Video-based tasks for emotional processing rehabilitation in schizophrenia

Schizophrenia is a mental disorder characterized by a breakdown of cognitive processes and by a deficit of typi-cal emotional responses. Effectiveness of computerized task has been demonstrated in the field of cognitive rehabilitation. However, current rehabilitation programs based on virtual environments normally focus on higher cognitive functions, not covering social cognition training. This paper presents a set of video-based tasks specifically designed for the rehabilita-tion of emotional processing deficits in patients in early stages of schizophrenia or schizoaffective disorders. These tasks are part of the Mental Health program of Guttmann NeuroPer-sonalTrainer® cognitive tele-rehabilitation platform, and entail innovation both from a clinical and technological per-spective in relation with former traditional therapeutic con-tents.

A graphical tool for designing interactive video cognitive rehabilitation therapies

Acquired Brain Injury (ABI) has become one of the most common causes of neurological disability in developed countries. Cognitive disorders result in a loss of independence and therefore patients? quality of life. Cognitive rehabilitation aims to promote patients? skills to achieve their highest degree of personal autonomy. New technologies such as interactive video, whereby real situations of daily living are reproduced within a controlled virtual environment, enable the design of personalized therapies with a high level of generalization and a great ecological validity. This paper presents a graphical tool that allows neuropsychologists to design, modify, and configure interactive video therapeutic activities, through the combination of graphic and natural language. The tool has been validated creating several Activities of Daily Living and a preliminary usability evaluation has been performed showing a good clinical acceptance in the definition of complex interactive video therapies for cognitive rehabilitation.

Thermal evolution of lower limbs during a rehabilitation process after anterior cruciate ligament surgery

Infrared thermography (IRT) is a safe and non-invasive tool used for examining physiological functions based on skin temperature (Tsk) control. The aim of this paper was to establish the probable thermal difference between the beginning and the end of the anterior cruciate ligament (ACL) rehabilitation process after surgery. For this purpose thermograms from 25 ACL surgically operated patients (2 women, 23 men) were taken on the first and last day of a six-week rehabilitation program. A FLIR infrared camera according to the protocol established by the International Academy of Clinical Thermology (IACT). The results showed significant temperature increases in the posterior thigh area between the first and the last week of the rehabilitation process probably due to a compensatory mechanism. According to this, we can conclude that temperature of the posterior area of the injured and non-injured leg has increased from the first to the last day of the rehabilitation process.

Study for the rehabilitation of vernacular architecture with sustainable criteria

This paper assesses rural vernacular heritage established in a warm temperate climate, with dry, hot summer, in São Vicente e Ventosa (SVV), Alentejo, Portugal, and takes part in a larger investigation intending to create rehabilitation guidelines, with sustainable criteria and integration of recent technologies, to improving indoor comfort, and revert the state of deterioration. To further reach this aim, this paper proposes a four phases methodology: data collection, evaluation, simulation and development; a first survey data analysis, including climate data and the adapted comfort climograph and isopleth diagram, allows an understanding of thermal comfort and main constraints in site, as well as suitable bioclimatic strategies for SVV: high thermal inertia for tempering extreme summer conditions and the considerable temperature amplitudes throughout the year, complementarily night ventilation for passive cooling, small-sized window openings and movable shading systems for solar radiation protection. An efficient behaviour in stabilizing indoor temperature swings is revealed.

A model of economic management of cultural heritage: the rehabilitation of fort christmas as an interpretation center of defensive architecture of the Mediterranean in Cartagena (Spain)

The Cultural Heritage constitutes a way to generate social identities and play an important role in the development of the Spanish Mediterranean cities that opt to sustainable quality tourism. The reflection on the necessity of intervention on this heritage, in addition to establishing what should be done, brings up the need to define the reasons for taking action, why and what-for. These decisions are essential to establish if its maintenance and recovery are economically sustainable. The Project "Cartagena Port of Cultures", with support from the European Union, is an example of effective instrument for ensuring the sustainability of our built heritage conservation. Its main objective was to enable sustainable development of tourism in Cartagena based on sustainability and seasonality. This was achieved through a process of recovery of heritage resources and their optimum promotion and marketing.

Intelligent Therapy Assistant (ITA) for cognitive rehabilitation in patients with Acquired Brain Injury

This paper presents the design, development and first evaluation of an algorithm, named Intelligent Therapy Assistant (ITA), which automatically selects, configures and schedules rehabilitation tasks for patients with cognitive impairments after an episode of Acquired Brain Injury. The ITA is integrated in "Guttmann, Neuro Personal Trainer" (GNPT), a cognitive tele-rehabilitation platform that provides neuropsychological services.

