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Neuro-Rehabilitation

@RehabRGS

Over the past 15 years SPECS has been dveloping science-based technology tools to drive perceptual, cognitive, affective and motor systems of the brain that may facilitate its functional recovery after damage. By means of novel interaction paradigms such as Virtual Reality or music therapy, and based on the Distributed Adaptive Control theory of mind and brain DAC developed by P.Verschure, SPECS studies the brain and the mechanisms underlying loss of function and its rehabilitation and recovery after stroke, and other brain diseases (see P. Verschure Conf Proc IEEE Eng Med Biol Soc. 2011Mónica S. Cameirão et al. Restor Neurol Neurosci 2011  and Stroke 2012 )

The Rehabilitation Gaming System    - RGS - http://rgs-project.eu

The Rehabilitation Gaming System is a neurorehabilitation technology that assists in the recovery of function after lesions to the brain. RGS is based on concrete neuroscientific principles derived from a comprehensive theory of mind and brain in health and disease.

 

Image: [left] Extension of brain damage after stroke.  [right] A stroke patient trains with RGS under the supervision of her physician/physioterapist at Val d'Hebron Hospital in Barcelona.  Stroke can cause brain damage with loss of motor and cognitive functions. The efficacy of RGS in the recovery of these functions has been clinically tested with hundreds of patients. RGS is based on the neurobiological considerations that plasticity of the brain remains  throughout life and therefore can be utilized to achieve functional reorganization of the brain areas affected by stroke.

http://www.euronews.com/2016/02/15/takeaway-train-your-brain

http://www.euronews.com/2016/02/15/a-virtual-reality-game-to-help-stroke...

RGS was developed by combining the idea of interactive media for neurorehabilitation, in particular virtual reality, with the DAC theory of mind and brain. This decision was a key step since it made choices on the content of non-arbitrary treatment protocols and every intervention became a well defined interaction with a user from which lessons could be immediately drawn. By now RGS incorporates about 20 specific DAC derived principles that range from the key role of sensori-motor contingencies in organizing cognition and action (see Prochnow, D. et al., Eur. J. of Neurosc. 2013) to the importance of goal-oriented and error-driven intervention. (see Belen Rubio Ballestr et al., J. NeuroEng. Rehab. 2015)

RGS has advanced over the last decade with an extensive experimental agenda realized with dedicated partners in Barcelona 

To support our experimental studies we have installed RGS therapy stations in associated hospitals, which are in continuous use (see collaborators below). As a result, RGS has build up an unprecedented empirical track record (see key references sbelow) having been tested with over 500 patients at the acute and chronic stages of stroke, including at home settings. Building on these results, together with our clinical partners, we are now validating the generalization of RGS to other neuropathologies such as Parkinson’s disease, cerebral palsy, traumatic brain injury and spinal cord lesions and the initial analysis looks very encouraging. 

Many of the patients in our clinical experiments have asked to be able to continue the RGS therapy.

This demand combined with the clinical results that show that RGS is more effective than any other intervention available today, has lead to the creation of the spin-off company Eodyne.com together with the University Pompeu Fabra and the Catalan Institute of Advanced Studies. Eodyne’s goal is to make RGS available to as many people as possible for a minimum cost.

Schematic representation of the RGS platform: from the laboratory to the patient at the clinic and at home 

 

This video shows the collaboration between the SPECS laboratory, the hospital la Esperanza with Dr Ester Duarte and TiC Salut Foundation a catalan agency within the Ministry of Health

 

  • Rehabilitation Gaming System set up
  • Virtual Reality tools (graphics, game design, game engine Unity...)
  • Custom made gloves
  • Oculus
  • Physiological measuring devices
  • Haptic interfaces (GRAB)
  • Eye tracker (TOBII)
  • Wearable devices

          

Other tools used to investigate the impact of RGS on motor function and recovery

The Passive exoskeletons (ARMEO) provides support against gravity and allows the capture of different arm joint angles that are translated to the virtual world. The GRAB haptic interface system provides force-feedback to the user by means of two mechanical arms that detect collisions in the virtual environment.

ArmeoHaptic

Collaborators

Key Articles

[16] Belén Rubio Ballester, Jens Nirme, Esther Duarte, Ampar Cuxart, Susana Rodriguez, Paul Verschure and Armin Duff (2015), "The visual amplification of goal-oriented movements counteracts acquired non-use in hemiparetic stroke patients", Journal of NeuroEngineering and Rehabilitation, 12:50 ; doi 10.1186/s12984-015-0039-z.

