suffer a stroke. Eighty-five percent of the survivors end up having some degree of hand disability as a result.

After leaving the hospital, the majority of a stroke patient's rehabilitation consists of repetitive at-home exercises, says Nizan Friedman, a biomedical engineering student at the University of California, Irvine. "The therapist basically will give the person a booklet of exercises and say 'Move your fingers like this 100 times, stretch your hand out 100 times.' And in reality that's not motivating. Most people don't complete the therapy and they don't recover."

Friedman is part of a research group that's trying to make therapy a little more fun. The scientists invented a game, based on Guitar Hero, meant to make rehabilitation therapy more interesting for people recovering from stroke or who have hand impairments due to cerebral palsy, spinal cord injury, or multiple sclerosis. "Guitar Hero is the third largest video game created in the history of video games," Friedman says. "This is something that people get addicted to, and we want people to get addicted to our therapy."

To play, the patients match their hand movements to notes falling on the screen. And as in ordinary Guitar Hero, the notes are timed rhythmically with music. But rather than mashing buttons on a fake plastic guitar, the patient touches the thumb to one of their four fingers—each finger corresponds to a different color, or "note".

The MusicGlove uses conductive fingertip sensors to detect whether the player has achieved the correct finger position. By playing six or seven songs, the patients complete between two and three thousand repetitions of their therapeutic exercises, with real-time feedback about whether they've performed the right gestures at the right times. They get a score at the end of each song and can work to beat their previous scores.

The researchers say their test patients preferred the MusicGlove therapy over the standard exercises, and showed significantly more improvement in hand function. "They reported being able to write better, wipe themselves, fasten a bra," Friedman says. "These were things that they previously would need a care-giver for, and now they don't."

The team has since founded a company to commercialize the device, and they expect the MusicGlove will be available to clinics and individuals in six to 12 months. It has already been introduced in a few hospitals around the country, including the Rehabilitation Institute of Chicago and the Rancho Los Amigos Rehabilitation Center.

One drawback is that the game works best for patients who already have moderately high hand dexterity, so folks with more severe impairments will have a harder time playing the game and benefitting from it. However, for those who've lost much of the ability to move their hands, a team of students from Worcester Polytechnic Institute has created a different kind of rehabilitation glove.

"Initially after someone goes through a stroke, the connection between the hand and the brain can be cut off or muddled," says Phillip Gauthier, a master's student in mechanical engineering. "What this device is designed to do is provide enough assistance just so that they can get their hand moving again, so that their muscles don't atrophy. It gets the brain and the hand communicating again."

Credit: AIM Lab, Worcester Polytechnic Institute

The prototype uses cables to open and close the hand via a set of spools carried in a backpack, while the patient operates an on/off switch in the other hand. A therapist can program individualized exercises into the system—for instance, pressing the thumb to the forefinger 50 times every two minutes—and could add resistance from the cables for an extra challenge.

Inside the glove, a custom-designed electrode array senses which muscles are used and how hard they're working. Eventually, grad student Michael Delph says, that information will be used to automatically adjust the levels of assistance and resistance based on the patient's progress. The team expects to begin testing the glove in stroke patients within the next few months.

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