Housing plans and urban rehabilitation in Spain, 1992-2012

This paper explores the urban rehabilitation projects promoted by the Spanish Government between 1992 and 2012 through housing plans. The analysis is based on the comparison of programmes and estimations gathered in these plans with actual housing production within this period in order to find the connection between sectoral housing planning and real estate cycles in these last twenty years. During the period under review, six state housing plans, that were mainly focused on the promotion of newly-constructed state-subsidised housing, were developed, including the Areas of Integrated Rehabilitation programmes (ARI programmes). In spite of the relevance and growing complexity of these programmes, these played a subsidiary role in the government housing policy and were insignificant regarding the whole real estate production in this period.

On the improvement of urban regeneration processes from more than thirty years of rehabilitation experiences

At this moment of extended economic, social and environmental crisis within which new interventions on the consolidated city are being set out, it is essential to count on the acquired experience in urban rehabilitation processes that were carried out in Spain during the last thirty years. Despite the complexity of this kind of processes and the diversity of the situations and actions that happened, this paper addresses the analysis of common patterns in twenty urban rehabilitation experiences. Different stages of the processes were studied, from the management to the regenerated areas in order to ease the design of new intervention initiatives.

The role of rehabilitation of building in the urban integration, social cohesion and environmental responsibility

In the framework ofthe National Research Plan2008-2011, our research poses estrategy for the design and evaluation of plans and programmes of urban integrated regeneration. The objective is to develop a study on the role of rehabilitation of buildings in concepts like urban integration, social cohesion and environmental responsibility. The research proposes a methodological tool for evaluating urban regeneration processes from a holistic perspective that can serve as a guide for governments and technical teams to address intervention in consolidated urban areas with physical and socio-economic problems. The development of the tool has inevitably led to delve into different areas where you can intervene but has not lost sight of the complex interplay of factors involved in the process.It is an open source tool to visualize Urban Integrated Rehabilitation processes.

A novel motion tracking system for evaluation of functional rehabilitation of the upper limbs

Upper limb function impairment is one of the most common sequelae of central nervous system injury, especially in stroke patients and when spinal cord injury produces tetraplegia. Conventional assessment methods cannot provide objective evaluation of patient performance and the tiveness of therapies. The most common assessment tools are based on rating scales, which are inefficient when measuring small changes and can yield subjective bias. In this study, we designed an inertial sensor-based monitoring system composed of five sensors to measure and analyze the complex movements of the upper limbs, which are common in activities of daily living. We developed a kinematic model with nine degrees of freedom to analyze upper limb and head movements in three dimensions. This system was then validated using a commercial optoelectronic system. These findings suggest that an inertial sensor-based motion tracking system can be used in patients who have upper limb impairment through data integration with a virtual reality-based neuroretation system.

A data-globe and immersive virtual reality environment for upper limb rehabilitation after spinal cord injury

While a number of virtual data-gloves have been used in stroke, there is little evidence about their use in spinal cord injury (SCI). A pilot clinical experience with nine SCI subjects was performed comparing two groups: one carried out a virtual rehabilitation training based on the use of a data glove, CyberTouch combined with traditional rehabilitation, during 30 minutes a day twice a week along two weeks; while the other made only conventional rehabilitation. Furthermore, two functional indexes were developed in order to assess the patient’s performance of the sessions: normalized trajectory lengths and repeatability. While differences between groups were not statistically significant, the data-glove group seemed to obtain better results in the muscle balance and functional parameters, and in the dexterity, coordination and fine grip tests. Related to the indexes that we implemented, normalized trajectory lengths and repeatability, every patient showed an improvement in at least one of the indexes, either along Y-axis trajectory or Z-axis trajectory. This study might be a step in investigating new ways of treatments and objective measures in order to obtain more accurate data about the patient’s evolution, allowing the clinicians to develop rehabilitation treatments, adapted to the abilities and needs of the patients.

Improving brain injury cognitive rehabilitation by personalized telerehabilitation services: Guttmann neuropersonal trainer

Cognitive rehabilitation aims to remediate or alleviate the cognitive deficits appearing after an episode of acquired brain injury (ABI). The purpose of this work is to describe the telerehabilitation platform called Guttmann Neuropersonal Trainer (GNPT) which provides new strategies for cognitive rehabilitation, improving efficiency and access to treatments, and to increase knowledge generation from the process. A cognitive rehabilitation process has been modeled to design and develop the system, which allows neuropsychologists to configure and schedule rehabilitation sessions, consisting of set of personalized computerized cognitive exercises grounded on neuroscience and plasticity principles. It provides remote continuous monitoring of patient's performance, by an asynchronous communication strategy. An automatic knowledge extraction method has been used to implement a decision support system, improving treatment customization. GNPT has been implemented in 27 rehabilitation centers and in 83 patients' homes, facilitating the access to the treatment. In total, 1660 patients have been treated. Usability and cost analysis methodologies have been applied to measure the efficiency in real clinical environments. The usability evaluation reveals a system usability score higher than 70 for all target users. The cost efficiency study results show a relation of 1-20 compared to face-to-face rehabilitation. GNPT enables brain-damaged patients to continue and further extend rehabilitation beyond the hospital, improving the efficiency of the rehabilitation process. It allows customized therapeutic plans, providing information to further development of clinical practice guidelines.

