ICTs for Improving Patients Rehabilitation Research Techniques

The world population is rapidly aging and becoming a burden to health systems around the world. In this work we present a conceptual framework to encourage the research community to develop more comprehensive and adaptive ICT solutions for prevention and rehabilitation of chronic conditions in the daily life of the aging population and beyond health facilities. We first present an overview of current international standards in human functioning and disability, and how chronic conditions are interconnected in older age. We then describe innovative mobile and sensor technologies, predictive data analysis in healthcare, and game-based prevention and rehabilitation techniques. We then set forth a multidisciplinary approach for the personalized prevention and rehabilitation of chronic conditions using unobtrusive and pervasive sensors, interactive activities, and predictive analytics, which also eases the tasks of health-related researchers, caregivers and providers. Our proposal represents a conceptual basis for future research, in which much remains to be done in terms of standardization of technologies and health terminology, as well as data protection and privacy legislation.

Postural stability is often compromised in many pathological states and decreases with age. In clinical practice, an objective tool for balance control at home is fundamental. Recently, virtual tools, based on the use of depth cameras, have been presented. In this paper, a virtual system for balance control assessment is presented and used to implement a virtual task for balance tracking in real time at home. The usability of the tool is assessed through some experimental data collected by 6 healthy elderly people, that used the system and evaluated it through a questionnaire. Results are reported and discussed.

The impairment of basic cognitive functions such as attention and visual working memory can have a significant negative impact in our ability to adapt to the permanent changes in the environment. VR Serious Games are being used as a new tool for both assessment, stimulation and rehabilitation of such impaired functions. Even though the results of these novel applications seem to be promising, some of the assessments based in these solutions use indirect measures to evaluate attentional and mnesic performance (e.g. number of errors, task completion time). Gaze tracking (GT) can provide more accurate and direct indicators of these cognitive processes. On a sample of 46 non-clinical participants (33 Female; 71.7%), with an age average of 27.96 years old (SD = 11.92), ocular movements were recorded in two different comparative visual search tasks (CVSTs) that are an integrant part of the cognitive assessment protocol of the Systemic Lisbon Battery (SLB). Number of visits and total fixations differed based on the assessment with the Mini-mental state examination test (MMSE). These results highlight the possibility of combining both the data from the GT and the results of the “spot the differences” tasks in SLB, adding an unobtrusive and reliable solution for cognitive assessment in clinical and non-clinical settings.

This paper concerns the design and manufacture of medical devices, such as lower limb prosthesis, integrating low cost industrial technologies. In particular, it focuses the attention on the custom-fit component of a lower limb prosthesis, i.e., the socket, that is the interface with the residual limb. The considered process starts from the 3D reconstruction of patients’ limb and ends with the manufacture of the socket with a 3D printer using a multi-material approach. The process counts three steps: 3D modeling, testing (both experimental and numerical) and manufacturing. For each step adopted solutions and tools are described. Finally, conclusions are drawn mainly concerning the challenge of multi-material 3D printing of the socket.

A system for real-time gesture tracking is presented, used in active well-being self-assessment activities and in particular applied to medical coaching and music-therapy. The system is composed of a gestural interface and a computer running own (custom) developed software. During the test sessions a person freely moves his body inside a specifically designed room. The algorithms detect and extrapolate features from the human figure, such us spatial position, arms and legs angles, etc. An operator can link these features to sounds synthesized in real time, following a predefined schema. The augmented interaction with the environment helps to improve the contact with reality in subjects having autism spectrum disorders (ASD). The system has been tested on a set of young subjects and a team of psychologists has analyzed the results of this experimentation. Moreover, we developed a home version of the system, to be used without any operators, in order to maintain the obtained benefits. This paper is an extended version of the paper presented at REHAB 2015 [1].

A balance measurement software based on Kinect2 sensor is evaluated by comparing to Wii balance board in numerical analysis level, and further improved according to the consideration of BFP (Body fat percentage) values of the user. Several person with different body types are involved into the test. The algorithm is improved by comparing the body type of the user to the ‘golden-standard’ body type. The evaluation results of the optimized algorithm preliminarily prove the reliability of the software.

Heroin addiction has a negative impact on cognitive functions, which may also contribute to poorer treatment outcomes in drug addition. Traditional cognitive rehabilitation approaches suffer from limited motivational appeal and are relatively cumbersome to carry out. Thus, we report a study testing the efficacy of an alternative mHealth approach using tablets and serious games to stimulate cognitive functions in recovering addicts. This approach was tested in a sample 14 male heroin addicts undergoing a rehabilitation program for heroin addiction as inpatients at a local NGO. The exercises for cognitive training were based on serious games running on tablets. The results showed improvements in cognitive functioning between baseline and follow-up assessments in frontal lobe functions, verbal memory and sustained attention, as well as in some aspects of cognitive flexibility, decision-making and depression. Patients in cognitive training had a higher proportion of positive outcomes related to indicators of verbal memory cognitive flexibility than patients not in training. Overall results are promising but still require randomized control trials to determine the efficiency of this approach as an alternative to cognitive rehabilitation programs in heroin addicts.

