Upper Austria University Of Applied Sciences - E-mail mrh@ing ...
Upper Austria University Of Applied Sciences - E-mail mrh@ing ...
Upper Austria University Of Applied Sciences - E-mail mrh@ing ...
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<strong>Upper</strong> <strong>Austria</strong> <strong>University</strong> of <strong>Applied</strong> <strong>Sciences</strong><br />
(FH-OOE)<br />
School of <strong>Applied</strong> Health and Social <strong>Sciences</strong> – Campus Linz
<strong>Upper</strong> <strong>Austria</strong><br />
<strong>University</strong> of <strong>Applied</strong> <strong>Sciences</strong><br />
Facts & Figures<br />
The <strong>Upper</strong> <strong>Austria</strong> <strong>University</strong> of <strong>Applied</strong><br />
<strong>Sciences</strong>, in German Fachhochschule<br />
Oberoesterreich, is a vocationally-oriented<br />
higher education institution which provides<br />
academic programmes at university level<br />
to over 4000 students.<br />
We are a decentralized institution,<br />
comprising four schools in four different<br />
towns of the region of <strong>Upper</strong> <strong>Austria</strong>:<br />
Hagenberg, Linz, Steyr and Wels.<br />
We offer more than 40 programmes in total<br />
at Bachelor and Master level.<br />
Introduction FH-OOE<br />
Page 2
Schools of ...<br />
Introduction FH-OOE<br />
Page 3
Campus - Linz<br />
Campus Linz ...<br />
Education: <strong>Applied</strong> Health and Social <strong>Sciences</strong><br />
Research: - Medical Engineering<br />
- Assisting Technologies and Processes for the Elderly<br />
GKK-OOE<br />
Health Ins. Comp.<br />
Hospital<br />
Diakonissen<br />
General Hospital<br />
Linz<br />
Pediadric and Gynecological<br />
Clinic Linz<br />
Neurological Clinic<br />
Wagner Jauregg Linz<br />
Rehab. Amb.<br />
Linz<br />
Emergency Hospital<br />
Linz<br />
<strong>University</strong> of <strong>Applied</strong> <strong>Sciences</strong><br />
Campus Linz<br />
Most of the medical partners<br />
are within a square km.<br />
Introduction FH-OOE Page 4
Medical Engineering<br />
Bachelor (6 semester)<br />
Master (4 semester)<br />
Course of Study<br />
Comprehensive program in medicine and medical<br />
engineering to bridge the gap between medicine and<br />
technology to meet future demands.<br />
Curriculum:<br />
basic principles (engineering and medical) and specifics especially in<br />
• Electronics and Medical Instrumentation<br />
• Biomechanics, Rehabilitation Engineering and Prostetics<br />
• Computer Science and Medical Information Systems<br />
• Regulatory Affairs (MDD, Clinical Studies)<br />
Introduction FH-OOE<br />
Page 5
Research fields – Medical Eng.<br />
Biomechanics of the Muscoskeletal system<br />
• measurement and analysis of human movements<br />
• modelling and assessment of muscle fatigue<br />
• application of accelerometry for quantification of physiscal<br />
activities and ADL‘s (walking, running, sitting, lying, ...)<br />
Eye-movement Measurement<br />
• diagnosis of dizziness and okulomotorical diseases<br />
• set-up design for improving coordination of visual, vestibular<br />
and motorical system<br />
• non-invasive measurement technique for tear-film dynamics<br />
Microscopy<br />
• Atomic-Force-Microscopy (diagnosis, characterisation and<br />
analysis)<br />
Introduction FH-OOE<br />
Page 6
Projects - I<br />
Individual strength assessment<br />
• biomechanical modelling<br />
• instrumentation and protocol design<br />
• statistical analysis and validation<br />
• application: rehabilitation, individual strength assessm.<br />
Introduction FH-OOE<br />
Isometric experiment<br />
(sub-maximal)<br />
modelling of fatique, prediction<br />
of the N-RM<br />
Page 7
Projects - II<br />
Assessment of muscle fatigue with EMG-arrays<br />
