Posts Tagged Sensors

[Abstract + References] Novel Assessment Measures of Upper-Limb Function in Pre and Poststroke Rehabilitation: A Pilot Study – IEEE Conference Publication

Abstract

Hand function assessment is essential for upper limb rehabilitation of stroke survivors. Conventional acquisition devices have inherent and restrictive difficulties for their clinical usage. Data gloves are limited for applications outside the medical environment, and motion tracking systems setup are time and personnel demanding. We propose a novel instrument designed as a replica of a glass, equipped with an omnidirectional vision system to capture hand images and an inertial measurement unit for movements kinematic data acquisition. Four stroke survivors were invited as volunteers in pre and post-treatment experiments for its evaluating. The exercise of drinking water from a glass was elected for the trails. Before treatment, subjects used their contralesional and ipsilateral hands to perform them. Two main functional features were found in the data analysis. There were differences between limbs in the grasping hand postures, mainly in the index and thumb abduction angle, and in the task timing. After treatment, two volunteers repeated the protocol with their contralesional hands. Changes in the features were observed, index and thumb abduction angles were greater in both cases, and tasks timing were altered in distinct ways. These preliminary results suggest the instrument can be used both in evaluation of hand functional deficit and rehabilitation progress. Improvements and future work are also presented.
1. R. L. Sacco, S. E. Kasner, J. P. Broderick, L. R. Caplan, A. Culebras, M. S. Elkind, M. G. George, A. D. Hamdan, R. T. Higashida, B. L. Hoh et al., “An updated definition of stroke for the 21st century: a statement for healthcare professionals from the american heart association/american stroke association”, Stroke, vol. 44, no. 7, pp. 2064-2089, 2013.

2. C. A. Doman, K. J. Waddell, R. R. Bailey, J. L. Moore, C. E. Lang, “Changes in upper-extremity functional capacity and daily performance during outpatient occupational therapy for people with stroke”, American Journal of Occupational Therapy, vol. 70, no. 3, pp. 7003290040pl-7003290040p11, 2016.

3. B. Brouwer, M. V. Sale, M. A. Nordstrom, “Asymmetry of motor cortex excitability during a simple motor task: relationships with handedness and manual performance”, Experimental Brain Research, vol. 138, no. 4, pp. 467-476, 2001.

4. J. Langan, P. van Donkelaar, “The influence of hand dominance on the response to a constraint-induced therapy program following stroke”, Neurorehabilitation and neural repair, vol. 22, no. 3, pp. 298-304, 2008.

5. H. I. Krebs, M. L. Aisen, B. T. Volpe, N. Hogan, “Quantization of continuous arm movements in humans with brain injury”, Proceedings of the National Academy of Sciences, vol. 96, no. 8, pp. 4645-4649, 1999.

6. B. Fisher, C. Winstein, M. Velicki, “Deficits in compensatory trajectory adjustments after unilateral sensorimotor stroke”, Experimental brain research, vol. 132, no. 3, pp. 328-344, 2000.

7. H. Sugarman, A. Avni, R. Nathan, A. Weisel-Eichler, J. Tiran, “Movement in the ipsilesional hand is segmented following unilateral brain damage”, Brain and cognition, vol. 48, no. 2-3, pp. 579-587, 2002.

8. D. A. Nowak, “The impact of stroke on the performance of grasping: usefulness of kinetic and kinematic motion analysis”, Neuroscience & Biobehavioral Reviews, vol. 32, no. 8, pp. 1439-1450, 2008.

9. M. Coluccini, E. S. Maini, C. Martelloni, G. Sgandurra, G. Cioni, “Kinematic characterization of functional reach to grasp in normal and in motor disabled children”, Gait & posture, vol. 25, no. 4, pp. 493-501, 2007.

10. E. Jaspers, H. Feys, H. Bruyninckx, J. Harlaar, G. Molenaers, K. Desloovere, “Upper limb kinematics: development and reliability of a clinical protocol for children”, Gait & posture, vol. 33, no. 2, pp. 279-285, 2011.

11. D. A. Nowak, J. Hermsdörfer, H. Topka, “Deficits of predictive grip force control during object manipulation in acute stroke”, Journal of neurology, vol. 250, no. 7, pp. 850-860, 2003.

