Posts Tagged wearables

[Conference Paper] Modelling of a wearable jacket with sensors and actuators for upper limb rehabilitation

Abstract

Introduction Spinal Cord Injury (SCI) affects a large number of young people and, if left  untreated, can deal irreversible damage to the human body. Several studies have demonstrated the positive impact of physical therapy to the rehabilitation process, promoting neuro-plasticity and thus at least partial restoration of functionality of the body and gait. These studies focus on the implementation of engineered solutions, such as robotic exoskeletons and virtual reality training regimens. The common denominator in most of them is the implementation of some form of Human-Machine Interface (HMI), for the control of these modalities by direct user feedback. These HMIs are based on a plethora of sensor arrays, ranging from direct motion-specific body data, such as Electroencephalography (EEG) and Electromyography (EMG) to more common sensor devices, such as accelerometers and gyroscopes. These sensors can provide direct measurements, tailored to the application at hand and provide the necessary data for the desired functionality. Materials and Methods The proposed device will function as a sensor array for the upper-body, providing live data for muscle activity, through the use of Electromyography (EMG) electrodes, as well as relative joint positioning and rotation, utilizing Inertial Measurement Units (IMUs), for the purpose of monitoring and Augmented Reality (AR) integration. Said motion data will be then used to enhance the users desired movement, through the use of Functional Electronic Stimulation (FES), by providing the necessary impulse to each muscle group, from the measured feedback. The relationship between sensor input and stimulation will allow for reinforcement of the users’ movements, promoting neuroplasticity and ease of movement in the process of neuro-rehabilitation. Furthermore, this modality will act as a platform for several other physiological measurements, such as heart rate and perspiration, essentially creating a functional Body-Area Network (BAN) of sensors. Integration with external motion actuators will be investigated, as a means to provide upper-body support, providing the necessary strength, as a means of easing the rehabilitation process and removing unnecessary stress from the user. Finally, interactions with implanted medical devices will be explored. Such devices could provide telemetry data from inside the body, to be used as a form of direct feedback for the designed Body Area Network (BAN), and the aforementioned stimulation and actuation.

via Modelling of a wearable jacket with sensors and actuators for upper limb rehabilitation

, , , , , , , , , , , ,

Leave a comment

[WEB SITE] UK hospital to explore VR for stroke patient rehabilitation

The debilitating impact of a stroke can last long after the event has taken place. Sufferers are often left with a range of problems, which make include poor balance, loss of coordination, partial paralysis, impaired spatial awareness and speech, and a lengthy recovery timeline.

At the extreme end of the scale, patients have to spend time in rehab learning to walk again. But just as damaging to those seeking a return to normality is the challenge of performing everyday tasks with the ease they were able to in the past. Just putting the kettle on or operating a toaster, for example, are skills that require confidence to be rebuilt alongside no small amount of cognitive rehabilitation.

Using VR to aid stroke recovery

Traditionally, that process involves hours of supervised – and often tediously repetitive – physiotherapy. Although the majority of people survive their first stroke, one-third are left with significant cognitive impairment that impedes their ability to function. Often this translates into needing social and financial support, in many cases for the rest of their lives.

In an effort to cut lengthy hospital stays, ease the burden on nursing staff, clinicians and therapists, and improve patient outcomes, the University of Chester’s Medical Graphics team has partnered with the Stroke Department at the Countess of Chester Hospital to see where Virtual Reality (VR) technology might fit in.

The concept behind the project is to help patients gain confidence and cognitive support in the relatively risk-free virtual world first, before carrying out tasks in the real world. The experimental project has been awarded a £453,000 grant from Innovate UK and will be assisted by local 3D imaging company, CadScan.

Using off-the-shelf VR headsets, the aim is to make intensive rehabilitation more accessible and immediate. In turn, the VR solution could reduce the duration and cost of long-term care while making rehab programmes more adaptable.

The devices can be operated with minimal supervision, and it goes without saying that practising physical processes in the virtual world carries less risk to patients who are vulnerable both physically and psychologically.

