ABSTRACT
Survivors of brain injury or stroke can improve movement ability with intensive, supervised practice. Since the hours of supervised therapy with a physical or occupational therapist are limited, telerehabilitation will enable patients to greatly expand the hours that they practice therapeutic exercises. The Jerusalem TeleRehabilitation System (JTRS) consists of patient and therapist systems plus a central server and database connected via the internet. The system can work in two modes: (1) a cooperative mode in which the therapist and patient are online at the same time, and (2) a stand-alone mode in which the patient uses the system on his own. In both cases, the system will monitor the status and progress of the patient and various parameters of his movement abilities, and prepare reports for the patient and for the therapist. From the clinic, the therapist will be able to change the screen seen by the patient and change the level and types of tasks, as needed. Compared to existing systems, our system will have the following advantages: (1) inexpensive and easy to use; (2) remote monitoring and control of the patient's computer by the therapist in the clinic; (3) more detailed analysis of patient status and progress; (4) a "smart" system which self-adapts to the patient's capabilities in real time, increasing or decreasing the difficulty of the exercise as needed; and (5) a central, international database which, by gathering data on many patients over time, will provide the basis for "smart" therapy and will also facilitate coordinated multicenter research studies.
Subject(s)
Computer Simulation , Rehabilitation/methods , Remote Consultation/instrumentation , Telemedicine/instrumentation , Touch , User-Computer Interface , Equipment Design , Humans , Internet/instrumentation , Rehabilitation/instrumentation , Remote Consultation/methods , Software , Telemedicine/methods , Therapy, Computer-Assisted/instrumentation , Therapy, Computer-Assisted/methodsABSTRACT
Rhinomanometry is a method for measuring nasal resistance for the purpose of providing an objective evaluation of nasal patency. Posterior rhinomanometry is accomplished without the use of a mask, thus allowing the patient to breathe naturally. Here, we report on the improvements we have made to the existing posterior rhinomanometry system. In this system, nasal airflow is measured indirectly by measuring the pressure differential across a small mesh window in the body plethysmograph. We have calibrated this measurement and developed software that automatically provides the correct values for all airflow rates. Also, we have developed software that automatically corrects for the phase shift caused by the plethysmograph structure. These refinements should provide more accurate values for nasal resistance.
Subject(s)
Airway Resistance/physiology , Diagnosis, Computer-Assisted/instrumentation , Diagnosis, Computer-Assisted/methods , Manometry/instrumentation , Nose/physiology , Plethysmography/instrumentation , Transducers, Pressure , Adult , Equipment Design , Equipment Failure Analysis , Female , Humans , Male , Manometry/methods , Plethysmography/methods , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
Unilateral stroke results in hemiplegia or hemiparesis of the contralateral side of the body. The ipsilateral side of the body, the so-called "good" side, is often assumed to have no deficit. However, there is increasing evidence that the function of the unaffected limbs, especially the upper extremities, is different from that of normal age-matched controls. In the present study, we examined the motor control of both hands of chronic stroke subjects, 6 with left hemisphere brain damage (LHBD) and 5 with right hemisphere brain damage (RHBD). The control group consisted of 5 normal age-matched subjects. The task of the subject was to move a handle by flexing his/her fingers until the target position was reached. The target position was set as 33% of the range of each subject. No time constraints were imposed. The movements of the normal subjects were basically smooth, with few hesitations. In contrast to this, the movements of both hands in the two stroke groups were segmented and characterized by multiple starts and stops. As compared to normals, the time to reach the target, the number of pauses during the movement, and the percent of time spent in pauses, were significantly greater for both hands of the LHBD group. In the RHBD group, the percent of time spent in pauses was significantly greater than the control group for the ipsilesional hand. The increased segmentation seen in the movements of the ipsilesional, as well as the contralesional. hands of the hemiplegic subjects suggests that the motor deficits in stroke patients may be due to a global inability to correctly plan and carry out movements.