12. R. W. Bohannon, “Adequacy of hand-grip dynamometry for characterizing upper limb strength after stroke”, Isokinetics and exercise science, vol. 12, no. 4, pp. 263-265, 2004.

13. H. Zhou, H. Hu, “Human motion tracking for rehabilitationâĂŤa survey”, Biomedical Signal Processing and Control, vol. 3, no. 1, pp. 1-18, 2008.

14. A. C. P. Rocha, E. Tudella, L. M. Pedro, V. C. R. Appel, L. G. P. da Silva, G. A. d. P. Caurin, “A novel device for grasping assessment during functional tasks: preliminary results”, Frontiers in bioengineering and biotechnology, vol. 4, pp. 16, 2016.

15. E. Taub, G. Uswatte, “Constraint-induced movement therapy: bridging from the primate laboratory to the stroke rehabilitation laboratory”, Journal of Rehabilitation Medicine-Supplements, vol. 41, pp. 34-40, 2003.

16. R. d. N. B. Marques, A. C. Magesto, R. E. Garcia, C. B. d. Oliveira, G. d. S. Matuti, “Efeitos da terapia por contensão induzida nas lesões encefálicas adquiridas”, Fisioterapia Brasil, vol. 17, no. 1, pp. f-30, 2016.

17. E. E. Butler, A. L. Ladd, L. E. LaMont, J. Rose, “Temporal-spatial parameters of the upper limb during a reach & grasp cycle for children”, Gait & posture, vol. 32, no. 3, pp. 301-306, 2010.

18. E. E. Butler, A. L. Ladd, S. A. Louie, L. E. LaMont, W. Wong, J. Rose, “Three-dimensional kinematics of the upper limb during a reach and grasp cycle for children”, Gait & posture, vol. 32, no. 1, pp. 72-77, 2010.

19. L. Gauthier, Structural brain changes produced by different motor therapies after stroke, 2011.

20. L. M. Pedro, G. A. de Paula Caurin, “Kinect evaluation for human body movement analysis”, Biomedical Robotics and Biomechatronics (BioRob) 2012 4th IEEE RAS & EMBS International Conference on, pp. 1856-1861, 2012.

21. A. Hussain, S. Balasubramanian, N. Roach, J. Klein, N. Jarrassé, M. Mace, A. David, S. Guy, E. Burdet, “Sitar: a system for independent task-oriented assessment and rehabilitation”, Journal of Rehabilitation and Assistive Technologies Engineering, vol. 4, pp. 2055668317729637, 2017.

22. L. R. L. Cardoso, M. N. Martelleto, P. M. Aguiar, E. Burdet, G. A. P. Caurin, L. M. Pedro, “Upper limb rehabilitation through bicycle controlling”, 24th International Congress of Mechanical Engineering, 2017.

23. M. N. Martelleto, P. M. Aguiar, E. Burdet, G. A. P. Caurin, R. V. Aroca, L. M. Pedro, “Instrumented module for investigation of contact forces for use in rehabilitation and assessment of bimanual functionalities”, 24th International Congress of Mechanical Engineering, 2017.

 

via Novel Assessment Measures of Upper-Limb Function in Pre and Poststroke Rehabilitation: A Pilot Study – IEEE Conference Publication

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[Abstract] sEMG Bias-driven Functional Electrical Stimulation System for Upper Limb Stroke Rehabilitation

Abstract:

It is evident that the dominant therapy of functional electrical stimulation (FES) for stroke rehabilitation suffers from heavy dependency on therapists experience and lack of feedback from patients status, which decrease the patients’ voluntary participation, reducing the rehabilitation efficacy. This paper proposes a closed loop FES system using surface electromyography (sEMG) bias feedback from bilateral arms for enhancing upper-limb stroke rehabilitation. This wireless portable system consists of sEMG data acquisition and FES modules, the former is used to measure and analyze the subject’s bilateral arm motion intention and neuromuscular states in terms of their sEMG, the latter of multi-channel FES output is controlled via the sEMG bias of the bilateral arms. The system has been evaluated with experiments proving that the system can achieve 39.9 dB signal-to-noise ratio (SNR) in the lab environment, outperforming existing similar systems. The results also show that voluntary and active participation can be effectively employed to achieve different FES intensity for FES-assisted hand motions, demonstrating the potential for active stroke rehabilitation.
Published in: IEEE Sensors Journal ( Early Access ) Date of Publication: 18 June 2018

