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Abstract Mechanical energy harvesters have recently emerged as promising options for self‐powering sensors and small electronic devices. In this work, aluminum ferrite (AlFeO3)/PVDF hybrid perovskite electrospun nanofiber‐based tribo‐enhanced piezoelectric nanogenerators (TPENGs) are developed for energy harvesting. The as‐fabricated TPENG achieves an average voltage output of 52.3 V and an average current output of 1.23 µA. Additionally, the power density of the TPENG is calculated to be 0.085 W.m−2 at an 80 MΩ external resistance load. A 3D‐printed device is fabricated, containing nylon fabric (tribo‐positive) as a rotor attached to printed fins, while six (AlFeO3)/PVDF hybrid perovskite electrospun nanofiber piezoelectric nanogenerators (PENGs) wrapped with Kapton tape (tribo‐negative) serve as the stator. The three printed fins of the device are moved by a string‐based pulley, generating an open circuit voltage of 200 V and a short circuit current of 4.5 µA. The as‐fabricated 3D‐printed device with TPENGs is used to power small electronics (e.g., LEDs and watch) and an exercise setup, allowing patients to generate power by pulling the attached string, thereby estimating the level of impairment. Integrating energy harvesting into rehabilitation motivates patients to move impaired body parts, enhancing TPENG's application in healthcare as a practical and engaging tool for patient rehabilitation.

Goal functions make virtual goal-oriented motor tasks easier to analyze and manipulate by explicitly linking movement to outcome. However, they have only been used to study constrained (e.g., planar) upper limb movements. We present a design framework for integrating goal functions with unconstrained postural and upper limb movements in a virtual reality (VR) device. VR tasks designed with the framework can mimic unconstrained natural motions and thus train a range of functional movements yet remain analytically tractable. We created three in-place VR motor tasks: a bow-and-arrow, a reach-and-strike, and a punching bag task. Each task was adjusted to subject-specific workspace limits and anthropometrics. We studied the effects of 3 days of practice and 3 reach/lean distances on task performance in 12 healthy adults. Subjects performed all tasks on day 1 with moderate proficiency and improved with practice at all reach/lean distances. Task-specific results showed that performance decreased and movement variability increased near the edge of the reaching workspace; viewing angles and the imperfect depth cues in VR likely led to biases in performance and practice could attenuate the former effect; in reach-and-strike, subjects learned movement patterns similar to those seen in a real-world striking sport. These results show that our framework can deliver tasks useful for analyzing and training motor performance and can guide future in-place motor training. Post-hoc, we demonstrated the feasibility of generalizable methods that adjust required movement speeds and task difficulty for impaired populations.

Patients who have undergone hip fracture surgery have the primary goal of recovering their premorbid level of function across diverse functional domains, including walking ability, balance, cognitive function, emotional well-being, frailty, and activities of daily living. As the speed and level of recovery can vary substantially across functional domains and individuals, the varying recovery patterns of different outcome measures should be considered when designing rehabilitation plans for patients. However, the lack of knowledge of recovery trajectories and their variations in hip fracture patients impedes such efforts. In this study, we develop a multivariate time-series clustering algorithm to analyze the recovery patterns and identify patient groups with similar recovery patterns across multiple functional outcomes. Five distinct recovery patterns were observed that exhibit varying maximum recovery levels and speeds. These findings demonstrated the significance of utilizing multiple outcome measures concurrently to assess the patient’s recovery level. Recovery patterns are identified to exhibit variations across different domains, revealing contrasting trends between walking ability and cognitive outcomes. Furthermore, we present predictions on the trajectory of recovery during the post-acute phase solely based on the acute-phase information. This approach facilitates the early identification of patient groups with an unfavorable prognosis for recovery.

Abstract Post‐traumatic stress disorder (PTSD) is an anxiety condition caused by exposure to severe trauma. It is characterised by nightmares, flashbacks, hyper‐vigilance and avoidance behaviour. These all lead to impaired functioning reducing quality of life. PTSD affects 2–5% of the population globally. Most sufferers cannot access effective treatment, leading to impaired psychological functioning reducing quality of life. Eye movement desensitisation and reprocessing (EMDR) is a non‐invasive brain stimulation treatment that has shown significant clinical effectiveness in PTSD. Another treatment modality, that is, trauma‐focused cognitive behavioural therapy is also an effective intervention. However, both evidence‐based treatments are significantly resource intensive as they need trained therapists to deliver them. A concept of a neuro‐digital tool for development is proposed to put to clinical practice of delivering EMDR to improve availability, efficiency and effectiveness of treatment. The evidence in using new technologies to measure sleep, geolocation and conversational analysis of social media to report objective outcome measures is explored. If achieved, this can be fed back to users with data anonymously collated to evaluate and improve the tool. Coproduction would be at the heart of product development so that the tool is acceptable and accessible to people with the condition.

