Design and evaluation of Driver's SEAT: A car steering simulation environment for upper limb stroke therapy

Hemiplegia, affecting approximately 75% of all stroke survivors, is a common neurological impairment that results in upper and lower limb sensory and motor deficits. Recovery of coordinated movement of both upper limbs is important for bilateral function and promotes personal independence. This paper describes the philosophy and design of Driver's Simulation Environment for Arm Therapy, a one-degree-of-freedom robotic device that uses a modified Constraint-Induced therapy paradigm to promote coordinated bilateral movement in the upper limbs. Baseline force and tracking data for four neurologically unimpaired subjects who completed bilateral and unilateral steering with the impaired arm using the device are presented.