Posts Tagged ICT
[THESIS] Participation in everyday life after stroke : development and evaluation of f@ce – a team-based, person-centred rehabilitation intervention supported by information and communication technology
AIM: The general aim of this thesis was to generate knowledge about how Information and Communication technology (ICT) could be used in the rehabilitation process after stroke in order to develop and evaluate the feasibility of F@ce- a person-centred, team-based intervention, supported by ICT, to enable performance of daily activities and participation in everyday life for people after stroke.
METHODS: Studies I and II were qualitative grounded theory studies that were performed to generate knowledge on people after stroke and health care professionals working with rehabilitation after stroke, regarding the experiences of using ICT. The third study was a secondary analysis of a previously performed randomised controlled trial, evaluating a client-centred activities of daily living (CADL) intervention, to analyse factors of importance for a positive outcome in participation after stroke. The knowledge generated in studies I-III combined with previous research was used to develop F@ce, a team-based, person-centred intervention for rehabilitation after stroke, that was supported by ICT. Study IV was an evaluation of the feasibility of using F@ce, and the study design, in terms of the recruitment process, outcome measures used, fidelity, adherence, acceptability and potential harms.
RESULTS: People after stroke in study I described their drive to integrate ICT in their everyday lives after stroke. They used their mobile phones to feel safe, to stay connected to friends and family, and to improve physical and cognitive functions. They also used their computer for social networks, to manage daily occupations such as paying bills, online shopping and searching for information. The healthcare professionals in study II did not use ICT to any greater extent outside their office, however, they had a vision that ICT could be used as a platform for sharing information and collaboration within the rehabilitation process. The results from study III showed that within the control group (receiving usual ADL interventions) those with mild stroke and home-based rehabilitation had a better outcome in perceived participation compared to the intervention group, however, in the intervention group the difference between stroke severity and context of rehabilitation were not significant. This would indicate that the CADL intervention were specifically useful for those with moderate to severe stroke and those receiving rehabilitation at an in-patient unit. The feasibility testing of the newly developed F@ce intervention in study IV showed that it was feasible to use, and that the fidelity, adherence and acceptability of the intervention were good. The participants had positive outcomes in performance (n=4) and satisfaction with the performance (n=6) of daily activities according to Canadian Occupational Performance measure (COPM) and several participants had clinically significant improvements in different domains in the Stroke Impact Scale (SIS).
CONCLUSION: The studies within this thesis enabled the development and evaluation of a new rehabilitation intervention, F@ce, using ICT which is relevant in this time, with the rapid digitalization in the society, healthcare and rehabilitation. The knowledge from the previously developed CADL study, along with the experiences of people after stroke and healthcare professionals’ use of ICT, and the modelling of F@ce together with stakeholders created a strong foundation for the new intervention. Using a team-based, person-centred intervention with the support of ICT seemed to enable people to perform daily activities and thus increase their participation in everyday life.
List of papers:
I.Martha Gustavsson, Charlotte Ytterberg, Mille Nabsen Marwaa, Kerstin Tham & Susanne Guidetti. Experiences of using information and communication technology within the first year after stroke – a grounded theory study. Disability and Rehabilitation. 2016 (40) 561-568
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[Review] Evolution of Cognitive Rehabilitation After Stroke From Traditional Techniques to Smart and Personalized Home-Based Information and Communication Technology Systems: Literature Review – Full Text
Background: Neurological patients after stroke usually present cognitive deficits that cause dependencies in their daily living. These deficits mainly affect the performance of some of their daily activities. For that reason, stroke patients need long-term processes for their cognitive rehabilitation. Considering that classical techniques are focused on acting as guides and are dependent on help from therapists, significant efforts are being made to improve current methodologies and to use eHealth and Web-based architectures to implement information and communication technology (ICT) systems that achieve reliable, personalized, and home-based platforms to increase efficiency and level of attractiveness for patients and carers.
Objective: The goal of this work was to provide an overview of the practices implemented for the assessment of stroke patients and cognitive rehabilitation. This study puts together traditional methods and the most recent personalized platforms based on ICT technologies and Internet of Things.
Methods: A literature review has been distributed to a multidisciplinary team of researchers from engineering, psychology, and sport science fields. The systematic review has been focused on published scientific research, other European projects, and the most current innovative large-scale initiatives in the area. A total of 3469 results were retrieved from Web of Science, 284 studies from Journal of Medical Internet Research, and 15 European research projects from Community Research and Development Information Service from the last 15 years were reviewed for classification and selection regarding their relevance.
Results: A total of 7 relevant studies on the screening of stroke patients have been presented with 6 additional methods for the analysis of kinematics and 9 studies on the execution of goal-oriented activities. Meanwhile, the classical methods to provide cognitive rehabilitation have been classified in the 5 main techniques implemented. Finally, the review has been finalized with the selection of 8 different ICT–based approaches found in scientific-technical studies, 9 European projects funded by the European Commission that offer eHealth architectures, and other large-scale activities such as smart houses and the initiative City4Age.
Conclusions: Stroke is one of the main causes that most negatively affect countries in the socioeconomic aspect. The design of new ICT-based systems should provide 4 main features for an efficient and personalized cognitive rehabilitation: support in the execution of complex daily tasks, automatic error detection, home-based performance, and accessibility. Only 33% of the European projects presented fulfilled those requirements at the same time. For this reason, current and future large-scale initiatives focused on eHealth and smart environments should try to solve this situation by providing more complete and sophisticated platforms.[…]
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[Master’s thesis] Tracking, monitoring and feedback of patient exercises using depth camera technology for home based rehabilitation – ANNA RIDDERSTOLPE – Full Text PDF
Neurological and chronic diseases have profound impacts on a person’s life. Rehabilitation is essential in order to maintain and promote maximal level of recovery by pushing the bounds of physical, emotional and cognitive impairments. However, due to the low physical mobility and poor overall condition of many patients, traveling back and forth to doctors, nurses and rehabilitation centers can be exhausting tasks. In this thesis a game-based rehabilitation platform for home usage, supporting stroke and COPD rehabilitation is presented. The main goal is to make rehabilitation more enjoyable, individualized and easily accessible for the patients.
