The World Health Organization (WHO) estimates that at least 15% of the World population has some kind of disability. It is considered that, in the near future, this figure can be doubled due to the population ageing.

In Mexico, the last report published by COPRED shows that 13.2% of the population present limitations on their daily functioning. This means that at least 16,835,335 people require physical rehabilitation services, while there are only 10,000 physiotherapists in the country.

Faced with this social demand, the Mexican holding company Horkest offers global services related to Physiotherapy through four business units. In terms of education of future professionals, IPETH has an institution specialized in the training of physiotherapists in Mexico and Latin America in Puebla, Tlalpan, Tlalnepantla and Guatemala. They also offer rehabilitation services through Recovery, the network of Rehabilitation and Sports Medicine Clinics in Puebla, Tlalnepantla, Tlaxcala and Orizaba. Another of the group’s subsidiaries, Kinnov, develops technological innovation and equipment for physical rehabilitation and health care. And finally, the holding company carries out an important solidarity activity in favour of people with disabilities through HUMA Foundation.

The innovation area is transversal to the whole business group developing new technologies for the rest of the areas. As Erik Díaz explains, in Kinnov, they discovered the existence of MySignals thanks to the technological surveillance activity carried out by its professionals. “We were looking for IoT devices applied to health with the aim of bringing rehabilitation to social clinics in places where access to health services was difficult“, he says.

Location of Mexico

Kinnov’s aim for this project is to increase the service coverage offered by physiotherapists and to use remote medicine technologies to gain efficiency. “This made us start looking for solutions and developing this project that allows us to connect the patient to the MySignals platform. We find it very useful as MySignals sensor data can be downloaded via the API to the patient’s direct medical record“, he says.

Kinnov’s research team is currently using MySignals in a project that also involves other sensors necessary for the physiotherapeutic process. Aware of the current needs of the Physical Rehabilitation area, Kinnov offers technological and innovative equipment, products and services, with the purpose of providing doctors, physiotherapists, specialists and health promoters with tools that help to improve the patients’ quality of life.

IPETH research team

IPETH research team working with MySignals, Libelium’s eHealth platform

Jorge Bustamante, a graduate in Physiotherapy from IPETH, leads the research team that is conducting clinical trials to use MySignals with patients receiving physiotherapy treatment. They use different MySignals sensors to evaluate the results of four rehabilitation areas: Sports, Orthopedic, Pulmonary and Neurological.

The research is being carried out on a group of 175 patients: 50 from the sports area to analyze pathologies related to ankle sprain; 50 from the orthopaedic area to analyze performance improvement in university football players; 50 patients from the lung area with COPD (Chronic Obstructive Pulmonary Disease); and 25 patients from the neurological area with Spastic Cerebral Palsy.

Diagram of Kinnov rehabilitation project carried out by IPETH research team

The aim of this research is to conclude which sensors add value to the patient’s clinical diagnosis.

In the Orthopaedic area, the study led by Carla Daniela López Carrillo aims to determine the patient’s instability through proprioceptive tests after suffering a sprained ankle. Blood pressure, galvanic response (to detect the change in heat and electricity transmitted by the nerves), accelerometer (to measure body speed) and electromyogram (muscle contractions) sensors are used.

In the Sports area, the research led by Lenis Aidee Solis Roque aims to improve the physical performance of the athlete by measuring stability, strength and power. The sensors used here are an accelerometer, gyroscope (muscle enhancement), actigraph (heart rate), stopwatch (time), kinetic sensor (motor gestures), calorimeter (calories consumed), spiroergometry (to examine the effect of CF intake), electromyogram and isokinetic dynamometer (muscle strength).

MySignals eHealth platform to control athletes performance

In the area of Pulmonary Rehabilitation, Adrián Romero Ríos, aims to demonstrate the effectiveness of a physiotherapeutic treatment to improve ventilation and muscle levels in patients with COPD. The following sensors are used for this purpose: spirometer (lung capacity); airflow to show potential changes in the course of treatment; SPO2 (measures the percentage of oxygen carried in the blood); blood pressure (measures hypertension); and electromyogram to show the work of the respiratory musculature, including an analysis of the lower limb musculature which, in patients with COPD, may be affected.

Finally, in the Neurological area, the study directed by Cecilia Magallanes González plans to act with 25 patients with Spastic Cerebral Palsy with the objective of having quantifiable results of the movements and compensations that the patients make at the moment of starting the movement.

Spasticity is a hyperactivity of the myotatic reflex arc that brings with it the so-called pyramidal syndrome, which is associated with paralysis and selective loss of movement. Spasticity has symptoms such as muscular hypertonia, hyperreflexia and voluntary kinetic hyperactivity.

GSR sensor working with MySignals SW eHealth platform

Using MySignals and a set of sensors such as acceleration, electromyogram, pulse oximeter and galvanic response, the study is performed to define in each patient the level of Cerebral Palsy according to the Motor Function Classification System (GMFCS). The level scale established by the GMFCS is measured in a quantifiable way for each of the parameters to be reviewed. In this way, a better diagnosis of each patient can be offered to show which are the alterations in their locomotion.

The procedure of this study is performed in several phases with the patient

In the first stage, a postural evaluation is carried out by making a photographic and video record of the use of the sensors to evaluate the effectiveness of the movements that are carried out at that time. The accelerometer is placed in the cervical spine, the electromyogram is placed in the rectus abdominis muscle, the pulse oximeter is used before, during and after activity, and the galvanic response sensor measures sweating before activity.

The second stage evaluates the gross motor function and decubitus and rotary movements, sitting, on all fours, kneeling, standing and gait. The accelerometer measures the involuntary movements being performed, the electromyogram measures the behaviour of the rectus abdominis at the time of the movements, the pulse oximeter indicates the amount of oxygen at the time of exertion and the galvanic response sensor shows whether the patient is in a stress phase.

Evaluation of the patient using MySignals

The third stage evaluates the patient’s posture. Dissociation, alignment, stability, proprioception and centre of gravity positioning exercises are used to restore human body movement. It begins voluntarily, with emphasis on seating, transfers and mobility.

A correction of the quotient posture is made for the patient verbally and with stimuli to make the contraction of the muscles involved more effective. The accelerometer evaluates the voluntary movement that is performed; the electromyogram, the effectiveness of the contraction maintained during the exercises; the pulse oximeter indicates if the patient is breathing optimally according to the activity.

In the fourth stage, the postural evaluation and the evaluation of gross motor skills is carried out again, taking into account the previous data obtained in the evaluation of decubitus movements and rotations, sitting, on all fours, kneeling, standing and gait.

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