Rehabilitation Technology Research Articles

Hand function assessment: tests for adult patients with central nervous system disorders

Upper limb dysfunction is a very common and severe problem in patients with central nervous system disorders. The restoration of arm and hand functions is one of the priority goals of medical rehabilitation in these patients. The development of new and effective rehabilitation technologies, implementation of a patient-centered approach, and objective assessment of rehabilitation outcomes require validated tools. This review aimed to introduce specialists to those tools that evaluate the rehabilitation outcomes based on the patient’s performance in standardized tasks (tests). Functional abilities of the upper extremities should be assessed based on the International Classification of Functioning, Disability and Health. The general concepts of these tests are discussed. Standard requirements for measurement tools (validity, reliability, and sensitivity) ensure the reliability of test results. The tests that focused on the hand and arm function are briefly described. Only tests that have good psychometric characteristics and are suitable for the monitoring of rehabilitation outcomes for patients with stroke, multiple sclerosis, and spinal cord injury are also presented in the review. In conclusion, the choice of a specific test is based on the purpose and objectives of the study (clinical practice or scientific research), motor deficit peculiarities, and rehabilitation unit resources. However, new and validated tools that focus on the assessment of hand function abilities in patients with central nervous system disorders are needed.

Bone mineral density in osseointegration implant surgery: A review of current studies (Review).

Osseointegration implant (OI) surgery is the latest rehabilitation technology for amputees, where a bone-anchored implant obviates the limitations of traditional socket prostheses. The bone mineral density (BMD) in the periprosthetic and other anatomical regions can be used to assess bone remodelling following OI surgery. Currently, limited studies have used BMD measurements in reporting post-operative OI outcomes and the association between the maintenance of BMD and implant efficacy has remained elusive. This review captured and analysed all studies that have reported the BMD as an objective outcome measure in patients with trans-femoral or trans-tibial OI. The PubMed, Medline, Scopus and Web of Science databases were searched using the terms 'amputation', 'osseointegration' and 'bone mineral density'. A total of 6 studies involving human participants were included for analysis. All studies used dual X-ray absorptiometry and/or X-rays for measuring BMD. Rehabilitation of trans-femoral or trans-tibial amputation using OI may help restore healthy BMD by enabling physiological bone loading. However, there is a low correlation between the BMD around the OI and the success of OI surgery or the risk of periprosthetic fractures. This review summarises the current evidence on BMD assessment in OI for lower limb amputee rehabilitation. Despite the great variability in the results, the available evidence suggests that OI may help restore BMD following surgery. The limited evidence calls for further investigation, as well as the development of a standard BMD measurement protocol.

Advances in novel biomaterials combined with traditional Chinese medicine rehabilitation technology in treatment of peripheral nerve injury

Advances in novel biomaterials combined with traditional Chinese medicine rehabilitation technology in treatment of peripheral nerve injury

CSP2023: 285 - A model for co-creating accessible rehabilitation technology

CSP2023: 285 - A model for co-creating accessible rehabilitation technology

Haptic Glove for Post-Stroke Rehabilitaion

Abstract: The rehabilitation process for post-stroke patients often involves expensive haptic gloves, limiting accessibility to effective therapeutic tools. Additionally, existing market offerings are characterized by their bulkiness, impeding user comfort and freedom of movement during rehabilitation exercises. This paper will explain the development of our project which aims to develop an affordable and ergonomically designed haptic glove for post-stroke hand rehabilitation, utilizing flex sensors, vibration motors, and Arduino technology. This project not only addresses the financial constraints associated with rehabilitation technology but also aims to revolutionize the user experience by creating a compact, user-friendly, and affordable haptic glove, ultimately facilitating more accessible and effective post-stroke hand rehabilitation.

