Физиотерапия и новые технологии (Часть 1)

За последние несколько лет новые технологии существенно меняют стандарты применения физиотерапии - уход за пациентами становится более доступным, простым в применении; при этом достигаются лучшие результаты.

Рассмотрим некоторые из наиболее популярных технологических направлений в области физиотерапии и их применение.

Виртуальная реальность

Сочетание 3D виртуальной реальности (ВР) и физиотерапии впервые было протестировано в 2019 на группе пациентов, испытывающих проблемы с равновесием и походкой из-за болезни Паркинсона. 

Группа людей, использующих технологию виртуальной реальности, "значительно лучше справлялась со своими обязанностями по сравнению с группой обычной физической терапии".

Испанские медики провели клиническое испытание «Иммерсивная виртуальная реальность как новый метод физической терапии. Подход для нестареющих людей: Удобство использования и влияние на баланс. Результаты программы упражнений на основе игр». 

Оно показало, что физическая реабилитация может быть поддержана с помощью тренировочных приложений, основанных на упражнениях. Использование иммерсивной ВР повышает мотивацию, обучающие эффекты, может обеспечить более высокий уровень приверженности к терапии. Оно может также сделать доступным большое количество материальных ресурсов в виртуальном режиме, которые в противном случае физиотерапевты не смогли бы использовать в реальной обстановке. Это является осуществимым и эффективным методом для улучшения равновесия и снижения риска падений у женщин пожилого возраста, проживающих в домах престарелых.

Такие компании, как XRHealth, уже предлагают виртуальное лечение с использованием дополненной реальности. Пациенты получают по почте гарнитуры VR и тренируются с физиотерапевтами, чтобы самостоятельно восстановиться после определенных травм.

Хороший обзор предлагается в работе итальянских физиотерапевтов «Иммерсивная виртуальная реальность в реабилитации после инсульта: Систематический обзор. Андреа Демеко и др.»

Биомеханические системы захвата движений

Носимые технологии находят все большее применение как предпочтительный способ улучшения движения и снятия боли. Как правило, датчики крепятся к различным частям тела - отслеживают и регистрируют движения, основываясь на оптимальном диапазоне движения. Физиотерапевты применяют информацию от этих датчиков с программируемыми приложениями для создания персонализированных планов лечения.

MIO от компании  MIO Therapy - первая носимая технологическая платформа, которая объединяет эффективность традиционной физической терапии с интеллектуальными датчиками, лечебными упражнениями, играми и технологией 3D-визуализации для персонализации и улучшения амбулаторной реабилитации и ускорения восстановления. MIO обеспечивает стабильно точные измерения, которые могут быть использованы для мониторинга и персонализации лечения, сокращения времени восстановления и снижения затрат на здравоохранение.

Пациенты прикрепляют датчики к любой части тела с помощью наклеек или гибких ремней, чтобы физиотерапевты могли измерять, собирать и записывать все движения конкретной области тела, предоставляя ключевые данные о диапазоне движения пациента и измеримом прогрессе в выполнении программы упражнений. Чрезвычайно точные датчики измеряют, анализируют и сохраняют данные физиотерапии пациента в облаке для  доступа и анализа через приложение MIO. MIO также предлагает 3D-визуализацию в реальном времени, обеспечивая точную картину того, что делает пациент в любой момент, и может использоваться в кабинете или через платформу телемедицины под наблюдением врача.

В приложении представлены индивидуальные планы ухода при определенных травмах. Эти планы лечения включают интерактивные игры, которые способствуют выздоровлению с помощью системы баллов и поощрений.

Обзор направления представлен в статье «Возможности применения биомеханических систем захвата движений человека в медицинской реабилитации. Шейко Г.Е. и др.»

В России предлагаются

Система Орторент Виртуал – инновационное оборудование для проведения виртуальной реабилитации пациентов 

Система DynSTABLE (ДинСтейбл) оценки и коррекции расстройств баланса с помощью различных терапевтических приложений с виртуальной реальностью и обратной связью в режиме реального времени.