• instrumentation and experimental design<br />
• algorithm development (fatigue quantification)<br />
• statistical analysis and validation<br />
• application: rehabilitation, individual strength assessm.<br />
Introduction FH-OOE<br />
t = 20 sec.<br />
t = 12 sec.<br />
t = 24 sec.<br />
fatigue-map m. quadriceps<br />
Page 8
Projects – III<br />
Activity-Classification for ADL<br />
• device development (bed, chair, fall detector)<br />
• algorithmn development (activity index, weight meas.)<br />
• measurement and validation<br />
• application: detection of critical situations, AAL<br />
Introduction FH-OOE<br />
Page 9
Projects – IV<br />
Activity-Classification for physical activity<br />
• device development (accelerometer)<br />
• algorithm development (classification, energy expend.)<br />
• measurement and validation<br />
• application: preventive care, rehabilitation<br />
Introduction FH-OOE<br />
Page 10
Projects - V<br />
Videooculography<br />
• automatic measurements of torsion movements<br />
• compensation of artefacts<br />
• development of clinical application<br />
• application: dizziness diagnosis system<br />
Introduction FH-OOE<br />
torsion, artefacts<br />
Page 11
Medical Engineering - Team<br />
FH-Prof. Dr.<br />
Martin Zauner, MSc.<br />
Dean<br />
DI<br />
Fritz Mayr<br />
Electronics<br />
FH-Prof. PD. Dr.<br />
Thomas Haslwanter<br />
Eye-Movements<br />
Mag.<br />
Erich Mayr<br />
Research Center<br />
DI(FH)<br />
DI(FH)<br />
Gerold Schossleitner Thomas Minarik<br />
Research Assist. PhD-Student<br />
Introduction FH-OOE<br />
FH-Prof. Dr.<br />
Kurt Schilcher<br />
AFM<br />
Dr.<br />
James Ong<br />
Post-Doc<br />
DI(FH)<br />
David Fürst<br />
PhD-Student<br />
FH-Prof. Dr.<br />
Andreas Schrempf<br />
Biomechanics<br />
DI(FH)<br />
Michael Platz<br />
PhD-Student<br />
DI(FH)<br />
Tamara Gaisbauer<br />
PhD-Student<br />
FH-Prof. PD. Dr.<br />
Andreas Lindbaum<br />
MRI, CT<br />
DI(FH)<br />
Michael Ring<br />
PhD-Student<br />
Contact<br />
FH-Prof Dr.<br />
Robert Merwa<br />
Medical Instr.<br />
DI(FH)<br />
Marlene Plöderl<br />
Research Assist.<br />
Research Center Linz – Medical Engineering<br />
School of <strong>Applied</strong> Health and Social <strong>Sciences</strong><br />
Garnisonstrasse 21, 4020 Linz<br />
Mag. Erich Mayr, +43 (0)732 2008-5000<br />
www.fh-ooe.at/campus-linz<br />
Page 12
Actilab –<br />
An interactive<br />
activity-monitoring<br />
device for use in<br />
home-rehabilitation<br />
Thomas Minarik<br />
<strong>Upper</strong> <strong>Austria</strong> <strong>University</strong> of <strong>Applied</strong> <strong>Sciences</strong><br />
Project MRH Page 1 30 September 2010
Table of contents<br />
• Fundamentals<br />
• Pilot specific features<br />
• Status Quo<br />
• Outlook<br />
Project MRH Page 2 30 September 2010
FUNDAMENTALS<br />
Project MRH Page 3 30 September 2010
Phases of rehabilitation<br />
Rehabilitation Phase Duration Location Responsibility<br />
1 – Acute stage 7-10 days Hospital M.D., therapists<br />
2 – Sub acute stage 3-6 weeks<br />
2-3 h/day<br />
3 – Long term follow up several months<br />
50 min/Unit<br />
2 Units/day<br />
4 – Lifetime follow<br />
through<br />
MRH concept<br />
Project MRH Page 4 30 September 2010<br />
lifelong<br />
1-2 Units/day<br />
Rehabilitatio<br />
n Center<br />
(Clinic)<br />
Rehabilitatio<br />
n<br />
Ambulance,<br />
Home<br />
M.D., therapists<br />
therapists,<br />
own responsibility<br />
under remote<br />
supervision<br />
Home own responsibility<br />
[SIGN 2002] - modified
Critical factors for success<br />
• Motivate the patient for physical activity<br />
• Monitor the patient’s physical activities<br />
– track the progress of the rehabilitation<br />
– give adequate feedback<br />
– adjust the training schedule accordingly<br />
