Effective rehabilitation after stroke increases a patient’s quality
of life and his/her ability to resume work and live independently.
It is therefore vital that the intensity of rehabilitation training
is not diluted or therapies interrupted prematurely, as both these
scenarios prevent a return to optimal performance. There are,
however, various reasons why such scenarios do occur, not the least
related to cost pressures in the healthcare system, shortage of
staff and a lack of patient motivation. Philips Research is
developing and testing solutions to increase the efficiency and
effectiveness of rehabilitation. The Stroke Rehabilitation Exerciser
has been designed to support both patients and therapists in the
implementation and execution of personalized neurological motor
exercise plans at home. It can be programmed to provide medical
professionals with an efficient therapy planning tool and increase
the training intensity for the patient.
The Stroke Rehabilitation Exerciser supports patients and
therapists in the implementation and execution of a
personalized neurological motor exercise plan at home.
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The Stroke Rehabilitation Exerciser has been designed to support
patients and therapists in the implementation and execution of
personalized neurological motor exercise plans at home.
Delivering remote therapy
Supporting rehabilitation with effective technology is recognized as
a big challenge in the academic and medical world. Together with
medical experts, Philips is developing and testing integrated
solutions to increase the efficiency of rehabilitation. Using motion
sensors, which are attached to the patient’s torso and strapped to
their wrist and upper arm, the Stroke Rehabilitation Exerciser
accurately captures the patient’s upper body movements and evaluates
them in the light of a prescribed motor training. These personalized
training plans would be arranged by the patient’s physiotherapist.
The patient is coached through the training program in the comfort
of his/her own home. As the patient executes an exercise, the Stroke
Rehabilitation Exerciser processes and analyzes the acquired data to
direct the patient regarding correct execution of the exercise. At
the end of a session, the patient may either play back his actual
motion to foster an understanding of his movement behavior, or
receive a graphic illustration of progress in his/her performance.
Engaging training action and convincing computer-generated feedback
are essential for maintaining patient compliance and motivation over
a long period of time.
The physiotherapist plays a fundamental role in the assessment and
composition of a training plan, as well as in the administration of
essential therapeutic interventions. The Stroke Rehabilitation
Exerciser would enable a therapist to promote and track home
rehabilitation and to stay up-to-date with the progress of the
patient. The therapist may review the motion exercises, add or
modify the training modules and deliver personal messages to the
patient. Face-to-face sessions could be more effectively scheduled
and organized due to the continuous availability of training data.
Sensitive development and design
The latest Stroke Rehabilitation Exerciser prototype includes a
patient and therapist workstation. This prototype is capable of
assisting the patient and therapist with analytical and functional
exercises to assess the patient’s progress and improve real world
tasks, such as lifting a cup from a table.
The system uses inertial sensors to measure acceleration, rotation
rate and the earth’s magnetic field, and determines the orientation
of the sensor unit in space. The wireless sensors connect to the
patient’s workstation using a low-power radio personal area network
– similar to Bluetooth. Advanced algorithms track the motion data
from the different sensors to model the arm movements. Special
attention is paid to the design of the user interface of the patient
workstation and the attachment solution for the sensors, which both
need to take into account specific challenges for stroke survivors.
Various centers of expertise in Philips worked together to develop
the wireless inertial sensors, the motion tracking algorithms and
the design of the user interfaces. Philips is continuously extending
its network of clinical and academic partners to investigate
solutions that are valuable for rehabilitation, supportive for the
patient and efficient for the therapist. Assessing these solutions
together with patients and medical professionals is central to
guaranteeing the development of optimal and meaningful innovation.
The technology, which was contributed to by the University of
Ulster, the University of Bath and Sheffield Hallam University, has
been tested with patients in the United Kingdom. This group of
universities, also known as the SMART consortium, has conducted
pioneering research in the field of technology-assisted
rehabilitation.
Charité University Medical Center Berlin, one of the largest and
most renowned university medical centers in Europe is working
together with Philips Research to test a prototype of the Stroke
Rehabilitation Exerciser in a pilot study. In addition, a prototype
of the Stroke Rehabilitation Exerciser is being tested in the
Netherlands at the Hoensbroek Rehabilitation Center (affiliated to
the Stichting Revalidatie Limburg (SRL)).
