The ALLADIN project focuses on the development of a user-friendly natural language based decision support software for neuro-rehabilitation, in particular in stroke. ALLADIN, if implemented provides an adequate and fast solution for a client centred practice, for discharge planning and for utilization of rehabilitation resources. This fulfils the social and political expectation of a substantial but honest cost cutting by measuring therapeutic efficiency in terms of mean quality-adjusted duration.

Evidence-based practice has advanced slowly in stroke rehabilitation for 20 years because:

• Current clinical techniques for patient assessment routinely rely on subjective and labour intensive techniques involving gross rating scales or the application of motor behavioural tasks using motor proficiency test batteries. Applying current assessment techniques to complex problems encountered during neuro-rehabilitation is impossible.

• Moreover the used scales lack reliability and are unable to provide the healthcare professional with a good prediction of possible impairments and disabilities nor the healthcare provider with an estimate of the cost and outcome of the treatment.

• Complex measurements such as motion analysis or brain image technologies (CT, MRI, fMRI, SPECT..) are reliable but very expensive and also time consuming. Using them on a regular base for the evaluation of patients and steering neuro-rehabilitation is impossible.

Motivations

The changes occurring today in patient care and chart review demand dynamic, innovative changes in medical record keeping.

The concept of 'Problem-oriented Medical Record', which started several years ago, was the first revolutionary onset of a more organised medical record keeping.

Complex problems encountered in neuro-rehabilitation however ask for a second revolution. Therefore ALLADIN will be developed.  

ALLADIN offers a new and the first reliable standard for calculating and predicting the functional recovery of stroke patients, which is a crucial factor in client centred evidence based practice, discharge planning and utilization of rehabilitation resources. 

ALLADIN creates labels for conformity in the communication and understanding of neuro-rehabilitation data. This is a prerequisite for taking prompt and right decisions in stroke rehabilitation. 

ALLADIN makes clinical assessments and quantitative measurements exchangeable and fulfils in this way the wishes of therapists for user friendly, fast but reliable evaluation methods. 

ALLADIN outputs a numerical code attached to an operational definition of a milestone or marker for functional recovery analogous with ICD-9-10 codes. It has at the same time a trend-setting function for the further elaboration of the International Classification of Functioning and disabilities (ICF) with the objective to facilitate multidisciplinary responsibility and coordination of interventions. 

A list of keywords follows:

• Stroke

• Patient assessment in neuro-rehabilitation

• Force mapping of movement planning

• Whole-body isometric force measurements