Israeli Students Win International Prize for Developing App That Detects Strokes Early

 Good for those with smart phones and using them all the time. What would be the usage rate for 70+ people? I use my phone for texting, reading emails, almost no phone calls. Would this app work in those conditions? This would seem to require access to the camera non-stop, eating your battery in no time, and for that reason I wouldn't use it.

Israeli Students Win International Prize for Developing App That Detects Strokes Early

Strokes (cerebrovascular events, or CVAs) are among the most devastating medical conditions in humans, but in many cases, they can be prevented. A stroke occurs when the blood supply to part of the brain is halted or reduced, preventing brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes. 

The two main types of stroke

As it is a medical emergency, speedy treatment is crucial. Early action can reduce brain damage and other complications. There are two main types of stroke – ischemic, due to lack of blood flow, and hemorrhagic, the result of bleeding in the brain. Both cause parts of the brain to stop functioning properly.

Stroke symptoms include an inability to move or feel on one side of the body, problems understanding or speaking, dizziness or loss of vision to one side. A hemorrhagic stroke may also be associated with a severe headache.

Prevention includes decreasing risk factors

People with various medical conditions and habits are at high risk for a stroke – those who smoke, suffer from hypertension, obesity, uncontrolled diabetes, end-stage kidney disease, and atrial fibrillation. 

Prevention includes decreasing risk factors and surgery to open up the arteries to the brain in those with problematic narrowing of the carotid artery to the brain. 

MedHacks – a hackathon for developing medical technologies

Now, a team of students from the Technion-Israel Institute of Technology in Haifa and the University of Missouri in the US has won second place at MedHacks – a hackathon for developing medical technologies hosted by Johns Hopkins University. They were awarded for developing the Scan&Sound application, which detects strokes at early stages and alerts the victims.

Sean Heilbronn-Doron (Technion)

MedHacks is the largest hackathon in the US for developing medical technologies. This year, more than 1,000 people participated, including students, doctors, engineers, scientists and entrepreneurs from all over the world. The event was a collaboration between Johns Hopkins University and MLH-Major League Hacking, which organizes hundreds of student hackathons every year and was funded by various entities, including Google Cloud.

The Scan&Sound team consists of four Technion students and alumni: Hadas Braude, a 6th-year student in the Rappaport Faculty of Medicine; Sean Heilbronn-Doron, a fourth-year student in the faculty; Shunit Polinsky, a master’s-degree student in the Faculty of Mechanical Engineering; and Ron Liraz, an alumnus who received a master’s degree from the Viterbi Faculty of Electrical Engineering. The fifth student on the team was Leeore Levinstein, a third-year medical student at the University of Missouri. 

The different levels of stroke severity

One in four people in the US undergoes a stroke at some point in their lives. There are many different levels of severity, ranging from a stroke that one is not even aware of experiencing to an event that results in serious cognitive and motor impairmentsand even death. In addition to personal harm, strokes also incur enormous financial expenses for the individual, the health system and the country. As a result, there is a great deal of motivation to develop methods to identify strokes at the early stages when treatment is more effective. 

Scan&Sound won second place in the “Personalized Medicine Using Data-Driven Healthcare” category. The application detects early, subtle stages of stroke by studying voices and facial expressions and analyzing the data using artificial intelligence. If there is a significant change, the application alerts the user that he/she is suffering from symptoms that may indicate a stroke and suggests a call to predetermined contacts or an emergency call center. 

Keeping them up at night

Braude, who headed the group, proposed the idea after someone close to her suffered a stroke. On the day it happened, the person met with friends and family, who immediately noticed that something was wrong. They did not, however, suspect a stroke.

“As a result,” said Braude, “the man arrived at the hospital late and missed the ‘treatment window.’ Since then, I haven’t stopped thinking about how to prevent the next incident and have asked myself how it can be possible that the telephone that is always with us gathers information about us, but cannot detect and warn that something is wrong with us.”

Braude and Heilbronn-Doron met before this round of competition when they competed together in the T2Med hackathon hosted by the Rappaport Faculty of Medicine. Following their win there, the two registered for MedHacks and invited Liraz, a talented and experienced electrical engineer they met at T2Med, to join them. In classic Israeli fashion, the two other members of the unique and diverse trans-Atlantic Scan&Sound team arrived through personal and family contacts.

Meeting their goal through effective communication

The hackathon itself was very challenging. Besides the physical distance, the members of the team had to contend with the time difference between Israel and the US, as well as navigating classes and other prior commitments. They were able to meet their goal through effective communication, planning, determination, division of labor and, most importantly, through each member’s personal commitment to the project.

The judges at the competition were very impressed with their project. The team stressed the project’s true goal is to enable people to get treatment in time and to safeguard brains, identities and lives. This is, in fact, the motivation that inspired them to establish a technological team and to create partnerships with neurological departments and rehabilitation centers in Israel and the US,

 

FibriCheck smartphone app for checking heart rhythm disorder

Ask your doctor about this.

https://www.fibricheck.com/

The app helping to prevent stroke: FibriCheck
FibriCheck was the first smartphone app designed to detect heart rhythm disorder, without using any external medical devices, to receive a Food and Drug Administration (FDA) approval.
Co-founded by Bieke Van Gorp and Lars Grieten in Belgium, FibriCheck can help prevent stroke by detecting atrial fibrillation and other heart rhythm disorders using a smartphone or smartwatch.
By placing a finger on the smartphone’s camera, the app measures a person’s heart rhythm for one minute and gives them a detailed report and immediate actionable results, reviewed by FibriCheck’s team of medical experts. Users can then track their heart rhythm history and look back on how it has changed.
FibriCheck has received Food and Drug Administration (FDA) approval and designation as a diagnostic device. It can now be used by clinicians around the world thanks to this as well as its European Conformity (CE) medical approval. Over 130,000 people have so far been screened using the app.

pop up buttons on smart phones

At a friends house I tried to get my left fingers under it to hold it like normal people do. After 10 minutes of trying and not being able to get the first two fingers straightened out enough at the same time and long enough, I gave up in failure.  One handed use of a smart phone means holding it against my body to rotate it to get my thumb in position. So far I haven't dropped the phone from high enough to break it. Rings don't work either. What is your therapists solution?

