COMPLETE: Sensor Technologies Applied to Rehabilitation in Stroke

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This study is complete and is no longer recruiting subjects.

Sensor Technologies Applied to Rehabilitation in Stroke (STARS) is a Rehabilitation Engineering Research Center (RERC) program, funded by The National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR).

Based within the Shirley Ryan AbilityLab, with partners at Northwestern University, University of California at Irvine, and Virginia Tech, this center focuses on the pivotal role of clinicians and therapists in implementing routine rehabilitation care, and on enhancing their capacity to provide evidence-based, individualized, and precise therapy.

The primary objective of this research program is to enhance the capacity of clinicians to measure impairment by developing and testing a range of sensors suitable for use in a clinical rehabilitation facility. Our central hypothesis is that the measures of function currently used to evaluate progress in rehabilitation are insufficiently precise, and do not allow physicians and therapists to characterize and understand the sources of impairment that lead to loss of function. We will test this hypothesis by first designing, developing, and testing sensors suitable for measurement of impairment in stroke survivors, followed by studies to determine the feasibility of implementing these devices in routine clinical practice. We have chosen to focus on stroke, because this is the most common neurological disorder requiring intensive and prolonged rehabilitation.

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Our center includes four development projects (D1-4), supported by three cores, and a research project (R1) to determine the feasibility of implementing sensors in a clinical environment:

1. D1. Evaluation of use of small exoskeletons on the hands and fingers of persons to quantify finger extension forces after stroke. These forces are strong predictors of hand function. We will evaluate finger dexterity and assess the role of impaired finger proprioception using exoskeletons to measure and track finger joint position.
2. D2. Development of a Sensor Glove for Precise Quantification of Spasticity after Stroke. The glove design is based on designs by Dr. Arthur Prochazka at the University of Alberta, Canada, who designed an innovative glove for measuring increased tone (i.e., rigidity) in patients with Parkinson's disease. Subject to design and software modifications, the new glove will be used to quantify spastic hypertonia in a stroke sample.
3. D3. Low Cost Instrumentation and Computational Rating of ARAT Using an Adapted Semi-Automated Rehabilitation System. We will measure movement of the hand and arm towards designated objects and targets as part of the validated ARAT protocol. This work will be done in collaboration with Dr. Thanassis Rikakis from Virginia Tech, with technical support from Arizona State University (Dr. Turaga) and with clinical guidance from Dr. Steven Wolf, Emory University, Atlanta.
4. D4. Wearable sensors to measure gait impairments and function in individuals with stroke. These sensors will be provided by Dr. John Rogers and his team at Northwestern University, and measured by a team led by Arun Jayaraman PT PhD, director of the Max Näder Center at SRAlab.

After completion of these sensor development projects, we will undertake a pilot implementation trial to evaluate their benefits on clinical evaluation and barriers to their implementation in clinical practice. Completing this pilot study will prepare us to undertake full-scale clinical trials of sensors. These clinical studies will be directed by Miriam Rafferty, PT, PhD, an implementation scientist who studies factors that impact acceptance and use of new interventions. She will be guided by Allen Heinemann, PhD, a leading health services and outcomes investigator and Director of Outcomes Research at SRAlab, and Dr. Elliot Roth, Chair, Department of PM&R, Northwestern University.

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William Zev Rymer, MD, PhD, Principal Investigator

Arun Jayaraman, PT, PhD, Principal Investigator

Project Leads

D1 – David Reinkensmeyer, PhD of the University of California, Irvine

D2 – Arthur Prochazka, PhD of the University of Alberta, Nina Suresh, PhD and William Zev Rymer, MD, PhD of the Shirley Ryan AbilityLab

D3 – Thanassis Rikakis, PhD of Virginia Tech, Caitlin Doman, MS, OTR/L of the Shirley Ryan AbilityLab and Steven Wolf, PhD of Emory University

D4 – Arun Jayaraman, PT, PhD and William Zev Rymer, MD, PhD of the Shirley Ryan AbilityLab

R1 – Miriam Rafferty, PT, PhD & Allen Heinemann, PhD of the Shirley Ryan AbilityLab

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National Institute on Disability, Independent Living, and Rehabilitation Research (cc82288 8161//90REGE0010 -01-01).