In a pilot study of telerehabilitation at home for patients after stroke, we wanted to develop a rehabilitation service that would enable the patients after discharge from inpatient rehabilitation to work out at home over a longer period under the supervision of a therapist. Methods: We developed a model of telerehabilitation service, established the technological infrastructure for its implementation via Internet and prepared 19 multimedia contents (videos) % 14 to show correct postures and transfers and 5 comprising a variety of exercises for stretching. Five stroke patients who completed the inpatient rehabilitation program at the University Rehabilitation Institute in Ljubljana were included in the study. An occupational therapist and a physiotherapist supervised the telerehabilitation for 3 months after patient%s discharge. They selected multimedia contents for each patient and weekly adapted them to his needs during videoconferencing. Results: During the telerehabilitation service, 14 different videos were selected for two patients, 13 for another patient, and 10 for two others. The therapists held 13 videoconferences with three patients and 12 with two. With all patients, there were some problems with the Internet connection. Especially in the beginning of telerehabilitation, all patients needed a support of their relatives or other persons. The most viewed videos were those with the exercises for stretching. Conclusions: Responses of patients and their assistants to telerehabilitation service were positive. Further development should particularly address the identification of appropriate contents of telerehabilitation, adapted to the heterogeneous needs of patients after stroke.
F.21 Development of new health/diagnostic methods/procedures
COBISS.SI-ID: 2282857Article is a review of published references, evidences on telereehabiltiation and also presents our project.
B.04 Guest lecture
COBISS.SI-ID: 2168169Within the world congress of the International Society for Prosthetics and Orthotics, we organised a 90-minute symposium on telerehabilitation of patients after lower limb amputation. We presented the theoretical basis, a literature review and our project.
F.21 Development of new health/diagnostic methods/procedures
COBISS.SI-ID: 2051945Rehabilitation of persons following limb amputation should start even before amputation if amputation is planned or immediately after it if it is not planned. It has to be continuous until the full reintegration into community. In Slovenia, due to lack of capacities and professionals, after discharge from surgical wards, majority of persons go home and continue with rehabilitation approximately 2 months later. The aim of our project was to develop a telerehabilitation service that will enable them continuous rehabilitation. Methods: In the medical part of the project we developed multimedia interactive Cloud based movie service that is available for patients on the tablet PC provided by the study. For each patient the therapist prepared an individualized telerehabilitation program and monitored them by videoconference system (Skype). A convenient sample of 10 patients after unilateral trans-tibial amputation, without neurological diseases, other musculoskeletal or cognitive impairments were included into study and randomly divided into intervention and control group. Results: 26 videos were prepared each prescribed to at least one patient, some to all. Individual prescription contained 7 - 17 different videos. Patients watched them from 0 - 11 times. The therapist has 2 - 7 videoconferences per patient. Their main objective was to check exercise performance, giving advices on ADL devices, home adaptations and info on admission for further rehabilitation. All the patients and the therapists found the telerehabilitation useful. Conclusions: Our results indicate that telerehabilitation approach was adequate and can fill the gap in rehabilitation.
F.21 Development of new health/diagnostic methods/procedures
COBISS.SI-ID: 2017385The ability to monitor the patients' mobility activities outside a rehabilitation setting to get reliable information about the type, duration and frequency of their daily activities become valuable for clinical decision-making. The aim of our study was to evaluate a smartphone-based wearable mobility monitoring system (WMMS) in stroke patients to monitor their movements when performing ADL. Methods: 15 stroke patients capable of safely completing the mobility tasks participated in the study. WMMS application run on the Blackberry Z10 smartphone, which was attached to participant's pant waist. Participants perform a consecutive series of mobility and ADL tasks in the chosen environment. Trials were video recorded using a separate smartphone for activity timing comparison and contextual information. Data analysis involved sensitivity, specificity and F-scores for detecting the movements compared to results from the video recording. Results: Sensitivity and specificity of WMMS detecting the right movements decreased as the classification of mobility tasks become more complex. Sensitivity, specificity and F-scores of detecting standing were 0.759, 0.883 and 0.511, sitting 0.533, 0.903 and 0.529, lying 0.794, 1.000, and 0.883, walking 0.513, 0.903 and 0.645, walking stairs 0.622, 0.672 and 0.098 and small movements0.154, 0.987 and 0.212, respectively. Conclusions: A smartphone-based WWMS can provide relevant information on stroke patients' movement activities; however an increase in activity classification complexity leads to a decrease in WMMS performance.
F.21 Development of new health/diagnostic methods/procedures
COBISS.SI-ID: 2018409