Design and Validation of Vision-Based Exercise Biofeedback for Tele-Rehabilitation

Tele-rehabilitation has the potential to considerably change the way patients are monitored from their homes during the care process, by providing equitable access without the need to travel to rehab centers or shoulder the high cost of personal in-home services. Developing a tele-rehab platform with the capability of automating exercise guidance is likely to have a significant impact on rehabilitation outcomes. In this paper, a new vision-based biofeedback system is designed and validated to identify the quality of performed exercises. This new system will help patients to refine their movements to get the most out of their plan of care. An open dataset was used, which consisted of data from 30 participants performing nine different exercises. Each exercise was labeled as “Correctly” or “Incorrectly” executed by five clinicians. We used a pre-trained 3D Convolution Neural Network (3D-CNN) to design our biofeedback system. The proposed system achieved average accuracy values of 90.57% ± 9.17% and 83.78% ± 7.63% using 10-Fold and Leave-One-Subject-Out (LOSO) cross validation, respectively. In addition, we obtained average F1-scores of 71.78% ± 5.68% using 10-Fold and 60.64% ± 21.3% using LOSO validation. The proposed 3D-CNN was able to classify the rehabilitation videos and feedback on the quality of exercises to help users modify their movement patterns

Joint angle estimation during shoulder abduction exercise using contactless technology

Abstract Background Tele-rehabilitation, also known as tele-rehab, uses communication technologies to provide rehabilitation services from a distance. The COVID-19 pandemic has highlighted the importance of tele-rehab, where the in-person visits declined and the demand for remote healthcare rises. Tele-rehab offers enhanced accessibility, convenience, cost-effectiveness, flexibility, care quality, continuity, and communication. However, the current systems are often not able to perform a comprehensive movement analysis. To address this, we propose and validate a novel approach using depth technology and skeleton tracking algorithms. Methods Our data involved 14 participants (8 females, 6 males) performing shoulder abduction exercises. We collected depth videos from an LiDAR camera and motion data from a Motion Capture (Mocap) system as our ground truth. The data were collected at distances of 2 m, 2.5 m, and 3.5 m from the LiDAR sensor for both arms. Our innovative approach integrates LiDAR with the Cubemos and Mediapipe skeleton tracking frameworks, enabling the assessment of 3D joint angles. We validated the system by comparing the estimated joint angles versus Mocap outputs. Personalized calibration was applied using various regression models to enhance the accuracy of the joint angle calculations. Results The Cubemos skeleton tracking system outperformed Mediapipe in joint angle estimation with higher accuracy and fewer errors. The proposed system showed a strong correlation with Mocap results, although some deviations were present due to noise. Precision decreased as the distance from the camera increased. Calibration significantly improved performance. Linear regression models consistently outperformed nonlinear models, especially at shorter distances. Conclusion This study showcases the potential of a marker-less system, to proficiently track body joints and upper-limb angles. Signals from the proposed system and the Mocap system exhibited robust correlation, with Mean Absolute Errors (MAEs) consistently below $$10^\circ$$ 10 ∘ . LiDAR’s depth feature enabled accurate computation of in-depth angles beyond the reach of traditional RGB cameras. Altogether, this emphasizes the depth-based system’s potential for precise joint tracking and angle calculation in tele-rehab applications

A novel approach to tele-rehabilitation: Implementing a biofeedback system using machine learning algorithms

Tele-rehabilitation (Tele-rehab) is changing the landscape of virtual care by redefining assessment and breaking accessibility barriers as a convenient substitute for conventional rehabilitation. The COVID-19 pandemic resulted in a rapid uptake of virtual care. Researchers and health professionals have started developing new tele-rehab platforms, e.g., in the form of video conferencing. Albeit useful, these platforms still require the clinicians’ time and energy. Integrating a biofeedback system that can reliably distinguish between “Correctly Executed” from “Incorrectly Executed” exercises into tele-rehab platforms can help patients to perform rehab exercises correctly, avoid injuries, and enhance recovery. To address this gap, this paper proposes an automated system that uses machine learning to classify correct and incorrect executions of 9 rehabilitation gestures. The model is trained on 24 angle signals extracted from different body sections. The angle signals are obtained in 3D space, and 10 features are extracted from each signal. Six different classifiers, including Random Forest, Multi-Layer Perceptron Artificial Neural Networks, Naïve Bayes, Support Vector Machine, K-Nearest Neighbors, and Logistic Regression, are used, and evaluated with 10-Fold and Leave One Subject Out (LOSO) cross validations. The best classifiers achieved an average accuracy of 89.86% ± 3.38% and F1-Score of 72.84% ± 11.98% for 10-Fold and an average accuracy of 88.21% ± 3.90% and F1-Score of 68.16%±13.28% for LOSO. The proposed system has great potential to be integrated into tele-rehab platforms to help patients perform their exercises reliably.© 2017 Elsevier Inc. All rights reserved