Review of the Augmented Reality Systems for Shoulder Rehabilitation

Literature shows an increasing interest for the development of augmented reality (AR) applications in several fields, including rehabilitation. Current studies show the need for new rehabilitation tools for upper extremity, since traditional interventions are less effective than in other body regions. This review aims at: Studying to what extent AR applications are used in shoulder rehabilitation, examining wearable/non-wearable technologies employed, and investigating the evidence supporting AR effectiveness. Nine AR systems were identified and analyzed in terms of: Tracking methods, visualization technologies, integrated feedback, rehabilitation setting, and clinical evaluation. Our findings show that all these systems utilize vision-based registration, mainly with wearable marker-based tracking, and spatial displays. No system uses head-mounted displays, and only one system (11%) integrates a wearable interface (for tactile feedback). Three systems (33%) provide only visual feedback; 66% present visual-audio feedback, and only 33% of these provide visual-audio feedback, 22% visual-audio with biofeedback, and 11% visual-audio with haptic feedback. Moreover, several systems (44%) are designed primarily for home settings. Three systems (33%) have been successfully evaluated in clinical trials with more than 10 patients, showing advantages over traditional rehabilitation methods. Further clinical studies are needed to generalize the obtained findings, supporting the effectiveness of the AR applications

Automating senior fitness testing through gesture detection with depth sensors

Sedentarism has a negative impact on health, life expectancy and quality of life, especially in older adults. The assessment of functional fitness helps evaluating the effects of ageing and sedentarism, and this assessment is typically done through validated battery tests such as the Senior Fitness Test (SFT). In this paper we present a computer-based system for assisting and automating SFT administration and scoring in the elderly population. Our system assesses lower body strength, agility and dynamic balance, and aerobic endurance making use of a depth sensor for body tracking and multiple gesture detectors for the evaluation of movement execution. The system was developed and trained with optimal data collected in laboratory conditions and its performance was evaluated in a real environment with 22 elderly end-users, and compared to traditional SFT administered by an expert. Results show a high accuracy of our system in identifying movement patterns (>95%) and consistency with the traditional fitness assessment method. Our results suggest that this technology is a viable low cost option to assist in the fitness assessment of elderly that could be deployed for at home use in the context of fitness programs.info:eu-repo/semantics/publishedVersio

Innovative Technologies for Medical Education

This chapter aims to assess the current practices of anatomy education technology and provides future directions for medical education. It begins by presenting a historical synopsis of the current paradigms for anatomy learning followed by listing their limitations. Then, it focuses on several innovative educational technologies, which have been introduced over the past years to enhance the learning. These include E-learning, mobile apps, and mixed reality. The chapter concludes by highlighting future directions and addressing the barriers to fully integrating the technologies in the medical curriculum. As new technologies continue to arise, this process-oriented understanding and outcome-based expectations of educational technology should be embraced. With this view, educational technology should be valued in terms of how well the technological process informs and facilitates learning, and the acquisition and maintenance of clinical expertise

A real-time algorithm for the detection of compensatory movements during reaching

Introduction: Interactive game systems can motivate stroke survivors to engage with their rehabilitation exercises. However, it is crucial that systems are in place to detect if exercises are performed correctly as stroke survivors often perform compensatory movements which can be detrimental to recovery. Very few game systems integrate motion tracking algorithms to monitor performance and detect such movements. This paper describes the development of algorithms which monitor for compensatory movements during upper limb reaching movements in real-time and provides quantitative metrics for health professionals to monitor performance and progress over time. Methods: A real-time algorithm was developed to analyse reaching motions in real-time through a low-cost depth camera. The algorithm segments cyclical reaching motions into component parts, including compensatory movement, and provides a graphical representation of task performance. Healthy participants (n = 10) performed reaching motions facing the camera. The real-time accuracy of the algorithm was assessed by comparing offline analysis to real-time collection of data. Results: The algorithm’s ability to segment cyclical reaching motions and detect the component parts in real-time was assessed. Results show that movement types can be detected in real time with accuracy, showing a maximum error of 1.71%. Conclusions: Using the methods outlined, the real-time detection and quantification of compensatory movements is feasible for integration within home-based, repetitive task practice game systems for people with stroke

The immediate effect of a chiropractic manipulation of the spine on the hitting speed in squash

Abstract: Purpose: The aim of this study was to determine whether chiropractic manipulation has an immediate effect on the hitting speed of a squash ball in competitive squash players and to determine whether manipulation could be beneficial in increasing the ball speed post hit in the squash forehand drive. Method: Both male and female participants between the ages of 35 and 65 (n=100), who met the inclusion criteria of being active league squash players, were selected. The participants were split into two groups, a control group and an intervention group, each consisting of 50 participants. Procedure: Each participant, after consenting to be on this study, had a single consultation during which a patient history, physical examination and a cervical spine regional assessment were completed. Participants were given a standardised warmup which was followed by the first round of measurements for ball speed and cervical spine range of motion. Following the initial measurements, the intervention group received chiropractic manipulation via diversified techniques to any restrictions found within the cervical spine. The control group remained rested and received no treatment. A second round of measurements for ball speed and cervical spine range of motion were then taken following the intervention period for both groups. The average speed was determined for each participant and cervical range of motion difference was also noted...M.Tech. (Chiropractic

The potential psychological benefits of Active Video Games in the rehabilitation of musculoskeletal injuries and deficiencies: A narrative review of the literature

