A software to manage rehabilitation sessions with a robotic walker

Dissertação de mestrado integrado em Informatics EngineeringCerebellar ataxia arises from damage or dysfunction that affects the cerebellum and its pathways. As a result, the motor abilities of individuals with this condition become weakened. Robotics-assisted therapy is still an emerging area, but it has several advantages that could boost the rehabilitation of these individuals. Considering this problematic, WALKit Smart Walker is being developed. Its main purpose is to improve the treatment of ataxic patients through intelligent and multidisciplinary rehabilitation sessions. Thus, it is equipped with several sensors that provide monitoring capabilities through a continuous evaluation of the end-user gait and posture. A vast amount of data is acquired during each session by the walker sensors. For health professionals to analyse this data and have feedback on the patient’s status throughout therapy, tools are needed to control, manage, and monitor sessions in a clear, practical and intuitive way. Therefore, the main goal of this dissertation is centred on implementing an effective way to store the acquired data, along with the development of software that satisfies these requirements. To address these goals, a polyglot persistence database system, composed of a relational and a non-relational database, was implemented to store the required data while maintaining efficiency. Furthermore, a web application was developed to provide, not only to health professionals, but also to patients themselves, the management of the rehabilitation sessions with the walker. The application provides an individual and temporal analysis of the sessions through interactive graphics adapted to each patient. Additionally, it allows the management of the several patients who are/were in treatment and the addition of clinical ratting scales, which are useful to assess their motor condition and adapt therapies as needed. In this way, professionals can have a better perception of the patient’s condition, and can show patients their evolution, possibly contributing to increase their motivation in therapy. Moreover, in the context of this dissertation, the embedded software of WALKit SmartW, which allows the therapy configuration, was optimized. This software had no security mechanisms, thus the main goal was on the implementation of techniques capable of making the software secure. Additionally, other functionalities such as feedback alerts, were added to the existing application. Throughout the development of this project, it was possible to have continuous feedback from health professionals of the Hospital of Braga. Usability tests and questionnaires were also applied, and the results were very promising, enhancing the need for a system with these characteristics. Professionals claimed the system may help in analysing the patient clinical status in an intuitive form while keeping them motivated during treatments.A ataxia cerebelar surge a partir de danos ou disfunções que afetam o cerebelo e as suas vias. Como resultado, as capacidades motoras dos indivíduos que possuem esta condição ficam fragilizadas. A terapia assistida por robôs é ainda uma área em desenvolvimento, no entanto apresenta diversas vantagens que poderão agilizar os tratamentos destes indivíduos. Atendendo a esta problemática, o WALKit SmartW encontra-se a ser desenvolvido. O seu principal propósito é auxiliar os tratamentos de pacientes ataxicos através de sessões de reabilitação inteligentes e multidisciplinares. Para tal, é composto por um conjunto de sensores que fornecem uma monitorização e avaliação contínua da marcha e da postura do utilizador. Uma grande quantidade de dados é adquirida ao longo de cada sessão através dos sensores. De forma a que os profissionais de saúde analisem estes dados e tenham feedback do estado do paciente ao longo da terapia, são necessárias ferramentas que permitam controlar, gerir e monitorizar as sessões, de forma clara, prática e intuitiva. O principal objetivo desta dissertação centra-se na implementação de uma estratégia eficiente para armazenar os dados, juntamente com o desenvolvimento de um software que satisfaça estes requisitos. Para cumprir estes objetivos, um sistema de base de dados com persistência poliglota, composto por uma base de dados relacional e uma não relacional, foi implementado para armazenar os dados mantendo a eficiência. Além disso, uma aplicação web foi desenvolvida para proporcionar, não só aos profissionais de saúde, como também aos próprios pacientes, a gestão das sessões de reabilitação com o andarilho. A aplicação disponibiliza uma análise individual e temporal das sessões através de gráficos interativos adaptados a cada paciente. Adicionalmente, possibilita também a gestão dos diversos pacientes que estão/estiveram em tratamento, e a adição de escalas de classificação clínica, que são úteis para avaliar a condição motora e adaptar as terapias conforme necessário. Desta forma, os profissionais conseguem ter uma melhor perceção acerca do estado do paciente, e os pacientes podem ver a sua evolução, contribuindo para aumentar a motivação na terapia. Ainda no contexto desta dissertação, otimizou-se a aplicação embebida no software do andarilho WALKit, que permite as configurações da terapia. O software era isento de qualquer mecanismo de segurança, pelo que o maior foco centrou-se na aplicação de técnicas capazes de o tornar seguro. Adicionalmente, outras funcionalidades, como alertas e configurações de algoritmos, foram adicionadas à aplicação existente. Ao longo do desenvolvimento deste projeto, foi possível obter o feedback contínuo de profissionais de saúde do Hospital de Braga. Testes e questionários de usabilidade foram também aplicados, e os resusltados foram bastante promissores, reforçando a necessidade de um sistema com estas características. Os profissionais afirmaram que o sistema irá ajudar a analisar o estado do paciente de forma intuitiva, mantendo-o motivado durante os tratamentos

