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Microsoft Surface Project

Microsoft Surface Project. I have no relevant financial disclosures. Disclosures. Cerebral Palsy. Permanent, non-progressive physical disorders Caused by disturbances to fetal/infant brain Affects 1 in 303 children Causes impairments in: movement hearing vision Learning No cure

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Microsoft Surface Project

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  1. Microsoft Surface Project

  2. I have no relevant financial disclosures. Disclosures

  3. Cerebral Palsy • Permanent, non-progressive physical disorders • Caused by disturbances to fetal/infant brain • Affects 1 in 303 children • Causes impairments in: • movement • hearing • vision • Learning • No cure • Treatment: alleviation and maintenance of symptoms; Occupational and Physical Therapy.

  4. Therapy services • Help minimize contractures • Improve: • range of motion • coordination • quality of movement • Provide tasks that engage and motivate • We have designed a system based on Microsoft interactive touch screen surface to address these limitations in therapy sessions.

  5. The Platform • Five interactive games that encourage repetitive motions • Similar to iPad touch screen • Eight sensors on upper limbs • Record joint angles of shoulders and elbows • Accelerometer embedded in vest worn by the participant • Provides postural and positional data

  6. Unique features of the tabletop • Videogames allow for repeated practice • Participants can move on their own…can lead to motor recovery • Immediate auditory and visual feedback • Progress shown in a concrete way • Pain free range of motion

  7. Unique features of the tabletop • Children with auditory processing impairments often only learn through visual system. • Mechanics of hi/lo table allow for adaptability: • Gravity eliminated shoulder and elbow control • Easel allows for help with visual scanning, wrist • extension and holding head in neutral • Offers ability to play in sitting and standing • Adjust height for functional body mechanics • Games keep accurate record of performance • and progress.

  8. What motor skills do the games target? • Active range of motion in gravity eliminated, against gravity and weight bearing (standing). • Fine motor skills: • Speed • Pre-writing: finger isolation • Object use: sustaining hold of adaptive tool (adaptive stylus, ball, paddle with Butterfly game)

  9. What motor skills do the games target? • Bi-manual skills: Sub-divided into 4 categories: • Use of involved arm as stabilizer (hold paper while writing) • Ability to use involved arm symmetrically or simultaneously (pushing/pulling) • Ability to differentiate function (both arms can move to specific target) • Ability to alternate use from left to right reciprocally (playing musical instruments)

  10. Study Design • Pilot study • Usability and feasibility of the device • Novel games: Engaging and motivating children to perform upper extremity motions

  11. Hypothesis • Patients will be more motivated to perform therapeutic motions. • Movements to those performed in traditional therapy • Compensatory motions will be minimized by feedback from the wearable accelerometer. • Minimize failure to complete tasks. • Structure required motions that they slowly increase in difficulty and allowing interaction by patients with reduced function.

  12. Inclusion and Exclusion criteria • Inclusion Criteria • 6-12 years old • Upper extremity dysfunction due to cerebral palsy • Able to understand, read and write in English • Able to understand and comprehend directions from occupational therapist or physician • Exclusion Criteria: • Participants may be excluded if they have severe vision impairments

  13. Study setting • Recruitment procedures: Spaulding Rehabilitation Hospital (SRH) and Boston Children’s Hospital. • Data collection: Wyss Institute. • Data analysis: Wyss Institute and SRH. • Enroll 20 children.

  14. Study session will last no longer than 90 minutes (including consent and assent) • Each session will be videotaped, allowing critical analysis of child's interaction with system. • Games have been divided by four motor skills: • Gross movements • Coordinated movements • Distal control • Fine motor control Study setting

  15. Risk and benefits • We do not anticipate any physical risks to the participants from participating in this research study. • Participants enjoy using the games and received a $50 gift card.

  16. Conclusion • Could benefit children with Cerebral Palsy by providing new treatment/rehabilitation option for those with impaired upper extremities.

  17. Summary of Citations and Level of Evidence • A. Dunne, C. Shen, P.Bonato, Son Do-Lenh, G.O. Laighin, “Upper Extremity Rehabilitation of Children with Cerebral Palsy Using Accelerometer Feedback on a Multitouch Display”, Engineering in Medicine and Biology Society 2010 Annual International Conference of IEEE, pp 1751-1754, August 31-Sept 4, 2010 • M.Annett et al., “Using a Multi-touch Tabletop for Upper Extremity Motor Rehabilitation”, Interfaces, pp1-4, 2009 • M.Leitner, M. Tomitsch, T. Költringer, K. Kappel, and T.Grechenig, “Designing Tangible Tabletop Interfaces for Patients in Rehabilitation”, Conference and Workshop on Assistive Technologies for People with Vision and Hearing Impairments: Assistive Technology for All Ages (CVHI 2007), pp 1-7, 2007 • M. Alcañiz, V.Abarca, J.A. Lozano and N. Herrero, “Analysis of Multitouch Technology for Neurorehabilitation”, Journal of Cybertherapy & Rehabilitation, Volume 2 issue 3, Fall 2009

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