I-BaR: integrated balance rehabilitation framework

Abstract

Neurological diseases are observed in approximately 1 billion people worldwide. A further increase is foreseen at the global level as a result of population growth and aging. Individuals with neurological disorders often experience cognitive, motor, sensory, and lower extremity dysfunctions. Thus, the possibility of falling and balance problems arise due to the postural control deficiencies that occur as a result of the deterioration in the integration of multi-sensory information. We propose a novel rehabilitation framework, Integrated Balance Rehabilitation (I-BaR), to improve the effectiveness of the rehabilitation with objective assessment, individualized therapy, convenience with different disability levels and adoption of assist-as-needed paradigm and, with integrated rehabilitation process as whole, that is, ankle-foot preparation, balance, and stepping phases, respectively. Integrated Balance Rehabilitation allows patients to improve their balance ability by providing multi-modal feedback: visual via utilization of virtual reality; vestibular via anteroposterior and mediolateral perturbations with the robotic platform; proprioceptive via haptic feedback.

Keywords: anticipatory postural adjustment; balance rehabilitation; compensatory postural adjustment; multi-modal sensory feedback; rehabilitation methodology; robotic rehabilitation.

Figure 1

Protocol of I-BaR: (A) ankle-foot/preparation, (B) balance, and (C) stepping phases.

Figure 2

Protocol of I-BaR: (A) ankle-foot/preparation, (B) balance, and (C) stepping phases.

Figure 3

Representation of (A) the ankle DoF, (B) ankle-foot rehabilitation, (C) sole of the foot, (D) balance, and (E) stepping rehabilitation.