Telemedicine Framework for Evaluation and Training of Upper Extremity

Pictured above: Three-dimensional hand trajectory is measured using a stereo camera to capture the reachable 3D workspace in the shoulder. The surface area represents a quantitative score aimed to differentiate the range of motion with respect to human body planes in healthy (left) and patients with neuromuscular diseases (right).

Telecommunication, sensor technologies, and computer science come together to improve health care access and quality through telemedicine. Patients who are mobility impaired or disabled stand to gain greatly once a universal model is implemented and established. However, there is currently no effective telemedicine model of health care for these patients, especially those rural patients confined to wheelchairs due to various neuromusculoskeletal disorders.

Confounding this difficulty is the lack of an effective method to monitor and measure physical function in these patients, who often have significant weakness and cannot be assessed by the usual strength measurements. Currently, measuring the range of motion in a patient’s limb relies on manual goniometry, which is time-consuming, subjective, and requires large equipment to evaluate those motions.

This project is exploring ways to utilize technologies to better assess the upper extremity function and allow continuous monitoring to evaluate the success of a therapy or drug intervention. We are developing accurate, practical and user-friendly methods for measurement of range of motion in the shoulder joints based on reachable workspace envelope (Figure 1). A pilot study was undertaken with healthy individuals and a select group of patients with various neuromuscular diseases to demonstrate the effectiveness of the approach. Currently we are extending our research to include low-cost sensors and remote evaluation, which could also be useful in a variety of disciplines, including neuromuscular (physical medicine and rehabilitation, neurology) and musculoskeletal medicine (sports medicine, orthopedics, rheumatology, physical therapy, and occupational therapy).

In the future, this research will build upon the infrastructure of the California Tele-health Network to create a system that will facilitate remote medical office visit with support for video & audio communication. The proposed framework, which will also consider issues of privacy and security of data, is aimed to support cost-efficient hardware so that it can be in accessible to rural hospitals and clinics.

More information about this project is online at