title: Telerehabilitation approach for patients with hand impairment.
abstract: OBJECTIVE
  Telerehabilitation is one of the newest branches of telemedicine which has been developed because patients need regular trainings outside the medical institution but still under specialist supervision. It helps maintain regularity of exercises and reduces costs. The professional and advanced systems for telerehabilitation are presented in papers, however, there is still lack of development of minor systems which provide therapeutic values and are more accessible to people. Therefore we focus on a solution for hand telerehabilitation of poststroke patients, based solely on a personal computer and camera.
  
  
  METHODS
  We focused on the manipulative hand (fingers, metacarpus, wrist) movements trainings for patients with cerebral palsy. The contact between patient and physiotherapist is provided by using web cameras and web service. Additionally, the camera can be used to monitor the effectiveness of performed exercises. Computer vision system keeps track of the patient's hand movement. The digital image processing is used to detect if the patient performs exercises correctly.
  
  
  RESULTS
  We created web service and software application TeleReh that provides therapeutic values for the hand impaired people. The system created was evaluated by three physiotherapists, one doctor and a cerebral palsy patient.
  
  
  CONCLUSIONS
  Our solution applies to all patients who have undergone basic rehabilitation in hospital and need to continue hand rehabilitation at home. The main advantages are: easy adaptation to the individual needs and abilities, monitoring the progress by using automatically generated reports after each training session. It is worth noticing that discussion between IT specialists, rehabilitants and patients was necessary to achieve good results.
authors.affiliation: Faculty of Electrical Engineering, Automatics, Computer Science and Biomedical Engineering, AGH University of Science and Technology, Kraków, Poland.
authors.forename: Arleta
authors.initials: A
authors.lastname: Staszuk
authors.affiliation: Department of Basic Medical Sciences, Wrocław Medical University, Poland.
authors.forename: Benita
authors.initials: B
authors.lastname: Wiatrak
authors.affiliation: Faculty of Electrical Engineering, Automatics, Computer Science and Biomedical Engineering, AGH University of Science and Technology, Kraków, Poland.
authors.forename: Ryszard
authors.initials: R
authors.lastname: Tadeusiewicz
authors.affiliation: Division of Infectious Diseases of Animals and Veterinary Administration, Department of Epizootiology and Clinic of Bird and Exotic Animals, Wrocław University of Environmental and Life Sciences, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Karuga-Kuźniewska
authors.affiliation: Department of Experimental Surgery and Biomaterials Research, Wrocław Medical University, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Rybak
mesh_terms: D005081:Exercise Therapy / Q000379:methods*; D006225:Hand; D006801:Humans; D009068:Movement; D009069:Movement Disorders / Q000175:diagnosis / Q000534:rehabilitation*; D012648:Self Care / Q000379:methods; D000071939:Stroke Rehabilitation / Q000379:methods*; D000069350:Telerehabilitation / Q000379:methods*; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D014584:User-Computer Interface