Quantifying and Reducing Motor Compensation After Stroke in Ambient Settings



 DESCRIPTION (provided by applicant): This project will develop a lightweight, unobtrusive system of wearable sensors capable of monitoring an individual's motion in the home setting, and providing real-time feedback of motion quality. This system will help clinicians monitor changes in functional ability in home settings, and will help patients with neuro-motor deficits t take a more active role in self-care. Such a system is particularly useful for determining if individuals are using compensatory motions after stroke. Compensation describes the use of new limbs and strategies to accomplish tasks previously performed with the stroke affected limb. Such compensation is thought to be maladaptive and may lead to further injury and depressed quality of life. Compensatory strategies likely evolve and are affirmed in the absence of a clinical observer (e.g., at home). Thus, this project aims to (1) develop a technique for quantifying such compensation in the home setting using wearable sensors and (2) evaluate the relative efficacy of two biofeedback-based interventions designed to reduce the use of compensatory strategies at home. These interventions provide the participant with feedback regarding their movement quality, but differ in the style of delivery - one provides internally directed feedback regarding the person's body, and the other provides externally directed feedback regarding the person's environment. If successful, this project may benefit many of the seven million people living with chronic stroke in the United States. Our methodology will utilize a prospective experimental design, and a between-groups human subjects study. We anticipate that both biofeedback based interventions will benefit the participant, but that the internally directed feedback will significantly reduce the use of compensation. The methodology developed and validated in this project may eventually benefit other individuals living with chronic motor deficits.