Fragility fractures, caused by low-energy trauma, are a significant global health concern, with 158 million people aged 50 and over at risk. Hip fractures, a common issue in elderly patients, are often linked to underlying conditions such as osteoporosis. This study proposed a cost-effective solution using a non-wheeled smart walker with load sensors to measure gait parameters, addressing the high cost of traditional gait analysis equipment, the prototype used PASCO load cells PS2200 for force measurement, eliminating the need for Arduino UNO or microcontroller-based hardware. A lightweight amplifier PS2198 amplified the signal, which was transmitted via USB to a personal computer. PASCO capstone software was used for data recording and visualization. The smart walker was tested on forty volunteers divided into two equal groups: those with osteoporosis and those without, by performing a 10 m walk test three times. ANOVA comparing spatiotemporal parameters (TSPs) of the two participant groups (α = 0.05) showed that significant differences lay in terms of time taken to complete the walk test (p < 0.01), left step length (p = 0.03), walking speed (p = 0.02), and stride length (p < 0.02). The results indicate that this smart walker is a reliable tool for assessing gait patterns in individuals with osteoporosis. The proposed system can be an alternative for time consuming and costly methods such as motion capture, and for socially stigmatizing devices such as exoskeletons. It can also be used further to identify risk factors of osteoporosis. [ABSTRACT FROM AUTHOR]

The treatment strategy for Paget’s breast cancer (PBC), as for other morphological forms, is determined by the spread of the invasive tumor process, as well as the absence or presence of adverse factors. Significant prognostic factors, e.g. the invasive component of Paget’s cancer, the involvement status of regional lymph nodes, morphological criteria, the grade of malignancy, overexpression of epidermal growth factor Her2/neu, the presence of BRCA 1/2 and CHEK2 gene mutations, as well as age, affect the prognosis of Paget’s disease. According to various sources, PBC in 90–98 % is combined with invasive or non‑invasive breast cancer. For the most part, the lesion is multifocal. There’s high expectation for PBC to form tumor node. A palpable tumor node in the mammary gland is detected in half of the patients. PBC has certain features and specificity in relation to treatment methods. The method of radical surgical treatment of patients is primarily based on performing oncoplastic resections. Sufficient breast volume is a significant criterion for the possibility of performing an organ‑ preserving operation. The organ‑ preserving treatment is oncologically safe in case of PBC. The removal of the nipple‑ areolar complex is mandatory in case of PBC. It is possible to improve survival statistics by analyzing the biological characteristics of the tumor and developing a more accurate approach to the treatment of patients in this category. Determining clear indications for organ‑p reserving operations is the main opportunity to improve the quality of life of patients and their further rehabilitation.

Background: Cardiovascular disease (CVD) is the number one cause of death worldwide. Objective: To determine of coronary care unit nurses' knowledge regarding patient rehabilitation after myocardial infarction. Methodology: A crosssectional study was designed in the Cardiac Care Unit of Al-Diwaniyah Teaching Hospital and the Specialized Center for Cardiac Surgery and Catheterization for the period from (November 7, 2022) to (May 12, 2023). A non-probability (purposive) sample consisting of (75 nurses) working in the above-mentioned study site. To determination of coronary care unit Nurses' knowledge regarding patient rehabilitation after myocardial infarction, the researcher used a tool that consists of two parts: The first part: is the demographic data of the study sample, and the second part: nurses' knowledge about patient rehabilitation after myocardial infarction includes 28 items. Results: The study showed that (48%) of the nurses in the study sample had fair levels of knowledge regarding patient rehabilitation after myocardial infarction. It also showed that there is a statistically significant relationship between the nurses' knowledge and their age. Conclusion: The current study concluded that the largest percentage of the participants in the study have fair knowledge about patient rehabilitation after myocardial infarction, while a small number of them have satisfactory knowledge. [ABSTRACT FROM AUTHOR]

Background: Oxidative stress (OS) could cause various COVID-19 complications. Recently, we have developed the Pouvoir AntiOxydant Total (PAOT®) technology for reflecting the total antioxidant capacity (TAC) of biological samples. We aimed to investigate systemic oxidative stress status (OSS) and to evaluate the utility of PAOT® for assessing TAC during the recovery phase in critical COVID-19 patients in a rehabilitation facility. Materials and Methods: In a total of 12 critical COVID-19 patients in rehabilitation, 19 plasma OSS biomarkers were measured: antioxidants, TAC, trace elements, oxidative damage to lipids, and inflammatory biomarkers. TAC level was measured in plasma, saliva, skin, and urine, using PAOT and expressed as PAOT-Plasma, -Saliva, -Skin, and -Urine scores, respectively. Plasma OSS biomarker levels were compared with levels from previous studies on hospitalized COVID-19 patients and with the reference population. Correlations between four PAOT scores and plasma OSS biomarker levels were analyzed. Results: During the recovery phase, plasma levels in antioxidants (γ-tocopherol, β-carotene, total glutathione, vitamin C and thiol proteins) were significantly lower than reference intervals, whereas total hydroperoxides and myeloperoxidase (a marker of inflammation) were significantly higher. Copper negatively correlated with total hydroperoxides (r = 0.95, p = 0.001). A similar, deeply modified OSS was already observed in COVID-19 patients hospitalized in an intensive care unit. TAC evaluated in saliva, urine, and skin correlated negatively with copper and with plasma total hydroperoxides. To conclude, the systemic OSS, determined using a large number of biomarkers, was always significantly increased in cured COVID-19 patients during their recovery phase. The less costly evaluation of TAC using an electrochemical method could potentially represent a good alternative to the individual analysis of biomarkers linked to pro-oxidants. [ABSTRACT FROM AUTHOR]