Interacting with virtual characters, objects and environments: investigating immersive virtual reality in rehabilitation

Purpose This pilot study aimed to (a) investigate opportunities for immersive Virtual Reality (VR) technology in communication, physical, and visual rehabilitation by examining the interaction of people without disabilities in a range of structured virtual environments; and (b) validate research protocols that might be used to evaluate the physical, visual, and verbal interaction of users in virtual worlds, and their safety while using the technology. Methods Thirteen adults identifying as people without disability were exposed to VR via a head-mounted display. A video-review method was used to qualitatively code and analyse each participant’s communication, movement, orientation, and support needs. Results All participants oriented to their virtual environments sufficiently to use applications. Their spoken language was effective for interaction, although unconventional social behaviours were also observed. Two participants reported minor adverse reactions consistent with mild cybersickness. Conclusion The results provide insight into the types of environments and characters that support the greatest communicative, physical, and visual interaction in immersive VR. The tested protocols are useful to assess safety when using VR, and to observe communicative, physical, and visual interaction with virtual environments and characters. Implications for future research and use of VR with people with communication, physical and visual disability are discussed.

Enhancement of nitrogen on core taxa recruitment by Penicillium oxalicum stimulated microbially-driven soil formation in bauxite residue

Microbially-driven soil formation process is an emerging technology for the ecological rehabilitation of alkaline tailings. However, the dominant microorganisms and their specific roles in soil formation processes remain unknown. Herein, a 1-year field-scale experiment was applied to demonstrate the effect of nitrogen input on the structure and function of the microbiome in alkaline bauxite residue. Results showed that the contents of nutrient components were increased with Penicillium oxalicum (P. oxalicum) incorporation, as indicated by the increasing of carbon and nitrogen mineralization and enzyme metabolic efficiency. Specifically, the increasing enzyme metabolic efficiency was associated with nitrogen input, which shaped the microbial nutrient acquisition strategy. Subsequently, we evidenced that P. oxalicum played a significant role in shaping the assemblages of core bacterial taxa and influencing ecological functioning through intra- and cross-kingdom network analysis. Furthermore, a recruitment experiment indicated that nitrogen enhanced the enrichment of core microbiota (Nitrosomonas, Bacillus, Pseudomonas, and Saccharomyces) and may provide benefits to fungal community bio-diversity and microbial network stability. Collectively, these results demonstrated nitrogen-based coexistence patterns among P. oxalicum and microbiome and revealed P. oxalicum-mediated nutrient dynamics and ecophysiological adaptations in alkaline microhabitats. It will aid in promoting soil formation and ecological rehabilitation of bauxite residue. Environment implicationBauxite residue is a highly alkaline solid waste generated during the Bayer process for producing alumina. Attempting to transform bauxite residue into a stable soil-like substrate using low-cost microbial resources is a highly promising engineering. However, the dominant microorganisms and their specific roles in soil formation processes remain unknown. In this study, we evidenced the nitrogen-based coexistence patterns among Penicillium oxalicum and microbiome and revealed Penicillium oxalicum-mediated nutrient dynamics and ecophysiological adaptations in alkaline microhabitats. This study can improve the understanding of core microbes’ assemblies that affect the microbiome physiological traits in soil formation processes.

Feasibility Study of Using the Integrated Telemedicine Platform “IS-cardio” for Outpatient Cardiological Rehabilitation: Single-Centered Cohort Study

INTRODUCTION. The implementation of remote cardiac rehabilitation (RCR) technology based on telemedicine platforms (TMP) requires a preliminary assessment of the feasibility of use. AIM. A preliminary study of the feasibility of using the integrated TMP “IS-cardio” to perform RCR in patients with cardiovascular diseases (CVD) in the context of need, feasibility and acceptability. MATERIALS AND METHODS. Single-center cohort study of patients (n = 33; 75 % men; mean age 56 ± 8 years) with CVD. Testing of the TMP «IS-cardio» was carried out during 12-week physical training (PT) programs with an intensity of 55 %. Feasibility was assessed according to the following criteria: need, feasibility, acceptability. Data on need and acceptability were obtained from a patient survey. Feasibility was assessed as the proportion of patients completing RCR. Remote monitoring was performed using heart rate, blood pressure, electrocardiogram and mobile application recorders. Feedback was provided in the form of electronic reports and delayed consultation. Patient satisfaction was assessed in points. RESULTS. 79.2 % of respondents were interested in telemedicine monitoring. 100 % of patients completed RCR; 12 patients (39.6 %) fully completed the PT program. The patients’ activity amounted to 2.4 ± 0.7 PT sessions per week; the average duration of PT was 56.5 ± 29.8 min/week. With a total satisfaction of 29.0 ± 3 points, the level of RCR was highly rated (3.85 ± 0.16 points) as a real solution to the problem associated with the presence of CVD (3.67 ± 0.34 points). DISCUSSION. The medical-technological solution TMP “IS-cardio”, combining the principles of traditional cardiac rehabilitation with telecardiology tools (monitoring based on digital recorders, automatic data transfer and feedback) met the criteria for the feasibility of using TMP with a similar concept. CONCLUSION. The high demand for remote monitoring, feasibility, and patient satisfaction of RCR may indicate the feasibility of its use for implementation of its programs.

