CAREN (system)

CAREN (Computer Assisted Rehabilitation Environment) protocol—is a versatile, multi-sensory virtual reality system used for treatment and rehabilitation of human locomotion, or walking, as well as pain, posture, balance spinal stability and motor control integration.[1][2][3]

History

MOTEK was founded in 1993 as a privately held motion capture, animation and visualization studio.

The early mission of MOTEK focused on the development and implementation of innovative animation and visualization techniques focusing on real time generation of realistic animation.

The company managed project work to ensure growth without the need for venture capital or going public until 1998. In 1997, MOTEK had applied for a research grant to the European commission in order to develop the system now known as CAREN. This grant was received in 1998 and enabled the development of CAREN's 1st prototype.

The company also received external funding through TWINNING and NPM capital, both Dutch based investment companies.

The 1st production grade CAREN system was sold to the University of Groningen in 2000. Within the annals of CAREN’s beginnings, the technology was being used primarily by scientific and military organizations because of the sheer complexity of its modern intricacies and somewhat complicated testing.[4][5][6]

About

From a general public point of view, one of the first glimpses of the CAREN was seen in Peter Berg's sci-fi alien thriller Battleship. In the action-packed film based on the legendary board game, a scene depicting a real life ex-soldier who has lost both his legs walking in a virtual reality simulator hints at the incredible possibilities for this technology. The promise of a new dawn in technologies for the medical markets is at the core of what makes the CAREN platform so intriguing, yet it also goes further to encompass early diagnostics, rehabilitation, motor training and research.

The CAREN system is the brainchild of Motek Medical, and remains the company’s flagship product as an immersive virtual reality entity that uses motion capture elements for clinical and research settings. The system consists of a motion base, the aforementioned motion capture element, a projection screen and Motek’s D-flow software, with three default models available – all of which can be tailored for specific needs. In its most basic form, CAREN is fully tailored for posture and balance-related applications, containing components including a hydraulic six-DOF motion base, two-millimeter diameter platform top with integrated dual force plates, eight-camera real-time motion capture system, large flat-screen projection system, surround sound system and the D-flow software package.

The CAREN Extended system represents a significant upgrade from the CAREN Base, with the major differences being the additions of a dual-belt instrumented treadmill mounted on the motion base and a wider peripheral vision scope. Bespoke for both balance and all gait applications, the CAREN Extended contains a cylindrical projection system that allows for peripheral vision up to 180 degrees. The system’s components are a six-DOF motion base, three meter diameter platform top with aforementioned dual-belt instrumented treadmill, 10-camera real-time motion capture system, the aforementioned projection system with 120 to 180-degree cylindrical screen, surround sound system and the D-flow software.

The range-topping CAREN High-End model represents the most advanced setup, boasting a 360-degree dome for a “full-immersion virtual reality experience.” Additional components of this product include a six-DOF motion base with 1,000-kg payload, three-millimeter diameter platform top with dual-belt instrumented treadmill, 18-camera real-time motion capture system, spherical dome projection, surround sound system and, of course, the D-flow software architecture. Amongst the facilities utilizing this advanced CAREN system are the Brooke Army Medical Center in Texas and the SHEBA Medical Center in Tel Aviv, Israel.

Supplementing all CAREN configurations are Motek Medical-provided integrated components designed to further enhance the use of the systems. These consist of EMG (Electro-Myography), video capture, tailored motion capture suits, data gloves, haptic systems, energy consumption system, pressure measurement systems, heart rate measurement systems and head mount displays.

Usage of CAREN nowadays

Today, there has been a great use for Motek Medical’s CAREN in the medical practitioners area, with the first private clinic to use the system for a civilian demographic being New York’s Dynamic Neuromuscular Rehabilitation & Physical Therapy, founded by Dr. Lev Kalika. The Cleveland Clinic was the next facility to look into CAREN for more personal, rehabilitative and medical applications, and as of now – the close of 2014 – these two clinics are the only ones of their kind using the CAREN system in the U.S.{16}

References

  1. ↑ van der Eerden WJ, Otten E, May G, Even-Zohar O (1999). "CAREN--Computer Assisted Rehabilitation Environment". Studies in Health Technology and Informatics. 62: 373–8. doi:10.3233/978-1-60750-906-6-373. PMID 10538390.
  2. ↑ van den Bogert AJ, Geijtenbeek T, Even-Zohar O, Steenbrink F, Hardin EC (October 2013). "A real-time system for biomechanical analysis of human movement and muscle function". Medical & Biological Engineering & Computing. 51 (10): 1069–77. doi:10.1007/s11517-013-1076-z. PMC 3751375Freely accessible. PMID 23884905.
  3. ↑ Geijtenbeek, Thomas; Steenbrink, Frans; Otten, Bert; Even-Zohar, Oshri (2011). "D-flow: immersive virtual reality and real-time feedback for rehabilitation". Proceedings of the 10th International Conference on Virtual Reality Continuum and Its Applications in Industry - VRCAI '11. pp. 201–8. doi:10.1145/2087756.2087785. ISBN 978-1-4503-1060-4.
  4. ↑ Collins, John-David; Markham, Amanda; Service, Kathrine; Reini, LT Seth; Wolf, Erik; Sessoms, Pinata (August 2014). "A systematic literature review of the use and effectiveness of the computer assisted rehabilitation environment for research and rehabilitation as it relates to the wounded warrior". Work. doi:10.3233/WOR-141927. PMID 25167904.
  5. ↑ Kaufman KR, Wyatt MP, Sessoms PH, Grabiner MD (October 2014). "Task-specific fall prevention training is effective for warfighters with transtibial amputations". Clinical Orthopaedics and Related Research. 472 (10): 3076–84. doi:10.1007/s11999-014-3664-0. PMID 24811543.
  6. ↑ Isaacson BM, Swanson TM, Pasquina PF (July 2013). "The use of a computer-assisted rehabilitation environment (CAREN) for enhancing wounded warrior rehabilitation regimens". The Journal of Spinal Cord Medicine. 36 (4): 296–9. doi:10.1179/2045772313Y.0000000119. PMC 3758526Freely accessible. PMID 23820145.

Further reading

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