![](bg2.png)
ing with an outlook on the facts and preliminary re-
sults that we expect to have available soon.
2 OBJECTIVES
The StrokeBack project aims at increasing the reha-
bilitation speed of stroke patients while patients are in
their own home. The benefit we expect from our ap-
proach is twofold. Most patients feel psychologically
better in their own environment than in hospital and
also rehabilitation speed is improved. In addition, we
aim at exploiting the increased motivation of patients
when exercising with a tool similar to a gaming con-
sole. The ability of doing high quality exercises with-
out the need of being directly monitored by a physio-
therapist helps to reduce healthcare cost through min-
imisation of expensive human contact hours. Cur-
rently the quantity of hours performing occupational
(ergotherapeutic) and physiotherapeutic sessions are
restricted to payable effort for patient’s accommoda-
tion, transport or visit of therapists in the patient’s
home. StrokeBack aims at providing new technical
means and service structures to enable patients to en-
hance their healthiness by increasing the number of
training sessions while still being monitored by the
system. By ensuring proper execution of physiother-
apy trainings in an automated guided way, modulated
by appropriate clinical knowledge and in supervised
way only when necessary, StrokeBack empowers the
patients to exercise much more and at better quality
than it is possible today. By that StrokeBack improves
rehabilitation speed, and quality of life of the patient.
The StrokeBack concept will be complemented by
a Patient Health Record (PHR), in which rehabilita-
tion exercises, training measurements and vital data
of the patients will be stored. Thus, the PHR provides
all necessary information medical and rehabilitation
experts need to evaluate rehabilitation success, e.g. to
deduce relations between selected exercises and re-
habilitation speed of different patients, as well as to
assess the overall healthiness of the patient. In addi-
tion, the PHR will be used to provide the patient with
mid-term feedback, e.g., her/his rehabilitation speed
compared to average, as well as improvements over
last day/weeks, in order to keep patients motivation
high.
To summarise, the project goals are achieved by
investigating the following key objectives:
• Telemedicine supervision of rehabilitation exer-
cise.
• Continuous monitoring of impact of the exercises
also in ”normal” life situations.
• Integration of telemedicine rehabilitation and Per-
sonal Health Records for improved long term
evaluation of patient recovery.
• Providing feedback to health care professionals
on the impact of rehabilitation exercises.
Our system will empower the patient to do more
for fast recovery than today, it provides clinical ex-
perts with data not available today and by that it leads
also to a better understanding of the stroke recovery
process, higher recovery speed and thus, to reduced
healthcare cost while improving patients’ quality of
life.
3 APPROACH
Very recently gaming consoles have gained a lot of
attention when being used in the area of rehabilitation
(Anderson et al., 2010; Decker et al., 2009; Deutsch
et al., 2009; Gargin and Pizzi, 2010; John et al., 2009;
Miller, 2007). All publications report on very good
results in terms of speed of the rehabilitation process
and especially patient motivation (Sik-Lanyi et al.,
2005; Sik-Lanyi et al., 2006). A first evaluation has
shown that even though the majority of the publica-
tions deal with ”normal” rehabilitation process, e.g.,
after surgery, that similar results hold true for stroke
patients as well (Saposnik et al., 2010).
But most of the published articles about and envi-
sioned applications for computer-aided rehabilitation
of patients have revealed one major drawback. Since
these approaches target to train fine motor skills only,
they require the patients to already possess, or have
recovered up to, a certain level of mobility (Ander-
son et al., 2010). By that, these solutions cannot be
applied to patients having limited mobility such as
spasticity or partial palsy what is the major issue for
patients affected by stroke. These patients cannot be
asked to hold a sensing device by hand or to exercise
by stand. In contrast to that, StrokeBack aims to al-
ready assist in early stage of rehabilitation enabling
highly affected patients to profit from our proposed
monitoring system as well. Our system is designed
for ambulant use and targets to be adjustable to the
abilities of the patient - a patient-centric approach.
For example, it can be used by hemiplegic, paretic
patients as well as wheelchair users, too. By that we
intend to shorten the full time, stationary rehabilita-
tion and treatment program and allow patients to be
reintegrated into normal life as early as possible.
The StrokeBack concept puts the patient into the
centre of the rehabilitation process. It aims at exploit-
ing the fact the patients feel better at home, that it has
A TELEMEDICINE SYSTEM FOR IMPROVED REHABILITATION OF STROKE PATIENTS
271