An Integrated Ambient Intelligence System in the Monitoring and Rehabilitation of the Disorder of Consciousness

Ambient Intelligence (AmI) collectively refers to a family of sensitive electronic systems responsive to humans and mediating in the human interaction with devices and environment. This novel paradigm of information technology complies with the international standards for the functional integration of biomedical domotics and informatics in hospital and homecare. We have designed and implemented an AmI system with sensor networks for the continuous automatic monitoring of subjects with severe brain damage and disorder of consciousness hospitalized in the S. Anna-RAN Institute for medical care and rehabilitation. The system was designed to allow real-time analyses of relevant environmental parameters and the subjects' vital signs. Main purposes are to identify: 1- partially preserved or recovered circadian/ultradian rhythms; 2) functional changes potentially associated to prognostic indicators; 3) momentary subject/environment interactions or functional changes possibly indicative of residual/recovered responsiveness; 4) predictive models of responsiveness. The system also supports the clinician in decision making. In this respect, AmI should be regarded as equivalent to a traditional laboratory for data collection and processing, with substantially reduced dedicated equipment and staff and limited costs. Moreover, the AmI should provide an accurate system of observation of the patient-ambient interaction, offering a better support to the clinical decision in the rehabilitation phase.