One handed smart phoes woes

I can't blame my doctor and therapists for these problems, had a flip phone back in '06'.
Normal people hold the phone in one hand and use the other for swiping, typing, etc. When I try to put it in my affected left hand, due to spasticity it either turns off the phone, adjusts the volume or turns on Bixby. I tried the ring attachment on the back of the phone, didn't work. Took 5-10 minutes to get the finger flat enough to insert. Then the spasticity of the thumb would curl over the screen, pushing whatever icons were there. And typing the left most letters just were not available or inserted where they weren't wanted.  The pop up button I didn't try but that makes the assumption that you can squeeze your middle fingers together as needed to stabilize the phone, never occur in my case. Neither of these works with the magnetic attachment I have for use in my car. 

So I do icon selection and typing with the right hand thumb. while holding the phone with my fingers. Which is a problem for items out of thumb range. I end up having to press the phone against my body and rotate it to get the thumb in position.

Smartphone App Measures Parkinson's Severity

This should be so easy to modify this for stroke but our fucking failures of stroke associations will DO NOTHING. Your doctor will DO NOTHING . Your stroke hospital will DO NOTHING.  You're screwed. 
https://www.medpagetoday.com/neurology/parkinsonsdisease/71995

• by

Judy George, Contributing Writer, MedPage Today March 26, 2018

A smartphone application can provide objective measures of Parkinson's disease (PD) severity to help manage symptoms more effectively, reported researchers from Johns Hopkins University and the University of Rochester.

With the HopkinsPD app, Parkinson's disease patients can report objective, real-time movements and responses to medication to complement standard measures. "Patients can use their mobile phones to complete a few simple tasks which the proposed method turns into an objective score," explained Suchi Saria, PhD, of Johns Hopkins' Department of Computer Science. "This score, when plotted over time, provides a lens into the patient's Parkinson symptom profile and how it's varying over time."

In an observational study published online in JAMA Neurology, Saria and colleagues assessed individuals with PD who remotely completed five tasks -- voice, finger tapping, gait, balance, and reaction time -- on the app. A novel machine-learning approach was used that objectively weighed features derived from each smartphone activity -- stride length from the gait activity, for example -- and generated a mobile Parkinson disease score (mPDS) with a scale from 0 to 100.

The mobile score captured intraday symptom fluctuations, correlated strongly with current standard rating scales, and detected responses to dopaminergic therapy.

"Patients with Parkinson's disease show large fluctuations in disease severity from hour to hour," Saria noted. "But right now, we don't have ways to measure daily symptom fluctuations." Currently, many patients keep a motor diary and record when they experience good symptom control or complications like dyskinesia; these diaries are used to adjust medication doses.

"If we could measure daily symptom fluctuations and long-term trends in symptom severity objectively, it would be possible to titrate medications more precisely based on an individual's symptom profile," she said. "If the patient is not being responsive, we could add or change the mode of delivery or add medications to improve efficacy of levodopa."

The researchers derived the mPDS from 6,148 smartphone activity assessments collected from 129 individuals. Gait contributed 33% to the total score, balance 23%, finger-tapping 23%, voice 17%, and reaction time 3%.

The analysis showed that the mPDS correlated well with the Movement Disorder Society Unified Parkinson Disease's Rating Scale total (correlation coefficient r=0.81; P*lt;0.001) and part III only (r=0.88; P<0.001), the Timed Up and Go assessment (r=0.72; P=0.002), and the Hoehn and Yahr stage (r=0.91; P<0.001). The measure detected symptom fluctuations with a mean intraday change of 13.9 points, and improved by 16.3 points when patients received dopaminergic therapy.
The mPDS needs to be validated further in a larger sample, the researchers noted. And while this approach was applied to a smartphone application, it could be extended to wearable sensors or other devices, Saria said.

The study was funded in part by the Michael J. Fox Foundation and the National Institute of Neurological Disorders and Stroke.

The authors reported having no conflicts of interest.

last updated 03.26.2018

• Primary Source

JAMA Neurology

Source Reference: Zhan A, et al "Using smartphones and machine learning to quantify Parkinson disease severity: The mobile Parkinson disease score" JAMA Neurology 2018; DOI:10.1001/jamaneurol.2018.0809.

Butterfly Network’s smartphone plug-in ultrasound wins FDA nod

With this your doctor, nurse or yourself could maybe diagnose % blockage in your carotid arteries. At least that is what a great stroke association would figure out if it is possible.

Butterfly Network’s smartphone plug-in ultrasound wins FDA nod

by Amirah Al Idrus |

Oct 27, 2017 11:54am

The portable iQ ultrasound-on-a-chip device is cleared for 13 applications, so physicians don't need to switch transducers when imaging different parts of the body. (Butterfly Network)

Butterfly Network’s ultrasound-on-a-chip technology snagged the FDA nod for 13 applications, the broadest clearance to date for an ultrasound transducer. The pocket-size transducer, which plugs into an iPhone, would expand the availability of diagnostic ultrasound imaging.

