Rehabilitation Engineering Research Centers Program

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Rehabilitation Engineering Research Centers
Program National Institute on Disability and
Rehabilitation Research CFDA No. 84.133E-7
Priority i Rehabilitation Robotics and
Telemanipulation Systems Machines Assisting
Recovery from Stroke (MARS) RIC Feinberg School
of Medicine, Northwestern University University
of Illinois Chicago CUA/NRH University of
California Irvine
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• Center Mission
• To evaluate the utility of simple robotic devices
  for providing rehabilitation therapy after
  hemispheric stroke.
• Our broad intent is to develop devices that will
  assist the therapist in providing a rationally
  based, intensive, and long duration treatments.

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• MARS objectives Why choose stroke?
• Stroke is the most common disorder requiring
  neurologic rehabilitation
• It constitutes a very large economic and social
  problem
• It is increasing in prevalence as the nation ages
• Therapy cannot be funded currently for more than
  a few weeks
• yet we know that survivors will continue to
  improve for 1 -2 years

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• Why just stroke?
• Problems of stroke care and management are quite
  distinct
• Functional assessments, and analysis of progress
  are different
• Vocational and community reintegration issues
  are also distinct
• Focus on stroke to do credible job on one
  impairment at a time
• In due course, may be applied to SCI and
  traumatic brain injury

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MARS-RERC

• To establish such a center, the Rehabilitation
  Institute of Chicago together with its partners,
  including the National Rehabilitation Hospital in
  Washington, D.C., Catholic University and the
  University of California at Irvine will develop a
  program of research and development centered
  around restoration of function in hemispheric
  stroke survivors.

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• University Collaborators
• Northwestern U BME, ME
• UIC Computer Science
• UCI Mechanical Engineering
• Catholic UA, BME/NRH

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• Industrial Partners
• ARC (Java Therapy)
• Hocoma (lokomat)
• Cobotics (Cobots)
• PT Chicago (new PT strategies)
• Barrett Technology (WAM)
• Z-Kat (Florida)
• Muscle Tech (artificial muscle)
• Intelligent Automation
• (multiaxial training devices)

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MARS-RERCDissemination Plan
MARS-RERC will utilize peer reviewed scientific
publications, presentations at national and
international conferences, publications in
peer-reviewed journals. In addition, we will
develop websites, continuing education courses, a
newsletter, and will offer a major state of the
science conference in the third year of the
grant.
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MARS-RERC

• continuing education courses, available as
  on-site training within the RIC
• web-based presentations via our continuing
  education network (which will also archived for
  later review)
• intensive training in our research laboratories
  suitable for doctoral training of engineering and
  neuroscience students.

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MARS-RERC

• Five Projects
• Our focus will be on the assessment of four
  different approaches towards improving the
  performance of the upper extremity, and one
  project directed towards restoration of
  locomotion.

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• Five Projects
• Development of a Robotic System with an Augmented
  Reality Interface for Rehabilitation of Brain
  Injured Individuals Patton (PI), Kenyon, (Co-PI)
• Gait Restoration in Hemiparetic Stroke Patients
  using Goal-Directed, Robotic-Assisted Treadmill
  Training Hidler, Hornby (Co-PI)
• Robotic Therapy for Force Training of the Upper
  Extremity in Chronic Hemiparetic Stroke Kahn
  (PI), Reinkensmeyer (Co-PI)
• Rehabilitation of Finger Extension in Chronic
  Hemiplegia Derek G. Kamper, Ph.D. (PI), Robert
  Kenyon, Ph.D. (Co-Investigator)
• Home-Based, Telerehabilitation System for
  Improving Functional Hand and Arm Movement
  Recovery Following Stroke Reinkensmeyer (PI)

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Project 1 Development Of A Robotic System With
An Augmented Reality Interface For Rehabilitation
Of Brain Injured Individuals Investigators
James L. Patton, Ph.D. (PI) and Robert Kenyon,
Ph.D. (CO-PI)
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A Robotic System With An Augmented Reality
Interface

• Broad Project Aims
• Prolonged and intensive practice has a dramatic
  influence on recovery. Recent robotics studies
  have been encouraging but limited by the small
  and restricted movements that are possible with
  the devices used.
• To achieve significant practical applications in
  rehabilitation, human-interface robots must
  safely operate in three dimensions with a large
  workspace and an appropriately designed visual
  interface.
• No current system has all of these features.