• objective Methods<br />
– Reliable results<br />
– easy to use (invisible)<br />
– usability<br />
Project MRH Page 5 30 September 2010
Accelerometry<br />
• The quantitative determination of acceleration and deceleration in<br />
the entire human body or a part of the body in the performance<br />
of a task.<br />
– triaxial accelerometers<br />
• Objective method to monitor physical activity and estimate energy<br />
expenditure [Bouten et al., 1994], [Jacobi, 2007]<br />
– during exercises<br />
– during rehabilitation process<br />
• assist the physician / therapist<br />
– track the rehabilitation progress<br />
– adjust the training schedule<br />
– therapy assessment<br />
Project MRH Page 6 30 September 2010
PILOT SPECIFIC<br />
FEATURES<br />
Project MRH Page 7 30 September 2010
Actilab – Features I<br />
• developed in cooperation with g.tec medical engineering<br />
– Device development – g.tec medical engineering<br />
– Algorithm development – <strong>Upper</strong> <strong>Austria</strong> <strong>University</strong> of <strong>Applied</strong><br />
<strong>Sciences</strong><br />
• Mobile system<br />
– duration, intensity, frequency of activity<br />
• Intended to become a medical device<br />
• Triaxial accelerometer<br />
– measuring range: ±18g<br />
– Resolution: ~ 6.25mg<br />
• Barometric pressure sensor<br />
– Measurement range 30-120kPa<br />
– Resolution: ~10cm<br />
Project MRH Page 8 30 September 2010
Actilab – Features II<br />
• 16Mbyte Flash Memory<br />
– To store the recorded data<br />
• Programmable display<br />
– User information<br />
– Start / stop the recordings<br />
• µC<br />
– All calculations carried out on the device<br />
• GPRS / GSM module<br />
– Communication with a database<br />
– data can be assessed by a physician<br />
• Limited user interaction required<br />
Project MRH Page 9 30 September 2010
Case study<br />
Project MRH Page 10 30 September 2010
Application areas<br />
• 3 main application areas<br />
– preventive care<br />
– Rehabilitation<br />
– therapy evaluation<br />
• Special focus on various diseases<br />
– stroke<br />
– dementia<br />
– diabetes<br />
– Obesity<br />
– cardio – vascular diseases<br />
– orthopedic diseases<br />
– ….<br />
Project MRH Page 11 30 September 2010
STATUS QUO<br />
Project MRH Page 12 30 September 2010
Status Quo<br />
• Proof of concept activity measurement<br />
• Proof of concept altimetry<br />
• state of algorithm development<br />
Project MRH Page 13 30 September 2010
Proof of concept activity<br />
measurement<br />
• Comparison of estimated energy expenditure<br />
– Representative for intensity of physical activity<br />
– During different tasks<br />
– Running<br />
– walking<br />
• Measurement setup<br />
– Treadmill – PPS 55ortho (Woodway)<br />
– Ergospirometry – Oxycon Mobile (Viasys Healthcare)<br />
– Accelerometer –GT3X Activity Monitor (Actigraph)<br />
– Heart Rate monitoring system - T31 (Polar)<br />
Project MRH Page 14 30 September 2010
Proof of concept activity<br />
measurement<br />
mobile<br />
ergospirometry<br />
Project MRH Page 15 30 September 2010<br />
accelerometers Subject<br />
running on the<br />
treadmill
Proof of concept activity<br />
measurement<br />
• Indirect calorimetry<br />
– Mobile ergospirometry<br />
• Based on the consumption of oxygen / carbon dioxide<br />
– de van Weir [Jaeger 2007]<br />
– Elia / Livesey [Müller 2007]<br />
– caloric equivalent [Tomasits & Haber 2008]<br />
• Based on cardio - vascular parameters<br />
– “bycycle ergometer equivalent power” [Schulz 1999]<br />
– Heart rate<br />
• Based on accelerometry<br />
– GT3X Activity Monitor [ActiGraph 2008]<br />
– Actilab<br />
Project MRH Page 16 30 September 2010<br />
feasibility<br />
accuracy
Proof of concept activity<br />
measurement<br />
