Possibilities of telemedical monitoring risk factors in patients with cardiovascular diseases: experience of using a patient-oriented model of remote rehabilitation care

Introduction. The modern system for the prevention of cardiovascular diseases and the creation of conditions for the formation and maintenance of a healthy lifestyle (coolant) includes activities in the development of monitoring systems for information on risk factors. Purpose: to assess the capabilities of telemedicine monitoring of cardiovascular risk factors in the structure of a patient-oriented model of distance rehabilitation care. Material and methods. The study included patients with coronary heart disease and/or arterial hypertension of the I-III degree, without cognitive dysfunction and contraindications to physical rehabilitation, with a mobile device with Internet access. The following groups were distinguished: remote cardiac rehabilitation, with the participation of patients in a 12-month program (28 patients, 86% of men, average age 55.2 ± 10.7 years), and traditional follow-up (30 patients, 80% of men, average age 64.7 ± 6.9 years). Remote cardiac rehabilitation model provided for office consulting using a decision support system, monitoring indicators based on digital recording devices, mobile applications and the electronic «Patient Diary» deferred telemedicine counselling. The effectiveness of the observation was evaluated by the trend of the modified risk factors; patient satisfaction with remote assistance - according to the «Client Satisfaction Questionnaire - CSQ-8» questionnaire. Results. After completion of the remote cardiac rehabilitation (RCR) program, a significant decrease in systolic and diastolic blood pressure, total cholesterol, low-density lipoprotein cholesterol and triglycerides were observed, and a tendency to increase physical activity. Upon completion of the RCR-program, a high level of satisfaction with telemedicine assistance was noted. Conclusion. The results of the pilot phase of the study, dedicated to the study of the possibilities of remote rehabilitation in the context of maximizing the benefits for cardiovascular prophylaxis, indicate the possibility of using a patient-oriented model of remote cardiac rehabilitation to monitor and modify risk factors in patients with cardiovascular diseases.

A Novel Active Rehabilitation Model for Stroke Patients Using Electroencephalography Signals and Deep Learning Technology

The main clinical manifestations of stroke are motor, language, sensory, and mental disorders. After treatment, in addition to being conscious, other symptoms will still remain in varying degrees. This is the sequelae of stroke, including numbness, facial paralysis, central paralysis, and central paralysis. If the sequelae of stroke are not treated effectively, they can easily develop into permanent sequelae. Most of the affected people have sequelae, and most of them have symptoms of upper limb paralysis. Therefore, it is of great significance to study how to carry out effective rehabilitation training for stroke patients to reduce the disease and even restore their motor function. Based on this background, this research aims to use deep learning technology to design a stroke rehabilitation model based on electroencephalography (EEG) signals. First, the patient’s EEG signal will be preprocessed. Then, an improved deep neural network model (IDNN) is used to get the EEG classification results. The traditional DNN model construction process is simple and suitable for scenarios where there is no special requirement for the data format, but the generalization of a single DNN model is usually poor. Large margin support vector machine (LM_SVM) is an extension method of support vector machine (SVM), suitable for any occasion. By optimizing the edge distribution, better generalization performance can be obtained. Taking into account the advantages of DNN and LM_SVM and the high aliasing characteristics of stroke data, an improved DNN model is proposed. Finally, based on the EEG recognition result of the model, the rehabilitation equipment is controlled to assist the patient in rehabilitation treatment. The experimental results verify the superiority of the EEG classification model used, and further prove that this research has good practical value.

Introduction of alternative rehabilitation method for the patients with cardiovascular diseases in conditions of the COVID-19 pandemic

