Med-e-tel 2013 electronic proceedings.pdf

Med-e-Tel 2013
Electronic Proceedings
of
The International eHealth, Telemedicine and Health
ICT Forum for Educational, Networking and
Business
International Society for Telemedicine & eHealth (ISfTeH)Coordinating Officec/o Frank LievensWaardbeekdreef 11850 GrimbergenBelgiumPhone: +32 2 269 8456Fax: +32 2 269 7953E-mail: [email protected] Med-e-Tel 2013
Electronic Proceedings: The International eHealth, Telemedicine and
Health ICT Forum for Educational, Networking and Business
Editors: Malina Jordanova, Frank Lievens
ISSN 1818 - 9334
All rights reserved. No part of this proceedings may be reproduced, stored in a retrieval system or otherwise used without prior written permission from the publisher, ISfTeH. ISfTeH, 2013, Printed in G. D. of Luxembourg Telepulseoximetry Assessment for Elderly Patients
during Physical Therapy – Preliminary Study
A. ĩXNRZVND1,5, B. Glinkowska2,5, R. Krzyminiewski3, W. Glinkowski 4,5 1Student's Scientific Club - “TeleHealth”, Medical University of Warsaw, 2Department of Sports and Physical Education, Medical University of 3Medical Physics Division, Faculty of Physics Adam Mickiewicz 4Chair and Department of Orthopaedics and Traumatology of Locomotor System, Center of Excellence “TeleOrto”, Poland 5Polish Telemedicine Society, Warsaw, Poland Abstract: Physiotherapists prescribe frequently physical exercises for
health while treating disabilities. The vital signs are rarely monitored
patients’ to ensure patient’s safety while exercising. This study was
designed to evaluate the usefulness and applicability of pulseoximetry
for physical therapy patients suffering musculoskeletal disorders. The
aim of the study was also to implement telepulseoximetery to assess the
aerobic endurance and fitness of elderly patients during physical
therapy. Remote High Signal Resolution Pulse Wave (HSR-PW)
analysis, an innovative diagnostic tool for home care telemonitoring,
was used to enhance patient’s assessment. The group of patients
suffering musculoskeletal disorders, mainly osteoarthritis, was enrolled
to this study. We have used a novel algorithms developed for more
detailed pulsoximetry analysis beyond the measurement of arterial
oxygen saturation (SaO2). Telemonitoring of pulseoximetry was well
accepted by subjects. We have noted some cardiovascular improvement
of patients health status, however, further studies are required.
The experience in telehomecare and tele-monitoring, the pulsoximetry was already demonstrated for patients suffering respiratory impairment, COPD, cystic fibrosis and heart failure [1-10]. A review of literature shows that pulseoximetry measurement is rarely applied to support the physical therapy practice. Remote pulseoximetry allows achieving better safety for patients and allows monitoring patients’ cardiovascular status continuouslyat home or during physical activity [1, 11]. The aim of this study is to evaluate the usefulness and applicability of pulseoximetry for physical therapy patients suffering musculoskeletal disorders, mainly osteoarthritis(OA). This pilot service was applied to support rehabilitation exercises of patients suffering musculoskeletal disorders and promotion of monitored physical activity with wide opportunities of saturation monitoring with an efficient method for pulse oximeter application. Elderly patients with musculoskeletal disorders (mostly OA) were enrolled for this study. Remote High Signal Resolution Pulse Wave analysis was performed before and after a session of physical therapy. The pulse wave was recorded utilizing standard wireless pulse oximeter. The pulse waves were recorded in the range of 35%-99% with a resolution 1 % for SPO2. The measurement was transmitted via Bluetooth connection to laptop and transmitted to server viamobile broadband connection for further analysis. High Signal Resolution Pulse Wave analysis allows enhancing resolution of pulse wave. This allows obtaining the pulse wave details unseen in standard measurement.
Computer analyzes peaks for every patient individually and calculates parameters which show the status of cardiovascular system.
The measurement was performed on patients’ middle finger of the left hand. We have assessed the usefulness of the device and measurement. The attitudes towards the new telepulsoxymetry device among exercising elderlies suffering musculoskeletal disorders was evaluated.
Five female patients with different stages of OA were enrolled for this study. Average patient’s age was 65,4years (57-79 years). The range of heart rate had normalized after exercises in the study group. The saturation range had significantly risen after exercises. The average Aorta/Ventricle index was higher after exercises in the pilot study group.
Table 1. Patients results before and after rehabilitation session of physical Subjects who have experienced the measurements were interested in their results. They didn’t claim any discomfort or complaints due to applied pulsoximeter assessment. Remote health monitoring is usually provided with non-invasive mobile systems. The use of pulse oximetry rises along with the wide availability of mobile phones. Various devices have already pulseoximeter interfaced to mobile devices. The experience in telehomecare, tele-monitoring pulsoximetry was already demonstrated for patients suffering respiratory impairment, COPD, cystic fibrosis and heart failure[2, 3, 5, 7, 9, 12, 13].
