International Journal of Environmental Research and Public Health

Research

14 pages, 572 KiB

Open AccessArticle

Binaural Listening with Head Rotation Helps Persons with Blindness Perceive Narrow Obstacles

by Takahiro Miura, Naoyuki Okochi, Junya Suzuki and Tohru Ifukube

Int. J. Environ. Res. Public Health 2023, 20(8), 5573; https://doi.org/10.3390/ijerph20085573 - 19 Apr 2023

Cited by 2 | Viewed by 1551

Orientation and mobility (O&M) are important abilities that people with visual impairments use in their independent performance of daily activities. In orientation, people with total blindness pinpoint nonsounding objects and sounding objects. The ability to perceive nonsounding objects is called obstacle sense, [...] Read more.

Orientation and mobility (O&M) are important abilities that people with visual impairments use in their independent performance of daily activities. In orientation, people with total blindness pinpoint nonsounding objects and sounding objects. The ability to perceive nonsounding objects is called obstacle sense, wherein people with blindness recognize the various characteristics of an obstacle using acoustic cues. Although body movement and listening style may enhance the sensing of obstacles, experimental studies on this topic are lacking. Elucidating their contributions to obstacle sense may lead to the further systematization of techniques of O&M training. This study sheds light on the contribution of head rotation and binaural hearing to obstacle sense among people with blindness. We conducted an experiment on the perceived presence and distance of nonsounding obstacles, which varied width and distance, for participants with blindness under the conditions of binaural or monaural hearing, with or without head rotation. The results indicated that head rotation and binaural listening can enhance the localization of nonsounding obstacles. Further, when people with blindness are unable to perform head rotation or use binaural hearing, their judgment can become biased in favor of the presence of an obstacle due to risk avoidance. Full article

(This article belongs to the Special Issue Advanced Rehabilitative and Assistive Engineering for Older Adults and People with Disabilities)

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10 pages, 3286 KiB

Open AccessArticle

Quantitative Measurement of the Pressure and Shear Stress Acting on the Body of a Wheelchair User Using a Wearable Sheet-Type Sensor: A Preliminary Study

by Satoshi Shirogane, Shigeru Toyama, Motonori Hoshino, Atsushi Takashima and Toshiaki Tanaka

Int. J. Environ. Res. Public Health 2022, 19(20), 13579; https://doi.org/10.3390/ijerph192013579 - 20 Oct 2022

Cited by 3 | Viewed by 2220

Abstract

To provide a safer sitting environment for wheelchair users, it is important to quantitatively measure the forces acting on the contact surface between the seat and the person in the wheelchair. In addition to the pressure acting on the buttocks, shear forces have [...] Read more.

To provide a safer sitting environment for wheelchair users, it is important to quantitatively measure the forces acting on the contact surface between the seat and the person in the wheelchair. In addition to the pressure acting on the buttocks, shear forces have received particular attention in recent years; however, measuring shear force is more difficult than measuring pressure. To obtain this measurement, a thin and flexible sensor that can be used in a natural state on a wheelchair is needed. Therefore, we constructed a measurement system using our previously developed wearable sheet-type sensor (0.9 mm thick). In this study, preliminary tests were conducted using human dummies before testing on humans. Sensors were placed in four locations on the humanoid dummy’s back and buttocks, and the electric wheelchair was tilted and reclined five times each. The results showed that the sensor output pattern was reproducible and valid enough to proceed to the next step. However, the shear force in the internal and external directions was greater than expected, which indicates that the equipment and testing methods must be reviewed. On the basis of the results obtained in this preliminary study, preparations will be made for testing on human subjects. Full article

(This article belongs to the Special Issue Advanced Rehabilitative and Assistive Engineering for Older Adults and People with Disabilities)

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29 pages, 4625 KiB

Open AccessArticle

Statistical Study of User Perception of Smart Homes during Vital Signal Monitoring with an Energy-Saving Algorithm

by Carolina Del-Valle-Soto, Juan Arturo Nolazco-Flores, Jose Alberto Del Puerto-Flores, Ramiro Velázquez, Leonardo J. Valdivia, Julio Rosas-Caro and Paolo Visconti

Int. J. Environ. Res. Public Health 2022, 19(16), 9966; https://doi.org/10.3390/ijerph19169966 - 12 Aug 2022

Cited by 4 | Viewed by 2028

Abstract

Sensor networks are deployed in people’s homes to make life easier and more comfortable and secure. They might represent an interesting approach for elderly care as well. This work highlights the benefits of a sensor network implemented in the homes of a group [...] Read more.

