Title: Telerehabilitation system for Health Care Professionals and Adults with Multiple Sclerosis
Principal Investigator: Ph.D. Begoña García Zapirain, Natalia Ojeda del Pozo
Participants: Diputación Foral de Bizkaia; Universidad de Deusto, ADEMBI; DeustoTech LIFE
Convocatory: BIZKAILAB initiative of the Biscay Council
Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease (CIDD) of the central nervous system leading to progressive impairment of various Central Nervous System (CNS) that poses many complications for the affected person; both physical and psychosocial. The latter are the most disruptive as regards the patient’s psycho-emotional balance on certain occasions .
There is currently no medical nor rehabilitative action effective against MS. Patients should clearly understand that they have to live with certain limitations, and they must adapt physically and psychologically to such limitations. Patients with chronic disorders need to exercise and keep exercising continuously to improve their condition and motor skills. Some people will be able to undertake their rehabilitation at home by themselves with occasional contact from a health professional. Others will need more intensive care and support. The treatments the patients must undergo, such as physiotherapy, medical, psychological and occupational therapy would not return them to their previous situation, but would help to relieve the symptoms, to delay or avoid the progress of the disease, and try to make their quality of life as acceptable as possible. At the same time, the family also has to adjust to this new situation and understand the key role they play in the patient’s treatment.
Each MS patient has a unique set of symptoms and circumstances that requires a personalized combination of rehabilitation techniques. Evaluation is the first step. In addition to assessing patients’ physical abilities, cognition, and personal goals, evaluation may also include an assessment of their environment to see if modifications to their home or workplace would be useful.
The physical treatment has to carry out correctly. Poorly carried out exercises could aggravate muscular problems which also contributes to the worsening of physical health. The way patients sit, stand and walk has a long-term effect on the musculoskeletal system. The objectives of Telerehab project are the following:
Rehabilitation based on video and multimedia applications, either web-based or stand-alone applications, tries to make the therapeutic process more attractive to the patient, increasing motivation and improving treatment efficacy. These approaches incorporate an environment where the patient is able to work with an interactive application to carry out the rehabilitation in an innovative way. The rehabilitation-associated improvements may also be capable of detecting incorrect movements and provide sensorial and/or visual feedback to the patient and/or physiotherapist. In this project, we intend to address the following points:
- To re-educate and maintain all available voluntary control.
- To maintain the whole amplitude of the movement of joints and soft tissues, and to teach.
- To incorporate treatment techniques in livelihoods through a web application, relating them with appropriate daily activities, providing this way maintenance of all the improvement obtained.
- To stimulate any sensitive and perceptual experience, and maintain the experience of the normal movement throughout the progression of the disease.
The system is divided into two main parts: web application with several functionalities and the correction system. In summary, the web application part uses Joomla which acts as the infrastructure for data and modules handling. Joomla was chosen because it offers modularity, plenty of plug-ins, and a moderate learning curve. The data storage is powered by MySQL. Finally, the system runs in a Linux environment, specifically the Ubuntu Server environment, with Apache server, an Open Source HTTP Server. We selected these technologies in order to create an accessible, powerful, low-cost and easy-to-use tool.
The correction system analyzes and corrects in real time the verticality of the patient’s trunk (positions leaning forward or leaning backwards not included). It is a desktop application and it needs to be executed by the user before the exercise starts. The system consists of three main blocks (see Figure 1): Acquire data, Image Processing Algorithm and Correction system.