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Telerehabilitation: undertaking physiotherapy at home

03 January 2013

New technology has been developed that will allow patients to do physiotherapy exercises at home, while still making sure that they are performing correctly.

A new development gives patients added motivation to perform physiotherapy exercises at home or when out and about – during breaks at work, for instance. Experts call this telerehabilitation, and underpinning it is a technology developed by researchers at the Fraunhofer Institute for Open Communication Systems FOKUS in Berlin, comprising an exercise editor, a physio box and a mobile sensor unit that connects to a smartphone.

The therapist uses the exercise editor to work up a training program tailored to the individual patient, increasing the intensity from week to week. The patient can then run the program at home using the physio box, a sort of mini-PC for televisions providing internet connectivity, a camera and a microphone.

Exercise routines are displayed on the TV screen for the patient to copy, and the physio box analyses the data recorded by the camera as the patient does the exercises. Beforehand, software is used to map each patient’s bodily characteristics in 3D and translate them into a biomechanical computer model. Once the data has been interpreted, the box sends it via the internet to the rehabilitation centre, where the therapist sees how the patient is progressing and can adapt the exercises accordingly.

Alongside measurements of movements, therapists need to know their patients’ vital signs – pulse, oxygen saturation levels and, in some cases, readings from an electrocardiogram. This allows them not only to assess whether the patient is performing exercises correctly but also how much of a strain they are. This is particularly important when dealing with people who have a cardiovascular disease. 

“In light of this, we also developed a mobile unit,” says Dr Michael John, project manager at FOKUS. “Sensors placed in a chest strap, watch or walking stick measure vital signs like pulse, blood pressure or the quality of the patient’s movement, sending the data to a smartphone.” The therapist can set threshold values using the exercise editor; for example, if a patient’s pulse reaches a level that exceeds the limit set for them, a warning signal is emitted.

On the one hand, the mobile unit serves to complement the physio box, but it is also supposed to help patients in future to do their exercises while on the move – out walking or during office breaks, perhaps. “We’re working on how to get the mobile unit to analyse the patient’s quality of movement as well. To do this, we’re using motion tracking sensors that analyse limb movements in relation to each other and in terms of absolute position,” explains John.

The researchers are also currently working on a transmission standard for movement measurement data, as well as on how to standardise these values so that they can be read by a variety of devices. There is already a standard, ISO 11073, for data relating to vital signs. This specifies how to transmit data between devices, thus ensuring that data can be transferred between sensors, smartphones and medical devices from a variety of manufacturers without any problems.

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