Sensor networks are deployed in people’s homes to make life easier and more comfortable and secure. They might represent an interesting approach for elderly care as well. This work highlights the benefits of a sensor network implemented in the homes of a group of users between 55 and 75 years old, which encompasses a simple home energy optimization algorithm based on user behavior. We analyze variables related to vital signs to establish users’ comfort and tranquility thresholds. We statistically study the perception of security that users exhibit, differentiating between men and women, examining how it affects the person’s development at home, as well as the reactivity of the sensor algorithm, to optimize its performance. The proposed algorithm is analyzed under certain performance metrics, showing an improvement of 15% over a sensor network under the same conditions. We look at and quantify the usefulness of accurate alerts on each sensor and how it reflects in the users’ perceptions (for men and women separately). This study analyzes a simple, low-cost, and easy-to-implement home-based sensor network optimized with an adaptive energy optimization algorithm to improve the lives of older adults, which is capable of sending alerts of possible accidents or intruders with the highest efficiency. Full article

(This article belongs to the Special Issue Advanced Rehabilitative and Assistive Engineering for Older Adults and People with Disabilities)

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10 pages, 2427 KiB

Open AccessArticle

Influence of Varied Load Assistance with Exoskeleton-Type Robotic Device on Gait Rehabilitation in Healthy Adult Men

by Toshiaki Tanaka, Ryo Matsumura and Takahiro Miura

Int. J. Environ. Res. Public Health 2022, 19(15), 9713; https://doi.org/10.3390/ijerph19159713 - 6 Aug 2022

Cited by 3 | Viewed by 1935

Abstract

This study aimed to clarify how the power-assist function of the hybrid assistive limb (HAL^®), an exoskeleton-type gait-assist device, affected the gait characteristics of patients who wear it, specifically focusing on the “misalignment” of the robot joints and landmarks with the [...] Read more.

This study aimed to clarify how the power-assist function of the hybrid assistive limb (HAL^®), an exoskeleton-type gait-assist device, affected the gait characteristics of patients who wear it, specifically focusing on the “misalignment” of the robot joints and landmarks with the corresponding body parts. Five healthy adult men were video-recorded wearing the HAL^® as they walked normally on a treadmill under seven conditions corresponding to the strengths and sites of robotic power assistance. For kinematic analysis, reflective markers were attached to the HAL^® and the wearer at key locations, and participants were recorded walking past a set of four video cameras for each condition. A motion analysis system was used for analysis. The walking motion was segmented into eight-phase gait cycles. Knee misalignment, or the relative offset in position of the HAL^®/wearer knee joints, was calculated from kinematic data and joint angles. These values were compared with respect to two factors: assist level and gait phase. Statistical analysis consisted of parametric and nonparametric tests for comparing the values of misalignment of each gait phase, followed by multiple comparisons to confirm significant differences. The results showed that the knee misalignment was greatest in the pre-swing phase and was significantly lower overall in conditions with high levels of power assistance. The result of greater knee misalignment in the pre-swing phase may be attributed to the structural properties of the HAL^® lower-limb exoskeleton. This provides valuable insight regarding the walking stages that should be given special attention during the evaluation of synchrony between exoskeleton-type gait-assist robots and their wearers. Full article

(This article belongs to the Special Issue Advanced Rehabilitative and Assistive Engineering for Older Adults and People with Disabilities)

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15 pages, 2994 KiB

Open AccessArticle

Application of Spatial Cues and Optical Distortions as Augmentations during Virtual Reality (VR) Gaming: The Multifaceted Effects of Assistance for Eccentric Viewing Training

by Alexandra Sipatchin, Miguel García García, Yannick Sauer and Siegfried Wahl

Int. J. Environ. Res. Public Health 2022, 19(15), 9571; https://doi.org/10.3390/ijerph19159571 - 4 Aug 2022

Cited by 1 | Viewed by 2037

Abstract

The present study investigates the effects of peripheral spatial cues and optically distorting augmentations over eccentric vision mechanisms in normally sighted participants with simulated scotoma. Five different augmentations were tested inside a virtual reality (VR)-gaming environment. Three were monocular spatial cues, and two [...] Read more.