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via sEMG Bias-driven Functional Electrical Stimulation System for Upper-Limb Stroke Rehabilitation – IEEE Journals & Magazine

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[Abstract] A wearable monitoring system for at-home stroke rehabilitation exercises: A preliminary study

Abstract:

When stroke survivors perform rehabilitation exercises in clinical settings, experienced therapists can evaluate the associated quality of movements by observing only the initial part of the movement execution so that they can discourage therapeutically undesirable movements effectively and reinforce desirable ones as much as possible in the limited therapy time. This paper introduces a novel monitoring platform based on wearable technologies that can replicate the capability of skilled therapists. Specifically, we propose to deploy five wearable sensors on the trunk, and upper and forearm of the two upper limbs, analyze partial to complete observation data of reaching exercise movements, and employ supervised machine learning to estimate therapists’ evaluation of movement quality. Estimation performance was evaluated using F-Measure, Receiver Operating Characteristic Area, and Root Mean Square Error, showing that the proposed system can be trained to evaluate the movement quality of the entire exercise movement using as little as the initial 5s of the exercise performance. The proposed platform may help ensure high quality exercise performance and provide virtual feedback of experienced therapists during at-home rehabilitation.

I. Introduction

Stroke is a leading cause of death and disabilities in adults, and the majority of its survivors suffer from upper extremity paresis [1]. There is scientific evidence that repetitive rehabilitation exercises and training could improve motor abilities as a result of motor learning processes [2]. Among many, a reaching movement is a fundamental component of daily movement that requires the coordination of multiple upper extremity segments [3]. It is shown that repetitive reaching exercises improve the smoothness, precision, and speed of arm movements [4]. To continue to improve and to sustain motor function, it is clinically important that patients continue to engage in rehabilitation exercises even outside the clinical settings [5], which emphasizes the importance of the home-based therapy.

 

via A wearable monitoring system for at-home stroke rehabilitation exercises: A preliminary study – IEEE Conference Publication

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[WEB SITE] Wearable tech aids stroke patients – BBC News

Scientists in the US are developing wearable sensors to speed up the recovery of stroke patients.

The sensors are able to send information to doctors continuously.

The team developing the system says it could allow therapists to more closely monitor the effectiveness of their care.

Details of the study were released at the recent annual meeting of the American Association for the Advancement of Science in Texas.

Lizzy McAninch had a stroke two years ago. She could not move or speak or swallow for several weeks.

Lizzy is testing out wearable sensors that might speed her recovery.

They look like small white sticking plasters, but they send information wirelessly to her medical team.

She is a doctor herself and can see how they could help her.

Sensor

SHIRLEY RYAN ABILITYLAB They look like small sticking plasters

“This technology to put sensors on the body to assess which muscle groups work or not can really pinpoint the areas affected by the stroke and can target therapies to specifically improve those issues,” she told BBC News.

The sensors continue to send back readings even after she has finished her exercises. This means that her therapist Kristen Hohl, from the Shirley Ryan AbilityLab in Chicago, can monitor her progress at home.

“As a therapist, I think about what my patients are doing at home. Are they able to carry through the recommendations I’m giving them as a therapist to do more? Do we see that they are walking more or do we see them engaging in conversations?

“Those are the types of things that I can get feedback from the sensors where currently I have to rely on what they tell me they have done.”

Tablet

 SHIRLEY RYAN ABILITYLAB  The team is gathering large amounts of data

The challenge for the scientists was to pack a lot of electronics on to a small flexible material and still make it comfortable for the patient to wear for a long time.

“It is almost mechanically imperceptible to the patient who is wearing the device,” according to John Rogers, of Northwestern University in Chicago, who developed the sensors.

“And you can embed all sorts of advanced sensor functionality, microprocessor computing capability, power supplies and WiFi into this very unusual platform, and that is the uniqueness of what we do.”

By the end of this year, the research team will have more information than ever before on stroke recovery. The scientists believe that their study could transform the way patients are treated in the future.

