Building Social Telerehabilitation Services - ScienceDirect

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ScienceDirect Procedia Computer Science 77 (2015) 80 – 84

ICTE in Regional Development

Building social telerehabilitation services Velta Lubkinaa*, Gilberto Marzanoa a

Rezekne University of Applied Sciences, Atbrivosanas aleja 115, Rezekne, LV 4601, Latvia

Abstract This paper focuses on the use of ICT in social rehabilitation, reporting on the research activity of the Latvian national science program VPP INOSOCTEREHI, a new three year multidisciplinary project on social telerehabilitation, conducted by four Latvian Universities (Rezekne University, Latvia University, Riga Technical University, and Liepaja University). The general project objective is presented, and the activities aimed at the creation of a portable, inexpensive balance disorder assessment system are illustrated. © 2015 Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license © 2016 The Authors. Published by Elsevier B.V. (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer-reviewunder under responsibility of Sociotechnical the Sociotechnical Systems Engineering of Vidzeme Applied Sciences. Peer-review responsibility of the Systems Engineering InstituteInstitute of Vidzeme UniversityUniversity of Applied of Sciences Keywords: Rehabilitation; Social telerehabilitation; Social-re-adaptation; Balance disorder

1. Introduction Eliza, the computer program created by Weizenbaum between 1964 and 19661, can be considered a primitive social telerehabilitation attempt. It was a tongue-in-cheek application, which emulated the responses of a Rogerian non-directional psychotherapist in an initial psychiatric interview. Since then, much progress has been made, so social telerehabilitation is now a new topical research field. Over the last years, patients’ rehabilitation has moved from a predominantly medical point of view to one in which psychological and sociocultural aspects are deemed equally important2, 3, 4. Accordingly, the concept of rehabilitation has extended from a medically driven process of physical medicine to a more comprehensive multidisciplinary process5, 6, which includes socially driven intervention forms7.

* Corresponding author. E-mail address: [email protected]

1877-0509 © 2015 Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer-review under responsibility of the Sociotechnical Systems Engineering Institute of Vidzeme University of Applied Sciences doi:10.1016/j.procs.2015.12.362

Velta Lubkina and Gilberto Marzano / Procedia Computer Science 77 (2015) 80 – 84

Great emphasis has been placed on patients’ activity, and, today, the rehabilitation process also includes patients’ social re-adaptation. This paper analyses the concept of social telerehabilitation, reporting on the research carried out within the Latvian national science program VPP INOSOCTEREHI. 2. Social telerehabilitation Telerehabilitation is often considered a specialization of the wide field of telemedicine, and most of telerehabilitation services fall into three main categories: clinical assessment (the patient’s functional abilities in his or her environment), diagnosis, and clinical therapy. Telerehabilitation (or e-rehabilitation) is defined as the delivery of rehabilitation services over telecommunication networks and the Internet. Social telerehabilitation is the application of ICT to social rehabilitation activities. It aims to rehabilitate and improve the socio-functional capability of people and their inclusion into society. Figure 1 shows the position of social telerehabilitation in the broad area of rehabilitation.

Fig. 1. Interconnections between telemedicine, telecare, and telerehabilitation

2.1. Social telerehabilitation process Recent advances in ICT allow contact with patients at home, giving the possibility of extending the application range of social rehabilitation practices. The most popular goal of social telerehabilitation process is the use of ICT in order to: x Maximize the participation of patients in their social settings; x Minimize the pain and distress experienced by patients, as well decrease their mobility difficulties; x Minimize the distress and the stress on patients' families and caregivers, as well optimize time and costs. Figure 2 shows the essential flow of the telerehabilitation process. Assessment is the identification of either the nature and extent of patient's problems or relevant factors for their resolution. Intervention settings may include both treatments, which affect the process of restoring ability damages, and support, which maintains the patient's quality of life. Evaluation is the assessment of intervention effects.

