiate function (both arms can move to specific target)

Ability to alternate use from left to right reciprocally (playing musical instruments)

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Study Design

• Pilot study • Usability and feasibility

of the device • Novel games: Engaging

and motivating children to perform upper extremity motions

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Hypothesis

• Patients will be more motivated to perform therapeutic motions.

• Movements to those performed in traditional therapy• Compensatory motions will be minimized by

feedback from the wearable accelerometer.• Minimize failure to complete tasks. • Structure required motions that they slowly increase

in difficulty and allowing interaction by patients with reduced function.

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Inclusion and Exclusion Criteria

Inclusion Criteria• 6-12 years old• Upper extremity dysfunction due to cerebral palsy• Able to understand, read and write in English• Able to understand and comprehend directions from

occupational therapist

Exclusion Criteria:• Participants may be excluded if they have severe vision

impairments

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Study Setting

• Recruitment procedures: Spaulding Rehabilitation Hospital (SRH) and Boston Children’s Hospital.

• Data collection: Wyss Institute. • Data analysis: Wyss Institute and SRH.• Enroll 20 children.

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Study Setting• Study session will last no longer than 90 minutes (including

consent and assent)• Each session will be videotaped, allowing critical analysis of

child's interaction with system.• Games have been divided by four motor skills:

Gross movementsCoordinated movementsDistal controlFine motor control

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Risk and Benefits

• We do not anticipate any physical risks to the participants from participating in this research study.

• There are no direct benefits for participating in this study.

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Conclusion

• Could benefit children with Cerebral Palsy by providing new treatment/rehabilitation option for those with impaired upper extremities.

pb2015 pm&r, harvard medical school spaulding rehabilitation hospital motion analysis laboratory...

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