It’s also easier to track their recovery progress and pinpoint areas that require closer attention. “Patients will be able to measure how well their cognitive abilities are improving, building confidence in their ability to perform everyday tasks and reducing the psychological trauma often associated with the condition,” said Professor Nigel John from the University of Chester.

The UK spends around £9 billion every year caring for stroke sufferers. Fifty percent of that goes toward direct formal care. An influx of VR systems may sound like an expensive solution beyond the budget of most hospitals, but it could turn out to be a viable alternative for the future.

“The purpose of rehabilitation is to stimulate brain recovery through the stimulus of new areas that compensate for the area of damage. It can be tedious for many patients and expensive to provide. As a result, some of them may not receive the amount of specialist therapy time they actually need,” said Professor Kausik Chatterjee, consultant physician at the Countess of Chester Hospital.

“This is a problem not only for the NHS, but also for most of the healthcare system across the globe. This project is exciting in its ambition – both in terms of the benefit to the patient, and potential financial savings too.”

Plus: Researchers unveil ‘smart sticker’ for remote health monitoring

In related IoT health news, a research team at Purdue University, Indiana, have developed a smart sticker capable of remotely monitoring the health of heart patients.

The smart stickers’ largely cellulose structure means they are biocompatible and relatively inexpensive, explains the team’s research paper, published in ACS Applied Materials and Interfaces.

The smart stickers could be used internally, implanted onto internal organs to transmit data without causing adverse reactions. The researchers also suggest that athletes could use the technology to monitor health while exercising to provide alerts in real time.

To begin with, though, most applications are external. Ramses Martinez, Purdue University assistant professor of Industrial Engineering and Biomedical Engineering, said, “For the first time, we have created wearable electronic devices that someone can easily attach to their skin and are made out of paper to lower the cost of personalised medicine.

“The low cost of these wearable devices and their compatibility with large-scale manufacturing techniques will enable the quick adoption of these new fully disposable, wearable sensors in a variety of healthcare applications requiring single-use diagnostic systems,” he added.

Internet of Business says

The exploratory use of connected technologies in healthcare, including AI, wearables, and augmented and virtual reality, is booming and holds out great promise for the future, especially when it comes to the treatment of serious and debilitating conditions.

The wearables market in particular is seeing extensive innovation. For example, earlier this year we reported on how researchers have developed a smart sticking plaster that can monitor a patient’s blood pressure. Made of silicon elastomer, the postage-stamp sized wearable works by sending ultrasonic waves into the skin, which reflect off the wearer’s bodily tissues and blood.

In theory, the patch could be used to monitor patients at home, with the data collected over time and analysed on a laptop. As well as avoiding the need for multiple appointments, uncomfortable pressure tests, and invasive procedures, the wearable may help cut costs and reduce the risk of infection.

The system is being developed at the University of California, San Diego.

 

via UK hospital to explore VR for stroke patient rehabilitation | Internet of Business

, , , , , , , , , , , , , ,

Leave a comment

[Editorial] E-Rehabilitation: New Reality or Virtual Need?

 

This is an era of digitalization, internet, wifi, use of mobile and smart phones, virtual world, applications and technology. On one hand these are contributing to cyber psychopathology, on the other hand these have a potential for management.

With the understanding of disability as a complex interaction between the effects of illness and contextual factors, both personal and environmental, the relevance of new avenues to deliver rehabilitative services is profound. A significant proportion of the population is underserved, with the National Mental Health Survey of India 2016- a survey which covered 34,802 individuals from 12 states of India- showing a mental morbidity of 10.6% in those over the age of 18 years, and 7.3% in those between the ages of 13 and 17, but with a treatment gap of 28–83% (and 86% for alcohol use disorders). In addition, “three out of four persons with a severe mental disorder experienced significant disability in work, social and family life” [1]. Given the extent of the need and the dearth of services, the report recommends the following, “Technology based applications for near-to-home-based care using smart-phone by health workers, evidence-based (electronic) clinical decision support systems for adopting minimum levels of care by doctors, creating systems for longitudinal follow-up of affected persons to ensure continued care through electronic databases and registers can greatly help in this direction. To facilitate this, convergence with other flagship schemes such as Digital India needs to be explored” [1]. Recent data has shown that smartphone user base in India has crossed 300 million users in 2016, making it the second largest smartphone market in the world [2]. The potential for service delivery via internet enabled devices seems likely only to rise over time, but what are the possibilities before us now, and equally important, what are the challenges to such approaches?

