Posts Tagged interactive

[WEB SITE] imHere Homepage – mHealth Platform for Self-management

IMHERE

Interactive Mobile Health and Rehabilitation

iMHere is an mHealth platform promoting clinician-guided self-care to patients with chronic diseases. Internet accessibility provides a secure bridge between patients’ smartphone applications and a web-based clinician portal, and successfully empowers patients to perform subjective self-care and preventative measures. The app was designed to send monitorial data to the portal and also receive output regarding self-care regimens as recommended by the attending clinician. The combination of interactive, real-time medical monitoring with patient control offers a powerful, unique solution for patients living with chronic illnesses where cognitive and physical disabilities present significant barriers to effective self-care.

Using a web-based portal, the clinician (typically a nurse coordinator, social worker, case manager, or patient advocate) could monitor patients’ compliance with regimens and indicate self-care plans to be delivered to the patient via the app, allowing the clinician to monitor a patient’s status and intervene as needed. Clinicians could use the portal to tailor a regimen or treatment plan for each and every patient (e.g. scheduled medication, wound care instructions, etc.) and the portal would consolidate the plan to the smartphone app in real time—an advancement over existing comparable health portals which cannot push data to the app. Results of clinical implementation suggest that the iMHere app was successful in delivering values for patients and in engaging them to comply with treatment. In the first 6 months of the clinical implementation, patients have been consistently using the app for self-management tasks and to follow the regimes set up by their respective clinicians. We observed that the daily usage increased significantly in the first two months (from approximately 1.3-times/day to over 3-times/day), and then plateau at around 3.5 times per day per patient. This pattern of increasing usage in the first two months and the subsequent plateau is relatively consistent across all patients. The app is currently available in Android platform with an iPhone version under development.

via imHere Homepage – mHealth Platform for Self-management

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[Abstract] Optimizing Hand Rehabilitation Post-Stroke Using Interactive Virtual Environments

The main goal of this project is to refine and optimize elements of the virtual reality-based training paradigms to enhance neuroplasticity and maximize recovery of function in the hemiplegic hand of patients who had a stroke.

PIs, Sergei Adamovich, Alma Merians, Eugene Tunik, A.M. Barrett

This application seeks funding to continue our on-going investigation into the effects of intensive, high dosage task and impairment based training of the hemiparetic hand, using haptic robots integrated with complex gaming and virtual reality simulations. A growing body of work suggests that there is a time-limited period of post-ischemic heightened neuronal plasticity during which intensive training may optimally affect the recovery of gross motor skills, indicating that the timing of rehabilitation is as important as the dosing. However, recent literature indicates a controversy regarding both the value of intensive, high dosage as well as the optimal timing for therapy in the first two months after stroke. Our study is designed to empirically investigate this controversy. Furthermore, current service delivery models in the United States limit treatment time and length of hospital stay during this period. In order to facilitate timely discharge from the acute care hospital or the acute rehabilitation setting, the initial priority for rehabilitation is independence in transfers and ambulation. This has negatively impacted the provision of intensive hand and upper extremity therapy during this period of heightened neuroplasticity. It is evident that providing additional, intensive therapy during the acute rehabilitation stay is more complicated to implement and difficult for patients to tolerate, than initiating it in the outpatient setting, immediately after discharge. Our pilot data show that we are able to integrate intensive, targeted hand therapy into the routine of an acute rehabilitation setting. Our system has been specifically designed to deliver hand training when motion and strength are limited. The system uses adaptive algorithms to drive individual finger movement, gain adaptation and workspace modification to increase finger range of motion, and haptic and visual feedback from mirrored movements to reinforce motor networks in the lesioned hemisphere. We will translate the extensive experience gained in our previous studies on patients in the chronic phase, to investigate the effects of this type of intervention on recovery and function of the hand, when the training is initiated within early period of heightened plasticity. We will integrate the behavioral, the kinematic/kinetic and neurophysiological aspects of recovery to determine: 1) whether early intensive training focusing on the hand will result in a more functional hemiparetic arm; (2) whether it is necessary to initiate intensive hand therapy during the very early inpatient rehabilitation phase or will comparable outcomes be achieved if the therapy is initiated right after discharge, in the outpatient period; and 3) whether the effect of the early intervention observed at 6 months post stroke can be predicted by the cortical reorganization evaluated immediately after the therapy. This proposal will fill a critical gap in the literature and make a significant advancement in the investigation of putative interventions for recovery of hand function in patients post-stroke. Currently relatively little is known about the effect of very intensive, progressive VR/robotics training in the acute early period (5-30 days) post-stroke. This proposal can move us past a critical barrier to the development of more effective approaches in stroke rehabilitation targeted at the hand and arm.

via Hand Rehabilitation Post Stroke

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[WEB SITE] Electronic Caregiver Enters Clinical Trials With G60Trauma.org

 Dec. 7, 2018

PHOENIXDec. 7, 2018 /PRNewswire/ — Virtual Caregiving is set to enter both the healthcare industry and patient home settings. In January 2019, G60 Trauma (G60Trauma.org) will begin testing Addison Care, the world’s first, comprehensive virtual caregiving system to provide real time, 24/7 patient monitoring and care.