Lizzy and scientist

SHIRLEY RYAN ABILITYLAB

 

via Wearable tech aids stroke patients – BBC News

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[Abstract+References] A Computer-Assisted System with Kinect Sensors and Wristband Heart Rate Monitors for Group Classes of Exercise-Based Rehabilitation

Abstract

Exercise-based rehabilitation for chronic conditions such as cardiovascular disease, diabetes, and chronic obstructive pulmonary disease, constitutes a key element in reducing patient symptoms and improving health status and quality of life. However, group exercise in rehabilitation programmes faces several challenges imposed by the diversified needs of their participants. In this direction, we propose a novel computer-assisted system enhanced with sensors such as Kinect cameras and wristband heart rate monitors, aiming to support the trainer in adapting the exercise programme on-the-fly, according to identified requirements. The proposed system design facilitates maximal tailoring of the exercise programme towards the most beneficial and enjoyable execution of exercises for patient groups. This work contributes in the design of the next-generation of computerised systems in exercise-based rehabilitation.

References

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[CORDIS] A sensor-fitted suit to analyse stroke patients’ movements.

The moment when stroke patients return home after treatment has always been a source of concern for both themselves and their physicians, as the latter are left blind without any feedback. But this is now a thing of the past: a novel suit fitted with 41 sensors is finally ready for commercialisation.

A sensor-fitted suit to analyse stroke patients’ movements

© Wright Studio, Shutterstock 

Could resorting to rehabilitation clinics be less of a necessity in the near future? Whilst these clinics effectively help patients to face post-stroke everyday life, stakeholders tend to agree that a better understanding of how these people function in the absence of medical support could lead to more effective rehabilitation at a lower cost.

This is what Bart Klaassen, PhD student at the University of Twente, and and a large team of researchers from across Europe have been working on under the INTERACTION project. Together they developed and validated an unobtrusive and modular system for monitoring daily life activities and for training motor function in stroke subjects, in the shape of a multi-sensor-equipped suit.

This project is presented by Klaassen and his team as a world first. ‘There has long been a great need for systems like this, but the technology simply was not ready,’ he says. ‘That is now changing rapidly, thanks to rapid developments in the fields of battery technology, wearables, smart e-textiles and big data analysis.’

The INTERACTION suit has been extensively tested on patients over a period of three months, during which they were asked to wear it under their regular clothes. The data was then transmitted, stored and processed thanks to a portable transmitter that can relay all of the information gathered through the internet to data processing servers at the University of Twente. The 41 sensors included in the suit monitor a large number of body segments, providing information on muscle strength, stretch and force.

‘We have been able to demonstrate that all the information is transmitted successfully, that this process is very efficient, and much more besides,’ Klaassen enthuses. ‘We have succeeded in modelling all of the relevant movements, and in cleaning up the data that is relevant for the therapist by filtering out the rest. Our project has delivered new techniques and methods that can be used to monitor patients at home for extended periods of time, and to identify any differences with structured clinical measurements. We are currently engaged in further research to obtain final verification that these methods are indeed an ideal way of supervising rehabilitation.’

The press release recently published by the University of Twente says no word about a potential date of commercialisation. However, the fact that both insurance companies and healthcare professionals were involved from the early stages of the project leaves little doubt that stroke patients will soon benefit from this technological breakthrough.

For more information, please see:
CORDIS project page

Source: Based on a press release from the University of Twente

 

via European Commission : CORDIS : News and Events : A sensor-fitted suit to analyse stroke patients’ movements

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[Abstract] The eWrist — A wearable wrist exoskeleton with sEMG-based force control for stroke rehabilitation.

Abstract:

Chronic wrist impairment is frequent following stroke and negatively impacts everyday life. Rehabilitation of the dysfunctional limb is possible but requires extensive training and motivation. Wearable training devices might offer new opportunities for rehabilitation. However, few devices are available to train wrist extension even though this movement is highly relevant for many upper limb activities of daily living. As a proof of concept, we developed the eWrist, a wearable one degree-of-freedom powered exoskeleton which supports wrist extension training. Conceptually one might think of an electric bike which provides mechanical support only when the rider moves the pedals, i.e. it enhances motor activity but does not replace it. Stroke patients may not have the ability to produce overt movements, but they might still be able to produce weak muscle activation that can be measured via surface electromyography (sEMG). By combining force and sEMG-based control in an assist-as-needed support strategy, we aim at providing a training device which enhances activity of the wrist extensor muscles in the context of daily life activities, thereby, driving cortical reorganization and recovery. Preliminary results show that the integration of sEMG signals in the control strategy allow for adjustable assistance with respect to a proxy measurement of corticomotor drive.