A pilot exploration of staff and service-user perceptions of a novel digital health technology (Virtual Engagement Rehabilitation Assistant) in complex inpatient rehabilitation

Purpose Digital health technologies have the potential to advance rehabilitation. The Virtual Engagement Rehabilitation Assistant (VERA) is a digital technology, co-designed to increase service-user engagement and promote self-management. This qualitative study explored staff and service-user perceptions of implementing VERA on a UK complex inpatient rehabilitation ward. Methods Purposively sampled service-users were allocated to VERA for up to six weeks. The Non-adoption, Abandonment, Scale-up, Spread and Sustainability (NASSS) framework underpinned service-user post-intervention interviews and staff focus groups, and structured analysis of the data. Seven service-users were interviewed. Nine staff contributed to focus groups. Results A framework analysis identified themes (and subthemes) structured by the NASSS framework domains: 1. Nature of Clinical Condition, 2. Technology (Ease of Use, Holding Information/Resources in a single Digital Location, Appointments), 3. Value Proposition (Structuring Time, Feedback, Unexpected Benefits) 4. Adopters (Confidence in using Technology, Usefulness), 5. Wider Organisation. Ease of use and storage of key information in a single location were beneficial. Reliability, and provision of accurate and timely feedback to staff and service-users, were identified as essential. Conclusions A blended approach is required to meet staff and service-user needs. The potential for VERA in a community setting was identified and requires further investigation. Learning from VERA will support development of other digital technologies and their implementation.

Stepping Up Recovery: Integrating Patient-reported Outcome Measures and Wearable Technology for Rehabilitation Following Knee Arthroplasty.

Improvement after knee arthroplasty (KA) is often measured using patient-reported outcome measures (PROMs). However, PROMs are limited due to their subjectivity. Therefore, wearable technology is becoming commonly utilized to objectively assess physical activity and function. We assessed the correlation between PROMs and step/stair flight counts in total (TKA) and partial knee arthroplasty (PKA) patients.Analysis of a multicenter, prospective, longitudinal cohort study investigating the collection of average daily step and stair flight counts, was performed. Subjects (N = 1,844 TKA patients and N = 489 PKA patients) completed the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS JR) and provided numerical rating scale pain scores pre- and postoperatively. Only patients who reported living in a multilevel home environment (N = 896 TKA patients and N = 258 PKA patients) were included in analysis of stair flight counts. Pearson correlation coefficients were calculated to determine correlations between variables.Among TKA patients, pain scores demonstrated a negative correlation to mean step counts at preoperative (r = -0.14, p < 0.0001) and 1-month follow-up (r = -0.14, p < 0.0001). Similar negative correlations were true for pain and stair flight counts at preoperative (r = -0.16, p < 0.0001) and 1-month follow-up (r = -0.11, p = 0.006). KOOS JR scores demonstrated weak positive correlations with mean step counts at preoperative (r = 0.19, p < 0.0001) and 1-month postoperative (r = 0.17, p < 0.0001). Similar positive correlations were true for KOOS JR scores and stair flight counts preoperatively (r = 0.13, p = 0.0002) and at 1-month postoperatively (r = 0.10, p = 0.0048). For PKA patients, correlations between pain and KOOS JR with step/stair counts demonstrated similar directionality.Given the correlation between wearable-generated data and PROMs, wearable technology may be beneficial in evaluating patient outcomes following KA. By combining subjective feedback with the objective data, health care providers can gain a holistic view of patients' progress and tailor treatment plans accordingly.