(Продолжение следует)

#физиотерапия #виртуальнаяреальность #паркинсон #паркинсона #паркинсонизм #реабилитация #реабилитацияпослеинсульта #реабилитацияпослеоперации #VR #3D

Portable detector of SARS-CoV-2 virus COVID Hunter

 

American company Advanced Medical Solutions International (AMSI) announced development of non-invasive, touchless, immediate, and portable detector of the virus SARS-CoV-2 which causes the disease COVID-19, demonstrating >99% specificity and sensitivity within 0-2 meters (6.5 feet) on surfaces, through glass or transparent material, and inside the human body.

 The COVID Hunter would allow rooms, restaurants, venues, vehicles, hospitals, hotels, schools, offices, and others to be scanned for SARS-CoV-2. Surfaces with the virus will be cleaned and retested to ensure the disinfectant was successful. Once areas are clean, persons and objects entering the area would be scanned to screen for the virus.

 Salient tech specs:

·       Immediate detection of 2 internal and external components of SARS-CoV-2 (such as RNA or spike protein) in a specific and sensitive manner

·       Immediate detection of SARS-CoV-2 in any human sample, including nasal swabs, oral swabs, sputum, saliva, bronchoalveolar lavage (lung aspirate)

·       Immediate detection of SARS-CoV-2 inside human body (identification of people infected with SARS-CoV-2 (“carriers”)) in a non-invasive manner

·       Immediate detection of SARS-CoV-2 in air coughed or sneezed or blown out  of mouth or nose of infected people into a transparent container (identification of people infected with SARS-CoV-2 AND who are infectious (transmitters of infection))

·       Immediate detection of SARs-CoV-2 in different body organs (throat, lung, sinus)

·       Immediate detection of SARS-CoV-2 on the outside of human body (skin and clothes)

·       Immediate detection of SARS-CoV-2 on contaminated objects (such as door handles, mobile phones, high-touch surfaces, packages, etc.)

·       Verification of RT-PCR results of COVID19 (SARS-CoV-2) infection to eliminate false readings

 

AMSI is working with Biologics Consulting Group, Inc. to handle the FDA Emergency Use Authorization (EUA) submission for The COVID Hunter.

IoT-based framework for early identification and monitoring of COVID-19 cases

 The proposed system would employ an Internet of Things (IoTs) framework to collect real-time symptom data from users to early identify suspected coronaviruses cases, to monitor the treatment response of those who have already recovered from the virus, and to understand the nature of the virus by collecting and analyzing relevant data. The framework consists of five main components: 

• Symptom Data Collection and Uploading (using wearable sensors), 
• Quarantine/Isolation Center, 
• Data Analysis Center (that uses machine learning algorithms), 
• Health Physicians, and 
• Cloud Infrastructure. 

To quickly identify potential coronaviruses cases from this real-time symptom data, this work proposes eight machine learning algorithms, namely Support Vector Machine (SVM), Neural Network, Naïve Bayes, K-Nearest Neighbor (K-NN), Decision Table, Decision Stump, OneR, and ZeroR. An experiment was conducted to test these eight algorithms on a real COVID-19 symptom dataset, after selecting the relevant symptoms. The results show that five of these eight algorithms achieved an accuracy of more than 90 %. Based on these results we believe that real-time symptom data would allow these five algorithms to provide effective and accurate identification of potential cases of COVID-19, and the framework would then document the treatment response for each patient who has contracted the virus.

An IoT-based framework for earlyidentification and monitoring of COVID-19 cases. Mwaffaq Otoom, et al. Biomed Signal Process Control. 2020 Sep; 62: 102149. doi: 10.1016/j.bspc.2020.102149

Technology for Diabetes: 2018 Overview of Devices, Gadgets & Tech Part 2

  Here is a look at certain business, scholarly and academic papers.

 First, the most acute problem for any person that is suffering from diabetes is glucose monitoring.

 A researcher for the Netherlands tries to delineate where we stand some 10 years after the first retrospective CGM device entered the market

Continuousglucose monitoring: coming of age? J Hans DeVries, Departments of Internal Medicine and Endocrinology and Metabolism, Academic Medical Center, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands:

Endocrine Society Clinical Practice Guideline on Continuous Glucose Monitoring (CGM) was published, co-sponsored by the European Society of Endocrinology. Such a guideline is a necessary step in the maturation of any new technology. This commentary tries to delineate where we stand some 10 years after the first retrospective CGM device entered the market from a European perspective.

