PORTEFEUILLE

The goal of this project is to build a virtual reality therapy system for patients recovering motor function after stroke. Stroke is one of the most common conditions requiring rehabilitation, and it is a major source of disability with a large personal and societal burden. Conventional physical therapies are resource-intensive, involve intensive, repetitive training and are limited to addressing nervous system recovery via manipulation of the periphery. Computer-based rehabilitation approaches can mobilize additional cognitive and motivational systems that may speed up recovery by delivering intensive, concentrated therapy in a personalized exercise environment where the intensity of practice and positive feedback can be consistently and systematically manipulated and enhanced to create the most appropriate learning approach. Furthermore, computer-based rehabilitation can reduce therapy costs, improve patient/staff motivation, allow objective evaluation of patient status and offer the possibility for home-based rehabilitation and monitoring.

Gebert Rüf Stiftung supports this innovative project which has clear potential for more effective stroke rehabilitation with large social and economic benefits.

Several prototypes of the system have been constructed, focusing on rehabilitation of upper arm movements. Novel patient-optimized data gloves and entertaining gaming scenarios have been developed. Five systems are now in active use in several rehabilitation clinics with acute stroke patients, chronic stroke patients and paediatric patients with various neurological disorders. Preliminary user acceptance testing shows high user motivation to use the system, high acceptance of the therapy protocol and indications of beneficial effects for arm and hand function. More extensive patient testing is in progress. The technologies behind the system are now being commercialized.

Eng, K, Pescatore, A, Chevrier, E, Pyk, P, Holper, L, Schuster, C, Heinrichs, A and Kiper, D C. Patient Evaluation of a Mirrored Display for Viewing of Co-located Virtual Arms. World Congress on Med. Phys. Biomed. Eng. 2009, Munich, Germany (in press).
Wille, D, Eng, K, Holper, L, Chevrier, E, Hauser, Y, Kiper, D, Pyk, P, Schlegel, S and Meyer-Heim, A. Virtual Reality based Paediatric Interactive Therapy System (PITS) for improvement of arm and hand function in children with motor impairment - a pilot study. Developmental Neurorehabilitation 12(1): 44-52, 2009, Informa.
Vuillermot, S, Pescatore, A, Holper, L, Kiper, D and Eng, K. An Extended Drawing Test for the Assessment of Arm and Hand Function with a Performance Invariant for Healthy Subjects. Journal of Neuroscience Methods 177(2): 452-460, 2009, Elsevier.
Pescatore, A, Holper, L, Pyk, P, Kiper, D and Eng, K. A Display for Supporting Ownership of Virtual Arms. Presence 2008 (Spagnolli, A, Gamberini, L, eds.), 270-273, Padova, Italy.
Haegni, K, Eng, K, Hepp-Reymond, M-C, Holper, L, Keisker, B, Siekierka, E and Kiper, D. Observing virtual arms that you imagine are yours increases the galvanic skin response to an unexpected threat. PLoS ONE 3:e3082, 2008.
Pyk, P, Wille, D, Chevrier, E, Hauser, Y, Holper, L, Fatton, I, Greipl, R, Schlegel, S, Ottiger, L, Rückreim, B, Pescatore, A, Meyer-Heim, A, Kiper, D and Eng, K. A Paediatric Interactive Therapy System for Arm and Hand Rehabilitation. Virtual Rehabilitation 2008, 127-132, Vancouver, Canada.
Eng, K, Siekierka, E, Pyk, P, Chevrier, E, Hauser, Y, Holper, L, Cameirao, M, Haegni, K, Zimmerli, L, Duff, A, Schuster, C, Bassetti, C, Verschure, P and Kiper, D. Interactive Visuo-Motor Therapy System for Stroke Rehabilitation. Medical and Biological Engineering and Computing 45(9):901-907, 2007, Springer.
Haegni, K, Eng, K, Hepp-Reymond, M-C, Holper, L, Keisker, B, Siekierka, E and Kiper, D. The Effect of Task and Ownership on Time Estimation in Virtual Environments. Presence 2007, Barcelona, Spain. Ed.: Moreno, Laura. Starlab Barcelona S.L.
Siekierka, E, Eng, K, Bassetti, C, Blickenstorfer, A, Cameirao, M, Dietz, V, Duff, A, Erol, F, Ettlin, T, Hermann, D, Keller, T, Keisker, B, Kesselring, J, Kleiser, R, Kollias, S, Kool, J, Kurre, A, Mangold, S, Nef, T, Pyk, P, Riener, R, Schuster, C, Tosi, F, Verschure, P and Zimmerli, L. New technologies and concepts for rehabilitation in the acute phase of stroke: a collaborative matrix. Neurodegenerative Diseases 4(1): 57-69, 2007, Karger.
Eng, K, Siekierka, E, Cameirao, M, Zimmerli, L, Pyk, P, Duff, A, Erol, F, Schuster, C, Bassetti, C, Kiper, D and Verschure, P. Cognitive Virtual-Reality Based Stroke Rehabilitation. 2006 World Congress on Medical Physics and Biomedical Engineering, Seoul, Korea.

Pyk, P, Holper, L, Mochancki, D, Kiper, D and Eng, K. The SpiderGlove. CyberTherapy & Rehabilitation, Vol. 1 Issue 2, p. 24, 2009.
Eng, K and Hotz, S. Wir überlisten das Gehirn. Regeneration, 33, p. 3, International Foundation for Paraplegia Research, 2009.
Thomson, H. Swapping your body becomes a virtual reality. New Scientist, 02.12.2008.
Kiper, D. Voir et vouloir: la réalité virtuelle au service de rehabilitation. EXTRA, FRAGILE Suisse, 2008, Axel Springer Schweiz AG.
Christen, M. Wenn der Hase dem Hirn auf die Sprünge hilft. NZZ am Sonntag, Mensch & Medizin, p.69, 2008-06-01.
Gibson, J. Mirror, Mirror on the Wall - Stroke Rehabilitation. Brain Blogger, 2008-10-22, Global Neuroscience Initiative Foundation.