D3.1: Emerging & Accessible Healthcare Technologies

Access to Interoperable Monitoring and Therapy with Integrated Telesupport:

A number of student D3-based technical reports have been worked on as D3.1 activities. In each case, these were students' "second projects" during the Summers of 2003 and 2004.

The primary target of D3.1 development activities has been three ongoing pilot projects, two of which have been jointly funded by another award (Falk Foundation) and the other of which is a joint D1-D3 pilot evaluation project:

• Accessibility of UniTherapy software for computer-assisted motivating rehabilitation [Xin “ Tyre ” Feng (doctoral student) and Jack Winters]. The development of UniTherapy software technology, partially supported by the RERC-AMI for D3.1, has continued to evolve and has been presented at three conferences (BMES in Philadelphia, October 2003; RESNA in Orlando, June 2004, IEEE-EMBS in San Francisco in September 2004). This technology supports many computer input devices such as force-reflecting joysticks, IP telecommunication between a “consumer/patient interface” (PI) and “telepractitioner interface” (TI) for simple interactive two-way interfaces and videoconferencing, and support for multiple communication modes. Using the .Net framework and DirectX capability of Windows, in 2003 software was developed that successfully supported telecommunication between joysticks, force-reflecting joysticks, Joymouse (joystick functioning as a mouse), wireless mouse, wireless PDA touchscreens, and simple voice commands. This modular software is a step in the direction of universally usable computer input interfaces. Accessibility features such as simple IP audio/video conferencing and speech control were successfully integrated into the software. During the spring 2004 the UniTherapy technology was expanded and re-structured for use with an IRB-approved protocol entitled Evaluation of an Enhanced TheraJoy Technology and the UniTherapy Program for use in Stroke Neurorehabilitation. One consequence is that it now includes considerable support for human performance assessment protocols, administered either locally or remotely. This includes the new accessibility feature of documenting user range of motion and mapped subsequent use to the user-ability space. It also provides tools for access through integrated tele-supported therapy. Accessibility features related interfaces and the V2 standard are being systematically integrated into the technology during Year 3 as a D3.2 activity.

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• Effectiveness of Multimedia Telecommunication among Persons with Disabilities [Jason Long, Jack Winters}. In this pilot study persons with various disabilities were given a chance to serve in both the roles of “instructor” and “apprentice” for cooperatively achieving certain goal-directed tasks related to completing a questionnaire and assembling “modern art” sculptures from components. In all cases the instructor and apprentice have different primary disabilities. A key component is evaluating performance of each instructor-apprentice team when using Internet-based versus ISDN/phone-based videoconferencing tools. This project is supported primarily by other sources (Falk and Whitaker Foundations), with partial support by the RERC-AMI.
• Accessibility of Exercise Ergometers & Monitors When Used by Older Adults with Disabilities [Sean Campbell (graduate student) with Jill Winters, Jack Winters] . This pilot study, influenced by discussions with Dr. Jim Rimmer, an Advisory Council member who is also PI of the RERC on Recreational Technologies, addresses the profound challenge of low adherence to home-based rehabilitative exercise programs. It is designed to develop knowledge about the relative accessibility of alternative exercise ergometers, heart rate monitors, blood pressure monitors, and telehealth interfaces for subjects with a diversity of abilities. The MU-Lab system of D1 is being used as a tool for this analysis, including both use of the Protocol Manager and MVTA for task analysis. It is expected to yield insights that will provide a foundation for development of innovative approaches to integrating accessible exercise equipment with easy-to-use physiologic monitoring instrumentation, with effective strategies for access to telesupport. Pilot data has been collected for five subjects with disabilities over 2-3 sessions, with each participant using four different cycle ergometers, several different heart rate monitors, several types of cuffs for blood pressure measurement, one pulse oximetry (SP)2) unit, and three alternatives for recording data (paper-pencil, audio, videoconferencing).