This RERC will promote rehabilitation engineering-based devices, strategies, techniques and interventions that can facilitate activity and mobility following neurologic injuries. Over the last decade, with the help of innovative devices, technologies and protocols, rehabilitation has evolved from compensation for impairment to goals of recovery through neurorehabilitation. The ultimate goal is improved integration of impaired limbs into functional activities in the home and community. However, treatment and assessments are done predominantly in the clinic by therapists. Home-based technologies can have a large impact by providing tools to augment clinic-based delivery with assessments that are more valid and treatments that are less expensive, more convenient and potentially more effective.
The need to travel to the clinic to receive treatment from a therapist severely limits access for many patients and may blunt the effectiveness of some interventions. In this RERC, we develop home-based technologies for treating motor impairments. D1 will develop wearable upper extremity exoskeletons that can be integrated into activities of daily living for individuals with stroke. D2 will develop an ankle-based mechanical platform combined with video games for home-based rehab of children with cerebral palsy (CP). There are no clinically-accepted, objective methods of assessing spontaneous use of impaired limbs in the home and community. R1 will track sensorimotor development and predict future outcomes in infants at risk for motor delay using home-based video and specially designed toys that provide novel sensory feedback. R2 will study machine learning algorithms and wrist worn accelerometry for objectively measuring the amount of functional arm use in persons with stroke. R3 will investigate factors that affect the everyday choices made by persons with stroke to either use an impaired upper extremity or compensate with the opposite limb. This is critical to understand, as even mild stroke-related impairment, when measured in the clinic, can result in very little spontaneous functional use at home. Rehab technologies are often rejected by consumers. D3 will explore the patient and caregiver perspective on these home-based technologies and develop guidelines and best practices for how to translate all these technologies into the home.