Remote Data-Acquisition in Rehabilitation

Abstract Poliomyelitis, peripheral vascular disease, ‘strokes’ and serious traumatic injury all contribute to the relatively large population of physically handicapped members of our society. In an attempt to restore function, at least in part, the rehabilitation physician or surgeon is called upon to prescribe orthotic or prosthetic devices and to modify them from time to time in response to patient performance. Assessment can be undertaken (a) by questioning the patient about his mobility at home and work and (b) by inspection of gait in the severely limited confines and atypical environment of the outpatient clinic. Both approaches are notoriously fallible. In a pilot attempt to introduce a degree of objectivity a group of lower limb amputees were fitted with miniature FM radio transmitters to telemeter physical activity and physiological cost parameters over the immediate environs of a city center campus. In the end the results were extremely disappointing, main problems were, interference, signal loss, limited range etc. The added requirement of acquisition of 3 channels of data over 24 h periods in unrestricted patients travelling up to 30 miles distance to their home led to the examination of a miniature analog tape recorder system carried by the patient. The effects of the move were so far-reaching as to alter the entire philosophical approach to the investigation. Perhaps the only real limitation is the non-availability of data in real-time. Using modified ‘Medilog’ recorders with an integral crystal clock signal on one channel, 24 h records of ECG, trunk acceleration and body postures are obtained. On replay through purpose-built analyzers a dramatic picture of the ‘life-style’ of the patient emerges with temporal relations of changes in posture etc. along with quantitative measures of mobility and, of course, physiological cost. Once the transducers are fitted, the cables taped down and the recorder secured to a broad waist-band worn next to the skin, the patient is dressed and able then to undertake all his normal daily and overnight activities, immersion only excepted. Current experience suggests that only very rarely does the patient feel restricted to any degree. Acquisition of high-quality data in the domiciliary or working environment can bring a new and valuable dimension to the problems faced by the handicapped in the real-life situation.