Embedded Arts for Movement Retraining - The Ohio State College of ...

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13 Νοε 2013 (πριν από 3 χρόνια και 8 μήνες)

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EMBEDDED ARTS FOR
MOVEMENT RETRAINING

Lise Worthen
-
Chaudhari

Description

Embedded Arts
is an interactive computer program
designed as a rehabilitation biofeedback tool. The
purpose of the system is to tap into artistic and
creative neural pathways during performance of
standard rehabilitation exercises. Using real
-
time
data from biophysical sensors, the program
integrates creative process within rehabilitation
protocols by translating movement into art.

Therapy and Neurorehab


This ability of our neural wiring to reroute when
given the right stimuli can be a powerful agent
for recovery and has, since the 1980s,
emerged as the most promising phenomenon
for facilitating
neurorehabilitation
.”


Nudo

&
Dancause

(2007)

in Brain Injury Medicine: Principles and Practices

http://www.youtube.com/watch?v=MABD7sYplkk

Purpose


enable patients to create fun, individualized
images that would be


aesthetically and
kinesthetically satisfying, but that would also
represent a patient's personal healing through
the process of activity
-
based medicine.

Hypothesis


Embedding interactive arts processes within
rehabilitation exercises may improve
outcomes


Increasing gains in physical tacit knowledge
construction


Improving patient attention and compliance


Enhancing clinician tracking


Leveraged Phenomenon


Implicit Learning
Gentile (1998
)


Can’t be imparted explicitly from outside.


Immersive Learning
Mirelman

(2010),
Keshner


Multi
-
sensory (aka multi
-
modal)


Both

Deeply felt on embodied level during performance.

Implicit & Immersive


Research


Stroke
Patton et al. (2004, 2005); Pohl et al. (2006); Boyd et al. (2010) ,
Mirelman

(2010)


Parkinson’s
Witt et al. (2006),
Keshner
,
Thaut


Examples


Robotics & video gaming



Arts generative experiences

Worthen
-
Chaudhari

(2011),
Modugno

(2011)


Implicit & Immersive



Acknowledged
for importance in cognitive
knowledge construction but underused for
physical knowledge
construction


Participation and Engagement

Design Research


Asked the experts


Patients, artists, and clinicians


Feedback was iterative process of using the program, getting
feedback, implementing improvements (exploration within the
exploration)


Results


Practical
issues
addressed


Dancers suggested explicit use
instructions while
patients tended
to figure out for themselves.


Artists
were logical/pragmatic while
clinicians
were
artistic.



Feasibility
Study


8 patients single session


6 patients longitudinal study


Results


No AE


Feasible to incorporate the technology in clinical practice


Accepted and desired by patients & clinicians


Limiting factors:


T
ime for computer to boot


IT support for secure data storage


Access to EA “concierge”
help as needed



Summary


Interactive arts technologies enhance standard
rehabilitation


Embedding creative process within rehabilitation may
improve outcomes


Outputting artistic work from rehabilitation exercises
adds economic element to rehabilitation endeavors


Motion capture data transformed for feedback and
recorded for quantitative outcomes analysis in the
clinic and home health settings


Artistic nature of personal movement in a
rehabilitation setting is explored



Conclusion

In the rehabilitation paradigm, movement is
medicine. In the dance paradigm, movement is
art. Often, a single movement can be both.
Perhaps, through the
phenomemon

of
movement, the arts and medicine are more
interdependent than we previously imagined.


Worthen
-
Chaudhari

(2011)
New Partnerships Between Dance and
Neuroscience: Embedding the Arts for
Neurorecovery
,
Dance Research
Journal, 29.2, p 469.

Acknowledgements


This project has been partially funded by the College of Arts & Sciences,
Department of Dance, Department of Physical Medicine and
Rehabilitation, and the Medical Center Alumni Association at The Ohio
State University.


