MyoTel application

Overall system architecture

The MyoTel service consists of a mobile healthcare application that uses clinical data; surface ElectroMyoGraphy of the trapezius muscle of patients, to be feed backed to patients themselves but also presented to medical specialists, physiotherapist or occupational therapist providing the treatment. This MyoTel service is based on a telematics system consisting of four major building blocks: 1) Body Area Network (BAN), 2) MyoTel Service Centre (i.e. service-centric computer system), 3) Medical Display, and 4) hybrid data Communication Infrastructure consisting of public and private wireless networks, the Internet and an intranet (e.g. hospital network). The figure below presents a high-level schematic overview of the MyoTel service infrastructure showing the patient and professionals, equipment (i.e. BAN, MyoTel service centre, medical display) and communication infrastructure.

Fig 1: The MYOfeedback based TELetreatment service

The BAN is worn by the patient underneath the clothes during every day activities . In this BAN dry surface electromyography (sEMG) electrodes are incorporated in a garment. These electrodes enable an appropriate recording of upper trapezius muscle activity. When the patient has too few moment of muscle relaxation she receives feedback by vibration of the system attached to the garment (left picture).  The vibration is for the patient the sign to relax. Besides this vibration visual feedback about his muscle activation and relaxation is provided to the patient on a PDA. From this PDA, the muscle activity data is also send to a webbased portal via a wireless protected connection. The therapist has access to this portal and can examine the muscle activity data.

The patient and the therapist consult each other by telephone at least once a week. During the first consultation, the patient and professional meet in vivo to hand over the MyoTel equipment and for the patient to learn some first myofeedback principles (relaxation of the trapezius muscle). In the consecutive weeks, remote consultations between the patient and the professional will take place to discuss the progress of the MyoTel treatment by telephone. Essential information in this consultation is the patient diary and the electromyographical data which is available at the server. At the end of the MyoTel treatment, the patient and professional again meet in vivo to deliver the MyoTel equipment and evaluate the progress of the MyoTel treatment. A schematic overview of the treatment protocol is shown in the figure below.