title: A telemedicine instrument for Internet-based home monitoring of thoracoabdominal motion in patients with respiratory diseases.
abstract: Changes in thoracoabdominal motion are highly prevalent in patients with chronic respiratory diseases. Home care services that use telemedicine techniques and Internet-based monitoring have the potential to improve the management of these patients. However, there is no detailed description in the literature of a system for Internet-based monitoring of patients with disturbed thoracoabdominal motion. The purpose of this work was to describe the development of a new telemedicine instrument for Internet-based home monitoring of thoracoabdominal movement. The instrument directly measures changes in the thorax and abdomen circumferences and transfers data through a transmission control protocol∕Internet protocol connection. After the design details are described, the accuracy of the electronic and software processing units of the instrument is evaluated by using electronic signals simulating normal subjects and individuals with thoracoabdominal motion disorders. The results obtained during in vivo studies on normal subjects simulating thoracoabdominal motion disorders showed that this new system is able to detect a reduction in abdominal movement that is associated with abnormal thoracic breathing (p < 0.0001) and the reduction in thoracic movement during abnormal abdominal breathing (p < 0.005). Simulated asynchrony in thoracoabdominal motion was also adequately detected by the system (p < 0.0001). The experimental results obtained for patients with respiratory diseases were in close agreement with the expected values, providing evidence that this instrument can be a useful tool for the evaluation of thoracoabdominal motion. The Internet transmission tests showed that the acquisition and analysis of the thoracoabdominal motion signals can be performed remotely. The user can also receive medical recommendations. The proposed system can be used in a spectrum of telemedicine scenarios, which can reduce the costs of assistance offered to patients with respiratory diseases.
authors.affiliation: Biomedical Instrumentation Laboratory, Institute of Biology, Faculty of Engineering, State University of Rio de Janeiro, Brazil.
authors.forename: Evert Pereira
authors.initials: EP
authors.lastname: da Silva Junior
authors.forename: Guilherme Pompeu
authors.initials: GP
authors.lastname: Esteves
authors.forename: Karla Kristine
authors.initials: KK
authors.lastname: Dames
authors.forename: Pedro Lopes de
authors.initials: PL
authors.lastname: Melo
mesh_terms: D000005:Abdomen / Q000502:physiology / Q000503:physiopathology*; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006699:Home Care Services; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D009068:Movement; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D017216:Telemedicine / Q000295:instrumentation*; D013909:Thorax / Q000502:physiology / Q000503:physiopathology*; D055815:Young Adult