Dennis Hofs

Design, development and deployment of a hand/wrist exoskeleton for home-based rehabilitation after stroke - SCRIPT project

Objective: this manuscript introduces the Supervised Care and Rehabilitation Involving Personal Tele-robotics (SCRIPT) project. The main goal is to demonstrate design and development steps involved in a complex intervention, while examining feasibility of using an instrumented orthotic device for home-based rehabilitation after stroke. Methods: the project uses a user-centred design methodology to develop a hand/wrist rehabilitation device for home-based therapy after stroke. The patient benefits from a dedicated user interface that allows them to receive feedback on exercise as well as communicating with the health-care professional. The health-care professional is able to use a dedicated interface to send/receive communications and remote-manage patients exercise routine using provided performance benchmarks. Patients were involved in a feasibility study (n=23) and were instructed to use the device and its interactive games for 180 min per week, around 30 min per day, for a period of 6 weeks, with a 2-months follow up. At the time of this study, only 12 of these patients have finished their 6 weeks trial plus 2 months follow up evaluation. Results: with the “use feasibility” as objective, our results indicate 2 patients dropping out due to technical difficulty or lack of personal interests to continue. Our frequency of use results indicate that on average, patients used the SCRIPT1 device around 14 min of self-administered therapy a day. The group average for the system usability scale was around 69% supporting system usability. Conclusions: based on the preliminary results, it is evident that stroke patients were able to use the system in their homes. An average of 14 min a day engagement mediated via three interactive games is promising, given the chronic stage of stroke. During the 2nd year of the project, 6 additional games with more functional relevance in their interaction have been designed to allow for a more variant context for interaction with the system, thus hoping to positively influence the exercise duration. The system usability was tested and provided supporting evidence for this parameter. Additional improvements to the system are planned based on formative feedback throughout the project and during the evaluations. These include a new orthosis that allows a more active control of the amount of assistance and resistance provided, thus aiming to provide a more challenging interaction.

Supporting Engagement and Floor Control in Hybrid Meetings

Remote participants in hybrid meetings often have problems to follow what is going on in the (physical) meeting room they are connected with. This paper describes a videoconferencing system for participation in hybrid meetings. The system has been developed as a research vehicle to see how technology based on automatic real-time recognition of conversational behavior in meetings can be used to improve engagement and floor control by remote participants. The system uses modules for online speech recognition, real-time visual focus of attention as well as a module that signals who is being addressed by the speaker. A built-in keyword spotter allows an automatic meeting assistant to call the remote participants attention when a topic of interest is raised, pointing at the transcription of the fragment to help him catch-up.

A Full Body Sensing System for Monitoring Stroke Patients in a Home Environment

Currently, the changes in functional capacity and performance of stroke patients after returning home from a rehabilitation hospital is unknown to a physician, having no objective information about the intensity and quality of a patient’s daily-life activities. Therefore, there is a need to develop and validate an unobtrusive and modular system for objectively monitoring the stroke patient’s upper and lower extremity motor function in daily-life activities and in home training. This is the main goal of the European FP7 project named “INTERACTION”. A complete full body sensing system is developed, whicj integrates Inertial Measurement Units (IMU), Knitted Piezoresistive Fabric (KPF) strain sensors, KPF goniometers, EMG electrodes and force sensors into a modular sensor suit designed for stroke patients. In this paper, we describe the complete INTERACTION sensor system. Data from the sensors are captured wirelessly by a software application and stored in a remote secure database for later access and processing via portal technology. Data processing includes a 3D full body reconstruction by means of the Xsens MoCap Engine, providing position and orientation of each body segment (poses). In collaboration with clinicians and engineers, clinical assessment measures were defined and the question of how to present the data on the web portal was addressed. The complete sensing system is fully implemented and is currently being validated. Patients measurements start in June 2014.

Conveying directional gaze cues to support remote participation in hybrid meetings

We study videoconferencing for meetings with some co-located participants and one remote participant. A standard Skype-like interface for the remote participant is compared to a more immersive 3D interface that conveys gaze directions in a natural way. Experimental results show the 3D interface is promising: all significant differences are in favor of 3D and according to the participants the 3D interface clearly supports selective gaze and selective listening. We found some significant differences in perceived quality of cooperation and organization, and on the opinions about other group members. No significant differences were found for perceived social presence of the remote participants, but we did measure differences in social presence for co-located participants. Measured gaze frequency and duration nor perceived turn-taking behavior did differ significantly.

A Remote Home Monitoring System to Support Informal Caregivers of People with Dementia.

Informal caregivers of people with dementia have a high risk of becoming overburdened. Health informatics for aging in place can provide them support by deploying unobtrusive remote home monitoring systems to assess real-time events and monitor changes in the behavior of the person with dementia (PwD). In this paper, we describe the concept, development, and evaluation of an intelligent remote Home Monitoring System (HMS) that provides support to informal caregivers by giving key information related to the health and independent living of the PwD. The HMS consists of a Sensor System that monitors low-level behaviors of the PwD, a Decision Support System that translates this into high-level behaviors, and a connected Smartphone Application that allows the caregiver to receive notifications, review behavioral information at a glance, and facilitates the collaborative care process between informal caregivers. The final HMS prototype was evaluated and scored high in terms of usability and quality of the Smartphone Application. The Sensor System showed no significant flaws during testing, and the Decision Support System is considered a viable proof of concept. The next step is to evaluate the HMS in a real-life setting in terms of offering peace of mind and reducing the burden of care.

An Integrated Virtual Group Training System for COPD Patients at Home

Chronic Obstructive Pulmonary Disease (COPD) patients often experience a downward spiral of fear for breathlessness, inactivity and social isolation which leads to a bad physical condition. Motivation to keep patients compliant to their training scheme is a key factor in home-based exercise training. This paper presents the Integrated Training System for COPD patients; a home based virtual group exercise system to facilitate improvement of the exercise capacity safely at home using a virtual group environment. The four components of the system are the Home Trainer, the Virtual Exercise Environment, the Web Portal and the Controller. These components are implemented in a prototype, in which as much as possible existing components are used. An in-training evaluation was performed to evaluate the subsystems used during a training exercise. All subsystems are working correctly during the evaluation. In this paper the focus for the Integrated Training System is on COPD patients, but the system might be used for other groups such as Chronic Heart Failure patients or elderly people in general.

Development of an Integrated Virtual Group Training System for COPD Patients

COPD patients experience a downward spiral of fear for breathlessness, inactivity and social isolation which leads to a bad physical condition. Motivation to keep patients compliant to their training scheme is a key factor in home-based exercise training. This paper presents the Integrated Training System for COPD patients; a home based virtual group exercise system to facilitate improvement of the exercise capacity safely at home using a virtual group environment. The four components of the system are the Home Trainer, the Virtual Exercise Environment, the Web Portal and the Controller. These components are implemented in a prototype. An in-training evaluation was performed to evaluate the subsystems used during a training exercise. All subsystems are working correctly during the evaluation. In this paper the focus for the Integrated Training System is on COPD patients, but the system might be used for other groups such as Chronic Heart Failure patients or elderly people in general.

The IMIX Demonstrator: An Information Search Assistant for the Medical Domain

In the course of the IMIX project a system was developed to demonstrate how the research performed in the various subprojects could contribute to the development of practical multimodal question answering dialog systems. This chapter describes the IMIX Demonstrator, an information search assistant for described, as well as its role in the IMIX project.