RESUMO
This paper presents a low-cost portable system for applying a rehabilitation therapy, based on virtual reality, functional electrical stimulation and a training device. This open-hardware system, intended to support a home-made therapy process in people with reduced dorsiflexion ability, contains three main building blocks: an electromechanical platform, an immersive virtual reality interface and the firmware. The electromechanical training platform is the core of the system, which acts as a gateway interface of sensors-actuators for a closed loop system, through an immersive virtual reality application, the patient closes the loop by acting as the controller by means of a "virtual dummy" preforming in mirror configuration. The platform measures and process the dorsiflexion angle described by both ankles, real-time transmitting the information to the mobile phone virtual application to be presented as a mirror. The onboard microprocessor drives the operation of the electric stimulation interface, which is sent through two channels to both, healthy and affected lower limbs. The platform communicates continuously through a USB bidirectional interface with a personal computer, in which the physician enters the rehabilitation protocol and follows the patient performance. A first case study by using this device has been reported in [1].
RESUMO
Antecedentes: Recuperar el movimiento de dorsiflexión es importante para la estabilidad corporal en personas que han sufrido un accidente cerebrovascular (ACV). Diferentes métodos de rehabilitación aplicados presentan resultados satisfactorios en el tratamiento de extremidades afectadas; sin embargo, este trabajo pretende indagar la posibilidad de unificar estas tres técnicas en un solo proceso de rehabilitación destinado a la dorsiflexión del pie. Objetivo: Evaluar el efecto que tiene implementar realidad virtual inmersiva, estimulación eléctrica funcional y rehabilitación por terapia de espejo a un paciente con limitación de marcha causada por un ACV. Métodos: Participante con afectación de movimiento en la extremidad derecha a causa de un ACV al que se le aplica protocolo de rehabilitación con un periodo de 3semanas con intensidad de 5días a la semana y un tiempo de 15min. Se evalúa el progreso en la movilidad de dorsiflexión al inicio, en el intermedio y al final del proceso de rehabilitación. Resultados: El participante genera un progreso en la movilidad de dorsiflexión del 6,75% y mejora la precisión en el movimiento de dorsiflexión que se potencializa en cada sesión de evaluación, lo que supone una mejoría en el control motor y en la estabilidad del equilibrio del paciente. Conclusiones: Se demuestra que la combinación de estos métodos de rehabilitación puede mejorar la movilidad del tobillo en personas que sufren un ACV y, a su vez, la necesidad de ampliar el estudio a una población representativa para consolidar los resultados obtenidos.
Background: Regaining the dorsiflexion movement is important for body stability in people who have suffered a stroke. Different applied rehabilitation methods show satisfactory results in the treatment of affected limbs. However, this work aims to investigate the possibility of unifying these three techniques in a single rehabilitation process aimed at dorsiflexion of the foot. Aim: To evaluate the effect of implementing immersive virtual reality, functional electrical stimulation, and mirror therapy rehabilitation in a patient with gait limitation caused by a stroke. Methods: Participant with movement impairment in the right limb due to stroke, a rehabilitation protocol is applied with a period of 3weeks with intensity of 5days a week and a time of 15min. Progress in dorsiflexion mobility is evaluated at the beginning, in the middle and at the end of the rehabilitation process. Results: The participant generates a 6.75% progress in dorsiflexion mobility, improved precision in the dorsiflexion movement that is potentiated in each evaluation session, which implies an improvement in motor control and in the stability of the patient's balance. Conclusions: It is shown that the combination of these rehabilitation methods can improve ankle mobility in people who suffer a stroke and, in turn, extend the study to a representative population to consolidate the results obtained.
