Virtual Reality Rehabilitation System for individuals with Acquired Brain Injury

包括中风在内的获得性脑损伤（ABI）可能是一种具有长期影响的毁灭性疾病。这些影响包括身体和认知缺陷，大约75%的人在中风后无法恢复其麻痹的手臂和手的功能使用。加拿大脑损伤协会预计，目前有150万加拿大人患有脑损伤，每年有16万加拿大人遭受脑损伤。据估计，全国每年对ABI的总成本为30亿美元。ABI的一个常见副作用是偏瘫，这是一种由于大脑神经损伤而导致身体一侧麻痹的情况。为了帮助偏瘫患者康复，镜像疗法（MT）已被证明可以减少上肢部分瘫痪的影响。MT是利用镜子将健康肢体的运动反映到受损肢体上，通过这种视觉扭曲来欺骗大脑，使其认为受损（受影响）的肢体像健康的肢体一样运动。MT虽然有效，但已知对患者缺乏参与，并且在功能活动，活动范围和实用性方面受到限制。因此，虽然它是有益的，但在一些康复诊所并没有广泛应用于上肢部分瘫痪。

Acquired Brain Injury (ABI) including stroke can be a devastating medical condition with long-lasting effects. These effects include both physical and cognitive deficiencies with about 75% of individuals failing to regain functional use of their paretic arm and hand after a stroke. The Brain Injury Association of Canada projects that 1.5 million Canadians are currently living with a brain injury, and 160,000 Canadians sustain brain injuries each year. The total estimated national annual cost of ABI is $3 billion. A common side effect of ABI is hemiplegia, a condition in which one side of the body becomes paretic due to neural damage in the brain. To help rehabilitate those with hemiplegia, Mirror Therapy (MT) has been shown to reduce the effects of upper limb partial paralysis. MT is the use of a mirror to reflect movements of healthy limbs onto impaired limbs in order to trick the brain, through this visual distortion, into thinking that the impaired (affected) limb is moving as a healthy limb. While effective, MT is known to lack engagement for the patient and is limited in terms of functional activities, the range of motion, and practicality. Thus, although it is beneficial, it is not widely practiced in some rehabilitation clinics for upper limb partial paralysis. The proposed research program will investigate the design and development of a new medical device that will be used for Virtual Mirror Therapy (VMT) for ABI subjects with upper limb partial paralysis. The system implements an immersive head-mounted display where the subject sees only the virtual world. The system will simulate a variety of Activities of Daily Living (ADL) designed for the users to make it appear that both limbs are moving when only the unaffected limb is moving. Each activity incorporates repetitive unilateral tasks that involve lifting, pushing to or tapping on a target. The work will research the design of a safe, portable, easy to use, low cost, acceptable, and comfortable device to use while providing greater gains for the rehabilitation of the upper limbs of ABI subjects. Through training and therapy of the upper limbs, these tasks aim to enhance: range of motion, strength, fine motor, gross motor, coordination and sensorimotor skills. Incorporating multiple axes for the hand, elbow, wrist, and shoulder will provide important biomechanical parameters that support the design and natural movements of the upper limbs. To verify and evaluate this new medical device at its early development stage, the investigator will experiment and test the new VMT system using human subjects. The outcomes of the experiment will help improve and optimize the integrated hardware and software of the new VMT system. The long-term objective of the research is to advance the science and development of assistive and therapeutic rehabilitation technology where needed in rehabilitation clinics or in a home care environment.