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Étude et conception d’objets de rééducation instrumentés pour le suivi de l’activité motrice des membres supérieurs des patients après un AVC

Abstract : As the population ages, stroke is one of the major health problems affecting 15 million people worldwide each year. After a stroke, many motor and sensory disorders, which have a direct impact on activities of daily living (ADL), can appear as lack of coordination, spasticity or tremors. In order to restore their motor and sensory abilities as much as possible, patients must undergo a long and costly rehabilitation process. In addition, patient monitoring and evaluation is based on visual observations. Little or no objective and quantifiable information on the execution of exercises is collected during rehabilitation sessions. Thus, potentially crucial information on patients' motor abilities is not measured. Many rehabilitation and monitoring platforms have been developed to collect objective information using virtual reality, augmented, interactive screens or portable devices. However, these platforms may have cost, portability and usability constraints.The objective of this thesis is to propose tools to improve the accompaniment of patients during the process of functional rehabilitation by offering health professionals a more representative follow-up of the state of health of these, session after session. This monitoring is carried out using objective and quantifiable information on the motor functions of the upper limbs collected by objects instrumented with sensor. On the basis of the state of the art and the results of an observational study conducted with fourteen health professionals, we developed five instrumented rehabilitation objects for monitoring the motor functions of the hand and arm and the activities of daily life that are materialized by: (i) a jack that collects information on manual dexterity (finger position and pressure, orientation, irregular movements, tremors), (ii) a cube that collects information on overall hand grip (overall finger pressure, orientation, irregular movements and tremors), (iii) a commercially available connected watch that collects information on arm motor functions (arm movements), (iv) an instrumented garment that measures the bending angle of the elbow and (v) a cup that collects information on the motor functions of the arm and hand during complex action sequences (fluid level, orientation, position on a target, finger pressure and tremors) and allows the recognition of activities of daily living such as drinking, sitting, standing, walking, climbing and descending stairs. We conducted an experimental study with fourteen healthcare professionals to explore the functionalities and the design of the objects in order to gather feedback on possible improvements. The results of this study allowed us to tighten the measurement perimeter and make the objects more functional. This study also allowed us to develop visualization interfaces to display data in a simple, fast and easy to interpret manner. We conducted a study with six healthcare professionals to validate the development of these interfaces. The results indicate that the design choices of these visualization interfaces are relevant. Finally, we conducted an experimental usability and acceptability study in nine stroke patients. The results indicate that the efficiency and usability satisfaction criteria are met. The results show that patients found the objects easy to use and are willing to use them during rehabilitation sessions and at home to adapt their rehabilitation program according to their progress.
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  • HAL Id : tel-02004344, version 1

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Maxence Bobin. Étude et conception d’objets de rééducation instrumentés pour le suivi de l’activité motrice des membres supérieurs des patients après un AVC. Technologies Émergeantes [cs.ET]. Université Paris Saclay (COmUE), 2018. Français. ⟨NNT : 2018SACLS419⟩. ⟨tel-02004344⟩

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