EMBEDDED ARTS FOR MOVEMENT RETRAININGLise Worthen-Chaudhari

DescriptionEmbedded Arts is an interactive computer program

designed as a rehabilitation biofeedback tool. The purpose of the system is to tap into artistic and creative neural pathways during performance of standard rehabilitation exercises. Using real-time data from biophysical sensors, the program integrates creative process within rehabilitation protocols by translating movement into art.

Therapy and Neurorehab

“This ability of our neural wiring to reroute when given the right stimuli can be a powerful agent for recovery and has, since the 1980s, emerged as the most promising phenomenon for facilitating neurorehabilitation.”

Nudo & Dancause (2007) in Brain Injury Medicine: Principles and Practices

http://www.youtube.com/watch?v=MABD7sYplkk

Purpose

• enable patients to create fun, individualized images that would be aesthetically and kinesthetically satisfying, but that would also represent a patient's personal healing through the process of activity-based medicine.

Hypothesis

• Embedding interactive arts processes within rehabilitation exercises may improve outcomes– Increasing gains in physical tacit knowledge

construction– Improving patient attention and compliance– Enhancing clinician tracking

Leveraged Phenomenon• Implicit Learning Gentile (1998 )

– Can’t be imparted explicitly from outside.• Immersive Learning Mirelman (2010), Keshner

– Multi-sensory (aka multi-modal)• Both

Deeply felt on embodied level during performance.

Implicit & Immersive• Research– Stroke Patton et al. (2004, 2005); Pohl et al. (2006); Boyd et al. (2010) , Mirelman (2010)

– Parkinson’s Witt et al. (2006), Keshner, Thaut

• Examples– Robotics & video gaming– Arts generative experiences Worthen-Chaudhari (2011), Modugno (2011)

Implicit & Immersive

• Acknowledged for importance in cognitive knowledge construction but underused for physical knowledge construction

• Participation and Engagement

Design Research• Asked the experts

– Patients, artists, and clinicians – Feedback was iterative process of using the program, getting

feedback, implementing improvements (exploration within the exploration)

• Results– Practical issues addressed– Dancers suggested explicit use instructions while patients tended

to figure out for themselves. – Artists were logical/pragmatic while clinicians were artistic.

Feasibility Study• 8 patients single session• 6 patients longitudinal study• Results

– No AE– Feasible to incorporate the technology in clinical practice– Accepted and desired by patients & clinicians – Limiting factors:

• Time for computer to boot• IT support for secure data storage• Access to EA “concierge” help as needed

Summary• Interactive arts technologies enhance standard rehabilitation• Embedding creative process within rehabilitation may

improve outcomes • Outputting artistic work from rehabilitation exercises adds

economic element to rehabilitation endeavors• Motion capture data transformed for feedback and recorded

for quantitative outcomes analysis in the clinic and home health settings

• Artistic nature of personal movement in a rehabilitation setting is explored

Conclusion

In the rehabilitation paradigm, movement is medicine. In the dance paradigm, movement is art. Often, a single movement can be both. Perhaps, through the phenomemon of movement, the arts and medicine are more interdependent than we previously imagined.

Worthen-Chaudhari (2011) New Partnerships Between Dance and Neuroscience: Embedding the Arts for Neurorecovery, Dance Research Journal, 29.2, p 469.

Acknowledgements

• This project has been partially funded by the College of Arts & Sciences, Department of Dance, Department of Physical Medicine and Rehabilitation, and the Medical Center Alumni Association at The Ohio State University.

• Special thanks to: Helen Alkire, Brad Burns, Chuck Crosby, John Griffith, Ashley Hahn, Joseph F. Kuspan, Jill Sarina, Aaron Wolfe (artists), Michael Kelly Bruce, David Covey, Susan Petry (Dance), D. Michele Basso (Health & Rehab Sciences), W. Jerry Mysiw (PM&R), staff of the NeuroRecovery Network and Dodd Inpatient clinics at OSUWMC, my children and my husband, Dr. Ajit Chaudhari.

Design constraints• Action painting aesthetic

“…shifted the emphasis from the object [of art] to the struggle itself, with the finished painting being only the physical manifestation, a kind of residue, of the actual work of art, which was in the act or process of the painting’s creation.”

http://en.wikipedia.org/wiki/Action_painting

• Random aesthetic elements

Future Directions

• Phase II Effectiveness Study • Implement programs found to be feasible and

effective (Dodd Hospital - all floors)

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Yadev V, Schmiedeler J, McDowell SK, Worthen-Chaudhari LC. Quantifying age-related differences in human reaching while interacting with a rehabilitation robotic device, Journal of Applied Biomechanics and Bionics accepted 2010.