motion monitoring application in clinical rehablitation netsim2011

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HCTM/ETE-Wang | 17/06/2010 | © Robert Bosch GmbH 2010. All rights reserved, also regarding any disposal, exploitation, reproduction, editing, distribution, as well as in the event of applications for industrial property rights.

02.06.2011 Amsterdam

Xin Wang-BOSCH Healthcare

Motion Monitoring application in clinical rehabilitation

2 Department | 4/26/2011 | © Robert Bosch GmbH 2011. All rights reserved, also regarding any disposal, exploitation, reproduction, editing, distribution, as well as in the event of applications for industrial property rights.

Outline of presentation

Quality assessment of clinical rehabilitation using motion monitoring- RBK rehabilitation quality assessment project (MEMBeR)- Bosch Motion Recorder (BMR) system architecture- BMR system CWT processing experiment setting- BMR system experiment result- Experiment result analysis (algorithm)

Other applications in clinical rehabilitation- Orthopaedic application after hip/knee replacement surgery- Cardiovascular application : COPD, CHF- Neurology application : Stroke, Parkinson patients

Q & A

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MEMBeR Project in Robert BOSCH Krankenhaus (RBK)


Activity monitoring: documentation of rehabilitation process

• Targets : geriatric patients after hip replacement or stroke

• Parameters : cumulated walking time or total time on feet (in upright position)

• Improvement of used parameters in activity monitoring are comparable or better than other functional tests (balance in unsupported standing, repeated chair rising, gait speed, TUG and 2-min walk)

Big advantage of activity monitoring : no floor or ceiling effect in parameters whereas it happens in all other functional tests.

(source: Symposium of MEMBeR Project @ RBK, Aug. 2010, Dr. Ulrich Lindemann)


Bosch Motion Recorder system architecture

Bosch Motion Recorder (BMR) Concept

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Feedback to Medical experts

sensor

Online processed parametersextracted: CWT, activity patternand raw data ..

1, sensor2, base station3, charging station4, Motion viewer (GUI)5, Laptop

In order to fulfill the clinical rehabilitation application requirement(e.g. required CWT parameter in quality assessment), Bosch Healthcare has developed BMR system.


BMR system CWT processing experiment setting

Experiment protocol (cross validation of CWT parameter among BMR, ActivPAL3, MiniMod) [14 test persons are included] Phase One: Straight corridor (72 meters long), testing various speeds cases with stops in between

Phase Two: Lab defined course (sit, lie down, stand, walk, slalom walk)

72 m

Internal | CR/AEY-Sohnke | 07/03/2011 | © Robert Bosch GmbH 2011. All rights reserved, also regarding any disposal, exploitation, reproduction, editing, distribution, as well as in the event of applications for industrial property rights.

Bosch Motion Recorder (algorithm classification based on decision tree)

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Example Scene from test on 17.2.2011 at 13:00

CWT comes from locomotion, walking and running 3 classes.


BMR system experiment result

Protocol Phase 1 result:

Protocol Phase 2 result:

Mean error [%] against reference CWT among 3 devices: BMR 1,5% ; ActivPAL3 2,9% ; MiniMod 39%


Experiment result analysis (algorithm performance)

Conclusions:

- The final BMR algorithm deviation is within range of 10% compared to reference CWT (using stop watch), the algorithm performance fulfills the potential clinical rehabilitation quality assessment requirement.

- The BMR algorithm reaches comparable performance range as initial benchmark device ActivPAL3, which is mounted at a much better position for steps detection. (ActivPaL3: UpperLeg, BMR: Belt at the Hip)

- MicRoberts’ MiniMod has problem while detecting extreme slow walking speed (down to 1.4 km/h = 0.4 m/s), because of worse mounting position compared to ActivPAL3.

- BMR system has online processing algorithm (fixed point computation) while MiniMod system uses offline processing mode.

- The main error source is from test persons’ transition pattern and mis-classification into locomotion class in standing and sitting cases.


Motion Monitoring application in orthopaedics

Important information for decision making process (pre- & post- joint, hip, knee replacement surgery) based on motion monitoring:

- appropriateness of surgery : alternative , conservative treatment (pre-selection)- optimal time to operate and discharge from hospital- recovery exercise program planning and compliance with exercise program monitoring


Motion Monitoring application in in orthopaedics

Outcome of motion monitoring in orthopaedics:

- Reduction of unnecessary procedures (pre-selection for surgery) - Faster and better recovery from surgery (reduction of GP visits, patients’ quality of life)- Early detection of complications post surgery (more effective intervention, overloading prevention, gait training at home)

Orthopaedics economics figures in Germany:- around 210, 000 patients need prosthesis every year in Germany, complications rate is up to 40%. It costs 2 billion € per year.- artifical joints do not last forever, the patients who are operated twice are threatened by staying in wheelchair for life time- a subsidiary of Germany orthopaedics society is cooperating with AOK insurance company to make voluntary registry to track bad surgeries

Spiegel magazine article “Giftige Geschäfte” on 22.04.2011

http://www.spiegel.de/spiegel/0,1518,758035,00.html


Motion Monitoring application in cardiovascular & neurology rehabilitation

Cardiovascular / Pulmonary:- Physical activity vital signs together with ECG, O2 saturation for home environment monitoring to optimize the care management solution for chronic disease patients

- Epidemiology research: explore the relationship between PA level, heart condition and the severity of COPD patients (e.g. TUM project in Augsburg)

Neurology:- Parkinson patients: monitoring patient’s PA level as to keep the lowest drug level & gait training.- Stroke patients: monitor the degree of recovery in post-stroke patients; measure the balance during sit-to-stand action in a simple and inexpensive way; optimize gait training to restore patients’ independence ability (tele-rehabilitation in home environment).

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Q & A


Thank you for your attention!

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motion monitoring application in clinical rehablitation netsim2011

Documents

robert bosch gmbh

industrial property

bmr system experiment

event of applications

minimod system

final bmr algorithm

reference cwt

required cwt parameter