Claudia Villalobos
The loss of mobility on one side of the body or muscle weakness in the upper limbs is among the most common aftereffects of a stroke (Cerebrovascular Accident, CVA). Physiotherapy plays a crucial role in rehabilitation and in restoring muscle capacity.
Considering that this process is complex and often painful—requiring a series of exercises to help the brain reconnect through neuroplasticity to regain movement—researchers at the Instituto Politécnico Nacional (IPN) have designed a system based on a video game that makes physiotherapy more engaging and facilitates remote patient recovery.
Due to the high demand for rehabilitation services following a stroke and the shortage of physiotherapists, the system developed at IPN could provide a portable tool that allows specialists to remotely monitor rehabilitation progress at home, making therapy more efficient through feedback.
Dr. Mariana Felisa Ballesteros Escamilla, a researcher at the Medical Robotics and Biosignals Laboratory of the Center for Innovation and Technological Development in Computing (CIDETEC) and the Interdisciplinary Professional Unit of Biotechnology (UPIBI), and lead researcher of the project emphasized that the initiative was developed in response to the needs identified by specialists at the General Hospital of Mexico "Dr. Eduardo Liceaga," with whom IPN collaborates and who require devices to enhance patient rehabilitation after a stroke.
In the project's initial phase, several modules were developed at the Medical Robotics and Biosignals Laboratory. These modules consist of small, lightweight boxes measuring 6 x 3.5 cm, housing an electromyographic sensor and a microcontroller embedded in a small circuit board.
“The function of these modules is to detect muscle movement and generate a digital signal, which is then wirelessly transmitted to a computer. The specialist can observe and assess whether the exercises are performed correctly,” stated Manuela Gómez Correa, M.Sc. in Computer Technology, who previously earned a Bioengineering degree for her role in developing this technology.
The young researcher added that, in addition to visualizing the signal on a screen, it is also possible to observe its intensity, providing the physician with quantitative data to verify whether the exercise is performed with the necessary strength.
This system can be customized according to the requirements of each patient. Therefore, this technology is calibrated by measuring the user's maximum muscle strength and, based on this parameter, the difficulty of the exercises is increased so that the rehabilitation is effective.
This system can be customized according to the needs of each patient. The technology is calibrated by measuring the user's maximum muscle strength. Based on this parameter, the difficulty of the exercises gradually increases to ensure effective rehabilitation.
Gómez Correa explained that performing certain exercises might cause discomfort or pain. For instance, if a movement involving the wrist is painful, some individuals might compensate by moving their shoulder. The interface can detect whether the signal amplitude matches the system's calibration. If the muscle is inactive, the interface displays a continuous line.
The game is designed with five fixed levels, which are tailored to the patient's muscle strength, exercises, and repetitions prescribed by the physiotherapist, as well as the required intensity.
All results are stored in the system, allowing specialists to review them at any time to assess the patient’s progress.
Dr. Ballesteros explained that two types of electrodes are used to generate electromyographic signals. The first type consists of dry electrodes made from medical-grade stainless steel, which conduct electricity. The second type comprises wet electrodes, which adhere to the skin and contain silver chloride to measure muscle electrical impulses.
When the correct movement is executed, the signal is transmitted via the interface to a phone, tablet, or computer.
Once the device is placed on the required body part, it can measure the desired muscle activity.
When the correct movement is performed, the signal reaches the application installed on the device (phone, tablet, or computer), displaying an animated chick that jumps when the patient completes the exercise.
The game progresses by achieving set goals, which involve performing the number of repetitions prescribed by the physiotherapist.
If the exercise is not executed with the required intensity, the chick remains still. However, when the movements are performed correctly, the animated character lays an egg, hatching into another chick, and the user advances to the next level. This game development was part of Manuela Gómez Correa’s master’s project.
Both the modules and the video game were designed in compliance with national and international regulatory standards. However, clinical trials are essential before obtaining official registration for the technology.
Dr. Ballesteros Escamilla emphasized that although the General Hospital of Mexico “Dr. Eduardo Liceaga” already possesses the devices, protocols must be followed according to regulations, which require recruiting a specific number of patients to validate the system.
“The hospital specialists conduct the clinical protocol and have a patient recruitment metric necessary for the study. The process takes time, as it requires not only stroke patients but also healthy individuals of similar age and physical conditions for comparative analysis.”
The expert in health-oriented technological development highlighted that projects undertaken at the Medical Robotics and Biosignals Laboratory at CIDETEC and UPIBI aim to solve real-world problems. Once they achieve the necessary technological maturity, they can be transferred to improve people’s quality of life.
Meanwhile, Manuela Gómez Correa noted that although the devices have not yet been officially registered, the goal is to continue working to make them available to patients. This technology aims to assist in the rehabilitation process, helping individuals regain their autonomy, self-esteem, and social inclusion.
INSTITUTO POLITÉCNICO NACIONAL
D.R. Instituto Politécnico Nacional (IPN). Av. Luis Enrique Erro S/N, Unidad Profesional Adolfo López Mateos, Zacatenco, Alcaldía Gustavo A. Madero, C.P. 07738, Ciudad de México. Conmutador: 55 57 29 60 00 / 55 57 29 63 00.
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