Virtual Reality Rehabilitation System for individuals with Acquired Brain Injury

获得性脑损伤（ABI）包括中风可能是一种具有长期影响的破坏性医疗状况。这些影响包括身体和认知缺陷，约75%的人在中风后未能恢复其瘫痪手臂和手的功能。加拿大脑损伤协会估计，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。ABI的国家年度总成本估计为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瘫痪的情况。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是使用镜子将健康肢体的运动反射到受损肢体上，以便通过这种视觉扭曲欺骗大脑，使其认为受损（受影响）肢体正在作为健康肢体移动。虽然有效，但已知MT缺乏患者的参与，并且在功能活动、运动范围和实用性方面受到限制。因此，虽然它是有益的，但在一些上肢部分瘫痪的康复诊所中并没有广泛应用。 拟议的研究计划将调查一种新的医疗设备的设计和开发，该设备将用于上肢部分瘫痪的ABI受试者的虚拟镜像治疗（VMT）。该系统实现了一个沉浸式头戴式显示器，其中受试者只看到虚拟世界。该系统将模拟为用户设计的各种日常生活活动（ADL），使其在只有未受影响的肢体移动时看起来似乎两个肢体都在移动。每项活动都包含重复的单边任务，包括举起、推到或敲击目标。这项工作将研究设计一个安全，便携，易于使用，成本低，可接受的，舒适的设备使用，同时提供更大的收益为ABI受试者的上肢康复。 通过上肢的训练和治疗，这些任务旨在提高：运动范围、力量、精细运动、粗大运动、协调和感觉运动技能。手、肘、腕和肩的多轴定位将提供重要的生物力学参数，支持上肢的设计和自然运动。 为了在早期开发阶段验证和评价这种新的医疗器械，研究者将使用人类受试者对新的VMT系统进行实验和测试。实验结果将有助于改进和优化新VMT系统的硬件和软件集成。该研究的长期目标是在康复诊所或家庭护理环境中推动辅助和治疗性康复技术的科学和发展。

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.