The present study investigates the effects of peripheral spatial cues and optically distorting augmentations over eccentric vision mechanisms in normally sighted participants with simulated scotoma. Five different augmentations were tested inside a virtual reality (VR)-gaming environment. Three were monocular spatial cues, and two were binocular optical distortions. Each was divided into three conditions: baseline with normal viewing, augmentation with one of the assistance methods positioned around the scotoma, and one with only the simulated central scotoma. The study found that the gaming scenario induced eccentric viewing for the cued augmentation groups, even when the peripheral assistance was removed, while for the optical distortions group, the eccentric behavior disappeared after the augmentation removal. Additionally, an upwards directionality of gaze relative to target during regular gaming was found. The bias was maintained and implemented during and after the cued augmentations but not after the distorted ones. The results suggest that monocular peripheral cues could be better candidates for implementing eccentric viewing training in patients. At the same time, it showed that optical distortions might disrupt such behavior. Such results are noteworthy since distortions such as zoom are known to help patients with macular degeneration see targets of interest. Full article

(This article belongs to the Special Issue Advanced Rehabilitative and Assistive Engineering for Older Adults and People with Disabilities)

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14 pages, 2458 KiB

Open AccessArticle

Affective States and Virtual Reality to Improve Gait Rehabilitation: A Preliminary Study

by Jafet Rodriguez, Carolina Del-Valle-Soto and Javier Gonzalez-Sanchez

Int. J. Environ. Res. Public Health 2022, 19(15), 9523; https://doi.org/10.3390/ijerph19159523 - 3 Aug 2022

Cited by 3 | Viewed by 2169

Abstract

Over seven million people suffer from an impairment in Mexico; 64.1% are gait-related, and 36.2% are children aged 0 to 14 years. Furthermore, many suffer from neurological disorders, which limits their verbal skills to provide accurate feedback. Robot-assisted gait therapy has shown significant [...] Read more.

Over seven million people suffer from an impairment in Mexico; 64.1% are gait-related, and 36.2% are children aged 0 to 14 years. Furthermore, many suffer from neurological disorders, which limits their verbal skills to provide accurate feedback. Robot-assisted gait therapy has shown significant benefits, but the users must make an active effort to accomplish muscular memory, which usually is only around 30% of the time. Moreover, during therapy, the patients’ affective state is mostly unsatisfied, wide-awake, and powerless. This paper proposes a method for increasing the efficiency by combining affective data from an Emotiv Insight, an Oculus Go headset displaying an immersive interaction, and a feedback system. Our preliminary study had eight patients during therapy and eight students analyzing the footage using the self-assessment Manikin. It showed that it is possible to use an EEG headset and identify the affective state with a weighted average precision of 97.5%, recall of 87.9%, and F1-score of 92.3% in general. Furthermore, using a VR device could boost efficiency by 16% more. In conclusion, this method allows providing feedback to the therapist in real-time even if the patient is non-verbal and has a limited amount of facial and body expressions. Full article

(This article belongs to the Special Issue Advanced Rehabilitative and Assistive Engineering for Older Adults and People with Disabilities)

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7 pages, 627 KiB

Open AccessArticle

by Yusuke Maeda, Daisuke Sudo and Daiki Shimotori

Int. J. Environ. Res. Public Health 2022, 19(15), 9056; https://doi.org/10.3390/ijerph19159056 - 25 Jul 2022

Viewed by 1420

Abstract

Fall incidents are increasing every year and prevention is necessary. Preventing falls can increase the quality of life of the elderly and decrease medical costs. Stumbling and tripping are the main causes of falls and falls in the lateral direction, causing the hip [...] Read more.

