Posts Tagged telerehabilitation

[ARTICLE] Towards a New Wave of Telerehabilitation Applications – Full Text PDF

Abstract

In recent years, new scenarios for experimenting telerehabilitation services have been opening thanks to the diffusion of the new technologies. The revolution brought about by the Internet of Things and Big Data Analytics is having an effect also in the field of telerehabilitation services. The literature has broadened in scope and grown in volume and, in certain aspects, the focus of research has changed in the last few years. This article examines the major changes that have come about in the field of telerehabilitation, which can essentially be divided into two main strands: low-cost end-user applications, and the integration of telerehabilitation services. We will briefly review the emerging investigations and experimentations in the field of telerehabilitation, analyzing the market trends in the sector and the commercial strategies of companies working in it, and aim to outline the most relevant challenges that exist for the delivery of effective and sustainable telerehabilitation services. Our opinion is that telerehabilitation currently represents a very promising field, although many questions still remain open, for which concrete and reliable answers are required. In this respect, we focus on a fundamental issue that underlies the field of telerehabilitation services, namely the influence that environment has on the effectiveness of treatment. In short, how can the type of environment affect the results of treatment?

The Telerehabilitation Scenario

Many different terms are used to designate the application of ICTs in the field of healthcare. The term medical informatics, first coined around 1970, was superseded at the end of the 1990s by eHealth, while, nowadays, telemedicine, tele health, and tele care are all used fairly interchangeably.

The main advantages of Telemedicine in healthcare are evident [1-3]. It is a form of secondary prevention encompassing services dedicated to persons classified as at risk or suffering from chronic diseases (e.g. diabetes or cardiovascular disease) who require a constant monitoring of vital parameters in order to reduce the risk of complications, such as that of blood glucose levels for diabetic patients. Meanwhile, Tele-diagnosis focuses on moving diagnostic information rather than the patient. Although a complete diagnosis cannot be performed exclusively through the use of ICT tools, computer-based systems can effectively support diagnostic processes, for example by giving the possibility of exchanging data amongst specialists and facilitating its communication.

Home health monitoring services utilise ITC-based technology to monitor patients in their homes by means of devices that measure vital data, such as blood pressure, glucose levels, pulse, blood oxygen levels, etc., and enable the transmission of this data to clinicians [4,5].

Recently, the concept of telerehabilitation has been introduced to refer to the provision of rehabilitation care at a distance. Telerehabilitation, or e-rehabilitation, is considered a subcomponent of the broader area of telemedicine [6], and can be divided into three main categories: image based telerehabilitation, sensor based telerehabilitation, and telerehabilitation based on virtual technologies [7]. Lately, the notion of social telerehabilitation has been introduced to distinguish the application of ICT to the social rehabilitation sphere [8,9].

Telerehabilitation is widely considered to be advantageous in the treatment of patients. Telerehabilitation services are seen as being a costeffective alternative to traditional rehabilitation services since they can be delivered at a distance, thus reducing the travel costs and difficulties for patients to receive care at a healthcare facility.

The increasing interest in telerehabilitation is closely related to the diffusion of the internet. Indeed, thanks to the internet, all traditional sectors, including healthcare, are going through processes of transformation in order to become more effective and accurate, as well as cheaper and more powerful.

Telerehabilitation solutions have been experimented in many areas, particularly that of rehabilitation following traumatic injury (for assessment, physical therapy, and monitoring). …

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[ARTICLE] User-centered design of a patient’s work station for haptic robot-based telerehabilitation after stroke – Full Text

Abstract:

Robotic therapy devices have been an important part of clinical neurological rehabilitation for several years. Until now such devices are only available for patients receiving therapy inside rehabilitation hospitals. Since patients should continue rehabilitation training after hospital discharge at home, intelligent robotic rehab devices could help to achieve this goal. This paper presents therapeutic requirements and early phases of the user-centered design process of the patient’s work station as part of a novel robot-based system for motor telerehabilitation.

1 Introduction

Stroke is one of the dominant causes of acquired disability [1] and it is the second leading cause of death worldwide [2]. The high incidence of the disease and the current demographic developments are likely to increase the number of stroke patients in the future. Most of the survivors have physical, cognitive and functional limitations and require intensive rehabilitation in order to resume independent everyday life [3]. Therefore, the main goal of motor rehabilitation is relearning of voluntary movement capability, a process which takes at least several months, some improvement can occur even after years. In the rehabilitation clinic, patients usually receive a daily intensive therapy program. However, for further improvement of motor abilities, severely affected patients are required to continue their rehabilitation training outside the rehabilitation settings, after being discharged from the rehabilitation clinic. Langhammer and Stanghelle [4] found that a lack of follow-up rehabilitation treatment at home leads to deterioration of activities of daily living (ADL) and to motor functions in general. A possible solution is an individualized and motivating telerehabilitation system in the patient’s domestic environment. Some studies [5], [6] have confirmed the advantage of home rehabilitation after stroke and showed that telerehabilitation received high acceptance and satisfaction, both from patients, as well as from health professionals [7]. Most of the existing telesystems [7], [8] are based on audio-visual conferencing or on virtual environments and contain rather simple software for monitoring patients’ condition. However, in neurological rehabilitation the sensorimotor loop needs to be activated by provision of physiological haptic feedback (touch and proprioception) [3].

