Tele-Snap: a joint impedance estimation system using snap motor and openPose for remote rehabilitation diagnosis

We propose a remote joint impedance estimation system called Tele-snap for a rehabilitation diagnosis under the COVID-19 pandemic. Dynamic resistance of the human joint is essential physical information reflecting the motor function. The resistance is assessed based on the touching sensation of the doctor (physiotherapist), but the pandemic restricts such an in-person manner. Our proposing system aims to provide this physical information quantified by the joint impedance for a diagnosis in the telerehabilitation context. The proposed system employs a compact impulsive perturbation generator called the snap motor and a marker-less motion capture technology called the OpenPose. The subsystem installed in the patient's place is then simplified remarkably, which consists of the wearable snap motor and Raspberry Pi with a built-in camera module. The proposed system can collect the dataset for impedance estimation through the examiner's teleoperation of the snap motor and camera via a virtual private network, with no need for the operation by the patient. We verify the proposed system through an in-person experiment and then demonstrate the remote impedance estimation scheme. [ FROM AUTHOR] Copyright of Advanced Robotics is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Designing a Soft-Actuated Smart Garment for Postural Control and Fall Prevention in Elderly Women

A fall in third age triggers a domino effect of consequences that are recognized by specialists as leading causes of further falls. After the first event, the post-fall syndrome onsets: a pathological fear of falling that affects quality of life. It leads to loss of self-efficacy, sedentarism, musculoskeletal weakening, reduced mobility, postural insufficiency, gait disorders, isolation and depression—all acknowledged as fall risk factors. Specialists agreed that the most effective approach to prevent new episodes is to restore confident postures and good alignments. This paper presents the first design stages of a soft-actuated re-educational garment for remote post-fall rehabilitation in female users. The objective is to i) restore postural control by providing a gentle pressure stimulus, suggesting corrections when poor body alignments are detected;ii) restore the perceived self-efficacy;iii) promote physical activity by motion monitoring and providing daily reports through a patient-therapist smartphone app. To date, we have tested a soft body-postures detection system by cross-checking data from a network of e-textile stretch sensors, along with a pneumatic actuator system around the user's torso providing a targeted pressure stimulus to correct bad habits. Tests have been run on a limited number of users due to the Covid-19 emergency. Data are not yet statistically conclusive but suggest the way to a new dimensional approach, both for rehabilitation and prevention. © 2023, ICST Institute for Computer Sciences, Social Informatics and Telecommunications Engineering.

Determinants of participation in cardiac telerehabilitation during the first surge of COVID-19.

BACKGROUND: Participation rates in cardiac rehabilitation (CR) are low. In multiple trials, telerehabilitation (TR) has been demonstrated to be effective. Still, real-life evidence is scarce. During the first surge of the COVID-19 pandemic our centre deployed a TR programme. This study aimed to characterise the patient population that had, for the first time, the opportunity to participate in cardiac TR and to analyse if there were determining factors for participation or non-participation in TR. METHODS: All patients enrolled in CR in our centre during the first wave of the COVID-19 pandemic were included in this retrospective cohort study. Data was collected from the hospital electronic records. RESULTS: 369 patients were contacted in the setting of TR. 69 patients could not be reached and were excluded from further analysis. 208 (69%) patients that were contacted agreed to participate in cardiac TR. No significant differences in baseline characteristics were seen between TR participants and TR non-participants. A full model logistic regression did not reveal any significant determinants on participation rate in TR. CONCLUSION: This study demonstrates that the rate of participation in TR was high (69%). Of the analysed characteristics, none was directly correlated with the willingness to participate in TR. Further research is needed to further assess determinants, barriers and facilitators of TR. Also, research is needed on better delineating digital health literacy and on how to reach also those patients that are less motivated and or less digitally literate.

A Remote Rehabilitation and Evaluation System Based on Azure Kinect

In response to the shortage, uneven distribution, and high cost of rehabilitation resources in the context of the COVID-19 pandemic, we developed a low-cost, easy-to-use remote rehabilitation system that allows patients to perform rehabilitation training and receive real-time guidance from doctors at home. The proposed system uses Azure Kinect to capture motions with an error of just 3% compared to professional motion capture systems. In addition, the system pro-vides an automatic evaluation function of rehabilitation training, including evaluation of motion angles and trajectories. After acquiring the user's 3D mo-tions, the system synchronizes the 3D motions to the virtual human body model in Unity with an average error of less than 1%, which gives the user a more intuitive and interactive experience. After a series of evaluation experiments, we verified the usability, con-venience, and high accuracy of the system, finally con-cluding that the system can be used in practical rehabilitation applications. © Fuji Technology Press Ltd.

