Remote monitoring and quantification of upper limb and hand function in chronic disability conditions

This paper describes a convenient, home-based telereha-bilitation system designed to improve upper limb and hand function in adults with cerebral palsy. The training program incorporates a variety of computer-guided sensorimotor activities, such as unilateral and bilateral reaching, reaching and grasping, object manipulation, and tactile discrimination tasks. Quantitative measures of performance are uploaded to the laboratory after each training session for further analysis. Webcam monitoring of performance occurs periodically throughout the training period. Twelve adults with cerebral palsy completed a 45 min/day, 5 days/week training program over 8 weeks. Temporal measures of performance indicated significant improvement in reaching and hand manipulation ability as well as improved tactile discrimination. Preliminary analysis of the time course of change revealed variable patterns within and across participants. The capacity to measure change throughout a training program provides an opportunity to investigate how learning occurs over time in chronic disability. Compliance was excellent, with subjective reports indicating improvement in activities of daily living. Future development includes a fully automated system with stand alone modules, which allow for customization of training protocols depending upon specific needs of the user.