Monitoring pulmonary rehabilitation and long-term oxygen therapy for people with chronic obstructive pulmonary disease (COPD)

This report outlines a proposed approach to monitoring access to, and utilisation of, pulmonary rehabilitation and long term oxygen therapy, by capitalising on existing data sources and identifying data development opportunities.SummaryChronic obstructive pulmonary disease (COPD) is a major cause of death and disability in Australia. About 1 in 13 people aged 40 and over have lung function consistent with a diagnosis of COPD. The disease develops over many years and therefore mainly affects middle-aged and older people. Smoking is its main, but not only, cause. Current clinical guidelines for the management of COPD (developed by the Thoracic Society of Australia and New Zealand and Lung Foundation Australia) emphasise the importance of care that encompasses both drug and non-drug based interventions designed to improve quality of life and survival. Pulmonary rehabilitation is a system of care that includes a combination of exercise, education and psychosocial support. It has been shown to have a wide range of beneficial effects, particularly because of its exercise component. Pulmonary rehabilitation implemented after a hospital admission reduces the risk of re-hospitalisation and death, and improves quality of life. Selective use of long-term oxygen therapy (LTOT)-the provision of supplemental oxygen therapy for 15 hours per day or more for people with COPD who have persistently low levels of oxygen in their blood-has been shown to improve quality of life and improve survival. Both of these therapies are among the key non-pharmacological interventions recommended in national and international clinical guidelines. Available evidence suggests, however, that pulmonary rehabilitation and LTOT are under-utilised in managing patients with COPD in Australia. The full extent of service provision, utilisation and under-utilisation is not known as there are no national data. This report outlines: proposed indicators relevant to monitoring access to, and utilisation of, pulmonary rehabilitation and LTOT in Australiaexisting data sources that may inform these indicatorsoptions for data developmentpotential challenges in monitoring these therapies. Improved information about access to, and use of, these interventions among people with COPD would enable: identification of opportunities for health improvementmeasurement of the benefits derived from these interventions. This would form a useful basis for data development to support assessment of the appropriateness of use, barriers to uptake and outcomes of these therapies. Similar information about the provision of non-inpatient, non-procedural and non- pharmaceutical therapies is also relevant to monitoring other chronic diseases in which these interventions improve quality of life and extend life. The authors of this report are Guy Marks, Helen Reddel, Elyse Guevara-Rattray, Leanne Poulos and Rosario Ampon of the Australian Centre for Asthma Monitoring (ACAM)

Physioland: a motivational complement of physical therapy for patients with neurological diseases

The number of patients with mobility constraints is increasing as a result of neurological diseases. From the substantiation of the lost functions recoveries, it was possible to determine that the nervous system is able to reorganize itself expressing its property called neuroplasticity. Physical therapy is the well-known way to encourage and promote this ability. However, repetitive traditional physical therapy exercises may become boring and patients eventually abandon their physiotherapeutic programs. The development of new environments that motivate patients to continue with their treatments may be a suitable alternative or complementary tool. Serious games seems to be the ideal tool to provide them. Thus, the purpose of this paper is to present Physioland, a serious game already developed which can be a motivational complement for the physical therapy of patients with neurological diseases. Physioland is a non-invasive system that uses Image Processing Techniques and Artificial Intelligence to monitor patients and adapts some exercises of traditional physical therapy to electronic game situations. To determine whether Physioland would be motivating and challenging enough to increase a patient's desire to perform the exercises and continue/complete the rehabilitation process the game was tested in a clinical environment using two samples: one with twelve health professionals in the area of physiotherapy and the other with eleven patients with neurological diseases. The research team carried out a questionnaire-based survey. This questionnaire is an adaptation of another one already validated in the literature—the Technology Acceptance Model (TAM). For the analysis of the data obtained with the Likert scale, percentages were calculated. The answers to the open questions were subject to a content analysis. The results showed that the developed game, Physioland, proved to be highly motivating for patients at the physiotherapy clinic where it was tested. If the results are similar in other clinics, Physioland, can be used as a good and effective complement to traditional physical therapy for patients with neurological diseases.info:eu-repo/semantics/publishedVersio

Sensor-Based Rehabilitation in Neurological Diseases: A Bibliometric Analysis of Research Trends