Fall incidents are increasing every year and prevention is necessary. Preventing falls can increase the quality of life of the elderly and decrease medical costs. Stumbling and tripping are the main causes of falls and falls in the lateral direction, causing the hip fracture. This study aimed to analyze the accuracy and speed of lateral obstacle crossing in the elderly, especially from leaning posture. Twenty healthy older adults (6 men and 14 women, aged 71.7 ± 1.5 years) and 20 healthy young adults (5 men and 15 women, aged 21.4 ± 1.2 years) participated in this study. We set four conditions (normal, fast, leaning, and leaning fast), and participants crossed the obstacle laterally ten times under each condition. The crossing motion was captured using a three-dimensional analysis system. The trajectory of the foot, landed position, step time, center of gravity of the body, and moment of the lower extremity during the swing phase were calculated and compared between older and younger adults. In the leaning condition, the step time and knee moment of the elderly were significantly longer and larger than those of young adults. From the results of the trajectory of the foot and landed position in the leaning condition, motion inconsistency of the foot was found in the elderly. We believe that it is difficult for the elderly to perform the intended crossing motion and swing quickly because of aging. This inconsistency in motion is a serious cause of falls in the elderly. Full article

(This article belongs to the Special Issue Advanced Rehabilitative and Assistive Engineering for Older Adults and People with Disabilities)

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11 pages, 3012 KiB

Open AccessArticle

Monitoring Eye Movements Depending on the Type of Visual Stimulus in Patients with Impaired Consciousness Due to Brain Damage

by Katarzyna Kujawa, Alina Żurek, Agata Gorączko, Roman Olejniczak and Grzegorz Zurek

Int. J. Environ. Res. Public Health 2022, 19(10), 6280; https://doi.org/10.3390/ijerph19106280 - 22 May 2022

Cited by 4 | Viewed by 1707

Abstract

The eyeballs are often the only way to communicate messages as a result of brain damage. However, it is not uncommon for them to become dysfunctional, thus requiring the introduction of appropriate therapy. The trajectory of eye movements (saccadic movements and gaze fixation) [...] Read more.

The eyeballs are often the only way to communicate messages as a result of brain damage. However, it is not uncommon for them to become dysfunctional, thus requiring the introduction of appropriate therapy. The trajectory of eye movements (saccadic movements and gaze fixation) during observation of a static and dynamic point presented with an eye tracker was analyzed in the present study. Twelve patients with brain injury of different etiology, with different degrees of consciousness disorders and not communicating through verbal and motor skills, qualified for the study. All participants demonstrated greater eye movement activity when presented with a dynamic task in which they observed a moving point. The findings suggest that effective eye movement therapy must incorporate dynamic stimuli. Full article

(This article belongs to the Special Issue Advanced Rehabilitative and Assistive Engineering for Older Adults and People with Disabilities)

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9 pages, 824 KiB

Open AccessArticle

Effects of Robot-Assisted Gait Training with Body Weight Support on Gait and Balance in Stroke Patients

by Wonho Choi

Int. J. Environ. Res. Public Health 2022, 19(10), 5814; https://doi.org/10.3390/ijerph19105814 - 10 May 2022

Cited by 21 | Viewed by 4002

Abstract

This study investigated the effects of robot-assisted gait training with body weight support on gait and balance in stroke patients. The study participants comprised 24 patients diagnosed with stroke. Patients were randomly assigned to four groups of six: robot A, B, C, and [...] Read more.

This study investigated the effects of robot-assisted gait training with body weight support on gait and balance in stroke patients. The study participants comprised 24 patients diagnosed with stroke. Patients were randomly assigned to four groups of six: robot A, B, C, and non-robot. The body weight support (BWS) for the harness of the robot was set to 30% of the patient’s body weight in robot group A, 50% in robot group B, and 70% in robot group C. All experimental groups received robot-assisted gait training and general physical therapy. The non-robot group underwent gait training using a p-bar, a treadmill, and general physical therapy. The intervention was performed for 30 min a day, five times a week, for 6 weeks. All participants received the intervention after the pre-test. A post-test was performed after all of the interventions were completed. Gait was measured using a 10 m Walking test (10MWT) and the timed up and go (TUG) test. Balance was assessed using the Berg Balance Scale (BBS). Robot groups A, B, and C showed significantly better 10MWT results than did the non-robot group (p < 0.5). TUG was significantly shorter in robot groups A, B, and C than in the non-robot group (p < 0.5). The BBS scores for robot group A improved significantly more than did those for robot groups B and C and the non-robot group (p < 0.5), indicating that robot-assisted gait training with body weight support effectively improved the gait of stroke patients. Full article