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Fig. 2. The flow of telerehabilitation process

2.2. Social telerehabilitation services Nowadays, new services have been designed to overcome and minimize people limitations/impairments both in physical and social context. In designing these new rehabilitation services, patients’ attitudes, beliefs, and expectations are increasing in importance. The scope of social telerehabilitation services is wide: it faces challenges that set it apart from the broader telemedicine and telehealth arenas. It has been observed that one of such challenges is that rehabilitation is often provided across both acute medical and community settings, often with different funding structures and rehabilitation protocols in place8. Recently, an emerging crucial issue is to regain people psycho-physical functions and improving their quality of life in everyday life using ICT and mobile technologies9, 10, 11, 12. Research has underlined the potential for social media, mobile phones, and the Internet in general, to improve mental health and physical health, take care of physical handicaps and emotional disturbances13, 14, 15, treat addictions16, 17, and even help homeless people18, 19, 20. 3. VPP INOSOCTEREHI research activity VPP INOSOCTEREHI (http://www.telerehabilitation.lv/) project aims to develop multidisciplinary research in the context of inclusive education targeted at students’ balance disordersa. It wants to experiment with the possibility of implementing new prototypes and innovative methodologies (approaches, methods, techniques) for the social telerehabilitation of people with balance disorders. In particular, it aims to ensure the transfer of innovation through the application of knowledge formerly acquired with BIOSWAY equipment.

a

Data previously acquired by Rezeknes University through BioSway equipment21, a portable balance system for testing and training patients, are used.


3.1. A mobile-based application for balance disorder One of the project’s goals is the creation of a portable, inexpensive balance disorder assessment system that has widespread availability. The basic idea is to use mobile technology to capture data about a patient’s body movement through sensors connected via Bluetooth to a mobile device. Data will be stored in a cloud application. For this purpose, new wearing devices for balance disorder rehabilitation have been considered, e.g. that utilize inertial sensors and sensor fusion processing to measure body posture and provide real-time feedback to alert the wearer to remain in the region of stability22. We are also investigating the possibility of using augmented reality with or instead of optical sensors and the possibility of implementing a mobile app that emulates the movement sensors calculating the changes from the patient’s equilibrium position. Some prototypes have been analysed and compared23, 24, 25. As a result of the analysis, a new prototype has been designed. It uses the three components: mobile, cloud and web applications. The mobile detects balance instability using sensors from a smartphone, interacts with audio feedback and manages exercise information, while the cloud performs trend analysis from the stored users’ profile and data. 4. Conclusion Almost 50 years have passed from the creation of the Eliza Weizenbaum program to the new robots designed for rehabilitation services. The difference is that Eliza was one of the first experimental programs in the field of natural language processing, while the new robots use the achievements in natural language processing for communicating with patients. VPP INOSOCTEREHI project tackles the challenge of using ICT in the rehabilitation sector. It aims at exploiting the use of new technologies to implement social rehabilitation services based on control and treatment from a distance. VPP INOSOCTEREHI research focuses on balance disorders since it requires a long and intensive process. The possibility for a clinician to receive early warnings and information about the balance disorder by means of a portable, inexpensive and valid system could provide numerous benefits in a wide range of patient populations.

Acknowledgments This paper was supported by the National Research Program “Innovative solutions in social rehabilitation in Latvian schools in the context of inclusive education” („Inovatīvi risinājumi sociālajā telerehabilitācijā Latvijas skolās iekļaujošās izglītības kontekstā – VPP INOSOCTEREHI”).

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Velta Lubkina Professor in Pedagogy Since 2002; Director of Regional Institute of Research (REGI) at Rezekne University (Latvia). Since 2006, she is Director of the Doctoral Study Program „Pedagogy”; since 2007, elected expert in Pedagogy in the Latvian Council of Science. She was Director of the Personality Socialization Research Institute of Rezekne University.

Gilberto Marzano, Professor and Head of the Laboratory of Pedagogical Technologies of Regional Institute of Research (REGI) at Rezekne University (Latvia). Member of the PhD professors board at Udine University (Italy) on Economy, Ecology, Landscape and Territory. He was an executive manager in private ICT companies and director of an R&D software laboratory in Italy.