Today 15 million persons throughout the world suffer from an ictus every year and 5 million are left with chronic disabilities. FIK designed a system for alleviating neuromuscular disability amongst these patients from their homes and by which these can be permanently supervised by the therapist who will be able to carry out a quantitative evaluation of the therapy. To this end, they have brought together new technologies and entertainment and a greater quality of rehabilitation.
The patient will be able to enhance his or her arm mobility by means of a portable robotic device and a software platform with videogames for tele-rehabilitation, so that the doctor can carry out the online monitoring of these exercises through the quantitative results obtained from the said games. This is the ArmAssist project, currently based at the La Fe Hospital in Valencia, to find out the degree of satisfaction of patients who have suffered a brain stroke and admitted to this hospital. Subsequently ArmAssist will be tested in other geographical areas such as Barcelona`s Guttmann Institute.
The aim is to evaluate the usefulness of the system and thus be able to identify the professional training needs that may arise both amongst patients as well as for therapists. The clinical protocol designed in this case will be a prospective, non-randomised clinical trial. The goal is to identify both the viability of the technology as well as possible obstacles when taking the rehabilitation to the home. During the clinical trials, patients will start to use ArmAssist as soon as possible, and will be sent home with it in order to continue rehabilitation at home under the remote supervision of the therapist.
Behind this novel project is FIK, a business initiative focused on research into the field of ageing and disability. Two years ago it launched its first patents in this field and today ArmAssist is the embodiment of this commitment to providing solutions of value for an ageing population.
ArmAssist consists of a mobile-based device that is connected to the user through a orthesis that records and measures the movements of the shoulder and the elbow. This mobile base is connected to a Standard computer that links the movements carried out by the arm with the requests and exigencies of the videogames developed ad hoc for the rehabilitation of the upper limbs.
The exercises proposed for favouring the rehabilitation of the patient are of two kinds: evaluation and training. The evaluation ones are short and which should be undertaken every day at the beginning and the end of the training session. These videogames train independently the range of motion, force, distance and of precision, so that the therapist can evaluate the progress of the patient.
For their part, the training games last longer and are more amenable for the patient. The objective is precisely to motivate the patient, training the arm over a longer period. These games also integrate a cognitive component in order to train also this aspect. Amongst these videogames, there are puzzles, memory games and card solitaire games.
The programmes of rehabilitation involve a combination of exercises to be carried out in the hospital under medical supervision and a series of exercises recommended to be undertaken at home. Currently, these exercises, in the majority of cases, cannot be done outside the medical centre – due to the excessive size of the current systems and which impede their portability. Moreover, the therapists have no kind of control over the therapy and so cannot provide a suitable programme of monitoring and enhancement.
Using telerehabilitation software that this assitive arm includes, a link is created between the patient and the therapist, which enables training him or her in their homes, and more independently, given that, using the computer programme with an Internet connection, the doctor can ensure the patient is doing the exercises correctly.
The therapist will thus be able to carry out a quantitative evaluation of the progress of the patient, an aspect that to date has not been covered by rehabilitation systems and represents a value enhancement for both patient and doctor. This software for telerehabilitation is a complete tool as it encompasses all stages of the therapy, from planning, carrying it out, and its monitoring.
ArmAssist can be used by acute phase patients, after having suffered a brain stroke, as well as chronic patients, for continuous training of the upper limbs for other kinds of disorders apart from ictus.
FIK is a business initiative with more than twenty-five investment partners and which carries out research in the field of disability. FIK is tackling a deep problem in advanced societies and represents, at the same time, a great business opportunity.
This is a new form of business cooperation which aims to obtain exploitable results, i.e. patents, enabling maximising the investment made and giving rise to products and services that maximise the personal independence, health and the quality of life of elderly people with disabilities. The patents will arrive on the market through existing business or by generating new technology-based companies. It is, thus a mechanism for regenerating the economic infrastructure. FIK aims to be the vanguard of new business in dealing with ageing.
The TECNALIA Research Centre is leading the scientific-technological aspects of this project, as it has ample experience in health fields, concretely in the area of ageing and disability.
A summary document prepared by the Institute of Health Economics Canada and the Finnish Office for health Technology Assessment, 2010 entitled evidence on the effectiveness of tele-rehabilitation applications can be found at http://bit.ly/fMlLe1
In reference to tele-rehabilitation (TRH) within the neurology area the report discusses five studies on support for stroke patients, TRH was successful in three, but of limited or no benefit in two. In addition the report details studies in TBI and MS. www.HandTutor.com
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