MedVir: an interactive representation system of multidimensional medical data applied to Traumatic Brain Injury's rehabilitation prediction

Clinicians could model the brain injury of a patient through his brain activity. However, how this model is defined and how it changes when the patient is recovering are questions yet unanswered. In this paper, the use of MedVir framework is proposed with the aim of answering these questions. Based on complex data mining techniques, this provides not only the differentiation between TBI patients and control subjects (with a 72% of accuracy using 0.632 Bootstrap validation), but also the ability to detect whether a patient may recover or not, and all of that in a quick and easy way through a visualization technique which allows interaction.

Energy rehabilitation of social housing for rent, as demonstrator in the LIFE 'New4Old' Project

The main goal of the cofounded by the European Commission LIFE Project, New4Old (LIFE10 ENV/ES/439), is to define the most appropriate method and the best available practice in social housing rehabilitation with energy and environmental sustainability criteria, as well as to apply innovative technologies in the fight against climate change through an efficient use of resources and energy. The institutions involved in the Project are the Technological Centre AITEMIN, Madrid Polytechnic University (UPM), Portugal Technological Centre for Ceramics and Glass (CTCV) and the Zaragoza City Housing Society (SMZV). The demonstrator project consists in the energy rehabilitation of a rental social housing building located in Zaragoza?s historic quarter, according to the conclusions and strategies developed for the LIFE project. In actions taken in households of this nature passive design strategies are essential due to the limited income of owners, who often cannot afford energy bills. Therefore, the proposed actions will help improve the building?s passive performance and reach a higher thermal comfort, without increasing the economic cost linked to energy consumption.