Robot-based rehabilitation is currently one of the most prevalent therapeutic approaches. It is often applied in hospitals alongside conventional therapy and is beneficial for motor recovery [9]. Rehabilitation training including a haptic-therapy device may therefore be even more promising for home environments than non-haptic telerehabilitation. Several telerehabilitation systems, which include not only audio and visual, but also haptic modality, already exist [10], [11] . Most of these solutions use low-cost commercial haptic devices (e.g. joysticks) for therapy training, with the goal of cost minimization and providing procurable technology. Nonetheless, devices specifically developed for stroke rehabilitation, which are already established in clinical settings, may have greater impact on motor relearning and could therefore also be more effective at home, compared with existing home rehabilitation devices.

In a previous paper [12], we presented a concept and design overview of a haptic robot-based telerehabilitation system for upper extremities which is currently under development. In the present work, we describe therapeutic requirements, user-centred development [13] and implementation of the patient’s station of the telesystem.

Continue —> User-centered design of a patient’s work station for haptic robot-based telerehabilitation after stroke : Current Directions in Biomedical Engineering

Figure 3 Implementation of the patient’s work station based on Reha-Slide (left) and Bi-Manu-Track (right).

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[Abstract] GEAR: A Mobile Game-Assisted Rehabilitation System

Abstract:

Rehabilitation exercises are an important means for gaining mobility and strength after injuries or surgery. Self-exercising in between physio-therapy sessions is vital for effective rehabilitation. Yet, many people do not follow exercise regimes, which can hamper their recovery. This study proposes GEAR – a mobile GamE Assisted Rehabilitation system – to engage users in self-exercising and to improve adherence to their exercise regime. The system consists of a wearable wristband to monitor users’ movements, a mobile game that incorporates the exercises, and a dashboard to monitor and visualize users’ exercise performance. GEAR has advantages of portability and lower cost as compared to PC or Kinect-based rehabilitation systems. This study describes GEAR and reports on a pilot assessment of its interface and system. The pilot test demonstrates the feasibility of GEAR and provides feedback that is being used to enhance the system prior to full-scale evaluation.

Source: GEAR: A Mobile Game-Assisted Rehabilitation System – IEEE Xplore Document

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[VIDEO] HandTutor Introduction: 2017 Rehabilitation – YouTube

HandTutor Introduction: 2017 Rehabilitation – YouTube

Published on Dec 11, 2016

#1 Technology for Physical and Occupational therapists.

Enjoy the convenience and flexibility of treating your patients remotely with the state of the art MediTouch systems through TeleRehabilitation. TeleRehabilitation sessions enable the therapist to grade the intensity of treatment activities through remote access to their patient’s computer.

Patients are highly motivated by the visual biofeedback they receive. The challenging yet fun customized rehabilitation activities encourage full participation yielding noticeable improvements in range of motion, motor control and functional movements.
Want to know more?
Visit http://meditouch.co.il/products/handt…

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[Abstract] An interactive distance solution for stroke rehabilitation in the home setting – A feasibility study

Background: In this study an interactive distance solution (called the DISKO tool) was developed to enable home-based motor training after stroke. Objectives: The overall aim was to explore the feasibility and safety of using the DISKO-tool, customized for interactive stroke rehabilitation in the home setting, in different rehabilitation phases after stroke. Methods: Fifteen patients in three different stages in the continuum of rehabilitation after stroke participated in a home-based training program using the DISKO-tool. The program included 15 training sessions with recurrent follow-ups by the integrated application for video communication with a physiotherapist. Safety and feasibility were assessed from patients, physiotherapists, and a technician using logbooks, interviews, and a questionnaire. Qualitative content analysis and descriptive statistics were used in the analysis. Results: Fourteen out of 15 patients finalized the training period with a mean of 19.5 minutes spent on training at each session. The DISKO-tool was found to be useful and safe by patients and physiotherapists. Conclusions: This study demonstrates the feasibility and safety of the DISKO-tool and provides guidance in further development and testing of interactive distance technology for home rehabilitation, to be used by health care professionals and patients in different phases of rehabilitation after stroke.

Source: An interactive distance solution for stroke rehabilitation in the home setting – A feasibility study: Informatics for Health and Social Care: Vol 0, No 0

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[Poster] Feasibility of Telerehabilitation in Stroke Recovery: A Survey on Access and Willingness to Use Low-Cost Consumer Technologies

To investigate the access to consumer technologies and willingness to use them to receive rehabilitation services among stroke survivors.