[15] Grechuta, K, Rubio, B, Duff, A, Duarte Oller, E, and Verschure, P (2014), “Intensive language-action therapy in virtual reality for a rehabilitation gaming system“, Proc. 10th Intl Conf. on Disability, Virtual Reality and Assoc. Technologies, PM Sharkey, L Pareto, J Broeren, M Rydmark (Eds), pp. 265-273, Gothenburg, Sweden, 2-4 Sept. 2014

[14] Rubio, B., Nirme, J., Duarte, E., Cuxart, A., Rodriguez, S., Duff, A., & Verschure, P. F. M. J. (2013). Virtual Reality Based Tool for Motor Function Assessment in Stroke Survivors. In J. L. Pons, D. Torricelli & M. Pajaro (Eds.), Converging Clinical and Engineering Research on Neurorehabilitation (Vol. 1, pp. 1037-1041): Springer Berlin Heidelberg.

[13] Maier, M., Rubio Ballester, B., Duarte, E., Duff, A. and Verschure, Paul F.M.J. (2012). “Social Integration of Stroke Patients through the Multiplayer Rehabilitation Gaming System“. Games for Training, Education, Health and Sports. Lecture Notes in Computer Science Volume 8395, 2014, pp 100-114.

[12] Rodriguez, S., Bermudez i Badia, S., Cameirão, M. S., Fina, A. C., Duarte, E., Duff, A., Verschure, P. F. M. J., et al. (2011). “Effects of Virtual Reality Upper Limb Based Training (Rehabilitation Gaming System) on Spasticity, Shoulder Pain, and Depression After Stroke”. 2011 AAPM&R annual assembly (Vol. 3, p. S160). Elsevier Inc. doi:10.1016/j.pmrj.2011.08.013.

[11] Nirme, J., A. Duff, and P.F.M.J. Verschure. “Adaptive rehabilitation gaming system: On-line individualization of stroke rehabilitation”. in Engineering in Medicine and Biology Society, EMBC, 2011 Annual International Conference of the IEEE. 2011. IEEE.

[10] Verschure, P. F. M. J. (2011). “Neuroscience, virtual reality and neurorehabilitation: brain repair as a validation of brain theory”. Conference proceedings for the Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. (Vol. 2011, pp. 2254–7). IEEE.

[9] Nirme, J., Duff A., & Verschure P.F.M.J. (2012) “Adaptive Enhanced Mapping Of Upper Limb Movement In A Virtual Reality System For Stroke Rehabilitation”. Conference Abstract presented at the 8th FENS Forum of Neuroscience, Barcelona, Spain.

[8] Rubio, B., Nirme, J., Duarte, E., Cuxart, A., Rodriguez, S., Duff, A., & Verschure, P. F. M. J. (2013). “Virtual Reality Based Tool for Motor Function Assessment in Stroke Survivors”. In J. L. Pons, D. Torricelli & M. Pajaro (Eds.), Converging Clinical and Engineering Research on Neurorehabilitation (Vol. 1, pp. 1037-1041): Springer Berlin Heidelberg.

[7] Nirme, J., Rubio, B., Duff, A., Duarte, E., Rodriguez, S., Cuxart, A., & Verschure, P. F. M. J. (2013). “At Home Motor Rehabilitation in the Chronic Phase of Stroke Using the Rehabilitation Gaming System”. In J. L. Pons, D. Torricelli, & M. Pajaro (Eds.), Converging Clinical and Engineering Research on Neurorehabilitation SE – 151 (Vol. 1, pp. 931–935). Berlin: Springer Berlin Heidelberg.

[6] Duff, J. Nirme, B.Rubio, E. Duarte, A. Cuxart, S. Rodríguez, P.F.M.J. Verschure “The optimal dosage of the Rehabilitation Gaming System: The impact of a longer period of virtual reality based and standard occupational training on upper limb recovery in the acute phase of stroke”. Abstract presented during the 22nd European Stroke Conference 2013, LONDON, UK.

[5] Ballester, B. R., Nirme, J., Duarte, E., Cuxart, A., Rodriguez, S., Verschure, P., & Duff, A. (2015). The visual amplification of goal-oriented movements counteracts acquired non-use in hemiparetic stroke patientsJournal of neuroengineering and rehabilitation12(1), 50.

[4] Prochnow, D., Bermudez I Badia, S., Schmidt, J., Duff, A., Brunheim, S., Kleiser, R., Seitz, R., et al. “A functional magnetic resonance imaging study of visuomotor processing in a virtual reality-based paradigm: Rehabilitation Gaming System“. The European journal of neuroscience, (January), 1–7, 2013.

[1]    Mónica S. Cameirão, Sergi Bermúdez i Badia, Esther Duarte, Antonio Frisoli, and Paul F.M.J. Verschure. The combined impact of Virtual Reality Neurorehabilitation and its interfaces on upper extremity functional recovery in patients with chronic stroke. “Stroke”, vol. 43 (10) 2720-2728, 2012

 

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