Telemonitoring of self-administered kinesiotherapy programs is a promising approach to the rehabilitation of hand functions in patients with rheumatic disease.

Current clinical practice suggests that recovering the hand functionality lost or reduced by injuries, interventions and chronic diseases requires, beyond pharmacological treatments, a kinesiotherapic intervention. This form of rehabilitation consists of physical exercises adapted to the specific pathology. Its effectiveness is strongly dependent on the patient's adhesion to such a program. In this paper we present a novel device with remote monitoring capabilities expressly conceived for the needs of rheumatic patients. It comprises several sensorized tools and can be used either in an outpatient clinic for hand functional evaluation, connected to a PC, or afforded to the patient for home kinesiotherapic sessions. In the latter case, the device guides the patient in the rehabilitation session, transmitting the relevant statistics about his performance to a TCP/IP server exploiting a GSM/GPRS connection for deferred analysis. An approved clinical trial has been set up in Italy, involving 10 patients with Rheumatoid Arthritis and 10 with Systemic Sclerosis, enrolled for 12 weeks in a home rehabilitation program with the proposed device. Their evaluation has been performed with traditional methods but also with the proposed device. Subjective (hand algofunctional Dreiser's index) and objective (ROM, strength, dexterity) parameters showed a sustained improvement throughout the follow-up. The obtained results proved that the device is an effective and safe tool for assessing hand disability and monitoring kinesiotherapy exercise, portending the potential exploitability of such a methodology in clinical practice.

The aims of this study were to estimate the energy expenditure (EE) and the intensity of physical activity (PA) during a competitive simulation of Latin American dancing and to evaluate the differences in PA and EE values between the sexes, between different dance types, and between the various phases of the competition. METHODS: Ten Italian dancers (five couples, 5 males and 5 females) competing in Latin American dancing at the international level were examined in this study. The EE (kcal) was measured during the semifinal and final phases of the competition using the SenseWear Pro Armband (SWA). Paired-sample t-tests were used to determine differences in the metabolic equivalent (MET) and EE values between the semifinal and final phases and between each dance. One-way analysis of variance was used to analyze the differences in the MET and EE values between the sexes. RESULTS: The intensity of PA during the dance sequence ranged from moderate (3 to 6 METs) to vigorous (6 to 9 METs). The male dancers had higher EE values than the female dancers during all phases of the simulation. Similar MET values were observed in both sexes. The PA intensity during the finals phase was vigorous for 56% of the time of dance. Of all the dance styles, the rumba had the lowest MET and EE values. CONCLUSION: Our results demonstrate that competitive Latin American dancing is a heavy exercise and suggest that monitoring variables during normal training can improve training protocols and the dancers’ fitness levels.

Background Patients with inflammatory rheumatic diseases characterized by a chronic progressive course, such as Rheumatoid Arthritis (RA) and Systemic Sclerosis (SSc), develop a disability of the hand which requires an adequate assessment and therapeutic intervention through a pharmacological treatment and a proper rehabilitation program. The Re.Mo.Te. device consists of sensorized aids, allowing the execution of hand rehabilitation exercises and the extraction of relevant parameters (motion, force, pressure, speed of execution) from the analysis of several repetitions of the same movement, performed in real rehabilitation exercises typically prescribed to RA and SSs patients (1). These data are part of a larger project called Re.Mo.Te. Recovery Movement and Telemonitoring for rheumatology patients with disabilities of the hand. Objectives To validate portable device Re.Mo.Te for the evaluation of hand disability in patients with RA and SSc. Methods Ten RA patients (10F, age 56.9 ± 13.1 years) and 10 SSc patients (9F, age 56.3 ± 10.4 years) underwent an assessment of hands function through the device Re.Mo.Te. and through the measurement of: 1) Range Of Movement (ROM) of the wrists and 2) grip strength (pinch and grip) of the hand and fingers, 3) hands and fingers extension. The HAQ and the algo-functional index of Dreiser were administered to both RA and SSc patients while the Hamis test was administered exclusively to SSc patients. The Spearman’s correlation coefficient was applied to test the validity of the results obtained with the Re.Mo.Te. device and to compare them with traditional assessment; p values ​​<0.05 were considered significant. Results All patients had a reversible hand disability (HAQ = AR: 1.5 ± 0.82; SSc: 1.4 ± 0.65 - Dreiser’s index = AR: 15.7 ± 6.0; SSc: 15.0 ± 5.7). The Spearman’s correlation coefficients between the traditional hand functional assessment and the Re.Mo.Te. device assessment were high (0.67-0.79) and statistically significant for the measurement of grip strength (p <0.0001) and overall extent (p <0.001). The ROM results showed significant correlation with the global finger extension (p <0.01) and the speed of fingers extension (p <0.001) abilities evaluated by Re.Mo.Te. Conclusions The Re.Mo.Te. device is a valuable aid for the assessment of hand disability in chronically ill subjects requiring a quantitative evaluation for the proper set up of a personalized rehabilitation program. References D. Pani, G. Barabino, A. Dessì, M. Piga, I. Tradori, A. Mathieu, L. Raffo “An integrated Portable Device for the hand functional assessment in the clinical practice” Biomedical Engineering Systems and Technologies 2012 - Revised Selected Papers, J. Gabriel et al. Eds., in press Disclosure of Interest None Declared

The functionality of the human hand is of paramount importance for the daily life activity of a subject. Several chronic diseases can have localized lesions on the hands, causing disability, as for the Systemic Sclerosis and Rheumatoid Arthritis. In these cases the evaluation of the hand functionality is a necessary step for setting up the therapeutic and rehabilitation program. This research presents a novel device tackling this problem, allowing the evaluation of hand dexterity and strength on 4 simple rehabilitation exercises. Real-time controlled by a wirelessly connected PC where a C++ physician graphical interface enables a user-friendly management of the assessment, the device provides hitherto unavailable measurements. A first evaluation of the device in a real outpatient rheumatology clinic has been performed and the preliminary results reveal the potentialities of the approach