COVID-19 pandemic caused structure reorganization in rehabilitation. Nowadays telerehabilitation is the best method due to close-out and readjustment of clinics. There is a need to search and develop alternative rehabilitation models in the conditions of COVID-19 pandemic. Aim Developing and introducing an alternative rehabilitation model for the patients after acute coronary syndrome in the conditions of COVID-19 pandemic. Methods An alternative rehabilitation model was developed for the patients after acute coronary syndrome in the condition of COVID-19 pandemic. 70 patients after the acute coronary syndrome who were hospitalized into the cardiology center went thought our rehabilitation model. The 1st stage of the rehabilitation is conducted during in-patient treatment. Before the discharge from the hospital, the patient gets evaluated his/her clinical state, physical activity level, evaluation of his/her psychological state, risk stratification with noting in a developed by us patient's individual self-check diary. The individual diary includes: ID data, pharmaceutical treatment, recommendations on physical activity with a possibility to note daily data on angina and dyspnea attacks, their number, need in medications, heart rate, blood pressure, distance walked during a day, evaluation in points according to the Borg scale, HADS and SAQ questionnaires. The 2nd stage is conducted using telerehabilitation methods: phone call, group training on the ZOOM platform, and individual consulting. At this stage we used the components of rehabilitation: – group training in breathing exercises and using relaxation techniques, are conducted 2 times/week during 3 months after discharge, then 1 time/week up to 6th month or on patient's request individually – group training using an author's method of psychological rehabilitation while optimizing internal health picture, is conducted 2 times/week during 3 months after discharge, then 1 time/week up to 6th month or on patient's request individually Control of the patient's state and indices (according to data from the patient's individual diary) is conducted after 1, 6 months, and a year. Results We established that our alternative rehabilitation method contributed to the improvement of clinical and functional capabilities of the patients, decrease of depression and anxiety, improved quality of life, attitude towards the disease and health. Conclusion The COVID-19 pandemic changed our life and health care for the patients. But a time-lag in conducting and using rehabilitation in patients with cardiovascular diseases causes complications and progression of the disease. Using alternative rehabilitation methods will grant providing timely and complex medical care, improving clinical, physical, and psychological indices that will contribute to increased adherence to rehabilitation and treatment in conditions of the COVID-19 pandemic. FUNDunding Acknowledgement Type of funding sources: None. Alternative rehabilitation model The patients' state dynamics

IoT-Based Patient Movement Monitoring: The Post-Operative Hip Fracture Rehabilitation Model

Hip fracture incidence is life-threatening and has an impact on the person’s physical functionality and their ability to live independently. Proper rehabilitation with a set program can play a significant role in recovering the person’s physical mobility, boosting their quality of life, reducing adverse clinical outcomes, and shortening hospital stays. The Internet of Things (IoT), with advancements in digital health, could be leveraged to enhance the backup intelligence used in the rehabilitation process and provide transparent coordination and information about movement during activities among relevant parties. This paper presents a post-operative hip fracture rehabilitation model that clarifies the involved rehabilitation process, its associated events, and the main physical movements of interest across all stages of care. To support this model, the paper proposes an IoT-enabled movement monitoring system architecture. The architecture reflects the key operational functionalities required to monitor patients in real time and throughout the rehabilitation process. The approach was tested incrementally on ten healthy subjects, particularly for factors relevant to the recognition and tracking of movements of interest. The analysis reflects the significance of personalization and the significance of a one-minute history of data in monitoring the real-time behavior. This paper also looks at the impact of edge computing at the gateway and a wearable sensor edge on system performance. The approach provides a solution for an architecture that balances system performance with remote monitoring functional requirements.

An Explorative Study of Coping Mechanisms Towards Vulnerability and Victimization Within Commercial Sexual Exploitation in India

Trafficking for commercial sexual exploitation constitutes more than 59% of the entire trafficking industry. An efficient rehabilitation model reflects the utilization of the victim's coping mechanism to overcome the stress and trauma of past victimization. The main aim of the study is to explore various coping mechanisms utilized by both victims of commercial sexual exploitation and individuals vulnerable to commercial sexual exploitation at rehabilitation and protective homes in India. The research utilized the participatory action research with stress coping behavior scale to understand the various employed coping mechanism by the beneficiaries of rehabilitation and protective (R&P) homes. In total, 30 victims of commercial sexual exploitation and 30 individuals vulnerable to commercial sexual exploitation, aged 18-50 years, participated in the study. The statistical analysis identified pursual of specific coping by participants and measured risk ratio reflected the relative risk of alcohol and drug use over prior exposure to commercial sexual exploitation.