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Kinderspital Zürich

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Automated motion analysis and playful training of the trunk in children and adolescents with neuro-logical diagnoses

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The challenge

Trunk control is vital as it maintains posture and balance, enables functional movements, aids mobility and gait, supports upper limb function and drives postural reactions. It is crucial for functional independence and overall well-being.

The loss of trunk mobility during neurological shock can result in impaired balance, reduced independence in daily activities, breathing difficulties, limitations in upper limb function, abnormal gait, risk of pressure sores, digestion issues, and negative psychosocial effects. Rehabilitation is essential to improve outcomes in such cases. In Switzerland, such rehabilitation is provided at the the Swiss children's rehabilitation center (University Children's Hospital Zurich, Eleonoren Foundation) providing support and state-of-the-art treatments to children.

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The solution

Therapists know from their clinical experience that trunk control is of uttermost importance for walking and for using the arms and hands during self-care activities, e.g., washing, grooming, getting dressed. Indeed, improving walking ability and self-care are the most frequently mentioned goals in their rehabilitation centre. Scientifically, they could recently confirm how important trunk control is for these activities. Therefore, an objective, precise, and feasible assessment of trunk control is very important to identify specific impairments, to plan a personalized therapy program, and to visualize progress of therapy over time. Furthermore, a playful, motivating and intensive trunk control training could contribute significantly to the functional improvements in walking and self-care activities of many children undergoing neurorehabilitation.

« Trunk control is vital as it maintains posture and balance, enables functional movements, aids mobility and gait, supports upper limb function and drives postural reactions »

Concerning therapy, they have various novel technologies to playfully train walking, hand and arm function, or leg muscle strength. However, there are hardly any commercial systems available to train trunk control for paediatric patients. Therefore, they have created a game to train trunk control in the past and they use this game in their clinic, but it can only be played by children who can sit independently. After intensive research, is seems that no technologies that have been specifically designed to train trunk control in children, particularly those unable to sit independently.

To overcome this lack of available treatment, they have started to develop a low-cost, practicable 3D motion tracking system especially for children. They will use a 3D camera that was originally developed for body-motion control of console games. This camera system has also an integrated body tracking. In a recently submitted paper, they could show that this build-in tracking system is not accurate enough for clinical applications in children. Instead, their computer specialist Dr. Nikolas Hesse, developed their own method. This model computes a “skeleton” with joints out of the camera’s data, thus allowing to calculate changes in position and changes in joint angles displaying enough accuracy in measurements to improve the treatment.

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