In healthcare, the Nine Hole Peg Test (NHPT) is considered a standard for assessing hand dexterity. A digital version of the classic Nine-Hole Peg Test – the dNHPT - has been developed that allows digital measurement of hand function. The prototype of this dNHPT was investigated in this study with test-retest and crossover design with 32 healthy adults. Pearson Correlation Coefficient and Bland-Altman diagram were used to analyze concurrent validity. Intraclass Correlation Coefficients (ICC), standard error or measurement (SEM) and smallest detectable change (SDC) were used to determine test-retest and interrater reliability. Our results showed a moderate concurrent validity (r = 0.592). The Bland Altman analysis showed an estimated a mean difference of −2.47 between the dNHPT in comparison with the conventional NHPT. The dNHPT demonstrated good test-retest reliability (ICC: 0.75, SEM: 0.89, SDC: 2.47) and high interrater reliability (ICC: 0.76). To conclude, the dNHPT can contribute to objectify the measurement of hand dexterity without losing its most compactness and simplicity as the most important properties of NHPT.

Abstract Introduction: This study aimed to estimate the criterion validity of functional movement and posture measurement using remote technology systems in people with and without Axial spondylarthritis (axSpA). Methods: Validity and agreement of the remote‐technology measurement of functional movement and posture were tested cross‐sectionally and compared to a standard clinical measurement by a physiotherapist. The feasibility of remote implementation was tested in a home environment. There were two cohorts of participants: people with axSpA and people without longstanding back pain. In addition, a cost‐consequence analysis was performed. Results: Sixty‐two participants (31 with axSPA, 53% female, age = 45(SD14), BMI = 26.6(SD4.6) completed the study. In the axSpA group, cervical rotation, lumbar flexion, lumbar side flexion, shoulder flexion, hip abduction, tragus‐to‐wall and thoracic kyphosis showed a significant moderate to strong correlation; in the non‐back pain group, the same measures showed significant correlation ranging from weak to strong. Conclusions: Although not valid for clinical use in its current form, the remote technologies demonstrated moderate to strong correlation and agreement in most functional and postural tests measured in people with AxSA. Testing the CV‐aided system in a home environment suggests it is a safe and feasible method. Yet, validity testing in this environment still needs to be performed.

Vibratory stimulation may improve post-stroke symptoms such as spasticity; however, current studies are limited by the large, clinic-based apparatus used to apply this stimulation. A wearable device could provide vibratory stimulation in a mobile form, enabling further study of this technique. An initial device, the vibrotactile stimulation (VTS) Glove, was deployed in an eight-week clinical study in which sixteen individuals with stroke used the device for several hours daily. Participants reported wearing the glove during activities such as church, social events, and dining out. However, 69% of participants struggled to extend or insert their fingers to don the device. In a follow-up study, eight individuals with stroke evaluated new VTS device prototypes in a three-round iterative design study with the aims of creating the next generation of VTS devices and understanding features that influence interaction with a wearable device by individuals with impaired upper-limb function. Interviews and interaction tasks were used to define actionable design revisions between each round of evaluation. Our analysis identified six new themes from participants regarding device designs: hand supination is challenging, separate finger attachments inhibit fit and use, fingers may be flexed or open, fabric coverage impacts comfort, a reduced concern for social comfort, and the affected hand is infrequently used. Straps that wrap around the arm and fixtures on the anterior arm were other challenging features. We discuss potential accommodations for these challenges, as well as social comfort. New VTS device designs are presented and were donned in an average time of 48 seconds.

In an augmented reality environment, the range of possible real-time visual feedback is extensive. This study aimed to compare the impact of six scenarios in augmented reality combining four visual feedback characteristics on achieving a target walking speed. The six scenarios have been developed for Microsoft Hololens augmented reality headset. The four feedback characteristics that we have varied were: Color; Spatial anchoring; Speed of the feedback, and Persistence. Each characteristic could have different values (for example, the color could be unicolor, bicolor, or gradient). Participants had to walk for two consecutive walking trials for each scenario: at their maximal speed and an intermediate speed. Mean speed, percentage of time spent above or around target speed, and time to reach target speed were compared between scenarios using mixed linear models. A total of 25 children with disabilities have been included. The feasibility and user experience were excellent. Mean speed during scenario 6, which displayed feedback with gradient color, attached to the world, with a speed relative to the player equal to his speed, and that disappeared over time, was significantly higher than other scenarios and control (p =0.003). Participants spent 80.98% of time above target speed during scenario 6. This scenario mixed the best combination of feedback characteristics to exceed the target walking speed (p=0.0058). Scenarios 5 and 6, which shared the same feedback characteristics for spatial anchoring (world-locked) and feedback speed (equal to the player speed), decreased the time to reach the target speed (p=0.019). Delivering multi-modal feedback has been recognized as more effective for improving motor performance. Therefore, our results showed that not all visual feedback had the same impact on performance. Further studies are required to test the weight of each feedback characteristic and their possible interactions inside each scenario. This study was registered in the ClinicalTrials.gov database (NCT04460833).

