Final results of the NINFA project: impact of new technologies in the daily life of elderly people.

BACKGROUND: The paper presents the work carried out within NINFA (iNtelligent Integrated Network For Aged people), a project for the wellbeing of the elderly people at home. AIMS: The impact of new technologies on elderly people is evaluated with respect to the three main topics faced by NINFA. METHODS: NINFA was structured into three main topics: (1) active user engagement from the very beginning of the planning stage: the use of specially designed questionnaires to evaluate the acceptability of new technology in general and robot caregiver specifically; (2) assessment of the well-being through non-invasive techniques: natural language processing for language change monitoring in elderly subjects; (3) automated assessment of motor and cognitive functions at home: systems to deliver tests and exergames through user interfaces compliant with elderly subjects. RESULTS: The analysis shows that there is no a priori closure to support the technology, but it must not be invasive and must allow social interactions. The study of speech transcripts shows that a large variations in the number of words used to describe the same situation could be a sign on the onset of cognitive impairments. The specifically designed systems highlight, after the training period, significant improvements in the performances of the participants and a satisfaction with regards to the systems usability. CONCLUSIONS: The outcomes of NINFA project highlight some important aspects of the relationship between elderly people and new technologies concerning: engagement and acceptability, assessment of the wellbeing and of the modifications of motor, cognitive and language functions.

Monitoring of Gait Parameters in Post-Stroke Individuals: A Feasibility Study Using RGB-D Sensors.

Stroke is one of the most significant causes of permanent functional impairment and severe motor disability. Hemiplegia or hemiparesis are common consequences of the acute event, which negatively impacts daily life and requires continuous rehabilitation treatments to favor partial or complete recovery and, consequently, to regain autonomy, independence, and safety in daily activities. Gait impairments are frequent in stroke survivors. The accurate assessment of gait anomalies is therefore crucial and a major focus of neurorehabilitation programs to prevent falls or injuries. This study aims to estimate, using a single RGB-D sensor, gait patterns and parameters on a short walkway. This solution may be suitable for monitoring the improvement or worsening of gait disorders, including in domestic and unsupervised scenarios. For this purpose, some of the most relevant spatiotemporal parameters, estimated by the proposed solution on a cohort of post-stroke individuals, were compared with those estimated by a gold standard system for a simultaneous instrumented 3D gait analysis. Preliminary results indicate good agreement, accuracy, and correlation between the gait parameters estimated by the two systems. This suggests that the proposed solution may be employed as an intermediate tool for gait analysis in environments where gold standard systems are impractical, such as home and ecological settings in real-life contexts.

Feasibility of Home-Based Automated Assessment of Postural Instability and Lower Limb Impairments in Parkinson's Disease.

A self-managed, home-based system for the automated assessment of a selected set of Parkinson's disease motor symptoms is presented. The system makes use of an optical RGB-Depth device both to implement its gesture-based human computer interface and for the characterization and the evaluation of posture and motor tasks, which are specified according to the Unified Parkinson's Disease Rating Scale (UPDRS). Posture, lower limb movements and postural instability are characterized by kinematic parameters of the patient movement. During an experimental campaign, the performances of patients affected by Parkinson's disease were simultaneously scored by neurologists and analyzed by the system. The sets of parameters which best correlated with the UPDRS scores of subjects' performances were then used to train supervised classifiers for the automated assessment of new instances of the tasks. Results on the system usability and the assessment accuracy, as compared to clinical evaluations, indicate that the system is feasible for an objective and automated assessment of Parkinson's disease at home, and it could be the basis for the development of neuromonitoring and neurorehabilitation applications in a telemedicine framework.

An Integrated Multi-Sensor Approach for the Remote Monitoring of Parkinson's Disease.

The increment of the prevalence of neurological diseases due to the trend in population aging demands for new strategies in disease management. In Parkinson's disease (PD), these strategies should aim at improving diagnosis accuracy and frequency of the clinical follow-up by means of decentralized cost-effective solutions. In this context, a system suitable for the remote monitoring of PD subjects is presented. It consists of the integration of two approaches investigated in our previous works, each one appropriate for the movement analysis of specific parts of the body: low-cost optical devices for the upper limbs and wearable sensors for the lower ones. The system performs the automated assessments of six motor tasks of the unified Parkinson's disease rating scale, and it is equipped with a gesture-based human machine interface designed to facilitate the user interaction and the system management. The usability of the system has been evaluated by means of standard questionnaires, and the accuracy of the automated assessment has been verified experimentally. The results demonstrate that the proposed solution represents a substantial improvement in PD assessment respect to the former two approaches treated separately, and a new example of an accurate, feasible and cost-effective mean for the decentralized management of PD.

A Self-Managed System for Automated Assessment of UPDRS Upper Limb Tasks in Parkinson's Disease.

A home-based, reliable, objective and automated assessment of motor performance of patients affected by Parkinson's Disease (PD) is important in disease management, both to monitor therapy efficacy and to reduce costs and discomforts. In this context, we have developed a self-managed system for the automated assessment of the PD upper limb motor tasks as specified by the Unified Parkinson's Disease Rating Scale (UPDRS). The system is built around a Human Computer Interface (HCI) based on an optical RGB-Depth device and a replicable software. The HCI accuracy and reliability of the hand tracking compares favorably against consumer hand tracking devices as verified by an optoelectronic system as reference. The interface allows gestural interactions with visual feedback, providing a system management suitable for motor impaired users. The system software characterizes hand movements by kinematic parameters of their trajectories. The correlation between selected parameters and clinical UPDRS scores of patient performance is used to assess new task instances by a machine learning approach based on supervised classifiers. The classifiers have been trained by an experimental campaign on cohorts of PD patients. Experimental results show that automated assessments of the system replicate clinical ones, demonstrating its effectiveness in home monitoring of PD.

Vision-Based Pose Estimation for Robot-Mediated Hand Telerehabilitation.

Vision-based Pose Estimation (VPE) represents a non-invasive solution to allow a smooth and natural interaction between a human user and a robotic system, without requiring complex calibration procedures. Moreover, VPE interfaces are gaining momentum as they are highly intuitive, such that they can be used from untrained personnel (e.g., a generic caregiver) even in delicate tasks as rehabilitation exercises. In this paper, we present a novel master-slave setup for hand telerehabilitation with an intuitive and simple interface for remote control of a wearable hand exoskeleton, named HX. While performing rehabilitative exercises, the master unit evaluates the 3D position of a human operator's hand joints in real-time using only a RGB-D camera, and commands remotely the slave exoskeleton. Within the slave unit, the exoskeleton replicates hand movements and an external grip sensor records interaction forces, that are fed back to the operator-therapist, allowing a direct real-time assessment of the rehabilitative task. Experimental data collected with an operator and six volunteers are provided to show the feasibility of the proposed system and its performances. The results demonstrate that, leveraging on our system, the operator was able to directly control volunteers' hands movements.