Journal of Rehabilitation and Assistive Technologies Engineering最新文献

Introduction: Increasingly, geriatric institutions are adopting video calling services to promote social interactions between residents and their loved ones. However, a gap persists between the technologies used and the needs and abilities of older users. Interactive Televisions (iTVs) could be part of the solution as they provide a familiar and accessible way to strengthen the relationship between residents and their environment (family, friends, professionals).

Methods: User tests were conducted to evaluate the ability of older adults (OAs) from different place of living to use iTV. A total of 32 user tests were carried out with OAs living at home, in residential facilities (RFs), and in nursing homes (NHs) between November 2022 and June 2023.

Results: The quantitative analysis revealed mixed opinions on the iTV's usability. OAs living at home tended to produce less errors and needed less help to successfully use video calling and messaging functionalities of the iTV than others. However, participants in NHs required more repetitions to benefit from a learning effect, unlike participants in RFs and at home.

Conclusions: This study proposed another approach to user testing, based on cognitive psychology methods. Based on the analysis of the critical stages, ergonomic recommendations were identified.

Introduction: The purpose of this study was to compare the impact of three types of orthoses (knee orthosis, ankle foot orthosis (AFO), and foot orthosis) on knee alignment, pain, function, and quality of life in individuals with medial knee osteoarthritis (MKOA).

Method: Thirty patients took part in this study and were randomly assigned to three groups (n = 10 in each group) based on the type of intervention. Knee function was assessed using the knee injury and osteoarthritis outcome score (KOOS) questionnaire, and knee alignment was evaluated by measuring angles using the images of bony prominence (AMI) method.

Results: After using knee orthosis and AFO, all subscales of KOOS showed significant improvement (p < .05). However, there was no significant difference in the results after using foot orthosis (p > .05).

Conclusion: The findings indicate that knee orthosis or AFO for 6 weeks can improve clinical outcomes for individuals with MKOA. This suggests that clinicians can consider using knee orthosis and AFO among the available treatment options to improve clinical outcomes.

Introduction: Activity-based therapy is effective at improving trunk control in children with spinal cord injury. A prototype sensorized rocking chair was developed and confirmed as an activity that activates trunk muscles. This study uses data collected from the chair to predict muscle use during rocking. Methods: The prototype rocking chair included sensors to detect forces, accelerations, as well child and chair movement. Children with spinal cord injury and typically developing children (2-12 years), recruited under an approved IRB protocol, were observed rocking while sensor and electromyography data were collected from arm, leg, and trunk muscles. Features from sensor data were used to predict muscle activation using multiple linear regression, regression learning, and neural network modeling. Correlation analysis examined individual sensor contributions to predictions. Results: Neural network models outperformed regression models. Multiple linear regression predictions significantly correlated (p < 0.05) with targets for four of eleven children with SCI, while decision tree regression predictions correlated for five children. Neural network predictions correlated for all children. Conclusions: Embedded sensors capture useful information about muscle activation, and machine learning techniques can be used to inform therapists. Further work is warranted to refine prediction models and to investigate how well results can be generalized.

In this review and meta-analysis, we aimed to investigate the effect of spine orthotics in osteoporotic patients. The relationship between osteoporosis, osteoporotic vertebral fractures (OVFs), and age-related hyperkyphosis has made this effect unclear. We believe that taking participants' conditions into consideration may help to alleviate this controversy. The electronic database includes Web of Science, PubMed, Cochrane Library, Medline, and ClinicalTrials.gov. For English language literature was searched up to March 2023, and 34 articles were included in the review and 15 article had sufficient quality for meta-analysis based on the methodology quality index. There was no significant effect found from using either rigid or soft orthoses alone during the acute phase of one level (OVFs). Both semi-rigid and weighted orthoses have shown a positive significant effect on thoracic kyphosis angle and back extensor muscle strength in osteoporotic or older hyperkyphotic patients. The results of this review indicate that using a soft or rigid orthosis alone does not have a superior effect in the acute phase of one-level (OVFs) compared to not using an orthosis. However, using a semi-rigid or weighted orthosis in osteoporotic or hyperkyphotic older adults with or without (OVFs) can benefit thoracic kyphosis angle, back muscle strength, and balance.

Introduction: The C-Brace microprocessor-controlled stance and swing control orthosis has been shown to improve function, mobility, and quality of life. A systematic registry to gather long-term, real-world safety and effectiveness data in patients fit with a C-Brace has not been performed.

Methods: International multicenter registry. Patients undergoing routine C-Brace fittings were assessed at baseline and 1 year after fitting. Primary outcomes were fast walking speed (FWS) measured by 25-foot or 10-meter walk test, Timed Up and Go (TUG) and the Activity-specific Balance Confidence (ABC) Scale. Secondary and exploratory outcomes included the Patient-specific Functional Scale (PSFS), falls, pain, PROMIS Pain Interference (PI), and quality of life.

Results: 48 subjects with 1-year baseline and follow up data were analyzed. With the C-Brace, FWS improved by + 0.26 ± 0.33 m/s (p < .0001), TUG by -8.1 ± 14.6 sec (p < .0001), and ABC by + 24.9 ± 25.8% (p < .0001). Mean falls reduced from 33 ± 77 to 3.0 ± 5.6 (p = .0005). PSFS increased by 3.60 ± 2.34 points (p < .0001). Outcomes for pain, PI and quality of life showed significant improvements with the C-Brace.

Conclusion: The C-Brace is an effective option to improve safety, mobility, and quality of life for patients needing a KAFO for ambulation.

Background: Children with developmental coordination disorder (DCD) have difficulty learning and performing movements, often requiring increased feedback. Technology may be useful for delivering augmented feedback. Co-design methodology for developing therapeutic interventions has become popular in healthcare, including for technology in rehabilitation. However, there are limited guidelines on how to use co-design methodology in healthcare. Methods: We applied three key principles, (1) Understanding, (2) Exploring, and (3) Materialising, to inform a co-design process. End-user participants included paediatric clinicians, young learners, their caregivers, and the research team, who shared their expertise and lived experience to inform the creation of a novel system. Results: A team of end-users designed and developed an augmented reality intervention prototype for practicing motor skills aimed at children with DCD using a generative co-design process. From understanding the unmet needs, we explored and then materialised a series of games using bespoke technology solutions. Conclusion: The use of a co-design process was beneficial in engaging end-users as the experts of their experience in the creation of a novel augmented reality intervention prototype aimed for children with DCD. The co-design process was successful in facilitating a prototype that meets consumer needs, and ensured all end-user voices were heard.

Introduction: Lower limb orthoses (LLOs) and assistive devices (ADs) can be used together or separately to improve mobility when performing daily activities. The goal of this study was to examine utilization of LLOs and ADs in a national sample of adult LLO users.

Methods: A survey was designed to ask participants whether they typically use their LLOs and/or ADs to perform 20 daily activities. LLO users from orthotic clinics across the United States were invited to complete the survey. Descriptive statistics were used to examine utilization trends.

Results: Survey responses from 1036 LLO users were analyzed. Community-based activities were performed with LLOs by at least 80% of participants. Activities that involved walking short distances in the home were more often performed without LLOs or ADs. Among participants with the four most prevalent health conditions, LLO use in the community was greatest among participants with Charcot-Marie-Tooth disease.

Conclusions: LLOs were frequently used for a wide range of community-based activities. Simultaneous use of ADs and LLOs may be most beneficial for LLO users when performing activities outside of the home. Clinicians can discuss LLO and AD use with patients to optimize their functional outcomes at home and in the community.

Augmented reality is increasingly used in health care, yet little is known about how AR is being used in physical therapy practice and what clinical outcomes could occur with technology use. In this scoping review, a broad literature review was conducted to gain an understanding of current knowledge of AR use and outcomes in physical therapy practice. A structured literature search of articles published between 2000 to September 2023 that examined the use of AR in a physical therapy context was conducted. Reference lists of articles for full review were searched for additional studies. Data from articles meeting inclusion criteria were extracted and synthesized across studies. 549 articles were identified; 40 articles met criteria for full review. Gait and balance of neurological and older adult populations were most frequently targeted, with more recent studies including orthopedic and other populations. Approximately half were pilot or observational studies and half are experimental. Many studies found within group improvements. Of studies reporting between group differences, AR interventions were more effective in improving function almost half of the time, with 20%, 27% and 28% showing efficacy in disability, balance, and gait outcomes. AR in physical therapy holds promise; however, efficacy outcomes are unclear.

Tele-rehabilitation is a healthcare practice that leverages technology to provide rehabilitation services remotely to individuals in their own homes or other locations. With advancements in remote monitoring and Artificial Intelligence, automatic tele-rehabilitation systems that can measure joint angles, recognize exercises, and provide feedback based on movement analysis are being developed. Such platforms can offer valuable information to clinicians for improved care planning. However, with various methods and sensors being used, understanding their pros, cons, and performance is important. This paper reviews and compares the performance of recent vision-based, wearable, and pressure-sensing technologies used in lower limb tele-rehabilitation systems over the past 10 years (from 2014 to 2023). We selected studies that were published in English and focused on joint angle estimation, activity recognition, and exercise assessment. Vision-based approaches were the most common, accounting for 42% of studies. Wearable technology followed at approximately 37%, and pressure-sensing technology appeared in 21% of studies. Identified gaps include a lack of uniformity in reported performance metrics and evaluation methods, a need for cross-subject validation, inadequate testing with patients and older adults, restricted sets of exercises evaluated, and a scarcity of comprehensive datasets on lower limb exercises, especially those involving movements while lying down.

Introduction: Early mobilisation is paramount in the rehabilitation of patients with acquired brain injuries. However, the effectiveness of mobilisation to standing combined with passive leg movement in mitigating orthostatic intolerance remains uncertain. Hence, we investigated whether participants exhibited better tolerance standing in a motorized standing device with passive leg movements, Innowalk Pro, compared to a traditional standing frame.

Methods: 17 patients with acquired brain injury (<1 year post-injury) performed two sessions in each standing device on four separate days. Maximum standing time was 30 min, less when symptoms of syncope or volitional exhaustion occurred. Besides total standing time, electromyography of thigh muscles, and changes in mean arterial pressure and heart rate were monitored at rest and during standing.

Results: No significant differences were found in standing time, changes in mean arterial pressure or heart rate between standing in Innowalk Pro and the standing frame. However, participants had significantly more thigh muscle activation (p = 0.006) when standing in Innowalk Pro.

Conclusions: Mobilising participants with a subacute acquired brain injury in a standing frame with motorised passive movements of the lower limbs did, despite higher thigh muscle activation, not lead to better orthostatic tolerance or prolonged standing time compared to a traditional standing frame.