134 research outputs found
Devices and Data Workflow in COPD Wearable Remote Patient Monitoring: A Systematic Review
Background: With global increase in Chronic Obstructive Pulmonary Disease (COPD)
prevalence and mortality rates, and socioeconomical burden continuing to rise, current
disease management strategies appear inadequate, paving the way for technological
solutions, namely remote patient monitoring (RPM), adoption considering its acute disease
events management benefit. One RPM’s category stands out, wearable devices, due to its
availability and apparent ease of use.
Objectives: To assess the current market and interventional solutions regarding wearable
devices in the remote monitoring of COPD patients through a systematic review design from
a device composition, data workflow, and collected parameters description standpoint.
Methods: A systematic review was conducted to identify wearable device trends in this
population through the development of a comprehensive search strategy, searching beyond
the mainstream databases, and aggregating diverse information found regarding the same
device. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis
(PRISMA) guidelines were followed, and quality appraisal of identified studies was
performed using the Critical Appraisal Skills Programme (CASP) quality appraisal
checklists.
Results: The review resulted on the identification of 1590 references, of which a final 79
were included. 56 wearable devices were analysed, with the slight majority belonging to the
wellness devices class. Substantial device heterogeneity was identified regarding device
composition type and wearing location, and data workflow regarding 4 considered
components. Clinical monitoring devices are starting to gain relevance in the market and
slightly over a third, aim to assist COPD patients and healthcare professionals in
exacerbation prediction. Compliance with validated recommendations is still lacking, with
no devices assessing the totality of recommended vital signs.
Conclusions: The identified heterogeneity, despite expected considering the relative
novelty of wearable devices, alerts for the need to regulate the development and research of
these technologies, specially from a structural and data collection and transmission
standpoints.Introdução: Com o aumento global das taxas de prevalência e mortalidade da Doença
Pulmonar Obstrutiva Crónica (DPOC) e o seu impacto socioeconómico, as atuais estratégias
de gestão da doença parecem inadequadas, abrindo caminho para soluções tecnológicas,
nomeadamente para a adoção da monitorização remota, tendo em conta o seu benefício na
gestão de exacerbações de doenças crónicas. Dentro destaca-se uma categoria, os
dispositivos wearable, pela sua disponibilidade e aparente facilidade de uso.
Objetivos: Avaliar as soluções existentes, tanto no mercado, como na área de investigação,
relativas a dispositivos wearable utilizados na monitorização remota de pacientes com
DPOC através de uma revisão sistemática, do ponto de vista da composição do dispositivo,
fluxo de dados e descrição dos parâmetros coletados.
Métodos: Uma revisão sistemática foi realizada para identificar tendências destes
dispositivos, através do desenvolvimento de uma estratégia de pesquisa abrangente,
procurando pesquisar para além das databases convencionais e agregar diversas
informações encontradas sobre o mesmo dispositivo. Para tal, foram seguidas as diretrizes
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), e a
avaliação da qualidade dos estudos identificados foi realizada utilizando a ferramenta CASP
(Critical Appraisal Skills Programme).
Resultados: A revisão resultou na identificação de 1590 referências, das quais 79 foram
incluídas. Foram analisados 56 dispositivos wearable, com a ligeira maioria a pertencer à
classe de dispositivos de wellness. Foi identificada heterogeneidade substancial nos
dispositivos em relação à sua composição, local de uso e ao fluxo de dados em relação a 4
componentes considerados. Os dispositivos de monitorização clínica já evidenciam alguma
relevância no mercado e, pouco mais de um terço, visam auxiliar pacientes com DPOC e
profissionais de saúde na previsão de exacerbações. Ainda assim, é notória a falta do
cumprimento das recomendações validadas, não estando disponíveis dispositivos que
avaliem a totalidade dos sinais vitais recomendados.
