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Austrian Scholar Working with Yale to Quantify Patient Recovery Benchmarks

May 01, 2023
by John Ready

Wolfgang Grosek is a visiting Marshall Plan Scholar from the Management Center Innsbruck (MCI) Entrepreneurial School in Austria who is conducting research at Yale thanks to a collaborative project between the two universities, as well as the Yale School of Engineering & Applied Science (SEAS) and the Yale School of Medicine.

Grosek’s research project, which is entitled “Digitalization of the Physical Performance Test and Training,” will serve as the foundation for his master’s thesis in the field of mechatronics and smart technologies with a focus on electrical engineering at MCI. He developed the concept for this endeavor at MCI under principal investigator, Yeongmi Kim, PhD, who contributed predominantly to the development of this project. The research also has the potential to dramatically impact physical medicine and rehabilitation in orthopaedics.

Grosek is working out of Yale’s Center for Engineering, Innovation and Design (CEID), under the guidance of design mentor and senior research scientist, Larry Wilen, PhD, as well as Deputy Dean of Engineering, Vince Wilczynski. Both Wilen and Wilczynski guided a student team that developed the original balance board in their ENAS 118 Introduction to Engineering, Innovation, and Design course. Senior research scientist Steve Tommasini, PhD, is also meeting with Grosek weekly to review his device design and software processes. The CEID serves as Grosek’s base of operations, where he has easy access to resources for device development.

“This international research project is the latest collaboration between engineering and orthopaedics that provides new opportunities for student learning and improved health care for patients.” Wilczynski said. “Grosek’s work illustrates Yale’s wide reach and highlights one of its strongest attributes, which is a willingness to partner with others from different disciplines, schools, universities, and nations. In doing so, knowledge and best practices are rapidly shared across boundaries and the speed of discovery and implementation is increased, all to the benefit of a global society.”

“We strive to provide opportunities for students to apply their knowledge in solving important problems,” he added. “Beyond the potential positive impact on patients, it is inspiring to see that first-year student work can lead to graduate-level research, thereby illustrating the potential for projects to be developed as commercial products.”

During his February – August 2023 tenure at Yale, Grosek will additionally be mentored by Daniel Wiznia, MD, an orthopaedic surgeon with a dual appointment between SEAS and Yale School of Medicine, and Rumanna Aslam, MD who serves as section chief of physiatry for orthopaedics. Wiznia co-directs the newly created MS in Personalize Medicine & Applied Engineering program with Tommasini and Aslam has been evaluating the balance board device developed by SEAS in her clinical practice to quantify patient stability.

In recent years, measuring the human body’s physical functions has garnered ever-growing interest in post-operative cases, following traumatic accidents, among the aging population, and with impaired individuals. A powerful tool for this measurement is known as the Modified Physical Performance Test (MPPT). The MPPT consists of different tasks where the performance level of physical functions can be both determined and evaluated using a point system. This test is traditionally carried out with a supervisor and a stopwatch, which can lead to inaccuracy, aberrance, and missing data.

The digitalized version of the Physical Performance Test developed by Grosek, which is a more general version of the MPPT, will be able to measure the movements of the human body with the help of sensors. The two types of sensors used for these measurements are the Inertial Measurement Unit (IMU) and force sensors. Grosek’s thesis will focus on digitizing the conventional test and obtaining objective and continuous data from patients to increase the accuracy of the assessment.

Computer software will be developed to evaluate the test score of each patient. The resulting score will then be evaluated with the help of a regression machine learning algorithm and those results will be compared with the evaluation of a rehabilitation therapist. Adding the sound of a metronome and transforming physical feedback via vibration stimuli to the patient's legs will improve the timing of the patient's steps during the test.

The innovations and technological advances will impact patient recovery and the clinical professionals such as physicians, physical therapists, and members of the care team who manage this process. This is particularly true of in-patient populations comprising post-operative orthopaedic surgery, those recovering from stoke, trauma patients, and individuals with neurological conditions or traumatic brain injuries.

“The work Wolfgang is undertaking will help us generate quantifiable benchmarks in a patient’s personal recovery,” Aslam said. “This diagnostic and therapeutic tool will be able to track trend data and metrics related to strength, balance, and objective measurement through modeling. That is critically important because data from this testing will be used to generate baseline indicators for physical function and are tracked throughout the recovery process.”

Objective metrics like this give providers tremendous flexibility and better equip them to make informed decisions as it relates to a patent’s continuum of care.

“Numerical scoring will provide our care teams with objective calculations that indicate where the patient is struggling, which allow us to respond and better optimize each person’s recovery,” Aslam continued. “If a patient’s strength is not improving, we can modify physical therapy. For example, using this objective data, we can determine when patients should transition from a walker to a cane and ultimately be discharged from an inpatient setting. Although our goal is to maximize independence, objectively knowing when a patient can safely and confidently gain that independence using data has never been more important.”

According to Wilen, collaborations with international students and universities like this provide unique opportunities for cross-cultural exchange where the perspectives and practices from the different countries can often be combined to yield new avenues in problem solving and improving technology.

“It can be particularly useful in the medical field where approaches to health care can be very different around the world and sharing ideas can be extremely valuable,” Wilen said. “This is an example where work that was initially done by undergraduates has been leveraged to facilitate and inspire a new set of ideas developed by Grosek. Those concepts have great potential for application to medical rehabilitation assessment, which, in turn, may allow future opportunities for participation by Yale undergraduates and result in a perpetuating ecosystem for student involvement in research.”

“The entire endeavor speaks to the growing overlap and the importance between engineering, orthopaedic care, and sustained advancements in personalized medicine,” Wiznia added. “With the development of this technology, we will be able to utilize data to restore function and improve the lives of those recovering from a range of conditions, and do it in a way that is as most efficient, objective, and as personalized to the individual as possible.”

The intent of this research endeavor is to establish a permanent research collaboration between Yale University and MCI where results of the project can be integrated with existing technology and then presented at a conference or published in a journal paper.

Submitted by John Ready on May 01, 2023