ABSTRACT
A digital healthcare system based on augmented reality (AR) has promising uses for postoperative rehabilitation. We compare effectiveness of AR-based and conventional rehabilitation in patients after rotator cuff repair (RCR). This study randomly allocates 115 participants who underwent RCR to digital healthcare rehabilitation group (DR group) and conventional rehabilitation group (CR group). The DR group performs AR-based home exercises using UINCARE Home+, whereas the CR group performs brochure-based home exercises. The primary outcome is a change in the Simple Shoulder Test (SST) score between baseline and 12 weeks postoperatively. The secondary outcomes are the Disabilities of the Arm, Shoulder and Hand (DASH) score; Shoulder Pain And Disability Index (SPADI) score; EuroQoL 5-Dimension 5-Level (EQ5D5L) questionnaire score; pain; range of motion (ROM); muscle strength; and handgrip strength. The outcomes are measured at baseline, and at 6, 12, and 24 weeks postoperatively. The change in SST score between baseline and 12 weeks postoperatively is significantly greater in the DR group than in the CR group (p = 0.025). The SPADI, DASH, and EQ5D5L scores demonstrate group×time interactions (p = 0.001, = 0.04, and = 0.016, respectively). However, no significant differences over time are observed between the groups in terms of pain, ROM, muscle strength, and handgrip strength. The outcomes show significant improvement in both groups (all p < 0.001). No adverse events are reported during the interventions. AR-based rehabilitation shows better improvement in terms of shoulder function after RCR compared to conventional rehabilitation. Therefore, as an alternative to the conventional rehabilitation, the digital healthcare system is effective for postoperative rehabilitation.
ABSTRACT
BACKGROUND: Among the tools for relieving lower back pain, footrests are commonly recommended. Few studies have investigated the effects of footrest and the proper application of footrest height. OBJECTIVE: The purpose of this study was to compare the effects of the normalized footrest height on muscle fatigue, kinematics, kinetics, and pain intensity. METHODS: In total, 13 males who had a history of non-specific lower back pain during prolonged standing were recruited. The experimental conditions were 2-hour prolonged standing with no footrest and with footrests of 5%, 10%, and 15% of body height. Muscle fatigue was investigated through measurements of the median frequency ratio and the muscle activity ratio (post/pre) in lumbar erector spinae. The lumbo-pelvic angles, and the external moment in the lumbar region were investigated. A visual analog scale was used to investigate the intensity of the pain. RESULTS: The footrests at 10% and 15% of the body height caused a lower change in the median frequency ratio and the muscle activity ratio than the other conditions. The footrest at 10% of the body height placed the lowest external moment on the lumbar region among all the conditions. The pain intensity was significantly lower in with footrest conditions than with no footrest condition. CONCLUSIONS: The results suggests that a footrest height of 10% of the body height can be recommended as a normalized height for prolonged standing work in subjects with a history of non-specific lower back pain during prolonged standing.