Staten Island Advance, Lifestyle Health Fitness, Monday, December 15, 1997, p B1
The Staten Island Advance (USPS 520-540), which has its offices at 950 Fingerboard Rd., Staten Island, NY 10305, is published daily except Sunday. Established in 1886 as the Richmond County Advance. 718-981-1234.
The Computer as a Diagnostic Tool
By Rochelle Steinhaus, Advance Staff WriterUsing the principals of biomechanics, physics, and human movement, a Staten Island duo have created a computer program which can be used to diagnose bone disorders.
For problems ranging from lower back pain to carpal tunnel syndrome, a patient has a number of means to obtain a diagnosis: An examination by a physical therapist, a chiropractor, an orthopedist - or even a computer. A computer program set for release next month, developed by two Staten Islanders, can help diagnose a variety of conditions, including sports injuries, neurological and developmental problems, wound care, musculoskeletal disorders and bone abnormalities.
Engineer Don Helt, 24, began the project three years ago as a college junior on his personal computer in his Prince's Bay home. Since then, he entered into a creative partnership with Annadale physical therapist Michael DiStefano, 28, to create the program, called OrthoImager, that has sent them touring businesses, universities and medical offices throughout North America.
Both adjunct professors in the College of Staten Island's physical therapy department, the duo did most of the work in Helt's home office, producing the software, which analyzes movements performed by a patient. Here's how their program works:
First, the patient is videotaped or photographed performing a variety of activities utilizing the parts of the body to be analyzed. The images are then scanned into a computer.
The software uploads a still image of the patient's posture during movement, and using a computer mouse, points are plotted onto the picture to denote the position of certain bones or joints.
"The whole point is just connecting the dots. The bones don't change, and it can be done on any bone or any body part," said DiStefano.
The program then measures the length of the bones and the angles between the points, and, based on formulas derived from principles of physics, kinesiology (which is the study of human movement) and biomechanics, it then evaluates whether the patient's motion is unhealthy or abnormal.
For example, a person experiencing neck pain would be asked to perform a variety of movements using that muscle group, which is photographed or videotaped. After the images are scanned into the computer, the points are plotted onto the screen to identify specific bones and joints, and then lines are automatically drawn between the dots. By measuring the angles of the lines, the program can measure the neck's range of motion. Knowing if the patient's range of motion is inhibited, and to what degree, allows the doctor, physical therapist or chiropractor to know what type and how much therapy is needed.
The creators say it's a time-saver for both patients and doctors alike, since other health care workers such as nurses, physical therapist assistants, and nurses' aides are qualified to identify the patient's bones and joints on the screen. The physician, chiropractor or physical therapist is necessary to interpret the results, and only they can make a diagnosis.
And because it's all processed and stored on computer, results can be analyzed by doctors world via the Internet and electronic mail.
Somebody can take the picture for you. You can be on the other side of the world, and get the images on a laptop through the Internet and do the analysis," said Helt. "It saves time."
OrthoImager is also a tool in preventing injuries, according to Helt, especially on the job. Helt's background in ergonomics, coupled with a combined bachelor and master's degree in occupational safety and health engineering, industrial engineering, and mechanical engineering technologies from Columbia Southern University in Alabama, enabled him to recognize the need for such technology in the workplace, as well as medical offices.
"The idea is to evaluate the patient before they hurt themselves," said DiStefano.
"Now you're just a fly on the wall to take a picture," said Helt. Since the program acts as a tool for physical therapists, chiropractors and doctors, not a replacement, DiStefano is confident that health care practitioners won't feel threatened by the dawning of the computer age. And since the program is designed to help the clinician analyze movements, diseases such as osteoporosis, for example, still need a doctor's touch to be formally diagnosed.
Since the system relies on mathematics in calculating the degree of abnormalities, it has a smaller margin of error than humans do, according to DiStefano, who earned a bachelor of science degree in physical therapy from Hunter College, a master of arts in pathokinesiology from New York University in Manhattan, and is currently pursuing a doctorate in physical therapy from the University of St. Augustine in Florida.
Helt and DiStefano have been to several U.S. cities as well as Canada and Mexico on behalf of Med-Data Systems, Inc., the Cherry Hill, NJ, company that bought the rights to Helt's program and provides backing for the product. The soft- ware for the program, depending on the options, will cost between $1,500 and $3,000. The figure does not include the actual computer or scanners that are needed, which can be purchased through other suppliers.
The duo isn't the only ones using computers in the medical field. A Toronto-based podiatrist, Glenn Copeland, has developed a system for manufacturing orthotics, which are shoe inserts designed to provide comfort and relief for sore feet.
Dr. Copeland's Footmaxx system focuses on how people walk and put pressure on their feet. A patient would walk on an electronic mat, which translates information about the pressure and motion of the foot. The computer determines if there is an abnormality, and a custom-made orthotic can be produced within a week.
"We can see abnormal gait through the dynamic measurement, while' it also shows us exactly how to make the custom-crafted orthotic," said Copeland, who is also team podiatrist for the Toronto Blue Jays baseball team.
