Authors

  1. Matsuoka, Yoky MD
  2. Zafonte, Ross DO
  3. Roberts-Brewer, Bambi BS
  4. Luciow-Harrison, Christine BS

Article Content

Objectives: To demonstrate treatment effects of a 6-week robotic and virtual reality intervention on upper extremity function in a person with traumatic brain injury (TBI). Hypothesis: Interactive treatment using a small force-feedback robot while receiving gradually distorted visual feedback will improve hand function following TBI. Participants: The patient had sustained a severe TBI with residual modest hemiparesis 1 year prior to treatment. Her Ashworth in the treated extremity at the wrist elbow and fingers was 2. Methods: The patient participated in a 6-week rehabilitation paradigm designed to increase strength of the metacarpophalangeal (MCP) joint of the index finger. The patient interacted with a small force-feedback robot while receiving visual feedback that was gradually distorted during each session ("Rehabilitation by Distortion"). An independent OT evaluated the patient before and after the treatment. Results: An upward trend in maximum force MCP joint force was seen over 6 weeks. Tests showed a 28[degrees] increase in range of motion (ROM) for the index finger MCP joint. Increase in ROM was also seen in all joints of the treated hand. Thumb and index finger spasticity decreased from an Ashworth score of 2 to 1. Strength improved to the highest level measurable by the robot. Conclusions: Rehabilitation employing a distortion model has the potential to be a novel technique that could be delivered in the home or other setting. By employing a virtual reality environment, we have been able to utilize perceptual gaps to a person's advantage. In our case the improvements in ROM and strength are worthy of notation and warrant further exploration.