 International team of researchers suggest (Remote Patient Monitoring System Architecture for Diabetes ManagementBarroon Isma’eel Ahmad, Media Anugerah Ayu, Ibrahim Abdullahi,) diabetes monitoring with Health Information Technology (HIT):  Remote Patient Monitoring System with Electronic Health Record (EHR) and Clinical Decision Support System (CDSS) to make decision about patients suffering from diabetes.

 Researchers from the University of Qom suggest the following:  Noninvasive Optical Diagnostic Techniques forMobile Blood Glucose and Bilirubin Monitoring :

People with diabetes need to monitor their blood sugar levels constantly and attend health centers regularly for checkups. The aim of this study is to provide a healthcare system for mobile blood glucose and bilirubin monitoring. Methods: It includes a sensor for noninvasive blood glucose and bilirubin measurement using near‑infrared spectroscopy and optical method, respectively, communicating with a smartphone.

 And, finally, The World Health Organization produced a comprehensive report: MedicalDevices: Managing the Mismatch - this observation is regarding Blood Glucose Measurement Devices.

“In both high- and low-resource countries, blood glucose testing is used by patients at home. Many blood glucose meters require patient with diabetes to insert tiny test strips into the device. The results appear on the display as small numbers. However, as visual problems are common in people with diabetes, the tiny displayed numbers may prevent patients from reading their results. In addition, the design of these devices ignores the fact that at a certain stage of the disease, patients may lose their fine motor skills and therefore have difficulty inserting the test strips. Further development into more appropriate designs could be beneficial to people with diabetes. It would also be helpful if glucose meters that use multiple languages and measurement systems could be developed.”

 HERE ARE my 2018 PICKS FOR MANAGEMENT AND MONITORING OF DIABETES

 Balansio 

Balansio is a diabetes management system for hospitals and clinics to provide diabetes care directly to the daily life of their diabetic patients. With clinical intelligence, Balansio follows automatically every diabetic using the system on a 24/7 basis, by analyzing their care data. This helps the diabetic to better follow the agreed care plan on a daily basis. The goal here is to enable the individual with diabetes to learn and improve their own diabetes management routines. Balansio system is a cloud-based software-as-a-service (SaaS) solution, which is used through a mobile app and web application. Balansio a is CE marked medical device.

 DPNCheck®  Device for Diabetic Peripheral Neuropathy (DPN) Test

Fast, accurate, and quantitative nerve conduction test that is used to evaluate systemic neuropathies such as diabetic peripheral neuropathy (DPN). Designed to be used by clinicians at the point-of-care to objectively detect, stage, and monitor DPN. Measures nerve conduction velocity & response amplitude of the sural nerve, a nerve in the lower leg and ankle. These parameters are widely recognized as sensitive and specific biomarkers of DPN.

 DiabetioSocial AI Application Suite For Diabetes Self-Care Management

Works on all common digital communication devices. Comes with a suite of intelligent apps to help you manage diabetes. Helps to determine if a person is at risk to develop Type 2 diabetes. Application suite comes with different knowledge levels and works on all common digital devices such as smartphones, tablets, and desktop computers. Consists of Diabetio Buddy for children & Diabetio Companion for adults. Includes applications such as Diabetio Teacher, Diabetio CarbCalc that helps manage carbohydrates intake. Will continuously learn about your daily activities, thus quickly becoming your personalized best Buddy or Companion.

PredictBGLInsulin Dose Calculator Application

Track active insulin, blood sugar, bolus, basal, shots, food, carbs, weight, HbA1c and more. Effortless live Dexcom integration. Data is automatically synchronized to unlimited carers and your Health Care Team. Calculate doses. Track insulin on board (IOB) to avoid over-dosing. Real, actionable data - see how many carbs to eat when too low, and how long to delay eating when too high. Minimize damaging glucose variability. PredictBGL calculates insulin doses, tracks active insulin to avoid stacking, and uniquely, warns of hypos hours ahead. It makes dose suggestions, reminds you of meals and basal insulin, and sounds alerts for predicted hypos and for hypo follow-up.

GlucoWiseNeedle-Free Diabetes Monitoring Device

Monitors attenuation of electromagnetic waves after they cross the skin: technology enables blood glucose concentration to be measured at capillary level. Utilizes high-frequency radio waves around the 65 GHz range. Sensors have integrated nano-composite films which temporarily make the skin transparent to the radio waves when a measurement is initiated. This ensures consistent readings across all people independent of age, or skin type and colour. User just needs to place it on skin between thumb & forefinger - device will take accurate blood glucose reading every few seconds - then displays the reading in real-time on screen. Glucowise™ mobile app & cloud-based data management system will allow you to store historical data.

