報告學生:陳祖麗 指導老師:林昭宏教授 報告日期:Jan 16, 2010

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報告學生:陳祖麗

指導老師:林昭宏教授

報告日期:
Mar 13, 2010


Telerehabilitation in patients
with

stroke

中風病人的遠距復健


1

INTRODUCTION

2

Tele
-

home care/ telerehabilitation

3

What is telerehabilitation


Telerehabilitation is the provision of


rehabilitation services at a distance using


telecommunications technology as the


delivery medium.


4


It desires to provide individuals who are


-

remote from rehabilitation specialists




-

isolated as a result of a physical


impairment which prevents them from


attending a local service

5

History of telerehabilitation


When compared to other areas of
telemedicine, telerehabilitation has had a
short history.



In the past decade or so with the
development of sophisticated optical and
sensor
-
based technologies, have these
perceptual barriers started to erode.

6

Currently uses


Sensor based rehabilitation



Imaged based rehabilitation



Virtual
-

reality based rehabilitation




7

Sensor based rehabilitation


It employs equipment such as tilt
switches, accelerometers and gyroscopes
to sample and quantify movement
through three
-
dimensional space.

8

Imaged based rehabilitation


Pioneering work in the use of
videoconferencing for rehabilitation
consultations was conducted at the
Tripler army medical centre on Oahu,
Hawaii in 1993.

9

Virtual
-

reality based rehabilitation


It makes use of configurable computer
-
generated three
-

dimensional virtual
environments to elicit specific movement
and motor responses by the patient.

10

APPLICATION IN
STROKE PATIENTS

11

Comparison of finger tracking
versus simple movement training

12

13

14

Exercises for paretic upper limb
after stroke

15

Fig. 3. Fugl
-
Meyer Upper Extremity (Fugl
-
Meyer UE) scores, in

experimental (Telerehab) and control groups. *Statistical
significance for Wilcoxon test, p < 0.05. †Statistical significance
for Mann
-
Whitney U test, p < 0.05.

Cognitive load and dual
-
task
performance during locomotion
post
-

stroke

16

17

Virtual reality


induced cortical
reorganization and associated
locomotor recovery in chronic
stroke

18

19

ADVANTAGE

20


21

FUTURE CHALLENGE

22

Future challenge


Complex packaging



Consistent computer and internet
capabilities and access



Data management



Technical support


23

Future challenge


Privacy protection



Seizure



Distance trials



Scientific scrutiny and rigorous support
from insurance companies


24

Future challenge


Difficulties in evaluating and quantifying
human movement remotely



The conceptual difficulties of providing
rehabilitation without the ability to place
hands on the patient have slowed the
development of viable telerehabilitation
services.

25

David M Brennan, 2008

26

References


27

THANK YOU FOR
YOUR ATTENTION !!

28