Project Description

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The COMFORT Project is a Eurostars project co-funded by the EUREKA member countries and the European Union Horizon 2020 Framework Programme. COMFORT stands for COMplex Fracture Orthopedic Rehabilitation.

The COMFORT project

Each year 610,000 Europeans incur a hip fracture. This number is rising with the aging population. Their rehabilitation is hampered by absence of proper tools. COMFORT creates a rehabilitation program for patients with hip fractures. This program will help these patients rehabilitate faster. The rehabilitation program is supported by three innovations: a force sensor system, for daily used during regular exercise routines, a bone density analyzer for periodic measurements, and an app with intelligent software that each day determines the optimal loading target for the patient from the measurements of the force sensor and the bone density analyzer.

Mechanical loading and early mobilization are considered important goals in the early stage of the rehabilitation process of patients after fractures of the lower extremity. Unfortunately, the optimal loading pattern that a patient should follow during the weeks of rehabilitation is not well understood. The advice given by doctors to rehabilitating patients varies from zero to complete loading, and everything in between. Because objective methods to monitor loading during rehabilitation have not been generally available, little is known about the actual loading that patients exert during their rehabilitation. This means that advice is based mostly on opinion and experience.

COMFORT focuses on this problem, and takes advantage of two new ICT-based technologies. The first innovative technology used is a small, wireless force sensor recently developed by Evalan and UMC Utrecht; The SensiStep. The second innovative is a bone density analyzer that will be able to measure density in longitudinal bones with RF waves and that is currently under development by Uppsala University.

During the first half of this project 200 patients with hip fractures will be monitored with these two technologies. The force that they exert on their affected leg will be measured daily while they are performing exercises, and once a week bone density measurements will be taken. This data will be correlated with the duration of the rehabilitation of the patients. The duration is defined as the number of days between the day of the fracture and the day of release from the rehabilitation clinic.


With this information a “smart operator” will be developed and incorporated in an app. Once completed, this smart operator will be fed with the loading data and the bone density measurements that are collected from a patient in real time, and will determine the optimal loading target for the rehabilitating patient during each day of the rehabilitation process. As no patient will exactly follow the desired pattern, the optimal pattern will change from day to day and the program in the app will dynamically adjust the optimal target as the patient proceeds with his rehabilitation.

During the second half of the project, the combination of these technologies will be validated during a trial with 94 additional patients. Now the app will provide a daily loading target (to a healthcare professional, who will approve this target). The rehabilitation duration of these patients will be compared to the duration of a matched sample of similar cases retrieved from the first half of the project. Based on the expectation that the duration will reduce by at least 6 days.