BIORescue
System for analysis
and
postural-sequential physiotherapy
BIORescue® is a system that combines a platform, equipped with 1,600 sensors, and software, making it possible to carry out analyses and receive feed-back about the physiotherapy.
If your connection Internet does not enable you to visualize this film of presentation correctly, write us with the following address: contact@rminformatique.com, will we forward to you a specimen on CD. |
As an analysis tool BIORescue® makes it possible to objectively observe the sequences of the patient’s everyday movements, from registering his support and analysing displacements of the centre of pressure (CP - CdP), which occurs, under certain conditions, when his centre of gravity is changed.
All traumatic or neurological pathologies systematically lead to a change in posture, of the support and so a signal that is registered by BIORescue® is produced.
With BIORescue® it is equally possible to check the relevance and efficiency of the technique of a movement or the progress of a treatment.
Thanks to the postural retroaction (biofeedback) exercises, most of which are in the format of a game, the practitioner can use a physiotherapy that is extremely effective. From the measurements taken by the system, these exercises are automatically adapted to the patient’s functional abilities.
Thanks to its action on the central nervous system and also the different stages of integration on the group of muscle chains, BIORescue® offers a powerful reconstruction tool, albeit very gentle, that with natural progression, under the guise of a game, gives complete feedback.
BIORescue® portrays a modern and proficient image in practices and constitutes a real communication tool when one must discuss the outcome with the patient and the person who prescribed the treatment.
The Analyses
BIORescue® makes it possible to make objective analyses, and quantify and compare deficiencies and inabilities :
- Muscular
- Articular
- Neurological
- Sports pathologies
- The pathologies caused by age
- Pathological development leading to indications (signs) of prostheses and functional re-adaptation.
The dynamic analyses can be carried out with the patient standing up or sitting down, kneeling or with the arms on the platform, barefoot of wearing shoes, with or without soles, with or without prostheses, with or without equipment (for amputees, specially adapted shoes), or walking aids used by the patient.
Example : The analysis of the foot print or the print of the buttock makes it possible to assess the posture of a patient giving a clear indication how the weight is distributed.
One can also establish very easily what the hyper support areas are and the other anomalies indicated during the clinical examination: when the patient has flat or arched feet, valgus or varus .... But in addition one could carry out objective measurements following more or less pressure being applied on the front of the foot or, adversely, on the heel; the consequences of a lateral posture (more weight being placed on one leg); one limb being shorter than the other; rocking or turning of the pelvis; the flexum of the hip, etc.
The podal analysis makes it equally possible to place the centre of pressure of each foot as well as the overall centre of pressure.
When the patient is sitting on the platform, placed on a horizontal pedestal (adjustable height chair), the print of the pressure makes it possible to study the distribution of the support when in a seated position and to verify the consequences of all the problems with the position of the spinal column: turning of the pelvis, lumbar scoliosis, lordosis cyphosis. This analysis is essential as it also makes it possible to confirm or invalidate the podal assessment without taking into account the impact the lower limbs.
The test can be carried out with and without wearing a corset (or all other systems such as a suspension, an active effort to stand straight or of self-correction …).
Studying the movements is done by means of the protocols defined in the software and defined in general medical specialties such as neurology, orthopaedics, geriatrics, balance, etc...
The protocols are very varied and make it possible to study the basic movements made by the patients on a daily basis.
These are movements such as:
- To remain standing upright, eyes open or closed
- To stand up
- To step forwards or backwards
- To step over an obstacle
- To make a quarter or a half turn
- To squat
- Etc.
The displacement of the patient’s CP in relation to the execution of a movement defined by the protocol, makes it possible to make an objective assessment and quantify the effect that his pathology has on the effectiveness of this movement .
Example 1 : If one considers that a healthy person who stands up will exert a pressure that is more or less evenly distributed between his two legs, a person presenting pathology (of the knee, ankle, hip or lumbar vertebra) will have the tendency to exert a stronger pressure on the side where he doesn’t feel pain.
.By doing this, instead of staying on the axel between the two feet during this movement, the CdP moves under the foot that exerts the pressure on standing up.
The amplitude of the lateral displacement is therefore an indication of the difficulty the patient has in getting up and the strategy that should be employed to achieve that.
