Medicom MTD Ltd
System presents biofeedback signals in the form of controlled images of visual, acoustic and tactile modalities. Together with traditional digital, pointer, line, colour, etc. indicators, "natural" biofeedback signals presentation are realized in the form of topically selected slides, image rows, videoclips, audio effects and musical works of various genres, and also in the form of a game.
Feedback signals in visual modality are presented on the patient’s monitor, and they may be duplicated on the doctor’s monitor, if required. The whole variety of visual modality images are divided into the following groups:
- Image rows
- Video display
- Game images
Any of the enumerated visual images may be displayed on the patient’s monitor in full-screen or window modes. The second variant allows displaying to patient several visual images in random combination simultaneously or carrying out training of several patients at a time, selecting one image for every test person (independent work) or various features of an image (the patient’s collaboration or competition). Wide range of visual forms of feedback signals presentation and their customization allows significantly stimulating the patient’s motivation to task-oriented change of his state and makes every procedure attractive.
Needle indicator with activated digitalization of scale edges, digital display of current value, indication of controlled parameter name, electrode attachment place and picture place and background picture.
Indicators — are the group of the most simple, traditional forms of signals presentation, meant primarily for initial introduction of the patient into biopotential control capabilities. Rheacor indicators are multiparameter, i.e. there is an option of simultaneous display of several parameters change simultaneously, not only of one controlled parameter (for coupled indicators – for two ones). The patient does not have to switch attention focus or distribute it between several indicators at carrying out of multiparameter training procedure. All necessary information about change of associated physiological processes is displayed on one visual object with corresponding control of its various features. Besides, every indicator, at customer’s option, can additionally display current value of controlled parameters in digitalized form, change sizes and location on the monitor, use changing colour or any image as a background and many other capabilities, which make indicators customizable instrument for a doctor and well-comprehencible and informative image for a patient.
- Pointer paired horizontal
- Pointer paired vertical
- Paired graph
The second type of visual modality images, Image, differs from indicators in essentially wide variety and additional facilities of influence on patient’s emotional state. It is primarily meant for relatively short working stages of multiply repetitive sessions of rehabilitation course. Specified main and background images may be selected from rich image library, which can be enriched by the user himself. Transfer of information about current state of controlled parameters to the patient is carried out by means of change (distortion) of one or simultaneously several image features from the following list:
- Size: initially small image size is proportionally increasing, becoming maximally possible (full screen) during task carrying out, while controlled parameter is approaching to set value (threshold)
- Dripping frequency
- Drops size
- Colour (red, green, blue)
- Orientation (Х,Y,Z axes)
The illustrations below give about a notion of what your patient will see as a feedback signal during use of various image properties.
Picture size: initially small image size is proportionally increasing, becoming maximally possible (full screen) during task carrying out, while controlled parameter is approaching to set value (threshold).
Picture transparency: the first picture main image is almost transparent and the background picture is viewed through it . The nontransparent image fully overlaps the background in the third picture.
Dripping frequency and size: the image is not distorted in the first illustration, the nontransparent image fully overlaps the background in the second and the third illustrations.
The third type of visual modality images, Image rows, differ from images in the ability of a patient to clear from distortions and sequentially view set of topically selected images (slide show) during the stage. You may open every slide only when a controlled parameter achieves the threshold, set by the doctor, which motivates the patient to achieve required value at once and to maintain it during defined time. Scrolling temp and slides change speed are selected by the user. This image is primarily meant for relatively continuous work stages (and also for rest periods) of rehabilitation session. Specified image row may be selected from supplied image rows library or created with required images selection and grouping by the user himself.
The fourth type of visual modality images is Videoclip, which display quality depends on degree of approximation of controlled parameter to specified threshold value. If parameter change trend is opposite to a set one, videoclip demonstration is stopped (frozen picture) until parameter change direction is normalized. Mosaic and/or effect of submersion with water may be used to distort clip.
The fifth type of visual modality images — Video display, possesses the most expressed motivating effect. The essence of this image type is smooth transformation into another while controlled parameter is changing (e.g. an old face grows young, an infant transforms into an athlete, a dressed girl undresses, etc.). Concrete videoindicator content, which maximally consideres individual particularities of the actual patient, may be prepared with standard morphing programs by the user himself.
