Search Results (979)

Background/Objectives: Quadriceps arthrogenic muscle inhibition (AMI) represents a key impairment following anterior cruciate ligament reconstruction (ACLR), contributing to quadriceps weakness. Although transcutaneous electrical nerve stimulation (TENS) and percutaneous electrical nerve stimulation (PENS) have been primarily investigated for analgesia, their effects on quadriceps strength in the early postoperative period remain underexplored. Methods: This study describes a single-blinded, parallel-group randomized controlled trial investigating the short-term effects of a single high-frequency TENS session and a novel long-term potentiation (LTP) PENS protocol on quadriceps strength and related clinical outcomes after ACLR. Fifty-four participants will be randomly allocated using block randomization in a 1:1:1 ratio to one of three groups: a control group (conventional post-ACLR rehabilitation only), a TENS group (conventional rehabilitation plus a single high-frequency TENS session), or a PENS group (conventional rehabilitation plus a single LTP PENS session). Participants will receive neuromodulatory intervention during the sixth postoperative week. The LTP PENS protocol consists of five 5 s stimulation bursts at 100 Hz and 250 μs pulse width and has only been investigated once in patients with upper limb pathology, underscoring its novelty in a postoperative setting. Results: The primary outcome is quadriceps maximal voluntary isometric contraction, selected as a clinically relevant surrogate of quadriceps activation deficits associated with AMI. Secondary outcomes include pain intensity, pressure pain threshold, knee range of motion, thigh muscle perimeter, knee effusion and swelling, and self-reported function and knee-related quality of life. Outcomes will be assessed at baseline, immediately post-treatment, and 1 and 7 days post-intervention by a blinded assessor. Full article

Recent reports have revealed that the number of lower limb amputees worldwide has increased as a result of war, accidents, and vascular diseases and that transfemoral amputation accounts for 39% of cases, highlighting the need to develop an improved functional prosthetic knee joint that improves the amputee’s ability to resume activities of daily living. To enable transfemoral prosthesis users to walk on level ground, accurate prediction of the intended knee joint angle is critical for transfemoral prosthesis control. Therefore, the purpose of this research was to develop a technique for estimating knee joint angle utilizing a long short-term memory (LSTM) network and kinematic data collected from inertial measurement units (IMUs). The proposed LSTM network was trained and tested to estimate the contralateral knee angle using data collected from twenty able-bodied subjects using a lab-developed sensory gadget, which included four IMUs. Accordingly, the present work represents a feasibility investigation conducted on able-bodied individuals rather than a clinical validation for amputee gait. This study contributes to the field of bionics by mimicking the natural biomechanical behavior of the human knee joint during gait cycle to improve the control of artificial prosthetic knees. The proposed LSTM model learns the contralateral knee’s motion patterns in able-bodied gait and demonstrates the potential for future application in prosthesis control, although direct generalization to amputee users is outside the scope of this preliminary study. The contralateral LSTM models exhibited a real-time RMSE range of 2.48–2.78° and a correlation coefficient range of 0.9937–0.9991. This study proves the effectiveness of LSTM networks in estimating contralateral knee joint angles and shows their real-time performance and robustness, supporting its feasibility while acknowledging that further testing with amputee participants is required. Full article

This study aims to assess hand function recovery in stroke patients during the mid-to-late Brunnstrom stages and to encourage active participation in rehabilitation exercises. To this end, a deep residual network (ResNet) integrated with Focal Loss is employed for gesture recognition, achieving a Macro F1 score of 91.0% and a validation accuracy of 90.9%. Leveraging the millimetre-level precision of Leap Motion 2 hand tracking, a mapping relationship for hand skeletal joint points was established, and a static assessment gesture data set containing 502,401 frames was collected through analysis of the FMA scale. The system implements an immersive augmented reality interaction through the Unity development platform; C# algorithms were designed for real-time motion range quantification. Finally, the paper designs a rehabilitation system framework tailored for home and community environments, including system module workflows, assessment modules, and game logic. Experimental results demonstrate the technical feasibility and high accuracy of the automated system for assessment and rehabilitation training. The system is designed to support stroke patients in home and community settings, with the potential to enhance rehabilitation motivation, interactivity, and self-efficacy. This work presents an integrated research framework encompassing hand modelling and deep learning-based recognition. It offers the possibility of feasible and economical solutions for stroke survivors, laying the foundation for future clinical applications. Full article

