Telerehabilitation approach for patients with hand impairment.

PURPOSE: Telerehabilitation is one of the newest branches of telemedicine which has been developed because patients need regular trainings outside the medical institution but still under specialist supervision. It helps maintain regularity of exercises and reduces costs. The professional and advanced systems for telerehabilitation are presented in papers, however, there is still lack of development of minor systems which provide therapeutic values and are more accessible to people. Therefore we focus on a solution for hand telerehabilitation of poststroke patients, based solely on a personal computer and camera.
METHODS: We focused on the manipulative hand (fingers, metacarpus, wrist) movements trainings for patients with cerebral palsy. The contact between patient and physiotherapist is provided by using web cameras and web service. Additionally, the camera can be used to monitor the effectiveness of performed exercises. Computer vision system keeps track of the patient's hand movement. The digital image processing is used to detect if the patient performs exercises correctly.
RESULTS: We created web service and software application TeleReh that provides therapeutic values for the hand impaired people. The system created was evaluated by three physiotherapists, one doctor and a cerebral palsy patient.
CONCLUSIONS: Our solution applies to all patients who have undergone basic rehabilitation in hospital and need to continue hand rehabilitation at home. The main advantages are: easy adaptation to the individual needs and abilities, monitoring the progress by using automatically generated reports after each training session. It is worth noticing that discussion between IT specialists, rehabilitants and patients was necessary to achieve good results.