A growing number of researchers and startup companies are looking to integrate artificial intelligence (AI) into perhaps the most human of places in health care: the therapy room. The hope is that AI can help mitigate the time and expense it takes for humans to rate and code elements of the patient-provider interaction in a therapy session, a process that is vital for training new therapists, evaluating therapy quality, and conducting research studies and clinical trials of psychotherapy. [ABSTRACT FROM AUTHOR]

Vibratory stimulation may improve post-stroke symptoms such as spasticity; however, current studies are limited by the large, clinic-based apparatus used to apply this stimulation. A wearable device could provide vibratory stimulation in a mobile form, enabling further study of this technique. An initial device, the vibrotactile stimulation (VTS) Glove, was deployed in an eight-week clinical study in which sixteen individuals with stroke used the device for several hours daily. Participants reported wearing the glove during activities such as church, social events, and dining out. However, 69% of participants struggled to extend or insert their fingers to don the device. In a follow-up study, eight individuals with stroke evaluated new VTS device prototypes in a three-round iterative design study with the aims of creating the next generation of VTS devices and understanding features that influence interaction with a wearable device by individuals with impaired upper-limb function. Interviews and interaction tasks were used to define actionable design revisions between each round of evaluation. Our analysis identified six new themes from participants regarding device designs: hand supination is challenging, separate finger attachments inhibit fit and use, fingers may be flexed or open, fabric coverage impacts comfort, a reduced concern for social comfort, and the affected hand is infrequently used. Straps that wrap around the arm and fixtures on the anterior arm were other challenging features. We discuss potential accommodations for these challenges, as well as social comfort. New VTS device designs are presented and were donned in an average time of 48 seconds. [ABSTRACT FROM AUTHOR]

The papers in this special section focus on the development and applications supported by wearable robots. Wearable powered robots may be used for functional substitution in patients suffering from motor disorders, rehabilitation, assistance, and strength augmentation. Despite recent technological and scientific achievements, more research is needed to realize the promise of intuitive, easy-to-wear, safe, and effective wearable robots [ABSTRACT FROM AUTHOR]

Abstract Exoskeleton has been applied in the field of medical rehabilitation and assistance. However, there are still some problems in the interaction between human and exoskeleton, such as time delay, the existence of certain constraints on the human body, and the movement in time is hard to follow. A human motion pattern recognition model based on the long short‐term memory (LSTM) is proposed, which can recognise the state of the human body. Meanwhile, the orthogonalisation method is integrated to make personal‐specific disentangling, and it can effectively improve the generalisation ability of different groups of people, so as to improve the effective follower ability of the exoskeleton. Compared with some other traditional methods, this model has better performance and stronger generalisation ability, which has certain significance in the field of exoskeleton algorithm.

Background: Oxidative stress (OS) could cause various COVID-19 complications. Recently, we have developed the Pouvoir AntiOxydant Total (PAOT®) technology for reflecting the total antioxidant capacity (TAC) of biological samples. We aimed to investigate systemic oxidative stress status (OSS) and to evaluate the utility of PAOT® for assessing TAC during the recovery phase in critical COVID-19 patients in a rehabilitation facility. Materials and Methods: In a total of 12 critical COVID-19 patients in rehabilitation, 19 plasma OSS biomarkers were measured: antioxidants, TAC, trace elements, oxidative damage to lipids, and inflammatory biomarkers. TAC level was measured in plasma, saliva, skin, and urine, using PAOT and expressed as PAOT-Plasma, -Saliva, -Skin, and -Urine scores, respectively. Plasma OSS biomarker levels were compared with levels from previous studies on hospitalized COVID-19 patients and with the reference population. Correlations between four PAOT scores and plasma OSS biomarker levels were analyzed. Results: During the recovery phase, plasma levels in antioxidants (γ-tocopherol, β-carotene, total glutathione, vitamin C and thiol proteins) were significantly lower than reference intervals, whereas total hydroperoxides and myeloperoxidase (a marker of inflammation) were significantly higher. Copper negatively correlated with total hydroperoxides (r = 0.95, p = 0.001). A similar, deeply modified OSS was already observed in COVID-19 patients hospitalized in an intensive care unit. TAC evaluated in saliva, urine, and skin correlated negatively with copper and with plasma total hydroperoxides. To conclude, the systemic OSS, determined using a large number of biomarkers, was always significantly increased in cured COVID-19 patients during their recovery phase. The less costly evaluation of TAC using an electrochemical method could potentially represent a good alternative to the individual analysis of biomarkers linked to pro-oxidants.

In traditional physical therapy, balance evaluation is performed by the physical therapist (PT) intermittently during clinic visits, which is subjective, inconvenient, and time-consuming. In this paper, we use sensors and deep learning to propose an automated balance evaluation system for home and clinical use. First, we propose a deep learning-based model to estimate the subject's Center of Mass (CoM) position using a depth camera, which outperforms other CoM estimation methods with high accuracy and ease of use. Then we propose a balance evaluation system to evaluate the subject's dynamic balance in a Gait Initiation (GI) task. The subject's CoM position is estimated by the proposed CoM estimation model and the Center of Pressure (CoP) position is measured by a Wii balance board. The CoP-CoM trajectory during the GI task is used to assess and quantify the patient's dynamic balance control. Using data collected from both healthy subjects and patients with Parkinson's Disease, the proposed balance evaluation model is able to quantify the subject's balance level which is consistent with the human PT's assessments in traditional balance evaluation tests. The proposed balance evaluation system can be used as a portable and low-cost tool for on-demand balance evaluation.

A rapidly aging population worldwide has spurred interest in developing new strategies to cope with neural declines and neurodegenerative disorders. Noninvasive brain stimulation (NIBS) is increasingly being used to explore functional mechanisms of the brain and induce the therapeutic modulation of behavior, cognition, and emotion. Galvanic vestibular stimulation (GVS), a safe and well-tolerated NIBS technique, is capable of modulating activity in various cortical and subcortical areas involved in vestibular and multisensory processing. A key facet of GVS is that the resultant effects may, in part, be a function of the individual being treated and the stimulus waveform that is delivered. Yet, most GVS studies have utilized the same generic stimulus, chosen from a reduced repertoire of candidates, across all subjects. The future use and, ultimately, clinical adoption of this technology will rely on contributions from the signal processing community to customize stimuli that are optimized for their effect and to exert maximum influence on brain imaging biomarkers. We provide a signal processing-focused overview of the current GVS state of the art in neurorehabilitation, including general stimulation design, concurrent analysis with neuroimaging data, and suggestions for future directions. [ABSTRACT FROM AUTHOR]

The proposed training system helps the examined people to generate motor images based on the example maps of the activity of neuronal cell fractions presented to them. The study involved 16 students at the Laboratory of Neuroinformatics and Decision Systems of the Technical University of Opole. The group was divided into two equal subgroups, one of which was acquainted with the operation of the system, while the other – considered as a control – was not. Electroencephalographic signals were recorded when users were imagining the upper limb movement for two subgroups before and after the imagery training in order to verify the introduction of the proposed training system. The area used for data acquisition as part of the monitoring session implemented with the use of the Emotiv EPOC Flex device is a sensorimotor cortex. As it results from the carried‐out literature analysis, it was the first attempt to use the 32‐channel Emotive EPOC Flex device in the scope of the training system construction in the field of motor imagery. [ABSTRACT FROM AUTHOR]

To solve the problem of uncertain parameters in dynamic modelling of upper-limb rehabilitation robots, a dynamic parameter identification method based on variable parameters particle swarm optimisation (PSO) is developed. Based on the dynamic model of the system, the algorithm changes the inertia parameter and learning law of the basic PSO algorithm from the fixed-parameter to the function that changes with the number of iterations. It solves the problems of small search space in the early stage and slow convergence speed in the later stage of the basic PSO algorithm, which greatly improves its identification accuracy. Finally, through the comparison and analysis of the simulation results, compared with those of the least square (LS) and unmodified PSO identification algorithms, a great improvement in the identification accuracy of the algorithm is achieved. The control effect in the actual control system is also much better than those of the LS and PSO algorithms.

For patients with ankle injuries, rehabilitation training is an important and effective way to help patients restore their ankle complex's motor abilities. Aiming to improve the accuracy and performance of ankle rehabilitation, the authors focus on the control strategies of the developed parallel ankle rehabilitation robot with novel 2-UPS/RRR mechanism. Firstly, the kinematics model of the mechanism is established, and they deduce the inverse solution of positions as well as the velocity mapping between the driving speed and the robot's angular velocity, based on which they realise the trajectory tracking control in the process of passive rehabilitation training. Secondly, they set up experiments to determine the torque threshold that can be used to detect the motion intention of ankle joint, and then they propose the active rehabilitation training strategy according to the motion intention detection. Finally, experiments were carried out with healthy subjects, with results showing that the trajectory tracking error during passive rehabilitation training is very small, and the moving platform of the ankle rehabilitation robot can drive the ankle joint to the detected motion intention direction at a constant speed flexibly and smoothly, which verifies the effectiveness of the control strategies for ankle rehabilitation training.

This study aims to determine the spiritual behavior of patients rehabilitating drugs. This discussion is entitled "Spiritual Counseling Guidance to Rehabilitation Patients". This research is qualitative with a descriptive approach that is observation, an interview. The results showed that the implementation of the rehabilitation of the Patients of Drugs can also be in the form of personality by providing guidance and counseling on the spiritual aspect which includes the aspect of Prayer Fulfillment performed by the five subjects are conducted simultaneously namely the practice of worship, the belief of life (Universality) as well as the responsibility of their life (Linkage) they have fully undergone as rehabilitation patients. There are an attitude and mental change from a previously dependent patient to a person who can manage himself well and more appreciate the meaning of life.

For patients with ankle injuries, rehabilitation training is an important and effective way to help patients restore their ankle complex's motor abilities. Aiming to improve the accuracy and performance of ankle rehabilitation, the authors focus on the control strategies of the developed parallel ankle rehabilitation robot with novel 2‐UPS/RRR mechanism. Firstly, the kinematics model of the mechanism is established, and they deduce the inverse solution of positions as well as the velocity mapping between the driving speed and the robot's angular velocity, based on which they realise the trajectory tracking control in the process of passive rehabilitation training. Secondly, they set up experiments to determine the torque threshold that can be used to detect the motion intention of ankle joint, and then they propose the active rehabilitation training strategy according to the motion intention detection. Finally, experiments were carried out with healthy subjects, with results showing that the trajectory tracking error during passive rehabilitation training is very small, and the moving platform of the ankle rehabilitation robot can drive the ankle joint to the detected motion intention direction at a constant speed flexibly and smoothly, which verifies the effectiveness of the control strategies for ankle rehabilitation training. [ABSTRACT FROM AUTHOR]

