Posts Tagged measurement
[Abstract] Information Management in IoT Cloud-Based Tele-Rehabilitation as a Service for Smart Cities: Comparison of NoSQL Approaches
Posted by Kostas Pantremenos in REHABILITATION, Tele/Home Rehabilitation on November 12, 2019
Abstract
Nowadays, recent advancements in ICT have sped up the development of new services for smart cities in different application domains. One of these is definitely healthcare. In this context, remote patient monitoring and rehabilitation activities can take place either in satellite hospital centres or directly in citizens’ homes. Specifically, using a combination of Cloud computing, Internet of Things (IoT) and big data analytics technologies, patients with motor disabilities can be remotely assisted avoiding stressful waiting times and overcoming geographical barriers. This paper focuses on the Tele-Rehabilitation as a Service (TRaaS) concept. Such a service generates healthcare big data coming from remote rehabilitation devices used by patients that need to be processed in the hospital Cloud. Specifically, after a feasibility analysis, by using a Lokomat dataset as sample, we measured and compared the performances of four of the major NoSQL DBMS(s) demonstrating that the document approach well suits our case study.
[Abstract + References] Complex network changes during a virtual reality rehabilitation protocol following stroke: a case study
Posted by Kostas Pantremenos in Virtual reality rehabilitation on May 25, 2019
Abstract
References
[ARTICLE] Outcome Measures for Persons With Moderate to Severe Traumatic Brain Injury: Recommendations From the American Physical Therapy Association Academy of Neurologic Physical Therapy TBI EDGE Task Force – Full Text
Posted by Kostas Pantremenos in Uncategorized on December 5, 2018
Background and Purpose: The use of standardized outcome measures (OMs) is essential in assessing the effectiveness of physical therapy (PT) interventions. The purposes of this article are (1) to describe the process used by the TBI EDGE task force to assess the psychometrics and clinical utility of OMs used with individuals with moderate to severe traumatic brain injury (TBI); (2) to describe the consensus recommendations for OM use in clinical practice, research, and professional (entry-level) PT education; and (3) to make recommendations for future work.
Methods: An 8-member task force used a modified Delphi process to develop recommendations on the selection of OMs for individuals with TBI. A 4-point rating scale was used to make recommendations based on practice setting and level of ambulation. Recommendations for appropriateness for research use and inclusion in entry-level education were also provided.
Results: The TBI EDGE task force reviewed 88 OMs across the International Classification of Functioning, Disability, and Health (ICF) domains: 15 measured body functions/structure only, 21 measured activity only, 23 measured participation only, and 29 OMs covered more than 1 ICF domain.
Discussion and Conclusions: Recommendations made by the TBI EDGE task force provide clinicians, researchers, and educators with guidance for the selection of OMs. The use of these recommendations may facilitate identification of appropriate OMs in the population with moderate to severe TBI. TBI EDGE task force recommendations can be used by clinicians, researchers, and educators when selecting OMs for their respective needs. Future efforts to update the recommendations are warranted in order to ensure that recommendations remain current and applicable.
Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A140).
INTRODUCTION
The use of standardized outcome measures (OMs) in physical therapy (PT) practice is growing and becoming the standard of practice. Evidence of intervention effectiveness depends on, among other things, common use of valid and reliable tests and measures, which reflect clinically important outcomes and are responsive to change. An important initial step toward best practice is the identification and selection of the most appropriate OMs for patients whom therapists treat. However, clinicians may be uncertain in how to select the best OM based on an individual’s specific limitations.1,2 Common barriers to using OMs include the time required to learn or use them, perceptions that OMs are too difficult for patients to understand, and the time burden for clinicians to score and analyze test results.3 The ability to track patient progress during recovery from a neurologic condition improves with the use of standardized OMs that are employed across settings. In addition, the use of common OMs may facilitate ongoing clinical research.
To address some of these issues, the Academy of Neurologic Physical Therapy of the American Physical Therapy Association (APTA) began a process to develop recommendations for the identification of core sets of OMs in 2009. A Research Section of APTA task force, the Evaluation Database to Guide Effectiveness (EDGE), was developed to make recommendations for OM utilization in PT practice. Building on recommendations from that group, members of the Academy of Neurologic Physical Therapy initiated what was described as an “EDGE group” focusing on the stroke population. This group established a yearlong process for rating and evaluating OMs, which culminated in the StrokEDGE report.4 The following year, the process was followed by a group focused on OMs for patients with Multiple Sclerosis.5 In the fall of 2011, the Academy of Neurologic Physical Therapy initiated task forces to evaluate OM use in traumatic brain injury (TBI) and spinal cord injury. Task forces looking at vestibular dysfunction and Parkinson disease measures were conducted the following year.
The choice of appropriate OMs for use with TBI can be a challenge. Traumatic brain injury is a chronic health condition that affects physical, cognitive, and behavioral function, often in heterogenous ways. Outcome measures must accommodate a large range of physical and cognitive strengths and limitations. Clinicians must be aware of the complexity of this diagnosis to determine which OMs are most appropriate.6 After TBI, individuals are treated in a wide variety of settings, including intensive care units, acute care, in- and outpatient rehabilitation settings, long-term care facilities, and in the home. The environment, available space and equipment, as well as the individual’s cognitive and physical limitations, all influence which OMs are feasible and appropriate.
The objectives of the TBI EDGE task force were:
- to develop recommendations for clinicians, educators, and researchers for the use of standardized OMs to utilize throughout the continuum of care of the TBI population and span the domains of the International Classification of Functioning, Disability, and Health (ICF) and,
- following the Academy of Neurologic Physical Therapy Board of Directors approval, to disseminate recommendations through available avenues such as the section Web site, conference presentations, and publications.
