Developing an Innovative System for Upper Limb Diagnosis and Rehabilitation
Figure 1: The figure shows the analysis panel. It reports the main extracted parameters such as performed trajectories; speed, acceleration and jerk profiles, directional error, linear error, time error, and so on.
"The system is easy to use and does not require particular technical expertise."
- A. Novellino, ETT
Creating an innovative, inexpensive, and easy-to-use system to perform clinical diagnosis and rehabilitation of upper limb movement, supervise pharmacological therapy, and study learning processes.
Using NI LabWindows™/CVI software to develop a commercially available instrument to perform and study shoulder-elbow movements. We developed an inexpensive and easy-to-use system to perform upper limb analysis for diagnosis and rehabilitation for patients with degenerative disorders such as Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, and/or stroke patients. Our system, the Motor Task Manager (MTM), provides an innovative way to perform upper limb analysis because no similar systems are commercially available. Generally, shoulder-elbow motion analysis is achieved using very expensive stereoscopic instrumentation or less accurate goniometric devices.
A. Novellino - ETT
A. Maccione - ETT
Creating the Motor Task Manager
We designed the MTM to analyze the reaching motion to visual targets, which involves transformations in the neural representation of the configuration of the arm in space and the movement speed as the hand moves from its initial position to the target, or its final position. This implies that the brain plans movements (feed-forward model) by integrating visual information about the target location and proprioceptive information about the arm position, and then adjusts muscle strength and smooth movement (feedback control) by integrating visual and instantaneous position information of the arm to precisely reach the target.
Some degenerative diseases, such as Parkinson’s disease, multiple sclerosis, and Huntington’s disease, strongly affect daily movements and require pharmacological treatments and the availability of easy-to-use and portable devices to monitor the disease evolution and immediately check the effect of a particular drug treatment.
The MTM system objectively characterizes the evolution of the motion capability in response to simple motion tasks. For example, in a patient affected by a degenerative disease, we can supervise the pharmacological therapy and understand if the patient’s condition improves or if we need to increase the drug dosage.
With patients under medical rehabilitation because of an injury or stroke, MTM allows better supervision of rehabilitation treatment. The MTM requires the subject to move a cursor with a hand on the digitizing surface while their hand position and target locations are displayed on a computer screen with a cursor indicating the hand position on the digitizing surface.
Taking Advantage of NI Software
We developed the MTM software using NI LabWindows™/CVI to control the experiment, generate screen displays, and acquire kinematic data at 200 Hz. The software decreases the design and development costs and fully manages the experimental session, from the protocol parameters definition to the report sheet printing through user-friendly GUIs.
The patient sits in front of an LCD computer screen and a seat belt system prevents any undesired shoulder movement. All motor tasks require arm movements from a central start area to one of the radial targets. Generally, the background color is white, the targets are black, and the cursor is red. At the start of a trial block, the patient moves the screen cursor within the central start area and a series of three tones usually sounds to provide the required tempo of the movement to follow. With the fourth and successive tones, subsequent targets turn black and the patient is instructed to move the hand smoothly out and back to each target without corrections and with sharp reversal movements. Targets can be randomly presented or they can follow a predefined sequence that the patient previously learned to evaluate learning capabilities.
Then MTM processes the x and y coordinates of each hand path and extracts movement parameters such as reaction time, time error, directional error, speed profile, acceleration, and jerk profiles. These parameters are widely adopted by the scientific community to identify movement capabilities due to degeneration.
The MTM is the first commercially available, inexpensive, and easy-to-use system that does not require any particular technical background knowledge and provides full management of the upper limb experimental session, from defining the protocol parameters to printing the report sheet. Using LabWindows/CVI graphical tools libraries, we developed a very friendly user system.
Successful Development of a User-Friendly System
Currently, researchers who want to perform similar experimentation have to use several, often homemade, devices and software – one for each experimental session to create the task, manage a digitizing device, and analyze and extract relevant parameters. The MTM system overcomes these limitations and provides a semiautomated solution for analyzing upper limb movements.
Using the filtering libraries and mathematical functions in LabWindows/CVI, doctors and therapists can create and manage patient databases; customize the number, color, size, and sound of each target; and define distortion such as plane rotation and gain in the cursor feedback.
The mark LabWindows is used under a license from Microsoft Corporation. Windows is a registered trademark of Microsoft Corporation in the United States and other countries.
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