Traditional cart-based ultrasound machines comprise at least three transducers and are bulky, so they can be hard to get hold of or maneuver in the emergency room. They also use ceramic crystal materials called piezoelectrics to generate and receive sound, the National Institute of Biomedical Imaging and Bioengineering says.
Butterfly Network’s iQ device uses its ultrasound-on-a-chip technology, which integrates the capabilities of the three typical ultrasound probes into a single 2D matrix array comprised of thousands of microelectromechanical systems, the company said. This array is overlaid on an integrated circuit with electronics like those found in high-performance ultrasound systems.
RELATED: FierceMedicalDevices’ 2015 Fierce 15—Butterfly Network
A physician uses the hand-held device to scan a patient’s body and sees the imaging on an iPhone. Because the iQ system combines three transducers in one, the physician does not need to switch out transducers to conduct imaging on a different part of the body, saving valuable time. The images are then sent to the cloud for storage.
"Butterfly's Ultrasound-on-a-Chip technology enables a low-cost window into the human body, making high-quality diagnostic imaging accessible to anyone," said Butterfly CEO and founder Jonathan Rothberg in the statement. "Two-thirds of the world's population has no access to medical imaging, … and today our team is doing something about it. And they are just getting started."

Butterfly’s iQ is cleared for diagnostic imaging in 13 clinical applications, including musculoskeletal, cardiac and peripheral vessel applications. The device is priced at less than $2,000 and Butterfly will begin shipping systems in 2018.
"By removing the barrier of price, I expect Butterfly to ultimately replace the stethoscope in the daily practice of medicine. We can now provide a diagnostic system to address the millions of children that die of pneumonia each year and the hundreds of thousands of women that die in childbirth, and these are just two examples of the impact this technology will have,” said John Martin, M.D., Butterfly’s chief medical officer.
Philips has been working on a hand-held ultrasound too, but its Lumify smart-device system uses three transducers, like traditional systems. Last fall, the FDA cleared a cardiac transducer for use with Lumify, alongside two other transducers for OB/GYN and focused assessment with sonography for trauma examinations.

Smartphone apps launched for atrial fibrillation patients and their healthcare providers

In case you need to train your doctor on this.
http://www.alphagalileo.org/ViewItem.aspx?ItemId=179761&CultureCode=en

10 October 2017 European Society of Cardiology (ESC)

The two apps communicate to maximise face-to-face time
Novel smartphone and tablet applications (apps) for atrial fibrillation patients and healthcare professionals have been launched by heart experts. The objectives and design of the apps are outlined in a paper published online today in EP Europace,1 with a summary published in the European Heart Journal.2
Atrial fibrillation is the most common heart rhythm disorder and significantly increases the risk of stroke and death. One in four middle-aged adults in Europe and the US will develop atrial fibrillation, and the incidence and prevalence are rising.
“Around two-thirds of people in Europe and the US have a mobile device and use it as their main way of accessing online information,” said lead author Dr Dipak Kotecha, a clinician scientist in cardiovascular medicine at the Institute of Cardiovascular Sciences, University of Birmingham, UK. “This presents a big opportunity to improve self management and shared decision making in atrial fibrillation.”
The My AF app and AF Manager app were designed by the European Society of Cardiology (ESC) Guidelines Task Force on Atrial Fibrillation and the CATCH ME consortium of which the ESC is a partner. The apps were developed over the last two years in tandem with the writing of the 2016 ESC Guidelines on atrial fibrillation.3
Both apps are freely available for Android and iOS devices through the Google Play, and Apple stores (see figure 1).
My AF is for patients with atrial fibrillation. It provides information about the condition, the risk of stroke, atrial fibrillation treatments, and tips on improving lifestyle. Patients can record symptoms and quality of life in a diary which can be shared with a nominated health professional before each consultation to maximise face-to-face time.
Developed in collaboration with patients and patient support groups, My AF provides high quality information in a simple format which is suitable for adults of all ages. Work is underway to translate the app into several languages.
Dr Kotecha said: “The app aims to encourage active patient involvement in the management of their condition. There is evidence that patient education can improve self-care, adherence to therapy, and long-term outcomes.”
AF Manager is for doctors, nurses and other healthcare professionals. It is the first app of its kind to be submitted for CE certification and is in the final stages of approval. AF Manager imports information shared by the patient and allows the healthcare professional to amend details and enter other medical information, such as electrocardiogram or echocardiography data. The Treatment Manager tool within the app then suggests individualised treatment options based on ESC guidelines.4 After a consultation, the notes, treatment decisions, and medication dosages can be entered and then shared with the patient.
“Many studies have shown that when clinicians follow guideline recommendations, patients have better outcomes,” said Dr Kotecha. “All of the decision aids in AF Manager are based on ESC guidelines so we hope this will encourage guideline implementation. Patients will have the option to anonymously donate their data which will enable us to assess the guideline adherence rate.”
The apps are linked to allow transfer of data between patients and healthcare professionals via a secure server at the University of Birmingham, UK. Patients control who can view and edit their data. When data sharing is enabled, updates are synced on both apps. All shared information is encrypted and password protected.
Dr Kotecha said: “We know that effective management of atrial fibrillation is suited to shared decision making and we have created the apps in the hope of facilitating this process. Sharing information should save clinicians time and enable them to devote consultations to choosing the best treatments.”
He concluded: “The dynamic nature of this technology will allow us to modify and update the features and content to reflect feedback from users, as well as future versions of the ESC atrial fibrillation guidelines.”
More information at www.escardio.org/AF-apps
https://www.escardio.org/The-ESC/Press-Office/Press-releases/smartphone-app-directs-first-responders-to-cardiac-arrest-three-minutes-before-ambulance

• Full bibliographic information1 Kotecha D, et al. European Society of Cardiology (ESC) smartphone and tablet applications for patients with atrial fibrillation and their healthcare providers. EP Europace. 2017. DOI: 10.1093/europace/eux299
  https://academic.oup.com/europace/article-lookup/doi/10.1093/europace/eux299 (link will be live when embargo is lifted)
  2 Kotecha D, Kirchhof P. ESC Apps for Atrial Fibrillation. Eur Heart J. 2017;38:2643–2645.
  3 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37(38):2893–2962. doi: 10.1093/eurheartj/ehw210

New app picks up signs of stroke risk through your smart device

I wouldn't want this, it seems like it would drain my battery and I wouldn't want video being taken without my control. I never take selfies and I highly doubt most elderly people do. And then I would have to switch the camera from front to back. when I want to use it.
http://www.democratandchronicle.com/story/news/2017/09/18/looking-early-signs-heart-trouble-new-app-help/678184001/

You do a lot of things on your phone and tablet.

