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Bedridden patients risk presenting several problems caused by prolonged immobility, leading to a long recovery process. There is thus a need to develop solutions that ensure the implementation of physical rehabilitation programs in a controlled and interactive way. In this context, the ABLEFIT project aims to develop a medical device to physically rehabilitate bedridden patients with prolonged immobility. A partnership was established between the school of nursing, business enterprises and an engineering institute to develop a prototype. After creating the prototype, a pre-clinical experimental usability study was created using the user-centred multi-method approach (User and Human-Centered Design) to assess the device’s functionality, ergonomics and safety. The pre-clinical stage was initiated with a sample of 12 health professionals (that manipulated the device’s functionalities) and 10 end-users (who used the device). During the pre-clinical stage, the need to incorporate in the final version joint stabilizers was observed. Another important finding was the importance of the continuous monitorization of vital signs on Ablefit, namely, heart rate and SPO2. Therefore, the development of the Ablefit system allows the monitoring of a set of variables and conditions inherent to immobility. At the same time, this device will be a dynamic solution (using gamification and simulation technologies) by generating personalized rehabilitation plans.

Background: Scientific and technological development has constituted a reality in the lives of populations, making it unimaginable to live without specific incentives that development has allowed. That said, given the increase in the longevity of people, it will be helpful to implement these resources in promoting health and disease prevention in the elderly. The objective of this study is to identify, in the scientific evidence, the effects of Wii games on the physical training of the elderly. Methods: A systematic review will be carried out according to the methodology recommended by the Joanna Briggs Institute. Relevant databases will be used for the research, where the words will be used: rehabilitation, exercise, physical activity, rehabilitation exercise; movement; therapeutic exercise; engine activity; rehabilitation, geriatric, gerontologic care, and aged. Results: This systematic review will include experimental and quasi-experimental studies, including randomised studies with and without a control group, pre- and post-assessment. Conclusions: To promote the autonomy of the elderly and consequently healthy and prosperous ageing, it is crucial to implement all available measures and resources. For this purpose, exergames have been shown to be effective, and it is necessary to know which ones are suitable for the physical training of the elderly. This one protocol is registered with the Open Science Framework.

The current study compared the effects of exercise program and a rehabilitation exercise program (REP) with electro muscle stimulation (EMS) on participants who had anterior cruciate ligament (ACL) reconstruction. The control group (CONG, n = 12) and the electro muscle stimulation group (EMSG, n = 12) were equally assigned among the 24 patients who underwent ACL reconstruction. For 12 weeks, CONG executed the REP, and EMSG executed of added EMS into the REP. Every participant in the rehabilitative exercise program completed two 60 min sessions each week for a total of 12 weeks. Both a pre- and post-evaluation were completed before and after the workout session. IKDC (International Knee Documentation Committee) score, Lysholm score, thigh circumference, muscular activity, and isokinetic muscle function were the variables examined. The EMSG exposed a significant increase (p < 0.05) in Lysholm score, muscle circumference, muscle activity of vastus medialis (VM), rectus femoris (RM), and vastus lateralis (VL), and isokinetic function (peak torque, total work). However, CONG only showed a significant increase in IKDC score (p < 0.05). This study proved that the REP employing EMS following ACL reconstruction enhanced muscular activation during muscle contraction when compared to REP, and it showed that using EMS in rehabilitation exercise is an effective rehabilitation strategy.

The present study examined the effects of a rehabilitation exercise program with blood flow restriction (BFR) vs. a general rehabilitation exercise program in patients who have undergone anterior cruciate ligament (ACL) reconstruction. Among a total of 24 patients, the general rehabilitation exercise group (GRE, n = 12) and blood flow restriction group (BFR, n = 12) were assigned the same. The GRE group conducted a general rehabilitation exercise, and the BFR group conducted a BFR exercise along with the general rehabilitation exercise. All participants performed the rehabilitation exercise program session for 60 min three times a week for 12 weeks under supervision. All dependent parameters (Lysholm score and International Knee Documentation Committee (IKDC) subjective score, muscle activity, isokinetic muscular function, Y-balance test) were evaluated before and after the rehabilitation exercise program. GRE improved the Lysholm score, IKDC subjective score and Y balance test (posterior-medial, posterior-lateral) (p < 0.05). Moreover, BFR was effective in improving the Lysholm score and IKDC subjective score and muscle activity (e.g., vastus medialis oblique during isokinetic contraction and rectus femoris during isometric contraction), isokinetic function (e.g., peak torque and total work) and Y-balance test (e.g., anterior, posterior medial, posterior lateral) (p < 0.05). Our study confirmed that a rehabilitation exercise program with BFR after ACL reconstruction is a more effective rehabilitation modality for improving muscle activity during muscle contraction and muscle function compared with GRE. Therefore, it is recommended to use BFR as an effective rehabilitation program for rapid recovery after ACL reconstruction.

