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HITT 1211
Chapter 11 Lecture Notes
Information Technology in Rehabilitative Therapies: Computerized Medical
Devices, Assistive Technology, and Prosthetic Devices
Computerized medical instruments are “electronic devices equipped with
microprocessors [which] provide direct patient services such as monitoring
. . . [and] administering medication or treatment.” They are both more
accurate and more reliable than their predecessors.
•
Computerized drug delivery systems are used to give
medications.
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Computerized monitoring systems collect data directly from
patients via sensors.
Physiological monitoring systems analyze blood
Arrhythmia monitors monitor heart rates
Pulmonary monitors measure blood flow through the
heart and respiratory rate
Fetal monitors measure heart rate of the fetus
Neonatal monitors monitor infant heart and breathing
rates
Monitoring devices may or may not be linked to a
network.
•
Standalone devices include intravenous (IV) pumps,
electrocardiogram (ECG) and cardiac monitors, defibrillators,
temperature pulse respiration (TPR), and blood pressure
monitors.
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Networked equipment is most common in emergency rooms,
operating rooms, and critical and intensive care units.
•
Several
computerized
devices
are
used
in
optometry/ophthalmology for vision testing, early diagnosis of
macular degeneration, glaucoma, cataracts, and diabetic
retinopathy.
A newly developed type of glasses (which include a
computer) may improve vision in people with tunnel
vision.
The FDA has approved the testing of retinal implants,
but they have not yet been approved as of 2006.
Software developed in France can calculate the
dimensions for glasses that will maximize the amount
of light transmitted to any part of the retina that is still
functioning.
A prototype of smart glasses, developed at the
University of Arizona, will soon be able to
automatically change focus.
In 2007, P2, an integrated system that will automate
the examination and treatment of the eye, will be
introduced.
Adaptive or assistive technology makes it possible for people with
disabilities to exercise control over their home and work environments.
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Devices are being developed that help people adjust balance.
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Smart wheelchairs can climb stairs and find their way in a
crowd.
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Computer technology can help those with impaired vision,
hearing, speech, and mobility.
People with impaired vision can use speechrecognition systems as input and speech synthesizers
for output.
Brain input systems are being developed for people
who lack the muscle control to use alternative input
devices.
A new portable speech-synthesizing device that uses
a digital camera and a handheld organizer has been
developed. The device takes a picture of the written
text and scans and reads it.
Other alternate input devices include
•
Head mouse
•
Puff straws
•
Eye movement
An augmentative communication device is any device that helps a person
communicate.
Environmental control systems help physically challenged people control
their environments.
Prosthetic devices replace natural body parts or organs with artificial
devices.
•
Myoelectric limbs—artificial limbs containing motors and
responding to the electrical signals transmitted by the residual
limb to electrodes mounted in the socket now contain
microprocessors.
Other prosthetic devices include
•
A knee socket has been developed that includes a computer
chip that allows patients to walk naturally.
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Energy-storing feet
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C-leg or computerized leg. It includes a prosthetic knee and shin
system controlled by a microprocessor.
A digital hearing aid (essentially a tiny computer), which can be
programmed to meet individual needs and adjust to background noise,
helps some hearing-impaired people. So does the cochlear implant.
•
The newest hearing aids (2006) include “digital processing and
directional microphones.”
Computerized functional electrical stimulation (CFES or FES) directly
applies low-level electrical stimulation to muscles that cannot receive
these signals from the brain.
•
It is now used to strengthen paralyzed muscles with exercise.
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It can be used to simulate a full cardiovascular workout for
people who are paralyzed.
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FES even makes it possible to restore movement to some limbs
paralyzed by stroke and spinal injury.
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FES is used in many implanted medical devices, including
pacemakers and implantable cardioverter defibrillators.
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A breathing pacemaker controls breathing by sending electrical
impulses to the phrenic nerve.
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An implanted device reduces seizures in people with epilepsy
by delivering electrical signals to the brain.
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Osseointegration involves using titanium. The human tissue
grows around the implant, so that the implant is more integrated
with the human body.
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Pacemakers for the brain are being tested for treatment of
bipolar disorder and depression.
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Electronic stimulation is also being used to prevent chronic pain.
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A neuroprosthesis—uses “low levels of electricity in order to
activate nerves and muscles in order to restore movement” to
paralyzed limbs (when it is switched on).
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Neuromove and Biomove 3000 are for stroke patients. Both
devices help to stimulate the muscles to avoid atrophy and
increase both range of motion and blood circulation. The
devices help to communicate with paralyzed muscles through
electrical stimulation of the brain.
•
“BrainGate Neural Interface System,” for ALS (Lou Gehrig’s
disease), is in clinical trials. The system involves implanting a
chip in the brain that will convert brain cell impulses to computer
signals.
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Neuromodulation is a new field that may help treat disorders of
the central nervous system including chronic pain.
•
There are some risks posed by implanted devices:
Blood clots
Infection
Rejection
Computers are used in rehabilitation
•
HELEN (HELp Neuropsychology) contains diagnostic analyses
for stroke patients. HELEN also contains a rehabilitative
module.
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FES has been used for many years in several forms of
rehabilitation.
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Virtual reality is being used experimentally to help people with
amputations control phantom pain.
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Vision replacement therapy (VRT) retrains the brain of stroke
victims who have lost their vision. Using dots on a computer
screen, the aim is to stimulate peripheral vision.