An exploration of the role of modern technology in rehabilitation in January, 2016, has highlighted the various possibilities in terms of social networking and peer support, telepsychiatry, E health services as well as smartphones and apps [3]. It’s interesting that estimates at the time alluded to smartphone users crossing the 200 million mark in 2016, a 100 million users less than later estimates! Looking ahead these are the ways new and emerging technologies could change the ways we approach and conceptualise recovery,

  1. (a)

    Information access: Access to information and more specifically, access to relevant and accurate information have to potential to allow caregivers and patients to recognise mental health issues early, and seek help. Some of this information will be from traditional media, such as radio and television, but a significant proportion of people are likely to glean this information from social media sites and communication apps—such as the almost ubiquitous Whatsapp—on which they also consume other services and obtain their daily news and information from. Search algorithms and the way they rank different sources of information are likely to play an important role in the way people form their opinions about the illnesses they suffer from and the way they seek help. There is a need for curated information on mental health, especially in the Indian context and in vernacular languages, that people can not only refer to themselves, but which they can direct their friends and family toward as reliable sources of information too. Health care professionals must be prepared to help their patients learn ‘eHealth literacy’ [4].

  2. (b)

    Automation: Work is something that most people with mental illness aspire to do, and this can enhance their quality of life significantly [5]. Automation and applications of artificial intelligence are poised to change the face of industry as well as our lifestyles. Some traditional jobs such as fabrication and driving are poised to radically change. This will mean that vocational rehabilitation programmes will have to keep pace with a changing environment, and look to integrating industry expertise in the designing of courses and course materials which remain relevant to patients. Government programmes such as the Skill India initiative have the potential to help evolve this flexibility in course design, and to skill or re-skill persons in their quest to obtain and sustain jobs.

    Workplace is being replaced by home based workstations, computers, laptops and notebooks. People accustomed to these run their office from anywhere and everywhere. There will be a need to redefine ‘work place’ as ‘where ever the laptop is’. Thus, in future, persons undergoing rehabilitation, can ‘work from home’, provided they have the facilities, and job to do. Staying and working from home for persons with mental health problems, will prevent them from ‘live’ socialising, using social skills, and giving respite to family caregivers. On the other hand, they would be under direct supervision of the family, reducing their concerns and anxieties.

  3. (c)

    Digital identities and digital payments: With the increasing digitisation of access to services, there is a growing need for education in digital literacy and security. Programmes which teach life skills will have to help their users familiarise themselves with the advantages of new technologies as well as the risks they bring. A number of records related to disability are likely to form parts of central databases, such as the Unique Disability ID [6], and the potential to offer a number of services through a single user interface to those with disability is significant. It would also ease the accessing of such benefits even when patients travel or move to other states, whether temporarily or permanently. The storage of health records in electronic formats, e-health records, would allow patients to exert control over access to their own records and enable transfers from one healthcare provider to another without delay or loss of information. An e-health record format which is shared among different providers and which allows different hospital information systems to effectively share information is an important need. There can be a possibility to maintain a central registry of persons receiving mental health rehabilitation services.

  4. (d)

    Wearables and digital phenotyping: The mobile devices and other wearable accessories we use have the potential to collect vast amounts of information about our health. Newer approaches look to collect information such as changes in the speed of our typing or motor movements, or the searches we repeat and use these to make estimates about the status of our cognitive and neurological health in real time–an approach called digital phenotyping. This could aid in monitoring persons suffering from dementia or mild cognitive deficits. It could also be used to explore trajectories of development in children and adolescents, and could help inform early intervention programmes. Over and above monitoring, the use of digital assistants could be used to guide and shape behaviour in real time, provide cognitive aids and reduce dependency as well as the burden on caregivers for some tasks.