A multifaceted suite of metrics for comparative myoelectric prosthesis controller research.

Upper limb robotic (myoelectric) prostheses are technologically advanced, but challenging to use. In response, substantial research is being done to develop person-specific prosthesis controllers that can predict a user's intended movements. Most studies that test and compare new controllers rely on simple assessment measures such as task scores (e.g., number of objects moved across a barrier) or duration-based measures (e.g., overall task completion time). These assessment measures, however, fail to capture valuable details about: the quality of device arm movements; whether these movements match users' intentions; the timing of specific wrist and hand control functions; and users' opinions regarding overall device reliability and controller training requirements. In this work, we present a comprehensive and novel suite of myoelectric prosthesis control evaluation metrics that better facilitates analysis of device movement details-spanning measures of task performance, control characteristics, and user experience. As a case example of their use and research viability, we applied these metrics in real-time control experimentation. Here, eight participants without upper limb impairment compared device control offered by a deep learning-based controller (recurrent convolutional neural network-based classification with transfer learning, or RCNN-TL) to that of a commonly used controller (linear discriminant analysis, or LDA). The participants wore a simulated prosthesis and performed complex functional tasks across multiple limb positions. Analysis resulting from our suite of metrics identified 16 instances of a user-facing problem known as the "limb position effect". We determined that RCNN-TL performed the same as or significantly better than LDA in four such problem instances. We also confirmed that transfer learning can minimize user training burden. Overall, this study contributes a multifaceted new suite of control evaluation metrics, along with a guide to their application, for use in research and testing of myoelectric controllers today, and potentially for use in broader rehabilitation technologies of the future.

Therapeutic effects of rehabilitation technologies in patients with functional asthenia

Abstract. Post-traumatic stress disorder is widespread in the young patient population and tends to increase. Studying the therapeutic effects of a complex of rehabilitation technologies in patients with post-traumatic stress disorder is an urgent scientific and practical task. Purpose of the study: to determine the therapeutic effects of a complex of rehabilitation technologies in patients with post-traumatic stress disorder. Material and methods. 71 patients aged 33 (20–49) years with post-traumatic stress disorder (ICD–X code F43.1) were studied. The patients were prescribed a set of physical exercises, a course of audiovisual polysensory relaxation, transcranial magnetic stimulation, chromotherapy, hydrobalneotherapy, climatotherapy, therapeutic nutrition and psychotherapy. The total duration of the course is 20 days. Clinical, instrumental, psychophysical, and integral methods of assessing the condition of patients were used. Results. A significant improvement in clinical and psychological status, an increase in adaptive potential, the level of physical health, a significant increase in physical performance, and an improvement in autonomic regulation were revealed. Conclusion. The complex of restorative technologies of medical and psychological rehabilitation produces pronounced actoprotective and psychocorrective therapeutic effects in patients with post-traumatic stress disorder.

The effectiveness of medical and psychological rehabilitation of patients with nervous tension

Abstract. The prevalence of anxiety disorders during life among residents of developed countries reaches 34 %. The low effectiveness of pharmacotherapy and psychotherapy determines the search for comprehensive technologies for the treatment of patients with nervous tension. The purpose of the study: to determine the prognosis of the effectiveness of medical and psychological rehabilitation (MPR) in patients with nervous tension and to identify its determinants. Methods: 254 patients aged 32 (19–50) years with nervous tension (ICD–X code R45.0) were studied. The complex of medical and psychological rehabilitation included physical exercises, courses of audiovisual polysensory relaxation, transcranial magnetic therapy, alpha massage, sodium chloride baths, climatotherapy, cognitive behavioral psychotherapy and therapeutic nutrition. The total duration of the MPR course is 10–20 days. To determine the relationship between integral health parameters and individual clinical and functional signs of nervous tension, correlation analysis was performed, canonical correlation analysis was used to select the most informative signs, and discriminant analysis was used to determine the prognosis of MPR and the dominants of its effectiveness. Results: A significant improvement in clinical and psychological status, physical health, increased physical performance, increased adaptive potential and autonomic regulation in patients was revealed. Significant high correlations of improvement of adaptive potential and physical performance with SAD (0.77), double product (0.81), Martin — Kushelevsky breakdown (0.74), average — with heart rate (0.58), DBP (0.69), level of physical health (0.54), weak — with BMI (0.47) were established. The effectiveness of MPR in patients with FA is 90 %. The determinants of effectiveness are indicators characterizing the heart rate, SAD, double product, BMI, age, Kerdo vegetative index, DAD, indicators of the Martinet — Kushelevsky test and physical performance PWC170–1. Conclusion: Various components of the pathogenesis of nervous tension determine the choice of rehabilitation technologies, the combination of mechanisms of therapeutic action of which determine the high effectiveness of MPR in patients with nervous tension.

