Technologies for Monitoring and Rehabilitation of Motor Disabilities

A special issue of Bioengineering (ISSN 2306-5354).

Deadline for manuscript submissions: closed (31 July 2024) | Viewed by 12771

Special Issue Editors


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Guest Editor
Institute of Electronics, Computer and Telecommunication Engineering, National Research Council, 10129 Turin, Italy
Interests: vision systems; motion capture and analysis; technologies for health monitoring; motor rehabilitation; machine learning; artificial intelligence; parkinson's disease; movement disorders
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Guest Editor
Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milano, Italy
Interests: bioengineering; movement analysis; biomechanics; rehabilitation; healthcare
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Motor disabilities are a major consequence of acute events, neurodegenerative processes, accidents, and injuries, severely impacting people's safety, independence, and quality of life. Dysfunctions in gait, postural stability and balance, upper limbs, and hand dexterity are among the most evident and disabling motor impairments. In addition, motor disabilities are strictly related to speech, swallowing, or facial expression disorders. Deficits in planning, control, and motor coordination impair the simplest daily activities, negatively affecting the psychological and emotional domains (frustration, depression, and anxiety are common consequences), thus complicating an already compromised clinical picture. Rehabilitation treatments aim to restore and optimize impaired functions through tailored physical activities and physiotherapy programs in order to regain autonomy and improve quality of life. However, traditional rehabilitation programs generally last only a few weeks and are accessible in health facilities to only a few patients at a time. Thanks to recent developments, technologies are already gaining more space in supporting the clinical management of patients. However, technologies may also play a crucial role in rehabilitation by integrating traditional protocols with new tools and methodological approaches that ensure continuity of treatment, home usability, and accessibility to more patients. Another advantage of technological solutions is the possibility to monitor performance quantitatively, continuously, and objectively, thus allowing improvements and worsening to be measured and interventional strategies (pharmacological and rehabilitative) to be customized based on the patient's current condition.

This Special Issue aims to collect recent studies and applications focused on the use of technological solutions and methodological approaches for rehabilitation and monitoring of motor disabilities and related effects. We welcome authors submitting manuscripts (original papers, reviews, and others) that focus on, but are not limited to, the following topics:

  • Sensors for rehabilitation and monitoring of motor disabilities (such as wearable sensors, optical sensors, video analysis, electromyography, smart textiles, and sensorized fabrics);
  • Innovative approaches for rehabilitation (such as virtual reality, augmented reality, exergaming, serious games, and gamification);
  • Artificial intelligence, machine, and deep learning to support clinical decision making;
  • Usability issues related to technological approaches for rehabilitation.

You may choose our Joint Special Issue in IJERPH.

Dr. Claudia Ferraris
Prof. Dr. Veronica Cimolin
Guest Editors

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Keywords

  • motor disabilities
  • technologies for health monitoring
  • motor rehabilitation
  • movement disorders
  • movement analysis

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Published Papers (5 papers)

