Quantitative Assessment of Clinician Assistance During Dynamic Rehabilitation Using Force Sensitive Resistors

Frontiers in Rehabilitation Sciences, 2021 · DOI: 10.3389/fresc.2021.757828 · Published: December 2, 2021

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

This study explores the use of force sensitive resistors (FSRs) to measure how much assistance clinicians provide during body weight supported treadmill training (BWSTT) for individuals with spinal cord injury (SCI). The goal is to quantify clinician support and participant progress objectively. Two participants with chronic SCI underwent 12 months of BWSTT with epidural electrical stimulation (EES). FSRs were placed on their knees to measure the force applied by clinicians during stepping. The data collected helps to understand how much assistance is needed and how it changes over time. The study found that FSRs can effectively detect the point of contact and duration of forces applied by clinicians. This information relates to increased stance duration, showing how participants become more independent in stepping with EES-enabled BWSTT after SCI.

Study Duration

12 months

Participants

Two male participants with chronic SCI

Evidence Level

Feasibility study

Key Findings

1
Force sensitive resistors (FSRs) can effectively detect the point of contact and duration of forces applied by clinicians during dynamic rehabilitation with EES.
2
Reduced contact time measured by FSRs correlated with increased stance duration, indicating improved independence in stepping during EES-enabled BWSTT following SCI.
3
The study revealed a proportional bias in the output of FSRs, and loading required for maximal assist training exceeded the active range of the FSRs.

Research Summary

This study validated the use of force sensitive resistors (FSRs) to quantify clinician assistance during body weight supported treadmill training (BWSTT) for individuals with spinal cord injury (SCI) undergoing epidural electrical stimulation (EES). The results showed that FSRs effectively detected the point of contact and duration of forces applied by clinicians at the knees during dynamic rehabilitation. This data correlated with increased stance duration, indicating progression toward independence in stepping. While the FSRs accurately measured contact initiation and duration, the study identified limitations in the accuracy of force magnitude assessment. Future studies with improved calibration techniques and customized sensor designs are recommended for more precise force measurement during dynamic therapeutic interventions.

Practical Implications

Objective Assessment of Rehabilitation

FSRs provide an objective tool to quantify clinician assistance during BWSTT, allowing for a more precise evaluation of patient progress.

Optimization of Stimulation Parameters

By measuring clinician assistance, stimulation parameters can be optimized to promote greater independence in stepping for individuals with SCI.

Application to Other Populations

The technology can be applied to other populations, such as stroke or TBI patients, to assess changes in clinician assistance during various dynamic tasks.

Study Limitations

1
The 6-mm-thick Akton pad used may have had greater compliance than that of the soft tissue located at the knee on a human limb.
2
The use of a single FSR between the two clinicians for the validation may have resulted in a degradation of quality of the sensor over time between testing bouts.
3
The conditions of use of the FSR in the clinical study were not strictly controlled as this was not a priority of the study, and this could have been a limitation on data analysis.

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