scholarly journals Kinect-Based Exergames Tailored to Parkinson Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Ioannis Pachoulakis ◽  
Nikolaos Papadopoulos ◽  
Anastasia Analyti
Keyword(s):  
Motor Dysfunction ◽  
Microsoft Kinect ◽  
Dropping Out ◽  
Clinical Settings ◽  
Dopaminergic Drugs ◽  
Rehabilitation Programs ◽  
Interactive Environment ◽  
Interactive 3D ◽  
Game Context ◽  
Nonlinear Fashion

Parkinson’s disease (PD) is a progressive neurodegenerative movement disorder where motor dysfunction gradually increases. PD-specific dopaminergic drugs can ameliorate symptoms, but neurologists also strongly recommend physiotherapy combined with regular exercise. As there is no known cure for PD, traditional rehabilitation programs eventually tire and bore patients to the point of losing interest and dropping out of those programs just because of the predictability and repeatability of the exercises. This can be avoided with the help of current technology, character-based, interactive 3D games promote physical training in a nonlinear fashion, and can provide experiences that change each time the game is played. Such “exergames” (a combination of the words “exercise” and “game”) challenge patients into performing exercises of varying complexity in a playful and interactive environment. In this work we present a Unity3D-based platform hosting two exergames tailored to PD patients with mild to moderate symptoms. The platform employs Microsoft Kinect, an affordable off-the-shelf motion capture sensor that can be easily installed in both home and clinical settings. Platform navigation and gameplay rely on a collection of gestures specifically developed for this purpose and are based upon training programs tailored to PD. These gestures employ purposeful, large-amplitude movements intended to improve postural stability and reflexes and increase upper and lower limb mobility. When the patient’s movements, as detected by Kinect, “match” a preprogrammed gesture, an onscreen 3D cartoon avatar responds according to the game context at hand. In addition, ingame decision-making aims at improving cognitive reaction.

Hiring Practices of Exercise Physiologist in Cardiac Rehabilitation Programs among Mid-Atlantic States in the United States

2016 ◽  
Vol 5 (3) ◽  
pp. 32-36 ◽  
Author(s):  
Allison Hope Bowersock ◽  
William Alexander Breeding ◽  
Carmel Alexander Sheppard
Keyword(s):  
United States ◽  
Patient Education ◽  
Cardiac Rehabilitation ◽  
Science Curriculum ◽  
Exercise Physiology ◽  
Clinical Skill ◽  
The United States ◽  
Hiring Practices ◽  
Clinical Settings ◽  
Rehabilitation Programs

Purpose: The purpose of this survey was to identify factors that may be influencing the appreciation of exercise physiology as a discipline as demonstrated by hiring practices in regional clinical settings. Methods: A telephone survey was administered to 33 cardiac rehabilitation programs in 5 states in the Mid-Atlantic region of the United States (Kentucky, North Carolina, Tennessee, Virginia, and West Virginia). Results: The distribution of nurses and exercise physiologists (EPs) employed by the 33 facilities varied by state, but overall there were 86 nurses and 55 EPs working among the surveyed facilities. Of the 33 surveyed facilities, 12 (36%) reported a preference for hiring nurses over EPs; only 4 (12%) reported a preference for hiring EPs over nurses. The remaining facilities (n = 17; 52%) reported no preference (n = 12; 36%) or that the decision depends on a variety of factors (n = 5; 15%). Several common themes were identified from respondents. These included that, compared to nurses, EPs have greater expertise in exercise prescription and better understanding of safe exercise progression for patients. However, nurses were believed to possess greater assessment and clinical skill with an emphasis on emergency response preparedness and greater general patient education skills. Conclusion: Academic programs that prepare students for careers as EPs employed in clinical settings may benefit from additional coursework and internship site selection that focus on clinical assessment skills, emergency preparedness, and patient education to reinforce their work in an exercise science curriculum.

Individual, Institutional, and Environmental Factors Promoting Patient Retention and Dropout

2021 ◽  
pp. 1590-1606
Author(s):  
Precious Arnan ◽  
Emmanuel Adugu
Keyword(s):  
Cardiac Disease ◽  
Illness Perception ◽  
Drop Out ◽  
Dropping Out ◽  
Individual Factors ◽  
Related Factors ◽  
Program Administrators ◽  
Rehabilitation Programs ◽  
Client Dropout ◽  
Patient Retention

The primary purpose of this chapter is to determine factors that shape client dropout and adherence to Cardiac Disease Prevention and Rehabilitation Programs. The sample consists of 68 individuals, including those currently in the program (adherents) and those who have dropped out (dropouts). Findings show that clients undergoing rehabilitation are much likely to drop out when they are in the critical zone. This is a point where institutional factors, individual factors and environmentally-related factors are not favorable to clients. The risk of clients dropping out can be drastically reduced through the provision of an enabling environment comprising a set of factors that foster adherence such as financial sponsorship, institutional support, high intrinsic motivation, improved illness perception. In that context, there is the need for program administrators to closely monitor at-risk clients, especially those whose social, economic and psychological profiles predict non-adherence.

