Chih Chen

Application of RFID technology—upper extremity rehabilitation training

[Purpose] Upper extremity rehabilitation after an injury is very important. This study proposes radio frequency identification (RFID) technology to improve and enhance the effectiveness of the upper extremity rehabilitation. [Subjects and Methods] People use their upper extremities to conduct daily activities. When recovering from injuries, many patients neglect the importance of rehabilitation, which results in degraded function. This study recorded the training process using the traditional rehabilitation hand gliding cart with a RFID reader, RFID tags in the panel, and a servo host computer. [Results] Clinical evidence, time taken to achieve a full score, counts of missing the specified spots, and Brunnstrom stage of aided recovery, the proximal part of the upper extremity show that the RFID-based upper extremity training significantly and reduce negative impacts of the disability in daily life and activities. [Conclusion] This study combined a hand-gliding cart with an RFID reader, and when patients moved the cart, the movement could be observed via the activated RFID tags. The training data was collected and quantified for a better understanding of the recovery status of the patients. Each of the participating patients made progress as expected.

Application of the blobo bluetooth ball in wrist rehabilitation training

[Purpose] The introduction of emerging technologies such as the wireless Blobo bluetooth ball with multimedia features can enhance wrist physical therapy training, making it more fun and enhancing its effects. [Methods] Wrist injuries caused by fatigue at work, improper exercise, and other conditions are very common. Therefore, the reconstruction of wrist joint function is an important issue. The efficacy of a newly developed integrated wrist joint rehabilitation game using a Blobo bluetooth ball with C# software installed was tested in wrist rehabilitation (Flexion, Extension, Ulnar Deviation, Radial Deviation). [Results] Eight subjects with normal wrist function participated in a test of the system’s stability and repeatability. After performing the Blobo bluetooth ball wrist physical therapy training, eight patients with wrist dysfunction experienced approximately 10° improvements in range of motion (ROM) of flexion extension, and ulnar deviation and about 6° ROM improvement in radial deviation. The subjects showed progress in important indicators of wrist function. [Conclusion] This study used the Blobo bluetooth ball in wrist physical therapy training and the preliminary results were encouraging. In the future, more diverse wrist or limb rehabilitation games should be developed to meet the needs of physical therapy training.

Football APP based on smart phone with FES in drop foot rehabilitation

BACKGROUND Long-term, sustained progress is necessary in drop foot rehabilitation. The necessary inconvenient body training movements, the return trips to the hospital and repetitive boring training using functional electrical stimulation (FES) often results in the patient suspending their training. The patients drop foot rehabilitation will not progress if training is suspended. OBJECTIVE A fast spread, highly portable drop foot rehabilitation training device based on the smart phone is presented. This device is combined with a self-made football APP and feedback controlled FES. The drop foot patient can easily engage in long term rehabilitation training that is more convenient and interesting. METHODS An interactive game is established on the smart phone with the Android system using the originally built-in wireless communications. The ankle angle information is detected by an external portable device as the game input signal. The electrical stimulation command to the external device is supplemented with FES stimulation for inadequate ankle efforts. RESULTS After six-weeks training using six cases, the results indicated that this training device showed significant performance improvement (p< 0.05) in the patients ankle dorsiflexion strength, ankle dorsiflexion angle, control timing and Timed Up and Go. CONCLUSIONS Preliminary results show that this training device provides significant positive help to drop foot patients. Moreover, this device is based on existing and universally popular mobile processing, which can be rapidly promoted. The responses of clinical cases also show this system is easy to operate, convenient and entertaining. All of these features can improve the patients willingness to engage in long term rehabilitation.

