Phase 1 REWIRE - Rehabilitative Wayout In Responsive Home Environments, A Pilot Trial

The REWIRE rehabilitation platform consists of three hierarchical components: the "Patient Station" (PS), which is installed in the home environment of the patient; the "Hospital Station" (HS), which allows an exchange of information with more horsepower and is served by the therapists in the hospital; and the "Networking Station" (NS), which allows a combination of a plurality of HS.

The PS consists of a standard laptop with a specifically created for the rehabilitation REWIRE platform and pre-installed software (Università degli Studi di Milano, Italy, Applied Intelligent Systems Laboratory Department of Computer Science). In the context of a training system connected to the computer, the software enables the collection of data, which are recorded as part of the training. In this study only exercises for balance ability are part of the training program. The training system consists of a so-called Tymoplate® (Tyromotion, Austria), a medical device class 1 with CE certification and approval by the FDA for use in neurorehabilitation after stroke. The Tymoplate® is connected to the computer and allows by means of a base plate with integrated pressure sensors and custom-developed training software, various postural biofeedback exercises. In combination with 3D cameras (Kinect®, PrimeSense, CA, USA), the patient sees him-/herself or an avatar in real time on a screen which moves in the virtual training environment. By various, attractive and entertaining designed training games as well as provided audio-visual feedback and balanced score system, patients should be maximum motivated to exercise.

The HS enables the interaction between patient and therapist and essentially consists of a MySQL database with web-based interface. The data collected on each PS can be retrieved from the HS and can be used by therapists in order to set up the training program on the PS to control and to adjust the difficulty level of the exercises to the individual performance of each patient.

The NS also consists of a database. It links collected training data and the associated epidemiological data of different HS at the regional level (potentially also between different health institutions) to identify on the application of statistical algorithms general models for the description of relaxation processes in rehabilitation medicine.

In this simple way a frequent and intensive training is without direct therapeutic help in the home setting at low cost possible. By attractive and entertaining designed training games as well as interaction and feedback by the therapist, patients are motivated to train each day with the system and to continually improve in the games. The supervision of the training by the therapist with the rehabilitation platform REWIRE additionally serves to recognize improvements of the individual performance or problems and to adapt the difficulty level of the exercises.