Background: Spasticity is a complex and multifactorial condition resulting from upper motor neuron injury. It manifests through muscle contractions, pain, limited range of motion, and clonus, which significantly impair daily activities and quality of life. High-frequency spinal cord stimulation (HF SCS) has shown optimal results in treating chronic neuropathic pain, but its potential role in spasticity remains underexplored. This study aimed to evaluate the efficacy of HF SCS in patients with spasticity. Methods: From April 2021 to July 2024, six patients with spasticity from various etiologies underwent SCS implantation at our institution. Clinical evaluations including the use of the Visual Analog Scale (VAS), Douleur Neuropathique 4 (DN4), and the Ashworth score, as well as ambulation ability and clonus episodes, were performed preoperatively and at a minimum of six months post-surgery. Subjective assessments of motor function, including coordination, movement efficiency, and postural transitions, were also recorded. Results: The mean age of patients was 50.12 ± 9.41 years, with follow-up averaging 24.32 ± 10.83 months. Statistically significant improvements were observed in VAS (p = 0.0412) and DN4 (p = 0.0422) scores, alongside a reduction in clonus episodes. All patients reported subjective improvements in coordination, movement efficiency, and postural transitions. Ambulation remained stable or improved in all cases. No perioperative complications or sensory/motor side effects were noted. Conclusions: HF SCS offers a promising approach to managing spasticity, with improvements in motor function, ambulation, and postural transitions. These findings support further investigation into HF SCS for spasticity, with multicenter trials needed to optimize treatment protocols and identify the most responsive patient populations. Full article

Background and Objectives: Coracoid process (CP) fractures combined with acromioclavicular (AC) joint dislocation are extremely rare, and evidence guiding optimal surgical management remains limited. This retrospective, single-center case series study evaluated clinical and radiologic outcomes after simultaneous fixation of both lesions using a clavicular hook plate and a coracoid screw. Materials and Methods: We retrospectively reviewed 15 consecutive patients with Ogawa type I CP fractures combined with AC joint dislocation who underwent clavicular hook plate and coracoid screw fixation between March 2019 and May 2024. Clinical outcomes at final follow-up included shoulder range of motion (ROM), visual analog scale (VAS) for pain, and the Constant score. Radiologic outcomes included CP union confirmed by computed tomography (CT) and residual AC joint subluxation. Results: The cohort comprised 13 men and 2 women with a mean age of 55.2 years, and the mean final follow-up was 40.2 months. At final follow-up, mean ROM was 168° for forward elevation, 161° for abduction, and 69° for external rotation at the side, with internal rotation to L1. The mean VAS score was 0.4 and the mean Constant score was 97. CT-confirmed union of the CP fracture was achieved in all patients, and no residual AC joint subluxation was observed. All patients returned to sports and activities of daily living. Conclusions: In this series, simultaneous fixation using a clavicular hook plate and a coracoid screw provided reliable stabilization for CP fractures with AC joint dislocation, achieving consistent CP union, restoration of AC joint alignment, and favorable clinical outcomes. However, given the retrospective, non-comparative study design, these findings should be interpreted with caution, and further comparative studies are warranted. Full article

Reliable autonomy for drones operating in GNSS-intermittent or denied environments requires both stable inter-vehicle coordination and a shared global understanding of the environment. This paper presents a unified vision-based framework in which UAVs use biologically inspired swarm behaviors together with online monocular point-cloud registration to achieve real-time global localization. First, we apply a passive-perception strategy, bird-inspired drone swarm-keeping, enabling each UAV to estimate the relative motion and proximity of its neighbors using only monocular visual cues. This decentralized mechanism provides cohesive and collision-free group motion without GNSS, active ranging, or explicit communication. Second, we integrate this capability with a cooperative mapping pipeline in which one or more drones acting as global anchors generate a globally referenced monocular SLAM map. Vehicles lacking global positioning progressively align their locally generated point clouds to this shared global reference using an iterative registration strategy, allowing them to infer consistent global poses online. Other autonomous vehicles optionally contribute complementary viewpoints, but UAVs remain the core autonomous agents driving both mapping and coordination due to their privileged visual perspective. Experimental validation in simulation and indoor testbeds with drones demonstrates that the integrated system maintains swarm cohesion, improves spatial alignment by more than a factor of four over baseline monocular SLAM, and preserves reliable global localization throughout extended GNSS outages. The results highlight a scalable, lightweight, and vision-based approach to resilient UAV autonomy in tunnels, industrial environments, and other GNSS-challenged settings. Full article