The lack of patient effort during robot‐assisted gait training (RAGT) is thought to be the main factor behind unsatisfactory rehabilitative efficacy among hemiparetic stroke patients. A key milestone to implement patient‐driven RAGT is to predict gait intent prior to actual joint movement. Here, the authors propose a method of predicting step speed intent via surface electromyogram (EMG) signals from the soleus. Six lower‐limb muscles were initially evaluated on a treadmill, and the results suggest that the soleus EMG signals correlate well with step speed. The authors further propose a simple linear regression model which predicts subsequent step speed via current soleus EMG signals with over‐ground gait sessions, R2 of ∼0.6. The proposed experimental results and simple prediction model should be applicable for RAGT without significant modifications. [ABSTRACT FROM AUTHOR]

Medicine aims toward [ABSTRACT FROM AUTHOR]

The articles in this special section focus on signal processing for neurorehabilitation and assistive technologies. [ABSTRACT FROM AUTHOR]

Venous leg ulcerations are a common problem, with high prevalence in the middle-aged and elderly population, and more attention on research of their physical activities has been paid, as they have great effects on the blood circulation of the lower limb. With enough, appropriate training, the chronic venous ulcerations in the lower limb can be avoided and alleviated, and venous hypertension can be reduced effectively. The study deals with a physical activity tracking system for the patients based on a three-axis accelerometer. The system uses a three-axis accelerometer, a microcontroller, and a wireless Bluetooth module to form a data acquisition platform to acquire accelerations of the lower limb movement, and sends it to a smart mobile phone via the wireless Bluetooth module. The system takes advantages of the smart mobile phone to guide the chronic venous leg ulcers to do prescribed rehabilitation exercises for the lower limb muscles, perform acceleration data preprocessing, wavelet transform and reconstruction, denoising and feature extraction, obtain the results of the rehabilitation exercises, and then give reasonable evaluation and judgment. It is helpful to treat underlying venous reflux, create such an environment that allows skin to grow across an ulcer, and accelerate ulcer healing process consequently.

Lower extremity exoskeleton systems have been widely applied in walking assistance, rehabilitation, and augmentation-related applications merely through human-exoskeleton movement collaboration, which cannot analyse cognitive load and pressure of pilots. Cognitive exoskeleton systems can reinforce cognitive cooperation of the human-exoskeleton systems through perception and assessment. Cognitive cloud exoskeleton systems can enhance the ability of the continuous learning and transfer learning of the exoskeleton systems through cloud brain platform. This paper presents a cognitive cloud exoskeleton system Cognitive Cloud AssItive DEvice for paralysed patient (c^2AIDER). The main idea is that the cooperation between the c^2AIDER system and pilots is more intelligent and natural through cloud brain platform, which can achieve high-performance computing thus providing better walking assistance for pilots.

Post-traumatic stress disorder (PTSD) is an anxiety condition caused by exposure to severe trauma. It is characterised by nightmares, flashbacks, hyper-vigilance and avoidance behaviour. These all lead to impaired functioning reducing quality of life. PTSD affects 2-5% of the population globally. Most sufferers cannot access effective treatment, leading to impaired psychological functioning reducing quality of life. Eye movement desensitisation and reprocessing (EMDR) is a non-invasive brain stimulation treatment that has shown significant clinical effectiveness in PTSD. Another treatment modality, that is, trauma-focused cognitive behavioural therapy is also an effective intervention. However, both evidence-based treatments are significantly resource intensive as they need trained therapists to deliver them. A concept of a neuro-digital tool for development is proposed to put to clinical practice of delivering EMDR to improve availability, efficiency and effectiveness of treatment. The evidence in using new technologies to measure sleep, geolocation and conversational analysis of social media to report objective outcome measures is explored. If achieved, this can be fed back to users with data anonymously collated to evaluate and improve the tool. Coproduction would be at the heart of product development so that the tool is acceptable and accessible to people with the condition., Competing Interests: Richard Laugharne and Rohit Shankar are directors of Psychoanalytica, which is a non‐commercial social enterprise Psychoanalytica. Christopher James and Rohit Shankar are co‐investigators of the N‐Code EPSRC grant which funded the study group involved in designing this paper. Christopher James is the current editor‐in chief of the journal. Rohit Shankar has received institutional and research support from LivaNova, UCB, Eisai, Veriton Pharma, Neuraxpharm, Bial, Angelini, UnEEG and Jazz/GW Pharma outside the submitted work. No other author has any declared conflict of interest related to this paper., (© 2023 The Authors. Healthcare Technology Letters published by John Wiley & Sons Ltd on behalf of The Institution of Engineering and Technology.)

While optical motion analysis systems can provide high‐fidelity gait parameters, they are usually impractical for local clinics and home use, due to high cost, requirement for large space, and lack of portability. In this study, the authors focus on a cost‐effective and portable, single‐camera gait analysis solution, based on video acquisition with calibration, autonomous detection of frames‐of‐interest, Kalman‐filter + structural‐similarity‐based marker tracking, and autonomous knee angle calculation. The proposed system is tested using 15 participants, including 10 stroke patients and 5 healthy volunteers. The evaluation of autonomous frames‐of‐interest detection shows only 0.2% difference between the frame number of the detected frame compared to the frame number of the manually labelled ground truth frame, and thus can replace manual labelling. The system is validated against a gold standard optical motion analysis system, using knee angle accuracy as metric of assessment. The accuracy investigation between the RGB‐ and the greyscale‐video marker tracking schemes shows that the greyscale system suffers from negligible accuracy loss with a significant processing speed advantage. Experimental results demonstrate that the proposed system can automatically estimate the knee angle, with R‐squared value larger than 0.95 and Bland‐Altman plot results smaller than 3.0127° mean error. [ABSTRACT FROM AUTHOR]

