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Open Access Highly Accessed Research

Cell phone based balance trainer

Beom-Chan Lee1, Jeonghee Kim2, Shu Chen3 and Kathleen H Sienko14*

Author Affiliations

1 Department of Mechanical Engineering, University of Michigan, Ann Arbor, USA

2 Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, USA

3 Institute of Gerontology, University of Michigan, Ann Arbor, USA

4 Department of Biomedical Engineering, University of Michigan, Ann Arbor, USA

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Journal of NeuroEngineering and Rehabilitation 2012, 9:10  doi:10.1186/1743-0003-9-10

Published: 8 February 2012

Abstract

Background

In their current laboratory-based form, existing vibrotactile sensory augmentation technologies that provide cues of body motion are impractical for home-based rehabilitation use due to their size, weight, complexity, calibration procedures, cost, and fragility.

Methods

We have designed and developed a cell phone based vibrotactile feedback system for potential use in balance rehabilitation training in clinical and home environments. It comprises an iPhone with an embedded tri-axial linear accelerometer, custom software to estimate body tilt, a "tactor bud" accessory that plugs into the headphone jack to provide vibrotactile cues of body tilt, and a battery. Five young healthy subjects (24 ± 2.8 yrs, 3 females and 2 males) and four subjects with vestibular deficits (42.25 ± 13.5 yrs, 2 females and 2 males) participated in a proof-of-concept study to evaluate the effectiveness of the system. Healthy subjects used the system with eyes closed during Romberg, semi-tandem Romberg, and tandem Romberg stances. Subjects with vestibular deficits used the system with both eyes-open and eyes-closed conditions during semi-tandem Romberg stance. Vibrotactile feedback was provided when the subject exceeded either an anterior-posterior (A/P) or a medial-lateral (M/L) body tilt threshold. Subjects were instructed to move away from the vibration.

Results

The system was capable of providing real-time vibrotactile cues that informed corrective postural responses. When feedback was available, both healthy subjects and those with vestibular deficits significantly reduced their A/P or M/L RMS sway (depending on the direction of feedback), had significantly smaller elliptical area fits to their sway trajectory, spent a significantly greater mean percentage time within the no feedback zone, and showed a significantly greater A/P or M/L mean power frequency.

Conclusion

The results suggest that the real-time feedback provided by this system can be used to reduce body sway. Its advantages over more complex laboratory-based and commercial balance training systems in terms of cost, size, weight, functionality, flexibility, and accessibility make it a good candidate for further home-based balance training evaluation.

Keywords:
vibrotactile; rehabilitation; sensory augmentation; balance; cell phone; smart phone; mobile phone