Virtual Reality, Robot, and objects in hand and arm training: A case of Guillain-Barre

Many patients experience severe motor, proprioception and tactile sensory loss following central or peripheral nervous system injury such as Guillain-Barre syndrome (GBS). For many, there are no traditional therapies available and patients fail to use the hand and arm dramatically affecting their quality of life. Our project investigates technology assisted protocols to help re-calibrate body perceptions and improve sensory dependent motor skills. We designed, built and tested an easy to use system to provide technology assistance to a variety of underserved patients, and therapists. The Sensory Motor Training Station (SMTS) accommodates the patient's lost sensory and motor skills and is used to train cognitive, sensory, motor, and proprioception skills. Virtual Reality (VR) is used with immersive virtual limbs and real objects to increase sense of involvement, and provide tactile experiences in a real world integrated arm and hand task. Robot assistance as needed or transparent mode is provided to overcome patient weakness and promote practice plasticity. We trained a person suffering from GBS. The patient successfully exercised and skills were assessed using the system. SMTS can easily be adapted to accommodate left or right limb, heterogeneous patients, and individual cognitive, sensory and motor issues. Results revealed patient performance varies in each sensory and motor training condition; performance improved in the presence of real objects and also during voluntary motor participation in the exercises facilitated by the robot transparent mode with support against gravity and friction. Our multi-sensory technology assistance system provided exercise and assessment for both upper limbs in a real world integrated hand and arm task.