Source: The eWrist — A wearable wrist exoskeleton with sEMG-based force control for stroke rehabilitation – IEEE Xplore Document

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[Abstract] Towards an ankle neuroprosthesis for hybrid robotics: Concepts and current sources for functional electrical stimulation

Abstract:

Hybrid rehabilitation robotics combine neuro-prosthetic devices (close-loop functional electrical stimulation systems) and traditional robotic structures and actuators to explore better therapies and promote a more efficient motor function recovery or compensation. Although hybrid robotics and ankle neuroprostheses (NPs) have been widely developed over the last years, there are just few studies on the use of NPs to electrically control both ankle flexion and extension to promote ankle recovery and improved gait patterns in paretic limbs. The aim of this work is to develop an ankle NP specifically designed to work in the field of hybrid robotics. This article presents early steps towards this goal and makes a brief review about motor NPs and Functional Electrical Stimulation (FES) principles and most common devices used to aid the ankle functioning during the gait cycle. It also shows a current sources analysis done in this framework, in order to choose the best one for this intended application.

Source: Towards an ankle neuroprosthesis for hybrid robotics: Concepts and current sources for functional electrical stimulation – IEEE Xplore Document

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[Abstract] Preliminary study on the design and control of a pneumatically-actuated hand rehabilitation device

Abstract:

In recent years, the robotic devices have been used in hand rehabilitation training practice. The majority of existing robotic devices for rehabilitation belong to the rigid exoskeleton. However, rigid exoskeletons may have some limitations such as heavy weight, un-safety and inconvenience. This paper presents a device designed to help post-stroke patients to stretch their spastic hands. This hand rehabilitation device actuator is fabricated by soft material, powered with fluid pressure, and embedded in one glove surface. The distinguished features of this device are: safety, low cost, light weight, convenience and pneumatic actuation. In clinical practice, rehabilitation therapists should help the post-stroke patients to stretch fingers to a desired joint position. Therefore, the control objective of the proposed hand rehabilitation device is to drive the patient’s finger bending angle to a predesigned position. To this end, curvature sensors embedded in the glove are used to measure the finger’s bending angle. A commercial data glove is used to collect the actual finger’s bending angle for calibrating the curvature sensors based on a three-layer back-propagation (BP) neural network. Then the error between the designed joint position and the actual joint position can be calculated. An error proportional control strategy is adopted for the positioning control objective (the controller’s input is the pump speed). Finally, experiments are conducted to validate the effectiveness of control method and the capacity of the proposed hand rehabilitation device.

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Source: Preliminary study on the design and control of a pneumatically-actuated hand rehabilitation device – IEEE Xplore Document

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[WEB SITE] ‘Telerehab’ system allows patients to do physiotherapy at home

SINGAPORE – It is a Friday afternoon and Mr Chin Tian Loke, 72, is watching a video on an iPad Air in his five-room flat in Jurong West. He mimics the movements of the person on screen, lifting his arm, which has a sensor attached to it at a 90-degree angle. A voice from the iPad then congratulates him: “Spectacular!”

It appears as though Mr Chin, a retired odd-job worker, is playing a game. But he is actually undergoing rehabilitation therapy, to help him gain strength in his limbs after he fell and broke his spinal tail bone in November last year.

Mr Chin is one of the first to try out a novel healthcare system, announced on Friday (May 5) by healthcare technology agency Integrated Health Information Systems (IHiS).

The system aims to make physiotherapy as painless as possible: by allowing patients to exercise at any time of the day, within the comfort of their own homes. This removes the need for a patient to commute to and from a rehabilitation centre and hopefully, boost participation rates in attendance for rehabilitative therapy, which would then prevent the chances of re-admission to hospital. As National University of Singapore’s Associate Professor Gerald Koh, who pioneered the system, noted: “Often, the reason why a patient needs therapy is the reason why the patient finds it hard to go for therapy.”

