A Device for Local or Remote Monitoring of Hand Rehabilitation Sessions for Rheumatic Patients

IEEE J Transl Eng Health Med. 2014 Jan 9:2:2100111. doi: 10.1109/JTEHM.2014.2299274. eCollection 2014.

Abstract

Current clinical practice suggests that recovering the hand functionality lost or reduced by injuries, interventions and chronic diseases requires, beyond pharmacological treatments, a kinesiotherapic intervention. This form of rehabilitation consists of physical exercises adapted to the specific pathology. Its effectiveness is strongly dependent on the patient's adhesion to such a program. In this paper we present a novel device with remote monitoring capabilities expressly conceived for the needs of rheumatic patients. It comprises several sensorized tools and can be used either in an outpatient clinic for hand functional evaluation, connected to a PC, or afforded to the patient for home kinesiotherapic sessions. In the latter case, the device guides the patient in the rehabilitation session, transmitting the relevant statistics about his performance to a TCP/IP server exploiting a GSM/GPRS connection for deferred analysis. An approved clinical trial has been set up in Italy, involving 10 patients with Rheumatoid Arthritis and 10 with Systemic Sclerosis, enrolled for 12 weeks in a home rehabilitation program with the proposed device. Their evaluation has been performed with traditional methods but also with the proposed device. Subjective (hand algofunctional Dreiser's index) and objective (ROM, strength, dexterity) parameters showed a sustained improvement throughout the follow-up. The obtained results proved that the device is an effective and safe tool for assessing hand disability and monitoring kinesiotherapy exercise, portending the potential exploitability of such a methodology in clinical practice.

Keywords: Telerehabilitation; adapted physical exercise; rehabilitation; rheumatic diseases; telemedicine.

Grants and funding

This work was supported in part by the Region of Sardinia, Fundamental Research Programme, L.R. 7/2007 Promotion of the scientific research and technological innovation in Sardinia under Grant Agreement CRP2_584 Re.Mo.To. Project. A. Dess and M. Piga gratefully acknowledge Sardinia Regional Government for the financial support (P.O.R. Sardegna F.S.E. Operational Programme of the Autonomous Region of Sardinia, European Social Fund 2007-2013—Axis IV Human Resources, Objective l.3, Line of Activity l.3.1).