(Dissemination Budget Open Only - 103) Jane Burridge NIHR i4i: Mechanical Muscle Activity with Real-time Kinematics (M-MARK): A novel combination of existing technologies to improve arm recovery following stroke

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 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.