Home-based rehabilitation of the shoulder using auxiliary systems and artificial intelligence: an overview

Advancements in modern medicine have bolstered the usage of home-based rehabilitation services for patients, particularly those recovering from diseases or conditions that necessitate a structured rehabilitation process. Understanding the technological factors that can influence the efficacy of home-based rehabilitation is crucial for optimizing patient outcomes. As technologies continue to evolve rapidly, it is imperative to document the current state of the art and elucidate the key features of the hardware and software employed in these rehabilitation systems. This narrative review aims to provide a summary of the modern technological trends and advancements in home-based shoulder rehabilitation scenarios. It specifically focuses on wearable devices, robots, exoskeletons, machine learning, virtual and augmented reality, and serious games. Through an in-depth analysis of existing literature and research, this review presents the state of the art in home-based rehabilitation systems, highlighting their strengths and limitations. Furthermore, this review proposes hypotheses and potential directions for future upgrades and enhancements in these technologies. By exploring the integration of these technologies into home-based rehabilitation, this review aims to shed light on the current landscape and offer insights into the future possibilities for improving patient outcomes and optimizing the effectiveness of home-based rehabilitation programs.info:eu-repo/semantics/publishedVersio

Impact of Ear Occlusion on In-Ear Sounds Generated by Intra-oral Behaviors

We conducted a case study with one volunteer and a recording setup to detect sounds induced by the actions: jaw clenching, tooth grinding, reading, eating, and drinking. The setup consisted of two in-ear microphones, where the left ear was semi-occluded with a commercially available earpiece and the right ear was occluded with a mouldable silicon ear piece. Investigations in the time and frequency domains demonstrated that for behaviors such as eating, tooth grinding, and reading, sounds could be recorded with both sensors. For jaw clenching, however, occluding the ear with a mouldable piece was necessary to enable its detection. This can be attributed to the fact that the mouldable ear piece sealed the ear canal and isolated it from the environment, resulting in a detectable change in pressure. In conclusion, our work suggests that detecting behaviors such as eating, grinding, reading with a semi-occluded ear is possible, whereas, behaviors such as clenching require the complete occlusion of the ear if the activity should be easily detectable. Nevertheless, the latter approach may limit real-world applicability because it hinders the hearing capabilities.</p

Energy Regeneration and Environment Sensing for Robotic Leg Prostheses and Exoskeletons

Robotic leg prostheses and exoskeletons can provide powered locomotor assistance to older adults and/or persons with physical disabilities. However, limitations in automated control and energy-efficient actuation have impeded their transition from research laboratories to real-world environments. With regards to control, the current automated locomotion mode recognition systems being developed rely on mechanical, inertial, and/or neuromuscular sensors, which inherently have limited prediction horizons (i.e., analogous to walking blindfolded). Inspired by the human vision-locomotor control system, here a multi-generation environment sensing and classification system powered by computer vision and deep learning was developed to predict the oncoming walking environments prior to physical interaction, therein allowing for more accurate and robust high-level control decisions. To support this initiative, the “ExoNet” database was developed – the largest and most diverse open-source dataset of wearable camera images of indoor and outdoor real-world walking environments, which were annotated using a novel hierarchical labelling architecture. Over a dozen state-of-the-art deep convolutional neural networks were trained and tested on ExoNet for large-scale image classification and automatic feature engineering. The benchmarked CNN architectures and their environment classification predictions were then quantitatively evaluated and compared using an operational metric called “NetScore”, which balances the classification accuracy with the architectural and computational complexities (i.e., important for onboard real-time inference with mobile computing devices). Of the benchmarked CNN architectures, the EfficientNetB0 network achieved the highest test accuracy; VGG16 the fastest inference time; and MobileNetV2 the best NetScore. These comparative results can inform the optimal architecture design or selection depending on the desired performance of an environment classification system. With regards to energetics, backdriveable actuators with energy regeneration can improve the energy efficiency and extend the battery-powered operating durations by converting some of the otherwise dissipated energy during negative mechanical work into electrical energy. However, the evaluation and control of these regenerative actuators has focused on steady-state level-ground walking. To encompass real-world community mobility more broadly, here an energy regeneration system, featuring mathematical and computational models of human and wearable robotic systems, was developed to simulate energy regeneration and storage during other locomotor activities of daily living, specifically stand-to-sit movements. Parameter identification and inverse dynamic simulations of subject-specific optimized biomechanical models were used to calculate the negative joint mechanical work and power while sitting down (i.e., the mechanical energy theoretically available for electrical energy regeneration). These joint mechanical energetics were then used to simulate a robotic exoskeleton being backdriven and regenerating energy. An empirical characterization of an exoskeleton was carried out using a joint dynamometer system and an electromechanical motor model to calculate the actuator efficiency and to simulate energy regeneration and storage with the exoskeleton parameters. The performance calculations showed that regenerating electrical energy during stand-to-sit movements provide small improvements in energy efficiency and battery-powered operating durations. In summary, this research involved the development and evaluation of environment classification and energy regeneration systems to improve the automated control and energy-efficient actuation of next-generation robotic leg prostheses and exoskeletons for real-world locomotor assistance

Wearable Movement Sensors for Rehabilitation: From Technology to Clinical Practice

This Special Issue shows a range of potential opportunities for the application of wearable movement sensors in motor rehabilitation. However, the papers surely do not cover the whole field of physical behavior monitoring in motor rehabilitation. Most studies in this Special Issue focused on the technical validation of wearable sensors and the development of algorithms. Clinical validation studies, studies applying wearable sensors for the monitoring of physical behavior in daily life conditions, and papers about the implementation of wearable sensors in motor rehabilitation are under-represented in this Special Issue. Studies investigating the usability and feasibility of wearable movement sensors in clinical populations were lacking. We encourage researchers to investigate the usability, acceptance, feasibility, reliability, and clinical validity of wearable sensors in clinical populations to facilitate the application of wearable movement sensors in motor rehabilitation