Game-changing Virtual Rehabilitation Exploration

    Benjamin Bishop, Ph.D., professor of computing sciences, and Renee Hakim, Ph.D., professor of physical therapy, are collaborating on research to determine if the specialized devices that have aided recovery in stroke patients can similarly aid those who have or had fractures, carpal tunnel syndrome or any type of nerve injury.
    May 15, 2018

    It’s probably safe to say many people have wished for a robot at one point or another, especially if that robot could, say, clean the house or do the grocery shopping.

    In the medical world, however, robots have been all the rage for decades now, as have healing devices enhanced by virtual reality. For at least 20 years, exciting strides have been made in the field for patients with neurologic disorders, for example.

    Call it “the other VR,” or virtual rehabilitation.

    Enter physical therapist Renée Hakim, Ph.D., and Benjamin Bishop, Ph.D., two University of Scranton professors collaborating on pioneering research to determine if the specialized devices that have aided recovery in stroke patients can similarly aid those who have or had orthopedic injuries such as fractures, carpal tunnel syndrome or any type of nerve injury.

    Their research is titled “Haptic Devices To Improve Hand-Arm Function: An Interdisciplinary Approach.”

    Dr. Bishop, a professor in the Department of Computing Sciences, said haptic devices simulate physical sensation, the touch sensation you would have if interacting with an object. This research focuses on assistive and resistive devices, he noted.

    Dr. Hakim, professor of physical therapy at the University, explained the difference between the two. Assistive devices provide some degree of help in moving a body part either completely (as the user is passive) or partially, as the user tries to help with the motion. A resistive device pushes back against the user and may be used to strengthen, as in lifting a weight.

    Dr. Bishop, whose expertise is in graphics and computer hardware, said his part of the joint research is on the technical and implementation side – “How do we go about building it?” – while Dr. Hakim’s expertise is on the domain side.

    “It,” in this case, is a haptic system purchased from a third-party manufacturer (OR3D Ltd.) This end-effector device is hooked up to a portable computer with software that he, with the help of his graduate students, customized according to Dr. Hakim’s specifications.

    In this case, Dr. Hakim specified that the software should aid in the seemingly simple task of handwriting: cursive and printed.

    Handwriting and plenty of other fine motor skills necessary to daily life can become nearly impossible tasks for those who’ve suffered orthopedic injuries, which was what prompted Dr. Hakim to choose the particular skill for the pilot of phase of this study.

    “We tried to come up with something functional and meaningful,” she said, explaining the concept of experience-dependent neuroplasticity, which, in simple terms, refers to the brain’s capacity to change in response to environmental stimuli and learning.

    Handwriting, in the virtual rehab world, is accomplished using what Dr. Hakim describes as a fat pen that acts as a stylus. A certain level of ability, such as the capacity to physically hold the pen, is necessary to take advantage of the technology.

    “We really wanted to pick something that is an actual physical task that someone would have to do on a daily basis,” Dr. Hakim said.

    So far, she and Dr. Bishop have had subjects merely trying out the experimental technology, as the customized program they have co-created is still in the feasibility stage.

    “It’s more exploratory right now,” Dr. Hakim said, nonetheless anticipating advancement to the next stage, which is a four-week protocol to measure such factors as strength and motion in real subjects, may be just weeks away.

    Part of the challenge, she said, is getting people to come to campus who meet the study criteria. The program is free, she said, but subjects must fit certain specifications, so Dr. Hakim, who also has her own batch of graduate students involved in the research, has put the word out to fellow professors and others that potential candidates are needed.

    Part of the mission is to spread the news about how this research could rewrite futures for those with orthopedic injuries.

    Orthopedic recovery tends to focus on impairments but not always task-specificity, she said.

    Most people, Dr. Hakim said, are used to traditional therapies involving, for example, stretching, icing and reduction of pain.

    “This is really going beyond that with an emphasis on high-intensity functional training,” she said. “This is really a paradigm shift for people with orthopedic problems following the acute stage of recovery.”

    Dr. Bishop agrees. Still, he stresses that the research, which for him is all about the algorithms, is still in its infancy, even a little “rough around the edges.”

    But that could be the most exciting time for the venture, which he said began as a master’s thesis project from a student, Bret Oplinger, and has been evolving since.

    “In terms of the future, it’s dependent on the results of this work,” he said. “If it turns out this is very effective therapy, it would be well worth investing in.”

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