ePhysio: A Wearables-Enabled Platform for the Remote Management of Musculoskeletal Diseases

Technology advancements in wireless communication and embedded computing are fostering their evolution from standalone elements to smart objects seamlessly integrated in the broader context of the Internet of Things. In this context, wearable sensors represent the building block for new cyber-physical social systems, which aim at improving the well-being of people by monitoring and measuring their activities and provide an immediate feedback to the users. In this paper, we introduce ePhysio, a large-scale and flexible platform for sensor-assisted physiotherapy and remote management of musculoskeletal diseases. The system leverages networking and computing tools to provide real-time and ubiquitous monitoring of patients. We propose three use cases which differ in scale and context and are characterized by different human interactions: single-user therapy, indoor group therapy, and on-field therapy. For each use case, we identify the social interactions, e.g., between the patient and the physician and between different users and the performance requirements in terms of monitoring frequency, communication, and computation. We then propose three related deployments, highlighting the technologies that can be applied in a real system. Finally, we describe a proof-of-concept implementation, which demonstrates the feasibility of the proposed solution

Toward enhanced clinical decision support for patients undergoing a hip or knee replacement: focus group and interview study with surgeons

Background: The current assessment of recovery after total hip or knee replacement is largely based on the measurement of health outcomes through self-report and clinical observations at follow-up appointments in clinical settings. Home activity-based monitoring may improve assessment of recovery by enabling the collection of more holistic information on a continuous basis. Objective: This study aimed to introduce orthopedic surgeons to time-series analyses of patient activity data generated from a platform of sensors deployed in the homes of patients who have undergone primary total hip or knee replacement and understand the potential role of these data in postoperative clinical decision-making. Methods: Orthopedic surgeons and registrars were recruited through a combination of convenience and snowball sampling. Inclusion criteria were a minimum required experience in total joint replacement surgery specific to the hip or knee or familiarity with postoperative recovery assessment. Exclusion criteria included a lack of specific experience in the field. Of the 9 approached participants, 6 (67%) orthopedic surgeons and 3 (33%) registrars took part in either 1 of 3 focus groups or 1 of 2 interviews. Data were collected using an action-based approach in which stimulus materials (mock data visualizations) provided imaginative and creative interactions with the data. The data were analyzed using a thematic analysis approach. Results: Each data visualization was presented sequentially followed by a discussion of key illustrative commentary from participants, ending with a summary of key themes emerging across the focus group and interview data set. Conclusions: The limitations of the evidence are as follows. The data presented are from 1 English hospital. However, all data reflect the views of surgeons following standard national approaches and training. Although convenience sampling was used, participants’ background, skills, and experience were considered heterogeneous. Passively collected home monitoring data offered a real opportunity to more objectively characterize patients’ recovery from surgery. However, orthopedic surgeons highlighted the considerable difficulty in navigating large amounts of complex data within short medical consultations with patients. Orthopedic surgeons thought that a proposed dashboard presenting information and decision support alerts would fit best with existing clinical workflows. From this, the following guidelines for system design were developed: minimize the risk of misinterpreting data, express a level of confidence in the data, support clinicians in developing relevant skills as time-series data are often unfamiliar, and consider the impact of patient engagement with data in the future

Design and Development of Biofeedback Stick Technology (BfT) to Improve the Quality of Life of Walking Stick Users

Biomedical engineering has seen a rapid growth in recent times, where the aim to facilitate and equip humans with the latest technology has become widespread globally. From high-tech equipment ranging from CT scanners, MRI equipment, and laser treatments, to the design, creation, and implementation of artificial body parts, the field of biomedical engineering has significantly contributed to mankind. Biomedical engineering has facilitated many of the latest developments surrounding human mobility, with advancement in mobility aids improving human movement for people with compromised mobility either caused by an injury or health condition. A review of the literature indicated that mobility aids, especially walking sticks, and appropriate training for their use, are generally prescribed by allied health professionals (AHP) to walking stick users for rehabilitation and activities of daily living (ADL). However, feedback from AHP is limited to the clinical environment, leaving walking stick users vulnerable to falls and injuries due to incorrect usage. Hence, to mitigate the risk of falls and injuries, and to facilitate a routine appraisal of individual patient’s usage, a simple, portable, robust, and reliable tool was developed which provides the walking stick users with real-time feedback upon incorrect usage during their activities of daily living (ADL). This thesis aimed to design and develop a smart walking stick technology: Biofeedback stick technology (BfT). The design incorporates the approach of patient and public involvement (PPI) in the development of BfT to ensure that BfT was developed as per the requirements of walking stick users and AHP recommendations. The newly developed system was tested quantitatively for; validity, reliability, and reproducibility against gold standard equipment such as the 3D motion capture system, force plates, optical measurement system for orientation, weight bearing, and step count. The system was also tested qualitatively for its usability by conducting semi-informal interviews with AHPs and walking stick users. The results of these studies showed that the newly developed system has good accuracy, reported above 95% with a maximum inaccuracy of 1°. The data reported indicates good reproducibility. The angles, weight, and steps recorded by the system during experiments are within the values published in the literature. From these studies, it was concluded that, BfT has the potential to improve the lives of walking stick users and that, with few additional improvements, appropriate approval from relevant regulatory bodies, and robust clinical testing, the technology has a huge potential to carve its way to a commercial market

pHealth 2021. Proc. of the 18th Internat. Conf. on Wearable Micro and Nano Technologies for Personalised Health, 8-10 November 2021, Genoa, Italy

