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Title: Review: How Can Intelligent Robots and Smart Mechatronic Modules Facilitate Remote Assessment, Assistance, and Rehabilitation for Isolated Adults With Neuro-Musculoskeletal Conditions?
Worldwide, at the time this article was written, there are over 127 million cases of patients with a confirmed link to COVID-19 and about 2.78 million deaths reported. With limited access to vaccine or strong antiviral treatment for the novel coronavirus, actions in terms of prevention and containment of the virus transmission rely mostly on social distancing among susceptible and high-risk populations. Aside from the direct challenges posed by the novel coronavirus pandemic, there are serious and growing secondary consequences caused by the physical distancing and isolation guidelines, among vulnerable populations. Moreover, the healthcare system’s resources and capacity have been focused on addressing the COVID-19 pandemic, causing less urgent care, such as physical neurorehabilitation and assessment, to be paused, canceled, or delayed. Overall, this has left elderly adults, in particular those with neuromusculoskeletal (NMSK) conditions, without the required service support. However, in many cases, such as stroke, the available time window of recovery through rehabilitation is limited since neural plasticity decays quickly with time. Given that future waves of the outbreak are expected in the coming months worldwide, it is important to discuss the possibility of using available technologies to address this issue, as societies have a duty to protect the most vulnerable populations. In this perspective review article, we argue that intelligent robotics and wearable technologies can help with remote delivery of assessment, assistance, and rehabilitation services while physical distancing and isolation measures are in place to curtail the spread of the virus. By supporting patients and medical professionals during this pandemic, robots, and smart digital mechatronic systems can reduce the non-COVID-19 burden on healthcare systems. Digital health and cloud telehealth solutions that can complement remote delivery of assessment and physical rehabilitation services will be the subject of discussion in this article due to their potential in enabling more effective and safer NMSDK rehabilitation, assistance, and assessment service delivery. This article will hopefully lead to an interdisciplinary dialogue between the medical and engineering sectors, stake holders, and policy makers for a better delivery of care for those with NMSK conditions during a global health crisis including future pandemics.  more » « less
Award ID(s):
2031594 2037878
NSF-PAR ID:
10232258
Author(s) / Creator(s):
; ;
Date Published:
Journal Name:
Frontiers in Robotics and AI
Volume:
8
ISSN:
2296-9144
Format(s):
Medium: X
Sponsoring Org:
National Science Foundation
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    Methods

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    Results

    In addition to telehealth and telerobot advantages, evidence from the literature suggests 3 promising robot-mediated supports that contribute to optimal child development—belonging, competence, and autonomy. These robot-mediated supports may be leveraged for improved pediatric patient socioemotional development, well-being, and quality-of-life activities that transfer traditional developmental and behavioral experiences from organic local environments to the remote child.

    Conclusions

    This review contributes to the creation of the first pediatric telehealth taxonomy of care that includes the personal use of telehealth technologies as a compelling form of telehealth care.

     
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    Results

    In this paper, we provide a critical review of how a rural hospital adapted its health care approach to incorporate telehealth services and distance services to meet the needs of a diverse population.

    Conclusions

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    Conflicts of Interest

    None declared.

     
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  5. Abstract Introduction

    Utilization of telemedicine for health care delivery increased rapidly during the coronavirus disease 2019 (COVID‐19) pandemic. However, physical examination during telehealth visits remains limited. A novel telerehabilitation system—The Augmented Reality‐based Telerehabilitation System with Haptics (ARTESH)—shows promise for performing synchronous, remote musculoskeletal examination.

    Objective

    To assess the potential of ARTESH in remotely examining upper extremity passive range of motion (PROM) and maximum isometric strength (MIS).

    Design

    In this cross‐sectional pilot study, we compared the in‐person (reference standard) and remote evaluations (ARTESH) of participants' upper extremity PROM and MIS in 10 shoulder and arm movements. The evaluators were blinded to each other's results.

    Setting

    Participants underwent in‐person evaluations at a Veterans Affairs hospital's outpatient Physical Medicine and Rehabilitation (PM&R) clinic, and underwent remote examination using ARTESH with the evaluator located at a research lab 30 miles away, connected via a high‐speed network.

    Patients

    Fifteen participants with upper extremity pain and/or weakness.

    Interventions

    Not applicable.

    Main Outcome Measures

    Inter‐rater agreement between in‐person and remote evaluations on 10 PROM and MIS movements and presence/absence of pain with movement was calculated.

    Results

    The highest inter‐rater agreements were noted in shoulder abduction and protraction PROM (kappa (κ) = 0.44, confidence interval (CI): −0.1 to 1.0), and in elbow flexion, shoulder abduction, and shoulder protraction MIS (κ = 0.63, CI: 0 to 1.0).

    Conclusions

    This pilot study suggests that synchronous tele‐physical examination using the ARTESH system with augmented reality and haptics has the potential to provide enhanced value to existing telemedicine platforms. With the additional technological and procedural improvements and with an adequately powered study, the accuracy of ARTESH‐enabled remote tele‐physical examinations can be better evaluated.

     
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