Sistema para treinamento e avaliação dos membros superiores para aplicação em terapias de reabilitação pós-avc: um estudo da coordenação bimanual cooperativa

Abstract

The number of hemiplegic survivors has risen due to the increase in the post-stroke survivability rate. Robot Assisted Therapies have been introduced as an auxiliary therapeutic tool in patient's rehabilitation in order to improve the treatment quality, however studies suggest a device predisposition to focus only in paretic limb, neglecting the practice of bimanual exercises during the treatment, which are extremely important to complete daily cooperative tasks. The purpose of this work arises from the development of a mechatronic system for motor training and assessment of the upper limbs, being capable to collect inertial, force and displace measurements from a single sensorized cooperative instrument and a smart activities table, interacting with task oriented computer games aiming, initially, kinematics and kinect study of healthy subjects, to characterize the bimanual coordination as a first step in order to validate the technology application in rehabilitation. The project has been divided into three main categories: the System Technology Development, the Experiment composed by 4 activities and 36 participants and Data Analysis using fundamental statistical principles and linear models.The results allows one to classify different types of force signatures, execution strategies, movement patterns and to verify characteristics such as symmetry, stability, timing and accuracy that mainly evidenced the presence of motor learning during the exercises, the independence of correspondence of the prehension force between lateralization and maximum hand strength and, lastly, the dominant limb influence in the movement precision. The healthy subjects' measurements were used to build a data bank, allowing a future inquiry and comparison between other experimental groups.

Avaliação do desempenho motor bimanual em hemiparéticos

“…O Acidente Vascular Cerebral (AVC) é decorrente da insuficiência de irrigação sanguínea nos tecidos cerebrais, que ocasiona lesão a esses tecidos. Podendo ser dividido em duas categorias: isquêmico, onde se tem uma obstrução e, hemorrágico, caracterizado por ruptura dos vasos sanguíneos 1,2 .…”