The design of a real-time, multimodal biofeedback system for stroke patient rehabilitation

ABSTRACT

This paper presents a novel real-time, multi-modal biofeedback system for stroke patient therapy. The problem is important as traditional mechanisms of rehabilitation are monotonous, and do not incorporate detailed quantitative assessment of recovery in addition to traditional clinical schemes. We have been working on developing an experiential media system that integrates task dependent physical therapy and cognitive stimuli within an interactive, multimodal environment. The environment provides a purposeful, engaging, visual and auditory scene in which patients can practice functional therapeutic reaching tasks, while receiving different types of simultaneous feedback indicating measures of both performance and results. There are three contributions of this paper - (a) identification of features and goals for the functional task (b) The development of sophisticated feedback (auditory and visual) mechanisms that match the semantics of action of the task. We additionally develop novel action-feedback coupling mechanisms. (c) New metrics to validate the ability of the system to promote learnability, stylization and engagement. We have validated the system for nine subjects with excellent results.

REFERENCES

• 1: Motion Analysis Corporation http://www.motionanalysis.com.
• 2: M.C. CIRSTEA, A.B. MITNITSKI, A.G. FELDMAN and M.F. LEVIN (2003). Interjoint coordination dynamics during reaching in stroke. Exp Brain Res 151(3): 289--300.
• 3: S. COREN, L.M. WARD and J.T. ENNS (2003). Sensation and perception. John Wiley Hoboken, NJ.
• 4: C. GHEZ, T. RIKAKIS, R.L. DUBOIS and P. COOK (2000). An Auditory display system for aiding interjoint coordination, Proc. International Conference on Auditory Display, Apr. 2000, Atlanta, GA.
• 5: G.E. GRESHAM, P.W. DUNCAN and W.B.E.A. STASON (1996). Post-Stroke Rehabilitation/Clinical Practive Guideline. Aspen Publishers, Inc. Gaithersburg, Maryland.
• 6: D.J. GROUT and C.V. PALISCA (2001). A history of western music. Norton New York.
• 7: E.R. HILGARD and G.H. BOWER (1975). Recent developments. Theories of learning(eds). Englewood Cliffs, N.J., Prentice-Hall: 550--605.
• 8: M. HOLDEN and T. DYAR (2002). Virtual environment traing: a new tool for neurorehabilitation. Neurology Report 26(2): 62--72.
• 9: M. HOLDEN, E. TODOROV, J. CALLAHAN and E. BIZZI (1999). Virtual environment training imporves motor performance in two patients with stroke: case report. Neurology Report 23(2): 57--67.
• 10: H. HUANG, T. INGALLS, L. OLSON, K. GANLEY, T. RIKAKIS and J. HE (2005). Interactive Multimodal Biofeedback for Task-Oriented Neural Rehabilitation, 27th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, IEEE, Sep. 1st~4th, Shanghai, China.
• 11: A.S. MERIANS, D. JACK, R. BOIAN, M. TREMAINE, G.C. BURDEA, S.V. ADAMOVICH, M. RECCE and H. POIZNER (2002). Virtual reality-augmented rehabilitation for patients following stroke. Phys Ther 82(9): 898--915.

INDEX TERMS

Primary Classification:
  J. Computer Applications
  J.3 LIFE AND MEDICAL SCIENCES
      Subjects: Health

Additional Classification:
  H. Information Systems
  H.5 INFORMATION INTERFACES AND PRESENTATION (I.7)
      H.5.2 User Interfaces (D.2.2, H.1.2, I.3.6)
          Subjects: Auditory (non-speech) feedback; Screen design (e.g., text, graphics, color); Interaction styles (e.g., commands, menus, forms, direct manipulation)

  I. Computing Methodologies
  I.6 SIMULATION AND MODELING
      I.6.4 Model Validation and Analysis

General Terms:
Design, Experimentation, Human Factors, Performance

Keywords:
action-feedback coupling, analysis, biofeedback, validation