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Projects / Programmes source: ARIS

Telerehabiltation

Research activity

Code Science Field Subfield
3.08.00  Medical sciences  Public health (occupational safety)   

Code Science Field
B007  Biomedical sciences  Medicine (human and vertebrates) 

Code Science Field
3.03  Medical and Health Sciences  Health sciences 
Keywords
Telerehabilitation, amputation, stroke
Evaluation (rules)
source: COBISS
Researchers (10)
no. Code Name and surname Research area Role Period No. of publicationsNo. of publications
1.  06166  PhD Zdravko Balorda  Systems and cybernetics  Researcher  2014 - 2016  47 
2.  14962  PhD Helena Burger  Public health (occupational safety)  Head  2013 - 2016  864 
3.  20180  PhD Imre Cikajlo  Systems and cybernetics  Researcher  2013 - 2016  259 
4.  10684  PhD Nika Goljar  Neurobiology  Researcher  2013 - 2016  341 
5.  03324  PhD Črt Marinček  Public health (occupational safety)  Researcher  2013 - 2014  562 
6.  14038  PhD Zlatko Matjačić  Systems and cybernetics  Researcher  2013 - 2016  370 
7.  23484  PhD Metka Moharić  Public health (occupational safety)  Researcher  2013 - 2016  194 
8.  20396  Darko Oberžan    Technical associate  2013 - 2016 
9.  03410  PhD Drago Rudel  Medical sciences  Researcher  2013 - 2016  193 
10.  17837  PhD Gaj Vidmar  Systems and cybernetics  Researcher  2013 - 2016  550 
Organisations (4)
no. Code Research organisation City Registration number No. of publicationsNo. of publications
1.  0309  University Rehabilitation Institute, Republic of Slovenia  Ljubljana  5053919000  5,742 
2.  0381  University of Ljubljana, Faculty of Medicine  Ljubljana  1627066  48,236 
3.  0436  MKS Electronic Systems  Ljubljana  5308194000  208 
4.  7848  ČETRTA POT, avtomatska identifikacija, računalništvo in informatika, d.o.o. (Slovene)  KRANJ  5337976 
Abstract
Disability level is estimated as 10% in most of the European countries and is increasing with aging. Problems that arise from various disabilities can be reduced with rehabilitation. Rehabilitation should begin immediately after the reduced capability occur and end with a successful return to the home environment. Many patients do not receive adequate rehabilitation in Slovenia. Telerehabilitation presents an appropriate and modern solution to these problems. It enables rehabilitation services through modern information and communication technologies (ICT) at a patient’s home. Telerehabilitation allows greater efficiency and shortens the duration of rehabilitation. The proposed project is limited to telerehabilitation for patients after stroke and lower limb amputation. In the first group we are interested in the continuation of the relevant procedures after discharge from rehabilitation facilities to the home, whilst in the second group will participant in a telerehabilitation program before the start of their comprehensive rehabilitation program. Stroke is the most common cause of disabilities in most of the developed countries. Rehabilitation is needed for the best functional recovery possible. It has to continue in the first year, be intensive and performed by a multidisciplinary team composed of rehabilitation health professionals. The number of people with lower limb amputation continues to increase in developed countries. After the amputation and before starting complex rehabilitation, patients are supposed to bandage the stump in a special way and to perform appropriate exercises. Complex rehabilitation can start as late as two month after amputation and patients are not controlled during this time. Sometimes moderate to severe damage can be done – muscles atrophy and the stump changes its form. If the person is appropriately prepared at home, these problems can be minimized. Our goals are to scientifically prove that the implementation of telerehabilitation in Slovenia is realistic, that patients are willing to participant in the programme, and that the outcomes of rehabilitation with additional telerehabilitation are better and can be seen in a shorter term. Our goal is also to combine existing technologies, upgrade them, and use them for new purposes. The project will include patients recovering from stroke that completed the first rehabilitation treatment at URI and patients after lower limb amputation before the beginning of complex rehabilitation. Both populations will be randomly divided into two groups, a group that will have standard rehabilitation and additional telerehabilitation and a control group that will only have standard rehabilitation. Rehabilitation outcome measurements will be performed using verified instruments. In the I. phase of the project, the possibility of using smart phones with built-in accelerometer and camera to monitor the implementation of various activities will be studied. In the II. phase an innovative approach for the implementation of individual programs of telerehabilitation will be introduced, including remote support and monitoring. Multimedia content composed of various exercises and activities will be recorded for the patients at home to perform . In the III. phase of the project, patients involved in telerehabilitation will also be equipped with smart phones that will be worn daily. Task developed software (developed in the first part of the project) will enable effective tracking of patient movement, whereas movement activities will be categorized (when the actual pattern of movement corresponds to the movement of the requested exercises). This will be the basis for proposing and facilitating the transition from the existing health system to a more advanced form that would support modern technologies in order to better meet the needs of an aging population and improved quality of life, while decreasing healthcare costs.
Significance for science
Quality of the existing evidence of effectiveness and benefits of telerehabilitation for patients after stroke and after lower limb amputation was low at the beginning of the project, and remains low for the patients after lower limb amputation. Methods with proven effectiveness are required for a high-quality and efficient health-care system. The project has brought us additional knowledge of usefulness of telerehabilitation in both patient groups, and made a minimal contribution to the level of evidence. The solution that we provided for the patients after lower limb amputation is the first of its kind, and has attracted lots of attention of international experts. We have also begun the talks for submitting a European project where our work would be continued.
Significance for the country
The results of this research project are important for all those involved and interested in the rehabilitation process: for patients, health care professionals, health insurance providers, the health care system as a whole, and the telerehabilitation service industry. The results provide a basis for modifying the rehabilitation process. Because there is no physical and rehabilitation medicine network in Slovenia, the project demonstrated the possibility for improving the accessibility of rehabilitation. This way, more people will have access to rehabilitation, regardless of their distance from tertiary rehabilitation centre. Rehabilitation can be more continuous and can continue after discharge from inpatient rehabilitation facility. Because telerehabilitation is managed by experienced experts from tertiary level, the included patients receive the best possible rehabilitation. We have shown that such services are feasible and effective. The end results are improved independence and quality of life of the included patients and decreased burden for their caregivers. Hence, the main importance for the development of Slovenia is better accessibility of rehabilitation at the highest level, better functioning and less burden for the caregivers.
Most important scientific results Annual report 2014, 2015, final report
Most important socioeconomically and culturally relevant results Annual report 2014, 2015, final report
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