Implementation and Management Approach

The project is subdivided into the following five technical work packages (WPs) addressing the core challenges of StrokeBack:

WP1 - Design Methodologies & System Architecture

The design of the StrokeBack telemedicine system combines two different solutions, i.e. a Body Area Network for short term monitoring of patients and patient health records for long term evaluation of patients progress. The challenge in this work package is to design the overall architecture in such a way that the architecture itself allows for easy adaptation to other specific technical solutions such as different cryptographic means or other databases than those selected in this project.

WP2 - Selection of Rehabilitation Trainings

In this work package first appropriate training exercises are selected which will be used later on to evaluate the technical solutions developed in other work packages. To facilitate the latter also the representation of the training sequences will be analysed and determined in this work package. In addition we will develop a model which enables medical doctors and physical therapists to do long term evaluation of interdependencies of training effort, training accuracy and vital parameters.

WP3 - BAN for Mobility & Vital Parameter Monitoring

In this work package the BAN architecture is defined. The major effort will go into highly efficient communication protocols for data sharing, signal processing for determining the body positions and into a light weight decision making solution which assesses the current movement with respect to accuracy compared to the selected exercise. Another key issue is the protection of the patient's privacy by employing strong crypto means inside the BAN as well as for communication of patient data with the patient health record.

WP4 - Universal PHR Platform& Rehabilitation Related Applications and Services

In this work package we will develop an online Patient Health Record (PHR) system compliant with the needs and requirements of the StrokeBack services, while at the same time ensuring that our solution is standardised and flexible to allow for adaptation to the latest, e.g., HL7 v3 and emerging new standards. The proposed approach will produce a controllable, flexibly-extendable, yet fully open solution, so as to ensure the smooth execution of the project trials as well as enabling its continuous evolution towards supporting other user groups and diverse future medical service needs.

WP5 - Integration, Test and Evaluation

In this work package we will do early evaluation of all system parameters. I.e. we will evaluate the technical parameters to verify whether we will be able to ensure real time behaviour with a given set of hardware modules. We will also evaluate the look and feel of the StrokeBack components involving experts and patients in order to ensure high acceptance from all involved groups.

Technology solution

In order to provide remote rehabilitation exercises at gold standard level, i.e., as good as in a face-to-face training with rehabilitation experts, we plan to exploit the advanced features of today's Body Area Networks (BAN). A BAN attached to the patient enables permanent monitoring of patients activity and vital parameters. We aim to monitor and record the patients' activity enabling them to regularly, maybe daily, exercise independently from the guidance of the physical therapist. With a correct instrumentation we expect to be able to detect also unwanted additional movements. In order to achieve a comparable monitoring by cameras at least two of them need to be deployed at the patient's home. This is a costly solution which also bears a privacy risk. Both issues can be solved with our BAN based solution.

As one possible application, the physical therapist has to look after the patient once a week only to exploit the level of rehabilitation, to analyse the results of last exercises based on recorded data and to take corrective action if necessary. Further, the physical therapist may show new exercises and configure a new exercise schedule. By that, we intend to boost the rehabilitation process at home. Finally, it allows the physical therapists and the medical experts to get detailed insights into kind and number of exercises the patient executes during absence of the care persons.

The envisioned BAN can be worn by the patients throughout the whole day, which enables comparing actual movements in their daily life with the correct movement patterns defined in rehabilitation exercises. To simplify the configuration process of the system, we will analyse and evaluate self-learning techniques for exercise recognition, i.e., the StrokeBack system may learn the correct behaviour (patient's movements) itself when exercises are carried out under instruction of the physical therapist.

We will additionally evaluate the feasibility and requirements of using electronic Personal Health Records (PHR) to store and document recorded data and to remotely track the rehabilitation process, e.g., by the attending doctor. This includes the recordings done during rehabilitation exercises and during daily life. The recorded data will be stored and can then be processed by healthcare professionals. The evaluation can be used to deduce detailed information of effects of individual exercises. This feedback can be used to select exercises for other patients, to assess effectiveness of exercises for specific groups of patients etc. In addition the vital parameters can be used to assess the healthiness of the patients which might even help to assess the probability of a further stroke.