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Previous studies suggest that craniofacial manual lymphatic drainage (MLD) facilitates brain fluids clearance, reducing intracranial pressure and reabsorbing chronic subdural hematoma. This study aimed to explore the effect of craniofacial MLD in combination with pharmacological treatment for improving cranial pain intensity, vital signs, and cerebral edema (Hounsfield units, HUs) in moderate traumatic brain injury (mTBI). Patient 1 received pharmacological therapy, while patient 2 received both pharmacological and craniocervical MLD treatment. Patient 2 showed decreased cranial pain intensity and systolic blood pressure (66%–11.11%, respectively) after two 30 min daily sessions of treatment for three days. HUs in the caudate nucleus of both hemispheres (left 24.64%–right 28.72%) and in the left temporal cortical gray matter increased (17.8%). An increase in HU suggests a reduction in cerebral edema and vice versa. For patient 1, there were no changes in cranial pain intensity, but a slight increase in the systolic blood pressure was observed (0%–3.27%, respectively). HUs decreased in the temporal cortical (14.98%) and caudate nucleus gray matter (9.77%) of the left and right cerebral hemispheres (11.96%–16.74%, respectively). This case study suggests that craniofacial MLD combined with pharmacological treatment could reduce cerebral edema, decrease head pain intensity, and maintain vital signs in normal physiologic values in patients with mTBI. Sin financiación 3.160 Q2 JCR 2021 0.550 Q2 SJR 2022 No data IDR 2021 UEV

In the recent years, software applications for medical assistance, including the tele-rehabilitation, have known a high and continuous presence in the medical field. Guaranteeing the correct use of these applications induces to incorporate a study of usability in the life cycle of any interactive system. This paper synthesizes the results obtained from a study of effectiveness, efficiency, and subjective user satisfaction conducted with ePHoRt. ePHoRt is a web-based platform for home motor rehabilitation; 39 participants tested the platform. We report the empirical results based on the subjective usability perception and self-reported feedback based on the IBM Computer System Usability Questionnaire. The results suggest that ePHoRt is useful, effective, efficient, easy to use, and its interfaces are acceptable. Overall, the participants are satisfied to use the platform. The main findings of this paper show that the user guidance is a critical aspect to ensure a good usability of the tele-rehabilitation platform.

In the current medical practice, personal physical physiotherapy is expensive, the therapist’s time of service is limited, and training equipment is available in a clinical environment. So, the need to provide low-cost and convenient smart health assistance services are growing tremendously. ePHoRt is a web-based platform created for helping patients after hip replacement surgery. We discuss and present the techniques, methods, and strategies used throughout the execution of the project.

Objective. To analyse the effect of the manual ischemic compression (IC) on the upper limb motor performance (MP) in patients with LTrPs. Materials and Methods. A quasiexperimental study was performed in twenty subjects allocated to either patients group with LTrPs (PG, n=10) or healthy group with no symptoms (HG, n=10). Subjective pain and linear MP (movement time and Fitts’ Law) were assessed before and after a linear tapping task. Data were analysed with mixed factorial ANOVA for intergroup linear motor performance differences and dependent t-student test for intragroup pain differences. Results. PG had a linear MP lower than the HG before treatment (p < 0.05). After IC, the PG showed a significant decrease of pain (4.07 ± 1.91 p < 0.001). Furthermore, the movement time (15.70 ± 2.05 p < 0.001) and the Fitts’ Law coefficient (0.80 ± 0.53 p < 0.001) were significantly reduced. However, one IC session did not allow the PG to get the same MP than the HG (p < 0.05). Conclusion. The results suggest the IC effectiveness on pain and MP impairment in subjects with LTrPs. However, the MP of these patients is only partially improved after the IC application.

Over the past few years, software applications for medical assistance, including tele-rehabilitation, have known an increasing presence in the health arena. Despite the several therapeutic and economic advantages of this new paradigm, it is important to follow certain guidelines, in order to build a safe, useful, scalable, and ergonomic tool. This work proposes to address all these points, through the case study of a physical tele-rehabilitation platform for patients after hip replacement surgery. The scalability and versatility of the system is handled by the implementation of a modular architecture. The safeness and effectiveness of the tool is ensured by an artificial intelligence module that assesses the quality of the movements performed by the user. The usability of the application is evaluated by a cognitive walkthrough method. Results show that the system (i) is able to properly assess the correctness of the human&rsquo, s motion through two possible methods (Dynamic Time Warping and Hidden Markov Model), and (ii) provides a good user experience. The discussion addresses (i) the advantages and disadvantages of the main approaches for a gesture recognition of therapeutic movements, and (ii) critical aspects to provide the patient with the best usability of a tele-rehabilitation platform.

This study presents key features to develop an efficient tele-rehabilitation platform to support the recovery process in patients after hip replacement surgery. The tool is designed on the concepts of therapeutic education and serious games, in order to enhance the self-rehabilitation. Also, the system is built on a modular architecture to ensure its scalability and adaptation to other physical therapeutic programs. The assessment module integrated in the platform and implemented in dynamic time warping allows for a fair discrimination of the quality of the exercises performed by the users, especially when the motion acquisition is not affected by occlusion. An important contribution of this work is to propose a method that can assess both the range of motion and the compensation movements that may be involved in each exercise.