Now, they may be able to something for you — predict your risk of stroke or heart failure.

Scientists at the University of Rochester Medical Center and the Rochester Institute of Technology teamed up to use the camera on your smart device to pick up changes in your skin color that are too subtle for the eye to see.

“I call it a useful selfie,” said Jean-Phillippe Couderc, associate professor of cardiology at URMC, who helped develop and now is testing an app to detect the irregular heartbeat of atrial fibrillation, AF. “Everybody takes a selfie and shows their face. … This is a new way of using this kind of behavior.”

The app has been tested in the hospital with people who’ve undergone treatment for AF. The next step is to test it at home with people who have experienced AF to see if the app is as sensitive in a less controlled setting.

The research team received a $2 million grant from the National Institutes of Health. By spring, the team will begin to enroll up to 300 people who have been treated for AF to test the app outside a hospital setting.

Couderc and Gill Tsouri, associate professor in the department of electrical & microelectronic engineering at RIT, explain:

Gill Tsouri, associate professor of electrical engineering at Rochester Institute of Technology, is developing the video system algorithm and app for a new system to detect atrial fibrillation. RIT is working with URMC on the project, which received $2 million from the National Institutes of Health. (Photo: Provided by Rochester Institute of Technology)

What does the app do?

The app runs in the background while the person uses the device to do the usual activities — watch a movie, read, scroll Facebook or do email. Every so often, the app takes a 15- to 20-second video. Using sophisticated algorithms, those images can show changes in the face caused by the heart pumping blood. Based on what it sees, the app can infer cardiac activity.

Why is this big deal?

AF happens when the heart’s two upper chambers beat out of rhythm. AF can lead to serious problems — risk of stroke is five times higher in people with AF, according to the American Heart Association.

Story from Bob Johnson Chevrolet

Keeping teen drivers safer with tech innovations

Treatments are available, but many people don’t have symptoms such as dizziness, palpitations or shortness of breath, and so they don’t think they are at risk.

Aren’t there other ways to detect AF?

You can have an exam by your doctor, or use sensors that attach to your finger or earlobe. But those require you to do something. With this app, you wouldn’t have to do anything special. People spend a lot of time with smart technology, and this wouldn’t intrude on their day.

Sounds like Big Brother is watching. What happens with the video?

The images are not stored. Once the information is extracted, the videos are deleted.

Who came up with the idea?

Scientists from RIT and URMC regularly get together to exchange ideas, and this one hatched at such a meeting. It has taken about five years to get to this point.

Who is eligible for the study?

Right now, only people who have AF and are treated at URMC will be considered. The researchers want to make sure the app will pick up the signs in people who are known to have the condition, and this way they are able to save money by not having to screen the general population.

Cell phone woes at Winnipeg Folk Festival

That time of year again where a bunch of my college roommates get together.
One day our spot in the stage area was in full sun, maybe 85 degrees or so. I had my phone in my lap with the extra battery pack attached to it charging the phone back up. Fell asleep for 15 minutes or so. When I woke up the phone told me two apps had overheated and shut down. Then the notice came that the battery pack was too hot to charge the phone. Moved to a somewhat shady area and both recovered in a half hour.
Friday night walking back from the main stage to the parking lot my cell phone fell out of the holster, velcro had died. I wasn't worried about getting it back because we are in Canada and at a folk festival. It wasn't at lost and found at 10:30 the next morning but at 1:30 it showed up. At least a dozen iPhones were waiting to be reclaimed.
Got a text on Friday that I was supposed to travel back to New York by Wednesday, I was flying from Minneapolis to Lansing on Tuesday, luckily on Tuesday the date was pushed back to Thursday so at least I got some rest before being thrown back into the fray.

New app offers support to clinicians on rehabilitation strategies for stroke patients

So fucking what? Guidelines, NOT PROTOCOLS. By doing it this way they don't have to specify efficacy. Lazy bastards. But download and look thru this yourself, it does give guidelines for Mirror therapy and motor imagery and sensory training. But nothing for spasticity but botox. Nothing for hand/fingers. 

New app offers support to clinicians on rehabilitation strategies for stroke patients

A new, first-of-its-kind app is now available to support clinicians with decisions on best practice rehabilitation strategies for patients with arm impairment due to stroke.
The ViaTherapy app, developed through a worldwide collaboration of stroke rehab researchers co-led by Drs. Mark Bayley, Medical Director, Brain and Spinal Cord Rehab Program, Toronto Rehab and Steven Wolf of Emory University, is the result of a five-year process which aimed to make the Stroke Rehabilitation Guidelines more accessible to clinicians.
ViaTherapy translates the guidelines to a decision-making algorithm for occupational therapists and physiotherapists to use with their patients.
"The right treatment for a patient today may not be the right treatment for them in three weeks," says Dr. Bayley. "In a sports setting, a good coach will always progress training as the player gets better. We tried to capture how a clinician should also evolve therapy to involve new treatments depending on how far along the patient is in their recovery."
The app's internal algorithm considers information inputted by the clinician: how long it has been since the patient's stroke, how severe their impairment is and whether they have any additional medical conditions. Based on these factors, it offers a list of suggestions of which rehabilitation exercises would best promote progress for the patient, such as assessments of certain movements and electrical stimulation for motor recovery.
According to Dr. Bayley, earlier research showed that because clinicians commit a large portion of their workdays to patient care, they often don't have the capacity to search the literature for evidence-based therapies, or didn't necessarily have the confidence to evaluate existing research on their own.

