Designing Physical Telerehabilitation System for Patients with Multiple Sclerosis

摘要

Physical rehabilitation positively affects clinical outcomes in multiple sclerosis (MS) however it is limited by delivery modes, cost and distance. Telemedicine approaches can potentially facilitate home-based rehabilitation however they were not systematically implemented for patients with MS. We developed a Home Automated Telemanagement (HAT) system for computer-guided management of patients with MS providing individualized instruction and monitoring of physical therapy exercise at patient homes. The HAT home unit runs on a netbook in the patient's home connected to a remote server via internet. The system questions the patient on their condition, gives detailed step by step exercise instructions, records their daily exercise log, and informs and quizzes the patient on their knowledge of multiple sclerosis. The exercise log is transmitted to the remote HAT server where it is analyzed using decision support algorithms to facilitate MS management. The exercise logs are available on-line for review by patient providers. Patient exercise regimen is determined by their physical therapist and can be updated on-line, keeping a personalized approach to disease management while taking advantage of the convenience the technology supplies. This telemanagement system has been successfully designed and implemented to optimize the care of patients with multiple sclerosis.