Chinese expert consensus on treatment of osteoporotic fractures with teriparatide (2024 edition)

Osteoporotic fracture is the most serious complication of osteoporosis, which is a special type of pathologic fracture of the skeleton that occurs because of osteoporosis. It is characterized by delayed fracture healing, high risk of re-fracture, high rate of disability and death, difficulty in treatment and long treatment time, and re-fracture has a"cascade effect". Guidelines in different countries recommend that patients with osteoporotic fractures and those at very high risk of fracture should consider anabolic agents as first treatment choice. Teriparatide is the only anabolic agent approved by National Medical Products Administration (NMPA), and it has the clinical efficacy of improving fracture healing, reducing the risk of re-fracture, and improving bone microstructure in the treatment of osteoporotic fracture. Due to deficiencies in the current standardization of clinical use of teriparatide, Committee of Accelerated Rehabilitation After Osteoporotic Fractures of China Association of Rehabilitation Technology Transformation and Promotion, Bone and Joint Group of Chinese Society of Osteoporosis and Bone Mineral Research and Osteoporosis Working Committee of Chinese Association of Orthopedic Surgeons developed this consensus. The development of this consensus follows the modified Delphi method and forms 8 evidence-based medical recommendations, aiming to propose methods and precautions for standardizing the application of teriparatide, and to emphasize the importance of teriparatide application for the treatment of patients with osteoporotic fracture.

Biomedical engineering point of view on the implementation of rehabilitation technology: a qualitative study

Biomedical engineering point of view on the implementation of rehabilitation technology: a qualitative study

Emerging trends in management of long COVID with a focus on pulmonary rehabilitation: A review.

Long COVID, or post-acute sequelae of COVID-19 (PASC), represents a complex condition with persistent symptoms following SARS-Cov-2 infection. The symptoms include fatigue, dyspnoea, cognitive impairment, decreased quality of life in variable levels of severity. Potential mechanisms behind long COVID include vascular damage, immune dysregulation and viral persistence. Diagnosing long COVID involves medical evaluation by multidisciplinary team and assessment of persistent symptoms with scoring systems in development. Treatment strategies are symptom-focused, encompassing multidisciplinary care, rehabilitation and tailored exercise programmes. Pulmonary rehabilitation, an effective and critical component of long COVID management, has shown promise, particularly for patients with respiratory symptoms such as dyspnoea. These programmes, which combine exercise, breathing techniques, education and psychological support, improve symptoms, quality of life and overall recovery. Innovative technologies, such as telemedicine, wearable devices, telerehabilitation, are transforming long COVID management. Telemedicine facilitates consultations and interventions, eliminating healthcare access barriers. Wearable devices enable remote and continuous monitoring of patients during their rehabilitation activities. Telerehabilitation has proven to be safe and feasible and to have high potential for COVID-19 recovery. This review provides a concise overview of long COVID, encompassing its definition, prevalence, mechanisms, clinical manifestations, diagnosis and management approaches. It emphasizes the significance of multidisciplinary approach in diagnosis and treatment of long COVID, with focus on pulmonary rehabilitation and innovative technology advances to effectively address the management of long COVID.

Recent Advances in Biomimetics for the Development of Bio-Inspired Prosthetic Limbs.