Objective: To identify key predictors of clinical outcomes in burn survivors and clarify the role of mixed-depth burns and confounding by indication in observational rehabilitation research. Design: Retrospective cohort study using data from a burn rehabilitation registry (January 2024 to July 2025). Setting: Burn rehabilitation center. Participants: 120 adult patients (age ≥ 18 years) with burns affecting ≥1% total body surface area (TBSA) and complete baseline data. Interventions: Not applicable. Main Outcome Measures: Primary outcome was functional improvement (ΔFIM). Secondary outcomes included pain reduction (ΔPain), scar severity (Vancouver Scar Scale; VSS), Activities of Daily Living (ADL) improvement, and Range of Motion (ROM) recovery. Multivariable linear and logistic regression models were used to identify predictors. Results: Patients achieved significant improvements in function (mean ΔFIM = 11.3 ± 8.9 points) and pain (mean ΔPain = 1.28 ± 0.81). Having a mixed-depth burn was the strongest predictor of worse scar outcomes (β = 2.52, 95% CI: 0.93 to 4.12, p = 0.002) and failure to achieve full ROM (OR = 0.089, 95% CI: 0.008 to 0.930, p = 0.043). An apparent association between inpatient ward care and better scar outcomes (β = −1.30, p = 0.020) was determined to be an artifact of confounding by indication, as the outpatient group had a higher proportion of high-risk mixed-depth burns (6.2% vs. 3.5%). Longer therapy duration was the only significant predictor of achieving ADL goals (OR = 1.014, 95% CI: 1.002 to 1.026, p = 0.025). Conclusions: Injury characteristics, particularly the presence of a mixed-depth burn, emerged as the dominant predictors of long-term scar and functional outcomes. This study identifies mixed-depth burns as a potentially high-risk clinical phenotype requiring targeted therapeutic strategies and demonstrates the critical importance of accounting for confounding by indication when evaluating rehabilitation outcomes in observational burn research. Full article

The use of virtual reality (VR) has made significant advancements, and now it is widely used across a range of applications. However, consumers’ capacity to fully enjoy VR experiences continues to be limited by a chronic problem known as cybersickness (CS). This study explores the feasibility of mitigating CS through geometric scene simplification combined with electroencephalography (EEG)-based monitoring. According to the sensory conflict theory, this issue is caused by the discrepancy between the visually induced self-motion (VIMS) through immersive displays and the real motion the vestibular system detects. While prior mitigation strategies have largely relied on hardware modifications or visual field restrictions, this paper introduces a novel framework that integrates geometric scene simplification with EEG-based neurophysiological activity to reduce VIMS during VR immersion. The proposed framework combines EEG neurophysiology, allowing us to monitor users’ brainwave activity and cognitive states during virtual immersion experience. The empirical evidence from our investigation shows a correlation between CS manifestation and neural activation in the parietal and temporal lobes. As an experiment with 15 subjects, statistical differences were significantly different with $P= 0.001$ and large effect size $\eta 2=0.28$, while preliminary trends suggest lower neural activation during simplified scenes. Notably, a decrease in neural activation corresponding to reduced optic flow (OF) suggests that VR environment simplification may help attenuate CS symptoms, providing preliminary support for the proposed strategy. Full article

Background/Objectives: The Achilles tendon is the largest tendon in the human body; it is frequently ruptured during sports and other dynamic physical activities. The purpose of this study was to compare recovery patterns over time between injuries to the dominant (DMT) and non-dominant (NDMT) limbs, and to examine differences in the limb symmetry index (LSI) for the uninjured side. Methods: This study includes a retrospective analysis of individuals who completed a standard rehabilitation program for 12 months and had regular checkups every three months. The study sample comprised 17 patients with DMT injuries and 17 patients with NDMT injuries, all active male recreational participants who underwent surgical repair of an Achilles tendon rupture. Outcome measures included dorsiflexion range of motion (ROM), calf circumference, plantarflexion strength, hop test performance, and the Y-Balance Test (YBT). Results: Both groups demonstrated continuous, progressive improvement in ROM, plantarflexion strength, hop test distance, and YBT scores, showing a significant main effect of time (p < 0.05). Although DMT showed greater strength than NDMT at 6 and 9 months, this difference was no longer significant at 12 months (p > 0.05). In all three YBT directions, the DMT group achieved greater reach distances than the NDMT group at 12 months (p < 0.05). At the final follow-up, both groups exceeded 90% LSI in ROM, calf circumference, plantarflexion strength, and hop performance (p < 0.05). However, in the YBT, only the DMT group surpassed 90% LSI, whereas the NDMT group showed poorer recovery. Conclusions: ROM, calf circumference, and muscle strength ultimately showed no significant differences between groups, but dynamic balance recovery was superior in the DMT group. These findings suggest that clinicians and rehabilitation specialists should consider leg dominance when designing rehabilitation programs. Full article

