Author/Editor		Krpič, Andrej; Cikajlo, Imre; Savanović, Arso; Matjačić, Zlatko
Title		A haptic floor for interaction and diagnostics with goal based tasks during virtual reality supported balance training
Translated title		Haptična tla za interakcijo in diagnostiko s ciljno zasnovano nalogo vaditi ravnotežje, podprti z navideznim okoljem
Type		članek
Vol. and No.		Letnik 83, št. 2
Publication year		2014
Volume		str. 127-136
ISSN		1581-0224 - Zdravniški vestnik
Language		eng
Abstract		Background: Balance training of patients after stroke is one of the primary tasks of physiotherapy after the hospitalization. It is based on the intensive training, which consists of simple, repetitive, goal-based tasks. The tasks are carried out by physiotherapists, who follow predefined protocols. Introduction of a standing frame and a virtual reality decrease the physical load and number of required physiotherapists. The patients benefit in terms of safety and increased motivation. Additional feedback % haptic floor can enhance the virtual reality experience, add additional level of difficulty and could be also used for generating postural perturbations. The purpose of this article is to examine whether haptic information can be used to identify specific anomalies in dynamic posturography. Methods: The performance and stability of closedloop system of the haptic floor were tested using frequency analysis. A postural response normative was set up from data assessed in four healthy individuals who were exposed to unexpected movements of the haptic floor in eight directions. Postural responses of a patient after stroke participating in virtual reality supported balance training, where collisions resulted in floor movements, were assessed and contrasted to the normative. Results: Haptic floor system was stable and controllable up to the frequency of 1.1 Hz, sufficient for the generation of postural perturbations. Responses obtained after perturbations in two major directions for a patient after stroke demonstrated noticeable deviations from the normative. Conclusions: Haptic floor design, together with a standing frame and a virtual reality used for balance training, enables an assessment of directionally specific postural responses. The system was designed to identify postural disorders during balance training and rehabilitation progress outside specialized clinics, e.g. at patient%s home.Izhodišča: Rehabilitacija ravnotežja pri ljudeh po možganski kapi sodi med primarne naloge zdravljenja po hospitalizaciji in temelji na intenzivni vadbi, ki je sestavljena iz enostavnih, ponavljajočih se, ciljno usmerjenih nalog. Naloge izvajajo fizioterapevti, ki sledijo predpisanim protokolom. Uvedba podporne stojke in navideznega okolja olajša delo in zmanjšuje število potrebnih fizioterapevtov, bolniku pa zagotavlja ustrezno varnost in predstavlja dodatno motivacijo. S povratno informacijo % premičnimi haptičnimi tlemi, dodamo novo izkustveno razsežnost, uvedemo dodatno težavnostno stopnjo, hkrati pa jih uporabimo za vzbujanje posturalnih odzivov. Namen članka je preveriti, ali lahko haptično informacijo uporabimo tudi za prepoznavanje specifičnih težav pri dinamičnem ravnotežju. Metode: Zmogljivost in stabilnost zaprtozančnega sistema haptičnih tal smo preverili s frekvečno analizo. Iz meritev odzivov na štirih zdravih osebah smo izdelali normativ odzivov na nenadne premike haptične plošče v osmih smereh. Izmerili smo posturalne odzive osebe po možganski kapi med stojo in vadbo ravnotežja z navideznim okoljem, kjer je bil rezultat trkov nenadni premik haptičnih tal. Dobljene posturalne odzive smo primerjali z normativom. Rezultati: Sistem haptičnih tal je stabilen, uporaben do frekvence vzbujanja 1.1 Hz, kar zadošča za vzbujanje posturalnih odzivov. Izmerjeni posturalni odzivi v smereh desno nazaj in levo nazaj pri osebi po možganski kapi zelo odstopajo od normativa. Zaključki: Sorazmerno enostavna zasnova haptičnih tal, skupaj s podporno stojko in navideznim okoljem, omogoča poleg vadbe ravnotežja tudi zajem posturalnih odzivov v posameznih smereh. Tak sistem omogoča spremljanje poteka rehabilitacije ravnotežja tudi zunaj specializiranih kliničnih ustanov, npr. na bolnikovem domu.
Keywords		virtual reality balance training postural responses diagnostics rehabilitation robotics navidezna resničnost vadba ravnotežja posturalni odzivi diagnostika rehabilitacijska robotika