Flexible evaluation of electrotherapy treatments for learning purposes

Abstract

Computers are extensively used for training and simulating tasks that are hazardous in a real-life situation or require expensive, delicate or difficult to access equipment. In the present work we describe a system for the assessment of clinical practices involving the use of electrotherapy. The existing variety of currents, electrical parameters and electrode configurations make this a challenging subject for undergraduate physical therapy students. Extensive training is required before they can treat real patients, since an incorrect practice may have no effect on the patient’s condition, or even worse, cause severe pain or burns. Our system, implemented as a serious game, can facilitate this training, since the opportunity for supervised clinical practice with real equipment is limited. Our goal was to mimic the assessment of an electrotherapy treatment by an expert, by evaluating each of its aspects in a flexible way, detecting and highlighting critical situations that can affect the patient’s integrity and computing an overall score for the whole treatment. For this purpose, we have modeled the valid values of each electrical parameter (frequency, pulse width, intensity, etc.) and the treatment time using fuzzy sets. We also characterize the placement of the electrodes in the area of treatment through three geometric quantities (orientation, distance to center and spacing) on which three fuzzy terms are defined (well oriented, centered and well distributed). For each of these variables we get partial scores that are finally aggregated into an overall treatment score through a pessimistic exponential ordered weighted average operation. In order to test the reliability of the system we conducted an experiment with a group of physical therapy students that revealed a substantial agreement with a human expert.