A University of Maryland-led research collaboration received a $4.6 million grant to improve rehabilitation interventions for patients with sensorimotor impairments resulting from a stroke, as well as for older adults who face a high risk of falls. Funded by the National Institute on Disability, Independent Living, and Rehabilitation Research, the research team will work to develop technology-enabled therapies and novel techniques to assess impairment. The group hopes that their innovations could augment clinical and home-based treatment options.
“People who have had a stroke or older adults with high falling risks have compromised mobility and impaired use of the arm and hand, contributing to functional limitations and decreased quality of life,” said project director Li-Qun Zhang, a professor with the University of Maryland’s Fischell Department of Bioengineering (BIOE) in College Park, as well as Professor of Physical Therapy and Rehabilitation Science and Professor of Orthopaedics at the University of Maryland School of Medicine in Baltimore. “We plan to investigate how rehabilitation outcomes can be improved based on accurate assessment of impairment, decreased mobility, and increased risk of falls in these populations.”
Today, many patients rely on routine clinical evaluations for therapies and recovery of sensorimotor function. But, these evaluations lack the ability to provide patients with accurate assessments of their impairments, and subsequent impairment-specific treatment.
Recognizing this, Zhang and his team are working to create rehabilitation technologies that more accurately assess complex sensorimotor impairments in both clinical and home settings. In addition, the researchers hope to develop impairment-specific treatments and translate these treatments and technologies into useful, practical solutions that can improve patients’ quality of life.
“The goal is to improve therapeutic outcomes by developing and testing assessment-based rehabilitation, carried out beyond hospitals and clinics to reach the patient at home,” Zhang said. “For example, an individual’s fall risks and falling mechanisms will be assessed systematically with the help of rehabilitation robotics and machine learning. Impairment-specific training will then be conducted on the individuals with both hospital and home-based intervention training.”
The research group has formed a federally recognized Rehabilitation Engineering Research Center (RERC) program, with the goal of conducting research to improve the effectiveness of services authorized under the Rehabilitation Act. RERC teams conduct advanced engineering research and develop innovative technologies designed to solve particular rehabilitation problems or remove environmental barriers.
The UMD-led team plans to investigate how specific sensorimotor impairments contribute to decreased mobility, slow and asymmetric gait, reduced balance and stability, and an increased risk of falls. Their hope is that their technologies could be used to carry out impairment-specific therapeutic training that utilizes data from comprehensive assessments of patient impairments. In turn, patients would undergo tailored treatment to meet new targeted goals based on the severity of their case. Such targets would range from overcoming muscle weakness, to improving posture and balance control, to bearing weight or regaining the ability to walk with or without assistive devices.
“This marks an exciting opportunity for engineers and medical experts to work together to create new treatment options that are tailored to address the specific needs of stroke patients and those who face fall risks,” said John P. Fisher, BIOE Professor and Chair. “The work put forth by this research team could one day make a world of difference in the lives of those who face a daunting prognosis involving a loss of mobility or other sensorimotor impairments.”
“Innovation and research to help patients lead better lives is at the center of our mission,” said Dr. E. Albert Reece, Executive Vice President for Medical Affairs at the University of Maryland, Baltimore, and John Z. and Akiko K. Bowers Distinguished Professor and Dean at the University of Maryland School of Medicine. “Studies such as these can have real clinical implications in helping patients recover from strokes and other debilitating neurological conditions, so they can lead more functional, healthier lives.”
In addition to Zhang, the following researchers are also center collaborators: co-director Peter Lum (Catholic University of America); Gad Alon, Clive Pai, Douglas Savin, and Kelly Westlake (University of Maryland, Baltimore); X. Li and Yang Tao (University of Maryland, College Park); Jay Barton (Baltimore Veterans Affairs Medical Center); Jackey Gong (University of Maryland, Baltimore County); and Sang Wook Lee and Alex Dromerick, M.D. (Catholic University/National Rehabilitation Hospital).