scholarly journals An Instrumented Glove-Controlled Portable Hand-Exoskeleton for Bilateral Hand Rehabilitation

Biosensors ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 495
Author(s):  
Shih-Hung Yang ◽  
Chia-Lin Koh ◽  
Chun-Hang Hsu ◽  
Po-Chuan Chen ◽  
Jia-Wei Chen ◽  
...  
Keyword(s):  
Daily Living ◽  
Hand Function ◽  
Hand Movement ◽  
Clinical Settings ◽  
Hand Rehabilitation ◽  
Rehabilitation Programs ◽  
Home Based ◽  
Instrumented Glove ◽  
Flexible Mechanism ◽  
Hand Exoskeleton

Effective bilateral hand training is desired in rehabilitation programs to restore hand function for people with unilateral hemiplegia, so that they can perform daily activities independently. However, owing to limited human resources, the hand function training available in current clinical settings is significantly less than the adequate amount needed to drive optimal neural reorganization. In this study, we designed a lightweight and portable hand exoskeleton with a hand-sensing glove for bilateral hand training and home-based rehabilitation. The hand-sensing glove measures the hand movement of the less-affected hand using a flex sensor. Thereafter, the affected hand is driven by the hand exoskeleton using the measured hand movements. Compared with the existing hand exoskeletons, our hand exoskeleton improves the flexible mechanism for the back of the hand for better wearing experience and the thumb mechanism to make the pinch gesture possible. We designed a virtual reality game to increase the willingness of repeated movement practice for rehabilitation. Our system not only facilitates bilateral hand training but also assists in activities of daily living. This system could be beneficial for patients with hemiplegia for starting correct and sufficient hand function training in the early stages to optimize their recovery.

Individual, Institutional, and Environmental Factors Promoting Patient Retention and Dropout

2016 ◽  
pp. 41-57
Author(s):  
Precious Arnan ◽  
Emmanuel Adugu
Keyword(s):  
Cardiac Disease ◽  
Illness Perception ◽  
Drop Out ◽  
Dropping Out ◽  
Individual Factors ◽  
Related Factors ◽  
Program Administrators ◽  
Rehabilitation Programs ◽  
Client Dropout ◽  
Patient Retention

The primary purpose of this chapter is to determine factors that shape client dropout and adherence to Cardiac Disease Prevention and Rehabilitation Programs. The sample consists of 68 individuals, including those currently in the program (adherents) and those who have dropped out (dropouts). Findings show that clients undergoing rehabilitation are much likely to drop out when they are in the critical zone. This is a point where institutional factors, individual factors and environmentally-related factors are not favorable to clients. The risk of clients dropping out can be drastically reduced through the provision of an enabling environment comprising a set of factors that foster adherence such as financial sponsorship, institutional support, high intrinsic motivation, improved illness perception. In that context, there is the need for program administrators to closely monitor at-risk clients, especially those whose social, economic and psychological profiles predict non-adherence.

scholarly journals Effectiveness and Predictors of Outcome for Psychotherapeutic Interventions in Clinical Settings Among Adolescents

2021 ◽  
Vol 12 ◽  
Author(s):  
Vera Gergov ◽  
Nina Lindberg ◽  
Jari Lahti ◽  
Jari Lipsanen ◽  
Mauri Marttunen
Keyword(s):  
Psychological Distress ◽  
Externalizing Behavior ◽  
Externalizing Problems ◽  
Active Role ◽  
Role Expectations ◽  
Dropping Out ◽  
Clinical Settings ◽  
Psychotherapeutic Interventions ◽  
The Mean ◽  
Evaluation Outcome

BackgroundThe aim of this study was to investigate the effectiveness of psychotherapeutic interventions for clinically referred adolescents, as well as to examine whether sociodemographic, clinical, or treatment-related variables and patients’ role expectations predict treatment outcome or are possible predictors of treatment dropout.MethodThe study comprised 58 adolescents (mean age 14.2, 65.5% female) suffering from diverse psychiatric disorders referred to psychotherapeutic interventions conducted in outpatient care. The outcome measures, The Beck Depression Inventory, and the Clinical Outcomes in Routine Evaluation – Outcome Measure were filled in at baseline and at 3-, 6-, and 12-month follow-ups. Possible predictors were assessed at baseline.ResultsThe results indicate that the mean level of symptoms and psychological distress decreased during the treatment, most reduction occurring in the first 6 months. The frequency of treatment sessions was the strongest predictor of good outcome. Adolescents with a higher level of externalizing problems or lower level of expectations for their own active role in treatment seem to have a higher risk of dropping out.ConclusionOffering intensive treatment for a shorter period might be the most efficient way to gain symptom reduction and decrease psychological distress in psychotherapeutic interventions with adolescents. Being aware of externalizing behavior and increasing the adolescents’ own agency during the assessment could strengthen commitment and result in the adolescent benefiting more from treatment.

