An optimized infrastructure for deferred telemonitoring of home rehabilitation in chronic rheumatic patients

The interest towards telemedicine and its various branches is constantly growing, given the opportunities in terms of costs reduction, efficiency and capillarity in delivering health services. In particular, telerehabilitation aims at improving the quality of life of physically impaired patients, providing the support for home-managed rehabilitation sessions. Moving from an existing outpatient device for the quantitative evaluation of hand rehabilitation exercises, opportunely enhanced to be used in a telemonitoring scenario, in this paper the development of the remaining telerehabilitation infrastructure is presented and evaluated. It includes, beyond the rehabilitation kits, a remote server and a deferred monitoring software application. The kits, entrusted to the patients for rehabilitation in their home, are able to send to the remote server via a GSM/GPRS connection, quantitative measurements of the patients' performance. The physician's monitoring application, retrieving such data and providing an appropriate visualization, allows the evaluation of both the patients' compliance to the rehabilitation protocol and their progresses. The system has been evaluated by a small panel of rheumatologists in order to assess its acceptability in a clinical environment and is currently under test for experimental trials in Italy.