HELLODOC A Home Care Activity System (HCAD) for patients with arm/hand impairment to extent their rehabilitation at home

Upper limb impairment constitutes a major feature of neurological disorders. Due to the pressure on our current healthcare system caused by the increasing number of elderly and patients with chronic disorders; the length of stay in the rehabilitation settings for neurological patients is significantly reduced. To prevent deterioration or perhaps slightly improve arm/hand function when patients are discharged home, it is important to continue (intensive) treatment. For the patients as well as the therapists, this is often time-consuming (travel time), and expensive. A telerehabilitation approach to deliver arm/hand training could decrease treatment cost and increase access for many patients, possibly improving the quality of care. Because such training enables intensive training without the continuous attendance of a therapist it is hypothesized to be cost-effective.

The Home Care Activity Desk (HCAD) system is a promising device to extend the rehabilitation treatment for the upper extremity at home. The HCAD system consists of two main apparatuses: a hospital based server and the portable unit which is installed at the patient's home. The portable unit consists of 7 sensorised tools being key, light bulb, book, jar, writing, checkers and keyboard tasks. The portable unit is also equipped with two webcams, which allows teleconference and video recording. The portable unit and the hospital server are connected with a FTP Server Connectivity, which sends the recorded exercises from the patient to the therapists and makes teleconference possible.

The HCAD system has been developed to monitor the exercises performed by the patient at home and to transmit such data to the hospital. The HCAD training form a set of exercises that summarizes the movements for a correct functional activity of the upper limb: reaching, grasping, lateral pinch, pinch grip, holding, manipulation and finger dexterity. By using the HCAD system, patients can practice the activities they have learned during clinical rehabilitation and continue the treatment at home under remote supervision. Moreover, the progress of the patient can be assessed/monitored and therapists can intervene when needed.

The primary objective of the Hellodoc project is a market validation of the HCAD system. Within this project, Roessingh Research and Development is responsible for the clinical validation trial. The clinical trial compares usual care for patients with neurological disorders to the use of the HCAD system at home for arm/hand function. A total of eighty-one patients with chronic Stroke, TBI and MS patients were included in the clinical trial in Italy, Spain and Belgium. In both the HCAD group as well as the usual care group patients maintain or even improve on their arm/hand function. The HCAD system for chronic Stroke, TBI and MS patients is shown to be at least as effective as usual care. Both therapists and patients are satisfied with the HCAD system. As u sual care takes a lot of effort and time for the therapists as well as the patients to travel, the use of the HCAD system may increase the efficiency of care as it shows similar clinical effects but with less efforts and time for the therapists.

This European project runs from 2005-2007. Partners involved are ISS, Italy; Signo Motus, Italy; Pragma Engineering, Italy; UORIN, Italy; FPING, Spain and NMSC, Belgium.

For more information: http://ec.europa.eu/information_society/activities/eten/index_en.htm

This project has been sponsored by:

ETEN program of the European Community

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