**3. IoT in biomedicine: Rehabilitation IoT**

Health sciences are fields of study related to life and include several branches such as medicine, biomedicine, nursing, speech therapy, clinical criticism, pharmacy, physical health, dentistry, psychology, occupational therapy, nutrition, and physical therapy. All these fields consider the use of science, technology, engineering, or mathematics to provide medical care to human beings. Many people experience physical and/or motor limitations associated with a variety of reasons, whether due to problems at birth, work-related accidents, or restrictions caused by aging. Older people are more affected by motor impairments that make even simple daily tasks difficult, such as lifting an object without difficulty, eating alone, or even dressing. Such consequences can restrict personal activities and avoid the full participation of the elderly in the community, which has a negative effect on their daily work and life in general [47].

#### *Application of Internet of Things (IoT) in Biomedicine: Challenges and Future Directions DOI: http://dx.doi.org/10.5772/intechopen.113178*

Currently, the Internet of Things (IoT) has a significant impact in the field of medical rehabilitation as well. By connecting devices and sensors to the Internet, IoT facilitates the collection and analysis of real-time data, thereby enabling medical staff to monitor patients more effectively and provide personalized treatments. Some examples of the importance of IoT in medical rehabilitation are:


#### **3.1 Technologies**

The architecture of an IoT (Internet of Things) system for medical rehabilitation usually involves the integration of different components and technologies to monitor, collect, and analyze data related to the rehabilitation process. A high-level architecture overview is described below:

#### *3.1.1 Sensors and wearables*

These are the physical devices that capture data about the patient's movements, vital signs, and other relevant information. Examples include motion sensors, accelerometers, heart rate monitors, electromyography (EMG) sensors, and wearable devices such as smartwatches or fitness trackers. These sensors and devices are worn by the patient and communicate wirelessly with the IoT system [50, 51].

#### *3.1.2 Data acquisition and communication*

Data collected by sensors and wearable devices is transmitted to a gateway device or directly to the cloud for processing and analysis. This communication can be done using different wireless protocols such as Wi-Fi, Bluetooth, or Zigbee. The gateway device acts as a bridge between the sensors and the cloud, relaying the data securely.

#### *3.1.3 Cloud platform*

The cloud platform serves as a central hub for data storage, processing, and analysis. It receives data from sensors and wearable devices and stores it in a secure and scalable way. The cloud platform also provides the computing resources required for real time or batch processing of the data, depending on the requirements. Popular cloud platforms such as Amazon Web Services (AWS) or Microsoft Azure are often used to host IoT infrastructure.

#### *3.1.4 Data processing and analysis*

Collected data is processed and analyzed to obtain meaningful information about the patient's rehabilitation progress. This can involve various techniques, such as signal processing, machine learning, or statistical analysis. The data processed may include metrics such as range of motion, muscle activity, exercise adherence, or performance indicators. This information can be used to tailor rehabilitation programs, track progress, and provide feedback to the patient and healthcare professionals.

#### *3.1.5 Application and user interface*

Processed data are made available to various stakeholders, including patients, caregivers, and health professionals, through user-friendly applications and interfaces. These interfaces can be web portals, mobile apps, or specialized software used in rehabilitation clinics. They provide real-time feedback, visualizations, and progress reports to help monitor and manage your rehabilitation process.

#### *3.1.6 Security and privacy*

Given the sensitive nature of medical data, security and privacy measures are crucial in a medical rehabilitation IoT system. This includes encryption of data during transmission and storage, access control mechanisms, user authentication, and compliance with relevant data protection regulations such as the United States' Health Insurance Portability and Accountability Act (HIPAA). IoT architecture should ensure that patient data is handled securely and that the system is resilient to potential cyber security threats (**Figure 4**) [52].

It is important to note that the specific architecture may vary depending on the requirements of the rehabilitation program, the type of medical condition being treated, and the available technologies. The architecture presented above provides a general framework for understanding the key components involved in an IoT system for medical rehabilitation.

*Application of Internet of Things (IoT) in Biomedicine: Challenges and Future Directions DOI: http://dx.doi.org/10.5772/intechopen.113178*

**Figure 4.** *System overview of the home-based rehabilitation system.*

### **3.2 Applications**

The use of IoT (Internet of Things) in medical rehabilitation can improve the effectiveness, efficiency, and convenience of rehabilitation programs. IoT data can be used to tailor rehab programs to the specific needs of individual patients. Data collected from wearables and sensors can be used to identify areas of strength and weakness, and rehabilitation programs can be designed to target these areas. Personalized approach can help patients achieve better results and reduce the risk of injury.

