In my recent blog we spoke about people hospitalized with an acute stroke, but deprived of a timely medical assistance. As a result they were discharged with long-term disabilities. The usual path for those people is the rehabilitation clinic (the German abbreviation: REHA). One of such REHA clinics I have visited is located in Bad Aibling, in the heart of the picturesque Alpine meadows of Bavaria. The offered rehabilitation programs are extensive, but expensive. Health Insurances often allocate limited budgets to cover a full recovery process, and patients are soon released to the homecare of their families.  Only in extreme cases, certain patients are eligible to receive some support from their local community services.

What can families do to continue with professional and affordable rehabilitation care? How to control that exercises assigned by a physiotherapist are performed correctly and the physical stress matches the capacity of an individual patient? Alternatively, muscles will contract resulting in spasticity, the side effect extremely difficult to get rid of.

I had a chance to discuss the issue with Pablo Gagliardo, from the Spanish company Fivan. To support patients and their families both in hospital and at home Fivan has designed Neuro@Home – a telerehabilitation platform, aimed to treat individuals with neurological condition. The system includes more than 100 rehabilitation tasks destined to treat specific motor or cognitive functions by using the virtual reality and computer technologies with natural interface.

The therapist in the hospital assigns a rehabilitation program to a patient based on her/his physical conditions. The program consists of a series of computer-based exercises controlled by body gestures. Every time a patient moves, his avatar reproduces  gestures on the TV or computer screen. By watching the progress, medical professionals can adjust the program to the physical conditions of a person at a given instant. Once this is done, Neuro@Home stores a detailed session report in the patient management application. While patients carry out scheduled tasks, the therapeutic applications record their progress and transmit data back to the clinician.

Each rehabilitation task performed by a patient is quantified: Neuro@Home Pro measures the number of successfully completed tasks, response time and total number of completed tasks. The rehabilitation team can evaluate the progress not only by observations, but by “measurable” facts. New rehabilitation tasks could be added, existing ones modified or the rehabilitation task can be entirely stopped if not considered useful anymore. In a word: the therapy can be personalized and adjusted to the individual needs of a patient.

Fivan is now offering this program as online services for a very affordable monthly fee to families whose members were affected with long-term cognitive or motor disabilities. By subscribing to Neuro@Home a neurological patient can get a daily access to personalized exergames therapy with the assistance of a professional physician.

Neuro@Home is based on Microsoft Kinect for Windows sensors that can capture the slightest body motions.  Recently, Microsoft has launched a new version of Kinect sensors that can significantly enhance neurorehabilitation programs. Physicians will be able to track facial contractions to measure the emotional impact of the exercise (e.g., stress or fatigue), review rotation angles of the joints and  detect changes in the skin tint (such as, e.g., redness or paleness) to judge the variations in the heart beat.

The first clinical studies using Neuro@Home were conducted at a post-acute and long stay hospital in the Valencian Health Agency and have been presented at the International Brain Injury Association’s World Congress in San Francisco.

The studies covered cognitive rehabilitation of 12 patients (4 women and 8 men) who had suffered a stroke with a mean age of 56 years old. After receiving 40 one-hour sessions during two months (5 days a week), significant improvements were observed in the participants attention, working memory and executive functions.

Similarly, 33 patients (10 women and 23 men, mean age = 58 y.o.) who were accepted into an inpatient rehabilitation programme after suffering a stroke participated in a physical rehabilitation study with Neuro@Home. In this case, significant improvements were observed in patient’s balance, coordination and gait. As a result, both studies reported that patients also obtained significant improvements in their functionality.

Less stress, more enjoyment, is it not what helps people to recover faster?

For more information please contact Pablo Gagliardo pablog@fivan.org