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Augmented Reality Interface Cont.

• Our specific aims are
• To develop and integrate a robot with an AR
  display system.
• To determine whether training with this system
  leads to better functional returns compared to
  conventional rehabilitation.
• To determine future design specifications.

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Augmented Reality Interface Cont.

• We will develop instrumentation that allows
  subjects to receive therapeutic forces while they
  view synthetic cues and feedback superimposed on
  the real world.
• A longitudinal study on chronic stroke survivors
  will test the systems ability to perform as well
  as or better than conventional therapy.
• This panel of stroke survivors and clinicians
  will provide subjective and objective measures of
  the systems ability to restore function.

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• Project 2 Gait Restoration in Hemiparetic Stroke
  Patients using Goal-Directed, Robotic-Assisted
  Treadmill Training
• Hidler, Hornby (Co-PI).

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Gait Restoration in Hemiparetic Stroke

• The specific aims of this study are
• Determine whether robotic-assisted gait training
  with the Lokomat leads to higher functional
  returns in walking capability when compared to
  conventional rehabilitation.

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Gait Restoration in Hemiparetic Stroke

• The specific aims of this study are
• Investigate whether combined visual-motor
  therapeutic interventions are effective at
  training stroke patients to appropriately control
  muscle activation patterns in their lower limbs
  to successfully execute stepping.

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Gait Restoration in Hemiparetic Stroke
The specific aims of this study
are 3. Determine whether there are differences
between robotic-assisted gait training and
conventional rehabilitation in resolving
secondary complications commonly associated with
stroke, such as spasticity and muscle tone, and
improvement in performance of personal and
societal ADLs.
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Project 3 Robotic Therapy for Force Training of
the Upper Extremity in Chronic Hemiparetic
Stroke Kahn (PI), Reinkensmeyer (Co-PI)
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Project 3 Robotic Therapy for Force Training

• Aims/Hypotheses/Goals
• To implement guided force training with the ARM
  Guide
• To compare the effects of this training algorithm
  with free reaching exercise and conventional
  therapy.

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Robotic Therapy for Force Training
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Project 4 Rehabilitation of Finger Extension
in Chronic Hemiplegia Investigators Derek
G. Kamper, Ph.D. (PI) , Robert V. Kenyon, Ph.D.
(co-I), and William Z. Rymer
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MARS Rehabilitation of Finger Extension Project
Rationale for device design The goal of this
project is to develop and test two different
devices intended to facilitate rehabilitation of
finger extension in individuals with chronic
hemiplegia affecting finger function.
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Project 4 Rehabilitation of Finger Extension
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MARS Rehabilitation of Finger Extension Project
Rationale for device design cont. Finger
extension torques are often greatly diminished or
non-existent. Attempts to generate extension may
result in net flexion torques or movements
instead.
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MARS Rehabilitation of Finger Extension Project
Rationale for device design cont. The proposed
devices will utilize this asymmetry to reduce
complexity and cost by providing assistance only
for finger extension, not flexion.
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Project 5. Home-Based, Telerehabilitation System
for Improving Functional Hand and Arm Movement
Recovery Following Stroke Reinkensmeyer (PI)
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Project 5 Home-Based Telerehabilitation
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MARS-RERCWebsite and Contact Information
www.smpp.northwestern.edu/MARS/mars.html Business
Manager Mary-Ellen Devitt Business Support
Manager, MARS-RERC Rehabilitation Institute of
Chicago 345 East Superior Street, Suite
1436 Chicago, IL. 60611 Direct Line (312)
238-2910 Main Office [phone] FAX (312)
238-2208 medevitt_at_rehabchicago.org