1. Device for Acute Rehabilitation of the Paretic Hand After Stroke
Team: Carly Brown, Nathan Kleinhans, Lee Linstroth,Sasha Cai Lesher-Perez
BME 400
19 Oct 2007
LEe

2. Medical College of Wisconsin - Milwaukee
Client:
Dr. Michelle Johnson
Medical College of Wisconsin - Milwaukee
Advisor:
Prof. Mitch Tyler
Dept of Biomedical Engineering UW-Madison
Lee

3. Background Stroke 700,000 affected per year
Typically occurs in people above the age of 65
Can result in
Hemiplegia, loss of memory, loss of verbal skills, death
Lee:
Stroke impedes the flow of blood to the brain resulting in a loss of functioning. If a patient survives a stroke, depending on where the blockage occurs… hemiplegia (paralysis on one side of the body), loss of memory, loss of verbal skills can occur as a result
Stroke is the leading cause of disability in adults in the US. However, the disability can be temporary if rehabilitation occurs after stroke.

4. Rehabilitation Current methods for patients after stroke include:
Constraint-induced movement therapy
Electrical stimulation
Physical/occupational therapy
Robot-aided therapy
Constraint-induced movement therapy = constraining non-affected arm… forced to use impaired arm
Electrical stimulation = uses electrodes placed over nerves/muscles to innervate them to assist in movement of impaired limb
Physical/Occupational therapy = one on one work with therapist… work on compensation exercises for loss of functioning… work on independence
Robot-aided = uses mechanical means to assist in loss of movement… incorporates feedback for patient… tracks progress… changes with patient… different settings depending on level of recovery
Our client wanted us to develop a robot-aided device for sup/pro of wrist and grasping of hand…

5. Design a portable rehabilitation
Problem Statement
Design a portable rehabilitation
device, which is automated, universal, comfortable and will assist rehabilitation of supination/pronation as well as finger flexion/extension during the acute phase post-stroke.

6. Our Rehabilitation Robot-aided therapy
Supination/pronation done by the wrist rotator
Flexion/extension of fingers done by hand grasping device
Systems controlled by microprocessor
Systems used together or separate???
Universal for users
Nathan

7. Work Accomplished Thus Far
Wrist rotator completed and approved by client
New design for hand grasping device
Currently remodeling wrist rotator to fit with hand grasping device
Programming of microprocessor
IRB submitted to client
Nathan:

8. Work in Near Future
Finalizing full device – incorporating both hand grasping and wrist rotator devices in one system
Incorporating microprocessor into system
System testing and validation of technical specifications
Begin pilot study, once IRB is approved
Nathan

9. Testing Objectives Ensure system accuracy and technical specifications
Determine usability with clinicians
Observe baseline use and practicality with patients
Test for increase of active/passive movements compared to control group
Sasha Cai

10. System Testing
Determine and set maximal rotation speeds and forces applied within patient use
Adjust system programming to varied levels of patient recovery and development
Test system on ourselves to assure human-system interface
Sasha Cai

11. Clinician Testing Usability test
Ease of setting up patient into device
Subjective assessment of system by clinicians
???

12. Patient Testing Began Pilot Study
2-3 patients
10 sessions in addition to regular pt
Evaluate grip force and range of motion (active and passive) before and after pilot study
Determine whether device provided beneficial results
Subjective feedback from patients
Tweek system for future comparative study
Carly

13. Comparative Study Testing
6-10 patients
8 weeks – 35 sessions
Two groups – experimental and control
Evaluation pre-, mid-, and post-study
Grip force and range of motion (active/passive)
Subjective feedback from patients
Carly

14. Questions