Analysis of Recoverable Falls Via microsoft kinect: Identification of Third-Order Ankle Dynamics

2016 ◽  
Vol 138 (9) ◽  
Author(s):  
Mauricio E. Segura ◽  
Enrique Coronado ◽  
Mauro Maya ◽  
Antonio Cardenas ◽  
Davide Piovesan
Keyword(s):  
Vision System ◽  
Muscle Stiffness ◽  
Microsoft Kinect ◽  
Clinical Settings ◽  
Identification Algorithm ◽  
Third Order ◽  
Gaming Industry ◽  
Reliable Assessment ◽  
Soft Computing Techniques ◽  
Tracking Devices

This work combines the kinematics estimate of human standing with a hybrid identification algorithm to identify a set of ankle dynamics mechanical parameters. We used the hold and release (H&R) experimental paradigm to model a set of recoverable falls on a population of unimpaired adults. Body kinematics was acquired with a microsoft kinect (mk) version 2 after benchmarking its position accuracy to a camera-based vision system (CVS). The system identification algorithm, combining an extended Kalman filter (EKF) and a genetic algorithm (GA), allowed to identify the effect of tendon and muscle stiffness at the ankle joint, separately. This work highlights that, when associated to soft-computing techniques, affordable tracking devices developed for the gaming industry can be used for the reliable assessment of neuromechanical parameters in clinical settings.

scholarly journals Contribution of Psychological Factors in Dropping out from Chronic Obstructive Pulmonary Disease Rehabilitation Programs

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Athanasios Tselebis ◽  
Epaminondas Kosmas ◽  
Dionisios Bratis ◽  
Argiro Pachi ◽  
Ioannis Ilias ◽  
...  
Keyword(s):  
Pulmonary Rehabilitation ◽  
Educational Status ◽  
Rehabilitation Program ◽  
Drop Out ◽  
Psychological State ◽  
Dropping Out ◽  
Chronic Obstructive ◽  
Paranoid Ideation ◽  
Positive Effects ◽  
Rehabilitation Programs

Significant positive effects, particularly on psychological state in patients who completed the follow-up pulmonary rehabilitation programs, are indicated by a large number of studies. Yet, a remarkable proportion of selected patients drop out from these programs. In this study, we investigated existing differences on psychological variables among COPD patients who complete and those who drop out from pulmonary rehabilitation programs. The study included 144 patients, 43 (29.9%) of whom did not complete the program. SCL-90 was used for the assessment of psychological symptoms. On the SCL-90-R scale 55.6% of patients had abnormal findings. Patients who discontinued the program had higher rates of depression and somatization compared to those who completed it. Regarding the psychopathology scales of SCL-90R, we found that patients who discontinued the program showed higher levels of psychopathology on the scales of somatization, depression, paranoid ideation, and psychotism compared to those who completed the program. The final regression model showed that patients with low educational status and psychotism were more likely to leave the program. In conclusion, psychopathology contributes to patients dropping out from a COPD rehabilitation program; thus, psychological assessment prior to inclusion in rehabilitation programs may reduce dropouts.

scholarly journals Development of a Biomechatronic Device for Motion Analysis Through a RGB-D Camera

2020 ◽  
Vol 2 (3) ◽  
pp. 35-44
Author(s):  
Francesca Pristerà ◽  
Alessandro Gallo ◽  
Salvatore Fregola ◽  
Alessio Merola
Keyword(s):  
Augmented Reality ◽  
Real Time ◽  
Motion Analysis ◽  
Low Cost ◽  
Individual Characteristics ◽  
Microsoft Kinect ◽  
Body Motion ◽  
Depth Camera ◽  
Interactive Environment ◽  
Remote Assistance