Dr. Alicia Mangram (center) and G60 Trauma staff visit the Electronic Caregiver tower in downtown Las Cruces, New Mexico.

Addison Care provides exciting new components to an interactive voice platform to demonstrate an interactive, augmented reality feature tied to visual sensing and connected home devices. Now, not only can you have a two-way conversation with an Electronic Caregiver, but the technology comes alive with an expertly designed augmented reality character named Addison, developed on AWS Sumerian. Addison provides a breakthrough user interface.

What can Addison do? In a clinical setting, Addison can greet a patient, recognized through facial recognition, conduct a verbal health examination, collect vitals, and even direct a comprehensive gait and balance session to determine the probability of a ground level fall in a particular patient. In the residential environment, Addison provides medication reminders, verifies medication consumption, provides medical test reminders, monitors vitals, demonstrates rehabilitation exercises, assesses a patient’s progress, mood, fall risk and responses to escalating conditions and emergencies including contacting responders or caregivers in time of patient need.

How does Addison work? A network of wireless visual sensors, local AI (artificial intelligence)-based processors, interactive tablets, Bluetooth biometric devices and emergency monitoring devices will be setup in a residence. Addison Care will be marketed and supported by a network of nationwide private duty home care providers that will serve as both live caregivers and Addison Care representatives. CEO of SDS, Anthony Dohrmann said, “Our goal is to expand affordable population health careto the masses, while lightening the burden on providers and payers. We are delivering an exciting new form of technology to patients and the active aging to improve their quality of life and health outcomes.” Addison will be making its debut at the Las Vegas Consumer Electronics Show January 8-11, 2019, Booth: Sands Convention Center Halls A-D – 42142.

Why partner with G60 Trauma Organization? Dr. Alicia Mangram, founder of G60 Trauma in Phoenix, Arizona, is a surgeon and acclaimed trauma specialist who has devoted her career to improving trauma care through advocacy, surgical and critical care research, education and community services. G60 Trauma is a specialized care program designed for trauma patients over the age of 60, with the goal of optimizing their recovery and safely discharging them back to their homes. This partnership will allow us to study hundreds of patients who have had a ground level fall and provide us with the data and information we need to continue producing products and services geared toward prevention and superior outcomes.

With an expert research team of professionals behind hundreds of successful research publications and processes, G60 Trauma team will be conducting an expansive study involving over 500 patients to document the effectiveness of Addison Care and Electronic Caregiver on improving patient outcomes, increasing patient and family satisfaction, reducing hospital readmission and reducing mortalities. Also, improving treatment adherence with the hope of validating a more effective, outcome based, continuum of care capable of reducing the long-term pressures and costs associated with long-term care and chronic disease management.

“The costs of treatment non-adherence have been reported to be as high as $300B annually and is noted as being responsible for 50% of all treatment failures. In a period of nursing and physician shortages, where home care is inadequate in frequency partly due to high cost, our hope is that Addison Care and Electronic Caregiver can fill the gap in patient care and bring better outcomes to the masses,” Dr. Alicia Mangram stated.

About SameDay Security, Inc. and Electronic Caregiver

SameDay Security (SDS) is one of the fastest growing monitored technology providers in the U.S. and one of only a handful of nationwide service providers. Known as the Electronic Caregiver CompanyTM and founded in 2009, SDS currently provides automated home care solutions and safety devices nationwide to thousands of clients. SDS has invested over $35,000,000 in patient screenings, research and development. SDS will disclose a new capital offering after CES to fuel new product launches and expansion. SDS has developing contracts with hundreds of home care partners across America who will participate in Addison Care marketing to their clients. New clinical trials are scheduled with G60 Trauma of Phoenix, Arizona, involving 500 patients over 3 years to determine the impact on patient outcomes, cost reduction, lower hospitalization, chronic disease management and long-term care. Electronic Caregiver employs over 70 employees and is headquartered in Las Cruces, New Mexico. www.electroniccaregiver.com

About G60Trauma.org
G60 is a specialized trauma care program developed by Dr. Alicia Mangram. Since 2009, Dr. Mangram has devoted her career to improving trauma care through advocacy, surgical and critical care research, education and community services. In the beginning of her career, she quickly realized that a traumatic injury in patients 60 years and older could occur from a simple fall resulting in a hip fracture. The traditional approach was to admit them to a medical facility and await medical clearance for pre-existing conditions such as diabetes, heart disease, etc. prior to any surgery.

While patients waited for medical clearance, other medical related complications could develop. Recognizing the cause of these complications lead to a paradigm shift and implementing an aggressive care approach for our G60 population. Through evidence-based research, Dr. Mangram and her team developed a care plan to address the needs of G60 trauma patients. These care plans achieved several goals, such as: Expedited early identification in the ER, admission to trauma service, alternative pain management modalities, for example, hip block, multidisciplinary care rounds with integration of the Biopsychosocial Model, evaluation of care approach through research and data analysis, achievement of optimal level of functioning and independence upon discharge.