The sixth type, Game images, has two variants — for slow (e.g. local temperature increase, muscle tone decrease at relaxation) and quick (motor actions normalization) physiological processes. In the first game variant game object (an eagle, a balloon, a genie, etc.) ascends higher and increases flying speed against changing landscape at a smooth change of controlled parameter in required direction. If a parameter changes unfavorably, the object descends, and, influenced by the head wind, it is drifted back to start point. The game purpose is to fly the maximum distance, marked on the map. The second game variant supposes quick and dosed by amplitude and time change of a controlled parameter. E.g. at reactivation of movement muscles activity, time point, clonus power and duration of this clonus maintaining should contribute to catching maximum number of object-prizes, flying at different height.
2D game image of control of balloon height, direction and conveying speed depending on controlled physiological parameter.
3D game image – with an example of EMG biofeedback training for movement activity reactivation.
Feedback audio signals are presented with acoustic system or headphones, connected directly to computer. The whole variety of acoustic modality images are divided into the following groups:
- Audio fragment
- Audio message
- CD player
- Audio noise
- Sequence generator
Each of these audio images may be used simultaneously with any other or with same-type image (you should not use more than one CD player), which allows realizing extremely intensive and various audio execution of rehabilitation procedure with suggestion and music therapy elements.
The Audio fragment image allows playing defined set of any audio files (music, nature sounds, voice messages, etc.), selected beforehand from the Audio library, which can be expanded by a user. Files may be played sequentially according to the list or randomly once or with iteration.
Changes of controlled physiological parameter are reflected in a proportional change of volume and/or of audio channel balance in a set range. The actual image’s peculiarity is an opportunity of play start of selected audio file at the beginning of definite event, number of such events and the sounds, corresponding to them, is almost unrestricted. E.g. if the patient succeeds to increase finger temperature to 0,3 degree, the audio encouragement "good" will sound, 0,5 degree rise — "very good", 1 degree rise — you can hear applause and the exclamations "exellent".
The Audio message image also allows playing defined set of any audio files, but differs from the previous one in the fact that every audio file starts at set time from the stage start, due to this various sounds may overlap each other (e.g. audio instruction against the background of music, birdsong and tidal bore). Besides audio message volume and balance do nоt depend on a controlled physiological parameter.
The Midi image allows transforming change of controlled physiological parameter into change of tone pitch of selected single or simultaneously several musical instruments. The patient can hear and control music of work of one or another organ (brain music, heart music, etc.). This image is available only at stages of controlled type.
The CD player image allows using usual musical compact disks during procedure, if there is no need to copy them onto computer hard disk. You may select and indicate those disk tracks, which should sound at the procedure actual stage. Later on, while selecting a scenario, containing the CD player image, the program will reming the user, which disk should be inserted into computer before session start. Changes of controlled physiological parameter are reflected in a proportional change of volume and/or audio channel balance in a set range.
The Audio noise image is meant for quality deterioration of audio files play to increase the patient’s motivation to controlled parameter change in required direction – the better the task is carried out, the less interfering noise intensity is. This image is available only at stages of controlled type.
The Sequence generator image is a specific audio image, which allows forming random sequence from set of sounds, every of which is played with set probability and with random iteration period within set time range. It may be used in procedures with imitation of stress audio influence to decrease habituation effect. This image sound parameters are set by the user and do not depend on change of controlled physiological parameters of the patient.
Rehacor system provides a unique capability of feedback signals presentation by means of influence on tactile system of the patient with electrostimulation. The patient’s subjective sensations at stimulation parameters control change within a wide range – from full lack to moderately algesic sensation. If you consider biopotential control as a retraining process of one or another system of organism, dose use of electrostimulation allows essentially increasing the educable’s motivation to search and save a new, more adequate functioning stereotype of corrected function, and thereby, contributes to procedures efficiency. In other words, among the influence means, available to the doctor, there is a balance of "carrot and sticks" in supporting the patient’s activity to achieve a purpose of biopotential control course.
For all above mentioned the additional device Electrostimulator is used.
For system "Rehacor". Connected to a patient unit.
For system "Rehacor-T". Controlled via Bluetooth.
If you use electrostimuli as a feedback signals, depending on the change of controlled physiological parameter, you can see changes of the following stimulation parameters:
- Impulse amplitude
- Impulse duration
- Impulse repetition period
You may not connect these parameters with the patient’s state change and set some fixed values, in such a case, stimulation becomes a stress factor value. Its use during completive procedures of biopotential control course allows saving the selfregulation skill, formed under “hothouse” conditions of the doctor's office, and guaranteeing its transfer into daily reality conditions, increasing the patient’s stress resistance.