Related Stories

• Early treatment with stem cells can safely help recovery in stroke patients, study shows
• MGH scientists develop software that provides automated support for diagnosing cause of stroke
• WHO classifies stroke as neurological disease

"After processing vast amounts of rehab literature, we created this app which would close that gap," says Dr. Steven Wolf, Professor, Department of Rehabilitation Medicine, Emory University School of Medicine. "ViaTherapy will assist clinicians in recalling established therapies and learning about new ones."
From experience using the app personally and with Occupational Therapy students, Debbie Hebert, Clinic Lead for the Rocket Family Upper Extremity Clinic at Toronto Rehab, says this is a great tool for clinicians of all experience levels.
"It saves you a step – instead of looking through the evidence, it brings you to it right away which allows you to go into the techniques," says Hebert, who is also the Practice Lead in Occupational Therapy at Toronto Rehab.
"It doesn't take the art of physiotherapy or occupational therapy away in any way," she says. "The choice is still up to the clinician. This just helps you make sure you're considering all of the treatment options for your particular patient."
While the app is only available for stroke patients with upper extremity movement loss, Dr. Bayley sees an opportunity to one day expand it to various areas of rehabilitation medicine.
"This type of application has the potential to support clinicians who work with patients with Multiple Sclerosis, spinal cord injury and many other conditions that limit movement," he says. "In order to give the patient the best treatment available, this is how rehabilitation medicine should present its guidelines."

Source:

http://www.uhn.ca/corporate/News/PressReleases/Pages/First_of_its_kind_app_offers_personalized_rehab_therapy_for_stroke_patients.aspx

Mobile Tablet-Based Stroke Rehabilitation: Using mHealth Technology to Improve Access to Early Stroke Rehabilitation

Well shit, using smart phones or tablets for rehab has been out there for years.

PRELIMINARY EVALUATION OF A MOBILE APP FOR EVERYDAY STROKE REHABILITATION Dec. 2016 

Researchers devise a smarter way for stroke patients to rehabilitate June 2016 

All-female team merges high tech and high touch to serve stroke survivors - smartphone monitoring  Nov. 2015 

ARMStrokes: A Mobile App for Everyday Stroke Rehabilitation Oct. 2015 

The untapped potential of smartphone sensors for stroke rehabilitation and after-care  Oct. 2015 

The latest here:

Mobile Tablet-Based Stroke Rehabilitation: Using mHealth Technology to Improve Access to Early Stroke Rehabilitation

Michael William Pugliese, Kumanan Wilson, Julien Guerinet, Katherine M Atkinson, Karen H Mallet, Rany Shamloul, Lise Zakutney, Dale Corbett, Dar Dowlatshahi

Abstract

Mobile health (mHealth) technology represents a means through which more stroke survivors could access early stroke rehabilitation. Although rehabilitation is most effective when begun early post-stroke, limited resources (facilities, therapists) prevent survivors from initiating therapy. Furthermore, the coupling of an aging population with advances in acute therapy has led to an increase in the absolute number of individuals suffering from and surviving strokes which in turn has put further strain on already scarce rehabilitation resources. There is an urgency to conduct high-quality research exploring cost-effective and creative mHealth devices for early rehabilitation in the acute setting. Mobile technology allows therapists to prescribe apps based on standard cognitive/physical assessments in the acute setting, remotely monitor patient progress across individual carepaths, and update prescribed therapies based on patient feedback and recovery. Recognition of the growing problem of accessing early stroke rehabilitation, and the possibilities offered by mHealth technology led to the development of the RecoverNow platform for stroke rehabilitation in the acute setting. RecoverNow is a custom built, tablet-based stroke rehabilitation platform that houses a variety of previously existing apps with activities analogous or identical to exercises in speech language and/or occupational therapy. While RecoverNow represents how mobile technology can be utilized to address a growing public health issue, the feasibility, acceptability and efficacy of tablet-based stroke rehabilitation are unknown. Studies with the goal of establishing feasibility of early tablet-based stroke rehabilitation are needed and, if appropriate, a randomized controlled trial to establish efficacy.

Keywords

aphasia, mobile tablet; recovery; stroke

Full Text:

PDF

Happier People Live More Active Lives: Using Smartphones to Link Happiness and Physical Activity

What precisely is the happiness protocol your doctor has for you? And not just exercise more since your doctor did nothing to prevent a lot of the damage by stopping the 5 causes of the neuronal cascade of death in the first week. Thus leaving you too disabled to easily exercise.
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0160589

• Neal Lathia,
• Gillian M. Sandstrom,
• Cecilia Mascolo,
• Peter J. Rentfrow

• Published: January 4, 2017
• http://dx.doi.org/10.1371/journal.pone.0160589

Abstract

Physical activity, both exercise and non-exercise, has far-reaching benefits to physical health. Although exercise has also been linked to psychological health (e.g., happiness), little research has examined physical activity more broadly, taking into account non-exercise activity as well as exercise. We examined the relationship between physical activity (measured broadly) and happiness using a smartphone application. This app has collected self-reports of happiness and physical activity from over ten thousand participants, while passively gathering information about physical activity from the accelerometers on users' phones. The findings reveal that individuals who are more physically active are happier. Further, individuals are happier in the moments when they are more physically active. These results emerged when assessing activity subjectively, via self-report, or objectively, via participants' smartphone accelerometers. Overall, this research suggests that not only exercise but also non-exercise physical activity is related to happiness. This research further demonstrates how smartphones can be used to collect large-scale data to examine psychological, behavioral, and health-related phenomena as they naturally occur in everyday life.

  

Citation: Lathia N, Sandstrom GM, Mascolo C, Rentfrow PJ (2017) Happier People Live More Active Lives: Using Smartphones to Link Happiness and Physical Activity. PLoS ONE 12(1): e0160589. doi:10.1371/journal.pone.0160589

PRELIMINARY EVALUATION OF A MOBILE APP FOR EVERYDAY STROKE REHABILITATION

Once again working on the edges of useful stroke research, the rehabilitation silo only works fully 10% of the time. In other words a complete failure. 

