A solution from the videogame world—Kinect for Windows—could become a revolutionary new way for patients with Parkinson's disease to do rehab at home, and for physicians to remotely monitor how a person’s medication works. It also shows that telemedicine does not have to be expensive.
Do we really need special devices and highly advanced and expensive technology for telemedicine? Maybe in some cases, but as consumer technology evolves and gains more advanced functionality, it will be more than sufficient for many cases of telemedicine.
One example of consumer technology that is more than suitable to use in telemedicine is Kinect. Out of the box, it comes with functionality such as depth sensing, HD video, and skeleton tracking.
We at Softronic in collaboration with Karolinska University Hospital, are conducting a project called Kinecting Parkinson's to demonstrate the ability of a more cost-efficient way to do follow-up. The goal is to make this available for a larger number of patients with Parkinson's disease.
We have verified the technical platform, and the software supports five movements based on the standardized scale Unified Parkinson’s Disease Rating Scale (UPDRS). Examples of the movements are
- Finger taps where the patient taps the thumb with the index finger in rapid succession
- Leg Agility where the patient taps heel on the ground in rapid succession picking up entire leg
- Rapid Alternating Movements of Hands - Pronation-supination movements of hands, vertically and horizontally, with as large an amplitude as possible, both hands simultaneously
The purpose of the movements is to evaluate the motoric functions of the patients. Data from the movements are analyzed and presented in an interface that the doctor can use to make an assessment of the patient. Softronic and Karolinska have started patient trials.
The use of Kinect for telemedicine received a lot of interest from the doctors attending the Neurology and Care at a Distance conference, which gathered some of the world’s leading neurologists. The combination of a much lower price than standard telemedicine equipment with the possibility of remote assessment and remote visits seems to be a winning combination—at least according to the comments of the doctors. Also the fact that the doctor can choose to assess the exercises live or examine the graphs and a video of the exercises at a later time was seen as big advantage.
This also enables more efficient follow ups. Today patients with Parkinson's disease see their doctor once or twice a year. Giving the doctor the possibility of remote assessment, the doctor can also do follow-ups of patients on the basis of when needed instead routinely once or twice a year. Thus, the doctor will be able to focus on the patients that need follow ups. By using the Kinect the doctor will also have the possibility to do the follow up remotely and only the patients that really need to will have to visit the doctor at the hospital.
Another advantage of using Kinect is that it is a device that you can find in many households. As a patient, the device would not prompt a lot of questions because it does not “signal” that you are suffering from a disease.
In the future we see additional functionality being added. We are now in the process of looking into gamification and using this both as a way to make rehabilitation more fun and to involve the patients’ relatives in the rehabilitation. Imagine a situation where grandchildren playing a game with their grandfather would help with rehabilitation.
The solution can also be used to educate neurologists specializing in Parkinson’s disease and for second opinions. This will be possible since we record and save the movements. When a second opinion is needed it the exercises will be available for assessment. Either the patient or the treating doctor can initiate the initiative for a second opinion.
We also hope to be able to crowd-source the data collected from the exercises, allowing patients to upload their data to patient communities or to personal health records such as Microsoft HealthVault.
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