Electronic Caregiver logo. (PRNewsfoto/Electronic Caregiver)

View original content to download multimedia:https://www.prnewswire.com/news-releases/electronic-caregiver-enters-clinical-trials-with-g60traumaorg-300762135.html

SOURCE Electronic Caregiver

 

via Electronic Caregiver Enters Clinical Trials With G60Trauma.org | Markets Insider

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[ARTICLE] Improving executive function deficits by playing interactive video-games: secondary analysis of a randomized controlled trial for individuals with chronic stroke

BACKGROUND: Executive function deficits negatively impact independence and participation in everyday life of individuals with chronic stroke. Therefore, it is important to explore therapeutic interventions to improve executive functions.
AIM: The aim of this study was to determine the effectiveness of a 3-month interactive video-game group intervention compared to a traditional motor group intervention for improving executive functions in individuals with chronic stroke.
DESIGN: This study is a secondary analysis of a single-blind randomized controlled trial for improving factors related to physical activity of individuals with chronic stroke. Assessments were administered pre and post the intervention and at 3-month follow-up by assessors blind to treatment allocation.
METHODS: Thirty-nine individuals with chronic stroke with executive function deficits participated in an interactive video-game group intervention (N.=20) or a traditional group intervention (N.=19). The intervention included two 1-hour group sessions per week for three months, either playing video-games or performing traditional exercises/activities. Executive function deficits were assessed using The Trail Making Test (Parts A and B) and by two performance-based assessments; the Bill Paying Task from the Executive Function Performance Test (EFPT) and the Executive Function Route-Finding Task (EFRT).
RESULTS: Following intervention, scores for the Bill Paying Task (EFPT) decreased by 27.5% and 36.6% for the participants in the video-game and traditional intervention, respectively (F=17.3, P<0.000) and continued to decrease in the video-game group with small effect sizes. Effect size was small to medium for the TMT-B (F=0.003, P=0.954) and EFRT (F=1.2, P=0.28), without any statistical significance difference.
CONCLUSIONS: Interactive video-games provide combined cognitive-motor stimulation and therefore have potential to improve executive functioning of individuals with chronic stroke. Further research is needed.
CLINICAL REHABILITATION IMPACT: These findings highlight the potential of utilizing interactive video-games in a small group for keeping these individuals active, while maintaining and improving executive functioning especially for individuals with chronic stroke, who have completed their formal rehabilitation.

Source: Improving executive function deficits by playing interactive video-games: secondary analysis of a randomized controlled trial for individuals with chronic stroke – European Journal of Physical and Rehabilitation Medicine 2016 August;52(4):508-15 – Minerva Medica – Journals

 

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[WEB SITE] Epilepsy App Tracks Seizures

Patients with epilepsy can now track their seizures using an app downloaded onto their Apple Watch.

The interactive EpiWatch app, developed by researchers at Johns Hopkins Medicine in Baltimore, Maryland,, works with ResearchKit, an open-source framework designed by Apple to facilitate research studies carried out using its devices.

The information that’s collected by patients with epilepsy will eventually be used to develop a seizure detector, said Nathan Earl Crone, MD, co-director, clinical neurophysiology fellowship program and associate professor of neurology.

The interactive app enables patients to track seizures in real time. After downloading and installing the free app, patients are provided with a unique code. When they get an indication that they’re having a seizure, they simply activate the function, and the app continuously collects gyroscope, accelerometer, and heart rate data.

The coded data are uploaded to a server. None of the patient’s personal information is identifiable, said Dr. Crone.

At the end of the seizure, patients are given a short quiz asking about what kind of seizure they just had, how long it lasted, and whether they had a warning, “although by and large if they activated the app, they did have a warning,” said Dr Crone.

The app also has “built in” surveys gathering information on medication adverse effects, adherence, and seizure triggers, he said. Its journaling function prompts users to answer a series of questions on a daily basis, including: Have you had a seizure today? If so, what type of seizure was it? Did you take your medication? If not, why not?

“It’s very interactive” and includes text messaging capabilities, said Dr Crone. If patients don’t respond to a vibration or sound alert asking them to verify they’re having a seizure, a message can be sent to a family member or caregiver.

Users can review their data and compare their symptoms to those of others in their demographic with similar seizures.

All this will be useful information for researchers. Dr Crone and his colleagues will be using a “research dashboard” to keep tabs on how many patients are getting the app and how many seizures they’re tracking. “We will looking at the data as it comes in.”

Researchers aim to eventually use the data to develop a seizure detector that will be included in the app. Such a detector should come in handy in determining whether a seizure was falsely detected, said Dr Crone.

Over 2.5 million people are living with epilepsy in the United States. Any of these patients older than age 16 years could take advantage of the new app, said Dr Crone.

He would obviously like as many of these patients as possible to use the seizure tracker.

“Honestly, if a couple of thousand patients were to use it and actively contribute seizure data, it would be a success in my eyes. But I’m hoping that we will do even better than that.”

The app also works with the iPhone, but users won’t be able to participate in all research activities, said Dr Crone.

Source: Epilepsy App Tracks Seizures

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