Engineering Rehabilitation: Blending Two Tool-supported Approaches to Close the Loop from Tasks-based Rehabilitation to Exercises and Back Again

Abstract

Post-stroke or post-brain injuries rehabilitation is a long-term process defined by therapists and tuned to the specific damages and their consequences for each patient. This process requires the definition of well-defined multiple exercises to be performed multiple times by each patient over a long period of time. One of the key findings in the rehabilitation domain is that exercises should be tasks and goals oriented to increase functional independence, enhance development and prevent disability [24]. Patients performing the exercises must be carefully monitored to identify progress, possible regression and prevent damages due to the inadequate performance of the exercises. The SIVIRE tool [20] provides interactive graphical feedback to patients about the performance of their exercises and deviations from nominal, planed practice but fails at providing high-level descriptions of exercises and at connecting them to high-level rehabilitation goals (e.g. gain autonomy in cleaning a room). The HAMSTERS-XLE tool [16] provides a tuneable editor and a simulator to describe goals and task models including low-level tasks covering perception of the various senses, cognition and motoric actions. This paper presents the integration of these two tools and the benefits it brings both to the patients and to the therapists. The resulting tool and its engineering are presented in detail highlighting some generic integration mechanisms. On a case study, we show how exercises can be defined in HAMSTERS-XLE, transferred to SIVRE for fine tuning, monitored by SIVRE during the multiple practices of the patient and transferred back again to HAMSTERS-XLE to monitor progress, identify issues with the exercises and provide therapists with goal and task-based data about patients' evolutions