Background: As the field of sensor-based rehabilitation continues to expand, it is important to gain a comprehensive understanding of its current research landscape. This study aimed to conduct a bibliometric analysis to identify the most influential authors, institutions, journals, and research areas in this field. Methods: A search of the Web of Science Core Collection was performed using keywords related to sensor-based rehabilitation in neurological diseases. The search results were analyzed with CiteSpace software using bibliometric techniques, including co-authorship analysis, citation analysis, and keyword co-occurrence analysis. Results: Between 2002 and 2022, 1103 papers were published on the topic, with slow growth from 2002 to 2017, followed by a rapid increase from 2018 to 2022. The United States was the most active country, while the Swiss Federal Institute of Technology had the highest number of publications among institutions. Sensors published the most papers. The top keywords included rehabilitation, stroke, and recovery. The clusters of keywords comprised machine learning, specific neurological conditions, and sensor-based rehabilitation technologies. Conclusions: This study provides a comprehensive overview of the current state of sensor-based rehabilitation research in neurological diseases, highlighting the most influential authors, journals, and research themes. The findings can help researchers and practitioners to identify emerging trends and opportunities for collaboration and can inform the development of future research directions in this field

A Review of Wireless Body Area Networks for Medical Applications

Recent advances in Micro-Electro-Mechanical Systems (MEMS) technology, integrated circuits, and wireless communication have allowed the realization of Wireless Body Area Networks (WBANs). WBANs promise unobtrusive ambulatory health monitoring for a long period of time and provide real-time updates of the patient's status to the physician. They are widely used for ubiquitous healthcare, entertainment, and military applications. This paper reviews the key aspects of WBANs for numerous applications. We present a WBAN infrastructure that provides solutions to on-demand, emergency, and normal traffic. We further discuss in-body antenna design and low-power MAC protocol for WBAN. In addition, we briefly outline some of the WBAN applications with examples. Our discussion realizes a need for new power-efficient solutions towards in-body and on-body sensor networks.Comment: 7 pages, 7 figures, and 3 tables. In V3, the manuscript is converted to LaTe

Service delivery for people with hereditary spastic paraparesis living in the South West of England.

PURPOSE: Hereditary Spastic Paraplegia (HSP) is an inherited nervous system disorder characterized by development of leg weakness, spasms and stiffness. While generally acknowledged that health and social care services can minimise symptoms and improve quality of life, there is a lack of research exploring this from the perspective of people affected by HSP. This qualitative study explored the users and providers experience of using rural services. METHOD: Focus groups and interviews were undertaken of people with HSP (n = 14), carers (n = 6) and professionals (n = 12), to describe their experience of service provision and to suggest improvements for care. These were taped, transcribed and analysed. RESULTS: Four themes emerged: (1) Diagnosis, symptoms and finding support; (2) Therapy, treatment and the delivery of care; (3) Managing the disease together; and (4) The way forward. CONCLUSIONS: Rehabilitation and support for self-management is valued by those affected with HSP throughout the disease trajectory from diagnosis onwards. Key to this is the development of a partnership approach which includes carers. Single point, well-informed, gatekeepers may enhance the coordination and delivery of care in rural areas. These findings underline current guidance promoting a holistic approach for people with neurological conditions

Integrated and patient-centred management of Parkinson’s disease:a network model for reshaping chronic neurological care

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A Proposal for Multidisciplinary Tele-rehabilitation in the Assessment and Rehabilitation of COVID-19 survivors

A global pandemic of a new highly contagious disease called COVID-19 resulting from coronavirus (severe acute respiratory syndrome (SARS)-Cov-2) infection was declared in February 2020. Though primarily transmitted through the respiratory system, other organ systems in the body can be affected. Twenty percent of those affected require hospitalization with mechanical ventilation in severe cases. About half of the disease survivors have residual functional deficits that require multidisciplinary specialist rehabilitation. The workforce to deliver the required rehabilitation input is beyond the capacity of existing community services. Strict medical follow-up guidelines to monitor these patients mandate scheduled reviews within 12 weeks post discharge. Due to the restricted timeframe for these events to occur, existing care pathway are unlikely to be able to meet the demand. An innovative integrated post-discharge care pathway to facilitate follow up by acute medical teams (respiratory and intensive care) and a specialist multidisciplinary rehabilitation team is hereby proposed. Such a pathway will enable the monitoring and provision of comprehensive medical assessments and multidisciplinary rehabilitation. This paper proposes that a model of tele-rehabilitation is integrated within the pathway by using digital communication technology to offer quick remote assessment and efficient therapy delivery to these patients. Tele-rehabilitation offers a quick and effective option to respond to the specialist rehabilitation needs of COVID-19 survivors following hospital discharge