A balance measurement software based on Kinect2 sensor is evaluated by comparing to golden standard balance measure platform intuitively. The software analysis the tracked body data from the user by Kinect2 sensor and get user’s center of mass (CoM) as well as its motion route on a plane. The software is evaluated by several comparison tests, the evaluation results preliminarily prove the reliability of the software.

This paper presents a model based on Auditory-verbal therapy, which is carried out with deaf children who have benefited from a cochlear implant. These children must learn to acquire listening skills to develop their language. It is the speech therapist who helps the children during the rehabilitation process. A serious game could therefore help in the process of acquiring listening skills, wherein play activities are integrated but have a therapeutic effect. A model is presented here for the design of such a game. This model is based on an analysis of different types of game-therapy-player relationships, to identify the mechanics of the game and reliably build player profiles. All the inquiries are aimed at identifying different aspect between different types of game-therapy-player; to do this, 12 children from the Institute for Deaf and Blind Children, in Cali, Colombia participated, the children ranging from 7 to 11 years of age, all with a cochlear implant, where were analyzed a set of games for PC oriented toward speech therapy. The evaluations were made to identify different aspects like: users, game and pedagogical, in each action undertaken by the child on interact with the game. Finally it recreates a story through the character called Phonak who has become lost in a planet called Sounds and has to learn to listen in order to find his family. In turn, the game will help to develop not only speech and language skills but also cognitive ones. In this light, a serious game was put forward aimed at attracting the child’s attention.

As for the users of hyperbaric oxygen therapy apartment, this paper put forward a newfangled immersing entertainment system. As for this system, it is a mixture of software and hardware, and this paper has depicted the scheme. And a HMD (i.e. virtual reality glasses shell), a water-repellent bag and a smart-phone compose the hardware. Besides, as for the software, it can transform the tridimensional images of the three-dimensional game into the smart-phone’s screen at the same time. And in terms of the actual moving scene of the hospital hyperbaric oxygen treatment, people will talk about the option and comparison of the hardware. At last, it is likely to raise a rudimentary guideline to design this sort of system consequently.

The use of computer games as adjunct to conventional cerebral palsy (CP) rehabilitation provides a promising approach to actively engage CP children in physical therapy exercises. This chapter provides a summary of previous studies that incorporated computer games for CP rehabilitation. Moreover, a comprehensive game-based rehabilitation framework is presented to enable CP children to actively participate in upper-limb physical exercises. The framework design is based on five features that aim to achieve enjoyable and effective game-based physical exercises for complementing conventional CP rehabilitation. A prototype implementation of the framework is developed, which includes three Kinect-based games that target upper-limb excesses. The prototype implementation was employed in the rehabilitation of three CP patients, and the preliminary results suggest the feasibility of the framework for complementary CP rehabilitation. The chapter also discusses some design challenges that are being tackled to continue the development of the comprehensive rehabilitation framework along with proposed solutions.

Alcohol dependence syndrome has been associated to disfunctions of the pre-frontal cortex, with a negative impact on several areas of cognitive functioning, such as attention, memory and learning, visual-spatial synthesis, executive functions, and psychomotor functions. These changes in turn contribute to the perpetuation of the addictive behavior. We report a study with 249 recovering alcoholics assessed with neuropsychological tests pre- and post-treatment at an alcoholism rehab clinic, with follow-up for abstinence 3 and 6 months after treatment. We found that 3-month abstinence was associated to speed of psychomotor processing, whereas 6-month abstinence was related with decision-making, (lack of) impulsivity, speed of psychomotor processing, and emotional adjustment.

When interacting with interactive systems, users provide an input to the system and receive the corresponding output. On this cycle, there are translations between the components of the interactive process. But when using Web applications, translations can be affected due to the unique characteristics of the Web. Nowadays, and with the emergence of new interaction devices such as Microsoft Kinect which allows user movement to be captured, new approaches have appeared which facilitate the rehabilitation process. Web applications could be used on this process, for example, for designing postures or exercises. The creation of the postures may be complicated, involving a wide number of actions. If the physiotherapist does not feel comfortable using the rehabilitation system, it becomes cumbersome and hard to use. In this work we analyze how the interaction process of editing exercises in a virtual rehabilitation environment is affected when using Web applications. We propose the use local storage in a virtual rehabilitation environment based on the web to measure how it improves the interaction cycle and ultimately user usability and satisfaction.

In this article we present the results of an experiment where participants were asked to bike with selected soundscapes to measure their preferred pace and perception of the several aspects of the soundscapes. The results show that indeed different soundscapes can manipulate preferred pace of a biking person. This experiment is the first step into designing a system for rhythmic rehabilitation based on a stationary bike augmented in an audio reality. A concept of the system is as well presented. The specific sensors will be used to monitor users’ pace and heart rate while exercising and manipulate audio feedback and cues. Simple technology solutions will allow for the system to be used by the wide range of users. The innovation is to use as a feedback and cues ecological sounds, which has power to manipulate a bikers’ pace and give a more natural experience.