Smart mobile systems – microsystems, smart textiles, smart implants, sensor-controlled medical devices – together with related body, local and wide-area networks up to cloud services, have become important enablers for telemedicine and the next generation of healthcare services. The multilateral benefits of pHealth technologies offer enormous potential for all stakeholder communities, not only in terms of improvements in medical quality and industrial competitiveness, but also for the management of healthcare costs and, last but not least, the improvement of patient experience. This book presents the proceedings of pHealth 2021, the 18th in a series of conferences on wearable micro and nano technologies for personalized health with personal health management systems, hosted by the University of Genoa, Italy, and held as an online event from 8 – 10 November 2021. The conference focused on digital health ecosystems in the transformation of healthcare towards personalized, participative, preventive, predictive precision medicine (5P medicine). The book contains 46 peer-reviewed papers (1 keynote, 5 invited papers, 33 full papers, and 7 poster papers). Subjects covered include the deployment of mobile technologies, micro-nano-bio smart systems, bio-data management and analytics, autonomous and intelligent systems, the Health Internet of Things (HIoT), as well as potential risks for security and privacy, and the motivation and empowerment of patients in care processes. Providing an overview of current advances in personalized health and health management, the book will be of interest to all those working in the field of healthcare today

Wearable Technology Supported Home Rehabilitation Services in Rural Areas:– Emphasis on Monitoring Structures and Activities of Functional Capacity Handbook

The sustainability of modern healthcare systems is under threat. – the ageing of the population, the prevalence of chronic disease and a need to focus on wellness and preventative health management, in parallel with the treatment of disease, pose significant social and economic challenges. The current economic situation has made these issues more acute. Across Europe, healthcare expenditure is expected to rice to almost 16% of GDP by 2020. (OECD Health Statistics 2018). Coupled with a shortage of qualified personnel, European nations are facing increasing challenges in their ability to provide better-integrated and sustainable health and social services. The focus is currently shifting from treatment in a care center to prevention and health promotion outside the care institute. Improvements in technology offers one solution to innovate health care and meet demand at a low cost. New technology has the potential to decrease the need for hospitals and health stations (Lankila et al., 2016. In the future the use of new technologies – including health technologies, sensor technologies, digital media, mobile technology etc. - and digital services will dramatically increase interaction between healthcare personnel and customers (Deloitte Center for Health Solutions, 2015a; Deloitte Center for Health Solutions 2015b). Introduction of technology is expected to drive a change in healthcare delivery models and the relationship between patients and healthcare providers. Applications of wearable sensors are the most promising technology to aid health and social care providers deliver safe, more efficient and cost-effective care as well as improving people’s ability to self-manage their health and wellbeing, alert healthcare professionals to changes in their condition and support adherence to prescribed interventions. (Tedesco et al., 2017; Majumder et al., 2017). While it is true that wearable technology can change how healthcare is monitored and delivered, it is necessary to consider a few things when working towards the successful implementation of this new shift in health care. It raises challenges for the healthcare systems in how to implement these new technologies, and how the growing amount of information in clinical practice, integrates into the clinical workflows of healthcare providers. Future challenges for healthcare include how to use the developing technology in a way that will bring added value to healthcare professionals, healthcare organizations and patients without increasing the workload and cost of the healthcare services. For wearable technology developers, the challenge will be to develop solutions that can be easily integrated and used by healthcare professionals considering the existing constraints. This handbook summarizes key findings from clinical and laboratory-controlled demonstrator trials regarding wearables to assist rehabilitation professionals, who are planning the use of wearable sensors in rehabilitation processes. The handbook can also be used by those developing wearable sensor systems for clinical work and especially for use in hometype environments with specific emphasis on elderly patients, who are our major health care consumers

Smart and Pervasive Healthcare

Smart and pervasive healthcare aims at facilitating better healthcare access, provision, and delivery by overcoming spatial and temporal barriers. It represents a shift toward understanding what patients and clinicians really need when placed within a specific context, where traditional face-to-face encounters may not be possible or sufficient. As such, technological innovation is a necessary facilitating conduit. This book is a collection of chapters written by prominent researchers and academics worldwide that provide insights into the design and adoption of new platforms in smart and pervasive healthcare. With the COVID-19 pandemic necessitating changes to the traditional model of healthcare access and its delivery around the world, this book is a timely contribution

Latest research trends in gait analysis using wearable sensors and machine learning: a systematic review

Gait is the locomotion attained through the movement of limbs and gait analysis examines the patterns (normal/abnormal) depending on the gait cycle. It contributes to the development of various applications in the medical, security, sports, and fitness domains to improve the overall outcome. Among many available technologies, two emerging technologies that play a central role in modern day gait analysis are: A) wearable sensors which provide a convenient, efficient, and inexpensive way to collect data and B) Machine Learning Methods (MLMs) which enable high accuracy gait feature extraction for analysis. Given their prominent roles, this paper presents a review of the latest trends in gait analysis using wearable sensors and Machine Learning (ML). It explores the recent papers along with the publication details and key parameters such as sampling rates, MLMs, wearable sensors, number of sensors, and their locations. Furthermore, the paper provides recommendations for selecting a MLM, wearable sensor and its location for a specific application. Finally, it suggests some future directions for gait analysis and its applications