Showing the patient his movements at a slower speed will make him aware of his weaknesses which will help him with his physiotherapy.
Image 1 : The patient is sitting with his feet on the platform: the print is more pronounced on the heels when he begins to get up.
Image 3 : One sees very distinctly an important print underneath the left heel contrasting with the image on the right, revealing a relative discharge linked to the pathology.
Image 6 : The pressure is almost only exerted on the left foot and the ball of the right foot only contributes to maintaining balance. The CdP starts off completely on the left (the central black trace changing with the progression of the sequence – the software making it possible to zoom in on this trace).
Image 8 : The patient is standing upright and placing support on both his legs.
Example 2 : The quarter turn
The displacement of the CdP during this analysis has a very characteristic signature with a healthy person. One asks the patient to step off then platform from first one side and then the other. The “L” shaped trace seen is caused by lifting the first foot (the CdP is then transferred under the foot still resting on the platform) then, when lifting the second foot gradually upwards, the support is transferred from the heel to the tip of the foot.
Here one can very easily compare the strategy of a patient in accomplishing this movement one side after the other. The observation of the distinct strategies used depending on the side reveals the difficulty in carrying out a movement and confirms the existence of pathology.
.
In this example the patient is asked to step off the platform whist executing a quarter turn to the right .
Image 1 : The patient is standing upright o the platform (he anticipates the next movement: his posture is sufficiently positioned to the front).
Image 2 : He has begun to lift his right foot, the CdP is transferred towards the left, balancing on the foot .
Image 4 : His right foot has left the platform, the CdP no longer moves towards the left. An inverted print is very apparent (the lateral transfer of the body mass during this time of stabilisation).
Image 5 : The CdP has begun to move towards the front of the foot (time of turning left, the other foot turning to the side but ending up on the floor).
Image 8 : The trace of the left foot has almost entirely disappeared, the CdP moves forward forming an “L” shaped signature characteristic of this movement .
A distortion of this signature would reveal a tactic far removed from the efficient and effective strategy, found very generally in normal conditions for a movement carried out at normal speed.
The two previous examples show that, thanks to Biorescue, the practitioner can very easily analyse and quantify the effect of pathology on the ability of a patient to carry out a commonplace movement, but also to store this information in the patient’s file and thus to compare this observation with all subsequent observations, from the beginning through to the end of the treatment. Recording the CdP and the pressure that is exerted on the platform’s sensors at 40 Hertz (40 images per second) allows a very precise observation and breakdown of the movements made on the platform, with the possibility of “the replay” of the movements at a lower speed to best visualise the trace and the prints, and understand to the full the method and its ambiguities, to show images and give an opinion so to inform and educate the patient.
For sports training BIORescue® will be an extremely useful tool for the improvement of the postural kinetic component of each person’s performance. Therefore, for a sportsperson (martial arts combatant, golfer, archer, etc.) one can observe the breakdown in sequences of his movements and set objective goals to enable him to improve his performance.
The Assessment
Reference |
||
|
||
Eric ARTUSO (Specialist in vestibular rehabilitation) |
||
|
||
Jean-Claude |
||
|
||
DOCTOR Jean-Yves CORNU ( |
||
|
||
Nicolas DURAND ( |
||
|
||
| (Patient) | ||
|
||
Jérome GRAPINET (Specialist in vestibular rehabilitation) |
||
|
||
Nicolas PROUHAISE MASSEUR - PHYSIOTHERAPIST |
||
|
||
Guy SALAT |
||
|
||
Lise-Marie BONTOUX-PINATON |
||
|
||
Lise-Marie BONTOUX-PINATON |
BIORescue® allows carrying out a comparative assessment supported by many analyses repeated at different times throughout the treatment. The analyses or tests are put together in groups of 5, each organised by level of difficulty; a group giving a score or a profile of the patient, in addition to the parameters characteristic to each analysis.
A produced document contains an explanation of the protocol used as well as the dates and the results obtained. The document that is completed by the practitioner’s comments allows links to be made between the various persons involved (the treating doctor, health authorities, patient).
The Physiotherapy
The exercises proposed in BIORescue® are easy, essentially in the form of a game. They offer ideal conditions for the most effective physiotherapy possible.