The solution is technology.

All that is required is an iPad and two sets of sensors – which will be loaned to the patient by the healthcare institution – and an open mind.

Believed to be the first of its kind,Smart Health TeleRehab, as the system is known, will enable Mr Chin’s physiotherapist from Touch Home Care to keep tabs on his exercise regime remotely. Each exercise session will be automatically recorded and saved to a digital cloud, which his therapist views within two working days.

If a patient has completed the prescribed exercises successfully, the physiotherapist can increase the difficulty of the exercises at the touch of a button. If not, she will call Mr Chin to guide him on the right way to do the exercises. If further explanation is required, the physiotherapist will pay him a home visit within the week.

Smart Health TeleRehab is currently being used by 11 patients at two healthcare providers – Touch Home Care and NTUC Health. But 12 more -including Changi General Hospital, Khoo Teck Puat Hospital, and SPD (formerly known as the Society for the Physically Disabled) – will come on board by the end of this year (2017), as Singapore ramps up programmes in line with its Smart Nation ambition.

An estimated 1,000 patients are expected to benefit from the pilot programme by the end of next year (2018). IHiS’ latest initiative follows its April roll-out of a video call system for medical consultations to six public healthcare institutions that enables patients to consult experts from the comfort of their homes.

Mr Chee Hong Tat, Senior Minister of State for Health, visited Mr Chin on Friday at his home to see how the Smart Health TeleRehab system could be deployed. He said: “Smart Health TeleRehab could transform how therapy services are delivered in Singapore. Patients will benefit from greater convenience, cost savings and better outcomes. Therapists and therapy service providers will also benefit from the productivity improvements.”

The cost of Smart Health TeleRehab sessions depends on the various healthcare institutions, and the subsidies that a patient qualifies for.

As a gauge, at Ang Mo Kio Thye Hua Kwan Hospital, which will run the programme from next month (June 2017), a patient can expect to pay between $3 and $50 for one Smart Health TeleRehab session. In comparison, a patient has to pay more than $80 for one treatment session at the centre (excluding transportation costs, which could go up to $75 per way), or more than $160 for a therapist to visit him at home.

Singapore’s therapists too, will benefit from productivity gains. In 2016, there were about 2,570 occupational and physiotherapists here. However, figures from the Health Ministry show that 53,000 patients had to undergo physiotherapy in 2014 – and the health authorities are only expecting this number to grow over the years as the population ages.

An initial study led by Prof Koh found that the system could help therapists reap productivity gains of more than 30 per cent. A telerehab session, on average, takes about 52 minutes. A therapy session conducted in the patient’s home, however, could stretch up to almost 80 minutes. So in the time that a therapist usually takes to see three patients the conventional way, the therapist can see four patients instead via the TeleRehab method.

Smart Health TeleRehab may not be suitable for all patients, such as those who have diabetes or other complications.But with more patients on the technological platform, it frees up therapists so they can have more face-time with more needy patients.

Singapore Management University’s (SMU) School of Information Systems’ Associate Professor Tan Hwee Pink volunteers with the Stroke Support Station (Singapore) and has an elderly father recovering from a complex hip fracture after a road accident last year. He welcomed the new platform as a timely one.

https://www.youtube.com/watch?v=idQmQl73-WM

Despite the benefits, however, he pointed out that most patients recovering from an accident or stroke would have weakened mental strength. “This needs to be addressed for the patient to be motivated to do the rehab at home. As we know, patients tend to do what they are told in a controlled environment, but not necessarily so when they are in the home environment,” he added.

One possible way to do this is to allow more functions to be used on the iPads, such as watching TV or making calls, for example, he suggested.

Professor Atreyi Kankanhalli, from the department of information systems at the National University of Singapore’s School of Computing, said the TeleRehab method also give patients a greater sense of autonomy and control, as they can do the rehabilitation exercises on their own. She added: “With the increasing incidence of chronic diseases, shortage of healthcare professionals, and yet the availability of more intelligent technologies, healthcare is a prime sector that can benefit from Smart Nation initiatives – in addition to other key sectors such as transport, commerce, utilities, security and education.”

Source: ‘Telerehab’ system allows patients to do physiotherapy at home, Health News & Top Stories – The Straits Times

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