Various diagnostic medical instruments have been integrated into a personal wearable device and a home telehealthcare system. We have tested finger-worn health monitoring device which performs the measurements of non-invasive pulse oximetry (SpO2). The device is able to analyze the acquired bio-signals and transmit the resultant data to a healthcare service center through a commercial cellular phone or wireless Internet connection. Pulseoximetry is a low-cost, non-invasive method to measure patients’saturation and pulse rate. This data are crucial for assessment of cardiopulmonary system status [2]. A pulseoximeter diagnostic instrumentation was used for personalized healthcare services for unique telemedicine application for musculoskeletal rehabilitation. We have used a novel algorithms developed for more detailed pulseoximetry analysis beyond the measurement of arterial oxygen saturation (SaO2). Telemonitoring of pulseoximetry was well accepted by subjects. We have noted some cardiovascular improvement of patients health status, however, further studies are required [14]. This study is supported by student's mini-grant 1WE/NM1/12 funded by [1] Isik AH, Guler I. Pulse oximeter based mobile biotelemetry application. Studies in health technology and informatics 2012;181:197-201.
[2] Pak JG, Park KH. Advanced pulse oximetry system for remote monitoring and management. J Biomed Biotechnol 2012;2012:930582.
[3] Morillo DS, Gross N. Probabilistic neural network approach for the detection of SAHS from overnight pulse oximetry. Medical & biological engineering & computing 2012.
[4] Hudson J, Nguku SM, Sleiman J, Karlen W, Dumont GA, Petersen CL, et al. Usability testing of a prototype Phone Oximeter with healthcare providers in high- and low-medical resource environments. Anaesthesia 2012;67:957-67.
[5] Bohning N, Zucchini W, Horstmeier O, Bohning W, Fietze I. Sensitivity and specificity of telemedicine-based long-term pulse-oximetry in comparison with cardiorespiratory polygraphy and polysomnography in patients with obstructive sleep apnoea syndrome. J Telemed Telecare 2011;17:15-9.
[6] Buschmann JP, Huang J. New ear sensor for mobile, continuous and long term pulse oximetry. Conf Proc IEEE Eng Med Biol Soc 2010;2010:5780-3.
[7] Yan YS, Zhang YT. An efficient motion-resistant method for wearable pulse oximeter. IEEE transactions on information technology in biomedicine : a publication of the IEEE Engineering in Medicine and Biology Society 2008;12:399-405.
[8] Shin IH, Lee JH, Kim HC. Ubiquitous monitoring system for chronic obstructive pulmonary disease and heart disease patients. Conf Proc IEEE Eng Med Biol Soc 2007;2007:3689-92.
[9] Mendelson Y, Duckworth RJ, Comtois G. A wearable reflectance pulse oximeter for remote physiological monitoring. Conf Proc IEEE Eng Med Biol Soc 2006;1:912-5.
[10] Chun H, Kang J, Kim KJ, Park KS, Kim HC. IT-based diagnostic instrumentation systems for personalized healthcare services. Stud Health Technol Inform 2005;117:180-90.
[11] Krzyminiewski R DB, Ladzinska M, Jemielity M, Buczkowski P, Urbanowicz T, Clark T. High Signal Resolution Pulse Wave-Hope for a Fast and Cheap Home Care Monitoring Patients with Cardiac Diseases. In: Jordanova M, Lievens F, editors. Med-e-Tel 2011 Electronic Proceedings of The International eHealth, Telemedicine and Health ICT Forum for Educational, Networking and Business. Luxemburg: International Society for Telemedicine & eHealth (ISfTeH); 2011. p. 540-4.
[12] Kohl BA, Domski A, Pavan K, Fortino M. Use of telemedicine for the identification and treatment of sulfamethoxazole-induced methaemoglobinemia. J Telemed Telecare 2012;18:362-4.
[13] Kemper AR, Mahle WT, Martin GR, Cooley WC, Kumar P, Morrow WR, et al. Strategies for implementing screening for critical congenital heart disease. Pediatrics 2011;128:e1259-67.
[14] Zamith M, Cardoso T, Matias I, Marques Gomes MJ. Home telemonitoring of severe chronic respiratory insufficient and asthmatic patients. Rev Port Pneumol 2009;15:385-417.
$JQLHV]ND ĩXNRZVND - Bachelor of Physiotherapy degree (Medical University of Warsaw). She is continuing her physiotherapy studies for a Master degree at the same University. She is interested in telemedicine use in physiotherapy. She has received her student's minigrant in 2012. She chairs a Student's Scientific Club "Telehealth" at the Medical University of Warsaw since 2011.

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