This study investigates the characteristics and causes of a low-level wind shear (LLWS) event induced by downward momentum transport at Xining Airport, China on 5 April 2023. By utilizing Doppler Wind Lidar (DWL), Automated Weather Observing System (AWOS), and ERA5 reanalysis data, the detailed structure and synoptic-scale mechanisms of the event were analyzed. The LLWS manifested as a non-convective, meso-γ scale (2–20 km) directional wind shear, characterized by horizontal variations in wind direction. The system moved from northwest to southeast and persisted for approximately three hours. The shear zone was characterized by westerly flow to the west and easterly flow to the east, with their convergence triggering upward motion. The Range Height Indicator (RHI) and Doppler Beam Swinging (DBS) modes of the DWL clearly revealed the features of westerly downward momentum transport. Diagnostic analysis of the synoptic-scale environment reveals that a developing 300-hPa trough steered the merging of the subtropical and polar front jets. This interaction provided a robust source of momentum. The secondary circulation excited in the jet entrance region promoted active vertical motion, facilitating the exchange of momentum and energy between levels. Simultaneously, the development of the upper-level trough led to the intrusion of high potential vorticity (PV) air from the upper levels (100–300 hPa) into the middle troposphere (approximately 500 hPa), which effectively transported high-momentum air downward and dynamically induced convergence in the low-level wind field. Furthermore, the establishment of a deep dry-adiabatic mixed layer in the afternoon provided a favorable thermodynamic environment for momentum transport. These factors collectively led to the occurrence of the LLWS. This study will further deepen the understanding of the formation mechanism of momentum-driven LLWS at plateau airports, and provide a scientific basis for improving the forecasting and warning of such hazardous aviation weather events. Full article

Background/Objectives: Traumatic spinal cord (SC) injury (SCI) is a debilitating neurological condition. Minimally invasive approaches to monitor in real time the functional state of the neuromotor apparatus in animal models of SCI (at rest and movement) to assess effectiveness of therapy are needed in preclinical studies. We aimed to develop such a bioethically acceptable platform for SCI studies on non-human primates (Rhesus macaques). Methods: Epidural and myographic electrode implantation (EI) (wireless and wired, connected via a head plug) was performed. After EI, motor responses caused by electrical stimulation of the SC at the level of the cervical and lumbar thickening were recorded; electromyography of the limb muscles was recorded during quadrupedal movement of the animal on a treadmill with simultaneous assessment of movements’ kinematic parameters. Five weeks after EI, three animals underwent lateral hemisection of the SC in the C4–C5 segment under the control of a surgical microscope and intraoperative recording of motor- and sensory-evoked potentials. Results: Within 30 days after SCI, during treadmill testing, a decrease in electromyographic activity of the limb muscles and the volume of angular movement in the joints on the side of the injury was detected. Electrical stimulation at the L2–S1 segments of the SC at a frequency of 30 Hz led to the appearance of a locomotor pattern in the muscles of the hind limbs and an increase in the range of motion. Conclusions: Our platform can be used for pathophysiological studies of various neuromodulation modes and as a basis for the development of control neurointerfaces. Full article

Analyzing the dynamics of muscle activation patterns and joint range of motion is essential to understanding human movement during complex tasks such as tooth brushing Activities of Daily Living (ADLs). In individuals with neuromotor impairments, accurate assessment of upper limb motor patterns plays a critical role in rehabilitation, supporting the identification of compensatory strategies and informing clinical interventions. This study presents the validation of a previously developed novel, low-cost, wearable, and portable multimodal prototype that integrates inertial measurement units (IMU) and surface electromyography (sEMG) sensors into a single device. The system enables bilateral monitoring of arm segment kinematics and muscle activation amplitudes from six major agonist muscles during ADLs. Eleven healthy participants performed a functional task, tooth brushing, while wearing the prototype. The recorded data were compared with two established gold-standard systems, Qualisys^® motion capture system and Biosignalsplux^®, for validation of kinematic and electrophysiological measurements, respectively. This study provides technical insights into the device’s architecture. The developed system demonstrates potential for clinical and research applications, particularly for monitoring upper limb function and evaluating rehabilitation outcomes in populations with neurological disorders. Full article