This research work presents the design of the electronics modules of Adam's Hand, a transradial myoelectric prosthesis based on an innovative mechanism which can actuate five three‐phalanges fingers (15 degrees of freedom) with just one motor, instead of the five/six motors conventionally used in other prosthetic devices; moreover, the prosthesis uses two servomotors to actuate the wrist movements. Adam's Hand fingertips are provided with temperature and pressure sensors, while the user myoelectric signals are acquired wirelessly by means of the Myo armband, a wearable device provided with eight electromyography electrodes, a nine‐axis inertial measurement unit, and a transmission module. These data are received through an HM‐11 BLE module, connected to Adam's Hand custom PCB, which features an Arduino Micro board. This board processes all the data and drives the actuators by means of properly chosen drivers. A Raspberry Pi 3 board manages a touchscreen display – which can be used to visualise the gathered data – and sends them to a dedicate cloud platform, so that the orthopaedic technicians who take care of Adam's Hand users can monitor them in real time, thus improving their recovery during the rehabilitation period. [ABSTRACT FROM AUTHOR]

MEMS based wireless sensor network (WSN) for real‐time human health monitoring is promising in home‐based rehabilitation. It requires effective integration of a number of MEMS sensors and their placement on the human body to create a wireless body area network for continuous and timely monitoring of various biophysical parameters. This study attempts to develop an XBee‐based WSN for real‐time monitoring of human gait. Traditionally, the optical motion systems were used for gait analysis but they suffer from certain limitations such as the development of the complex algorithm and constrains in the work space. In comparison to the optical system, the attractive benefits of MEMS‐based sensor systems are small size and low cost. Magnetic field angular rate and gravity sensor system can perform a complete analysis of the human gait. The sensor modules were developed using the inertial sensors mainly accelerometer and gyro sensor. LabVIEW software is used for data acquisition from the body sensor nodes and gait analysis. Biometrics Lab System is used as the standard system for calibration of data obtained from sensors. The joint angle range of motion was calculated using both the systems. The advantage of the proposed system is that it facilitates wireless transmission of gait parameters (joint angle measurement) for easy monitoring of human gait in various rehabilitation programmes. [ABSTRACT FROM AUTHOR]

Virtual reality (VR) applications meet fundamental principles of rehabilitation: intensity, task oriented training, biofeedback, environments rich in stimuli, and motivation, all pivotal factors for the success of rehabilitation programs. This paper describes the development process of a set of VR minigames developed to increase the motivation of stroke patients while performing repetitive upper limb movements. [ABSTRACT FROM AUTHOR]

The growing trend of ageing has created many challenges. One of these challenges is the rehabilitation of individuals who take time, resources and manpower. The motivation for this study is to propose an ontology‐based automatic design methodology for use in intelligent rehabilitation systems in the Internet of things (IoTs). For interconnection, all health system resources in a network use IoT technology. In order to provide fast and effective rehabilitation for different patients, IoT is combined with ontology. The experimental results obtained from rehabilitation of the lower limbs show that the IoT‐based rehabilitation system works properly and an ontology‐based approach can help create an effective rehabilitation strategy, configure and quickly deploy all available resources with the requirements given. In this study, three types of biosensors have been selected. These biosensors are used for blood, saliva and breathing tests. The expansion of the growth and maturity of technology based on the Fisher‐Pry model is based on patent and bibliometrics analysis. The analysis of intellectual property rights according to their number indicates that blood vital sensors reached their turning point in 2009, but the vital sensors of saliva and respiration will reach their turning point and maturity with a delay of 8–14 years. [ABSTRACT FROM AUTHOR]

In this study, biological characteristic of manpower is analysed and then the structural of exoskeleton rehabilitation manipulator is designed base on the thought of modular. First, the overall assembly drawing is drawn by SolidWorks. Second, the controlled pneumatic system is designed. The mainly contents are selecting mini pneumatic cylinder as a driver and controlling electromagnetic reversing valve which can lead to the piston movement of cylinder by STM32F429 microcontroller. At last, the movement simulation of exoskeleton rehabilitation manipulator is done and analysed by ADAMS, and then the experimental research of the same move pattern with simulation is carried out. It is proved that the pneumatic exoskeleton rehabilitation manipulator system has certain reliability and feasibility. Furthermore, it has the ability to meet the rehabilitation needs of patients with finger movement disorders.

Breast cancer (BC) ranks first in the pattern of female malignancies (20.7 %) and remains the top cancer among women. Paget’s disease (PD) is a rare BC form that occurs in the orifice of the lactiferous tubes and that is characterized by involvement of the nipple, large ducts, often to form a lump in the breast; this rare abnormality is encountered in 0.5–5 % of all BC cases. PD has a number of peculiarities. According to different authors, PD is attended with invasive or noninvasive BC in most cases (90–98 %). The involvement is commonly multifocal. PD has a very high risk for a lump (100 and 96 % for palpable and nonpalpable breast tumors, respectively). Almost 50 % of these patients have palpable breast lumps. Despite the fact that the course of PD has its peculiarities because of the rarity of this abnormality, the approaches to its treatment are not different from those in other histopathological types of BC. As for the surgical treatment of PD, until the present time there have been many unsolved problems that remain a matter of debate. The surgical treatment of PD does not differ from the treatment of BC and is primarily determined by disease stage and tumor subtype. The volume of operations for PD varies: from Madden’s radical mastectomy to lumpectomy and sentinel lymph node biopsy. It should be kept in mind that besides nipple-areole complex involvement, invasive or noninvasive BC is often detected in PD. Organ-sparing surgery for PD is mainly a method of rehabilitation for patients. Whether organsparing surgery can be performed is also determined by breast size. Oncoplaplastic resections may be carried out for PD. If the patient wishes to preserve her breast, the range of both single-stage and delayed reconstructive operations is wide. The assessment of the biological features of a tumor and the more differentiated approach to therapy in this cohort of patents might improve considerable survival rates; the determination of indications for organ-sparing treatment is to improve quality of life in patients and their rehabilitation.