PRELIMINARY EVALUATION  OF A MOBILE APP FOR  EVERYDAY STROKE  REHABILITATION

Sonia Lawson*, Jin Guo, Ted Smith, Ziying Tang, Jinjuan Feng

*

Dept. of Occupational Therapy &

Occupational Science

,

Dept.

of Computer and

Information Sciences

Towson

University

ABSTRACT
A smartphone-based    rehabilitation    approach called ARMStrokes was developed that provides real-time  support  for  stroke survivors to  complete rehabilitation exercises  for
upper  extremity  recovery.  A pilot study of 10 stroke survivors was conducted to
examine  the  usability  and usefulness of  the application.  In  addition,  a  web-based  collaborative communication  system  was  evaluated for usability and  efficiency  by    therapists,  physicians,  and caregivers  monitoring  client  adherence  to  prescribed
home exercise  programs.  Post-test   quantitative improvements  were  noted  and  feedback  from focus groups involving stroke survivors, caregivers, and therapists  have  been  positive.  The  findings  assisted with  modifications  to  the  app  and the collaborative system.

MindSurf: A pilot study to assess the usability and acceptability of a smartphone app designed to promote contentment, wellbeing, and goal achievement

You need contentment, wellbeing, and goal achievement. What protocols does your doctor have for these needs? ANYTHING AT ALL? Big Whoopee, trying to make you feel better rather than actually address the underlying causes of your lack of  contentment, wellbeing, and goal achievement
https://www.mdlinx.com/family-medicine/medical-news-article/2016/12/13/mental-health-smartphone-app/6979222/? 

 

BMC Psychiatry, 12/13/2016

Carey TA, et al. – A pilot study was conducted to survey the usability and acceptability of receiving Method of Levels (MOL)–style questions via intermittent daily text messages. The findings demonstrate that MindSurf will be a usable and acceptable app.

Methods

• A pilot study utilizing quantitative as well as qualitative methods and incorporating a repeated measures, A-B design was directed.

Results

• The 23 members were healthy adult volunteers who were all either undergraduate students, postgraduate students, or staff of the University of Manchester.
• They got MOL-style questions on their mobile phones over a 1-week period.
• Qualitative outcomes were encouraging and demonstrated that the format and style of questioning were acceptable to participants and did not lead to increased worry or concern.
• A one-way, repeated measures ANOVA demonstrated that there was a nonsignificant decrease in scores on the 21-item Depression, Anxiety, and Stress Scale (DASS21) over a 2 week period.

Go to Abstract Print Article Summary Cat 2 CME Report

Cognitive offloading: Help or hindrance?

This is an interesting conundrum for you and your doctor to solve. How much of your use of technology; smartphones, tablets, calculators is compensation vs. recovery.  Do you need to ditch these because in order to recover better you need to do everything the hard way to get the fastest recovery? My example is; when I moved to Michigan I did not use a GPS to get around, I needed to learn the streets and addresses the normal way, by repetition. I didn't go all the way because I still relied on my phone to keep track of phone numbers, probably setting back my memory skills. Discuss.
http://exclusive.multibriefs.com/content/cognitive-offloading-help-or-hindrance/education

Roughly two-thirds of Americans (68 percent) have smartphones, and nearly half (45 percent) own tablet computers. Such devices tell us the time, date, sunrise, sunset, weather, what we need to do, when we need to do it and how we can get there. We can sync our calendars as well as our grocery to-do lists on all our devices. 
 
We use technology to carry out even the simplest of tasks. Instead of writing, we type. Instead of using our mental math skills, we use a calculator.
As an extension of our brains, these electronic devices help us to be faster and more efficient. They save us from needing to remember and reduce the effort necessary to perform a mental task. But are all these devices contributing to a weak memory muscle?
Memory is of such critical importance to our very existence. Like most of the brain's processes, memory remains a bit of a mystery. We often talk about memory as a single thing, when, in fact, it's a congregation of several complex processes.
As such, managing incoming information is also a complex function, involving the limbic system — the hippocampus, amygdala, cingulate gyrus, thalamus, hypothalamus, epithalamus, mammillary body and other organs, many of which are relevant to the processing of memory.
According to Evan F. Risko, a Canada Research chair in Cognitive Psychology at the University of Waterloo, and co-author Sam Gilbert, a Royal Society research fellow at University College London, if we program a smartphone to remind us of an upcoming appointment, we have engaged in "cognitive offloading." This means we are using physical action to alter the information processing requirements of a task to reduce cognitive demand.
We write appointments down and set reminders with our smartphones or tablets, eliminating the need to use our internal cognitive abilities because we think we are being more efficient or simply because we are on mental overload. Offloading may helps us get more done faster, but storing information on our smartphones, computers or tablets may cause us to become reliant on them, ultimately affecting how we remember.
To test this theory, Risco and Gilbert sent participants off to a museum equipped with digital cameras. What they discovered was that taking photographs of objects degraded participants' abilities to remember what they saw compared to the objects they didn't photograph.
In an earlier study, when participants took a photo of each object as a whole, they remembered fewer objects and fewer details about the objects and the objects' locations in the museum than if they only observed the objects without photographing them. When participants zoomed in to photograph a specific part of the object, their subsequent recognition and detail memory was not impaired. In fact, memory for features that were not zoomed in on was just as strong as memory for features that were zoomed in on.
Risko and Gilbert plan to focus on the way offloading changes the way we think in addition to what's happening in the brain when we offload. They are also interested in the long-term consequences of living in busy, high-tech environments that encourage us to constantly offload our cognition.
According to Risko, there is much discussion about whether devices like smartphones are ruining us cognitively, but research addressing the long-term cognitive consequences of offloading to a variety of devices is limited at this point in time.

About the Author

Dorothy L. Tengler, MA, is a freelance medical writer/communication specialist with nearly 20 years of experience in the pharmaceutical and medical communication industries. She has developed educational and medical marketing materials, including monographs, slide kits, health articles, primary and review manuscripts, and pharmaceutical sales training materials.

