Medicom MTD Ltd
Main stages of new scenario (protocol) creation in the system "Rehacor" consist of sequential carrying out of 9 steps. You can, certainly, create a scenario of new rehabilitation procedure , when the specialist comprehends correlation between one or another dysfunction and electrophysiological indices.
Selection of one or simultaneously several physiological signals, parameters of which will be used
for feedback signal forming and/or for current control of the patient’s state.
You can simultaneously record up to 6 signals (Record channels number depends on patient transceiver-recorder type: "Rehacor" – 4, "Rhean" - 6, "Encephalan" – up to 6 channels) in random combination, for every of which there is an indication of record unit input connector , place of electrodes attachment onto patient’s body, and you can set optimal record conditions (dynamic range, frequency band, rejection of power line disturbance).
à) basic parameters list for EEG signal.
b) basic parameters list for ECG signal.
For every of selected physiological signals you can set parameters,
which will be calculated in real time and presented to the patient as a feedback signal
and/or controlled by the doctor during session.
In such a case you may select parameters from the fixed set (the type "Basic"), specific for each physiological signals, or synthesize your own ones (the type "Compound"), setting formulas for their calculation. Basic parameters of any physiological signal selected at the previous step, united by arithmetical operations, may compound a formula.
Forming temporary scenario structure — setting of required number and duration of stages of various types: Instruction (setting type), Rest (background), Control over a physiological parameter (controlled).
Typical scenario structure contains:
- Starting screen saver with procedure name and introductory instruction;
- Record stage of the initial patient’s state;
- Instruction – task for the next stage;
- The patient’s work at controlled parameter change by feedback signals;
- Record stage of the resulting patient’s state;
- Finishing screen saver.
Stages 3-5 may be iterated many times. Duration of every stage may be set randomly in the range within 1 to 60 minutes.
Filling of every stage with content is selection of presentation forms of audiovisual stimuli and feedback signals from the list of available images of visual, acoustic and tactile modalities. E.g. at the controlled stage, feedback signal will be presented in the form of task-oriented image transformation using Image row, volume change of selected musical fragment (Audiofragment) and sounding tonality change of selected musical fragment (Midi image). In case of unfavourable trends in controlled parameter change, the patient may get moderately pain stimulation (the Operated Electrostimulator image), degree of which depends on the deviation level of parameter current value from the set one. Images number and combination may be random at every stage.
Images setting — for every selected image from the "Resources" library, you should select concrete content and parameters, with which it will be presented to the patient at the actual stage. E.g., setting of the Image row consists of selection of definite topic from the section "Video" of the Resources library (at the example – "Waterfalls") and setting of its displaying parameters (size, spatial orientation, brightness, intensity of "rain", etc.) on the patient’s monitor.
Setting of the image "Audiofragment" is carried out with selection of one or several audio files and indication of volume, balance and the audio files playing sequence in the section "Audio" of the Resources library. If there is no required audio fragment in the delivered Recourses library, then you can add it by means of copying from any computer-compatible source. There is an option of recording own audio instructions (if a microphone is available).
For the image "Electrostimulator", you can set the range of allowable amplitude values and stimulation impulse duration, and also their iteration period. You can select required parameters values by means of your own subjective sensations, attaching stimulation electrodes to yourself. Content and presentation parameters of all images used at the actual stage are selected likewise.
Selection of feedback signals type. For the controlled type stage, you can select those image features, which you can use as the feedback signal, reflecting changes of controlled physiological parameters. E.g. visual modality images afford an opportunity to use up to13 image parameters (see their list for Image row in the picture of step 5), acoustic modality images — up to 3 sounding parameters (volume, balance, messages). Any of controlled parameters, selected at step 2, may be connected to any image feature or even to several features. In the given example, respiratory cycle duration defines image size, "rain drops" rate in the picture depends on GSR amplitude, mosaic density is defined with HR, and rotation angle of image plane depends on muscles tonus (EMG). It allows realizing multiparameter (simultaneously by several physiological parameters) feedback with one integral visual image. Consequently the patient does not have to turn his attention to several indicators. This step is iterated for all stage images.
Thresholds setting. There can be set the range limits, within which controlled parameter changes determine proportional changes of selected image feature. One of the limits is the target threshold, setting that value of controlled physiological parameter, which the patient should try to achieve and keep at the actual stage. E.g. decreasing pulse rate to a set threshold will lead to full disappearance of masking image mosaic. Thresholds setting is possible in two types – absolute and relative. In the first case parameter concrete value, e.g. to increase respiratory cycle lasting (RC) up to 15 s, is set.
In the second case, threshold value is set in the form of the formula, containing statistical indices of controlled parameter, which will be calculated for the actual patient during the session before the controlled stage start. It allows automatically adapting task complexity to current state and individual capabilities of every patient, and thereby almost excluding the doctor’s operations of thresholds manual adjustment during the procedure at every controlled stage. This step is iterated for all selected features of every stage image.
View of collaboration of all created stage images with use of operated generator of controlled parameters. If the patient is absent, generator allows imitating changes of all physiological parameters, selected at step 2. Manual and automatic (with set distribution parameters) parameters control is possible.
If required, stage content and parameters correction is carried out by view results, and the same actions (step 4-7) are sequentially carried out for all the rest stages on acceptable result obtainment.
Name assigning and new scenario saving in scenarios library. Setting of new procedure name, indication of a montage configuration, created at step 1, and the scenario, saved in scenario library at the previous step. New scenario is ready for carrying out procedures with the patient.