Article

Gesture therapy: a vision-based system for upper extremity stroke rehabilitation.

Instituto Nacional de Astrofísica, Óptica y Electrónica, Luis Enrique Erro #1, Tonantzintla, Puebla, Mexico.
Conference proceedings: ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference 01/2010; 2010:3690-3. DOI: 10.1109/IEMBS.2010.5627458
Source: IEEE Xplore

ABSTRACT Stroke is the main cause of motor and cognitive disabilities requiring therapy in the world. Therefor it is important to develop rehabilitation technology that allows individuals who had suffered a stroke to practice intensive movement training without the expense of an always-present therapist. We have developed a low-cost vision-based system that allows stroke survivors to practice arm movement exercises at home or at the clinic, with periodic interactions with a therapist. The system integrates a virtual environment for facilitating repetitive movement training, with computer vision algorithms that track the hand of a patient, using an inexpensive camera and a personal computer. This system, called Gesture Therapy, includes a gripper with a pressure sensor to include hand and finger rehabilitation; and it tracks the head of the patient to detect and avoid trunk compensation. It has been evaluated in a controlled clinical trial at the National Institute for Neurology and Neurosurgery in Mexico City, comparing it with conventional occupational therapy. In this paper we describe the latest version of the Gesture Therapy System and summarize the results of the clinical trail.

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    ABSTRACT: Physical therapy (PT) is one of the key disciplines in interdisciplinary stroke rehabilitation. The aim of this systematic review was to provide an update of the evidence for stroke rehabilitation interventions in the domain of PT. Randomized controlled trials (RCTs) regarding PT in stroke rehabilitation were retrieved through a systematic search. Outcomes were classified according to the ICF. RCTs with a low risk of bias were quantitatively analyzed. Differences between phases poststroke were explored in subgroup analyses. A best evidence synthesis was performed for neurological treatment approaches. The search yielded 467 RCTs (N = 25373; median PEDro score 6 [IQR 5-7]), identifying 53 interventions. No adverse events were reported. Strong evidence was found for significant positive effects of 13 interventions related to gait, 11 interventions related to arm-hand activities, 1 intervention for ADL, and 3 interventions for physical fitness. Summary Effect Sizes (SESs) ranged from 0.17 (95%CI 0.03-0.70; I(2) = 0%) for therapeutic positioning of the paretic arm to 2.47 (95%CI 0.84-4.11; I(2) = 77%) for training of sitting balance. There is strong evidence that a higher dose of practice is better, with SESs ranging from 0.21 (95%CI 0.02-0.39; I(2) = 6%) for motor function of the paretic arm to 0.61 (95%CI 0.41-0.82; I(2) = 41%) for muscle strength of the paretic leg. Subgroup analyses yielded significant differences with respect to timing poststroke for 10 interventions. Neurological treatment approaches to training of body functions and activities showed equal or unfavorable effects when compared to other training interventions. Main limitations of the present review are not using individual patient data for meta-analyses and absence of correction for multiple testing. There is strong evidence for PT interventions favoring intensive high repetitive task-oriented and task-specific training in all phases poststroke. Effects are mostly restricted to the actually trained functions and activities. Suggestions for prioritizing PT stroke research are given.
    PLoS ONE 01/2014; 9(2):e87987. · 3.53 Impact Factor

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