title: A haptic-robotic platform for upper-limb reaching stroke therapy: preliminary design and evaluation results.
abstract: BACKGROUND
  It has been shown that intense training can significantly improve post-stroke upper-limb functionality. However, opportunities for stroke survivors to practice rehabilitation exercises can be limited because of the finite availability of therapists and equipment. This paper presents a haptic-enabled exercise platform intended to assist therapists and moderate-level stroke survivors perform upper-limb reaching motion therapy. This work extends on existing knowledge by presenting: 1) an anthropometrically-inspired design that maximizes elbow and shoulder range of motions during exercise; 2) an unobtrusive upper body postural sensing system; and 3) a vibratory elbow stimulation device to encourage muscle movement.
  
  
  METHODS
  A multi-disciplinary team of professionals were involved in identifying the rehabilitation needs of stroke survivors incorporating these into a prototype device. The prototype system consisted of an exercise device, postural sensors, and a elbow stimulation to encourage the reaching movement. Eight experienced physical and occupational therapists participated in a pilot study exploring the usability of the prototype. Each therapist attended two sessions of one hour each to test and evaluate the proposed system. Feedback about the device was obtained through an administered questionnaire and combined with quantitative data.
  
  
  RESULTS
  Seven of the nine questions regarding the haptic exercise device scored higher than 3.0 (somewhat good) out of 4.0 (good). The postural sensors detected 93 of 96 (97%) therapist-simulated abnormal postures and correctly ignored 90 of 96 (94%) of normal postures. The elbow stimulation device had a score lower than 2.5 (neutral) for all aspects that were surveyed, however the therapists felt the rehabilitation system was sufficient for use without the elbow stimulation device.
  
  
  CONCLUSIONS
  All eight therapists felt the exercise platform could be a good tool to use in upper-limb rehabilitation as the prototype was considered to be generally well designed and capable of delivering reaching task therapy. The next stage of this project is to proceed to clinical trials with stroke patients.
authors.affiliation: Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ONT, M5S 3G9, Canada. pty.lam@utoronto.ca
authors.forename: Paul
authors.initials: P
authors.lastname: Lam
authors.forename: Debbie
authors.initials: D
authors.lastname: Hebert
authors.forename: Jennifer
authors.initials: J
authors.lastname: Boger
authors.forename: Hervé
authors.initials: H
authors.lastname: Lacheray
authors.forename: Don
authors.initials: D
authors.lastname: Gardner
authors.forename: Jacob
authors.initials: J
authors.lastname: Apkarian
authors.forename: Alex
authors.initials: A
authors.lastname: Mihailidis
mesh_terms: D001132:Arm; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005081:Exercise Therapy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D009069:Movement Disorders / Q000534:rehabilitation*; D010865:Pilot Projects; D012371:Robotics / Q000295:instrumentation*; D000071939:Stroke Rehabilitation; D013813:Therapy, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D014110:Touch; D014584:User-Computer Interface