Graduation Year

2017

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Engineering

Major Professor

Rajiv Dubey, Ph.D.

Co-Major Professor

Stephanie Carey, Ph.D.

Committee Member

Kyle Reed, Ph.D.

Committee Member

William Lee, Ph.D.

Committee Member

Jason Highsmith, Ph.D.

Keywords

Kinematics, Biomechanics, Amputee, Motion-Analysis, Optimal-Model

Abstract

This dissertation focuses on the investigation and development of an effective prosthetic training and rehabilitation platform with the use of virtual reality to facilitate an effective process to return amputees to the highest level of independence and functioning possible.

It has been reported that approximately 10 million people live with a limb loss worldwide, with around 30% being an upper-extremity amputee. The sudden loss of a hand or arm causes the loss of fine, coordinated movements, reduced joint range of motion (ROM), proprioceptive feedback and aesthetic appearance, all which can be improved with the use of a prosthesis and proper training. Current literature has shown prosthetic devices to provide limited function to users in a variety of areas including hand operation, functionality and usability, all which could be improved with proper rehabilitation and training. It has been exhibited that a large percentage of amputees abandon or reject prosthesis use mostly due to limited function and lack of training or knowledge of the device. It has been reported that untrained amputees will adjust their body in an awkward or compensatory body motion rather than repositioning a joint position while performing a task with a prosthetic device. This causes misuse and improper function that has been shown to lead to significant injuries. An effective prosthetic training and rehabilitation regime would be advantageous in returning the patient to the highest level of independence and functioning possible, with proper use of their prosthetic device. A successful training and rehabilitation program would allow an amputee to improve their ability to perform with optimal motion and use all prosthetic control capabilities.

This dissertation describes the development of a stick figure model of the user’s motion in real-time and a character avatar animating the individualized optimal goal motions. The real-time model directly corresponds to the user’s motion, with the option to have the character avatar simultaneously animating an optimal goal motion for the user to follow. These were implemented into the Computer Assisted Rehabilitation Environment (CAREN) system (Motek Medical, Amsterdam, Netherlands) to provide real-time visual feedback to the users while performing specified training and rehabilitating tasks. A ten camera Vicon (Oxford, UK) optical motion captured system was used with the CAREN system capabilities to track body and upper extremity prosthetic segments during range of motion (ROM), activities of daily living (ADL), and return to duty (RTD) tasks, with and without the use of the virtual reality visual feedback. Data was collected on five able-bodied subjects and five subjects with a unilateral transradial amputation using their personal prosthetic device.

Through investigation and development, a preferred and effective way to display the visualization of the real-time and optimal models were revealed. Testing the subjects with and without the virtual reality visualization, exhibited the effectiveness of providing visual feedback. Results showed subject’s to have improved positing, movement symmetry, joint range of motion, motivation, and overall an improved performance of the series of tasks tested. With the integration of the optimal model visualization, real-time visual feedback, and additional CAREN system capabilities, upper-extremity training and rehabilitation techniques were shown to enhance with the use of virtual reality, through improved task performance, and functional advances. The results of this dissertation introduce an alternative means for clinicians to consider for effectively rehabilitating and training upper-limb amputees.

Findings of this dissertation sought to provide useful guidelines and recommendation to aid in the development of a small-scale adaptable option for rehabilitation practitioners and at home use. The techniques investigated in this study could also be applicable for lower-limb amputee, post-stroke, traumatic brain injury, poly-trauma, and other patients with physically limiting disabilities. The techniques investigated in this study are expected to aid in the development of training and rehabilitation procedures for a variety of patient populations, to enhance the effectiveness and assist in improving the overall quality of life of others.

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