Grant: Operating Grant

Current doses of rehabilitation for treating the arm and hand after stroke are not adequate for improving the brain pathways needed to promote optimal upper extremity function after stroke. Suggested strategies to increase the repetitions of practice include sessions of independent practice, group exercise, or family assisted exercise, as well as daily targets to increase the amount of arm and hand use throughout the entire day. A wearable sensor that can characterize the amount and type of arm and hand motions that occur during a therapy session or over the course of a day would be an ideal tool to monitor and motivate patients. It is a major challenge to identify what hand movements are occurring as adding instrumentation to a glove or the hand itself results in impeding normal hand sensations and motions. We have developed a preliminary prototype which uses a forearm band embedded with force sensors to detect changes in pressure which reflect the underlying muscle activity. Our device is novel in that hand movements such as grasp and release, as well as different arm movements, can be identified.Our initial results have proved feasibility of the unprecedented technology. We propose to advance this technology and validate this system with stroke patients who undertake the GRASP Program for Stroke which is a structured series of arm and hand exercises. Secondly, the system will be validated in an unconstrained task where stroke patients will be asked to prepare a simple meal in a kitchen. We will compare the movements classified by the device and the actual observer's classification of activities. We will utilize an iterative procedure to finalize the device. We expect this technology to benefit current and future stroke patients as monitoring and motivating upper extremity activity has the potential to significantly improve activities of daily living, reduce secondary complications, and improve the well-being of these individuals.