Session SB2.2

Requirements of a System for Cardiac Tele-Rehabilitation: Experiences from the SAPHIRE Project

O Nee, T Gorath, A Hein, C Busch*,
R Ludwig, D Willemsen, T Scheffold

OFFIS
Oldenburg, Germany

Rehabilitation following cardiosurgical intervention is a proven and effective method. It is, however, cost-intensive and often lacks the means to establish a sound basis for sustained long-term success of the intervention, mainly because of insufficient availability and limited capacities in rehabilitation centres and long distances between a patient’s home and cardiac sports groups or similar programmes. Tele-rehabilitation systems deal with the aforementioned problems that limit the overall efficiency of conventional rehabilitation measures.
We analysed clinical requirements and standards to define the technical requirements of the system. It should be easy to use, while adhering to safety standards concerning both medical sensor data and technical reliability. We chose a bicycle ergometer modified with 4-lead ECG, recognizing arrhythmia and ST-depression/-elevation, blood pressure measurement and O2-saturation. The system is controlled by a Panel-PC that is also serving as a gateway for data transfer. The physician defines limits for heart rate, blood pressure and O2-saturation, based on exercise testing, for an individual training program. Those limits and defined ECG-parameters ensure a safe training session. The patient has to log into a personal account to transfer current exercise data from the clinical server to the bike’s panel PC.
The EU-funded project SAPHIRE offers a platform for tele-rehabilitation of cardiac patients by providing a modified ergometer bike and a set of wireless sensors that facilitate a safe and supervised training. While the patient is exercising, the ECG, blood pressure and O2-saturation are monitored constantly. If sensor data exceeds a defined threshold, the patient will receive an alarm; as a result the training will either be stopped or continued at a reduced load, depending on the severity of the alarm. Before and after the actual training session the patient answers a set of questions that help the clinician to interpret the given sensor data of the training session. These answers, as well as the sensor data, are compiled in a report that is sent to the rehabilitation clinic to be validated by the treating physician.
The SAPHIRE system can provide a secure training at the patient’s home. If the condition of the patient deteriorates, this can be detected early to prevent re-hospitalisation.

(Abstract Control Number: 326)