Project MRH Page 17 30 September 2010
Proof of concept Altimetry<br />
• Barometric pressure sensor<br />
– Pressure → altitude<br />
• Measurement setup<br />
– GPS Sensor device - Aerospy<br />
Project MRH Page 20 30 September 2010
Proof of concept Altimetry<br />
Project MRH Page 21 30 September 2010
State of algorithm development<br />
• energy expenditure estimation<br />
– kinetic and potential energy of the subject have to be considered<br />
[Goldman, Givoni, 1971]<br />
filtering of measured<br />
acceleration<br />
Project MRH Page 23 30 September 2010<br />
using measured<br />
pressure
State of algorithm development<br />
• GPS Sensor device - Aerospy<br />
– Validate velocity on different route profiles<br />
• Heart Rate monitoring system - Team Polar System (Polar)<br />
– Validate energy expenditure on different route profiles<br />
Project MRH Page 24 30 September 2010
State of algorithm development<br />
Level ground<br />
Project MRH Page 25 30 September 2010<br />
ascending slope<br />
descending slope
State of algorithm development<br />
Project MRH Page 26 30 September 2010<br />
Level ground ascending slope<br />
descending slope
OUTLOOK<br />
Project MRH Page 27 30 September 2010
Outlook<br />
• Further development of the algorithm to estimate energy<br />
expenditure<br />
– Improve the accuracy<br />
– extend to activities of the daily life<br />
– individual calibration<br />
• Further validation of the algorithm<br />
– Therapy evaluation in the field of rehabilitation<br />
– Stroke<br />
– Dementia<br />
– diabetes<br />
– In cooperation with Linz General Hospital<br />
• Research towards development of a medical device<br />
– Regulations & standards<br />
– usability, user requirements,…<br />
Project MRH Page 28 30 September 2010
References<br />
• [Bouten et al., 1994] Bouten, C. V., K. R. Westerterp, M. Verduin, and J. D. Janssen.. "Assessment of Energy Expenditure<br />
for Physical Activity Using a Triaxial Accelerometer„. Medicine and Science in Sports and<br />
Exercise. 26, no.12: 1516, 1994<br />
• [Müller, 2007] Müller, Manfred J., Ernährungsmedizinische Praxis Methoden - Prävention - Behandlung;<br />
mit 219 Tabellen. Heidelberg: Springer, 2007, ISBN 3-540-38230-5<br />
• [Jacobi, 2007] D Jacobi, AE Perrin, N Grosman, MF Dore, S Normand, JM Oppert und C Simon, Physical<br />
Activity-Related Energy Expenditure With the RT3 and TriTrac Accelerometers in<br />
Overweight Adults , OBESITY, Band 4, Nr. 15, April 2007<br />
• [Jaeger, 2007] Gebrauchsanweisung Oxycon Mobile, Version 5.2, Dezember 2007.<br />
• [Schulz, 1999] Leistungsberechnung im Laufband / Energieverbrauch auf dem Laufband, Firma Woodway<br />
GmbH.<br />
• [ActiGraph, 2008] What exactly is a "Count"? The ActiGraph, Internet:<br />
http://www.theactigraph.com/index.php?option=com_content&view=article&id=<br />
146:whatisacount&catid=62:gt1m&Itemid=41 (Zugriff am 15.04.2009).<br />
• [Givoni, Goldman, 1971] Givoni B, and RF Goldman. "Predicting Metabolic Energy Cost„. Journal of applied<br />
Physiology. 30, no.3: 429-33, 1971<br />
• [Tomatsits, Haber, 2008] Tomasits, Josef, und Paul Haber; Leistungsphysiologie Grundlagen für Trainer,<br />
Physiotherapeuten und Masseure. Leistungsphysiology, Vienna: Springer Verlag/Wien, ISBN<br />
978-3-211-72018-9; 2008<br />
• [SIGN, 2002] Scottish Intercollegiate Guidelines Network. (2002). Cardiac Rehabilitation Quick Reference<br />
Guide. Abgerufen am 29. 09 2010 von http://www.sign.ac.uk/pdf/qrg57.pdf<br />
Project MRH Page 29 30 September 2010
Project MRH Page 30 30 September 2010
State of development<br />
Applications<br />
– Validation of the existing device against different reference methods<br />
– Ergospirometry<br />
Figure1 : Eslinger Tremblay Physical activity ….<br />
Page 31
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