Using a tele-rehabilitation platform for motor recovery obliges the user to interact at a remote distance from the computer. In such a situation, a natural user interface can be used both to record the therapeutic movements performed by the patient, and to navigate in the web application. Nevertheless, it is necessary to assess the user experience to validate the system usability. The present paper describes an experiment to test the usability of a platform designed to enhance the recovery of patients after hip replacement surgery. The user experience is evaluated through several metrics (completion time and usability questionnaire) and the results are related to a sociodemographic questionnaire. A clustering approach is implemented to identify a relationship between the user’s profile and the interaction performance with the platform.

CEPRA XI-2017-15. The enhancement of ubiquitous and pervasive computing brings new perspectives in terms of medical rehabilitations. In that sense, the present study proposes a Web-based platform to promote the reeducation of patients after hip replacement surgery. This project focuses on two fundamental aspects in the development of a suitable telerehabilitation application, which are: (i) being based on an affordable technology and (ii) providing the patients with a real-time assessment of the correctness of their movements. A comparative test shows that the movement's evaluation carried out by therapists is consistent with the output of the automatic assessment module. Improvements of the algorithm are discussed, in order to increase the accuracy and depth of the analysis. authorsversion published

Telemedicine is a current trend in healthcare. The present study is part of the ePHoRt project, which is a web-based platform for the rehabilitation of patients after hip replacement surgery. To be economically suitable the system is intended to be based on low-cost technologies, especially in terms of motion capture. This is the reason why the Kinect-based motion tracking is chosen. The paper focuses on the automatic assessment of the correctness of the exercises performed by the user. A Dynamic Time Warping (DTW) approach is used to discriminate between correct and incorrect movements. The classification of the movements through a Naïve Bayes classifier shows a very high percentage of accuracy (98.2%). Models are built for each individual and reeducation exercise with only few attributes and the same accuracy. Due to these promising results, the next step will consist of testing the algorithms on patients performing the exercises in real time.

Objective: the purpose of the present study was to analyze the concurrent validity and reliability of a force platform clinical COBS Feedback ® for the estimation of the height of vertical jumps. Design: a cross-sectional correlational and comparative study. Setting: University Human Movement and Physiotherapy Laboratory. Participants: healthy university students (14 female and 13 male) aged between 18 and 25 years old (mean = 20.074 ±1.542). Main Outcome Measures: vertical jump heights, technical error and grade of agreement between methods of measurement. Results: after the 27 subjects performed a total of 135 vertical jumps on COBS Feedback ® platform while simultaneously being recorded with a high-speed camera-based method, the intraclass correlation coefficient showed an almost perfect concordance between the two methods (ICC = 0.916, CI 95% = 0.882 to 0.940, p

Introducción: La incontinencia urinaria (IU) es una enfermedad que afecta principalmente a mujeres y adultos mayores repercutiendo en su calidad de vida. Además, su tratamiento y sus secuelas representan un costo económico relevante en los sistemas de salud. Objetivo: Determinar la prevalencia y los factores de riesgo de la IU en mujeres de 45 a 65 años, atendidas en el Hospital “Padre Carollo”, en el periodo 2016-2017. Materiales y métodos: Estudio descriptivo/retrospectivo revisando 887 historias clínicas. Se analizó la asociación entre variables (Chi2), los “odd ratios” (Regresión múltiple) y los valores Beta. Los factores de riesgo analizados fueron número de gestas, edad, ocupación, tipo de parto, IMC, hipertensión y tipo de tratamiento. Resultados: Cuarenta y cinco pacientes fueron diagnosticadas con IU (5.07%; IC95%:3.62-6.51), 44 tuvieron IU de esfuerzo y 1 tuvo IU mixta. La prueba Chi2 determinó una asociación entre IU, el número de gestas (p=0.002) y la hipertensión (p=0.025). La regresión múltiple encontró asociaciones significativas para el número de gestas (p=0.003), hipertensión (p=0.030) y partos por cesáreas (p=0.016). Los valores Beta ratificaron estos resultados. Conclusiones: La prevalencia de IU fue de 5.07%. En cuanto a los tipos de IU, el más frecuente dentro de la muestra fue la incontinencia urinaria de esfuerzo. El número de gestas fue el factor de riesgo más significativo en relación con las variables edad, ocupación, tipo de parto, IMC, hipertensión y tipo de tratamiento. La regresión múltiple mostró una relación significativa entre el número de gestas e IU, para primíparas, multíparas y gran multíparas. Los valores BETA demostraron que los factores de predicción de la presencia de IU más importantes fueron mujeres gran multíparas, multíparas, primíparas, hipertensión, IMC y edad.

This research was funded by CEDIA (Corporación Ecuatoriana para el Desarrollo de la Investigación y la Academia), grant number CEPRA XI-2017-15. The enhancement of ubiquitous and pervasive computing brings new perspectives in medical rehabilitation. In that sense, the present study proposes a smart, web-based platform to promote the reeducation of patients after hip replacement surgery. This project focuses on two fundamental aspects in the development of a suitable tele-rehabilitation application, which are: (i) being based on an affordable technology, and (ii) providing the patients with a real-time assessment of the correctness of their movements. A probabilistic approach based on the development and training of ten Hidden Markov Models (HMMs) is used to discriminate in real time the main faults in the execution of the therapeutic exercises. Two experiments are designed to evaluate the precision of the algorithm for classifying movements performed in the laboratory and clinical settings, respectively. A comparative analysis of the data shows that the models are as reliable as the physiotherapists to discriminate and identify the motion errors. The results are discussed in terms of the required setup for a successful application in the field and further implementations to improve the accuracy and usability of the system. publishersversion published