Researchers devise a smarter way for stroke patients to rehabilitate

Actually college students did this. Why don't our stroke associations put out a challenge to students to design stroke rehabilitation interventions? Probably much more innovative stuff will come out of that than anyplace else. But we have ossified thinkers in our stroke associations and our boards of directors are ok with such incompetence. I bet this will never make it to a stroke protocol because we have NO stroke leadership pushing good ideas forward.
http://medicalxpress.com/news/2016-06-smarter-patients.html
 Inexpensive Wearables and a Smartphone Aid Stroke Rehabilitation. Credit: New York University
A team of students from the NYU Tandon School of Engineering is using smartphones to improve the arduous and repetitive process patients must typically undergo to relearn the basic skills they lose after suffering a stroke.

The centerpieces are wearable mechatronic devices: a jacket to measure arm placement, a glove to measure wrist and finger placement and finger joint angles, and a finger trainer built of hand-friendly, compliant material. All are connected inexpensively by a smartphone. When a patient performs an exercise assigned by a physician or physical therapist, microcontrollers quantify the action—measuring grip strength, for example—and display that information via the smartphone to both the patient and medical provider. Rather than mindlessly repeat the exercise, patients engage in a virtual reality game that allows them to observe the performance of the unaffected side of the body and mimic the same performance on the affected side.
Rehabilitation in a clinical setting renders patients dependent on caregivers and therapists, but using smartphone technology allows stroke survivors to make great strides within their own homes, boosting morale and motivating them to continue rehabilitating their stroke-related disabilities. Because the microcontrollers are attached to easy-to-wear garments, exercising can be seamlessly integrated into a patient's day-to-day activities rather than treated as a separate, unwelcome task. Additionally, the cost-effective system, which the students project will sell for under $1,000, provides measurement results correlating to existing research-standard devices selling for eight times that amount.

Elements of low-cost tele-rehabilitation system. Credit: New York University

"Smartphone-integrated stroke rehabilitation is a marked improvement over the conventional treatment programs of the past," said NYU Tandon Professor of Mechanical and Aerospace Engineering Vikram Kapila, who guided the students. "The medical community acknowledges that while the central nervous system is highly adaptive and has the ability to regain functions with concerted effort, a patient must assiduously practice those regained skills. This makes stroke rehab a long and sometimes trying ordeal. Providing patients with immediate feedback and placing that feedback in the context of a virtual reality game that they can use within their own homes is definitely encouraging and motivational."
In addition to Kapila, who oversees NYU Tandon's Mechatronics Lab, Preeti Raghavan, M.D., of NYU Langone's Rusk Rehabilitation Ambulatory Care Center helped Ashwin Raj Kumar and Sai Prasanth Krishnamoorthy, the students who helped transform the original idea into a working prototype.
The team recently took third place in BMEidea, the nation's leading competition for biomedical and bioengineering students. The annual challenge is sponsored by VentureWell, a nonprofit higher education network that cultivates revolutionary ideas and promising inventions. The entries—each of which must pioneer a health-related technology that addresses a real clinical need—are judged on technical, economic, and regulatory feasibility; contribution to human health and quality of life; technological innovation; and potential for commercialization.

Special jacket for stroke rehabilitation. Credit: New York University

"It is an honor to place in a competition as prestigious as BMEidea," said Raj Kumar, a doctoral candidate in mechanical and aerospace engineering. "We are very grateful for the guidance and mentoring of Professor Kapila and Dr. Raghavan."
Added Krishnamoorthy, a master's degree student in mechatronics and robotics engineering: "We are also excited that our work may one day make life easier and more rewarding for the many people who suffer from strokes each year."
"I congratulate the students and their faculty mentors on this recognition," NYU Tandon Dean Katepalli R. Sreenivasan said. "This is a testament to both the fine quality of our aspiring engineers and NYU's commitment to invaluable cross-disciplinary research that allows technology to be used in service to society."
Next steps for the students include forming a company with the patent-pending technology and launching a startup at the NYU Tandon new-business incubators. They are currently refining their prototype and expect to shortly begin working with several patients from around the world including their native India.

Training fingers to react properly. Credit: New York University 

Pictures at link.

Pilot study finds smartphones may decrease sedentary time, increase physical activity

I could easily see a stroke app reminding you of your therapies you need to be doing and foods to be eating. But this will never occur under the existing stroke leadership of our fucking failures of stroke associations. You are going to have to write your own app, good luck with that.
http://www.mdlinx.com/internal-medicine/top-medical-news/article/2016/02/01/4

American Cancer Society News

Report calls use of prompts “a promising strategy”.
A pilot study finds that using smartphone reminders to prompt people to get moving may help reduce sedentary behavior. The study was supported by the American Cancer Society, with technical expertise provided by the e–Health Technology Program at the MD Anderson Cancer Center. It appears in the Journal of Medical Internet Research. Evidence has linked sedentary time to increased risk of breast, colorectal, ovarian, endometrial, and prostate cancers as well as weight gain, higher BMI, and obesity. Nevertheless, adults in the U.S. spend an average of about 8 waking hours per day being sedentary. Participants wore accelerometers, to measure movement, and carried smartphones for seven consecutive days. Participants who reported more than two hours of sitting during the previous day or replied that they were sitting during any random smartphone assessment received a message emphasizing that long uninterrupted sitting is bad for health, and encouraging them to stand up and move around more, and to sit less. Over the seven–day study period, participants had significantly fewer minutes of daily sedentary time and more daily minutes of active time than controls. Accelerometers recorded three percent less sedentary time than control participants, equaling about 25 minutes of time spent engaged in activity rather than in sedentary behavior on any given day. Due to the pilot nature of the study it had inherent limitations that should be noted: it was not randomized and the duration was brief. Nonetheless, the authors say: “Overall, simple smartphone prompts appear to be a promising strategy for reducing sedentary behavior and increasing activity, though adequately–powered and well–designed studies will be needed to confirm these preliminary findings. “

