CAREN – a completely new type of neurorehabilitation

This article is about CAREN – a gait robot and not a person, as the name might suggest. CAREN stands for “Computer Assisted Rehabilitation ENvironment”. There are currently around eight examples of this innovative robot worldwide, one of which is located in our clinic in Vitznau.

What is CAREN?

This robot can be used to train many movement deficits, such as gait, gait speed, coordination, dual-task skills, balance, peripheral vision and much more.

The term robot does not really do CAREN justice; it is much more of a comprehensive, interactive rehabilitation environment. At the middle of this environment is a large, movable platform equipped with two integrated treadmills. This makes it possible to simulate a wide variety of walking situations – from hill climbs and slopes to obstacles and simulated earthquakes. It is complemented by a 180-degree screen that allows a variety of environments and games to be projected. This transports patients into a virtual world in which they can work on their specific rehabilitation goals in a targeted manner, as realistically as possible and under safe conditions.

How does CAREN work?

For safety reasons, patients are first secured with a special belt and self-reflective markers, motion sensors (IMUs) or EMG sensors are attached to provide real-time feedback.

After the preparations, patients can choose one of the existing games or environments in the first training sessions. Our rehab engineer or the programmers from the research institute LLUI (Lake Lucerne University Institute), with whom we collaborate, can adapt or redesign the environments to the wishes and needs of our patients. Patients can pursue different goals while standing or walking. To improve gait, for example, there is the “Rope Bridge”, where you walk across a bridge on a treadmill at a speed chosen by the therapist or yourself. Or “Italian Alps”, where you have to collect pizza ingredients on a road by stepping more to the right or left on the treadmill. Particularly challenging are “Microbes” or “Perturb”, where you either have to adjust your gait to avoid a virtual object or be disturbed by external influences (movements of the platform or the treadmill). Another example is the “Kite Flyer”, where you have to walk and control a kite at the same time to improve your dual-task skills.

What is special about CAREN?

This robot combines several functions in one and can therefore address many deficits at the same time. Another special feature is its adaptability, allowing patients to train in the environments or games in which they feel most comfortable or which motivate them the most. All training data can be measured and analyzed in real time thanks to the sensors. Thanks to real-time measurement, patients receive immediate feedback on incorrect posture or irregular gait patterns and can then correct these directly under the instruction of the therapist.

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