The work of each EDGE task force had traditionally been completed in a year period, requiring a scope sufficiently focused to be feasible with a limited volunteer workforce. It is the goal of this article to describe the yearlong processes that were used to create recommendations for OM utilization in the TBI patient population in clinical practice, as well as additional recommendations for inclusion into entry-level PT curricula and for use in research.[…]
Continue —> Outcome Measures for Persons With Moderate to Severe Traumat… : Journal of Neurologic Physical Therapy
[BOOK] Epilepsy Across the Spectrum – NCBI Bookshelf
Posted by Kostas Pantremenos in Books, Caregivers, Epilepsy on March 9, 2018
Epilepsy Across the Spectrum
Institute of Medicine (US) Committee on the Public Health Dimensions of the Epilepsies; Editors: Mary Jane England, Catharyn T Liverman, Andrea M Schultz, and Larisa M Strawbridge.
Excerpt
Throughout this report, the committee emphasizes the ways in which epilepsy is a spectrum disorder. Epilepsy comprises more than 25 syndromes and many types of seizures that vary in severity. Additionally, people who have epilepsy span a spectrum that includes men and women of all ages and of all socioeconomic backgrounds and races/ethnicities, who live in all areas of the United States and across the globe. The impacts on physical health and quality of life encompass a spectrum as well, with individuals experiencing different health outcomes and having a range of activities of daily living that may be affected, including driving, academic achievement, social interactions, and employment. For some people, epilepsy is a childhood disorder that goes into remission (although the seizures may have lifelong consequences), while for others it is a lifelong burden or a condition that develops later in life or in response to an injury or other health condition. These many complexities of epilepsy make it a challenging health condition to convey to the general public to promote understanding and alleviate stigma. This report aims to provide evidence and impetus for actions that will improve the lives of people with epilepsy and their families.
Contents
- THE NATIONAL ACADEMIES
- COMMITTEE ON THE PUBLIC HEALTH DIMENSIONS OF THE EPILEPSIES
- Reviewers
- Preface
- Acknowledgments
- Acronyms
- Summary
- SCOPE OF WORK
- A VISION FOR THE FUTURE
- INCREASING THE POWER OF EPILEPSY DATA
- PREVENTING EPILEPSY
- IMPROVING HEALTH CARE
- IMPROVING COMMUNITY RESOURCES AND QUALITY OF LIFE
- RAISING AWARENESS AND IMPROVING EDUCATION
- STRENGTHENING STAKEHOLDER COLLABORATION
- ENGAGING PEOPLE WITH EPILEPSY AND THEIR FAMILIES
- PROMOTING HEALTH AND UNDERSTANDING
- 1. Introduction
- 2. Surveillance, Measurement, and Data Collection
- 3. Epidemiology and Prevention
- 4. Health Care: Quality, Access, and Value
- 5. Health Professional Education
- DEMONSTRATED KNOWLEDGE GAPS
- ATITTUDES AND BELIEFS OF HEALTH PROFESSIONALS
- INNOVATIVE TEACHING STRATEGIES
- MODELS FOR PROFESSIONAL EDUCATION
- CONTINUING EDUCATION
- ROLE OF EPILEPSY ORGANIZATIONS AND CENTERS
- EDUCATING HEALTH PROFESSIONALS TO EDUCATE PEOPLE WITH EPILEPSY AND THEIR FAMILIES
- CONCLUSION
- REFERENCES
- 6. Quality of Life and Community Resources
- 7. Educating People with Epilepsy and Their Families
- GOALS AND PRIORITIES FOR EDUCATION
- UNDERSTANDING INFORMATION NEEDS
- WHERE, WHEN, AND HOW PEOPLE WITH EPILEPSY AND THEIR FAMILIES RECEIVE INFORMATION
- MODELS OF EPILEPSY EDUCATION AND SELF-MANAGEMENT
- LESSONS FROM MODELS FOR OTHER HEALTH CONDITIONS
- A VISION FOR OPTIMAL EPILEPSY EDUCATION
- CONCLUSION
- REFERENCES
- 8. Public Education and Awareness
- 9. Next Steps and Recommendations
- APPENDIXES
- A Workshop Agendas
- B IOM Data-Gathering Effort
- C Data on Specialized Epilepsy Centers: Report to the Institute of Medicine’s Committee on the Public Health Dimensions of the Epilepsies
- D Health Professionals Who Care for People with Epilepsy: Possible Roles and Relevant Boards and Organizations
- E Committee Biographies
[Abstract+References] Upper Limb Coordination in Individuals With Stroke: Poorly Defined and Poorly Quantified.
Posted by Kostas Pantremenos in Paretic Hand, Uncategorized on December 2, 2017
Abstract
Background. The identification of deficits in interjoint coordination is important in order to better focus upper limb rehabilitative treatment after stroke. The majority of standardized clinical measures characterize endpoint performance, such as accuracy, speed, and smoothness, based on the assumption that endpoint performance reflects interjoint coordination, without measuring the underlying temporal and spatial sequences of joint recruitment directly. However, this assumption is questioned since improvements of endpoint performance can be achieved through different degrees of restitution or compensation of upper limb motor impairments based on the available kinematic redundancy of the system. Confusion about adequate measurement may stem from a lack a definition of interjoint coordination during reaching. Methods and Results. We suggest an operational definition of interjoint coordination during reaching as a goal-oriented process in which joint degrees of freedom are organized in both spatial and temporal domains such that the endpoint reaches a desired location in a context-dependent manner. Conclusions. In this point-of-view article, we consider how current approaches to laboratory and clinical measures of coordination comply with our definition. We propose future study directions and specific research strategies to develop clinical measures of interjoint coordination with better construct and content validity than those currently in use.
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