Health Telematics (AIM) Final Report


	Updated: Feb 1, 97
CAMARC-II

Computer Aided Movement Analysis in a Rehabilitation Context

Project Code: A2002

Project value: 5095 KECU

EC contribution: 3145 KECU

No of partners: 9

No of countries: 8

Duration: 36 months

Contact:
Prof. Leo Tommaso
Universita' di Ancona
Dip. di Elettronica e Automatica
Via delle Brecce Bianche
I-60131 Ancona, Italy
Tel.: +39-71-220.48.34
Fax: +39-71-89.82.46

Overview

CAMARC-II is aimed at establishing a European network of clinical and research centres, strictly interconnected with the main manufacturers of the relevant instrumentation and with important "end-users" like national and private insurance companies, which will allow a standardised approach to the Functional Assessment (FA) of the (dis)-ability of the motor impaired and/or the elderly.

The CAMARC-II projects is a continuation of CAMARC from the AIM Exploratory Action. The Consortium collects 8 EC and 2 EFTA countries, 6 industries, 12 outstanding Clinical Centres, 18 universities and research institutions, taking into account contractors, Associate Contractors and Subcontractors.

Purpose and objectives

The objectives of the project are:

to build-up a Europe-wide network of clinical and research laboratories willing to practice Movement Analysis (MA) in a standardised manner;
to define, on the largest consensus basis, protocols for data capturing and processing. This objective comprehends the assessment of measurement and data processing methodology for clinical MA, and the development of suitable new instrumentation and motor tasks that are impairment-oriented and/or disability-oriented;
to integrate the existing and new instrumentation by means of suitable hard- and soft-ware interfaces towards the various measurement systems and towards the users;
to define a comprehensive Knowledge Base (KB) of the already assessed MA experience and to implement a suitable representation of such a Knowledge;
to constitute consistent KBs using quantitative data relative to clinical applications and to make them accessible at least to the institutions belonging to the network of clinical and research centres;
to assess criteria and to collect preliminary results for the definition of normative data for a conventional age-related classification of normality, impairment and disability with respect to the motor behaviour.

It will create and test out a pilot network linking rehabilitation centres, hospitals, research centres and industry. This will, assisted by a knowledge base, enable evaluation of movement analysis methods and equipment and facilitate exchange of experience and knowledge respecting principles of data protection and confidentiality. The CAMARC-II system constitutes a Europe-wide reference for the functional assessment of the motor (dis)abilities of the motor impaired and/or elderly.

CAMARC-II is devoted to improve the efficiency and efficacy of the application of the most recent technological resources in the field of Functional Evaluation (FE) of motor disabled and elderly through MA methods and techniques. European industry competitiveness is being improved by suitable standardisation work and by the development of disability specific new instrumentation and of instrumentation aimed at ambulatory monitoring of motor behaviour during the Activities of Daily Life (ADL).

The quality of rehabilitative care is improved, and its cost are reduced by means of effective FE reducing time spent within the Hospital by the patient and allowing a better focusing of the treatment.

The economic and social impact of the project can be clearly perceived taking into account that it will affect the population of motor disabled and elderly. This category of people has a growing dimension; the elderly are something more than 13% of the population of E.C. with an important trend towards growth. A rough estimate for the 2000 is 20% of the population. The motor disabled range from 10% to 15% of the EC population according to the COST 219 estimates of some years ago. Of course there is partial superposition between the two figures above, so that a conservative estimation can give an overall figure of approximately 25% of the EC population for the coming years.

This situation has obviously an important incidence on Health Care costs and on their distribution among the different age ranges.

Cost could be usefully classified in: direct costs category, corresponding to the expenses for care delivery, and indirect costs category, mainly due to the expenses for personal assistance of dependent people.

An effective use of MA methods, even if on a restricted but significant number of motor pathologies, will certainly reduce the time spent in the Hospital and in the Rehabilitation Centres, reducing this way the direct costs for the H.C System.

Moreover, it has to be put into evidence that the consortium comprehends practically all the MA instrumentation manufacturers based on EC Countries. The numerical relevance of the motor diseases and the well recognised need of precise and agreed assessment criteria will give to these manufacturers a strong competitive advantage on the world market. Moreover it has to be noted that all these manufacturers are SME, that, individually, will not have enough strength to develop the relevant research work.

Finally, it has to be put into evidence that a Europe-wide uniform approach to the FE of motor disabilities will greatly affect the completion of the single market as far as the equal access of the EC citizens to the Health Care services is concerned.

Results

The main contribution of CAMARC-II to the application of Informatics and Telematics in the Motor Rehabilitation field is to establish a European Network of clinical and research centres, strictly interconnected with the main manufacturers of the relevant instrumentation, which will allow a standardised approach to the Functional Assessment (FA) of the motor (dis)ability of the motor impaired and/or the elderly.

CAMARC II has implemented a wide set of products, services and know-how relevant for the improvement of Health Care delivery in the field of Motor Rehabilitation. In particular systems and tools have been developed to be used in a Multi-Centre Trial and Remote Assessment context.

Consensus and interest about the CAMARC II philosophy and results are large, as stated by the amount of requests for deliverables and for the use of the telematic network and consultation of acquired data. To face all the possible economic development of the CAMARC II results, the consortium has started the constitution of a stable connection among the CAMARC II actors, in terms of launching an European Group of Economic Interest (EGEI).

