rehabnet: a distributed architecture for motor and cognitive neuro-rehabilitation

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RehabNet: A Distributed Architecture for Motor and Cognitive Neuro- Rehabilitation Athanasios Vourvopoulos PhD Student University of Madeira Madeira Interactive Technologies Institute [email protected]

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Every year millions of people worldwide suffer from stroke, resulting in motor and/or cognitive disability. Evolving to a chronic condition, stroke requires of continuous rehabilitation and therapy. As a result, patients experience an increased loss of independence, autonomy and low self-esteem. Current ICT approaches with the use of robotics and Virtual-Reality show some benefits over conventional therapy. However, most of the novel approaches are suitable only for a reduced subset of patients. RehabNet proposes an inclusive approach towards an open and distributed architecture for ‘in-home’ neuro-rehabilitation and monitoring by means of non-invasive ICT. In this paper we present the RehabNet architecture, its design and the implementation of a combined motor-and-cognitive system for post-stroke rehabilitation.

TRANSCRIPT

Page 1: RehabNet: A Distributed Architecture for Motor and Cognitive Neuro-Rehabilitation

RehabNet: A Distributed Architecture

for Motor and Cognitive Neuro-

Rehabilitation

Athanasios Vourvopoulos

PhD Student

University of Madeira

Madeira Interactive Technologies Institute

[email protected]

Page 2: RehabNet: A Distributed Architecture for Motor and Cognitive Neuro-Rehabilitation

Athanasios Vourvopoulos

HealthCom’13 - Lisbon August 25, 2014

• Stroke

• Problem Statement

• RehabNet

• Methods

• Implementation

• Preliminary Assessment

• Conclusions

• Future work

Contents

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Page 3: RehabNet: A Distributed Architecture for Motor and Cognitive Neuro-Rehabilitation

Athanasios Vourvopoulos

HealthCom’13 - Lisbon August 25, 2014

Ageing Population & Stroke

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% of the

population

with 60 +

years

2012

2050

~20%

30+%

• Chronic

conditions

• Loss of

independence

• High societal cost

• Unaffordable for

public health

systems

Page 4: RehabNet: A Distributed Architecture for Motor and Cognitive Neuro-Rehabilitation

Athanasios Vourvopoulos

HealthCom’13 - Lisbon August 25, 2014

Limitations of the Current Rehabilitation tools/technics:

• Require patients to have some degree of motor and/or cognitive control*

• We do not know how the brain reacts to a VR treatment

• Is there any functional remapping?

• What is the most efficient way to achieve it

Current Limitations

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K. Laver, S. George, S. Thomas, J. E. Deutsch, and M. Crotty, “Cochrane review: virtual reality for stroke

rehabilitation,” Eur J Phys Rehabil Med, vol. 48, no. 3, pp. 523–530, Sep. 2012

Page 5: RehabNet: A Distributed Architecture for Motor and Cognitive Neuro-Rehabilitation

Athanasios Vourvopoulos

HealthCom’13 - Lisbon August 25, 2014

RehabNet

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RehabilitationOptimal rehabilitation guidelines (e.g, training

intensity, specificity).

NeuroscienceCortical reorganization, other neural pathways, …

InteractionCustomization, usability, …

Serious Games/VRIndividualization, feedback, motivation,

quantification, …

Interactive

Technologies

for

Motor/Cogniti

ve

Rehabilitation

Page 6: RehabNet: A Distributed Architecture for Motor and Cognitive Neuro-Rehabilitation

Athanasios Vourvopoulos

HealthCom’13 - Lisbon August 25, 2014

Methods

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RehabNet Framework: requirements hierarchy

Why: Broad access to rehabilitation training

to the wider possible range of patients.

How: Off-the-shelf electrophysiological

signal acquisition and position tracking

devices.

Why: Maximizing adherence to treatment to

maximize its effect.

How: Lowering the access threshold (using

low-cost interfaces ; content in the cloud;

social and gamified elements to improve

engagement.

Why: Novel VR therapies need to be based

on clinical guidelines and neuroscientific

hypotheses of recovery.

How: Evaluating improvement in

performance, the correctness of the

rehabilitation approach, and validation of

the neuroscientific hypotheses of recovery.

Page 7: RehabNet: A Distributed Architecture for Motor and Cognitive Neuro-Rehabilitation

Athanasios Vourvopoulos

HealthCom’13 - Lisbon August 25, 2014

Methods

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Page 8: RehabNet: A Distributed Architecture for Motor and Cognitive Neuro-Rehabilitation

Athanasios Vourvopoulos

HealthCom’13 - Lisbon August 25, 2014

Implementation

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Page 9: RehabNet: A Distributed Architecture for Motor and Cognitive Neuro-Rehabilitation

Athanasios Vourvopoulos

HealthCom’13 - Lisbon August 25, 2014

Implementation

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Page 10: RehabNet: A Distributed Architecture for Motor and Cognitive Neuro-Rehabilitation

Athanasios Vourvopoulos

HealthCom’13 - Lisbon August 25, 2014

Quantification

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Page 11: RehabNet: A Distributed Architecture for Motor and Cognitive Neuro-Rehabilitation

Athanasios Vourvopoulos

HealthCom’13 - Lisbon August 25, 2014

A proof of concept study has been performed with three patients:

• 2 male and 1 female

• Age: 52, 68 and 72

• Left hemisphere stroke

• Right-sided hemiparesis

Experimental protocol:

• Paper & Pencil

• Mouse

• AnTS

• Kinect

• Keyboard*

Preliminary Assessment

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Page 12: RehabNet: A Distributed Architecture for Motor and Cognitive Neuro-Rehabilitation

Athanasios Vourvopoulos

HealthCom’13 - Lisbon August 25, 2014

Conclusions

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• RehabNet explores the use of non-invasive ICT for

neuro-rehabilitation post-stroke

• Low-cost novel treatments

• In-home rehabilitation

• Widened inclusion criteria

• Social networking (clinicians-patients-family)

Page 13: RehabNet: A Distributed Architecture for Motor and Cognitive Neuro-Rehabilitation

Athanasios Vourvopoulos

HealthCom’13 - Lisbon August 25, 2014

Future Steps

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• Deploying the RehabNet system to perform a

randomised controlled trial (RCT) to assess

the impact of the motor-and-cognitive training

component.

• Generalize the developed motor-and-

cognitive training paradigm by replacing the

active movement component by a

neurofeedback paradigm.

Page 14: RehabNet: A Distributed Architecture for Motor and Cognitive Neuro-Rehabilitation

Athanasios Vourvopoulos

HealthCom’13 - Lisbon August 25, 2014

Thank You

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