An example of a BSNCare+ system is where IoT-based rehabilitation equipment is embedded for both the patient and the involved environment as an end-to-end device. The nurse can use the mobile gateway to collect data in real time and offer better-quality medical services to the patient. All detection data will be transmitted to the BSN-Care server and maintained for the purpose of further data analysis and analysis of patient needs [53] (**Figure 5**).

Body Sensor Networks (BSN) take the concept of wearables to the next level. BSNs consist of a network of wearable sensors that can communicate with each other and

**Figure 5.** *Proposed IoT-based communication architecture for BSNCare+.*

#### **Figure 6.**

*Portable medical and healthcare devices worn on body parts used in medical rehabilitation IoT systems.*

with other devices. BSNs can provide real-time monitoring of multiple physiological parameters, making them useful for a wide range of applications, including medical rehabilitation [54] (**Figure 6**).

IoT devices can be used to create virtual rehabilitation environments simulating real-world activities. Virtual reality headsets, for example, can be used to create immersive experiences that can help with the rehabilitation process. Virtual rehab can also allow patients to practice their rehab exercises in a safe and controlled environment.

Gamification is using game design principles to motivate and engage patients in their rehabilitation program. IoT devices can be used to create gamified experiences that make rehab more fun and engaging. For example, sensors can be used to track a patient's movements during an exercise, and the data can be used to control a video game. This can make rehabilitation more enjoyable and increase patient adherence (**Figure 7**).

IoT devices can be used to provide remote guidance and support to patients during their rehab program. Video conferencing tools, for example, can be used to connect patients with rehabilitation professionals who can provide guidance and feedback on their exercise. This can be particularly useful for patients who live in remote areas or have limited access to health professionals [55].

Overall, the application of IoT in medical rehabilitation has the potential to transform the way patients receive rehabilitation services. By providing real-time data, personalized programs, and remote coaching, IoT can improve patient outcomes, reduce costs, and increase patient satisfaction.

*Application of Internet of Things (IoT) in Biomedicine: Challenges and Future Directions DOI: http://dx.doi.org/10.5772/intechopen.113178*

**Figure 7.**

*Brain-computer interfaces (BCIs) and IoT for stroke rehabilitation using gamification.*

#### **3.3 Challenges**

While the use of IoT (Internet of Things) in medical rehabilitation brings many benefits, there are also some challenges that need to be addressed. The accuracy and reliability of data collected by IoT devices are crucial for effective decision-making in rehabilitation. However, there may be situations where IoT devices produce inaccurate or inconsistent data due to device limitations, calibration issues, or user error. Adequate calibration, regular maintenance, and validation processes should be implemented to ensure the accuracy and reliability of IoT-generated data.

Privacy is provided by standardized data security protocols (such as encryption, authentication, and key distribution) during the data collection phase. In cases where security protocols are not suitable for IoT devices or cannot meet the application requirements, specific encryption, authentication, or key distribution algorithms are proposed. In these situations, there may also be issues related to indirect privacy leaks, such as finding user behavior patterns and protecting user anonymity. In the data transmission and storage/sharing phases, the individual system design must be made according to specific policies or rules that provide privacy to system users [56].

IoT devices and associated applications should be user-friendly and intuitive to ensure compliance and patient engagement. Complex user interfaces or difficultto-use devices may deter patients from actively participating in their rehabilitation programs. Designing devices and interfaces with the end user in mind, conducting usability tests, and collecting user feedback can help improve the overall user experience.

IoT devices collect and transmit sensitive patient data, including personal health information. Ensuring the security and confidentiality of this data is crucial to protecting patient privacy. Healthcare providers must implement robust security measures such as encryption, secure data storage, access control, and regular system updates to protect patient data from unauthorized access or cyber threats [57]. The solution is to develop uniform data quality standards. In this way, it can be managed more efficiently across countries, organizations, and departments, thereby facilitating the storage, delivery, and sharing of data and reducing errors in judgment and decision-making due to data incompatibility, data redundancy, and data deficiencies. Since IoT systems are distributed in nature, the use of international standards can have a positive effect on improving the performance of business processes by aligning different organizations with the same foundation, addressing interoperability issues, and ultimately working in a seamless manner [58].

