Electromyographic audio biofeedback for telerehabilitation in hospital
ABSTRACT We investigated the use of surface electromyography with biofeedback for telerehabilitation. The aim was to investigate the therapist's point of view, and the general acceptability of the system for the patient and for the therapist. The system allowed a therapist to modulate the rehabilitation protocol remotely, by changing the configuration variables, e.g. threshold and duration. The case study focused on a patient with arm impairment following a stroke. After two weeks of daily usage, there were some differences between the patient and the therapist about the ease of use of the equipment. However, there was general agreement about the usefulness of the system, ease of the performed tasks, appropriateness of the performed tasks and overall opinion. Wireless technology would reduce the complexity of the tasks required of the patient.
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ABSTRACT: Abstract Background: When designing a complete process of daily telerehabilitation, it should be borne in mind that patients should be furnished with properly designed methodologies for executing specific motion tasks and the assessment of the relevant parameters. In general, such a process should comprehend three basic elements in both the hospital and the home: (a) instrumented walkways, (b) walking aids or supports, and (c) equipment for the assessment of parameters. The objective, with gait being the focus, of this study was thus to design a simple, portable kit-as an alternative to the complex and expensive instruments currently used-to be easily interfaced or integrated with the instrumented walkways and aids/supports both for self-monitoring while patients are exercising with their own aids and for clinical reporting. Materials and Methods: The proposed system is a portable kit that furnishes useful parameters with feedback to both the patient and the trainer/therapist. Capable of being integrated with the most common mechanical tools used in motion rehabilitation (handrail, scales, walkways, etc.), it constantly monitors and quantitatively assesses progress in rehabilitation care. It is composed of one step counter, photo-emitter detectors, one central unit for collecting and processing the telemetrically transmitted data, and a software interface. Results and Discussion: The system has been successfully validated on 16 subjects at the second level of the Tinetti test in a clinical application for both home and the hospital. The portable kit can be used with different rehabilitation tools and on varying ground rugosity. Advantages include (a) very low cost, when compared with optoelectronic solutions or other portable devices, (b) very high accuracy, also for subjects with imbalance problems, compared with other commercial solutions, and (c) integration (compatibility) with any rehabilitative tool.Telemedicine and e-Health 02/2013; 19(3). DOI:10.1089/tmj.2012.0091 · 1.54 Impact Factor
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ABSTRACT: When designing a complete system of daily-telerehabilitation it should be borne in mind that properly designed methodologies should be furnished for patients to execute specific motion tasks and for care givers to assess the relevant parameters. Whether in hospital or at home, the system should feature two basic elements: (a) instrumented and walking aids or supports, (b) equipment for the assessment of parameters. Being gait the focus, the idea was to design, construct and validate - as an alternative to the complex and expensive instruments currently used - a simple, portable kit that may be easily interfaced/integrated with the most common mechanical tools used in motion rehabilitation (instrumented walkways, aids, supports), with feedback to both patient for self-monitoring and trainer/therapist (present or remote) for clinical reporting. The proposed system consists of: one step-counter, three couples of photo-emitter detectors, one central unit for collecting and processing the telemetrically transmitted data; a software interface on a dedicated PC and a network adapter. The system has been successfully validated in a clinical application on two groups of 16 subjects at the 1st and 2nd level of the Tinetti test. The degree of acceptance by subjects and care-givers was high. The system was also successfully compared with an Inertial Measurement Unit, a de facto standard. The portable kit can be used with different rehabilitation tools and different ground rugosity. The advantages are: (a) very low costs when compared with optoelectronic solutions and other portable solutions; (b) very high accuracy, also for subjects with imbalance problems; (c) good compatibility with any rehabilitative tool.Computer methods and programs in biomedicine 07/2013; 112(1). DOI:10.1016/j.cmpb.2013.06.001 · 1.09 Impact Factor
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ABSTRACT: Integrating emerging technologies has shown to have the potential to improve access to rehabilitation services and the adherence for physical therapy when they are applied into telemedicine environments. This systematic review aims to explore telerehabilitation systems that use motion capture and video games for upper-limb rehabilitation purposes. Motion capture was focused on the information fusion from inertial sensors and other technologies. The search was limited to 2010-2013, from which 667 papers were obtained; afterwards, duplicate papers were removed, thus, reducing the sample to 57 papers with full text availability. Finally, only 3 of them were selected by approaching the subject of this study. We conclude that the fusion information from inertial sensors and other motion capture technologies appears to be a new tendency in remote monitoring of motor rehabilitation process. However, the combination of them with active video games in physiotherapy programs is only an emerging research area with promising results. Integración de tecnologías emergentes de captura de movimiento y videojuegos para la telerehabilitación de miembro superior: Una revisión sistemática Resumen La integración de nuevas tecnologías ha mostrado tener el potencial de mejorar el acceso a servicios de rehabilitación y la adherencia de los pacientes a la terapia física cuando éstas son usadas en servicios bajo la modalidad de telemedicina. Esta revisión sistemática busca explorar sistemas de telerehabilitación que usan nuevas tecnologías de captura de movimiento y video juegos para rehabilitación de miembro superior, haciendo énfasis en la captura de movimiento que fusiona información de sensores inerciales y otras tecnologías. La búsqueda fue realizada entre 2010 y 2013, encontrando 667 artículos; que se redujeron a 57 artículos con texto completo, luego de un proceso de remoción de artículos repetidos. Finalmente, solo tres de ellos fueron seleccionados por abordar el tema de este estudio. Esta revisión nos permite concluir que se presenta una tendencia en usar la fusión de información proveniente de sensores inerciales y otras tecnologías de captura de movimiento para monitorear procesos de rehabilitación motora. Sin embargo, la integración de estas tecnologías con video juegos activos en programas de fisioterapia es apenas un campo emergente de investigación con resultados prometedores. Palabras clave: telerehabilitación o tele-rehabilitación, captura de movimiento sin marcadores, sensores inerciales, videojuegos activos, miembros superiores, revisión sistemática.Dyna (Medellin, Colombia) 03/2015; 82(189):68-75. DOI:10.15446/dyna.v82n189.42066 · 0.22 Impact Factor