Virtual and diverse: Digitization of rehabilitation and physiotherapy
Virtual and diverse: Digitization of rehabilitation and physiotherapy
From walking canes with built-in GPS sensor and SOS emergency call function to robot-assisted therapy sessions to virtual reality applications – digitization is making its way into the rehabilitation sector. We have reviewed the role this topic already played at REHACARE 2018 and highlighted some of the research projects that currently focus on this subject.
Researchers in the field of 3D motion and gait analysis are certain that in the coming years there will increasingly be technologies available that enable 3D motion analysis with simple body worn sensors.
"From my perspective, digitization doesn’t solve any problems but it opens up added possibilities for increased participation and an improved quality of life," said Christine Weiß from the Institute for Innovation und Technology (iit) at the 2018 REHACARE Congress. Even though the Congress and thus her statement were aimed at the ‘Digitization of the Quarter’, the assertion still reflects the perspective of many stakeholders in the healthcare and rehabilitation sector when it comes to the prospects of digitization.
After all, the subject is on everyone’s mind. That’s why we invited different experts to join the 2018 REHACARE Forum, where they discussed a possible digital transformation of the rehabilitation sector. Sophie Rabe was among them. The rehabilitation scientist sees great benefits in digitization if the subject is broached properly. "Patient education and patient self-management are key components of rehabilitation. This is where digital applications can sustainably support desirable behavior changes through clear objectives, interactive learning content, feedback functions, and social reinforcement," Rabe said in an interview with REHACARE.com. "As it pertains to post-rehabilitation support, digital solutions can also encourage interaction with the patient and carry the learned health-promoting behaviors into everyday life."
Small apps, big benefits
Despite the fact that they are often not considered in this particular context, chronically ill patients can also benefit from digitization. For example, people with diabetes can now use technology tools and gadgets to monitor and manage their disease. Whether it’s a blood glucose meter, which sends readings directly to the doctor for analysis via software and USB or Bluetooth data transmission, countless apps that work as digital diaries and calculate all the necessary values or insulin pumps and CGM devices for continuous glucose monitoring – there is a smart helper for (almost) every problem.
Meanwhile, app stores are bursting at the seams thanks to all the available fitness and health apps. Users still mostly learn by "trial and error" whether an app is worth downloading. When it comes to diabetes, "DiaDigital" is an official seal designed to help those affected to find the right app for their needs and use it with a clear conscience because they do not have to worry about their data. Having said that, most health apps don’t have a seal and only a few require certification as a medical device app. The Neolexon app falls into this category. As part of an innovation project, the German IKK gesund plus insurance provider is currently paying for the costs of the aphasia app. However, there are no reimbursement arrangements as of yet with any other health insurance companies, so that patients have to pay for the app out-of-pocket.
This is something Sophie Rabe also agrees with, who asked for the creation of framework conditions in the German health care system "to carry evidence-based digital rehabilitation options and services over into standard health care as complementary care services." Find out how the German healthcare system broaches the subject of digitization and learn about the opportunities and obstacles in our article titled "Digitization and the new opportunities it brings to the healthcare sector".
Robot-assisted stroke rehabilitation
The advance of digital transformation and its processes is unstoppable and is likely to shape the future. That’s why it is important to be prepared – this applies especially to health care personnel. Both people with many years of job experience, as well as future employees, must be prepared accordingly. After all, increased knowledge and understanding also increases the willingness to use digital systems to assist people’s jobs.
That’s when the digital helpers are not perceived as enemies but as friends. A robotic arm is used as part of the RWTH Aachen inRehaRob project with the goal to support both patients and physiotherapists. It is designed to help patients recover from movement problems caused by a stroke. Although this therapy assistant is intended to facilitate self-guided therapy units in the future, it doesn’t compete in any way with the skills of a physiotherapist. Find out in our video, how inRehaRob supports trained professionals as a therapy helper.
In the age of digitization, motor-assisted rehabilitation is increasingly finding its way into training sessions. For example, the RehaDigit system by the HASOMED Company targets passive finger movement and is intended to promote motor and sensory stimulation. As part of the RehaLab concept, it can make the rehabilitation process more effective and sustainable. At REHACARE 2018, Product Manager Patrick Hauff sat down for an interview with REHACARE.com.
Prof. Dr. Claudia Voelcker-Rehage instructs a test person in the gait analysis laboratory about the appearing cues during a walk in a virtual city. The virtual world is projected onto a 240 degree curved screen.
Rehabilitation in virtual reality
Apart from robot-assisted and motor-assisted therapy, virtual reality is also increasingly changing the rehabilitation process. The "Gait Real-time Analysis Interactive Lab" – or GRAIL – at the Chemnitz University of Technology (TU) takes advantage of interactive virtual environments to facilitate real-time gait analysis. In addition to visual and acoustic cues, a hydraulic, dual-axis, portable treadmill makes it possible to simulate walking on an uneven forest path, hill or a rope bridge – if needed, patients can also use a rolling walker or prosthetics. "Despite the realistic experience, we can create the same controlled and standardized conditions for all test subjects, which is very important to ensure data comparability for research purposes," explains Claudia Voelcker-Rehage.
Both the TU Chemnitz and the St. Pölten University of Applied Sciences use virtual reality to facilitate three-dimensional and personalized motion and gait analysis. Both research teams emphasize that these methods result in increased patient motivation; especially if there is a chance to incorporate gamification aspects into the rehabilitation measures.
Whether it’s virtual reality settings or robot-assisted therapy – it is highly likely that these developments will definitively shape the future of rehabilitation and physiotherapy.