Medical comorbidity was a significant predictor of rehabilitation efficiency in geriatric patients. Comorbidity scores >5 were prognostic of poorer rehabilitation outcomes and can serve as an empirical guide in estimating a patient's suitability for rehabilitation. Medical comorbidity predicted both the overall functional change achieved with retabilitation (Functional Independence Measure gains) and the rate at with which those gains were reached (rehabilitation efficiency ratio).
Smart homes are proposed as a new location for the delivery of healthcare services. They provide healthcare monitoring and communication services, by using integrated sensor network technologies. We validate a hypothesis regarding older adults' adoption of home monitoring technologies by conducting a literature review of articles studying older adults' attitudes and perceptions of sensor technologies. Using current literature to support the hypothesis, this paper applies the tradeoff model to decisions about sensor acceptance. Older adults are willing to trade privacy (by accepting a monitoring technology), for autonomy. As the information captured by the sensor becomes more intrusive and the infringement on privacy increases, sensors are accepted if the loss in privacy is traded for autonomy. Even video cameras, the most intrusive sensor type were accepted in exchange for the height of autonomy which is to remain in the home.
The current pandemic associated with the novel coronavirus (COVID-19) presents a new area of research with its own set of challenges. Creating unobtrusive remote monitoring tools for medical professionals that may aid in diagnosis, monitoring and contact tracing could lead to more efficient and accurate treatments, especially in this time of physical distancing. Audio based sensing methods can address this by measuring the frequency, severity and characteristics of the COVID-19 cough. However, the feasibility of accumulating coughs directly from patients is low in the short term. This paper introduces a novel database (NoCoCoDa), which contains COVID-19 cough events obtained through public media interviews with COVID-19 patients, as an interim solution. After manual segmentation of the interviews, a total of 73 individual cough events were extracted and cough phase annotation was performed. Furthermore, the COVID-19 cough is typically dry but can present as a more productive cough in severe cases. Therefore, an investigation of cough sub-type (productive vs. dry) of the NoCoCoDa was performed using methods previously published by our research group. Most of the NoCoCoDa cough events were recorded either during or after a severe period of the disease, which is supported by the fact that 77% of the COVID-19 coughs were classified as productive based on our previous work. The NoCoCoDa is designed to be used for rapid exploration and algorithm development, which can then be applied to more extensive datasets and potentially real time applications. The NoCoCoDa is available for free to the research community upon request. INDEX TERMS Acoustic signal processing, audio databases, audio systems, biomedical measurement, biomedical monitoring, data analysis, data collection, medical conditions, medical diagnosis, patient monitoring, smart homes.
The duration of a sit-to-stand (SiSt) transfer is a representative measure of a person's status of physical mobility. This paper measured the duration unobtrusively and automatically using a pressure sensor array under a bed mattress and a floor plate beside the bed. Pressure sequences were extracted from frames of sensor data measuring bed and floor pressure over time. The start time was determined by an algorithm based on the motion of the center of pressure (COP) on the mattress toward the front edge of the bed. The end time was determined by modeling the foot pressure exerted on the floor in the wavelet domain as the step response of a third-order transfer function. As expected, young and old healthy adults generated shorter SiSt durations of around 2.31 and 2.88 s, respectively, whereas post-hip fracture and post-stroke adults produced longer SiSt durations of around 3.32 and 5.00 s. The unobtrusive nature of pressure sensing techniques used in this paper provides valuable information that can be used for the ongoing monitoring of patients within extended-care facilities or within the smart home environment.
The use of Serious Games (SG) in the health domain is expanding. In the field of neurodegenerative disorders (ND) such as Alzheimer’s disease, SG are currently employed both to support and improve the assessment of different functional and cognitive abilities, and to provide alternative solutions for patients’ treatment, stimulation, and rehabilitation. As the field is quite young, recommendations on the use of SG in people with ND are still rare. In 2014 we proposed some initial recommendations (Robert et al., 2014). The aim of the present work was to update them, thanks to opinions gathered by experts in the field during an expert Delphi panel. Results confirmed that SG are adapted to elderly people with mild cognitive impairment (MCI) and dementia, and can be employed for several purposes, including assessment, stimulation, and improving wellbeing, with some differences depending on the population (e.g., physical stimulation may be better suited for people with MCI). SG are more adapted for use with trained caregivers (both at home and in clinical settings), with a frequency ranging from 2 to 4 times a week. Importantly, the target of SG, their frequency of use and the context in which they are played depend on the SG typology (e.g., Exergame, cognitive game), and should be personalized with the help of a clinician.
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