This work investigates the validity and reliability of a novel biomechatronic device providing an interactive environment in Augmented Reality (AR) for neuromotor rehabilitation. A RGB-depth camera and telemonitoring/remote signaling module are the main components of the device, together with a PC-based interface. The interactive environment, which implements some optimized algorithms of body motion capture and novel methodologies for human body motion analysis, enables neuromotor rehabilitation treatments that are adaptable to the performance and individual characteristics of the patient. The RGB-Depth camera module is implemented through a Microsoft Kinect, ORBBEC ZED2K devices; the telemonitoring module for teleassistance and therapy supervision is implemented as a cloud service. Within the module of body motion tracking, the abduction and adduction movements of the limbs of the full-body structure are tracked and the joints angles are measured in real-time; the most distinctive feature of the tracking module is the control of the trunk and shoulder posture during the exercises performed by the patient. Indeed, the device recognizes an incorrect position of the patient's body that could affect the objective of the exercise to be performed.  The recognition of an incorrect exercise is associated to the generation of an alert both to the patient and the physician, in order to maximize the effectiveness of the treatment based on the user's potential and to increase the chances of a better biofeedback. The experimental tests, which have been carried out by reproducing several neuromotor exercises on the interactive environment, show that the feature recognition and extraction of the joints and segments of the musculo-skeletal structure of the patient's, and of wrong posture during exercises, can achieve good performance in the different experimental conditions.  The developed device is a valid tool for patients affected by chronic disability, but it could be extended to neurodegenerative diseases in the early stages of the disease. Thanks to the enhanced interactivity in augmented reality, the patient can overcome some difficulties in interaction with the most common IT tools and technologies; at the meanwhile she/he can perform rehabilitation at home. The physician can also check in real time the results and customize the care pathway. The enhanced interactivity provided by the device during rehabilitation session increases both the motivation by the patient and the continuity of the care, as well as it supports low-cost remote assistance and telemedicine by optimizing therapy costs. The key points are: i) making rehabilitation motivating for the patient, becoming a "player"; ii) optimize effectiveness and costs; iii) possibility of low-cost remote assistance and telemedicine.

Use of Vestibular Rehabilitation in the Pediatric Population

2019 ◽  
Vol 4 (6) ◽  
pp. 1399-1405 ◽  
Author(s):  
Jennifer Christy
Keyword(s):  
Pediatric Population ◽  
Dynamic Balance ◽  
Vestibular Rehabilitation ◽  
Rehabilitation Program ◽  
Gross Motor ◽  
Gaze Stabilization ◽  
Motor Delay ◽  
Rehabilitation Programs ◽  
Motor Practice ◽  
Balance Exercises

Purpose The purpose of this article was to provide a perspective on vestibular rehabilitation for children. Conclusion The developing child with vestibular dysfunction may present with a progressive gross motor delay, sensory disorganization for postural control, gaze instability, and poor perception of motion and verticality. It is important that vestibular-related impairments be identified early in infancy or childhood so that evidence-based interventions can be initiated. A focused and custom vestibular rehabilitation program can improve vestibular-related impairments, enabling participation. Depending on the child's age, diagnosis, severity, and quality of impairments, vestibular rehabilitation programs may consist of gaze stabilization exercises, static and dynamic balance exercises, gross motor practice, and/or habituation exercises. Exercises must be modified for children, done daily at home, and incorporated into the daily life situation.

The Clinician Directed Hierarchy: A Clinical Training Tool

2008 ◽  
Vol 11 (2) ◽  
pp. 56-60 ◽  
Author(s):  
Jill K. Duthie
Keyword(s):  
Clinical Supervision ◽  
Clinical Training ◽  
Clinical Teaching ◽  
Clinical Skills ◽  
Clinical Settings ◽  
Specific Level ◽  
Problem Solving Skills ◽  
Training Tool ◽  
Target Behaviors ◽  
Intervention Process

Abstract Clinical supervisors in university based clinical settings are challenged by numerous tasks to promote the development of self-analysis and problem-solving skills of the clinical student (American Speech-Language-Hearing Association, ASHA, 1985). The Clinician Directed Hierarchy is a clinical training tool that assists the clinical teaching process by directing the student clinician’s focus to a specific level of intervention. At each of five levels of intervention, the clinician develops an understanding of the client’s speech/language target behaviors and matches clinical support accordingly. Additionally, principles and activities of generalization are highlighted for each intervention level. Preliminary findings suggest this is a useful training tool for university clinical settings. An essential goal of effective clinical supervision is the provision of support and guidance in the student clinician’s development of independent clinical skills (Larson, 2007). The student clinician is challenged with identifying client behaviors in the therapeutic process and learning to match his or her instructions, models, prompts, reinforcement, and use of stimuli appropriately according to the client’s needs. In addition, the student clinician must be aware of techniques in the intervention process that will promote generalization of new communication behaviors. Throughout the intervention process, clinicians are charged with identifying appropriate target behaviors, quantifying the progress of the client’s acquisition of the targets, and making adjustments within and between sessions as necessary. Central to the development of clinical skills is the feedback provided by the clinical supervisor (Brasseur, 1989; Moss, 2007). Particularly in the early stages of clinical skills development, the supervisor is challenged with addressing numerous aspects of clinical performance and awareness, while ensuring the client’s welfare (Moss). To address the management of clinician and client behaviors while developing an understanding of the clinical intervention process, the University of the Pacific has developed and begun to implement the Clinician Directed Hierarchy.

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