  5. (e)

    Virtual Reality and Augmented reality: Virtual reality (VR) refers to an interactive immersive experience wherein a computer generated world which a user can interact with is simulated with either a screen or a heads-up display. Augmented reality systems allow perception of the environment around along with the simulated projection. It’s also used to refer to situations where mobile phones or wearables can be used to interact with the environment around to either generate a virtual experience or provide additional information.

    It’s been used as an application for interventions in phobias for some time. Recent gains in the technology have coincided with an expansion of uses to cognitive rehabilitation, social skills training and even craving management in alcohol use disorders [7]. The number of mental health professionals available to deliver these services is low compared to demand and unequally distributed. With the evolution of mobile systems that can deliver VR experiences, such as the Google Daydream platform, it may be possible to translate some of these packages into content that can be delivered across such platforms with fidelity. There is still some work to be done about how perception of such experiences can affect symptoms in those with mental illness, and even if the same visual illusions are perceived differently.

  6. (f)

    Social networks, communication apps and peer support: Social networks and social media increasingly influence information access and viewpoints. They can serve as accepting communities to which people can feel as if they belong. They can also carry risks, including the spread of myths and misconceptions. Peer support groups, much like other networks, are now easier to form and to find. Hence, the potential for persons with mental illness to be involved in advocacy movements and to influence public policy is unprecedented, if still underutilised. The ability to use social networks and the internet to market products and expand networks can help those who chose to be entrepreneurs have greater reach and exposure. The ability to use these networks effectively, and other marketing skills, would also become a skill set that requires mentoring in.

  7. (g)

    The use of learning networks: Virtual classrooms and virtual learning networks have the potential to raise standards of care delivery by spreading best care practices and knowledge. Initiatives like the ECHO network and the Virtual Knowledge Network, NIMHANS can help spread the expertise of institutes by mentoring professionals who are involved in care delivery. They can also serve as ways to allow different institutes to demonstrate their own best practices and innovative models of service delivery to their peers.

The future of psychiatric practice, including psychiatric rehabilitation, in relation to virtual reality, technology and gadgets is likely to change with advances in technology and their usage [8]. While the tools that are available are changing, they will still be guided by the principles that form the bedrock of good practice in rehabilitation. Patients and their families may be drawn to online resources for rehabilitation.

The current issue of the journal is rather healthy with seventeen articles. And there is a good global distribution as well, with descriptions of mental health and rehabilitation services in Vietnam, Nigeria, USA, UK, Canada, Malaysia, and Iran. These have also covered a wide range of themes, from recovery scales, models for community based rehabilitation and community participation, in patient services, first episode psychosis, helping mothers with intellectual disabilities, and infertility. In addition, a book review on a very useful book on challenges of care giving for mental illness, cover an interesting spectrum of articles.

Source: E-Rehabilitation: New Reality or Virtual Need? | SpringerLink

, , , , , , , , , , , ,

Leave a comment

[WEB site] First trial of Cognition Kit wearables demonstrates effectiveness in measuring mental health

The neuroscience company Cambridge Cognition Holdings PLC, which develops near patient technologies for the assessment of brain health, has announced results from a new technology feasibility study. The results demonstrate for the first time that consumer grade wearables such as the Apple Watch® and Microsoft Band can be used to accurately measure clinically relevant cognitive performance in everyday life using the Company’s new Cognition Kit software.

Mental health conditions are among the leading causes of disability worldwide. With more than 450 million people living with mental illnesses, the cost of treatment and care to global economies will double by 2030 to over $6 trillion (Source: World Health Organization).

Current methods of brain health assessment rely on infrequent snapshots to characterise impairment and recovery. Such sparse sampling will often miss clinically significant changes, which can impact on a patient’s quality of life and limit the ability to accurately measure the effect of intervention and treatment.