Skeletal muscles require fitness and rehsabilitation exercises to develop. This paper presents a method to observe and evaluate the conditions of muscle extension. Based on theories about the muscles and factors that affect them during leg contraction, an electromyography (EMG) sensor was used to capture EMG signals. The signals were applied by signal processing with the wavelet packet entropy method. Not only did the experiment follow fitness rules to obtain correct EMG signal of leg extension, but the combination of inertial measurement unit (IMU) sensor also verified the muscle state to distinguish the muscle between non-fatigue and fatigue. The results show the EMG changing in the non-fatigue, fatigue, and calf muscle conditions. Additionally, we created algorithms that can successfully sense a user’s muscle conditions during exercise in a leg extension machine, and an evaluation of condition sensing was also conducted. This study provides proof of concept that EMG signals for the sensing of muscle fatigue. Therefore, muscle conditions can be further monitored in exercise or rehabilitation exercise. With these results and experiences, the sensing methods can be extended to other smart exercise machines in the future.

Background and Objectives: Rotator cuff tear is the most common cause of shoulder pain. If nonsurgical treatment fails, arthroscopic rotator cuff repair (ARCR) is recommended. Since the standards for rehabilitation after ARCR are not clear, various rehabilitation methods have been suggested. This study intends to investigate the effect on the recovery phase of ARCR patients through a postoperative rehabilitation protocol (PRP) that considers the healing process and rehabilitation trend. Materials and Methods: This single-arm, pragmatic intervention study was conducted on 30 patients, two weeks postoperative day (POD) after ARCR. ARCR patients received intervention for six weeks from POD two-week, and pain intensity and shoulder function were evaluated at two-week intervals until POD 12-week, and range of motion (ROM) was evaluated at POD four-week and eight-week. Results: In this study, all variables improved over time (p < 0.05). As a result of the comparison between time points, a significant improvement was found in shoulder function at POD 6-week. In addition, the effect size had a large effect on ROM (flexion, scaption flexion, abduction, and external rotation) and shoulder function. Conclusions: Management through the PRP based on scientific evidence in the strategy of postoperative rehabilitation of patients with ARCR is effective for pain intensity, ROM, and shoulder function.

Background: Postural activities involved in balance control integrate the anticipatory postural adjustments (APA) that stabilize balance and posture, facilitating arm movements and walking initiation and allowing an optimal coordination between posture and movement. Several studies reported the significant benefits of virtual reality (VR) exercises in frail older adults to decrease the anxiety of falling and to induce improvements in behavioural and cognitive abilities in rehabilitation processes. The aim of this study was thus to test the efficiency of a VR system on the enhancement of the APA period, compared to the use of a Nintendo Wii system. Methods: Frail older adults (n = 37) were included in this study who were randomized and divided into a VR exercises group (VR group) or a control group using the Nintendo Wii system (CTRL group). Finally, 22 patients were included in the data treatment. APA were studied through muscular activation timings measured with electromyographic activities. The functional reach test, the gait speed, and the time up and go were also evaluated before and after a 3-week training phase. Results and discussion: As the main results, the training phase with VR improved the APA and the functional reach test score along the antero-posterior axis. Together, these results highlight the ability of a VR training phase to induce neuromuscular adaptations during the APA period in frail older adults. Then, it underlines the effective transfer from learning carried out during the VR training movements to control balance abilities in a more daily life context.

