The L&S is preferable to the LR when possible for minimizing unwanted C-spine motion. There is little overall difference between HS and TS in a cooperative patient. When a patient is confused, the HS is much worse than the TS at minimizing C-spine motion.

Introduction: Understanding determinants of community mobility disability is critical for developing interventions aimed at preventing or delaying disability in older adults. In an effort to understand these determinants, capturing and measuring community mobility has become a key factor. The objectives of this paper are to present and illustrate the signal processing workflow and outcomes that can be extracted from an activity and community mobility measurement approach based on GPS and accelerometer sensor data and 2) to explore the construct validity of the proposed measurement approach using data collected from healthy older adults in free-living conditions.Methods: Personal, functional impairment and environmental variables were obtained by self-report questionnaires in 75 healthy community-living older adults (mean age = 66 ± 7 years old) living on the island of Montreal, QC, Canada. Participants wore, for 14 days during waking hours on the hip, a data logger incorporating a GPS receiver with a 3-axis accelerometer. Time at home ratio (THR), Trips out (TO), Destinations (D), Maximal distance of destinations (MDD), Active time ratio (ATR), Steps (S), Distance in a vehicle (DV), Time in a vehicle (TV), Distance on foot (DF), Time on foot (TF), Ellipse area (EA), and Ellipse maximum distance (EMD) were extracted from the recordings.Results: After applying quality control criteria, the original data set was reduced from 75 to 54 participants (28% attrition). Results from the remaining sample show that under free-living conditions in healthy older adults, location, activity and community mobility outcomes vary across individuals and certain personal variables (age, income, living situation, professional status, vehicle access) have potential mitigating effects on these outcomes. There was a significant (yet small) relationship (rho < 0.40) between self-reported life space and MDD, DV, EA, and EMD.Conclusion: Wearability and usability of the devices used to capture free-living community mobility impact participant compliance and the quality of the data. The construct validity of the proposed approach appears promising but requires further studies directed at populations with mobility impairments.

No abstract

One typical remote consultation envisioned for inhome telerehabilitation involves having the patient exercise on a stationary bike. Making sure that the patient is breathing well while pedaling is of primary concern for the remote clinician. One key requirement for in-home telerehabilitation is to make the system as simple as possible for the patients, avoiding, for instance, to have them wear sensors and devices. This paper presents a contactfree respiration rate monitoring system measuring temperature variations between inspired and expired air in the mouth-nose region using thermal imaging. The thermal camera is installed on a pan-tilt unit and coupled to a tracking algorithm, allowing the system to keep track of the mouth-nose region as the patient exercises. Results demonstrate that the system works in real time even when the patient moves or rotates its head while exercising. Recommendations are also made to minimize limitations of the system, such as the presence of people in the background or when the patient is talking, for its eventual use in in-home telerehabilitation sessions.

This paper proposes an innovative ambulatory mobility and activity monitoring approach based on a wearable datalogging platform that combines inertial sensing with GPS tracking to assess the lifespace and mobility profile of individuals in their home and community environments. The components, I/O architecture, sensors and functions of the WIMU-GPS are presented. Outcome variables that can be measured with it are described and illustrated. Data on the power usage, operating autonomy of the WIMU-GPS and the GPS tracking performances and time to first fix of the unit are presented. The study of lifespace and mobility with the WIMU-GPS can potentially provide unique insights into intrapersonal and environmental factors contributing to mobility restriction. On-going studies are underway to establish the validity and reliability of the WIMU-GPS in characterizing the lifespace and mobility profile of older adults.

This pilot study explored the feasibility of in-home teletreatment for patients with post-stroke anomia. Three participants over 65 years of age suffering from post-stroke anomia were treated in this pre/post-intervention case study. They received 12 speech therapy teletreatments (two sessions/week for 6 weeks) aimed at improving confrontation naming skills. Half of the failed items from a set of 120 preselected stimuli were trained during treatment (Block A-trained stimuli) while the other half served as controls (Block B-untrained stimuli). Variables measured were: 1) efficacy of treatment (performance on Block-A vs. Block B Stimuli), and 2) participants’ satisfaction with teletreatment (using a French adaptation of the Telemedicine satisfaction questionnaire). All participants showed a clinically relevant improvement on confrontation naming of trained items and less improvement for untrained items. The researchers also obtained high satisfaction scores on the questionnaire (above 57/60). This pilot study supports the feasibility of speech therapy teletreatments applied to neurological language disorders.

No abstract

Context: Health care providers must be prepared to manage all potential spine injuries as if they are unstable. Therefore, most sport teams devote resources to training for sideline cervical spine (C-spine) emergencies.Objective: To determine (1) how accurately rescuers and simulated patients can assess motion during C-spine stabilization practice and (2) whether providing performance feedback to rescuers influences their choice of stabilization technique.Design: Crossover study. Setting: Training studio. Patients or Other Participants: Athletic trainers, athletic therapists, and physiotherapists experienced at managing suspected C-spine injuries.Intervention(s): Twelve lead rescuers (at the patient's head) performed both the head-squeeze and trap-squeeze C-spine stabilization maneuvers during 4 test scenarios: lift-and-slide and log-roll placement on a spine board and confused patient trying to sit up or rotate the head. Main Outcome Measure(s):Interrater reliability between rescuer and simulated patient quality scores for subjective evaluation of C-spine stabilization during trials (O=best, 10 = worst), correlation between rescuers' quality scores and objective measures of motion with inertial measurement units, and frequency of change in preference for the head-squeeze versus trap-squeeze maneuver.Results: Although the weighted K value for interrater reliability was acceptable (0.71-0.74), scores varied by 2 points or more between rescuers and simulated patients for approximately 10% to 15% of trials. Rescuers' scores correlated with objective measures, but variability was large: 38% of trials scored as 0 or 1 by the rescuer involved more than 10°of motion in at least 1 direction. Feedback did not affect the preference for the lift-and-slide placement. For the log-roll placement, 6 of 8 participants who preferred the head squeeze at baseline preferred the trap squeeze after feedback. For the confused patient, 5 of 5 participants initially preferred the head squeeze but preferred the trap squeeze after feedback.Conclusions: Rescuers and simulated patients could not adequately assess performance during C-spine stabilization maneuvers without objective measures. Providing immediate feedback in this context is a promising tool for changing behavior preferences and improving training.Key Words: head squeeze, trap squeeze, spine board placement, head motion, inertial measurements, self-reports, training, feedback, spine injuries, spine immobilization, neck injuries Key Points• Properly stabilizing an injured cervical spine is an essential skill for sports medicine professionals.• In the absence of objective measures, neither lead rescuers nor simulated patients were able to accurately characterize the performance of cervical spine stabilization maneuvers.• Immediate, objective feedback during training may provide rescuers with practical suggestions for improving their skills in cervical stabilization.