Virtual reality physical therapy: a telerehabilitation tool for hand and finger movement exercise monitoring and motor skills analysis

Virtual Reality (VR) provides useful rehabilitation applications, motivation, and feedback, for chronic stroke patients who might benefit from intensive massed therapies. Extensive therapy is required to take advantage of brain plasticity to modify neural organization and improve motor skills during the chronic phase after a stroke. Existing measurements used in a clinical setting are expensive, offer gross scales, and are subjective making it difficult to measure improvement or to detect refractory symptoms. Robotics applications are constrained to specific movements. New methods and tools are needed that use an inexpensive architecture, objective analysis techniques, and that offer hope for assessing motor skills more frequently or in a telerehabilitation environment. Management of motor disorders would benefit from practical automated objective techniques to monitor activities, measure and track kinetics and kinematics of complex motor skills associated with activities of daily living (ADL's) during exercise sessions and throughout the course of a patient's treatment process. We developed and tested a VR system using an unconstrained low-cost data glove and motivational games; patients can partake in intensive therapies while a data gathering application tracks hand and finger movements including x, y, z, yaw, pitch, and roll, finger flexion, speed, and session duration. These monitoring capabilities facilitate innovative telerehabilitation, compliance, and disease management models for people who have hand dysfunction as a result of neurological impairment. Specific movement routines may also be used for periodic objective assessment of the patient's performance.