A Universalist strategy for the design of Assistive Technology

Assistive Technologies are specialized products aiming to partly compensate for the loss of autonomy experienced by disabled people. Because they address special needs in a highly-segmented market, they are often considered as niche products. To improve their design and make them tend to Universality, we propose the EMFASIS framework (Extended Modularity, Functional Accessibility, and Social Integration Strategy). We first elaborate on how this strategy conciliates niche and Universalist views, which may appear conflicting at first sight. We then present three examples illustrating its application for designing Assistive Technologies: the design of an overbed table, an upper-limb powered orthose and a powered wheelchair. We conclude on the expected outcomes of our strategy for the social integration and participation of disabled people

Information and Communication Technology

Welfare technology is currently in focus in most parts of the world, municipalities, companies, educational institutions, and in central programs and foundations. New products are being developed and tested. The range of products where welfare technology is included is wide. There is a technology built into many aids and there is a new technology with touch screens and video communication for a broad wide of patient groups. It is a broad field that can be included under the designation welfare technology. This chapter explains the trends and scratches the background for the current interest in welfare technology along with science and innovation, which is often presented as a means to solve what is referred to as an aging population with more upcoming chronic diseases, fewer resources and limitations among the healthcare professionals and fewer hands to take care of required needs in healthcare sections

A System for Monitoring Stroke Patients in a Home Environment

Currently, the changes of functional capacity and performance of stroke patients after returning home from a rehabilitation hospital is unknown for a physician, having no objective information about the intensity and quality of a patient's daily-life activities. Therefore, there is a need to develop and validate an unobtrusive and modular system for objectively monitoring the stroke patient's upper and lower extremity motor function in daily-life activities and in home training. This is the main goal of the European FP7 project named “INTERACTION‿. A complete sensing system is developed, whereby Inertial Measurement Units (IMU), Knitted Piezoresistive Fabric (KPF) goniometers, KPF strain sensors, EMG electrodes and force sensors are integrated into a modular sensor suit designed for stroke patients. In this paper, we describe the systems architecture. Data from the sensors are captured wirelessly and stored in a remote secure database for later access and processing via portal technology. In collaboration with clinicians and engineers, clinical outcome measures were defined and the question of how to present the data on the web portal was addressed. The first implementation of the complete system includes a basic version of all components and is currently being extended to include all sensors within the INTERACTION system

Future bathroom: A study of user-centred design principles affecting usability, safety and satisfaction in bathrooms for people living with disabilities

Research and development work relating to assistive technology 2010-11 (Department of Health) Presented to Parliament pursuant to Section 22 of the Chronically Sick and Disabled Persons Act 197

Improving brain injury cognitive rehabilitation by personalized telerehabilitation services: Guttmann neuropersonal trainer

Cognitive rehabilitation aims to remediate or alleviate the cognitive deficits appearing after an episode of acquired brain injury (ABI). The purpose of this work is to describe the telerehabilitation platform called Guttmann Neuropersonal Trainer (GNPT) which provides new strategies for cognitive rehabilitation, improving efficiency and access to treatments, and to increase knowledge generation from the process. A cognitive rehabilitation process has been modeled to design and develop the system, which allows neuropsychologists to configure and schedule rehabilitation sessions, consisting of set of personalized computerized cognitive exercises grounded on neuroscience and plasticity principles. It provides remote continuous monitoring of patient's performance, by an asynchronous communication strategy. An automatic knowledge extraction method has been used to implement a decision support system, improving treatment customization. GNPT has been implemented in 27 rehabilitation centers and in 83 patients' homes, facilitating the access to the treatment. In total, 1660 patients have been treated. Usability and cost analysis methodologies have been applied to measure the efficiency in real clinical environments. The usability evaluation reveals a system usability score higher than 70 for all target users. The cost efficiency study results show a relation of 1-20 compared to face-to-face rehabilitation. GNPT enables brain-damaged patients to continue and further extend rehabilitation beyond the hospital, improving the efficiency of the rehabilitation process. It allows customized therapeutic plans, providing information to further development of clinical practice guidelines

Design Requirements for a Patient Administered Personal Electronic Health Record

Published version of a chapter in the book: Biomedical engineering, trends in electronics, communications and software. Intech, 2011 Open Acces

Challenges in Developing Applications for Aging Populations

Elderly individuals can greatly benefit from the use of computer applications, which can assist in monitoring health conditions, staying in contact with friends and family, and even learning new things. However, developing accessible applications for an elderly user can be a daunting task for developers. Since the advent of the personal computer, the benefits and challenges of developing applications for older adults have been a hot topic of discussion. In this chapter, the authors discuss the various challenges developers who wish to create applications for the elderly computer user face, including age-related impairments, generational differences in computer use, and the hardware constraints mobile devices pose for application developers. Although these challenges are concerning, each can be overcome after being properly identified