Background and objectives: Motor rehabilitation improves physical mobility and quality of life in Parkinson’s disease (PD). As specialized rehabilitation is expensive and resource-consuming, there is a need for simpler, cost-effective methods. The purpose of the study was to determine whether Nordic Walking (NW) training may support the management of motor disability in PD. Materials and Methods: Forty patients (median age 64.0 years, range 50–75 years) with idiopathic PD, Hoehn and Yahr stages II–III, were randomly assigned to NW or standard rehabilitation (SR) programs, comprising twelve rehabilitation sessions conducted bi-weekly throughout the 6-week study period. Results: Median Unified Parkinson’s Disease Rating Scale part III scores were significantly reduced with NW, by 8.5, and with SR, by 6.0 points (both p < 0.001), with significantly greater improvement with NW than with SR (p = 0.047). Gait quality and balance control, measured using the Dynamic Gait Index, improved with NW by a median of 8.0 and with SR by 5.5 points (both p < 0.001), with slightly greater improvement with NW, compared to the SR group (p = 0.064). Quality of life, assessed using the Parkinson’s Disease Questionnaire (PDQ-39), improved with NW by a median of 15 and with SR by 12 points, p = 0.001 and p = 0.008, respectively. Conclusions: The 6-week Nordic Walking program improves functional performance, quality of gait, and quality of life in patients with PD and has comparable effectiveness to standard rehabilitation.

Older people face difficulty engaging in conventional rehabilitation exercises for improving physical functions over a long time period due to the passive nature of the conventional exercise, inconvenience, and cost. This study aims to develop and validate a dynamic time warping (DTW) based algorithm for assessing Kinect-enabled home-based physical rehabilitation exercises, in order to support auto-coaching in a virtual gaming environment. A DTW-based algorithm was first applied to compute motion similarity between two time series from an individual user and a virtual coach. We chose eight bone vectors of the human skeleton and body orientation as the input features and proposed a simple but innovative method to further convert the DTW distance to a meaningful performance score in terms of the percentage (0−100%), without training data and experience of experts. The effectiveness of the proposed algorithm was validated through a follow-up experiment with 21 subjects when playing a Tai Chi exergame. Results showed that the algorithm scores had a strong positive linear relationship (r = 0.86) with experts’ ratings and the calibrated algorithm scores were comparable to the gold standard. These findings suggested that the DTW-based algorithm could be effectively used for automatic performance evaluation of an individual when performing home-based rehabilitation exercises.

We developed a set of assessment tools for health professionals to evaluate the physical functions, mental functions, and social abilities of people with stroke (PWS) from 6 months to 3 years after stroke onset, to design a tailored "Rehabilitation Exercise and Sports" (RES) program, which the South Korean government was required to provide by the Act on Guarantee of Right to Health and Access to Health Services for people with disabilities. Since previous studies mainly dealt with the chronic stage of PWS, it would not be appropriate to apply assessment tools used in previous studies, as they are not compatible with the time window (6 months to 3 years) used to define the target population of the RES program. We reviewed the literature to identify evaluation factors and assessment tools applied in previous studies, and developed a Delphi questionnaire with closed-ended questions based on the literature review's results and supplementary open-ended questions. A 20-expert panel conducted four rounds of the Delphi survey, including two rounds to determine evaluation factors and two rounds to determine assessment tools. The Delphi survey revealed that 22 evaluation factors and 24 corresponding assessment tools reached consensus among the experts. However, no assessment tools reached consensus for three evaluation factors: muscle endurance, flexibility, and dynamic balance. A comprehensive set of assessment tools would be useful for health professionals to understand the health status of PWS from 6 months to 3 years after stroke onset, and help the design of tailored RES programs.

Many stroke survivors' quality of life is impaired. Few studies of factors influencing their quality of life have been based on the factors tested by the short form 36 instrument. This study did so with 308 physically disabled stroke survivors in rural China. Principal components analysis was applied to refine the dimension structure of the short form 36 assessment, followed by backward multiple linear regression analysis to determine the independent factors influencing quality of life. The structure revealed differed from the generic structure in showing that the mental health and vitality dimensions are not unidimensional. Subjects who reported access to the outdoors as convenient demonstrated better quality of life in all dimensions. Those who exercised regularly achieved better social functioning and negative mental health scores. Other factors influencing a better quality of life in terms of physical functioning were younger age and not being married. Being older and better educated predicted better role-emotion scores. Being female correlated with better social functioning scores, while men scored better on bodily pain. Being less educated predicted higher negative mental health, while being less disabled predicted better physical and social functioning. The results suggest that the SF-36's dimension structure should be re-evaluated before using it to assess stroke survivors., Competing Interests: The authors declare no conflicts of interest.