A modern remote rehabilitation system using the Osnova multifunctional simulator with biofeedback allows for professional rehabilitation of patients in a convenient place and comprehensive development of muscle motor skills in children with cerebral palsy, post-stroke patients, people with spinal cord and brain injuries, and war victims.

A successful project. The finalist of the international festival of innovative projects "Sikorsky Challenge 2023" was the development of a graduate student of the Department of Biosafety and Human Health Oleksandr Kryviakin. He created a device for health improvement and rehabilitation that allows you to perform the maximum amount of exercise in a minimal area. This was the second, improved project of the young researcher. He completed the previous one, of a simpler form and configuration, under the supervision of the head of the department, Professor Ihor Hudetskyi, in his master's degree program, where he acquired knowledge of physical rehabilitation, physical therapy, and occupational therapy. Then, in 2019, the work was performed as part of the educational program and also became a finalist of the festival.

Concept and realization. It is usually said that a person invents something new out of laziness, to avoid doing routine or hard work. But this is not the case with Oleksandr. He thought about creating an affordable rehabilitation simulator to restore patients' lost locomotor functions when, as a young specialist in psychological and physical rehabilitation, he worked with post-stroke patients but did not have the necessary tools to work effectively. At the same time, he tried to track patients' vital signs to assess their reactions to the rehabilitation measures. A smartwatch came in handy. Later, when he gained experience and the number of patients increased, he began to work remotely, via video communication, using a tablet with a webcam and appropriate programs to save time. "That's how my first system of tele-rehabilitation for post-stroke patients appeared," Oleksandr recalls, either dreamily or nostalgically. 

However, the researcher was able to fully realize his idea only under the scientific guidance of Associate Professor Yulia Antonova-Rafi after entering the master's program. The project was coming to fruition, and the inventor received a utility model patent for the basic Osnova simulator. They worked on its modification, Osnova-M, together with the department's veteran, Doctor of Pedagogical Sciences Professor Yurii Mykolaiovych Vykhliaiev, who has been developing technologies for correcting the physical fitness and performance of young people with disabilities for many years. The two of them received another patent (hopefully not the last).

Design and capabilities. So the inventor was faced with the task of creating a simulator with advanced functionality for the rehabilitation of people with musculoskeletal disorders. Ideally, the unit should provide the maximum number of therapeutic exercises for the upper, lower limbs and torso, occupy a minimum area, be safe and allow the use of additional physiotherapy tools. 

The Osnova device came in handy. The design is simple and straightforward: we have a two-meter rectangular frame with vertical guides inside. Variable loaders (2.5-10 kg) move up and down along the guides (with the help of muscle efforts of the arms or legs). The researcher quickly realized how to improve this reliable and useful device. Soon the frame was equipped with a small and attractive-looking exercise bike unit with pedals. It can be fixed at the required height depending on the user's height and position (standing or sitting) in the upper (for pedaling with hands) and lower (for pedaling with feet) positions. Soon after, the device was equipped with an electrical pulse generator and electrodes with the ability to fix them on the patient's muscles for electrical stimulation.

Today, such a hybrid allows you to perform a wide range of therapeutic/recreational exercises on an area of 1 square meter - standing, sitting or on a seat. Believe it or not, the list of exercises for coordination, endurance, strength, and restoration of range of motion takes up more than a page of text. It seems (and not without reason!) that every apartment should have such a "toy". No, exercise machines will not die out (young people need somewhere to "pump up" their muscles and improve their physique), but older people, and even more so people with special needs, should have free access to such devices.

According to the Department of Biosafety and Human Health, the device is easy to use, has a relatively low cost, and can be used on an outpatient or home basis. The use of an electric stimulator, along with medicines and methods appropriate to the patient's disease or injury, improves muscle function. In general, in terms of functionality, it is a compact rehabilitation center that has no analogues in Ukraine and is also cheaper than similar foreign systems. "A unique rehabilitation center for the price of an iPhone from a PhD student at FBMI," says Oleksandr Kryvyakin with a smile.

"When you get acquainted with the design and features of this multifunctional "craftsman", it's like opening a box with a secret: you open the door, and behind it is another one, then another and another. Judge for yourself: they took the basic design, expanded its capabilities, equipped it with additional features, but that's not all. "The peculiarity of using the presented rehabilitation system," says its developer, "is the use of biofeedback. That is, while performing physical exercises using a digital device (in this case, a smartwatch), a physical rehabilitation specialist receives real-time indicators of the patient's vital signs (heart rate, blood pressure, blood oxygenation level, etc.)." He explains: "This is extremely important when working with post-stroke patients, because physical activity leads to an increase in blood pressure, and uncontrolled surges can cause cerebral circulation disorders, even with fatal consequences. However, if the heart works with insufficient load, the physical performance of the body improves only slightly, and if it is overloaded, negative consequences are possible. So it is absolutely necessary to get accurate data in real time and adjust rehabilitation measures at the right time."

In addition. Video communication for remote rehabilitation has been used for a long time. Speech therapists, defectologists, and psychologists establish visual contact with patients to monitor and correct the performance of rights (tasks), or when they need to encourage and inspire a person. There are many similar video systems on the market, as the field of tele-rehabilitation and telemedicine is developing rapidly.

"Our remote rehabilitation system has really turned out well," the researcher says, "it has its own differences, features, and advantages. First, most developers focus on software, an attractive interface, artificial intelligence, and exclude the intervention of a qualified rehabilitation specialist (in our opinion, the human factor is of particular importance and cannot be replaced by artificial intelligence). The use of these and other tools in the remote rehabilitation system increases its cost and limits accessibility for patients. Second, we focus on functionality and accessibility. The main physical rehabilitation tool in our system is the Osnova simulator, which is simple, nothing more. It does not have artificial intelligence, does not require electricity, and is not afraid of atmospheric factors and mechanical damage. But this "iron" is designed with anatomy and biomechanics in mind and is 110% fit for purpose - to provide a dosed load on a specific muscle group, training them and forming a "new muscle memory." Thirdly, our system uses modern digital devices with sensitive sensors and sensors, which are widely available on the market. But we are not tied to a particular manufacturer: the equipment must meet certain criteria, be affordable, and have its own software. Any device equipped with a webcam can be used for video communication. As you can see, it's simple and reliable."

The developers are planning to create their own center where researchers and students will improve the rehabilitation system and provide services to restore the health of Ukrainians. In the future, they plan to manufacture simple and affordable rehabilitation devices and distribute them.

Nadiia Libert

The unique rehabilitation system developed by FBMI PhD student Oleksandr Kryvyakin allows for professional rehabilitation of patients in a place convenient for them.

The device allows for the comprehensive development of muscle motor skills in children with cerebral palsy, patients with post-stroke conditions, and people with spinal cord and brain injuries.

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