IoT devices in medical rehabilitation collect extensive data about patients' movements, health conditions, and activities. Healthcare providers must address ethical concerns about data ownership, consent, and use. Patients must be informed about the data collected, how it will be used, and have control over their data. Implementing clear data governance policies and complying with relevant privacy regulations are essential. Implementing IoT in medical rehabilitation may require significant investments in hardware, software, infrastructure, and ongoing maintenance. Healthcare providers need to assess the cost implications and ensure the availability of necessary infrastructure and resources to support IoT implementation effectively [59].

Addressing these challenges requires collaboration among healthcare providers, technology developers, regulatory bodies, and other stakeholders. By addressing security concerns, promoting interoperability, ensuring data accuracy, and prioritizing user experience, IoT can realize its potential to transform medical rehabilitation while providing safe and effective patient care.

### **3.4 Future directions**

The future direction of IoT (Internet of Things) in rehabilitation is poised to bring significant advances and benefits to the field.

Here are some possible evolutions and trends:

*Smart devices and sensor technology*: IoT-enabled smart devices and sensor devices will continue to play a crucial role in rehabilitation. These devices can monitor and collect real-time data about patients' movements, muscle activity, heart rate, and other vital signs. This data can be analyzed to provide customized feedback, track progress, and optimize rehabilitation programs.

*Adaptive and personalized rehabilitation*: The IoT can contribute to adaptive and personalized rehabilitation programs. By integrating sensors into rehabilitation equipment, IoT systems can automatically adjust resistance, range of motion, or intensity based on the patient's capabilities and progress. This personalized approach can optimize the efficacy of therapy and improve patient outcomes.

*Data analytics and machine learning:* The large amount of data generated by IoT devices in rehabilitation presents opportunities for data analytics and machine learning. By analyzing large datasets, patterns and insights can be identified to improve rehabilitation protocols, predict patient outcomes, and optimize treatment plans. Machine learning algorithms can also help automate rehabilitation progress assessment and provide personalized recommendations.

*Gamification and virtual reality:* IoT can use gamification and virtual reality (VR) technologies to make rehabilitation engaging and motivating. IoT-enabled devices can connect to VR platforms, allowing patients to interact with immersive environments that simulate real-life scenarios. Gamified experiences can increase patient participation, therapy adherence, and overall motivation, leading to improved rehabilitation outcomes.

*Collaborative ecosystems:* The future of IoT in rehabilitation will involve developing collaborative ecosystems. Different stakeholders, including healthcare providers, device manufacturers, software developers, and researchers, will work together to create integrated solutions. These ecosystems will promote interoperability between devices, secure data sharing, and standardized protocols, encouraging innovation and progress in rehabilitation practices.

*Application of Internet of Things (IoT) in Biomedicine: Challenges and Future Directions DOI: http://dx.doi.org/10.5772/intechopen.113178*

*Ethical and security considerations:* As IoT becomes more widespread in rehabilitation, it is critical to address ethical and security concerns. Patient confidentiality, data security, and informed consent must take precedence. Robust security measures, such as encryption and authentication protocols, should be implemented to protect sensitive patient information from unauthorized access [60, 61].

Overall, the future of IoT in rehabilitation has a great potential to transform the way rehabilitation is carried out. Using IoT technologies, healthcare professionals can provide more personalized, efficient, and accessible rehabilitation services to improve patient outcomes and quality of life.

## **4. Conclusions**

In the medical field, IoT enables remote patient monitoring, which improves the ability to diagnose and treat various conditions. Wearable devices equipped with sensors can collect real-time data on vital signs, medication adherence, and physical activity, providing healthcare providers with valuable information about patient health. This data can be analyzed to detect early warning signs, prevent complications, and facilitate timely interventions. IoT also enables telemedicine and virtual consultations, allowing healthcare professionals to connect remotely with patients, provide guidance, and monitor their progress.

In addition, IoT plays a crucial role in rehabilitation. Connected devices can help physical therapy by tracking movements, providing feedback, and guiding patients through exercises. This real-time monitoring helps to ensure correct form and adherence to prescribed regimens. IoT-based rehabilitation tools also enable remote rehabilitation, allowing patients to receive therapy from the comfort of their homes, thus increasing accessibility and convenience. Not only does this save time and cost, it also promotes patient engagement and adherence to treatment plans.

Despite these challenges, integrating IoT into medicine and rehabilitation holds immense promise for transforming healthcare delivery. It improves patients, improves outcomes, and revolutionizes how healthcare is practiced. As technology continues to advance and healthcare systems embrace IoT solutions, we can expect to see new advancements and innovations in this area, ultimately leading to a more connected and patient-centric healthcare ecosystem.