Background: Recent literature suggests that Active Video Games (AVGs) may offer potential psychological benefits during the rehabilitation of musculoskeletal injuries and their corresponding deficiencies. Objectives: To review existing literature regarding the potential psychological benefits of AVGs within the context of rehabilitation from musculoskeletal injury or debilitation. Method: A narrative review of the literature that used the Population, Intervention, Comparison, and Outcomes PICO method was conducted. The literature review included studies that discussed and/or investigated potential psychological benefits of AVGs during musculoskeletal rehabilitation. Of the total 163 papers that were identified, 30 met the inclusion criteria. Results: The Nintendo® WiiTM (Nintendo Co., Ltd, Kyoto, Japan) was the most commonly-used games console that was employed in AVG interventions (15 out of 21), and these studies that investigated potential psychological benefits were typically conducted with elderly populations. These studies reported that using AVGs in musculoskeletal rehabilitation resulted in a number of positive psychological effects (e.g., enjoyment, effects on self). However, most studies lacked a clear theoretical framework, and varied greatly in their designs and methodologies. Conclusion: Despite encouraging findings of AVG use, insufficient evidence exists to reliably verify or refute the potential psychological benefits of AVGs in musculoskeletal rehabilitation. It is recommended that future studies in this area contain a theoretical framework to ensure greater consistency in the methodology used and the execution of the intervention. The potential findings of such investigations may result in the development of optimal, client-tailored rehabilitation programmes

Health-Enabling Technologies for Telerehabilitation of the Shoulder: A Feasibility and User Acceptance Study

BACKGROUND: After discharge from a rehabilitation center the continuation of therapy is necessary to secure already achieved healing progress and sustain (re-)integration into working life. To this end, home-based exercise programs are frequently prescribed. However, many patients do not perform their exercises as frequently as prescribed or even with incorrect movements. The telerehabilitation system AGT-Reha was developed to support patients with shoulder diseases during their home-based aftercare rehabilitation. OBJECTIVES: The presented pilot study AGT-Reha-P2 evaluates the technical feasibility and user acceptance of the home-based telerehabilitation system AGT-Reha. METHODS: A nonblinded, nonrandomized exploratory feasibility study was conducted over a 2-year period in patients' homes. Twelve patients completed a 3-month telerehabilitation exercise program with AGT-Reha. Primary outcome measures are the satisfying technical functionality and user acceptance assessed by technical parameters, structured interviews, and a four-dimensional questionnaire. Secondary endpoints are the medical rehabilitation success measured by the active range of motion and the shoulder function (pain and disability) assessed by employing the Neutral-0 Method and the standardized questionnaire "Shoulder Pain and Disability Index" (SPADI), respectively. To prepare an efficacy trial, various standardized questionnaires were included in the study to measure ability to work, capacity to work, and subjective prognosis of work capacity. The participants have been assessed at three measurement points: prebaseline (admission to rehabilitation center), baseline (discharge from rehabilitation center), and posttherapy. RESULTS: Six participants used the first version of AGT-Reha, while six other patients used an improved version. Despite minor technical problems, all participants successfully trained on their own with AGT-Reha at home. On average, participants trained at least once per day during their training period. Five of the 12 participants showed clinically relevant improvements of shoulder function (improved SPADI score > 11). The work-related parameters suggested a positive impact. All participants would recommend the system, ten participants would likely reuse it, and seven participants would have wanted to continue their use after 3 months. CONCLUSION: The findings show that home-based training with AGT-Reha is feasible and well accepted. Outcomes of SPADI indicate the effectiveness of aftercare with AGT-Reha. A controlled clinical trial to test this hypothesis will be conducted with a larger number of participants

A Person-Centric Design Framework for At-Home Motor Learning in Serious Games

abstract: In motor learning, real-time multi-modal feedback is a critical element in guided training. Serious games have been introduced as a platform for at-home motor training due to their highly interactive and multi-modal nature. This dissertation explores the design of a multimodal environment for at-home training in which an autonomous system observes and guides the user in the place of a live trainer, providing real-time assessment, feedback and difficulty adaptation as the subject masters a motor skill. After an in-depth review of the latest solutions in this field, this dissertation proposes a person-centric approach to the design of this environment, in contrast to the standard techniques implemented in related work, to address many of the limitations of these approaches. The unique advantages and restrictions of this approach are presented in the form of a case study in which a system entitled the "Autonomous Training Assistant" consisting of both hardware and software for guided at-home motor learning is designed and adapted for a specific individual and trainer. In this work, the design of an autonomous motor learning environment is approached from three areas: motor assessment, multimodal feedback, and serious game design. For motor assessment, a 3-dimensional assessment framework is proposed which comprises of 2 spatial (posture, progression) and 1 temporal (pacing) domains of real-time motor assessment. For multimodal feedback, a rod-shaped device called the "Intelligent Stick" is combined with an audio-visual interface to provide feedback to the subject in three domains (audio, visual, haptic). Feedback domains are mapped to modalities and feedback is provided whenever the user's performance deviates from the ideal performance level by an adaptive threshold. Approaches for multi-modal integration and feedback fading are discussed. Finally, a novel approach for stealth adaptation in serious game design is presented. This approach allows serious games to incorporate motor tasks in a more natural way, facilitating self-assessment by the subject. An evaluation of three different stealth adaptation approaches are presented and evaluated using the flow-state ratio metric. The dissertation concludes with directions for future work in the integration of stealth adaptation techniques across the field of exergames.Dissertation/ThesisDoctoral Dissertation Computer Science 201