Non-invasive user monitoring in daily tasks for cognitive rehabilitation

El uso de técnicas para la monitorización del movimiento humano generalmente permite a los investigadores analizar la cinemática y especialmente las capacidades motoras en aquellas actividades de la vida cotidiana que persiguen un objetivo concreto como pueden ser la preparación de bebidas y comida, e incluso en tareas de aseo. Adicionalmente, la evaluación del movimiento y el comportamiento humanos en el campo de la rehabilitación cognitiva es esencial para profundizar en las dificultades que algunas personas encuentran en la ejecución de actividades diarias después de accidentes cerebro-vasculares. Estas dificultades están principalmente asociadas a la realización de pasos secuenciales y al reconocimiento del uso de herramientas y objetos. La interpretación de los datos sobre la actitud de este tipo de pacientes para reconocer y determinar el nivel de éxito en la ejecución de las acciones, y para ampliar el conocimiento en las enfermedades cerebrales, sus consecuencias y severidad, depende totalmente de los dispositivos usados para la captura de esos datos y de la calidad de los mismos. Más aún, existe una necesidad real de mejorar las técnicas actuales de rehabilitación cognitiva contribuyendo al diseño de sistemas automáticos para crear una especie de terapeuta virtual que asegure una vida más independiente de estos pacientes y reduzca la carga de trabajo de los terapeutas. Con este objetivo, el uso de sensores y dispositivos para obtener datos en tiempo real de la ejecución y estado de la tarea de rehabilitación es esencial para también contribuir al diseño y entrenamiento de futuros algoritmos que pudieran reconocer errores automáticamente para informar al paciente acerca de ellos mediante distintos tipos de pistas como pueden ser imágenes, mensajes auditivos o incluso videos. La tecnología y soluciones existentes en este campo no ofrecen una manera totalmente robusta y efectiva para obtener datos en tiempo real, por un lado, porque pueden influir en el movimiento del propio paciente en caso de las plataformas basadas en el uso de marcadores que necesitan sensores pegados en la piel; y por otro lado, debido a la complejidad o alto coste de implantación lo que hace difícil pensar en la idea de instalar un sistema en el hospital o incluso en la casa del paciente. Esta tesis presenta la investigación realizada en el campo de la monitorización del movimiento de pacientes para proporcionar un paso adelante en términos de detección, seguimiento y reconocimiento del comportamiento de manos, gestos y cara mediante una manera no invasiva la cual puede mejorar la técnicas actuales de rehabilitación cognitiva para la adquisición en tiempo real de datos sobre el comportamiento del paciente y la ejecución de la tarea. Para entender la importancia del marco de esta tesis, inicialmente se presenta un resumen de las principales enfermedades cognitivas y se introducen las consecuencias que tienen en la ejecución de tareas de la vida diaria. Más aún, se investiga sobre las metodologías actuales de rehabilitación cognitiva. Teniendo en cuenta que las manos son la principal parte del cuerpo para la ejecución de tareas manuales de la vida cotidiana, también se resumen las tecnologías existentes para la captura de movimiento de manos. Una de las principales contribuciones de esta tesis está relacionada con el diseño y evaluación de una solución no invasiva para detectar y seguir las manos durante la ejecución de tareas manuales de la vida cotidiana que a su vez involucran la manipulación de objetos. Esta solución la cual no necesita marcadores adicionales y está basada en una cámara de profundidad de bajo coste, es robusta, precisa y fácil de instalar. Otra contribución presentada se centra en el reconocimiento de gestos para detectar el agarre de objetos basado en un sensor infrarrojo de última generación, y también complementado con una cámara de profundidad. Esta nueva técnica, y también no invasiva, sincroniza ambos sensores para seguir objetos específicos además de reconocer eventos concretos relacionados con tareas de aseo. Más aún, se realiza una evaluación preliminar del reconocimiento de expresiones faciales para analizar si es adecuado para el reconocimiento del estado de ánimo durante la tarea. Por su parte, todos los componentes y algoritmos desarrollados son integrados en un prototipo simple para ser usado como plataforma de monitorización. Se realiza una evaluación técnica del funcionamiento de cada dispositivo para analizar si es adecuada para adquirir datos en tiempo real durante la ejecución de tareas cotidianas reales. Finalmente, se estudia la interacción con pacientes reales para obtener información del nivel de usabilidad del prototipo. Dicha información es esencial y útil para considerar una rehabilitación cognitiva basada en la idea de instalación del sistema en la propia casa del paciente al igual que en el hospital correspondiente. ABSTRACT The use of human motion monitoring techniques usually let researchers to analyse kinematics, especially in motor strategies for goal-oriented activities of daily living, such as the preparation of drinks and food, and even grooming tasks. Additionally, the evaluation of human movements and behaviour in the field of cognitive rehabilitation is essential to deep into the difficulties some people find in common activities after stroke. This difficulties are mainly associated with sequence actions and the recognition of tools usage. The interpretation of attitude data of this kind of patients in order to recognize and determine the level of success of the execution of actions, and to broaden the knowledge in brain diseases, consequences and severity, depends totally on the devices used for the capture of that data and the quality of it. Moreover, there is a real need of improving the current cognitive rehabilitation techniques by contributing to the design of automatic systems to create a kind of virtual therapist for the improvement of the independent life of these stroke patients and to reduce the workload of the occupational therapists currently in charge of them. For this purpose, the use of sensors and devices to obtain real time data of the execution and state of the rehabilitation task is essential to also contribute to the design and training of future smart algorithms which may recognise errors to automatically provide multimodal feedback through different types of cues such as still images, auditory messages or even videos. The technology and solutions currently adopted in the field don't offer a totally robust and effective way for obtaining real time data, on the one hand, because they may influence the patient's movement in case of marker-based platforms which need sensors attached to the skin; and on the other hand, because of the complexity or high cost of implementation, which make difficult the idea of installing a system at the hospital or even patient's home. This thesis presents the research done in the field of user monitoring to provide a step forward in terms of detection, tracking and recognition of hand movements, gestures and face via a non-invasive way which could improve current techniques for cognitive rehabilitation for real time data acquisition of patient's behaviour and execution of the task. In order to understand the importance of the scope of the thesis, initially, a summary of the main cognitive diseases that require for rehabilitation and an introduction of the consequences on the execution of daily tasks are presented. Moreover, research is done about the actual methodology to provide cognitive rehabilitation. Considering that the main body members involved in the completion of a handmade daily task are the hands, the current technologies for human hands movements capture are also highlighted. One of the main contributions of this thesis is related to the design and evaluation of a non-invasive approach to detect and track user's hands during the execution of handmade activities of daily living which involve the manipulation of objects. This approach does not need the inclusion of any additional markers. In addition, it is only based on a low-cost depth camera, it is robust, accurate and easy to install. Another contribution presented is focused on the hand gesture recognition for detecting object grasping based on a brand new infrared sensor, and also complemented with a depth camera. This new, and also non-invasive, solution which synchronizes both sensors to track specific tools as well as recognize specific events related to grooming is evaluated. Moreover, a preliminary assessment of the recognition of facial expressions is carried out to analyse if it is adequate for recognizing mood during the execution of task. Meanwhile, all the corresponding hardware and software developed are integrated in a simple prototype with the purpose of being used as a platform for monitoring the execution of the rehabilitation task. Technical evaluation of the performance of each device is carried out in order to analyze its suitability to acquire real time data during the execution of real daily tasks. Finally, a kind of healthcare evaluation is also presented to obtain feedback about the usability of the system proposed paying special attention to the interaction with real users and stroke patients. This feedback is quite useful to consider the idea of a home-based cognitive rehabilitation as well as a possible hospital installation of the prototype.