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Research

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18 pages, 3067 KiB  
Article
User Perspectives and Psychophysiological Manifestations of Fatigue with Trunk Orthosis for Dystrophinopathy Patients
by Ahmad Zahid Rao, Muhammad Danish Mujib, Muhammad Abul Hasan, Ahmad O. Alokaily, Tayyaba Tahira and Saad Ahmed Qazi
Bioengineering 2024, 11(8), 780; https://doi.org/10.3390/bioengineering11080780 - 1 Aug 2024
Cited by 1 | Viewed by 1030
Abstract
The chair-mounted passive trunk orthosis (CMPTO) is designed to enhance wheelchair safety for individuals with dystrophinopathy during their daily activities. Given the disease’s progressive nature, it is crucial to ensure that assistive devices are carefully evaluated to prevent overexertion. This study aims to [...] Read more.
The chair-mounted passive trunk orthosis (CMPTO) is designed to enhance wheelchair safety for individuals with dystrophinopathy during their daily activities. Given the disease’s progressive nature, it is crucial to ensure that assistive devices are carefully evaluated to prevent overexertion. This study aims to assess the CMPTO’s user experience and its impact on fatigue-related psychophysiological measurements. We conducted electromyography (EMG) evaluations of four trunk muscles and assessed perceived exertion using the Borg CR-10 scale in 40 healthy subjects while they performed seated maximal reaching tasks with the CMPTO. Additionally, fifteen dystrophinopathy patients evaluated the CMPTO for usability with the System Usability Scale. Paired t-tests were employed to compare the median frequency (MDF) of EMG signals, the Wilcoxon signed-rank test for evaluating exertion, and the Mann–Whitney U test to compare the usability reported by patients to those of healthy subjects. The 4-way ANOVA revealed that MDF patterns were significantly influenced by task orientation for each muscle. The CMPTO did not cause a significant reduction in the MDF. Tasks requiring greater trunk rotation were perceived as more exhaustive. Patients reported acceptable usability with the CMPTO, with scores higher than those of healthy subjects. The CMPTO’s usability was comprehensively evaluated in both healthy subjects and patients with dystrophinopathy. Our findings indicate that the CMPTO can be safely used by individuals with dystrophinopathy as an assistive device to improve seated comfort and functional abilities. Full article
(This article belongs to the Special Issue Technologies for Monitoring and Rehabilitation of Motor Disabilities)
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18 pages, 2562 KiB  
Article
Electroencephalogram Alpha Oscillations in Stroke Recovery: Insights into Neural Mechanisms from Combined Transcranial Direct Current Stimulation and Mirror Therapy in Relation to Activities of Daily Life
by Chia-Lun Liu, Ya-Wen Tu, Ming-Wei Li, Ku-Chou Chang, Chih-Hung Chang, Chih-Kuang Chen and Ching-Yi Wu
Bioengineering 2024, 11(7), 717; https://doi.org/10.3390/bioengineering11070717 - 15 Jul 2024
Cited by 1 | Viewed by 1376
Abstract
The goal of stroke rehabilitation is to establish a robust protocol for patients to live independently in community. Firstly, we examined the impact of 3 hybridized transcranial direct current stimulation (tDCS)-mirror therapy interventions on activities of daily life (ADL) in stroke patients. Secondly, [...] Read more.
The goal of stroke rehabilitation is to establish a robust protocol for patients to live independently in community. Firstly, we examined the impact of 3 hybridized transcranial direct current stimulation (tDCS)-mirror therapy interventions on activities of daily life (ADL) in stroke patients. Secondly, we explored the underlying therapeutic mechanisms with theory-driven electroencephalography (EEG) indexes in the alpha band. This was achieved by identifying the unique contributions of alpha power in motor production to ADL in relation to the premotor cortex (PMC), primary cortex (M1), and Sham tDCS with mirror therapy. The results showed that, although post-intervention ADL improvement was comparable among the three tDCS groups, one of the EEG indexes differentiated the interventions. Neural-behavioral correlation analyses revealed that different types of ADL improvements consistently corresponded with alpha power in the temporal lobe exclusively in the PMC tDCS group (all rs > 0.39). By contrast, alterations in alpha power in the central-frontal region were found to vary, with ADL primarily in the M1 tDCS group (r = −0.6 or 0.7), with the benefit depending on the complexity of the ADL. In conclusion, this research suggested two potential therapeutic mechanisms and demonstrated the additive benefits of introducing theory-driven neural indexes in explaining ADL. Full article
(This article belongs to the Special Issue Technologies for Monitoring and Rehabilitation of Motor Disabilities)
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19 pages, 5999 KiB  
Article
The Effect of a New Generation of Ankle Foot Orthoses on Sloped Walking in Children with Hemiplegia Using the Gait Real Time Analysis Interactive Lab (GRAIL)
by Federica Camuncoli, Giorgia Malerba, Emilia Biffi, Eleonora Diella, Eugenio Di Stanislao, Guerrino Rosellini, Daniele Panzeri, Luigi Piccinini and Manuela Galli
Bioengineering 2024, 11(3), 280; https://doi.org/10.3390/bioengineering11030280 - 16 Mar 2024
Viewed by 1730
Abstract
Cerebral palsy poses challenges in walking, necessitating ankle foot orthoses (AFOs) for stability. Gait analysis, particularly on slopes, is crucial for effective AFO assessment. The study aimed to compare the performance of commercially available AFOs with a new sports-specific AFO in children with [...] Read more.
Cerebral palsy poses challenges in walking, necessitating ankle foot orthoses (AFOs) for stability. Gait analysis, particularly on slopes, is crucial for effective AFO assessment. The study aimed to compare the performance of commercially available AFOs with a new sports-specific AFO in children with hemiplegic cerebral palsy and to assess the effects of varying slopes on gait. Eighteen participants, aged 6–11, with hemiplegia, underwent gait analysis using GRAIL technology. Two AFO types were tested on slopes (uphill +10 deg, downhill −5 deg, level-ground). Kinematic, kinetic, and spatiotemporal parameters were analyzed. The new AFO contributed to significant changes in ankle dorsi-plantar-flexion, foot progression, and trunk and hip rotation during downhill walking. Additionally, the new AFO had varied effects on spatiotemporal gait parameters, with an increased stride length during downhill walking. Slope variations significantly influenced the kinematics and kinetics. This study provides valuable insights into AFO effectiveness and the impact of slopes on gait in hemiplegic cerebral palsy. The findings underscore the need for personalized interventions, considering environmental factors, and enhancing clinical and research approaches for improving mobility in cerebral palsy. Full article
(This article belongs to the Special Issue Technologies for Monitoring and Rehabilitation of Motor Disabilities)
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10 pages, 3537 KiB  
Article
Control of Tibial Advancement by the Plantar Flexors during the Stance Phase of Gait Depends on Knee Flexion with Respect to the Ground Reaction Force
by Reinald Brunner and Carlo Albino Frigo
Bioengineering 2024, 11(1), 41; https://doi.org/10.3390/bioengineering11010041 - 31 Dec 2023
Cited by 2 | Viewed by 2346
Abstract
During the stance phase of a normal gait, the triceps surae muscle controls the advancement of the tibia, which contributes to knee extension. Plantar flexor weakness results in excessive dorsiflexion, and consequently, the knee loses this contribution. However, increasing knee flexion is also [...] Read more.
During the stance phase of a normal gait, the triceps surae muscle controls the advancement of the tibia, which contributes to knee extension. Plantar flexor weakness results in excessive dorsiflexion, and consequently, the knee loses this contribution. However, increasing knee flexion is also seen in patients with cerebral palsy who do not have plantar flexor weakness. We aimed to understand this mechanism through the use of a musculoskeletal dynamic model. The model consists of solid segments connected with rotatory joints and springs to represent individual muscles. It was positioned at different degrees of ankle plantarflexion, knee flexion, and hip flexion. The soleus muscle was activated concentrically to produce plantarflexion and push the foot against the ground. The resulting knee extension was analyzed. The principal determinant of knee flexion or extension associated with ankle plantarflexion was the position of the knee joint center. When this was anterior to the line of action of the ground reaction force (GRF), the soleus contraction resulted in increased knee flexion. The knee extension was obtained when the knee was flexed less than approximately 25°. The relation between joint angles, anthropometric parameters, and the position of the GRF was expressed in a mathematical formulation. The clinical relevance of this model is that it explains the failure of plantar flexor control on knee extension in patients with cerebral palsy, when increased knee flexion can occur even if there is a normal or plantarflexed foot position. Full article
(This article belongs to the Special Issue Technologies for Monitoring and Rehabilitation of Motor Disabilities)
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Review