Recent advancements in biomimetics have spurred significant innovations in prosthetic limb development by leveraging the intricate designs and mechanisms found in nature. Biomimetics, also known as "nature-inspired engineering", involves studying and emulating biological systems to address complex human challenges. This comprehensive review provides insights into the latest trends in biomimetic prosthetics, focusing on leveraging knowledge from natural biomechanics, sensory feedback mechanisms, and control systems to closely mimic biological appendages. Highlighted breakthroughs include the integration of cutting-edge materials and manufacturing techniques such as 3D printing, facilitating seamless anatomical integration of prosthetic limbs. Additionally, the incorporation of neural interfaces and sensory feedback systems enhances control and movement, while technologies like 3D scanning enable personalized customization, optimizing comfort and functionality for individual users. Ongoing research efforts in biomimetics hold promise for further advancements, offering enhanced mobility and integration for individuals with limb loss or impairment. This review illuminates the dynamic landscape of biomimetic prosthetic technology, emphasizing its transformative potential in rehabilitation and assistive technologies. It envisions a future where prosthetic solutions seamlessly integrate with the human body, augmenting both mobility and quality of life.

ANKLE JOINT MOTION RECOGNITION SYSTEM AND ALGORITHM OPTIMIZATION BASED ON PLANTAR PRESSURE

Due to the current focus of research on ankle rehabilitation robots on structural design, there is still limited research on ankle human–machine interaction technology. In order to enable rehabilitation robots to conduct personalized rehabilitation training based on patients’ ankle movement intentions, we propose a new ankle motion recognition method based on plantar pressure. First, we designed a plantar pressure collection system based on array sensors. Then, we collected nine types of ankle joint motion pressure data from five volunteers and conducted algorithm selection, data processing, and algorithm optimization. Finally, we proposed a small sample optimization algorithm based on support vector machine, with an average recognition rate of 93.16%. The recognition method proposed in this paper can be combined with ankle rehabilitation robots to achieve active rehabilitation functions, laying the foundation for the clinical application of active rehabilitation technology.

Rehabilitation of burnout patients: medical and psychological aspects

Abstract. Rationale: Determining the therapeutic effects of rehabilitation technologies in patients with burnout is a topical scientific and practical task. Purpose of the study: to determine the therapeutic effects of combinations of rehabilitation technologies in patients with burnout. Methods: 208 patients aged 31.9 (18–52.0) years with burnout (ICD-10 code Z73.0) were studied. The patients were prescribed a set of physical exercises, a course of audiovisual polysensory relaxation, transcranial magnetic therapy, non-selective chromotherapy, therapeutic massage, contrast showers (baths), climatotherapy, clinical nutrition, and psychotherapy. The total duration of the course was 20–30 days. Clinical, instrumental, psychophysical, and integral methods of assessing the condition of patients were used. Results: the study revealed significant dynamics of indicators of subjective well-being: interest in professional activity, attention to detail, psychophysiological status, heart rate, systolic arterial pressure, vital capacity, double product and the Martinet-Kushelevsky test, adaptive potential, and vegetative regulation. The rehabilitation course caused a significant improvement in integral health indicators: the level of somatic health increased from 1.75 ± 0.52 to 2.9 ± 0.58 points (p &lt; 0.001) and physical performance indicators PWC-170 — from 866.6 ± 10.2 to 1,031.1 ± 11.8 mcg/s (p &lt; 0.001). Conclusion: the complex of syndrome and pathogenetically conditioned rehabilitation technologies forms pronounced actoprotective and psychorelaxing therapeutic effects in patients with burnout.

How IT technologies are transforming the world of sports for people with disabilities

IT technologies in medical rehabilitation play a key role in opening new perspectives for people with physical disabilities. Sensor devices, virtual reality and specialized software solutions make it possible to create innovative training programs adapted for people with disabilities. Thanks to biometric sensors and monitoring systems, doctors and trainers can more effectively track progress and adjust treatment plans. IT technologies are becoming a powerful tool in the field of medical rehabilitation, opening up new opportunities for a full and active life.