Cognition Kit is a wearable software platform developed under a joint venture between Cambridge Cognition and London research agency Ctrl Group to address this growing need. The technology will enable doctors, scientists and patients to better understand and manage day-to-day brain health by measuring the key biological and psychological factors affecting mental performance accurately in real time.

The new study shows for the first time that wearable consumer devices can be used clinically to measure cognitive performance accurately when programmed with the Cognition Kit software.

During the study participants wore a wearable device to monitor their levels of stress and physiological activity using built-in sensors of heart rate, galvanic skin response and skin temperature.

Throughout each day, subjects completed game-like micro tests of cognition on the device to measure attention, memory, mood and reaction speed.

After each cognitive game, subjects reported how they felt by selecting one of six faces to convey their current mood. On June 24th, the day of the EU referendum results in the UK, the researchers observed a significant drop in the general mood of the British participants in the study.

The 30 million data points recorded demonstrate distinct patterns of performance within and across days, allowing a rich picture of a subject’s cognitive health to emerge. Cognition Kit thus has the potential to revolutionise brain health treatment at all stages – from patient assessments during the development of disease-modifying interventions to monitoring of patient health.

With drug development companies increasingly being required to demonstrate clinical outcomes-based value of treatments in patients, this Cognition Kit study provides evidence that new technologies could transform healthcare and medical research in a wearable health industry estimated to be worth $2 billion (Source: Soreon Research Wearable Healthcare Report 2014).

Cambridge Cognition is in discussion with a number of pharmaceutical partners following significant early interest boosted by the results of the study and expects to sign the first Cognition Kit contracts in the near future.

Francesca Cormack, PhD, Director of Research and Innovation, Cambridge Cognition commented

”This proof of concept study demonstrates for the first time that these consumer devices are enabling the rapid and accurate collection of largescale scientific datasets. This not only allows dramatically more detailed knowledge of moment-by-moment brain function but also opens up new possibilities to develop machine learning algorithms that will enable earlier detection and intervention in brain disorders.”

Ben Fehnert, Co-founder of Ctrl Group and Director of Cognition Kit commented

”Simple, regular interaction with peoples own phones and wearable devices is key to helping understand daily and longer term fluctuations in cognitive function. This study is the first demonstration of how Cognition Kit software can build a rich picture of brain health using peoples own devices during their daily lives.”

About Cognition Kit

Cognition Kit is a joint venture between Cambridge Cognition and Ctrl Group formed in 2016 to develop digital health tools on mobile and wearable devices. Cognition Kit software takes research out of the lab and into daily life, enabling doctors, scientists and the public to better understand and manage day-to-day brain health.

Source: First trial of Cognition Kit wearables demonstrates effectiveness in measuring mental health

, , , , , , , , , ,

Leave a comment

[Conference Item] Wearable Haptic Devices For PostStroke Gait Rehabilitation

Abstract

Wearable technologies, in the form of small, light and inconspicuous devices, can be designed to help individuals suffering from neurological conditions carry out regular rehabilitation exercises. Current research has shown that walking to a rhythm can lead to significant improvements in various aspects of gait.

Our primary aim is to provide a suitable, technology based intervention to enhance gait rehabilitation of people with chronic and degenerative neurological health conditions (such as stroke). This intervention will be in the form of small, lightweight, wireless, wearable devices the user can take out of the clinic, extending their rehabilitation to their own home setting. The devices can deliver a series of vibrations at a steady rhythm giving the patient a more stable and symmetric pace of walking.

The simplest version of this approach typically comprise of a very small network of just two nodes and a central controller. The existing prototypes (called the Haptic Bracelets) capture and analyse motion data in real time to provide adaptive haptic (through vibrations) cueing. In the future and after more refinement, the system could allow a single therapist to monitor and advise groups of stroke survivors undergoing therapy sessions.

Full Text PDF

 

Figure 1: A Haptic Bracelet device strapped on user’s leg.

Figure 2: Participant using the Haptic Bracelet devices

 

, , , , ,

Leave a comment

%d bloggers like this: