Biomechanical
indicators of hand functionality oriented to evaluation and
rehabilitation through virtual reality.
Abstract:
The hand is a
complex mechanical system, providing the human being with the
manipulative capacity required to interact with his physical
environment and to carry out activities of daily living (ADL),
giving him the autonomy for a full functional life. Different
pathologies and injuries can affect the function of the hand, from
occupational accidents and pathologies to neurological diseases,
generating a decrease in the ability to carry out ADLs to a greater
or lesser extent. The WHO establishes that the assessment of
dysfunction must be objective and based on the ability to perform
ADLs. However, in current clinical practice this dysfunction is
evaluated without taking into account objective biomechanical
parameters or indicators related to the ability to perform ADLs.
Similarly, current rehabilitation is not usually based on the
ability to perform ADLs, and in no case the progress is monitored
based on improvements in terms of ADL abilities. In recent times,
serious Virtual Reality (VR) games have been proposed for
rehabilitation. These games allow the patient to be "hooked", in
addition to allowing "tele-rehabilitation". These new techniques
allow working not only on ranges of movement, but also make it
possible to cover recovery in a more holistic way, also working on
coordination, proprioception or dexterity. However, the link with
the ability to perform ADLs is not clear in this case either. To do
this, it would be necessary to see what biomechanical parameters,
which quantify the ability to perform AVD, could be incorporated
into VR gaming techniques. The proposed project aims to contribute
to the use of biomechanical indicators of functional normality based
on the ability to perform ADLs, both to assess the impact of the
function and to favour its rehabilitation. The project is based on
the experience of the research team in the experimental
characterization of the kinematics and muscular activity of the
human hand during the performance of ADLs, as well as the use of
dimensional reduction techniques that will reduce the number of
signals required to be recorded, as well as the number of
representative activities to consider. All of this is essential to
ensure the feasibility of the clinical application, as it will
involve a reduced number of sensors (which will limit the price of
the equipment), and a reduced test time. These tests will use
function indicators based on the recording of kinematics, muscle
activation and grasping forces. It will try to relate all these
indicators with the ability to perform ADL. Finally, the use of
kinematic indicators in rehabilitation with serious Virtual Reality
games will be evaluated. To ensure the clinical usefulness of the
project, collaboration with the rehabilitation service of the
Provincial Hospital of Castellón, with which researchers have worked
previously, as well as with Unión de Mutuas, with whom an
colaboration agreement has also been signed, is considered
essential.