 AlertgyGM Wristband Blood Glucose Monitor

Works with app on your smartphone to measure your blood sugar. You will be able to get blood sugar reading on demand, see how your blood sugar levels change over time, allow you to set alerts to notify you, loved ones, or others if your blood sugar level goes too low or too high. The band will be waterproof, hypo-allergenic, worn 24 hours a day.

Technology for Diabetes: 2018 Overview of Devices, Gadgets & Tech Part 1

 Globally, diabetes poses a big problem for every country. “Diabetes is on the rise. No longer a disease of predominantly rich nations, the prevalence of diabetes is steadily increasing everywhere, most markedly in the world’s middle-income countries” (Global Report on Diabetes. World Health Organization 2016)

KPMG provides this disturbing stats U.S. CDC (Digital Health And Disruption In Diabetes by KPMG Centers for Disease Control; and Prevention. Diabetes Report Card 2017, Atlanta, Georgia, 2018)

• 30.3 million of Americans (9.4% of the population) have diabetes 
• 1.25 million American children and adults have T1D
•  86 million Americans age 18 and older have prediabetes.
• 1.5 million Americans are diagnosed with diabetes every year
•  The annual rate of increase is 1.8% for T1D and 4.8% for T2D

 

 “Today’s generation of digital migrants and digital natives do not want to write things down on paper; they expect technology to make their lives easier and perform these tasks for them.” (Powerto the Patient Diabetes Management in the Digital Age. Cambridge Consultants)

 And, indeed, Technology plays an important role in resolving all problems, associated with the disease. This is very clearly reflected in the market volume - the total revenue digital diabetes market tripled in 2017 to $98 million, according to Research2Guidance. Report:Digital diabetes market surging, will hit $742M by 2022 by Mobihealth.com

The research group expects the full market to be worth $742 million in 2022

It started with a stand-alone devices and evolves now to a full-bundled services that combine connected devices, test strip supplies, app-driven services, coaching services. According to  Research2Guidance, there are more than 2,000 different digital services currently available to diabetes patients. 

In the most general terms, digital technology for diabetes serves the following purposes:

• Deliver convenient access to time-critical information for patients, healthcare professionals, and researchers;
• Enable and enhance remote monitoring, diagnosis of patients often based on information delivered by wearable devices
• Decision support to assist patients in selecting treatment
•  Deliver timely recommendations for treatment to increase adherence to prescribed therapy

(Digital Diabetes Congress 2017 )

 

I would highly recommend exploring this detailed document: Digital Innovation inDiabetes Care - Trend Report 2016. The Center for Digital Technology and Management (CDTM)  - joint interdisciplinary institution of education, research, and entrepreneurship of the Ludwig-Maximilians-Universität München (LMU) and the Technische Universität München (TUM).

Among other themes, that are in detail analyzed, there are some worth to notice:

Technology Trends in Diabetes Care

• Telehealth 
• Big Data and Machine Learning 
• Networked Care
•  Advancements in Glucose Sensor Technology 
• Non-Invasive Insulin Delivery Systems
•  Smart Devices
•  Closed-Loop Systems
•  Bioengineering and Gene Therapy
• Food-Tech

 

Business Model Trends in Diabetes Care

• Internet of Things
• Predictive Medicine
•  Online Job Platforms
•  Telemedicine
•  Changing Lifestyle
•  Emerging Business Models Utilizing Crowdsourcing
•  Value-Based Healthcare Model

 

Above mentioned KPMG paper has this illustration of Digital Health In Diabetes Ecosystem

GizmoVlad - Essence

 

Over the part years I was associated with a medical technology startup, where one of my activities was monitoring of global medical technology market. In this Blog I am publishing the market overviews - the one that I hope may find some interest both among healthcare professionals and general public.

В течение нескольких лет я был связан со стартапом в области медицинских технологий, где одним из направлений моей деятельности был мониторинг мирового рынка медицинских технологий. В этом блоге я публикую обзоры рынка - те, которые, как я надеюсь, могут заинтересовать как профессионалов здравоохранения, так и широкую общественность.

Welcome to the Blog!!!