Chumbler NR et al, Stroke, 2012
BACKGROUND AND PURPOSE:
To determine the effect of a multifaceted stroke telerehabilitation (STeleR) intervention on physical function, and secondarily on disability, in veterans poststroke.
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Kurillo G et al, Medicine Meets Virtual Reality 18 - NextMed, 2011
We present work in progress on a tele-immersion system for telerehabilitation using real-time stereo vision and virtual environments. Stereo reconstruction is used to capture user’s 3D avatar in real time and project it into a shared virtual environment, enabling a patient and therapist to interact remotely.
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Johansson T, Wild C. J Telemed Telecare, 17(1)
We conducted a systematic review of telerehabilitation interventions in stroke care. The following databases were searched: Medline, Embase, DARE-NHSEED-HTA (INAHTA) and the Cochrane Library. Nine studies, all published after 2000, were included in the review. A wide variety of telemedicine interventions in post-stroke rehabilitation care was identified. Four studies had been carried out in the USA, two in the Netherlands, two in Italy and one in China. There were four randomized controlled trials and one qualitative analysis. Four studies used an observational study design/case series.
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Parmanto B et al, Telemedicine and e-Health, 16(9)
The versatile and integrated system for telerehabilitation (VISYTER) is a software platform for developing various telerehabilitation applications. VISYTER has been designed to take into account the environments and requirements of rehabilitation services. The requirements considered in the platform design include minimal equipment beyond what is available in many rehabilitation settings, minimal maintenance, and ease of setup and operation. In addition, the platform has been designed to be able to adjust to different bandwidths, ranging from the very fast new generation of Internet to residential broadband connections. VISYTER is a secure integrated system that combines high-quality videoconferencing with access to electronic health records and other key tools in telerehabilitation such as stimuli presentation, remote multiple camera control, remote control of the display screen, and an eye contact teleprompter.
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Huniche L et al, Seamless Care – Safe Care, 2010
This paper discusses how a tele-rehabilitation program using home tele-monitoring may empower patients with chronic obstructive pulmonary disease (COPD). The paper is based on preliminary findings from an ongoing research and innovation project, called “Tele-homecare, chronic patients and the integrated healthcare system” (the TELEKAT project) that employs triple interventions related to patients, professionals, and the organization of care.
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McCue, Michael et al, Medicine and Rehabilitation Clinics of North America, 21(1)
Telerehabilitation is an emerging method of delivering rehabilitation services that uses technology to serve clients, clinicians, and systems by minimizing the barriers of distance, time, and cost. The driving force for telerehabilitation has been as an alternative to face-to-face rehabilitation approaches to reduce costs, increase geographic accessibility, or act as a mechanism to extend limited resources. A rationale for telerehabilitation is the potential to enhance outcomes beyond what may result from face-to-face interventions by enabling naturalistic, in vivo interventions.
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Golomb, Meredith R. et al, Archives of Physical Medicine and Rehabilitation, 91(1)
To investigate whether in-home remotely monitored virtual reality videogame-based telerehabilitation in adolescents with hemiplegic cerebral palsy can improve hand function and forearm bone health, and demonstrate alterations in motor circuitry activation.
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Giansanti D et al, Telemedicine and e-Health. 15(3)
The authors have further developed a system to assess the motion of a patient in telerehabilitation using accelerometers. The gyroscopes and three assessment algorithms allow the distant therapist to make a proper assessment not possible with video alone. The system is wearable and articulates with Global System for Mobile communications (GSM) for messaging. One subject was monitored in a telemedicine link. The test showed a high degree of acceptance.
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Rogante, Marco et al, J Telemed Telecare 2009;15
A total of 50 patients (affected by traumatic brain injury, stroke or multiple sclerosis) were treated for one month using a rehabilitation protocol. Rehabilitation could be monitored using a Portable Unit (PU) which could be installed in a patient’s home allowing the measurement of kinetic and kinematic variables during exercise.
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Busch, Clemens et al, J Telemed Telecare 2009;15
We have developed a tele-rehabilitation application for training cardiac patients. It uses a modified ergometer bicycle with a set of wireless sensors. While the patient is exercising, the ECG, blood pressure and oxygen-saturation are monitored constantly and automatically. If sensor values exceed pre-defined thresholds, the patient receives an alarm. As a result the training will either be stopped or continued at a reduced load, depending on the severity of the alarm.
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Piron, Lamberto et al, J Telemed Telecare, 14(5)
We conducted a pilot telerehabilitation study with post-stroke patients with arm motor impairment. We compared the degree of satisfaction of patients undergoing a virtual reality (VR) therapy programme at home (Tele-VR group) to satisfaction experienced by those undergoing the same VR therapy in a hospital setting (VR-group). The rehabilitation equipment used a 3D motion tracking system to create a virtual environment in which the patient’s movement was represented. In tele-therapy, the patient equipment was installed in their homes, connected to the hospital by four ISDN lines at a total bandwidth of 512 kbit/s. Rehabilitation data were transmitted via one line and videoconferencing via the other three.
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Huijgen, Barbara et al, J Telemed Telecare, 14(5)
We conducted a randomized controlled multicentre trial to investigate the feasibility of a telerehabilitation intervention for arm/hand function (the Home Care Activity Desk [HCAD] training) in a home setting. Usual care was compared to HCAD training. The hypothesis was that the clinical outcomes of the HCAD intervention would be at least the same as those measured after a period of usual care for patients with stroke, traumatic brain injury (TBI) and multiple sclerosis (MS) with respect to their arm/hand function. Eighty-one patients with affected arm/hand function resulting from either stroke, MS or TBI were recruited in Italy, Spain and Belgium; 11 were lost during follow-up (14%).