(This article belongs to the Special Issue Advanced Rehabilitative and Assistive Engineering for Older Adults and People with Disabilities)

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13 pages, 1617 KiB

Open AccessArticle

Different Effects of 12-Week Speed or Accuracy Training on Obstacle-Crossing Foot Motion in Healthy Elderly

by Yusuke Maeda, Daisuke Sudo and Daiki Shimotori

Int. J. Environ. Res. Public Health 2022, 19(8), 4596; https://doi.org/10.3390/ijerph19084596 - 11 Apr 2022

Cited by 2 | Viewed by 1805

Abstract

Preventing falls is important in the elderly. One reason for falling is tripping or stumbling; hence, it is important to improve the crossing motion. This study aimed to compare speed- and accuracy-oriented crossing training and establish a useful training method. To investigate the [...] Read more.

Preventing falls is important in the elderly. One reason for falling is tripping or stumbling; hence, it is important to improve the crossing motion. This study aimed to compare speed- and accuracy-oriented crossing training and establish a useful training method. To investigate the effects of crossing motion training, we conducted a randomized controlled trial. Twenty healthy elderly individuals (aged 71.7 ± 1.5 years) were randomly assigned to two groups: speed training and accuracy training groups. They practiced initiating their crossing motion faster or more accurately for 12 weeks. Using a three-dimensional motion analysis system, the data on the crossing motion was captured before and after the training period. We set four conditions (normal speed, fast, leaning stance, and leaning stance and fast) and two directions (anterior and lateral) to analyze the crossing motion. The crossing motion of the speed training group became significantly faster compared to baseline (p < 0.05); however, the accuracy of the crossing motion of the accuracy training group was not statistically significant. Speed training in this study had clear effects on crossing motion. It is surprising that crossing motion training from a normal upright stance can also improve swing speed from the leaning stance. We believe that this training is easy and useful in the elderly population. Full article

(This article belongs to the Special Issue Advanced Rehabilitative and Assistive Engineering for Older Adults and People with Disabilities)

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10 pages, 1344 KiB

Open AccessArticle

Effect of Knee Orthosis Pressure Variation on Muscle Activities during Sit-to-Stand Motion in Patients with Knee Osteoarthritis

by Hiroaki Yamamoto, Shogo Okamatsu, Kodai Kitagawa and Chikamune Wada

Int. J. Environ. Res. Public Health 2022, 19(3), 1341; https://doi.org/10.3390/ijerph19031341 - 25 Jan 2022

Cited by 1 | Viewed by 2857

Abstract

It is yet not known whether the variation in knee orthotics pressure would lead to changes in muscle activity during-sit-to-stand postural transition in patients with knee osteoarthritis (OA). Participants in this analytical study were patients with knee OA. The research design was a [...] Read more.

It is yet not known whether the variation in knee orthotics pressure would lead to changes in muscle activity during-sit-to-stand postural transition in patients with knee osteoarthritis (OA). Participants in this analytical study were patients with knee OA. The research design was a cross-sectional study. They were enrolled in the study through a sample of convenience method. The primary outcome measure was surface electromyography for measuring muscle activity while changing knee orthotics pressure during sit-to-stand motion. Data were summarized with mean and standard deviation while Friedman’s test was performed for multiple comparison of variables, at a significance level of p = 0.05. Seven elderly patients with knee osteoarthritis (mean age 71.4 ± 11.8 years) participated in the study. Moderate orthotics (7.3 mmHg) led to a significant increase in the percentage maximum voluntary contraction (MVC) of tibialis anterior compared to that obtained without orthotics. Rectus femoris, vastus medialis, vastus lateralis, and biceps femoris tended to increase the % MVC with an increase in wearing pressure. It was therefore concluded that the muscle activity during sit-to-stand motion could be increased in patients with knee osteoarthritis by wearing flexible orthotics with varying pressure. Full article

