Kinematic Biofeedback for Independent Motor Retraining

DESCRIPTION (provided by applicant): This project proposes to develop a device that will improve the quality and availability of motor retraining for individuals with neuromotor disorders due to stroke or incomplete spinal cord injury. Biofeedback of postural control variables such as ground reaction force and center of pressure sway has been used effectively, however, existing devices are not suitable for use by many patients and are not widely available. We propose to develop a therapeutic system that enables patients to practice clinically-relevant, closed chain, lower-extremity tasks (sit-to-stand transitions and balance shifts) and that uses visual biofeedback of kinematic variables to encourage use of the affected limb(s). We anticipate that use of the proposed device will improve the efficacy of traditional therapy by allowing patients to begin sit-to-stand and balance shift exercises earlier in the rehabilitation process because the proposed mechanical device will reduce the risk of falls. In Phase I we will: 1} modify an existing exercise device to provide visual biofeedback of measured variables, 2) develop clinically relevant biofeedback exercises, 3) evaluate the biofeedback displays in a study involving age-matched individuals without a neuromotor deficit, and 4) demonstrate feasibility of the approach in a pilot study where patients use the device as one component of their traditional therapy during acute rehabilitation following stroke. The pilot study wilt provide insight into the following objectives: 1) determine if the device can be used safely for this population, 2} determine if patients can understand the biofeedback information and complete the specified tasks, 3) determine if the device is viewed as a beneficial form of therapeutic exercise by both physical therapists and patients, and 4) determine if a rehabilitation program using the device improves the rate of recovery and/or the efficacy of traditional therapy. In Phase II we will improve the biofeedback interface, optimize the protocols to improve transference, develop custom electronics to generate the biofeedback displays, and test the system in an extensive clinical trial. The target market for the device is rehabilitation hospitals and clinics that serve patients following stroke or incomplete spinal cord injury.