Conclusão: A heterogeneidade identificada, apesar de esperada face à relativa novidade
dos dispositivos wearable, alerta para a necessidade de regulamentação do
desenvolvimento e investigação destas tecnologias, especialmente do ponto de vista
estrutural e de recolha e transmissão de dados
Mobile Health Technologies
Mobile Health Technologies, also known as mHealth technologies, have emerged, amongst healthcare providers, as the ultimate Technologies-of-Choice for the 21st century in delivering not only transformative change in healthcare delivery, but also critical health information to different communities of practice in integrated healthcare information systems. mHealth technologies nurture seamless platforms and pragmatic tools for managing pertinent health information across the continuum of different healthcare providers. mHealth technologies commonly utilize mobile medical devices, monitoring and wireless devices, and/or telemedicine in healthcare delivery and health research. Today, mHealth technologies provide opportunities to record and monitor conditions of patients with chronic diseases such as asthma, Chronic Obstructive Pulmonary Diseases (COPD) and diabetes mellitus. The intent of this book is to enlighten readers about the theories and applications of mHealth technologies in the healthcare domain
A proof of concept of a mobile health application to support professionals in a portuguese nursing home
Over the past few years, the rapidly aging population has been posing several challenges to healthcare systems worldwide. Consequently, in Portugal, nursing homes have been getting a higher demand, and health professionals working in these facilities are overloaded with work. Moreover, the lack of health information and communication technology (HICT) and the use of unsophisticated methods, such as paper, in nursing homes to clinically manage residents lead to more errors and are time-consuming. Thus, this article proposes a proof of concept of a mobile health (mHealth) application developed for the health professionals working in a Portuguese nursing home to support them at the point-of-care, namely to manage and have access to information and to help them schedule, perform, and digitally record their tasks. Additionally, clinical and performance business intelligence (BI) indicators to assist the decision-making process are also defined. Thereby, this solution aims to introduce technological improvements into the facility to improve healthcare delivery and, by taking advantage of the benefits provided by these improvements, lessen some of the workload experienced by health professionals, reduce time-waste and errors, and, ultimately, enhance elders’ quality of life and improve the quality of the services provided.This work has been supported by FCT – Fundação para a Ciência e Tecnologia within the Project Scope: UID/CEC/00319/2019
Co-designing an eHealth Intervention to Support the Self-Management of Fibromyalgia
Fibromyalgia is a rheumatic pathology that causes a wide range of symptoms that can
appear individually, or in sets, such as fatigue, sleep disorders, attention, and concentration
deficit, also having connection with musculoskeletal, psychological, cardiovascular,
gastrointestinal disorders. This pathology has a greater predominance in women and, in
Portugal, for every man there are six women with the diagnosis and a total of approximately
two hundred thousand people (2.1% of the population).
The non-pharmaceutical way to mitigate these symptoms is through physical therapy.
Considering the pandemic moment in which we live, there have been many difficulties in
having physical therapy sessions because of the fear of infection through contact with their
physical therapists. There are also people who live in more isolated areas and with little access
to healthcare, who often must travel to larger urban centers to get the care they need. Moreover,
these people have difficulties in self-managing their illness, where depending on the day their
symptoms can get worse, and they do not know how to deal with them.
Currently, there is no specialized solution for people with this diagnosis that solves these
problems, so this dissertation aims to study and design a solution that allows people diagnosed
with fibromyalgia to self-manage their pathology, as well as have a closer contact with their
physical therapist, by being able to perform their sessions in a hybrid way, i.e., in person or
remotely.
This solution was designed using a Co-Design approach, following the Design Thinking
methodology, where the community (people with the diagnosis, physiotherapists, researchers
and academics) were involved in all stages of the process, from problem identification and
idealization of their solutions, to prototyping and its validation. This solution involved the
development of a mobile application, having several important components, such as self management, telerehabilitation, motivation, community and communication. In order to
evaluate the whole process and the usability of the solution, tests were performed with end
users who had not yet participated in the design of the solution
How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers
Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program
A Telerehabilitation System for the Selection, Evaluation and Remote Management of Therapies
Telerehabilitation systems that support physical therapy sessions anywhere can help save healthcare costs while also improving the quality of life of the users that need rehabilitation. The main contribution of this paper is to present, as a whole, all the features supported by the innovative Kinect-based Telerehabilitation System (KiReS). In addition to the functionalities provided by current systems, it handles two new ones that could be incorporated into them, in order to give a step forward towards a new generation of telerehabilitation systems. The knowledge extraction functionality handles knowledge about the physical therapy record of patients and treatment protocols described in an ontology, named TRHONT, to select the adequate exercises for the rehabilitation of patients. The teleimmersion functionality provides a convenient, effective and user-friendly experience when performing the telerehabilitation, through a two-way real-time multimedia communication. The ontology contains about 2300 classes and 100 properties, and the system allows a reliable transmission of Kinect video depth, audio and skeleton data, being able to adapt to various network conditions. Moreover, the system has been tested with patients who suffered from shoulder disorders or total hip replacement.This research was funded by the Spanish Ministry of Economy and Competitiveness grant number FEDER/TIN2016-78011-C4-2R
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