OBJECTIVE: To help patients with disabilities of the arm and shoulder recover the accuracy and stability of movements, a novel and simple virtual rehabilitation and evaluation system called the Kine-VRES system was developed using Microsoft Kinect. METHODS: First, several movements and virtual tasks were designed to increase the coordination, control and speed of the arm movements. The movements of the patients were then captured using the Kinect sensor, and kinematics-based interaction and real-time feedback were integrated into the system to enhance the motivation and self-confidence of the patient. Finally, a quantitative evaluation method of upper limb movements was provided using the recorded kinematics during hand-to-hand movement. RESULTS: A preliminary study of this rehabilitation system indicates that the shoulder movements of two participants with ataxia became smoother after three weeks of training (one hour per day). CONCLUSION: This case study demonstrated the effectiveness of the designed system, which could be promising for the rehabilitation of patients with upper limb disorders. [ABSTRACT FROM AUTHOR]

Given the flexibility and potential of cloud technologies, cloud-based rehabilitation frameworks have shown encouraging results as assistive tools for post-stroke disability rehabilitation exercises and treatment. To treat post-stroke disability, cloud-based rehabilitation offers great advantages over conventional, clinic-based rehabilitation, providing ubiquitous flexible rehabilitation services and storage while offering therapeutic feedback from a therapist in real-time during patients' rehabilitative movements. With the development of sensory technologies, cloud computing technology integrated with Augmented Reality (AR) may make therapeutic exercises more enjoyable. To achieve these objectives, this paper proposes a framework for cloud-based rehabilitation services, which uses AR technology along with other sensory technologies. We have designed a prototype of the framework that uses the mechanism of sensor gloves to recognize gestures, detecting the real-time condition of a patient doing rehabilitative exercises. This prototype framework is tested on twelve patients not using sensor gloves and on four patients wearing sensor gloves over six weeks. We found statistically significant differences between the forces exerted by patients’ fingers at week one compared to week six. Significant improvements in finger strength were found after six weeks of therapeutic rehabilitative exercises. [ABSTRACT FROM AUTHOR]

In this paper, a walker movement monitoring system is proposed for a standard walker and a front-wheeled walker. The walking parameters (step length, step time, step speed, and total walking distance) are accurately estimated from the movement of walker to provide a statistical analysis of rehabilitation assessment. First, a movement classification algorithm is proposed to identify walking styles (continuous rolling, step-by-step rolling, two back tips lifting, and complete lifting). Based on this classification, the movement of a walker can be estimated using either two encoders (only for front-wheeled walker) or an inertial measurement unit. The accuracy of walking parameter estimation is verified through five subjects’ experiments. In 20-m straight walking, the walking distance root mean square error is 0.1–0.3 m depending on walking styles. [ABSTRACT FROM PUBLISHER]

Objective: Functional electrical stimulation (FES) is conventionally performed by the stimulation of motor axons causing the muscle fibers innervated by these axons to contract. An alternative strategy that may evoke contractions with more natural motor unit behavior is to stimulate afferent fibers (primarily type Ia) to excite the motor neurons at the spinal level. The aim of the study was to investigate the range of forces that can be evoked in this way and the degree to which the torque can be controlled. Methods: We stimulated the tibial nerve of ten healthy participants at amplitudes at which the highest H-reflex with minimal M-wave was present. The evoked plantar flexion torque was recorded following short stimulation pulses (0.4 ms) with frequencies ranging from 20 to 200 Hz. Results: Across all subjects, the median highest evocable torque was 38.3% (quartiles: 16.9–51.0) of the maximum voluntary contraction torque (MVC). The average torque variability (standard deviation) was 1.7 +/- 0.7% MVC. For most subjects, the relation between stimulation frequency and evoked torque was well characterized by sigmoidal curves (median root mean square error: 6.4% MVC). The plateau of this sigmoid curve (indicating the range of frequencies over which torque amplitude could be modulated) was reached at 56.0 (quartiles: 29.4–81.9) Hz. Conclusion: Using the proposed method for FES, substantial evoked torques that could be controlled by stimulation frequency were achieved. Significance: Stimulation of afferent fibers could be a useful and fatigue-resistant strategy for several applications of FES. [ABSTRACT FROM PUBLISHER]

The outcome for patients diagnosed with facial palsy has been shown to be linked to rehabilitation. Dense 3D morphable models have been shown within the computer vision to create accurate representations of human faces even from single 2D images. This has the potential to provide feedback to both the patient and medical expert dealing with the rehabilitation plan. It is proposed that a framework for the creation and measuring of patient facial movement consisting of a hybrid 2D facial landmark fitting technique which shows better accuracy in testing than current methods and 3D model fitting.