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[IEEE 2007 Virtual Rehabilitation - Venice, Italy (2007.09.27-2007.09.29)] 2007 Virtual Rehabilitation - A home-based Virtual Reality system for Stroke Rehabilitation

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Page 1: [IEEE 2007 Virtual Rehabilitation - Venice, Italy (2007.09.27-2007.09.29)] 2007 Virtual Rehabilitation - A home-based Virtual Reality system for Stroke Rehabilitation

Abstract—We have developed and are continuously refining

a home-based rehabilitation system for victims of brain

diseases and injuries, with an initial focus on stroke. The

system incorporates VR (virtual reality), 3D stereoscopic

visualization and haptics (technology simulating the sense of

touch) into rehabilitation. The training is based on serious

games and activities of daily living. Our system is developed to

be placed in stroke patients’ homes or vicinity for daily

adjusted rehabilitation of the arm/hand.

I. INTRODUCTION

E propose a web based system organization that allows communication between patients and between

patients and a clinical rehabilitation center and clinical assessment/evaluation centers over the Internet. The system should increase compliance to training and then also provide better communication with the health care provider, as well as more social contacts.

The central component of this rehabilitation system is a library of engaging activities, i.e. serious games, intended to be stimulating and entertaining for the patient as well as beneficial for rehabilitation. The games train certain movements so that the patient can perform their daily training exercises in a stimulating environment. Lövquist and Dreifaldt carried out a study comparing the patients’ motivation using this system compared to traditional rehabilitation exercises [1]. One patient said that she felt the traditional exercises sometimes were only to tell her that she was worse than before the stroke, worse than average, and left her with a feeling of being worthless. Another patient said that she didn’t do her best, because the traditional exercises were not motivating enough. Letting the patient use our system showed that the motivation to carry out the rehabilitation increased highly and they are very positive to use it. A quote from one of the users is "I’m very

enthusiastic; actually, this is a perfect tool for therapy. This

is the most fun rehabilitation thing I’ve tried and moreover

you practice fine motor skills and I’m dependent on that in

my work, so it makes me very motivated."

As with traditional stroke rehabilitation an initial examination to measure the patient’s abilities to perform activities of daily life, and tests to assess the fine and gross motor function of the upper extremity is preformed. After that an individual training program is established and

Manuscript received August 13, 2007. This work is supported by VINNOVA (2004-02260), Sweden.

U. Dreifaldt is with Curictus AB, Isafjordsgatan 22, C5, 16440 Kista, Sweden Phone: +46 (0) 8 752 80 90; fax: +46 (0)8 751 60 62; e-mail: ulrika.dreifaldt@ curictus.com. D. Goude and M. Rydmark are with Mednet, at the Sahlgrenska Academy at Göteborg University (Sweden)

rehabilitation staff can prescribe games to be played by each patient, based on information in the clinical record and individual patient results [2]. During the use of the system motion monitoring tracks the progress to give instant biofeedback to the user and to the rehabilitation provider. In the activities we have integrated assessment methods, tuning of game parameters with respect to degree of difficulty and patient abilities.

Our solution is assisted by a patient management system, enabling training sessions to be tailored according to user's individual abilities and performance. Follow-up of results is performed by the therapist, and evaluated in relation to the training goals.

At the moment the long term recovery for a larger group of patients is under evaluation. [3, 4]

II. CONCLUSION

The benefits of a system for post-stroke rehabilitation, based on VR, Haptics and Telemedicine should be: increased quality of life, lesser isolation, feeling more secure, fewer tiring transportations, more frequent exercising, better compliance to training, lower cost for transportation.

The vision is to have a fully deployed regional rehabilitation organization, with clinical evaluation systems stationed at primary care facilities, rehabilitation centrals with activity libraries and training stations, and home-based units. The rehabilitation central has bidirectional contact with the home-based units for collection of daily assessments, game allocation and tuning of difficulty, and audiovisual communication between therapists and patients.

The ambition is to create cost-effective conditions for optimal compliance for rehabilitation after stroke, by distributing haptic/VR units to rehabilitation centrals and patients. At the moment ongoing research and development in close cooperation with the medical community to finalize product development is in progress.

REFERENCES

[1] E. Lövquist, and U. Dreifaldt “The design of a haptic exercise for post-stroke arm rehabilitation,” Proc. 6th Intl Conf. Disability, Virtual Reality & Assoc. Tech., Esbjerg, Denmark, 2006

[2] Broeren J, Dixon M, Stibrant Sunnerhagen K, Rydmark M. “Rehabilitation after Stroke Using Virtual Reality, Haptics (Force Feedback) and Telemedicine.” Proceedings of MIE2006.

[3] StrokeIT 2006 Presentation. http://www.mednet.gu.se/docs.[4] J. Broeren, L. Claesson, D. Goude, M. Rydmark, K. Stibrant

Sunnerhagen “Virtual Rehabilitation in an activity centre for community dwelling persons with stroke: the possibilities of 3D computer games.” Submitted.

A home-based Virtual Reality system for Stroke Rehabilitation

Ulrika Dreifaldt, Daniel Goude and Martin Rydmark

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891-4244-1204-8/07/$25.00 ©2007 IEEE