All-female team merges high tech and high touch to serve stroke survivors - smartphone monitoring

This makes a lot of sense except that lots of survivors are one-handed and use that hand to get various body parts into the correct position. But better than nothing.
http://thedailyrecord.com/2015/11/27/all-female-team-merges-high-tech-and-high-touch-to-serve-stroke-survivors-2/
Three professors at Towson University have developed a mobile app called ARMStrokes that allows stroke survivors to use a smart phone to perform their rehab exercises anywhere.
Stroke is a major contributor to adult disability in many countries. According to the Centers for Disease Control and Prevention, more than 795,000 people in the United States have a stroke each year. Stroke often causes long-term disabilities that affect cognitive, physical, and speech functions. Prompt and intensive rehabilitation exercise is critical for stroke recovery. However, only 31 percent of stroke survivors actually complete recommended exercise due to a variety of factors, including issues of accessibility and lack of motivation.
Smartphones are easily accessible and can be carried anyplace. They also do not require complicated installation or configuration processes, and can serve as a resource for learning and entertainment. With the proper app, smartphones can be used as a rehabilitation platform. Individuals can play rehabilitation games delivered through mobile phones while watching TV, relaxing in the park, or even waiting in line in a grocery store. In addition to the benefit of easy access, the mobile phone can also support timely communication between stroke survivors, therapists and their caregivers, so that compliance to in-home exercise programs and progress can be monitored effectively.
“Since the functionality of stroke patients varies dramatically, ARMStrokes can be easily customized to fit each stroke survivor’s specific functionalities in different recovery stages,” says Dr. Sonia Lawson who works in the area of adult neurological conditions and stroke rehabilitation in the Department of Occupational Therapy and Occupational Science. Completing the interdisciplinary team is Dr. Katherine Tang and Dr. Heidi Feng, who are both members of the Department of Computer and Information Sciences faculty. Dr. Tang’s research focuses on multimedia and game design. Dr. Feng is an expert in assistive technologies, human computer interaction and health informatics.
During each exercise session, the app guides the user through a series of gross motor movements (movements that use the large muscles in the arms, legs, torso and feet) and provides visual, audio and haptic feedback, usually in the form of phone vibrations, according to the quality of the movement performed.

Figure 2. Screenshots for daily goals and calibration settings.

ARMStrokes supports several arm motions such as shoulder flexion, abduction, elbow flexion and extension, and forearm pronation/supination. Built-in smartphone sensors detect the excursion of movements – number of repetitions and degree of movement – and transmit the data to a secured server. With a password, a therapist, caregiver or user can access the secured data server via a website to track performance and progress over time and improve therapy outcomes. The therapist can also make modifications to exercise programs remotely through the secure network.
The research team is conducting a field study in collaboration with the University of Maryland Rehabilitation and Orthopaedic Institute to evaluate the app without patients.
The project is supported by both the Aetna Foundation and the School of Emerging Technologies at Towson University. More information about the project is available at www.tustroketech.com.

Read more: http://thedailyrecord.com/2015/11/27/all-female-team-merges-high-tech-and-high-touch-to-serve-stroke-survivors-2/#ixzz3sj0aSPlf

Not paying attention - smartphone

Last week Thursday at the client I managed to have my smartphone unclip from the belt and fall into the toilet. At least it was after the flush. I should have been on the lookout since the weekend of the wine party I managed to bounce the phone off the toilet seat onto the floor. That night on the flight home it managed to sporadically be useable, most of the time just flashing pixels at me. Luckily when I got my phone a month ago it automatically came with insurance.  The replacement showed up at my apartment today(Monday) while I'm in New York again with a loaner phone, texting and phone calls basically. Luckily I must have somehow put my hundreds of contacts into the cloud and thus didn't have to try to recreate that. My pictures I don't know if they are salvageable yet.

I'm sure you'll have to get this thru your doctor. You wouldn't want to take your own initiative about your recovery because your ideas might conflict with your doctors ideas on getting you to 100% recovery. You do have a stroke protocol to get you to 100% recovery ? DON'T YOU?
http://dl.acm.org/citation.cfm?id=2811337

		SIGN IN   SIGN UP

ARMStrokes: A Mobile App for Everyday Stroke Rehabilitation Full Text: PDF Authors: Jin Guo Towson University, Balitmore, USA Ted Smith Towson University, Baltimore, USA David Messing Towson University, Baltimore, USA Ziying Tang Towson University, Baltimore, USA Sonia Lawson Towson University, Baltimore, USA Jinjuan Heidi Feng Towson University, Baltimore, USA 2015 Article Demonstration   Bibliometrics · Downloads (6 Weeks): 5 · Downloads (12 Months): 5 · Downloads (cumulative): 5 · Citation Count: 0 Published in: · Proceeding ASSETS '15 Proceedings of the 17th International ACM SIGACCESS Conference on Computers & Accessibility Pages 429-430 ACM New York, NY, USA ©2015 table of contents ISBN: 978-1-4503-3400-6 doi>10.1145/2700648.2811337

Tools and Resources Save to Binder Export Formats: BibTeX EndNote ACM Ref Share: Share on email Share on facebook Share on google_plusone_share Share on twitter Share on researchgate Share on reddit | More Sharing Services

Contact Us | Switch to single page view (no tabs)

Abstract

Authors

References

Cited By

Index Terms

Publication

Reviews

Comments

Table of Contents

In this paper, we present a novel smartphone-based rehabilitation approach called ARMStrokes
that provides real-time support for stroke survivors to complete rehabilitation exercises for upper
extremity recovery. ARMStrokes allows stroke survivors to exercise through interactive games
anytime and anywhere and receive instant feedback about the quality of their performance.
Stroke survivors can also communicate with their therapists or physicians through the
supporting web-based platform. Focus groups involving stroke survivors, caregivers, and
therapists have been conducted to evaluate the system and the feedback is highly positive.