Remote therapeutic monitoring devices are key in enhancing patient care and improving outcomes for various medical conditions. This week’s research summaries in telemedicine focus on remote therapeutic monitoring devices. We highlight two new studies that showcase the impact of two new technologies on rehabilitation.
What is Remote Therapeutic Monitoring?
As telehealth expands, new classifications like remote therapeutic monitoring (RTM) are emerging to meet healthcare provider and patient needs. RTM codes allow physical therapists, who can’t bill for remote patient monitoring (RPM), to offer services for respiratory system and musculoskeletal system status. Remote therapeutic monitoring devices enable healthcare professionals to use remote therapeutic monitoring devices for remote delivery of therapeutic patient care.
This approach not only enhances patient engagement but also facilitates proactive healthcare management. As we delve into this week’s studies, the spotlight is on innovative solutions for Parkinson’s disease and spinal cord injury patients.
Remote Therapeutic Monitoring Devices for Parkinson’s Disease
The first study introduces using soft robotic apparel to avert freezing of gait (FoG) in Parkinson’s disease. FoG is a disruptive gait disturbance causing unintended stops while walking. Existing therapies have shown modest and transient effects, leaving a gap in effective treatments. This proof-of-concept study explores the use of wearable soft robotics to augment hip flexion and prevent FoG.
The wearable garment utilizes cable-driven actuators and sensors to generate assistive moments in coordination with biological muscles. A trial involved a 73-year-old male with Parkinson’s disease, with five repeated measurements conducted over 6 months. The measurements assess the response to the robotic soft robotic apparel.
The RPM device eliminated FoG during indoor walking and reduced the time spent freezing from 39% to 0%. Additionally, the participant saw an 55% increase in walking distance (49 ± 11 m), faster walking speeds (+0.18 m/s), and a 25% reduction in gait variability, indicating improved gait quality. The positive effects were repeatable across multiple days, conditions, and environments. These results suggest potential for community use.
This study addresses an unmet need for effective interventions in managing FoG. The successful application of wearable robotics not only provides a novel solution for Parkinson’s patients but also highlights the potential for broader community use, marking a significant step forward in enhancing mobility and quality of life.
Remote Therapeutic Monitoring Devices for Spinal Cord Injury Patients
The second study focuses on using a powered exoskeleton as a medically necessary device for eligible Medicare beneficiaries with spinal cord injuries. The research explores the potential benefits of exoskeleton use in supporting adaptive neuroplasticity and reducing chronic pain in spinal cord injury patients.
Nineteen patients with complete and incomplete spinal cord lesions below T4 underwent assessments using the Rewalk Exoskeleton. Assessments using a computerized pressure algometer, Numerical Rating Scale , and Neuropathic Pain Questionnaire in Spinal Cord Injury were conducted at the beginning of each training session (T0) and after 9 (T1) and 18 (T2) training sessions.
Results showed significant improvement in tactile sensitivity at T1 (p<0.002) and T2 (p<0.01), particularly for the lower limb. Pain intensity also showed a consistent reduction exceeding 30% throughout all training sessions (T1 = p<0.009; T2 = p<0.045). Additionally, a significant correlation was found between pain intensity and improvements in tactile sensitivity (r = -0.63; p = 0.04). These results indicate that the degree of improvement in tactile sensitivity varied based on pain intensity.
Advances in Remote Therapeutic Monitoring
As we explore innovative studies in remote therapeutic monitoring devices, the research on exoskeleton training opens new possibilities for integrating medically necessary devices into the care and rehabilitation of SCI patients. Both studies highlight the evolving landscape of remote therapeutic devices and solutions, emphasizing the potential for improving independence, mobility, and overall well-being.
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