Source: Feasibility of Telerehabilitation in Stroke Recovery: A Survey on Access and Willingness to Use Low-Cost Consumer Technologies – Archives of Physical Medicine and Rehabilitation

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[Abstract] A Rehabilitation-Internet-of-Things in the Home to Augment Motor Skills and Exercise Training

Abstract

Although motor learning theory has led to evidence-based practices, few trials have revealed the superiority of one theory-based therapy over another after stroke. Nor have improvements in skills been as clinically robust as one might hope. We review some possible explanations, then potential technology-enabled solutions. Over the Internet, the type, quantity, and quality of practice and exercise in the home and community can be monitored remotely and feedback provided to optimize training frequency, intensity, and progression at home. A theory-driven foundation of synergistic interventions for walking, reaching and grasping, strengthening, and fitness could be provided by a bundle of home-based Rehabilitation Internet-of-Things (RIoT) devices. A RIoT might include wearable, activity-recognition sensors and instrumented rehabilitation devices with radio transmission to a smartphone or tablet to continuously measure repetitions, speed, accuracy, forces, and temporal spatial features of movement. Using telerehabilitation resources, a therapist would interpret the data and provide behavioral training for self-management via goal setting and instruction to increase compliance and long-term carryover. On top of this user-friendly, safe, and conceptually sound foundation to support more opportunity for practice, experimental interventions could be tested or additions and replacements made, perhaps drawing from virtual reality and gaming programs or robots. RIoT devices continuously measure the actual amount of quality practice; improvements and plateaus over time in strength, fitness, and skills; and activity and participation in home and community settings. Investigators may gain more control over some of the confounders of their trials and patients will have access to inexpensive therapies.

Source: A Rehabilitation-Internet-of-Things in the Home to Augment Motor Skills and Exercise Training

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[Abstract] The Present and Future of Robotic Technology in Rehabilitation – SpringerLink

Abstract

Robotic technology designed to assist rehabilitation can potentially increase the efficiency of, and accessibility to, therapy by assisting therapists to provide consistent training for extended periods of time, and collecting data to assess progress. Automatization of therapy may enable many patients to be treated simultaneously and possibly even remotely, in the comfort of their own homes, through telerehabilitation. The data collected can be used to objectively assess performance and document compliance as well as progress. All of these characteristics can make therapists more efficient in treating larger numbers of patients. Most importantly for the patient, it can increase access to therapy which is often in high demand and rationed severely in today’s fiscal climate. In recent years, many consumer-grade low-cost and off-the-shelf devices have been adopted for use in therapy sessions and methods for increasing motivation and engagement have been integrated with them. This review paper outlines the effort devoted to the development and integration of robotic technology for rehabilitation.

Source: The Present and Future of Robotic Technology in Rehabilitation | SpringerLink

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[Poster] Post-Stroke Reductions in Impairment and Functional Limitation Using a Telerehabilitation-Based Upper Extremity Protocol

To explore the feasibility and efficacy of remotely-delivered upper extremity (UE) therapy in a moderately impaired stroke survivor.

Source: Post-Stroke Reductions in Impairment and Functional Limitation Using a Telerehabilitation-Based Upper Extremity Protocol – Archives of Physical Medicine and Rehabilitation

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[Abstract] Scoping review of outcome measures used in telerehabilitation and virtual reality for post-stroke rehabilitation

Abstract

Introduction Despite the increased interest in telerehabilitation (TR), virtual reality (VR) and outcome measures for stroke rehabilitation, surprisingly little research has been done to map and identify the most common outcome measures used in TR. For this review, we conducted a systematic search of the literature that reports outcome measures used in TR or VR for stroke rehabilitation. Our specific objectives included: 1) to identify the outcome measures used in TR and VR studies; and 2) to describe which parts of the International Classification of Functioning are measured in the studies.

Methods We conducted a comprehensive search of relevant electronic databases (e.g. PubMed, the Cumulative Index to Nursing and Allied Health Literature, Embase, PSYCOINFO, The Cochrane Central Register of Controlled Trial and the Physiotherapy Evidence Database). The scoping review included all study designs. Two reviewers conducted pilot testing of the data extraction forms and independently screened all the studies and extracted the data. Disagreements about inclusion or exclusion were resolved by consensus or by consulting a third reviewer.

Results In total, 28 studies were included in this scoping review. The results were synthesized and reported considering the implications of the findings within the clinical practice and policy context.

Discussion This scoping review identified a wide range of outcome measures used in VR and TR studies and helped identify gaps in current use of outcome measures in the literature. The review also informs researchers and end users (i.e. clinicians, policymakers and researchers) regarding the most appropriate outcome measures for TR or VR.

Source: Scoping review of outcome measures used in telerehabilitation and virtual reality for post-stroke rehabilitation

 

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