Modules

Physiotest Module - Clinical Examinations

The PhysioTest module aims to manage the acquisition and archiving of data relating to clinical tests. The module was developed to include the following tests.

- 6 Minute Walk Test (6MWT), or "6-minute walk test", which allows a measurement of a patient's residual functional capacity and is generally recommended for diagnostic purposes.

- North Star Ambulatory Assessment (NSAA), a 17-item scale used to evaluate functional motor skills in children with neuromuscular pathologies and usually used to monitor the progression of disease and the effects of treatment on it.

- Performance of Upper Limb for Duchenne Muscular Dystrophy (PUL for DMD), a tool implemented to evaluate upper limb function in ambulatory and non-ambulatory patients with Muscular Dystrophy of Duchenne.

- Motor Function Measure (MFM), a generic scale that evaluates the effect of muscle weakness in neuromuscular pathologies. The assessments are made based on the posture and movements of the entire body and can also be used to evaluate the effects of ongoing therapies.

- Children's Hospital of Philadelphia Infant Test (CHOP), is a test for newborns on neuromuscular disorders at the Children's Hospital of Philadelphia. provides information about how strong a child's muscles are and how well the child can control them. The result measures the motor milestones.

- FSHD Evaluation Scale (FSHD Scale) is a test that quantifies muscle weakness by combining the functional evaluation of six muscle groups affected by facioscapulohumeral muscular dystrophy ( FSHD).

- HFMSE-Hammersmith Functional Motor Scale Expanded for SMA (HFMSE) is a test to evaluate the motor ability of children and adults with SMA types 2 and 3 .

- Muscular Impairment Rating Scale (MIRS) is a five-point ordinal rating scale, established in accordance with the clinically recognized distal to proximal progression of muscle involvement in muscular dystrophy.

- Pompe disease - functional tests (GSGC) evaluate the difficulty in carrying out certain actions. In infants and children affected by Pompe Disease, it checks whether they reach normal developmental milestones for their age, such as sitting, crawling and walking.

- RULM-Revised Upper Limb Module for SMA evaluates the motor skills of the upper limbs for subjects suffering from spinal muscular atrophy (SMA).

- Walton Gardner-Medwin Scale (WGM) is a generic clinical assessment tool used to evaluate a change in functional status. It has been adapted to produce an 11-point ordinal scale and the scale essentially assesses weakness.

- Times up and go (TUG) is a simple test to measure a person's level of mobility and requires static and dynamic balancing skills.

- 10 m Walking/Run is a test in which the patient must prepare to walk a distance of 10 meters (30 feet) in a corridor or on a walkway. The distance is timed from the moment the patient started walking until reaching 10 meters.

The management of the tests listed above has been integrated as a plugin of the Health360 Patients module, which is why each assessment, i.e. each test performed, is displayed in the patient's timeline as an event, accompanied by the information that identifies it (e.g. type of test, date, etc.) and the calculated scores that describe the result. Directly from Health360 it is also possible to create and run each of the tests mentioned above and store the results in the corresponding backend module.

In the case of NSAA, PUL for DMD, MFM, CHOP, FSHD Scale, HFMSE, MIRS, GSGC, RULM, and WGM, the test is characterized by a series of items with which the patient's functional motor capacity is usually assessed through the assignment of a variable score generally ranging from 0 to 6 but in any case depending on both the test and the specific item. In these tests, the execution by the operator is guided through a carousel interface which makes it simple to assign the value to the corresponding item, as well as the choice of some specific preferences for the patient (e.g. the choice of the dominant hand ). The interface also has a "matrix" display of the various items which allows both to understand the execution status of the test and to directly access a specific item in the event that a sequential execution is not foreseen.

For 6MWT, TUG and 10 m Walking/Run, a specific interface has been provided that allows the operator to note both distances and times. In the case of the 6MWT, pauses and any drops during the test execution interval are also noted.

The interface of the 6MWT (and other timed tests) is responsive on tablets in order to allow the operator to record events easily and safely, with an ergonomic position of the buttons, so that the operator can follow even standing and the patient in the most natural way possible during the test. A backup and recovery system for the test during its execution is available via client side technology which always allows the resumption of the interrupted test even following malfunctions. For each event created, the visualization of both all the details relating to the event itself and their comparisons with a similar type of assessment performed previously (if any) has been implemented, displaying the values of the items and the corresponding scores. The possibility of exporting the details of the table present in each event of the various physiotherapy tests in .csv format has also been added. In order to meet the needs of clinical staff, for each of the clinical tests implemented, the creation and printing of a report in .pdf format has been made available which contains useful information for both the operator and the doctor to analyze the patient's current health status and its evolution compared to previous assessments.
The .pdf report allows the display on one page of all the patient's basic information, including name, surname and date of birth, the details of the scores obtained and the measures relating to the execution of the test, as well as a graph for comparison with tests performed previously, and a graph for the trend relating to the scores achieved by the subject under examination for that specific test in previous tests. The execution of each test corresponds to an event on the timeline. For each event it is always possible to view the details including the scores obtained in the test and the trend of the results obtained by the patient over time for the same type of test.