Smart Rehabilitation for the 21st Century. Design of Transitional Living for Polytrauma Veterans

Scientific Paper

Technology

Wed, 6/15, 7:00 AM
Lincoln East

• Jan M. Jasiewicz, PhD
  Department of Veterans Affairs
  jan.jasiewicz@va.gov

• Participants will learn the current policies and practices of the US Army, Navy, Air Force, and Marine Corps regarding TBI.
• Participants will learn the outcomes, lessons, and best practices from current battlefield approaches to blast injury/TBI diagnosis and treatment across the Military Services.

This presentation will discuss the Smart Home at the James A. Haley Veterans' Hospital’s Polytrauma Transitional Rehabilitation Program (PTRP). The Smart Home is an implementation of context-aware technologies that are specifically developed to augment existing clinically based cognitive rehabilitation strategies for live-in traumatic brain injury veterans. It is designed to act as a cognitive prosthetic for the resident patients. The core technology of the Smart Home is an ultra-wide band (UWB) real time location system that tracks the locations and movements of patients and clinicians within the facility 24 hours a day. The Smart House has four design elements: patient safety; mapping/navigation assistance; scheduling/medication management and; behaviour prompting. Clinicians and resident patients are able to interact with context-aware applications through 65 touch sensitive displays mounted throughout the facility. Also integrated into the system are instrumented appliances in 5 residential living facilities and common areas. Residents relearn and reinforce activities of daily living, such as preparing simple meals, doing laundry, taking medications and maintaining appointments.

Behaviour prompting is performed in the context of locations; the system tracks and prompts specific behavioral components when it detects that a particular task (i.e. doing laundry) is being performed incorrectly. Using ‘errorless learning’ and ‘stimulus fading’ techniques, found to be effective in TBI cognitive rehabilitation, behavioral prompts are systematically faded. The clinician, depending upon the needs of the patient, may vary content and intricacy of prompts.

We will also introduce a metric called Fractal D (known alternately as path tortuosity) used to assess therapeutic improvement in patients undergoing ‘smart house therapy’. Fractal D is a statistic describing long-term movement variability and has been demonstrated to be related to cognitive function.