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Virtual Coaching Activities for Rehabilitation in Elderly

Periodic Reporting for period 3 - vCare (Virtual Coaching Activities for Rehabilitation in Elderly)

Okres sprawozdawczy: 2021-04-01 do 2022-08-31

Continuity of care from the professional treatment into the home environment is critical to ensure the patients’ quality of life (QoL). It is deeply related to the patients’ abilities to engage in their care and the health expectations. Evidence shows that one of the most relevant domains is the rehabilitation after an acute pathological episode. Rehabilitation is a complex process by which a patient and a multitude of caregivers are involved starting in the acute-care hospital. Ideally, at home the rehabilitation team is continued and enriched by additional caregivers. Even though rehabilitation does not “cure” the effects of a disease, rehabilitation can substantially help people to achieve the best possible long-term living. Unfortunately, the continuity of rehabilitation often interrupts with the transition to the home. Virtual Coaches can be a key technology to ensure the continuity of care by supplementing the professional human caregivers and thus reinforcing self-management, enhancing adherence to the care plan and risk prevention and ultimately empowering patients. Therefore, the vCare project developed and investigated a Virtual Coaching solution encapsulating a set of coaching services for empowering and motivating people, helping them to proceed with a personalized rehabilitation by means of a virtual avatar. For this, vCare monitors the patients’ daily activities and conditions to provide personalised measures to recover the QoL. For that, the coaching programmes are initialised by specialists by assigning a well-elaborated clinical pathway as a tailored rehabilitation plan to the patient. The Virtual Coach can intervene as it is permanently examining the patient.
As a general conclusion after conducting the final patient tests, the vCare system represents a safe and efficient solution for ensuring continuity of medical rehabilitation care and access to personalized cognitive and motor treatments for patients with neurological and cardiological disease. The use of the vCare system was associated with the improvement of the clinical conditions and an increase in Quality of Life.
After closing the conceptual project stage, the system implementation started with the Tech Lab prototype having the therapists substituting the patient behaviours. Within the Tech Lab phase the sole functioning of the technical components and their interplay have been successfully tested. Therefore, each component was deployed accordingly to the architecture and connected via a common messaging layer, the communication flows specified were implemented and the interplay of the components were tested based on pre-defined core activities. In parallel, the clinical pathways which set the baseline for the coaching activities were revised and enriched with technical details that are necessary to integrate them into the care process. After publishing them, the pathways are available in the professional portal and can be refined and prescribed to a concrete patient. The Virtual Coach interacts with the patient according to the boundaries the pathway sets but also personalizes the interaction.
In a second step, the Living Labs simulated the homes by research apartments providing a protected environment and support for the patients successfully trying out the VC solution. The Virtual Coaching solution was implemented into a controlled environment at the premises of each medical partner. Three Living Labs have been implemented for the pathologies of Stroke, Parkinson`s Disease, and Heart Failure. In addition to the Living Lab prototype, users are continuously involved in the design process. Results from the patients indicated good ratings of the vCare solution and, in general, a high level of enthusiasm and curiosity both by the patients and the professional users.
Thirdly, within the subsequent Pilot Phase the patients used the solution in their real home setting. Admittedly, the achieved final results vary a bit depending on the pathology and sub-score of the indicator assessment. But in sum, the main objective can be regarded as reached in terms of the measured improvements in QoL during the pilot phase by ensuring continuity of care and the access to personalized cognitive (for the neurological cases), motor exercises (for all patient groups) and overall coaching advises by the Virtual Coach. Also, the overall provision of an effectively working and well-acceptable smart virtual coaching could have been proved by the final user tests.
Orthogonally to the technical and clinical tests, altogether the foreseen dissemination plan has been successfully addressed: both the clinical (rehabilitation@home) and technological (vCoach related technology) aspects have been continuously followed trying to find the right communication angle and opportunities for each of the two. The focus was mainly to put on raising awareness on the potential benefits of the virtual coach in the rehabilitation clinical context and the strategy proposed by the consortium to reach solid results, i.e. Technology Readiness Level (TRL 7) by the end of the project. All the communication channels foreseen at the beginning of the project were created and maintained and some complementary initiatives were developed: this included the vCare Newsletter, the production of both animated and life videos and the activation of complementary social networks. All vCare consortium partners have been involved in the dissemination activities. Both direct and indirect exploitation routes have been drafted and prepared to be materialised post project.
The vCare project aimed to go beyond the state-of-the-art technology integrating and processing different data sources to personalize the coaching recommendation based on clinical pathways and patient preferences. Therefore, the project mission was to utilize the virtual coach in terms of the virtual avatar as communication mean for the patient. Acting like a physical coach, the VC channels the information and provides suitable recommendations to the patient, as well as engages the patient “like a coach” to stay in their training plan and also provides a backlink of the outcome as well as a possibility of intervention to the physician.
The vCare solution is deluged with several sensors to evaluate patient’s health status, care plan adherence, and other factors that are necessary for smooth recovery of quality of life. It also provides an interface for caregivers to extract patients’ relevant information and to tune the treatment.
Further, vCare integrates semantic technologies (reasoning, behavioural models, predictive analytics, going beyond only rule-based but more intelligent adaptations), well-elaborated coaching services and clinical pathway services having the virtual coach as the central and controlling element. The Virtual Coach encapsulates coaching and supportive services as well as tele-monitoring services. The latter provide the data-related basis for the virtual coach’s decision logic as well as tracing data the service provision is based on. However, the innovativeness of vCare does not only reside in the utilization of single technologies but in the combination of these technologies. This is to individualise/personalise the home care/rehabilitation and somehow fill the gap the caregiver’s absence in the home environment has caused.

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