Telemedicine-Rehabilitation and Virtual Reality in Orthopaedics and Sports Medicine.

Introduction: Tele-rehabilitation is a method of delivering rehabilitation services using information, technology and communication to everyone, irrespective of their geographic location. National zeal for competitive sports and COVID pandemic has led to an increase in its demand and popularity worldwide. The athletes need immediate treatment and correct rehabilitation to keep them in their game. This review aims to bring into perspective the importance of telemedicine and telerehabilitation in orthopaedics and sports medicine with a focus on virtual reality. Methods: Articles were searched based on suitable keywords 'telemedicine', 'telerehabilitation' 'orthopedics', 'orthopaedics', 'sports' and 'India*' which were combined using suitable boolean operators in PubMed, Scopus and Web of Science. Government guidelines and laws were also reviewed in view of telehealth and telemedicine. Conclusion: Tele-rehabilitation and virtual physical therapy are innovative and cost-effective ways to provide the best rehabilitative services to the patients at their doorstep. Virtual reality should be incorporated into the Indian telehealth delivering system with a special focus on the remote athlete population.

A remote rehabilitation training system using Virtual Reality

Τhe rehabilitation process of sports injuries, movement and balance of the elderly with mobility problems as well people with injuries, is of key importance for the best possible recovery of proper functioning and mobility of the limbs of these individuals. In most cases, rehabilitation is provided in specialized rehabilitation centers, through services and recovery programs that are carried out for a specific period of time. During the patient's stay in the rehabilitation center, professional gait and balance analysis systems are used to assess his condition. These systems are usually too expensive, difficult to use, and can not be easily replaced by lower cost devices that provide the same quality and reliability. Furthermore, due to COVID-19 pandemic, the physical presence of a person during the execution of rehabilitation program has become prohibitive in many cases. Our solution offers an at-home rehabilitation exercises system using Virtual Reality with a human-alike Virtual Coach. The exercises for each patient are defined by doctors providing a personalized record tracking the rehabilitation progress. © 2021 IEEE

Remote intervention, in childhood and adolescence neuropsychiatry: Limits and effectiveness. Some clinical cases

The UOC of Neuropsychiatry of Childhood and Adolescence (NPIA) during the lockdown for the COVID-19-19 pandemic had to modulate the therapeutic and rehabilitative activities in progress, in order to adapt to current regulations. Only patients in charge of the service, already with diagnosis and treatment started, were treated remotely. Some remote interventions were effective, managing to overcome the outcome of on-site treatments, in terms of short-term goals achieved and generalizability of the results. The following work highlights the potential and limitations of this new methodology, which made it possible to educate caregivers, reorganize and adapt the home setting to the purposes of the intervention, ensuring the generalizability of the results. By evaluating the resources and limits of each taking charge, it was possible to assess the effectiveness of the methodology remotely, considering it functional, if integrated with on-site activities. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Italian) L'UOC di Neuropsichiatria dell'Infanzia e dell'Adolescenza (NPIA), durante il lockdown dovuto alla pandemia da COVID-19, ha dovuto mo- dulare le attivita terapeutiche e riabilitative in corso, al fine di adattarle alle norme vigenti. Sono stati trattati in modalita da remoto solo i pazienti in carico al servizio aventi gia una diagnosi e un trattamento avviato. Alcuni interventi da remoto sono risultati efficaci in termini di obiettivi raggiunti a breve termine e di generalizzabilita dei risultati, riuscendo a superare l'esito dei trattamenti in sede. Il lavoro che segue evidenzia le potenzialita e i limiti di tale nuova metodologia, che ha consentito di istruire i caregiver, di riorganizzare e di adattare il setting domestico alle finalita dell'intervento, garantendo la generalizzabilita dei risultati. Valutando le risorse e i limiti di ogni presa in carico e stato possibile vagliare l'efficacia della metodologia da remoto, ritenendola funzionale, se integrata con l'attivita in sede. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Technologies to Support Frailty, Disability, and Rare Diseases: Towards a Monitoring Experience during the COVID-19 Pandemic Emergency.

This report illustrates the design and results of an activity of surveillance proposed by the National Centre for Innovative Technologies in Public Health and the National Centre for Rare Diseases of the Istituto Superiore di Sanità with the aim of monitoring the state-of-use of technologies by people with frailty, disabilities, and rare diseases. The results of the surveillance activity reported in this report are as follows: (a) An international Webinar; (b) A Full report published by the Istituto Superiore di Sanità (ISS); (c) an electronic survey tool, for periodic monitoring; (d) an initial summary of the survey (15 September-30 November 2020), giving an overall picture relating to the state-of-use of technologies by the interviewed; (e) an understanding of the needs that emerged, causing reflection on the current state-of-the-art and offering important stimuli for all the stakeholders involved.