Special thanks to: Helen
Alkire
, Brad Burns, Chuck Crosby, John Griffith,
Ashley Hahn, Joseph F.
Kuspan
, Jill
Sarina
, Aaron Wolfe (artists), Michael
Kelly Bruce, David Covey, Susan
Petry

(Dance), D. Michele Basso (Health &
Rehab Sciences), W. Jerry
Mysiw

(PM&R), staff of the
NeuroRecovery

Network and Dodd Inpatient clinics at OSUWMC, my children and my
husband, Dr.
Ajit

Chaudhari
.

Design constraints


Action painting aesthetic

“…shifted the emphasis from the object [of art] to
the struggle itself, with the finished painting being
only the physical manifestation, a kind of residue,
of the actual work of art, which was in the act or
process of the painting’s creation.”

http://en.wikipedia.org/wiki/Action_painting


Random aesthetic elements


Future Directions


Phase II Effectiveness Study


Implement programs found to be feasible and
effective (Dodd Hospital
-

all floors)





References

Boyd LA,
Quaney

BM, Pohl PS,
Winstein

CJ. Learning implicitly: effects of task and severity after
stroke.
Neurorehabil

Neural Repair 21: pp.444

454, 2007.

Brewer B, McDowell SK, Worthen
-
Chaudhari LC. Post
-
stroke upper extremity rehabilitation: a review
of robotic systems and clinical results. Topics in Stroke Rehab 14(6): pp. 22
-
44, 2007.

Cleeremans

A. Implicit learning. In:
Nadel

L, ed. Encyclopedia of Cognitive Science. London: Nature
Publishing Group, 2003.

Foerde

K. Implicit Learning and Memory: Psychological and Neural Aspects. Encyclopedia of
Behavioral Neuroscience, pp. 84
-
93, 2010.

Job Accommodation Network by the Office of Disability Employment Policy, “Network Fact Sheet
Series: Self employment for artists with disabilities”, viewed February 11, 2010
<
www.jan.wvu.edu/entre/pubs/Entre_Artists.doc
>.

Meulemans

T, Van
der

Linden M. Implicit learning of complex information in amnesia. Brain and
Cognition 52(2), pp. 250
-
257, 2003.

Patton JL,
Mussa
-
Ivaldi

FA. Robot
-
assisted adaptive training: custom force fields for teaching
movement patterns. IEEE Trans Biomed Eng. 51: pp. 636

646, 2004.

Patton JL,
Stoykov

ME,
Kovic

M,
Mussa
-
Ivaldi

FA. Evaluation of robotic training forces that either
enhance or reduce error in chronic
hemiparetic

stroke survivors. Exp Br Res 168 (3): pp.363
-
383,
2005.



References

Pohl PS, McDowd JM, Filion D, Richards LG, Stiers W. Implicit learning of a motor skill after mild and
moderate stroke. Clin Rehabil.20: pp.246

253, 2006.

Thaut MH, McIntosh GC, Rice RR, Miller RA. Rhythmic auditory stimulation in gait training for
parkinson’s disease patients. Movement Disorders 11(2): pp.193
-
200, 2004.

The New York Times, “Learning his body; learning to dance”, viewed February 11, 2010
<http://www.nytimes.com/2009/11/25/arts/dance/25palsy.html>.

Whitall J, Waller SM, Silver KHC, Macko RF. Repetitive bilateral arm training with rhythmic auditory
cueing improves motor function in chronic hemiparetic stroke. Stroke 31: pp. 2390
-
2395, 2000.

Witt K, Daniels C, Daniel V, Schmitt
-
Eliassen J, Volkmann J, Deuschle G. Patients with Prkinson’s
disease learn to control complex systems


an indication for intact implicit cognitive skill
learning. Neuropsychologia 44(12), pp. 2445
-
2451, 2006.

Yadev V, Schmiedeler J, McDowell SK, Worthen
-
Chaudhari LC. Quantifying age
-
related differences in
human reaching while interacting with a rehabilitation robotic device, Journal of Applied
Biomechanics and Bionics
accepted 2010
.