title: Potential of a suite of robot/computer-assisted motivating systems for personalized, home-based, stroke rehabilitation.
abstract: BACKGROUND
  There is a need to improve semi-autonomous stroke therapy in home environments often characterized by low supervision of clinical experts and low extrinsic motivation. Our distributed device approach to this problem consists of an integrated suite of low-cost robotic/computer-assistive technologies driven by a novel universal access software framework called UniTherapy. Our design strategy for personalizing the therapy, providing extrinsic motivation and outcome assessment is presented and evaluated.
  
  
  METHODS
  Three studies were conducted to evaluate the potential of the suite. A conventional force-reflecting joystick, a modified joystick therapy platform (TheraJoy), and a steering wheel platform (TheraDrive) were tested separately with the UniTherapy software. Stroke subjects with hemiparesis and able-bodied subjects completed tracking activities with the devices in different positions. We quantify motor performance across subject groups and across device platforms and muscle activation across devices at two positions in the arm workspace.
  
  
  RESULTS
  Trends in the assessment metrics were consistent across devices with able-bodied and high functioning strokes subjects being significantly more accurate and quicker in their motor performance than low functioning subjects. Muscle activation patterns were different for shoulder and elbow across different devices and locations.
  
  
  CONCLUSIONS
  The Robot/CAMR suite has potential for stroke rehabilitation. By manipulating hardware and software variables, we can create personalized therapy environments that engage patients, address their therapy need, and track their progress. A larger longitudinal study is still needed to evaluate these systems in under-supervised environments such as the home.
authors.affiliation: Medical College of Wisconsin, Dept. of Physical Medicine & Rehabilitation, 9200 W. Wisconsin Ave, Milwaukee, WI 53226, USA. mjjohnso@mcw.edu
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Johnson
authors.forename: Xin
authors.initials: X
authors.lastname: Feng
authors.forename: Laura M
authors.initials: LM
authors.lastname: Johnson
authors.forename: Jack M
authors.initials: JM
authors.lastname: Winters
mesh_terms: D000203:Activities of Daily Living; D017076:Computer-Aided Design; D003201:Computers; D004867:Equipment Design; D006699:Home Care Services; D006801:Humans; D009042:Motivation; D010291:Paresis / Q000209:etiology / Q000534:rehabilitation; D010349:Patient Compliance; D026741:Physical Therapy Modalities / Q000295:instrumentation; D012371:Robotics / Q000295:instrumentation*; D012984:Software; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome