1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team...
-
Upload
winfred-webster -
Category
Documents
-
view
219 -
download
1
description
Transcript of 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team...
![Page 1: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/1.jpg)
1
Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy
Team #: 15
Team members:
Jayce Holley
Fan (Peter) Zhu (Presenter)
Kevin Lind
Mentor: Dr. Jack Engsberg
Birkenmeier RL, Prager EM, Lang CE. (2010) Translating animal doses of task-specific training to people with chronic stroke in 1-hour therapy sessions: a proof-of-concept study. Neurorehabil Neural Repair. 24(7):620-35.
![Page 2: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/2.jpg)
2
BackgroundCerebral Palsy Permanent muscle and movement disorders[1]
Lesions in the developing brain[1]
Affecting 2 to 2.5 children per 1000 births[2]
No relation between muscle strength and spasticity [4]
Rehabilitation is benefit to both [5,6]
http://www.google.com/imgres?q=cerebral+palsy+patient&um=1&hl=en&sa=N&biw=1536&bih=720&tbm=isch&tbnid=bP2YeBFaLT3J4M:&imgrefurl=http://cerebralpalsyhelp.org/&docid=baAQzV7InNv_M&imgurl=http://cerebralpalsyhelp.org/images/Cerebral%252520Palsy%252520Help.jpg&w=340&h=378&ei=lylhUI3aBZOc8wTs3IHwCA&zoom=1&iact=hc&vpx=428&vpy=182&dur=324&hovh=237&hovw=213&tx=137&ty=104&sig=104437745059302163758&page=1&tbnh=162&tbnw=153&start=0&ndsp=20&ved=1t:429,r:1,s:0,i:78
![Page 3: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/3.jpg)
3
Background
Current practice Patients and therapists must be physically together Low compliance
http://www.google.com/imgres?q=cerebral+palsy+training&um=1&hl=en&biw=1536&bih=720&tbm=isch&tbnid=PuZujr7Y2BM3oM:&imgrefurl=http://www.neurodiagnosticdevices.com/treadmilltraininginchildrenwithcerebralpalsy.htm&docid=AHIuN5X5FpOsLM&imgurl=http://s1.hubimg.com/u/288764_f260.jpg&w=260&h=347&ei=TixhUNuWE4Lc8ATfqoGYBg&zoom=1&iact=hc&vpx=181&vpy=131&dur=2975&hovh=259&hovw=194&tx=119&ty=85&sig=104437745059302163758&page=1&tbnh=167&tbnw=119&start=0&ndsp=19&ved=1t:429,r:0,s:0,i:70
![Page 4: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/4.jpg)
4
BackgroundGoal Telerehabilitation and
virtual gaming Wii More motivation 97% of all American
adolescents (12-17) play video games[10]
http://www.google.com/imgres?q=play+video+games&um=1&hl=en&biw=1536&bih=720&tbm=isch&tbnid=xLu1nIU9ZnGTaM:&imgrefurl=http://tavrosperseveres.tumblr.com/post/3719884737&docid=g9lbu0KR7JR3ZM&imgurl=http://25.media.tumblr.com/tumblr_lhqfowFMYY1qhdse7o1_400.jpg&w=333&h=221&ei=fT1hUIWZKvP7yAGp-IDYCw&zoom=1&iact=hc&vpx=571&vpy=204&dur=153&hovh=176&hovw=266&tx=127&ty=106&sig=104437745059302163758&page=1&tbnh=158&tbnw=205&start=0&ndsp=21&ved=1t:429,r:2,s:0,i:103
![Page 5: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/5.jpg)
5
Need Knee joint
Shock absorption during stance
Foot clearance during swing
Range of motion Cheap, safe and
interactive tasks Therapist Home
http://www.google.com/imgres?q=knee+rehabilitation&um=1&hl=en&sa=N&biw=1536&bih=720&tbm=isch&tbnid=OB9BRT1C1TWQLM:&imgrefurl=http://www.nasa.gov/topics/nasalife/knee_brace.html&docid=jpX58Blh9fua_M&imgurl=http://www.nasa.gov/images/content/293783main_knee_brace1_lg.jpg&w=639&h=501&ei=zy1hUOnWKILo8gTLjoCIDg&zoom=1&iact=hc&vpx=365&vpy=333&dur=247&hovh=199&hovw=254&tx=169&ty=147&sig=104437745059302163758&page=1&tbnh=154&tbnw=209&start=0&ndsp=22&ved=1t:429,r:8,s:0,i:98
![Page 6: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/6.jpg)
6
Project ScopeSummary
Three foldA “Telekit”A “Teleprocess”A knee strengthening device
![Page 7: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/7.jpg)
7
Project Scope
“Telekit” Laptop Webcam Wifi Wii remote Knee rehabilitation device
http://www.google.com/imgres?q=laptop&um=1&hl=en&sa=N&biw=1536&bih=720&tbm=isch&tbnid=GLwjrHoaUgUSDM:&imgrefurl
http://www.google.com/imgres?q=wii+remote&num=10&hl=en&biw=1536&bih=720&tbm=isch&tbnid=9_0w48zli2aBnM:&imgrefurl=http://en.wikipedia.org/wiki/Wii_Remote&docid=cTxgRkmIFqpPWM&imgurl=
![Page 8: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/8.jpg)
8
Project Scope
“Teleprocess” Remote prescription Prescriptions = different sets of games Evaluation
Number of repetitions Range of motion Velocity
User manual
http://www.google.com/imgres?q=video+games&um=1&hl=en&sa=N&biw=1167&bih=530&tbm=isch&tbnid=BF_KAuszu8GfrM:&imgrefurl=http://www.biggtech.com/technology/hold-onto-your-seat-video-games-are-real_8545.html&docid=SDc850LOaKZfuM&imgurl=http://www.biggtech.com/wp-content/uploads/2011/08/Hold-onto-your-seat%2525E2%252580%2525A6Video-Games-are-Real.jpg&w=1024&h=768&ei=YMJhUPHzHqTuyAHohIHwCw&zoom=1&iact=hc&vpx=431&vpy=149&dur=3798&hovh=194&hovw=259&tx=125&ty=112&sig=104437745059302163758&page=2&tbnh=162&tbnw=214&start=18&ndsp=15&ved=1t:429,r:7,s:18,i:238
![Page 9: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/9.jpg)
9
Project ScopeKnee strengthening device Variable resistance Wii remote to track the flexion and extension of the knee
http://www.google.com/imgres?q=knee+extension&um=1&hl=en&sa=N&biw=1536&bih=720&tbm=isch&tbnid=vFw-maFB9PrWfM:&imgrefurl=http://jay-jee.blogspot.com/2012/05/new-extension-test-in-sitting.html&docid=Q7UODlB9rT-x-M&imgurl=http://4.bp.blogspot.com/-2mG7hglSIeQ/T7V-mzQEiFI/AAAAAAAAAas/aBmOnAAz_5I/s1600/knee.jpg&w=246&h=264&ei=6j1hUKHfL-rryAH_v4HoCg&zoom=1&iact=hc&vpx=581&vpy=182&dur=1156&hovh=211&hovw=196&tx=115&ty=110&sig=104437745059302163758&page=1&tbnh=149&tbnw=139&start=0&ndsp=21&ved=1t:429,r:2,s:0,i:119
![Page 10: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/10.jpg)
10
Specific Design RequirementsHardware
Laptop Windows 7 32-bit, 2.66GHz
dual core processor At least one USB 2.0
bus RAM of at least 2GB
Webcam Resolution: at least
640*480 pixel
Wi-Fi hotspot Fit in the palm of a
hand 3G internet
http://www.google.com/imgres?q=640*480+pixel&um=1&hl=en&sa=N&biw=1167&bih=530&tbm=isch&tbnid=HQsKR0lqJwx4KM:&imgrefurl=http://www.eheart.com/SHASTA/wall.html&docid=KPsAVciV_XUcTM&imgurl=http://www.eheart.com/SHASTA/wallpaper/alpenglow-640x480.jpg&w=640&h=480&ei=csxhUJrMN6b9ygG9wIHwCQ&zoom=1&iact=rc&dur=70&sig=104437745059302163758&page=1&tbnh=140&tbnw=201&start=0&ndsp=10&ved=1t:429,r:5,s:0,i:91&tx=93&ty=106
![Page 11: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/11.jpg)
11
Knee rehabilitation device: Costs under $200 Weighs less than 30 pounds Fits within the 2ft*2ft*2ft box and Includes a carrier for a Wii remote Has variable resistances Has range of motion from 0< θ<90
Specific Design RequirementsHardware
![Page 12: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/12.jpg)
12
Specific Design RequirementsSoftware
Face-time interactions Wii data keystroke commands online games Games
Therapist patient, Patient maneuver Time: old, 2-3 min; new, less than 10 min
![Page 13: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/13.jpg)
13
Specific Design RequirementsSoftware
Troubleshooting Content management system
Therapist Patient Calendar Blog
data
![Page 14: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/14.jpg)
14
Existing solutionsSolution #1
JAS Knee
The JAS Knee system with the user operating the angle control device.
(http://www.jointactivesystems.com/JAS-Systems/1/5/JAS-Knee.aspx)
Pros Portable Cheap Easy to use at home Doesn’t need excessive training or supervision
Cons Not able to work on any dynamic movements No data collection No quantitative analysis
![Page 15: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/15.jpg)
15
Existing solutionsSolution #2
System 4 Pro Pros
Force reading
Progress monitor
Adjustable resistances
Variety of exercises (Isokinetic, Isometric)
Cons
Big size
Not portable
Expensive
Specialist requirement
http://www.google.com/imgres?q=System+4+Pro&um=1&hl=en&sa=N&biw=1536&bih=720&tbm=isch&tbnid=FqgUtt-rX5qDLM:&imgrefurl=http://m.biodex.com/physical-medicine/products/dynamometers/system-4-pro-0&docid=YpRqUtkfKmz6tM&imgurl=http://www.biodex.com/sites/default/files/imagecache/product_landing_large_mobile/products/images/850-000_1_knee_extension_flexion.jpg&w=335&h=250&ei=FDthUM2gIIHo8gSAy4HQDQ&zoom=1&iact=rc&dur=122&sig=104437745059302163758&page=1&tbnh=162&tbnw=219&start=0&ndsp=19&ved=1t:429,r:11,s:0,i:107&tx=100&ty=68
![Page 16: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/16.jpg)
16
Existing solutionsSolution #3
http://www.google.com/imgres?q=Telerehabilitation&um=1&hl=en&sa&biw=1536&bih=720&tbm=isch&tbnid=GxoVMRQfe3LBM:&imgrefurl=htp://www.njinfotech.com/index2.html&docid=qIYk_YPrx0rJ2M&imgurl=htp://www.njinfotech.com/images/portfolio/ru_ti_large.jpg&w=750&h=63&ei=0zxhUJDiCdH8yAG_5YDIDA&zoom=1&iact=rc&dur=331&sig=10443775059302163758&page=3&tbnh=156&tbnw=186&start=42&ndsp=25&ved1t:429,r:13,s:42,i:253&tx=128&ty=89
Directed by Dr. Jack Engsberg last year
Interface
Wii & ankle rehabilitation device
Video games
Base plate
Telerehabilitation
![Page 17: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/17.jpg)
17
Preliminary analysesGeneral device introduction
Setup of our device
Patient knee
Resistance component
Base
Rotating arm
Pivotθ
Patient calf
Patient footCushion
Wii
Fixed arm
Chair
![Page 18: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/18.jpg)
18
Preliminary analysesMathematical calculations
θ
Mk
M1g
Tb
a
l Mp
Axis of rotation Four interactions acting on the yellow part
1. Torque from the knee of the CP patient (Mk)
2. Frictional torque from the pivot (MP)
3. Gravity from the patient’s calf, foot and the rotating arm (M1g)
4. Tension from the resistance component (T)
![Page 19: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/19.jpg)
19
Preliminary analysesMathematical calculations
Lever arm of T
a
b
A (Knee)
B
H
θ
θ
Mk
M1g
Tb
a
l Mp
Axis of rotation
T
![Page 20: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/20.jpg)
20
Preliminary analysesMathematical calculations
a
b
A (Knee)
B
H
θ
sin**21sin**
21)( baACABABCArea
AHBCheightbaseABCArea *21*
21)(
AHBCba *21sin**
21
Therefore:
BCabAH sin
So:
![Page 21: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/21.jpg)
21
Preliminary analysesMathematical calculations
a
b
A (Knee)
B
C
H
θ
)cos(2)cos(***2 2222 abbaACABACABBC
Law of cosine:
)cos(2sin
22
abbaabAH
Lever arm of T:
![Page 22: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/22.jpg)
22
Preliminary analysesMathematical calculations
Tension T calculation
)0)cos(2(*)0(** 22 labbaklBCkxkT
T
![Page 23: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/23.jpg)
23
Preliminary analysesMathematical calculations
Torque equation:
θ
Mk
M1g
Tb
a
l Mp
Axis of rotation
cos2
sin*))0cos2(*(sin122
22
abba
ablabbakMpglMMk
![Page 24: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/24.jpg)
24
Preliminary Design Schedule
![Page 25: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/25.jpg)
25
Current Organization of team responsibilities
![Page 26: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/26.jpg)
26
Questions?
![Page 27: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/27.jpg)
27
References[1] Morris, Christopher. "Definition and Classification of Cerebral Palsy: AHistorical Perspective." University of Oxford (n.d.): 1-7. Web. 17 Sept. 2012.[2] Graham, H. Kerr, and P. Selber. "MUSCULOSKELETAL ASPECTS OFCEREBRAL PALSY." Royal Children's Hospital (n.d.): n. page. Print.[3] Aisen, Mindy Lipson, Danielle Kerkovich, Joelle Mast, Sara Mulroy, TishyaAL Wren, Robert M. Kay, and Susan A. Rethlefsen. "Cerebral Palsy: ClinicalCare and Neurological Rehabilitation." The Lancet Neurology 10.9 (2011):844-52. Print.[4] Engsberg, Jack R., and Sandy A. Ross. "Relation between Spasticity andStrength in Individuals with Spastic Diplegic Cerebral Palsy." DevelopmentalMedicine & Child Neurology (2002): 149-57. Web.[5] Damiano, D., and M. F. Abel. "Functional Outcomes of Strength Training inSpastic Cerebral Palsy." Archives of Physical Medicine and Rehabilitation 79.2(1998): 119-25. Print.[6] Dodd, K. J., N. F. Taylor, and D. L. Damiano. "A Systematic Review of theEffectiveness of Strength-training Programs for People with CerebralPalsy." Archives of Physical Medicine and Rehabilitation 83.8 (2002): 1157164. Print.[7] Nudo, R.J., Milliken, G.W., & Merzenich, M.M., (1996). Use-dependentalterations of movement representations in primary motor cortex of adultsquirrel monkeys, Journal of Neuroscience,16 785-807.
![Page 28: 1 Telerehabilitation Gaming Therapy Development for Children with Cerebral Palsy Team #: 15 Team members: Jayce Holley Fan (Peter) Zhu (Presenter) Kevin.](https://reader036.fdocuments.net/reader036/viewer/2022070605/5a4d1af47f8b9ab059980731/html5/thumbnails/28.jpg)
28
References[8] Vliet, Paulette M., and Nicola R. Heneghan. "Motorcontrol and the Management of MusculoskeletalDysfunction." Manual Therapy 11.3 (n.d.): 208-13. Print.[9] Deutsch, Judith E., Megan Borbely, Jenny Filler, Karen Huhn, and Phyllis Guarrera-Bowlby. "Use of a LowCost, Commercially Available Gaming Console (Wii) for Rehabilitation of an Adolescent with Cerebral Palsy.“Journal of the American Physcial Therapy Association 88.10 (2008): 1196-207. Web.<http://ptjournal.apta.org/content/88/10/1196.full.pdf+html>.[10] Pew Internet & American Life Project Teens, Video Games and Civicshttp://pewresearch.org/pubs/953/September 16, 2008[11] Gage, James R. "Surgical Treatment of Knee Dysfunction in Cerebral Palsy." Clinical Orthopaedics andRelated Research&NA;.253 (1990): Print.[12] DeVita, Paul. "Obesity Is Not Associated with Increased Knee Joint Torque and Power during LevelWalking." Journal of Biomechanics 36.9 (2003): 1355-362. Print.[13] Owens, Charles. “Movement-Cure Apparatus.” Patent 721,737. 13 Dec 1901[14] Burns, Jebodiah Mose. “Knee Rehabilitation Exercise Device.” U.S. Patent Application No. 12/799,456.Publication No. 2011/0207585 A1. 26 April, 2010.[15] Bolano, Andrew, Eric Boccio, and Tonya An. Wii Controlled Gaming for Physical Therapy. WashingtonUniversity in St. Louis Senior Design Project. 2010. [16] Hill, Kelly, Amanda Mepplelink, and Liz Phillips. Flex2Play: An Ankle Strength Training Device with VirtualReality Interface for Children with Cerebral Palsy. Washington University in St. Louis Senior Design Project.2011.