Background: Arthroscopic anterior cruciate ligament (ACL) reconstruction is widely recognised as the primary treatment for ACL injuries. However, with the increasing incidence of sports-related injuries and growing demand for rehabilitation services, conventional rehabilitation models—largely reliant on therapists’ experience and subjective assessment—are increasingly insufficient to meet the clinical need for precise and individualised rehabilitation programmes. This study aimed to evaluate the effectiveness of a rehabilitation protocol incorporating an artificial intelligence (AI)-based assessment and correction system on functional recovery following ACL reconstruction. Methods: Using convenience sampling, 80 patients undergoing ACL reconstruction between June to December 2024 were recruited for this randomised controlled trial. Participants were randomly assigned to either a control group (n = 40), which received conventional functional exercise training, or a trial group (n = 40), which received rehabilitation intervention guided by an AI-based assessment and correction system. Knee function scores (Lysholm score, IKDC score), Berg Balance Scale (BBS) scores, joint range of motion (ROM), and rehabilitation exercise compliance scores were collected and analysed 1, 2, 3, and 4 months postoperatively. Results: Compared with the control group, the trial group demonstrated significantly greater improvements in Lysholm score, IKDC score, BBS score, and active knee joint ROM (p < 0.05) at postoperative assessment points. Additionally, rehabilitation exercise adherence was significantly higher in the trial group compared to the control group (p < 0.05). Conclusions: Rehabilitation protocols integrating AI-based assessment and correction systems effectively enhance knee function recovery, joint mobility and balance ability following ACL reconstruction. Moreover, these protocols significantly improve rehabilitation exercise adherence, demonstrating superior efficacy compared to conventional rehabilitation approaches. This digital rehabilitation model represents an efficient and promising intervention for postoperative ACL rehabilitation. Full article

Upper limb deficiencies can limit the range of tasks children can perform. Current prosthetics provide overall good performance to increase the activities that users can complete, but challenges remain. Body- or electrically powered prostheses struggle to restore the full range of motion needed for specific tasks. Currently, these systems do not allow for controlled hand closure or opening across all possible postures. A breathing-powered prototype named Airbender, which extracts energy from a breathing input by means of a Tesla turbine, provides the possibility of operation in any position. This paper introduces a novel design for a multi-finger actuated breathing-powered upper limb prosthetic concept and analyses its performance through a series of lab-based experiments. Results show that such a design could provide a fully controllable system. The final assembled design is capable of achieving full actuation under a flow rate of 340 Ls/min. The results obtained demonstrate that a functional multi-finger actuated breathing-powered upper limb prosthesis could be feasible and opens a path for future research in the field, with the ultimate goal of reducing the minimum flow rate required and actuation time to further improve its functionality. Full article

Premenstrual syndrome (PMS) negatively affects women’s physical performance, emotional balance, and quality of life. Although pharmacological therapies exist, their side effects and limited effectiveness highlight the need for alternatives. This partially controlled, non-blinded, non-randomized prospective pilot study included 34 women aged 18–40 years and examined the effects of an eight-week structured yoga program. Participants met the same eligibility criteria and were comparable at baseline in age, sociodemographic characteristics, and PMS severity. The study group attended two weekly 90-min hatha yoga sessions and completed a 15-min daily home practice, while controls maintained their usual physical activity. Outcome measures included body composition, hip range of motion, spinal mobility (flexion and lateral flexion), and Premenstrual Symptoms Screening Tool (PSST) scores. After eight weeks, the yoga group showed significant reductions in body weight and fat mass and an increase in muscle mass. Hip external rotation improved significantly among yoga participants, while changes in spinal mobility did not reach statistical significance. The intervention group showed a significant reduction in PMS symptom severity, while the control group showed no significant change. The findings suggest that regular yoga practice can enhance physical functioning and alleviate PMS-related symptoms, supporting its role as a movement-based approach for improving women’s health. Full article