Med-e-Tel 2013 Electronic Proceedings of The International eHealth, Telemedicine and Health ICT Forum for Educational, Networking and Business
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ISfTeH, 2013, Printed in G. D. of Luxembourg
Telepulseoximetry Assessment for Elderly Patients during Physical Therapy – Preliminary Study
A. ĩXNRZVND1,5, B. Glinkowska2,5, R. Krzyminiewski3, W. Glinkowski 4,5
1Student's Scientific Club - “TeleHealth”, Medical University of Warsaw,
2Department of Sports and Physical Education, Medical University of
3Medical Physics Division, Faculty of Physics Adam Mickiewicz
4Chair and Department of Orthopaedics and Traumatology of Locomotor
System, Center of Excellence “TeleOrto”, Poland
5Polish Telemedicine Society, Warsaw, Poland
Abstract: Physiotherapists prescribe frequently physical exercises for health while treating disabilities. The vital signs are rarely monitored patients’ to ensure patient’s safety while exercising. This study was designed to evaluate the usefulness and applicability of pulseoximetry for physical therapy patients suffering musculoskeletal disorders. The aim of the study was also to implement telepulseoximetery to assess the aerobic endurance and fitness of elderly patients during physical therapy. Remote High Signal Resolution Pulse Wave (HSR-PW) analysis, an innovative diagnostic tool for home care telemonitoring, was used to enhance patient’s assessment. The group of patients suffering musculoskeletal disorders, mainly osteoarthritis, was enrolled to this study. We have used a novel algorithms developed for more detailed pulsoximetry analysis beyond the measurement of arterial oxygen saturation (SaO2). Telemonitoring of pulseoximetry was well accepted by subjects. We have noted some cardiovascular improvement of patients health status, however, further studies are required.
The experience in telehomecare and tele-monitoring, the pulsoximetry
was already demonstrated for patients suffering respiratory impairment, COPD, cystic fibrosis and heart failure [1-10]. A review of literature shows that pulseoximetry measurement is rarely applied to support the physical therapy practice. Remote pulseoximetry allows achieving better safety for patients and allows monitoring patients’ cardiovascular status continuouslyat home or during physical activity [1, 11]. The aim of this study is to
evaluate the usefulness and applicability of pulseoximetry for physical therapy patients suffering musculoskeletal disorders, mainly osteoarthritis(OA).
This pilot service was applied to support rehabilitation exercises of
patients suffering musculoskeletal disorders and promotion of monitored physical activity with wide opportunities of saturation monitoring with an efficient method for pulse oximeter application. Elderly patients with musculoskeletal disorders (mostly OA) were enrolled for this study. Remote High Signal Resolution Pulse Wave analysis was performed before and after a session of physical therapy. The pulse wave was recorded utilizing standard wireless pulse oximeter. The pulse waves were recorded in the range of 35%-99% with a resolution 1 % for SPO2. The measurement was transmitted via Bluetooth connection to laptop and transmitted to server viamobile broadband connection for further analysis. High Signal Resolution Pulse Wave analysis allows enhancing resolution of pulse wave. This allows obtaining the pulse wave details unseen in standard measurement. Computer analyzes peaks for every patient individually and calculates parameters which show the status of cardiovascular system.
The measurement was performed on patients’ middle finger of the left
hand. We have assessed the usefulness of the device and measurement. The attitudes towards the new telepulsoxymetry device among exercising elderlies suffering musculoskeletal disorders was evaluated.
Five female patients with different stages of OA were enrolled for this
study. Average patient’s age was 65,4years (57-79 years). The range of heart rate had normalized after exercises in the study group. The saturation range had significantly risen after exercises. The average Aorta/Ventricle index was higher after exercises in the pilot study group.
Table 1. Patients results before and after rehabilitation session of physical
Subjects who have experienced the measurements were interested in their
results. They didn’t claim any discomfort or complaints due to applied pulsoximeter assessment.
Remote health monitoring is usually provided with non-invasive mobile
systems. The use of pulse oximetry rises along with the wide availability of mobile phones. Various devices have already pulseoximeter interfaced to mobile devices. The experience in telehomecare, tele-monitoring pulsoximetry was already demonstrated for patients suffering respiratory impairment, COPD, cystic fibrosis and heart failure[2, 3, 5, 7, 9, 12, 13]. Various diagnostic medical instruments have been integrated into a personal wearable device and a home telehealthcare system. We have tested finger-worn health monitoring device which performs the measurements of non-invasive pulse oximetry (SpO2). The device is able to analyze the acquired bio-signals and transmit the resultant data to a healthcare service center through a commercial cellular phone or wireless Internet connection. Pulseoximetry is a low-cost, non-invasive method to measure patients’saturation and pulse rate. This data are crucial for assessment of cardiopulmonary system status . A pulseoximeter diagnostic instrumentation was used for personalized healthcare services for unique telemedicine application for musculoskeletal rehabilitation. We have used a novel algorithms developed for more detailed pulseoximetry analysis beyond the measurement of arterial oxygen saturation (SaO2). Telemonitoring of pulseoximetry was well accepted by subjects. We have noted some cardiovascular improvement of patients health status, however, further studies are required .
This study is supported by student's mini-grant 1WE/NM1/12 funded by
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$JQLHV]ND ĩXNRZVND - Bachelor of Physiotherapy degree (Medical University of Warsaw). She is continuing her physiotherapy studies for a Master degree at the same University. She is interested in telemedicine use in physiotherapy. She has received her student's minigrant in 2012. She chairs a Student's Scientific Club "Telehealth" at the Medical University of Warsaw since 2011.
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