Whilst working in a retroactive style at the same time visual and proprioceptive, sometimes with sounds, they use the resources and characteristics of this method of physiotherapy, based on learning and training. Their gentle action on the group of muscle chains leads to optimal reconstruction of the postural kinetic ability of the patient.
With BIORescue® we work on the whole body not only on one part of it.
The exercises develop using the feedback (retroaction) from the platform which is sent back to the patient as a mirror image of his movements …. and his mistakes.
Example: The ski programme allows then patient to work transferring his lateral and anti-postural support. At the same time he must control his postural support and anticipate his actions.
By placing pressure on a side the skier can turn from one side to the other; by leaning forward the skier can increase his speed (SCHUSS) and he will slow down by placing his weight on the back (chasse-neige).
He is asked to pass through the gates and his performance is recorded in order to visualise his progress.
Through this work the patient regains the effectiveness of his support, works the weak muscles and articulation in the perspective of optimising the muscular stability, increasing the relevance of adapting his posture (acting on the central nervous system and things affecting it).
To undergo physiotherapy whilst enjoying oneself guarantees the total involvement of the patient. A patient’s limits of stability must always be registered before undertaking the exercises. These will therefore be automatically graded in comparison to the patient’s potentials. An 18 year old sportsman is going to suggest exercises that have a different level of difficulty than those suggested to an elderly handicapped person.
Several types of exercises make it possible to work on the re-establishment of the transfer of the support, the stability, the balance, the anticipation of movement, etc…
The exercises can be carried out in very different ways which will be defined by the practitioner to best achieve his objectives:
- Standing upright with or without shoes
- Seated on the platform.
- Seated on a ball. The movements of the patient on the ball are transferred to the platform.
- Legs stretched, or bend, exerting pressure with the feet or not.
- The platform is placed on the table or against the wall and the patient makes movements with his wrist, elbow or shoulder.
- The patient undergoes a lateral or anteropostural force (elastic, weights, …).
- On the knees, monopodal.
- On a moving platform (on a spring).
- On a platform that is placed on a seesaw, on foam, on an oscillating system.
- Etc
 |
 |
 |
 |
 |
 |
 |
 |
The scores that are obtained during the exercises are recorded in order to manage the patient’s adherence to the exercise he was asked to perform, and also his progress in the physiotherapy treatment .
The exercises can be carried out with several degrees of difficulty (5 levels)
Exercises with a simplified graphic design are equally suggested to patients for whom a more elaborate graphic design is not suited
Conclusion
BIORescue® is particularly useful for:
- Orthopaedics (Traumatology - Rheumatology)
- Recovering following a traumatic accident
- Problems with supporting articulations
- Defects of the axe of the lower limbs (preparation pre-, physiotherapy post surgical intervention)
- Following prosthesis fitting (hips, knees, ankles, shoulders, slipped disc)
- Back pain, vertebral deviations, following surgery for rickets, dealing with back problems
- Neurological
- Hemiplegia
- Parkinson’s disease
- Children with problems coordinating movement (when origin is known)
- Dizziness (internal ear) and problems of balance of a central origin
- Peripheral pathologies, asymmetric or not
- and others ...
- Geriatrics
- Prevention of falls
- Training in methods of balance
- Working towards independence – reinforcing methods of substitution
- Sports medicine
- Evaluation of the postural-kinetic ability of an individual
- Post-traumatic physiotherapy through biofeedback
- Seasonal preparation: balance, coordination
Necessary configuration minimum :
Microprocessor : 1 Ghz
Read-write memory (RAM) : 256 Mo
Hard disk : 500 Mo available
Operating system : Windows XP SP2
Resolution of screen : 1024 x 768 (24 Bits)
Graphics board : 32 Mo - 3D
 |
Project cofinanced by UNION EUROPENNE FUNDS EUROPEAN OF REGIONAL DEVELOPMENT |
For all information : RMIngénierie - Avenue de la Gineste - B.P. 3351 - 12033 RODEZ Cedex 9 - FRANCE - Phone : (+33)5.65.76.03.33 - Fax : (+33)5.65.76.03.09 - Email : medical.comm@rminformatique.com
©RM Engineering, CEGEDIM Group