Transcript Adaptive Assistance for Guided Force Training in Chronic Stroke

Guided Force Training with the
ARM Guide in Chronic Stroke
Lennie Kahn
Heidi Waldinger
Heidi Roth
W. Zev Rymer
David Reinkensmeyer
MARS-RERC September 2004 Advisory Board Meeting
Sensory Motor Performance Program, Rehabilitation Institute of Chicago
Department of Mechanical and Aerospace Engineering, University of California - Irvine
MIME
ARM Guide
(Mirror Image Movement Enabler)
(Assisted Rehabilitation and Measurement)
Free Reaching Results
14
* significant difference
between groups (p<0.05)
*
increases in reach extent [cm]
12
MIME
Conventional therapy
ARM Guide
Free reaching exercise
10
*
8
6
4
2
0
-2
-4
-6
forward medial
forward lateral
shoulder level
forward
tabletop level
The ARM Guide and
Guided Force Training
Aims & Hypotheses

Aims:



to implement guided force training using the ARM
Guide
to compare guided force training with traditional
therapy and free reaching therapy for restoring UE
function
Hypotheses: Guided force training…

accounts for the difference between the MIME and
ARM Guide free reaching outcomes

will be more effective than free reaching exercises and
conventional therapy in promoting arm movement
recovery
Since the last meeting…


Added adaptive assistance normalized to
each subject’s functional ability during
guided force protocol
Trained 9 participants
•
•
•
2 guided force therapy
4 free reaching therapy
3 conventional OT
Adaptive assistance

The assistance converges to approximate
a single value
CL01
CL10
Preliminary training outcomes
Guided force
Free reaching
Conventional OT
Δ supported
range
18.5%
14.6%
6.3%
Δ supported
velocity
12.5%
16.3%
12.2%
CL10
distance to target [m]
0.8
0.6
0.6
0.4
0.4
0.2
0.2
0
1
2 target 3
CL01
0.8
4
0
1
2 target 3
4
Activities of daily living
50
Average time per task [s]
45
40
35
30
25
20
15
10
5
0
Guided force training
Free reaching
Conventional OT
(18.4)
(8.7)
(-0.2)