Providing rehab from afar: Professor Ralph Maddison

Using digital health technologies, Professor Maddison is helping patients with cardiovascular disease to access the care they need.

The pandemic has not been kind to those suffering from heart disease. Patients require ongoing healthcare and rehabilitation – assistance which is difficult to administer in the current circumstances.

Help, however, is in the works. Professor Ralph Maddison – from Deakin University’s Institute for Physical Activity and Nutrition (IPAN) – is leading an extensive research program, dedicated to improving cardiovascular patients’ access to individualised care.

SCRAMbling to rehabilitate REMOTEly

Professor Maddison and his team at IPAN have worked on several projects around heart health and cardiovascular disease.

Most recently, there’s the Smartphone Cardiac Rehabilitation, Assisted self-Management intervention.

Or SCRAM, for short.

The intervention recognises the lifesaving role that rehab plays after a cardiac event.

Currently, as many as 70 percent of patients are unable or choose not to access traditional face-to-face delivered rehabilitation – especially if they’re geographically isolated, where accessing transport can be tricky.

The SCRAM smartphone program is working to change this.

Patients can access a rehab coach or exercise physiologist remotely – even from the comfort of their own homes.

Using wearable sensors, health practitioners can then monitor the patient as they complete a personalised exercise and rehabilitation program.

The program also provides information and support to engage in lifestyle change and better self-manage their heart conditions.

SCRAM is funded by the National Health and Medical Research Council, and is currently in its trial phase.

The team have also collaborated on REMOTE, another smartphone platform capable of delivering exercise rehab. But this program isn’t limited to patients with heart disease.

In partnership with the University of Melbourne, and supported by the Breast Cancer Foundation, Camille Short is working with Professor Maddison and his team to investigate the potential of the REMOTE program to help prevent cardiotoxicity in women with breast cancer.

In conjunction with Barwon Health, his team are also exploring its use to pre-habilitate people with myeloma.

“REMOTE and its successor, SCRAM, were originally intended for people with cardiovascular disease,” Professor Maddison says.

“But we always saw potential to apply them to other groups.”

The project is currently being implemented both nationally and overseas – even as far as Umea, Sweden.

Bringing rehab into the home 

Professor Maddison and his team follow each of their projects through their separate phases: from conception, to design, evaluation and implementation.

“They are all part of the continuum,” Professor Maddison says. “It’s important to see the work translate into practice.

“Our projects all build on each other, and our aim now is to better implement these programs into practice to improve the life of Australians living with chronic disease.”

To help achieve this, the team have developed a platform, Salvio, which hosts a suite of digital interventions. Users can access the interventions via a portal.

Using Salvio, and with the support of health practitioners, patients can then choose the digital program that best suits their needs.

There’s even plans to integrate these interventions into the home itself.

“We’re also investigating the viability of smart home technologies to support people to better manage their chronic disease.

This includes the use of pervasive sensing to sense people’s physiology and behaviour and provide advice via a conversational agent – such as Google Home, a tablet or a smartphone.”

Research interrupted 

In these times of physical distancing, digital health interventions are valuable tools, allowing us to continue receiving and providing care from afar.

Unfortunately, the pandemic has significantly interrupted some of these projects.

“It’s been difficult,” Professor Maddison says. “We haven’t been able to recruit participants for some of our studies.

“Our NHMRC-funded trial of our SCRAM platform has been affected the most. We have had to slow recruitment, and 2 out of 3 sites have been unable to collect outcome data.”

Despite this, he’s still finding joy in his field of research.

“The field of digital health is constantly changing and the potential to use these technologies to support and manage the health of Australians is enormous.

“Being able to realise this potential and actually develop something that can make a real difference to the health of Australians is incredibly motivating for me.”

Ralph Maddison is a Professor in Physical Activity and Disease Prevention within Deakin’s Institute for Physical Activity and Nutrition. This article was written by Melina Bunting and originally published in Deakin disruptr. Find the article here.

Click here for more information about Deakin IPAN’s research into physical activity and nutrition or follow us on Twitter @DeakinIPAN