Proof of Concept of a Partial Weight-Bearing Supporting Real-Time Feedback System.

BACKGROUND: Patient compliance with lower limb partial weight bearing (PWB) instructions during post-surgical early mobilization is often low and many are unable to adhere to the prescribed limits without the implementation of concurrent biofeedback. OBJECTIVES: A real-time feedback system based on eSHOE instrumented insoles was tested in order to preliminarily quantify its efficiency at improving geriatric patients' compliance. METHODS: In order to gain a proof of concept, measurements with one patient after a hip fracture were carried out. The compliance with the prescribed load restriction was measured on four measurement dates, first without and then with the feedback. The number of correctly loaded steps (NCS), the mean peak load (MPL) and the maximal load (ML) were considered. RESULTS: Preliminary results of one patient show that NCS was nearly doubled and the MPL was reduced to acceptable limits, while the ML was reduced on three of the four days. CONCLUSION: The results indicate that the developed system is easily implementable into the rehabilitative routine and has a positive effect on PWB performance of geriatric subjects while walking.

Biosignals, Standards and FHIR - The Way to Go?

BACKGROUND: Standards have become available to share semantically encoded vital parameters from medical devices, as required for example by personal healthcare records. Standardised sharing of biosignal data largely remains open. OBJECTIVES: The goal of this work is to explore available biosignal file format and data exchange standards and profiles, and to conceptualise end-to-end solutions. METHODS: The authors reviewed and discussed available biosignal file format standards with other members of international standards development organisations (SDOs). RESULTS: A raw concept for standards based acquisition, storage, archiving and sharing of biosignals was developed. The GDF format may serve for storing biosignals. Signals can then be shared using FHIR resources and may be stored on FHIR servers or in DICOM archives, with DICOM waveforms as one possible format. CONCLUSION: Currently a group of international SDOs (e.g. HL7, IHE, DICOM, IEEE) is engaged in intensive discussions. This discussion extends existing work that already was adopted by large implementer communities. The concept presented here only reports the current status of the discussion in Austria. The discussion will continue internationally, with results to be expected over the coming years.

Tele-monitoring of the rehabilitation progress in stroke patients.

Preservation of mobility in conjunction with an independent life style is one of the major goals of rehabilitation after stroke. The Rehab@Home framework shall support the continuation of rehabilitation in the domestic area. The framework consists of instrumented insoles, wireless linked to a tablet PC, a server and a web-interface for medical experts. The rehabilitation progress is estimated via automated analysis of movement data from standardized assessment tests which are executed via the tablet PC application designed according to the needs of stroke patients. Initial evaluation of the analysis algorithms shows reproducible results for the overall time of the Timed Up & Go Test. Therefore it is assumed that the Rehab@Home framework is applicable as monitoring tool for the gait rehabilitation progress in stroke patients.