A novel approach in remote monitoring and assessment of patient balance

Summary form only given. Balance disorders are prominent in the elderly population and also occur in patients of any age due to complications in the vestibular system which are often of idiopathic origin. Although there are no origin specific statistics, the National Institutes of Health data indicates that over 90 million of adult Americans experience dizziness and balance related problems. Worldwide, hearing or balance disorders affect close to 700 million people. A variety of sensory information and the brain interaction affect the complexity of balance mechanism. Therefore, an assessment of balance, awareness to patients, continuous feedback to assist in maintaining equilibrium, and overall monitoring with a capability of an alarm to a patient and/or patient caring staff are essential and demand technological solutions. Current rehabilitation strategies monitor the patient movement to observe specific patterns that occur before a fall. While this type of rehabilitation strategy has been proven effective it leads to higher patient costs, due to observation, as well as increased use of medical facility resources. A useful test should be inexpensive to implement, easy to administer, usable in different environments and simple to interpret. Accelerometers have recently been shown to provide highly relevant information for use as bio-feedback, or as an ambulatory device to record balance and gait performance over long periods of time in both clinical and natural living conditions. Specifically, this work focuses on a novel approach utilizing current accelerometer technologies incorporated into Wii video console remote. The major system components included an Analog Devices ADXL330 accelerometer, and a Broadcom BCM 2042 Bluetooth controller with an onboard 8051 processor which is compliant with the version 2.0 Bluetooth specification. Software was developed in Matlab that allows clinical staff to remotely observe the positioning of the device and the accelerations tha- t the device was currently experiencing. Two types of thresholds were implemented in the software to help in balance rehabilitation and aid in emergency response. The first set of thresholds monitored the position of the device relative to the patient´s center of mass ensuring the stable sitting and standing posture of the patient. The second set of values monitored the rate of change in the accelerations which increase greatly due to loss of equilibrium and typically result from a fall event. When any of these threshold values were surpassed an emergency signal was sent to the GUI alerting the clinical staff of a possible event. The threshold values in the program were adjusted for each individual to establish accurate monitoring and eliminate false warning activation. This type of system offers a low cost solution with an extremely small form factor. The design involves multiple coding languages relying on open source codes, and easily available low cost hardware. These characteristics translate directly into reduced patient costs, both of the product and rehabilitation, as well as a small enough form factor as to not interfere with patient movement.