Training dosage is the key to functional rehabilitation success in spinal cord injury (SCI) and stroke. Even in optimal inpatient conditions, due to manpower constraints patients waste hours per day waiting in bed or in wheelchairs instead of performing therapy. This project will develop, test and bring to market the first mobile system for interactive unsupervised lower limb rehabilitation training with virtual reality, based on a further development of the existing stationary YouKicker® product (YouRehab AG, Zurich, left picture). Hospitals will benefit by up to 400% increased therapist efficiency and patients will benefit by being able to access therapy anywhere, anytime.
YouKicker has been tested on fourteen incomplete spinal cord injury (iSCI) patients at Balgrist University Hospital, in standard one-on-one therapist-patient sessions. The training was accepted by all patients with high enjoyment, motivation and attention. Besides subjective positive changes expressed by the patients (PGIC), objective measures of walking capacity, balance and strength (10MWT, SCIM, WISCI II, BBS, LEMS, locomotion) revealed significant improvements in lower limb function. Neuroimaging data (fMRI) also shows evidence of large-scale cortical reorganization consistent with the improvements in motor function. Additionally, there have been indications of reductions in neuropathic pain, which normally affects many SCI patients.
Because the current YouKicker prototype requires one-on-one therapist-patient interaction, the potential cost and training dosage benefits of the system have not yet been realized. The overall goal of the proposed project is to provide a solution for intensive, repetitive but specific movement therapy in lower limb movement rehabilitation in situations where constant one-to-one therapist supervision and coaching is not possible.
 

Existing YouKicker Supervised, therapist interaction required One therapist can manage 2-3 patients simultaneously Patients must book time with the therapists

YouKicker upgrade (benefits) Unsupervised - therapist sets and checks training targets One therapist manages >15 patients Patients train when and where they want - turn wasted time into therapy No space needed in therapy rooms

For further information please contact: PD Dr. Marc Bolliger