NSF Convergence Accelerator: Track H: Restoring Arm Function with Connected Assistance and Rehabilitation Systems

Harvard University, Cambridge MA

Investigators

Abstract

This project focuses on developing and translating an at-home, connected wearable rehabilitation solution to restore arm function and independence for those with upper limb disability. Upper limb disability impacts over 10 million people in the United States; stroke is a leading cause. Of the almost one million people in the US who experience stroke annually, an estimated 75% have long-term challenges using their affected arm. The current standard of care for upper extremity rehabilitation is largely ineffective, due to limited duration and intensity of in-clinic therapy. Data suggest that stroke survivors require hundreds of repetitions per day to support upper limb recovery, but often lack the capacity and motivation to meet this standard. Without rehabilitation, a negative cycle of upper limb disuse occurs, resulting in further degradation of ability and gross impacts to independence, ability to work and life quality. This research enables a paradigm shift from the current 'in clinic' model of rehabilitation to one of remote physical rehabilitation for those with upper limb disability, where everyday activities are transformed into therapy. The results will open avenues for independence, societal participation, and return-to-work for millions of stroke survivors while reducing associated healthcare costs. The project broadening impacts aim is to attract, train, mentor the next generation of diverse rehabilitation technology innovators while providing continual telerehabilitation-focused education for therapists and reducing bias towards PWDs. This project will develop technology to enable higher repetitions and intensity of purposeful therapeutic movement by: (i) increasing capacity for upper limb movement through support from a soft wearable robot, and (ii) encouraging behavioral change with a digital therapeutic that provides thorough quantitative tracking and goal setting of upper extremity activity. The aims are to: (1) quantify upper extremity biomechanics and arm use after stroke, (2) optimize technology for at-home rehabilitation, and (3) evaluate and pilot technologies with stroke survivors and therapists. Building on low-fidelity prototypes co-created with end users, this project will optimize the technology-its mechanical design, estimation and control algorithms, and hardware, apparel, and software system parameters, and co-create advanced prototypes that will be evaluated in both lab and home-based settings. Stroke survivors of different functional levels and racial/ethnic backgrounds across multiple states will be involved through focus groups and a large-scale survey that will inform technical development. This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.