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Theodoros, Deborah G., J Telemed Telecare, 14(5)
Communication disorders in adults and children can have a significant effect on their quality of life and on that of their families. Speech-language pathologists face several challenges in providing assessment and treatment services to such people. Challenges include facilitating equitable access to services and providing appropriate management within a changing social and economic context. Telerehabilitation has the potential to deliver services in the home or local community via videoconferencing and through interactive computer-based therapy activities.
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In the period March 2005 – February 2007 the authors have been involved in the European Project HELLODOC (acronym for “HEaLthcare Service Linking Tele-rehabilitatiOn to Disabled peOple and Clinicians”). The primary objective of the Project was to validate the EU market – more specifically in Italy, Spain, The Netherlands and Belgium – for a home-care tele-rehabilitation service. Main aim of the service was to extend the rehabilitation treatment at patient’s home under close supervision of the hospital. The tele-rehabilitation service was mainly addressed to neurological patients affected by Traumatic Brain Injury (TBI), Stroke or Multiple Sclerosis (MS).
Basically, the service consisted of three main apparatuses: a portable unit to be installed at patients’ home, a doctor PC software module and an in-hospital based server managing all the transaction framework of the system. The portable unit (in the following HCAD) was an improved version of a prototype of a home-care activity desk which was developed in the framework of the previous European Project H-CAD.
Within the HELLODOC Project the following rehabilitative exercises were implemented:
- PENCIL: patient was asked to follow a path on the screen or to perform writing activities on it; in both cases he had to use a RF pen-like tool.
- JAR: patient was asked to move a jar to and from the shelves, and on the sensorized area of the screen. The jar was covered with reflective tape, in order to be detected by each shelf position sensors.
- BOOK: patient was asked to move a book to and from the shelves. The book was covered with reflective tape, in order to be detected by each shelf position sensors.
- KEY: patient was asked to insert a key and then rotate it up to an established angular position.
- LIGHTBULB: patient was asked to screw and unscrew a tool which resembled a lightbulb, and to turn on and off two different switches.
- KEYBOARD: patient was asked to press the keys according to an established sequence
- CHECKERS: patient was asked to move the checker-like tool on the sensorized screen according to established paths.
Main aim of this presentation, while reporting the main results of the project, is to discuss about possible trends for telerehabilitation for wider application in the clinical practices.Rogante M.a, Bernabeu M.b, Giacomozzi C.a, Hermens H.J.c, Ilsbroukx S.d, Magni R.e, Scattareggia S.f, Zampolini M.g, Macellari V.a
a Istituto Superiore di Sanité, Rome, Italy;
b Fundació Institut Guttmann, Barcelona, Spain;
c Roessingh Research and Development, Enschede, The Netherlands;
d National Multiple Sclerosis Centre, Melsbroek, Belgium;
e Pragma Engineering, Perugia, Italy;
f Signo Motus srl Messina, Italy;
g ASL 3 Umbria, Trevi, Italy
To be presented at the ICMCC Event
Telemedicine services must be designed and implemented with the users in mind. When conducting telerehabilitation, factors such as age, education and technology experience must be taken into account. In addition, telerehabilitation must also accommodate a range of potential patient impairments, including deficits in language, cognition, motor function, vision and voice. Telerehabilitation technology and treatment environments should adhere to universal design standards so as to be accessible, efficient, usable and understandable to all. This will result in improved access to a wider range of telerehabilitation services that will facilitate and enhance the rehabilitative treatment and recovery of people living with varying levels of injury, impairment and disability.”
Brennan, David M.; Barker, Linsey M., Journal of Telemedicine and Telecare, Volume 14, Number 2, March 2008, pp. 55-58(4), DOI: 10.1258/jtt.2007.007040
In this paper, we introduce an interactive telecommunication system that supports video/audio signal acquisition, data processing, transmission, and 3D animation for post stroke rehabilitation. It is designed for stroke patients to use in their homes. It records motion exercise data, and immediately transfers this data to hospitals via the internet. A real-time videoconferencing interface is adopted for patients to observe therapy instructions from therapists. The system uses a peer-to-peer network architecture, without the need for a server. This is a potentially effective approach to reducing costs, allowing easy setup and permitting group-rehabilitation sessions. We evaluate this system using the following steps: (1) motion detection in different movement patterns, such as reach, drink, and reach-flexion; (2) online bidirectional visual telecommunication; and (3) 3D rendering using a proposed offline animation package. This evaluation has subjectively been proved to be optimal.”
Shumei Zhang, Huosheng Hu, Huiyu Zhou, Medical and Biological Engineering and Computing Volume 46, Number 3 / March, 2008, DOI10.1007/s11517-007-0295-6
“Telerehabilitation is the provision at a distance of rehabilitation services such as physiotherapy, speech pathology or occupational therapy. The primary aim is to provide equitable access to rehabilitation services. Broadly speaking, the technologies used for telemedicine-based physical rehabilitation can be classified as: (1) image-based telerehabilitation; (2) sensor-based telerehabilitation; and (3) virtual environments and virtual reality telerehabilitation. To date, much of the research has been technology focused, and has consisted of single case or small sample research designs. The next step is to demonstrate viable telerehabilitation services in real world environments using well controlled research methodologies with large patient cohorts. In addition, the broader issues of cost-benefit and cost-effectiveness require investigation. If this can be done, then the undoubted potential benefits of telerehabilitation, for both the patient and health-care systems, can be realized.”
Russell, Trevor G., Journal of Telemedicine and Telecare, Volume 13, Number 5