Clinical evaluation of a low-cost alternative for stroke rehabilitation

摘要

Stroke is the main cause of disabilities in the world and is typically treated with intensive, hands-on physical and occupational therapy for several weeks after the initial injury. However, due to economic pressures, stroke patients are receiving less therapy and going home sooner, so the potential benefit of the therapy is not completely realized. Thus, it is important to develop rehabilitation technology that allows individuals who had suffered a stroke to practice intensive movement training without the expense of an always-present therapist. Although several robotic devices have been developed for stroke rehabilitation, these are too expensive for use at home or in small clinics.We have developed a low-cost alternative that allows stroke survivors to practice arm movement exercises at home or at the clinic, with periodic interactions with a therapist. The system integrates a virtual environment for facilitating repetitive movement training, with computer vision algorithms that track the hand of a patient, using an inexpensive camera and a conventional personal computer. This system, called Gesture Therapy, has been evaluated in a controlled clinical trial at a hospital in Mexico City, comparing it with conventional occupational therapy. The results show that both treatments improve the functionality of the affected upper extremity, with not significant difference between them. However, the patients that used the virtual environment have a greater motivation and attachment to the treatment, which in the long term are decisive for maximal recovery.