The game-based rehabilitation tool consists of three systems with integrated components: the caregiver’s planning and follow-up system, the patient’s gaming system and the connecting server system. The server back end components allow the storage of patient specific information that can be transmitted between the patient and the caregiver system for planning, monitoring and feedback purposes. The planning and follow-up system is a server system accessed through a web-based front-end, where the caregiver schedules the rehabilitation program adjusted for each individual patient and follow up on the rehabilitation progression. The patient system is the game platform developed in this project, containing 16 different games and three assessment tests. The games are based on specific motion patterns produced in collaboration with rehabilitation specialists. Motion orientation and guidance functions is implemented specifically for each exercise to provide feedback to the user of the performed motion and to ensure proper execution of the desired motion pattern.
The developed system has been tested by several people and with three real patients. The participants feedback supported the use of the game-based platform for rehabilitation as an entertaining alternative for rehabilitation at home. Further implementation work and evaluation with real patients are necessary before the product can be used for commercial purpose.
Both the demographics and lack of resources in the health and well-being industry are increasingly forcing us to find alternative solutions for individualized health and social care. In an effort to address this issue, smart technologies present enormous potential in solving this challenge. This book strives to enhance communication and collaboration between technology and health and social care sectors. The reader will receive an extensive overview of the possibilities of various technologies in care sectors (including ICT, electronics, automation, and sensor technology) written by experts from various countries. It will prove extremely useful for engineers developing well-being related systems, software, or other devices that can be used by professionals working with people with specialist needs, well-being and health service providers, educators teaching related courses, and upper level undergraduate students and graduate student studying related topics. The technology focus of the book is widespread and addresses elderly care and hospitals, in addition to solutions for various user groups, devices, and technologies. Beyond serving as a resource for nurses and people working in care sector, the book is also meant to give guidelines for engineers developing person-centered systems by exploring the integration of these technologies into service systems.
Despite the fact that stroke is the leading cause of long-term adult disability and a primary cause of death, one of the major problems in national healthcare systems is the inability to provide quality post-stroke rehabilitation. Geographical barriers, socioeconomic position, race, education, and cost all contribute to health care disparities. These disparities may not only obstruct access to the most appropriate rehabilitative care, but may contribute to psychological problems, reduced quality of life, and unsuccessful return to meaningful community participation. Information and communications technology (ICT) when combined with robotic technology can enhance the accessibility of rehabilitation in low-resource, capacity-constrained settings. In this paper we introduce a low cost, limited supervision, portable robot (H-Man) designed for upper extremity rehabilitation. A usability and feasibility study indicates that out-patient robotic treatment with the HMan leads to positive improvements in arm movement, and that the system is usable and well accepted by key stakeholders. This paper also introduces an implementation strategy to assess the effectiveness, benefits and barriers of using the H-Man robot for community-based neurorehabilitation in underserved populations, such as those that live in low income neighborhoods or in rural areas.
Stroke is the leading cause of disability in the United States, with 65% of the nearly four million people who have survived a stroke living with minor to severe impairments . It has been estimated that among the 75% of patients who survive the first month after a stroke, more than half will require specialized rehabilitation. Individuals are left with a broad range of disabilities, from mild paresis to complete paralysis of both the upper and lower extremities, proprioceptive deficits, disordered movement organization, loss of range of motion, muscle weakness and abnormal muscle tone, and impaired force generation. Impaired arm and …..
[ARTICLE] Multimedia and Gaming Technologies for Telerehabilitation of Motor Disabilities- IEEE Xplore, Full-Text PDF
Rehabilitation for chronic conditions resulting from acute or progressive disease might be delivered in an outpatient facility as in the case of telerehabilitation, selfrehabilitation and, more generally, in the context of home-based rehabilitation to improve the patients’ quality of life.
Here we present the emerging field of home-based applications for continuous digital health, focusing in particular on low-cost rehabilitation systems for motor disabilities based on multimedia and gaming technologies. Innovative technologies for telerehabilitation are illustrated. We also present recent advances in telerehabilitation, considering the most relevant projects that best represent new trends for research and development of new technologies and applications in this context. Telerehabilitation (TRH) is the provision of rehabilitation services at a distance using information and communication technologies (ICT) . TRH services might be needed for diagnosis, assessment, consultations, and monitoring, as well as to supervise therapies or therapeutic settings or to propose interactive therapies. Rather than being described as a super specialization of rehabilitation, therefore, TRH should be viewed as an alternative way to deliver rehabilitation services, particularly suited for chronic conditions that might benefit from home-based care. It has been demonstrated, in fact, that improving motor function, a major goal of any rehabilitative treatment, should be pursued even in the chronic stages of disabling condition, like stroke, Parkinson’s disease, and multiple sclerosis, for which telemedicine could be seen as a great opportunity to allow remote diagnosis and clinical monitoring.
The aim of this article is to present the emerging field of homebased applications for continuous digital health, focusing in particular on low-cost TRH systems for motor disabilities that adopt diffused ICT for gaming and multimedia as well as the networking connection…