The future possibilities for the exploitation and commercialisation of the services appear to be numerous and promising, provided that a support will be made available to the CAMARC II consortium in order to maintain and increase all the acquired knowledge and tools. In particular a support seems to be necessary to ensure the maintenance of software packages and a continuous check of data integrity and reliability. This would allow the availability of a system for clinical data exchange that could be very useful for Health Care Providers and Managers.

Results of the project can be grouped in four main categories:

Information and Communication Tools and Services;
Protocols;
Standards;
Equipment's.

These categories cover all the products and services mentioned above as an implication of the characters of motor rehabilitation and of the objective of building-up the telematic Network already specified.

The market potential of the CAMARC-II products is as follows:

Information and Telecommunication Tools and Services (UFI, DB, KB, WAN): the target market is constituted by the end users (Rehabilitation Centres, Health Care delivery managers and policy makers.) and by the service providers ( Telecom companies) with respect to which the CAMARC-II consortium can position itself as an information provider.
Protocols: the market is still constituted by the Rehabilitation Centres and the other relevant Health Care providers; an important aspect of such a market is education and training . -Equipment's: Small/Medium Enterprises, in particular the manufacturers already present in the consortium, are presumed to be primarily interested in their commercial exploitation.
Standards: the objectives of CAMARC-II imply the concertation and the acceptance from all the interested entities of Clinical and Experimental Protocols for the Functional Assessment of motor (dis)abilities.
The above mentioned standards are being submitted to evaluation on the field, or to the discussion with other relevant scientific bodies which have undertaken analogous standardisation activities. After these verifications these results will be submitted in the proper way to the relevant standardisation bodies.

List of Deliverables

Year 1

Database development management and interrogation - preliminary (8/R/P)
Proceedings of the workshop: "CAMARC-II - Problems and perspectives" (8/R/P)
User friendly interfaces for MA in clinics preliminary (9/R/P)
Terminology and units (9/R/P)
Standards for data storage and exchange (9/R/P)
Measurement and data processing Met. for MA in clinics - preliminary (9/R/P)

Year 2

F.E. protocols for Europe-Wide network of clinical centres - Preliminary (6/R/P)
Star like network of clinical evaluation centres (6/P/I)
Expert and CDM systems for MA in Clinics - Preliminary (6/R/P)
Instrumentation for disability assessment preliminary (6/R/P)
Data processing packages for MA in clinics (6/T/I)
Data Base development management and interrogation (9/R/P)

Year 3

Prototype system for clinical disability assessment (9/P/I)
Prototype system for ambulatory monitoring of motor behaviour (9/P/I)
Measurement and data processing met. for MA in clinics - Final (9/R/P)
Data processing packages for MA in clinics - Final (9/T/I)
Protocols for Europe-wide network of clinical centres - Final (9/R/P)
Distributed network of clinical evaluation centres (9/P/I)
User friendly interfaces for MA in clinics - final (9/R/P)
User friendly interfaces for MA in clinics (9/T/I)
Expert and CDM systems for MA in clinics - Final (9/R/P)
Expert systems for MA in clinics (9/T/I)
Database for MA in clinics (9/T/I)
Standards for instrumentation and specifications (9/R/P)
Criteria for an age related classification of normality and disability (9/R/P)
Instrumentation for disability assessment (9/R/P)
Recommendations for data protection, confidentiality and security (9/R/P)
Proceedings of the workshop: "CAMARC II experiences and results" (12/R/P)

List of Participants

Prof. John P. Paul University of Strathclyde Bioengineering Unit 106 Rottenrow Glasgow G4 0NW, U.K. Tel.: +44-415-52.44.00ext.3030 Fax: +44-415-52.60.98	Prof. Pierre Rabischong INSERM Unit 103 395 Avenue des Moulins F-34090 Montpellier, France Tel.: +33-67-63.27.48 Fax: +33-67-54.27.29
Prof. Gerald Zilvold Het Roessingh Revalidatiecentrum Roessingh R & D Roessinghsbleekweg 33 NL-7522 AH Enschede, The Netherlands Tel.: +31-53-87.57.77 Fax: +31-53-34.08.49	Prof. Arthur Spaepen Biomedical Kinanthropology Tervuursewest 101 B-3001 Leuven, Belgium Tel.: +32-16-21.67.80 Fax: +32-16-21.67.85
Prof. Thomas Sinkjaer University of Aalborg Dept. Medical Informatics Fr. Bajersvej 7D DK-9220 Aalborg, Denmark Tel.: +45-98-15.85.22 Fax: +45-98-15.40.08	Prof. Dr. Wolfgang Baumann Sport Schule Köln Inst. für Biomechanik Carl-Diem-Weg 6 D-5000 Köln, Germany Tel.: +49-221-498.25.66 Fax: +49-221-497.15.98
Dr. Mary Garrett UCD School of Physiotherapy Eccles Street IRL-Dublin 7, Ireland Tel.: +353-1-30.45.33 Fax: +353-1-30.35.50	Ing. Andrea Salemme Tecnobiomedica SpA Via Vaccareccia 41 Loc. Monte D'oro I-00040 Roma, Italy Tel.: +39-6-912.43.11 Fax: +39-6-912.16.81



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