(This article belongs to the Special Issue Advanced Rehabilitative and Assistive Engineering for Older Adults and People with Disabilities)

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8 pages, 1171 KiB

Open AccessArticle

Different Effects of Robot-Assisted Gait and Independent Over-Ground Gait on Foot Plantar Pressure in Incomplete Spinal Cord Injury: A Preliminary Study

by Young-Hyeon Bae, Won Hyuk Chang and Shirley S. M. Fong

Int. J. Environ. Res. Public Health 2021, 18(22), 12072; https://doi.org/10.3390/ijerph182212072 - 17 Nov 2021

Cited by 3 | Viewed by 2237

Abstract

Background: There is insufficient evidence to establish the optimal treatment protocol for robot-assisted gait training. Objective: This study aimed to analyze the effects of robot-assisted gait and independent over-ground gait on foot pressure and to determine an effective training protocol for improvement of [...] Read more.

Background: There is insufficient evidence to establish the optimal treatment protocol for robot-assisted gait training. Objective: This study aimed to analyze the effects of robot-assisted gait and independent over-ground gait on foot pressure and to determine an effective training protocol for improvement of gait pattern in patients with incomplete spinal cord injury due to industrial accidents. Methods: Four patients with incomplete spinal cord injury due to an industrial accident who had gait disturbance underwent measurement of peak foot pressure and stance phase duration using a foot pressure analysis system with robot-assisted gait and independent over-ground gait. Results: The robot-assisted gait condition has lower peak foot pressure and shorter stance phase duration than the independent over-ground gait. Conclusions: In this study, robot-assisted gait was found to limit gait pattern improvement in patients with gait disturbance caused by incomplete spinal cord injury due to industrial accidents. Therefore, future research will be conducted to determine the optimal protocol for robot-assisted gait training for gait pattern improvement. Full article

(This article belongs to the Special Issue Advanced Rehabilitative and Assistive Engineering for Older Adults and People with Disabilities)

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18 pages, 2760 KiB

Open AccessArticle

Foot Position Measurement during Assistive Motion for Sit-to-Stand Using a Single Inertial Sensor and Shoe-Type Force Sensors

by Kodai Kitagawa, Ibai Gorordo Fernandez, Takayuki Nagasaki, Sota Nakano, Mitsumasa Hida, Shogo Okamatsu and Chikamune Wada

Int. J. Environ. Res. Public Health 2021, 18(19), 10481; https://doi.org/10.3390/ijerph181910481 - 6 Oct 2021

Cited by 3 | Viewed by 2315

Abstract

Assistive motion for sit-to-stand causes lower back pain (LBP) among caregivers. Considering previous studies that showed that foot position adjustment could reduce lumbar load during assistive motion for sit-to-stand, quantitative monitoring of and instructions on foot position could contribute toward reducing LBP among [...] Read more.

Assistive motion for sit-to-stand causes lower back pain (LBP) among caregivers. Considering previous studies that showed that foot position adjustment could reduce lumbar load during assistive motion for sit-to-stand, quantitative monitoring of and instructions on foot position could contribute toward reducing LBP among caregivers. The present study proposes and evaluates a new method for the quantitative measurement of foot position during assistive motion for sit-to-stand using a few wearable sensors that are not limited to the measurement area. The proposed method measures quantitative foot position (anteroposterior and mediolateral distance between both feet) through a machine learning technique using features obtained from only a single inertial sensor on the trunk and shoe-type force sensors. During the experiment, the accuracy of the proposed method was investigated by comparing the obtained values with those from an optical motion capture system. The results showed that the proposed method produced only minor errors (less than 6.5% of body height) when measuring foot position during assistive motion for sit-to-stand. Furthermore, Bland–Altman plots suggested no fixed errors between the proposed method and the optical motion capture system. These results suggest that the proposed method could be utilized for measuring foot position during assistive motion for sit-to-stand. Full article

(This article belongs to the Special Issue Advanced Rehabilitative and Assistive Engineering for Older Adults and People with Disabilities)

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