For stroke survivors, the use of compensatory movements can lead to a reduction of range of motion, pain, and a pattern of “learned non-use”. A common compensatory movement present during upper limb reaching is trunk displacement. Although this motion has been identified as an important one to be reduced, few strategies for addressing this problem have been considered. The existing strategies require physical restraint of the person to the back of a chair, making them undesirable for use in unsupervised therapy. As a result, there is a current need for alternate methods that promote the use of correct movement patterns both in the clinic and in the home. In this sense, technology can act as an enabler to create new ways of reducing trunk compensation. Still, there is a gap in the literature as trunk compensation has only been investigated as a secondary theme in robotic and computer-aided rehabilitation. Consequently, in this project I will look into the reduction of trunk compensation using robotic devices and commercially available technology, to enable a focus on the quality of the movements in unsupervised therapy. The potential results from this PhD could later be applied and generalized to other modes of compensation in stroke and other neurological disabled populations.
Supervisor: Machiel Van der Loos
Stroke rehabilitation professionals acknowledge that about half of upper limb functional recovery after stroke is spontaneous. Any remaining recovery results from intensive, repetitive therapy over months of time, stimulating neuroplastic changes in the brain’s motor control pathways. From a human perspective, this is painful, frustrating and hard work. Sustaining a treatment over months requires significant doses of motivation and funding. Health plans do not provide sufficient coverage; motivation is highly dependent on a person’s support network and inner drive, and is often not adequately tapped.
We are combining low-cost robotic devices, a bimanual training program, social media frameworks such as Facebook Games, and on-line performance sharing between therapy clients and their therapists. This combination of components represents a best-practices approach to bidirectional knowledge transfer, development of technology and design of well-coordinated home-based therapy. We believe that together these approaches will yield interventions for people with stroke and children with hemiparetic cerebral palsy that significantly improve functional ability and lead to improved quality of life.
B.A. Valdés, H.F.M. Van der Loos, “Biofeedback vs. Game Scores for Reducing Trunk Compensation after Stroke: A Randomized Crossover Trial,” Topics in Stroke Rehabilitation. Published online: Oct. 27th, 2017, http://dx.doi.org/10.1080/10749357.2017.1394633 [PDF]
Editors’ Selections From Issue: B.A. Valdés, A.N. Schneider, H.F.M. Van der Loos, “Reducing trunk compensation in stroke survivors: A randomized crossover trial comparing visual vs. force feedback modalities”, Archives of Physical Medicine and Rehabilitation, vol.98, no.10, pp. 1932-1940, 2017, https://doi.org/10.1016/j.apmr.2017.03.034 [PDF]
B.A. Valdés, S.M.N. Glegg, H.F.M. Van Der Loos, “Trunk Compensation during Bimanual Reaching at Different Heights by Healthy and Hemiparetic Adults”, Journal of Motor Behavior, vol. 49, no. 5, pp. 580-592, 2017, http://www.tandfonline.com/doi/abs/10.1080/00222895.2016.1241748 [PDF]
S.M.N. Glegg, C.T. Hung, B.A. Valdés, B.D.G. Kim, H.F.M. Van der Loos, “Kinecting the Moves: The kinematic potential of rehabilitation-specific gaming to inform treatment for hemiplegia”, International Journal of Child Health and Human Development, vol. 9, no.3, pp. 351-360, 2016. [PDF]
Best Student Paper Award: Valdés, BA, Shirzad, N, Hung, CT, Glegg, SMN, Reeds, E, Van der Loos, HFM, “Visualisation of two-dimensional kinematic data from bimanual control of a commercial gaming system used in post-stroke rehabilitation”, in Proc. International Conference on Virtual Rehabilitation, Valencia, Spain, June 9-12, pp. 243-250, 2015. [PDF]
S.M.N. Glegg, C.T. Hung, B.A. Valdés, B.D.G. Kim, H.F.M. Van der Loos, “Kinecting the Moves: The kinematic potential of rehabilitation-specific gaming to inform treatment for hemiplegia”, in Technology, Rehabilitation and Empowerment of People with Special Needs, 1st ed. New York, Nova Science Publishers, ch. 10, pp. 111-121, 2015. [PDF]
Shirzad N, Valdés BA, Hung CT, Law M, Hay J, Van der Loos HFM, “FEATHERS, a bimanual upper limb rehabilitation platform: a case study of user-centred approach in rehabilitation device design”. in Proc. International Conference on Engineering Design ICED 2015, Milan, Italy, July 27-30, pp. 361-370, 2015. [PDF]
Best Short Paper Award: S.M.N. Glegg, C.T. Hung, B.A. Valdés, B.D.G. Kim, H.F.M. Van Der Loos, “Kinecting the Moves: The kinematic potential of rehabilitation-specific gaming to inform treatment for hemiplegia”, in Proc. International Conference on Disability, Virtual Reality and Associated Technologies, Gothenburg, Sweden, September 2-4, pp. 313-316, 2014. [PDF]
Valdés, BA, Hilderman, CGE, Hung, CT, Shirzad, N, Van der Loos, HFM, “Usability testing of gaming and social media applications for stroke and cerebral palsy upper limb rehabilitation,” in Proc. IEEE Engineering in Medicine and Biology Conference, Chicago, Il, August 26-30, pp. 3602-3605, 2014. [PDF]
B.A. Valdés, J.M. Gómez-González, Rodríguez-Sosa, J.J. Bernal-Alvarado, A. Vega-Gonzalez, 2012, “Detecting locomotive activity in the Procambarus clarkii crayfish, using machine vision and LabVIEW”, The XXXV National Congress of Biomedical Engineering (CNIB), San Luis Potosi, Mexico, October 4-6, pp. 135-138, 2012. [PDF]
PhD Dissertation: Reducing Compensatory Movements in Stroke Therapy through the Use of Robotic Devices and Augmented Feedback, B.A. Valdés, Faculty of Graduate and Postdoctoral Studies, The University of British Columbia, 2017. [PDF]
Master Thesis: Robotic Orthotic Device for Finger Rehabilitation, B.A. Valdés, Faculty of Engineering and Information Technologies, The University of Sydney, 2011. [PDF]
B.A. Valdés, N. Shirzad, C.T. Hung, S.M.N. Glegg, E. Reeds, H.F.M. Van der Loos, “Visualisation of 2D kinematic data from bimanual control of a commercial gaming system used in post-stroke rehabilitation”, in International Society for Virtual Rehabilitation Newsletter, New Jersey, USA, 2015, no.5, 2015. [PDF]
B.A. Valdés, “Reducing compensatory movements in stroke therapy through the use of robotic devices and augmented feedback (Abstract)”, in Proc. Eight Annual G.F. Strong Rehabilitation Centre Rehabilitation Research Day, Vancouver, BC, 2017 [PDF]