Kinect-based biofeedback interfaces to improve upper limb rehabilitation André Domingues1,2, Joaquim Jorge1,2 and Daniel Simões Lopes1 1.
INESC-ID Lisboa, Lisboa, Portugal;
2.
Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal.
Email contact of the corresponding author:
[email protected] Introduction: A sedentary lifestyle and bad eating habits are leading causes of cerebral vascular accidents or stroke [1]. Physical rehabilitation is often required to recover from upper extremity complications that commonly follow stroke. While computer-based interactive methods have been proposed to help defray person-hour costs, most require expensive dedicated hardware, lack good interfaces featuring user-centered biofeedback to better detect compensatory movements or assist the collaboration between patients and physiotherapists [2]. To approach these problems, we propose an inexpensive solution built with commercial off-theshelf hardware to promote upper limb rehabilitation and collaboration between stroke patients and physiotherapists. Materials and Methods: The proposed system relies on a Kinect v2 to track the patient’s body movement, a PC running Windows 10 and a pair of displays. Two distinct but related graphical user interfaces were developed: (i) a physiotherapist interface that contains a rich set of biofeedback portraying important patient kinematic data (e.g., shoulder flexion-extension and abduction-adduction angles) and compensatory movements (e.g., shoulder unevenness) in realtime; and (ii) a patient interface which displays a series of targets to be sequentially reached through arm elevation. Informal evaluations were performed by two physiotherapists and three physical medicine and rehabilitation physicians to validate both interfaces. Each participant was asked to verify if the proposed interfaces could help analyse or aid the treatment of acute stroke patients with physical limitations of the upper limbs. Results: In the conducted interviews, all the interviewed participants indicated that distinct interfaces for the physiotherapist and patient is a meaningful feature, as the patient interface must be very minimalistic to avoid unnecessary distractions, whereas the physiotherapist must contain the full range of kinematic data. For the patient interface, it is important to track the completed repetitions, the session time of the proposed task and to display a few targets to be reached. As for the physiotherapist interface, it is important to visualize the vertical (sagittal plane) and horizontal (transverse plane) angles of the arm movement and, most noticeably, in which angle ranges the compensatory movements occur. Discussion and Conclusions: The proposed interfaces have received positive response from several rehabilitation professionals. Although still in a pilot phase, the minimalistic design of the patient interface is devoid of graphical distractions, only delivering the necessary biofeedback for tracking shoulder movements by following predefined targets. On the other hand, the physiotherapist interface presents the necessary kinematic data and activity metrics to assist the evaluation and treatment of acute stroke patients. References: 1. Katzmarzyk, P. T., Church, T. S., Craig, C. L., & Bouchard, C. (2009). Sitting time and mortality from all causes, cardiovascular disease, and cancer. Med Sci Sports Exerc, 41(5), 998-1005. 2. Rado, D., Sankaran, A., Plasek, J., Nuckley, D., & Keefe, D. F. (2009). A Real-time physical therapy visualization strategy to improve unsupervised patient rehabilitation. In IEEE Visualization. Acknowledgements:This work was funded by the Fundação para a Ciência e a Tecnologia (FCT) through projects UID/CEC/50021/2013 and IT-MEDEX PTDC/EEI-SII/6038/2014. The last author thanks the financial support given by FCT for the postdoctoral grant SFRH/BPD/97449/2013.