A Pilot Study Delivering Physiotherapy Support for Rett Syndrome Using a Telehealth Framework Suitable for COVID-19 Lockdown.

Background: Rett syndrome (RTT) is a genetically caused neurodevelopmental disorder associated with severe disability. We assessed the feasibility of a telehealth program supporting gross motor skills in RTT.Methods: Five girls with RTT were assessed and a home-based exercise program developed in response to functional goals. Families then participated in monthly Skype sessions for 6 months, guided by a physiotherapist to monitor progress and adjust the program as necessary. Goal Attainment Scaling was used to evaluate progress and a parental satisfaction questionnaire was administered.Results: Four goals were established for each participant and progress was greater than would be expected in 16 of 20 goals. Parents evaluated the program as feasible and useful for their daughters.Discussion: A telehealth model of home-based intervention supported individuals with RTT to achieve gross motor skills and was found to be feasible. This model is important at present times during COVID-19 outbreak and lockdown.

Telerehabilitation in response to constrained physical distance: an opportunity to rethink neurorehabilitative routines.

Ensuring proper dosage of treatment and repetition over time is a major challenge in neurorehabilitation. However, a requirement of physical distancing to date compromises their achievement. While mostly associated to COVID-19, physical distancing is not only required in a pandemic scenario, but also advised for several clinical conditions (e.g. immunocompromised individuals) or forced for specific social contexts (e.g. people living in remote areas worldwide). All these contexts advocate for the implementation of alternative healthcare models. The objective of this perspective is to highlight the benefits of remote administration of rehabilitative treatment, namely telerehabilitation, in counteracting physical distancing barriers in neurorehabilitation. Sustaining boosters of treatment outcome, such as compliance, sustainability, as well as motivation, telerehabilitation may adapt to multiple neurological conditions, with the further advantage of a high potential for individualization to patient's or pathology's specificities. The effectiveness of telerehabilitation can be potentiated by several technologies available to date: virtual reality can recreate realistic environments in which patients may bodily operate, wearable sensors allow to quantitatively monitor the patient's performance, and signal processing may contribute to the prediction of long-term dynamics of patient recovery. Telerehabilitation might spark its advantages far beyond the mere limitation of physical distancing effects, mitigating criticalities of daily neurorehabilitative practice, and thus paving the way to the envision of mixed models of care, where hospital-based procedures are complementarily integrated with telerehabilitative ones.

Virtual Reality, Augmented Reality, Gamification, and Telerehabilitation: Psychological Impact on Orthopedic Patients' Rehabilitation.

BACKGROUND: Remote virtual rehabilitation aroused growing interest in the last decades, and its role has gained importance following the recent spread of COVID19 pandemic. The advantages of virtual reality (VR), augmented reality (AR), gamification, and telerehabilitation have been demonstrated in several medical fields. In this review, we searched the literature for studies using these technologies for orthopedic rehabilitation and analyzed studies' quality, type and field of rehabilitation, patients' characteristics, and outcomes to describe the state of the art of VR, AR, gamification, and telerehabilitation for orthopedic rehabilitation. METHODS: A comprehensive search on PubMed, Medline, Cochrane, CINAHL, and Embase databases was conducted. This review was performed according to PRISMA guidelines. Studies published between 2015 and 2020 about remote virtual rehabilitations for orthopedic patients were selected. The Methodological Index for Non-Randomized Studies (MINORS) and Cochrane Risk-of-Bias assessment tool were used for quality assessment. RESULTS: 24 studies (9 randomized controlled trials (RCTs) and 15 non-randomized studies) and 2472 patients were included. Studies mainly concern telerehabilitation (56%), and to a lesser extent VR (28%), AR (28%), and gamification (16%). Remote virtual technologies were used following knee and hip arthroplasty. The majority of included patients were between 40 and 60 years old and had a university degree. Remote virtual rehabilitation was not inferior to face-to-face therapy, and physical improvements were demonstrated by increased clinical scores. Orthopedic virtual remote rehabilitation decreased costs related to transports, hospitalizations, and readmissions. CONCLUSION: The heterogeneity of included studies prevented a meta-analysis of their results. Age and social context influence adaptability to technology, and this can modify compliance to treatment and outcomes. A good relationship between patient and physiotherapist is essential for treatment compliance and new technologies are useful to maintain clinical interactions remotely. Remote virtual technologies allow the delivery of high-quality care at reduced costs. This is a necessity given the growing demand for orthopedic rehabilitation and increasing costs related to it. Future studies need to develop specific and objective methods to evaluate the clinical quality of new technologies and definitively demonstrate advantages of VR, AR, gamification, and telerehabilitation compared to face-to face orthopedic rehabilitation.