Noninvasive tongue-motion controlled computer mouse for the disabled

BACKGROUND A patient whose spinal cord was damaged due to accident may result in Tetraplegia or lose the ability to control his/her daily living environment. Currently, patients must use an invasive tool tongue movement, to help the patient communicate with the external environment. OBJECTIVE This study designed a non-invasive tongue movement computer mouse system that allows the patient to use tongue movement to control a computer to communicate with the external environment. METHODS Via a pressure sensor and assistive holder designed in this study, the pressure sensor can be moved using the assistive holder close to the mylohyoid muscle of the patients lower jaw. The changes in pressure from the mylohyoid muscle are converted into computer mouse control signals to control a computer to communicate with the external environment. RESULTS This study is based on ISO9241-Part 9 to design four kinds of training modes with varying difficulties. The data were collected from five able persons participating in the test over 7 days. The data includes throughput, path efficiency, test completion time and reaction time. The data verifies that the proposed system is stable and practical for persons with disabilities. CONCLUSION The non-invasive computer mouse system for sensing tongue movement can completely breakthrough the limitations of the invasive tongue movement sensing system. This study uses non-invasive, simple tongue movements that correspond to the stretching and shrinking of the lower jaw mylohyoid muscle to control the computer mouse.

Balance training using an interactive game to enhance the use of the affected side after stroke

[Purpose] Stroke and other cerebrovascular diseases are major causes of adult mobility problems. Because stroke immobilizes the affected body part, balance training uses the healthy body part to complete the target movement. The muscle utilization rate on the stroke affected side is often reduced which further hinders affected side functional recovery in rehabilitation. [Subjects and Methods] This study tested a newly-developed interactive device with two force plates to measuring right and left side centers of pressure, to establish its efficacy in the improvement of the static standing ability of patients with hemiplegia. An interactive virtual reality game with different side reaction ratios was used to improve patient balance. The feasibility of the proposed approach was experimentally demonstrated. [Results] Although the non-affected-side is usually used to support the body weight in the standing position, under certain circumstances the patients could switch to using the affected side. A dramatic improvement in static standing balance control was achieved in the eyes open condition. [Conclusion] The proposed dual force plate technique used in this study separately measured the affected and non-affected-side centers of pressure. Based on this approach, different side ratio integration was achieved using an interactive game that helped stroke patients improve balance on the affected side. Only the patient who had suffered stroke relatively recently benefited significantly. The proposed technique is of little benefit for patients whose mobility has stagnated to a certain level.

Interactive Technology for the Elderly in the Hand-Eye Coordination Training

Taiwan has come to an aging society, dementia of the elderly has become a major concern of the community. The symptom causes a significant reduction of the hand-eye coordination and memory abilities. The hand-eye coordination ability involves many nerve systems. The brain perceives things through the eyes and acquires various information through the touches by different parts of the body, and then makes synthetic analysis before giving an executive order. Therefore, using fun interactive games to activate the hand-eye coordination and memory ability can delay the onset of dementia. In this modern technology era, using information technology to improve the training facility and better the approaches has become a trend. In this study, software programs coded in C# and Flash are developed to work on the Bluetooth ball hardware to facilitate the rehabilitation. The basic principle is use the reaction from the Bluetooth ball’s swaying or swinging to drive the movement of the objects on the computer screen, making the supposedly boring rehabilitation much more fun and vivid in the interactive multimedia environment, thus gaining better treatment effect. Also, RFID, Internet and databases can be integrated into this facility to provide patient identification and data storage for references in making rehabilitation training programs.

Dynamic Control of Gait and Posture Training on Robot

In the research, a robot with gait and posture training functions is developed as an interactive balance rehabilitation training system for balance control impaired people to use. The system uses an action control tool with braking and monitoring functions to obtain the dynamic posture and gravity position of the body of the trainee, followed by subsequent process with software which is developed and designed completely to generate related feedback instructions for the trainee. Moreover, the instructions are presented in image, audio and tactile feedback manners, such that the trainee is provided with multiple message instructions to perform training activities according to the action request actually. Clinically, the research may provide training contents oriented according to task need. Compared to the decomposed action approach emphasized in conventional rehabilitation, it does allow the trainee to focus on the activity and obtains more significant effect. Furthermore, the goal of falling prevention function is also achievable after trained by the robot with gait and posture training functions developed in the research.

Novel control for ambulation function restoration in a non-invasive functional electrical stimulation system

In this study, a patient-driven loop control in a non-invasive functional electrical stimulation (FES) system was designed to restore ambulation function of stroke patients with their residual capabilities.