1. Mechanical Muscle Activity with Real-time Kinematics (M-MARK): A novel
combination of existing technologies to improve arm recovery following
stroke
Led by Professor Jane Burridge, the team will create a wireless sleeve, which will
provide automatic intelligence about muscle movement and strength while
patients practice every-day tasks at home.
The data will be available on a tablet to feedback and encourage patients as well
as to allow therapists to tailor the rehabilitation programme.
The two-year project has been funded with a ~£1 million grant from Invention
for Innovation (i4i), which is part of the National Institute for Health Research
(NIHR) and is a collaboration between the Universities of Southampton and
Imperial College. The sleeve will be developed and trialed at North Bristol NHS
Trust and Portsmouth Hospitals NHS Trust. The project is also in collaboration
with two medical technology companies: Maddison, who lead on the commercial
design of the M-MARK and Tactiq who lead on the electronic assembly, safety
testing and CE marking.
M-MARK will help stroke patients regain arm function by supporting
independent home-exercise. It will reduce time spent with therapists and allow
patients to have the recommended 45 minutes daily therapy more flexibly. It will
diagnose patients’ problems accurately and more cheaply and practically than
using laboratory-based technologies.
M-MARK will provide feedback on an iPAD, using either an avatar (a human-like
figure that mimics patients’ movements) or through success playing games.
Patients practise movement tasks, such as reaching to pick up a cup. Feedback
during and after movements shows whether they have moved and used their
muscles correctly, such as reaching by extending their arm rather than leaning
forward. The therapists’ version, with different software and interfaces, will
provide important information for clinical decision-making, treatment and
progress, making therapy more efficient and effective. Patients and therapists
told us that this is what is needed.
Stroke survivors leave hospital as soon as possible to receive rehabilitation at
home, but about 60% fail to regain useful arm function. Intensive practice leads
to better recovery, but re-learning to move more normally is also important and
is traditionally guided by therapists, which is expensive. This low-cost wearable
device will provide guidance and feedback automatically. It will measure arm
movements using movement sensors like those in a mobile phone and muscle

2. activity using a device like a microphone that detects vibration when muscles are
active. Together they will describe amount and quality of movement.
We have built a prototype and demonstrated that it can generate the information
needed. Working with patients and therapists we will develop, validate and
feasibility-test a commercial (Mark2) device incorporating user interfaces,
wireless connectivity and an easy-to-don garment. We will CE mark it, examine
potential cost savings to the NHS and produce a business plan for
commercialization and implementation throughout the NHS.
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