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27 pages, 3874 KiB  
Review
fNIRS-EEG BCIs for Motor Rehabilitation: A Review
by Jianan Chen, Yunjia Xia, Xinkai Zhou, Ernesto Vidal Rosas, Alexander Thomas, Rui Loureiro, Robert J. Cooper, Tom Carlson and Hubin Zhao
Bioengineering 2023, 10(12), 1393; https://doi.org/10.3390/bioengineering10121393 - 6 Dec 2023
Cited by 9 | Viewed by 5353
Abstract
Motor impairment has a profound impact on a significant number of individuals, leading to a substantial demand for rehabilitation services. Through brain–computer interfaces (BCIs), people with severe motor disabilities could have improved communication with others and control appropriately designed robotic prosthetics, so as [...] Read more.
Motor impairment has a profound impact on a significant number of individuals, leading to a substantial demand for rehabilitation services. Through brain–computer interfaces (BCIs), people with severe motor disabilities could have improved communication with others and control appropriately designed robotic prosthetics, so as to (at least partially) restore their motor abilities. BCI plays a pivotal role in promoting smoother communication and interactions between individuals with motor impairments and others. Moreover, they enable the direct control of assistive devices through brain signals. In particular, their most significant potential lies in the realm of motor rehabilitation, where BCIs can offer real-time feedback to assist users in their training and continuously monitor the brain’s state throughout the entire rehabilitation process. Hybridization of different brain-sensing modalities, especially functional near-infrared spectroscopy (fNIRS) and electroencephalography (EEG), has shown great potential in the creation of BCIs for rehabilitating the motor-impaired populations. EEG, as a well-established methodology, can be combined with fNIRS to compensate for the inherent disadvantages and achieve higher temporal and spatial resolution. This paper reviews the recent works in hybrid fNIRS-EEG BCIs for motor rehabilitation, emphasizing the methodologies that utilized motor imagery. An overview of the BCI system and its key components was introduced, followed by an introduction to various devices, strengths and weaknesses of different signal processing techniques, and applications in neuroscience and clinical contexts. The review concludes by discussing the possible challenges and opportunities for future development. Full article
(This article belongs to the Special Issue Technologies for Monitoring and Rehabilitation of Motor Disabilities)
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