Department of Health Care Science

The Department

CliveThursfield

David Pratt

David Harrison

Tom Stone

Jemma Newman

MikeRyan

RalfPalmer

JohnSpriggs

GeoffHarbach

5 RegionalRehab

Engineers

MarkTuckerpart II

trainee

HelenDaviespart I trainee

Kevin McGrath

Clinical Scientist

Clinical Technologists

Technicians

Clinical Scientist Trainees

ACT

CML

Project Work

Project Overview

HCS

ACT- clinical workCML-

clinical work

Cognitive Therapy

Devices Clinic

Posturography

Head Mouse

Virtual Reality Gait Re-training

Voice Recorder

Eye Gaze

Upper Limb Lycra Evaluation

Wheelchair Collision

Avoidance

Attention Call Response Monitoring

Amputee Rehabilitation

Prosthetic Socket Interface Pressure

Measurement

Quality System Development

Orthotic Serial

Casting

Biofeedback Weight Bearing

Average Gait

Velocity

Animated Exercise

Activities Daily Living

Measurement

Dysphagia Re-training

VR Errorless Learning

Transfemoral Amputee

Assessment

Environmental Control

Assessment Procedures

Lecturing MEng Biomedical Engineering

EMG Reporting

Methodology

CML Kinematics Modelling

External Devices Power Supply for

Wheelchairs Visual Display Depth

Prosthetic Liner

…….

Overview

Today we will cover

– project examples

– Current services

– Some future Projects

Product Evaluation

Head Control of PC

Use your head..

Camera sits on monitor of PC

User wears reflective dot on

head.

Camera sees where the dot is and tells the computer to move

the mouse on the screen

Head Mouse Evaluation

• Only had one device to issue to patients £800 each

• Required technical and clinical evaluation of devices

• Comparison of dedicated head mice and web camera performances

• Potential Cost Savings so far this year of £2750

Virtual Reality

Dr. Thomas Stone Healthcare Science ©2008

Virtual Reality

• Using Virtual Worlds– Cognitive behavioural therapy– Errorless route learning– Augmenting traditional intensive

therapy

• Highly novel work– IP exploitation– “Paradigm” shifting

Photo’s courtesy of the Serious Games Department Birmingham University

Virtual Reality Gait Training

• Clinical need from medical staff for gait retraining in safe environment.

• Development of virtual environment and physical interface.

• Measure movement using current motion analysis suite in CML.

Set Up

• Treadmill, projector and screen

Clinical Measurement Laboratory

Using CML Motion Capture system to record patient movement

Sports Injury

Effectiveness and Efficiency

Fully utilising expensive specialist equipment

– Supporting clinical services by income generation.

– Advancing Diagnostic Movement Analysis

Preventing the future Tiger from injury…

Keeping the amateur Ashes wanabee healthy…?

New Design and Development

Design and production of specialised patient equipment

There are no low-cost, simple body-worn communication aids

Therapist identified problem

•High level design skills•Use of sophisticated software•Communication with industry

•Design of prototype•Promotion with MidTech•Potential IP and income generation

Portable Communication

Income Generation

Collision Avoidance

Clinical Researchand

Evidence Base

Measuring effectiveness

• How do we know if what we are doing is effective ?

• How do we compare alternative therapies ?

• How do we prioritise input ?• Measurement of Impairment

Posturography

Physiotherapists want to measure and record the balance of stroke recovery patients

Possible solution is use of a force platform

Highly Accurate

Very expensive

Concreted in laboratory

• Solution was to produce a mechanism to record the position of a digital pen on a digital tablet

• In-house data collection software is also being developed with input from the end user

• Quick and easy to implement

• Clinically viable?? – currently trialling with MSc student (University of Birmingham)

Dr. Thomas Stone Healthcare Science ©2008

Activities of Daily Living

• Quantifying Change– Investigating activity changes in patients– How does therapy affect change

• Ambulatory monitoring– Away from clinical environment

• Links to tele-rehabilitation and tele-health

Dr. Thomas Stone Healthcare Science ©2008

Activities of Daily Living

• Evaluate user feelings about new tools– Acceptance– Dignity

• Collaboration with industry– Get what we want, not what we’re given

• Monitor improvement– In “everyday” context– We know we make a difference but can

we prove it?

Foot Pressure Measurement

Current reporting methods for clinical foot pressures ambiguous

Clinical Scientist attended manufacturer training

Understand the equipment - hardware + software

Literature evidence

Feedback to MDT

New reporting methods being implemented

• Working towards implementing these measures into regular clinical practice within orthotics

• Evidence based practice

• Clinical effectiveness and biofeedback for patient

Lycra® Effectiveness

Measuring effect of Lycra® splinting on function in patients with multiple sclerosis

Healthcare Science used digital reaching tasks and functional movement to better quantify movement

Mean Jerk for movement

0

2000

4000

6000

8000

Without Lycra(n=2)

With Lycra(n=2)

Healthy control(n=12)

Jerk

(cm

/s3)

Historical measures qualitative – Clinicians observing tasks before and after Lycra® intervention

• Quick and easy to implement

• Routine measures within clinical environment available

• Accuracy

• Smoothness of movement (Jerk reduced = smoother movement)

• Time taken to carry out tasks

• Presented at Society for Research in Rehabilitation

Cognitive Technology Clinic

New possibilities for patients and the Foundation Trust ?

A monthly Cognitive Technology Clinic has been setup where Health Care Scientists work along side Psychologists, PT’s, OT’s , and SLT’s bringing innovation to wider range of patients.

An articulate memory aid to promote independent living.

“Geoff, your

cooking is ready”

“Geoff, your

cooking is ready”

“Geoff, your

cooking is ready”

Kitchen

Lounge

Geoff puts on his speaking belt

He then puts his meal on the cooker and sets the system accordingly

He goes about his normal business ….

When his meal is ready a radio signal is sent to his belt

..and the belt speaks to him repeatedly until …He goes back to the kitchen, takes his food off the cooker and resets the system

…and eats his dinner !

Preventing leaving the house at inappropriate times of night/ early morning.

Collaborations

HCS

Industry

Healthcare

Academic

ToumazETT

Sony

Physio

Prosthetics

Orthotics

SLT

Birmingham

Leeds Met

Bath

SurryVR

Gait analysisMech Testing

ADL

WheelchairStability

Computer Controls

Posture Measurement

ADL’s Lycra Outcomes

DysphagiaSerial Casting

Bio-feedback

Bespoke Wedges

Brunel

Biomechanics

ClinicalMeasurement

Gait analysis

Summary

• 42 project have been identified by discussing and educating staff about the possibilities

• Staff are now beginning to initiate new projects.