A Practical Design and Implementation of a Low Cost Platform for Remote Monitoring of Lower Limb Health of Amputees in the Developing World

In many areas of the world accessing professional physicians “when needed/as needed” might not be always possible for a variety of reasons. Therefore, in such cases, a targeted e-Health solution to safeguard patient long-term health could be a meaningful approach. Today's modern healthcare technologies, often built around electronic and computer-based equipment, require an access to a reliable electricity supply. Many healthcare technologies and products also presume access to the high speed internet is available, making them unsuitable for use in areas where there is no fixed-line internet connectivity, access is slow, unreliable, and expensive, yet where the most benefit to patients may be gained. In this paper, a full mobile sensor platform is presented, based around readily-purchased consumer components, to facilitate a low cost and efficient means of monitoring the health of patients with prosthetic lower limbs. This platform is designed such that it can also be operated in a standalone mode, i.e., in the absence of internet connectivity, thereby making it suitable to the developing world. Also, to counter the challenge of power supply issues in e-Health monitoring, a self-contained rechargeable solution to the platform is proposed and demonstrated. The platform works with an Android mobile device, in order to allow for the capture of data from a wireless sensor unit, and to give the clinician access to results from the sensors. The results from the analysis, carried out within the platform's Raspberry Pi Zero, are demonstrated to be of use for remote monitoring. This is specifically targeted for monitoring the tissue health of lower limb amputees. The monitoring of residual limb temperature and gait can be a useful indicator of tissue viability in lower limb amputees especially those suffering from diabetes. We describe a route wherein non-invasive monitoring of tissue health is achievable using the Gaussian process technique. This knowledge will be useful in establishing biomarkers related to a possible deterioration in a patient's health or for assessing the impact of clinical interventions.

[1]  Ivan Glesk,et al.  Skin Temperature Prediction in Lower Limb Prostheses , 2016, IEEE Journal of Biomedical and Health Informatics.

[2]  W. Press Numerical recipes in Fortran 77 : the art of scientific computing : volume 1 of fortran numerical recipes , 1996 .

[3]  Kamiar Aminian,et al.  Capturing human motion using body‐fixed sensors: outdoor measurement and clinical applications , 2004, Comput. Animat. Virtual Worlds.

[4]  Thomas Seel,et al.  IMU-Based Joint Angle Measurement for Gait Analysis , 2014, Sensors.

[5]  Rachid Aissaoui,et al.  New Accelerometric Method to Discriminate Between Asymptomatic Subjects and Patients With Medial Knee Osteoarthritis During 3-D Gait , 2008, IEEE Transactions on Biomedical Engineering.

[6]  Carl E. Rasmussen,et al.  Gaussian processes for machine learning , 2005, Adaptive computation and machine learning.

[7]  Ivan Glesk,et al.  Power Supply Issues in E-health Monitoring Applications , 2015 .

[8]  Kamiar Aminian,et al.  Measurement of stand-sit and sit-stand transitions using a miniature gyroscope and its application in fall risk evaluation in the elderly , 2002, IEEE Transactions on Biomedical Engineering.

[9]  Hylton B Menz,et al.  Accelerometry: a technique for quantifying movement patterns during walking. , 2008, Gait & posture.

[10]  Nandan Parameswaran,et al.  Mobile e-Health monitoring: an agent-based approach , 2008, IET Commun..

[11]  T. Chai,et al.  Root mean square error (RMSE) or mean absolute error (MAE)? – Arguments against avoiding RMSE in the literature , 2014 .

[12]  Angelo M. Sabatini,et al.  Estimating Three-Dimensional Orientation of Human Body Parts by Inertial/Magnetic Sensing , 2011, Sensors.

[13]  Wai Yin Wong,et al.  Clinical Applications of Sensors for Human Posture and Movement Analysis: A Review , 2007, Prosthetics and orthotics international.

[14]  J. Allum,et al.  Gait event detection using linear accelerometers or angular velocity transducers in able-bodied and spinal-cord injured individuals. , 2006, Gait & posture.

[15]  Yoshihiro Kai,et al.  Estimation of vertical reaction force and ankle joint moment by using plantar pressure sensor , 2003 .

[16]  W. Zijlstra,et al.  A body-fixed-sensor based analysis of compensatory trunk movements during unconstrained walking. , 2008, Gait & posture.

[17]  Ivan Glesk,et al.  Issues in wearable mobile sensor platform for lower limb prosthetic users , 2015, 2015 17th International Conference on Transparent Optical Networks (ICTON).

[18]  Hailong Zhu,et al.  Support vector machine for classification of walking conditions using miniature kinematic sensors , 2008, Medical & Biological Engineering & Computing.

[19]  Carl E. Rasmussen,et al.  In Advances in Neural Information Processing Systems , 2011 .

[20]  Ivan Glesk,et al.  Wearable mobile sensor and communication platform for the in-situ monitoring of lower limb health in amputees , 2016, 2016 IEEE International Symposium on Circuits and Systems (ISCAS).

[21]  I.P.I. Pappas,et al.  A reliable, gyroscope based gait phase detection sensor embedded in a shoe insole , 2002, Proceedings of IEEE Sensors.

[22]  A. David Marshall,et al.  Tracking people in three dimensions using a hierarchical model of dynamics , 2002, Image Vis. Comput..

[23]  Huiru Zheng,et al.  Position-sensing technologies for movement analysis in stroke rehabilitation , 2005, Medical and Biological Engineering and Computing.

[24]  K. Aminian,et al.  Physical activity monitoring based on accelerometry: validation and comparison with video observation , 1999, Medical & Biological Engineering & Computing.

[25]  A. Bourke,et al.  A threshold-based fall-detection algorithm using a bi-axial gyroscope sensor. , 2008, Medical engineering & physics.

[26]  Kamiar Aminian,et al.  Stair climbing detection during daily physical activity using a miniature gyroscope. , 2005, Gait & posture.

[27]  Tao Liu,et al.  Development of a wearable sensor system for quantitative gait analysis , 2009 .

[28]  Hongyin Lau,et al.  The reliability of using accelerometer and gyroscope for gait event identification on persons with dropped foot. , 2008, Gait & posture.

[29]  M.R. Popovic,et al.  A reliable gait phase detection system , 2001, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[30]  K. Aminian,et al.  A new ambulatory system for comparative evaluation of the three-dimensional knee kinematics, applied to anterior cruciate ligament injuries , 2006, Knee Surgery, Sports Traumatology, Arthroscopy.