Search Results (79)

Physical therapy is a critical component of medical rehabilitation, aiding recovery from conditions such as stroke, spinal cord injuries, and musculoskeletal disorders. Effective rehabilitation requires precise monitoring of patient performance to ensure exercises are executed correctly and progress is accurately assessed. This paper presents a novel automated system for controlling the rehabilitation process and evaluating physical therapy exercise quality using computer vision and a customized Human Skeleton-based Balanced Time Warping algorithm. The proposed method quantitatively assesses the similarity between a physiotherapist and patient performance by analyzing skeletal motion data extracted from RGB-D video sequences without requiring pre-alignment or sensor-specific calibration. A motion-dependent, weighted Euclidean distance between 3D skeletal models is used to compute pose dissimilarity, while a modified DTW approach aligns temporal sequences and evaluates dynamic consistency. The total dissimilarity measure is a balanced combination of posture (DP) and dynamics (DT) components. Evaluated on a custom dataset of 136 video recordings from 23 participants performing exercises in sitting and standing positions under varying performance accuracy levels (“good,” “intermediate,” and “bad”), the system demonstrates the strong clustering of accuracy levels. Proposed dissimilarity, together with a fixed reference element (physiotherapist), induces a natural non-strict order on the set of distances between patients and physiotherapists. A high value of Spearman’s rank correlation coefficient between computed dissimilarity and execution accuracy (0.977) indicates that this method is suitable for assessing exercise performance accuracy and for adequately evaluating the patient’s rehabilitation progress. The method enables objective, real-time feedback, reduces therapist workload, and supports remote monitoring, offering a scalable solution for personalized rehabilitation. Future work will involve clinical validation with post-stroke and cardiac patients. Full article

Limb amputation causes significant challenges for patients in achieving effective mobility and functionality through prosthetic limbs. The prosthetic socket plays a pivotal role in the success of rehabilitation. This review explores the current advancements in prosthetic socket design and fabrication, focusing on traditional techniques like casting and lamination, and emerging technologies such as 3D printing and computer-aided design (CAD). By comparing these methods, this review highlights the advantages, limitations, and suitability for different clinical needs. This article discusses the importance of pressure distribution in socket design, emphasizing the need to relieve pressure in sensitive areas to prevent skin complications. It also examines the materials used in socket fabrication, from high-density polymers to advanced composites, assessing their impact on patient comfort and prosthetic performance. Additionally, we discuss the challenges practitioners face in prosthetic care, particularly in low-resource settings, and propose potential solutions through innovative techniques and materials. Advancements in computational modeling improved socket design and validation, enhancing patient comfort and improving the overall biomechanical interaction between the prosthesis and the user. The manuscript concludes by identifying future research opportunities, particularly in personalized prosthetic design and the integration of smart materials, to further enhance the comfort, functionality, and accessibility of prosthetic sockets. Full article

Parkinson’s disease (PD) is a progressive neurological disorder with motor and non-motor symptoms that are inadequately addressed by current pharmacological and surgical therapies. Brain–computer interfaces (BCIs), particularly those based on electroencephalography (eBCIs), provide a promising, non-invasive approach to personalized neurorehabilitation. This narrative review explores the clinical potential of BCIs in PD, discussing signal acquisition, processing, and control paradigms. eBCIs are well-suited for PD due to their portability, safety, and real-time feedback capabilities. Emerging neurophysiological biomarkers—such as beta-band synchrony, phase–amplitude coupling, and altered alpha-band activity—may support adaptive therapies, including adaptive deep brain stimulation (aDBS), as well as motor and cognitive interventions. BCIs may also aid in diagnosis and personalized treatment by detecting these cortical and subcortical patterns associated with motor and cognitive dysfunction in PD. A structured search identified 11 studies involving 64 patients with PD who used BCIs for aDBS, neurofeedback, and cognitive rehabilitation, showing improvements in motor function, cognition, and engagement. Clinical translation requires attention to electrode design and user-centered interfaces. Ethical issues, including data privacy and equitable access, remain critical challenges. As wearable technologies and artificial intelligence evolve, BCIs could shift PD care from intermittent interventions to continuous, brain-responsive therapy, potentially improving patients’ quality of life and autonomy. This review highlights BCIs as a transformative tool in PD management, although more robust clinical evidence is needed. Full article

Background/Objectives: This retrospective study assessed the accuracy of implant positioning with dynamic computer-aided implant surgery (dCAIS) for Toronto Bridge fabrication, using a conometric prosthetic concept and a new intraoral splinting technique (CLIKSS). It compared discrepancies across various anatomical regions, bone qualities, and implant sites. Methods: This study involved 52 patients undergoing full-arch rehabilitation (17 in the mandible, 30 in the maxilla, and 5 in both), with 366 implants placed (125 in the mandible, 241 in the maxilla; 128 in post-extraction sites, and the remainder in healed sites). All implants were immediately loaded. Precision was assessed by measuring linear and three-dimensional (3D) angular deviations between planned and actual implant positions. Results: Measurement errors for apical linear and 3D deviations at the apex and entry point ranged from 0.24 ± 0.10 to 0.55 ± 0.57 mm, and angular deviations varied from 0.32 ± 0.65° to 0.35 ± 0.71°. Maxillary measurements were significantly higher at the entry, apical, and vertical levels, even when comparing anterior and posterior regions with the corresponding mandibular areas, while no differences were found in the angular deviation. Significant discrepancies were observed among different mandibular bone types. Maxillary post-extraction sites exhibited significantly greater deviations than mandibular sites in all parameters except angular deviation. No significant differences were found between healed and post-extraction sites within the same jaw. Conclusions: dCAIS improved implant placement accuracy, leading to predictable prosthetic outcomes, especially during parallel multi-implant insertions. This report introduced dCAIS for conometric/biconometric implant placement combined with the innovative CLIKSS technique as an effective intraoral split method for this prosthesis connection. Full article

Background and Objectives: Maxillofacial trauma represents a significant global health challenge with substantial physical, psychological, and socioeconomic consequences. Materials and Methods: This narrative review analyzed 112 articles published between 2000 and 2024 examining epidemiology, prevention, economics, and outcomes of maxillofacial trauma in critical care settings. Results: Road traffic accidents remain the primary cause globally, followed by interpersonal violence and occupational injuries. Effective prevention strategies include seat belt laws, helmet legislation, and violence prevention programs. Economic burden encompasses direct healthcare costs (averaging USD 55,385 per hospitalization), productivity losses (11.8 workdays lost per incident), and rehabilitation expenses (USD 3800–18,000 per patient). Surgical management has evolved toward early intervention, minimally invasive approaches, and advanced techniques using computer-aided design and 3D printing. Complications affect 3–33% of patients, with significant functional disabilities and psychological sequelae (post-traumatic stress disorder in 27%, depression/anxiety in 20–40%). Conclusion: Maxillofacial trauma management requires multidisciplinary approaches addressing both immediate treatment and long-term rehabilitation. Despite technological advances, disparities in specialized care access persist globally. Future efforts should implement evidence-based prevention strategies, reduce care disparities, and develop comprehensive approaches addressing physical, psychological, and socioeconomic dimensions through collaboration among healthcare professionals, policymakers, and community stakeholders. Full article

Background/Objective: Diagnostic trial restorations play a crucial role in restorative dentistry by allowing clinicians to evaluate aesthetics, function, and phonetics before finalizing definitive restorations. These restorations facilitate communication between patients, clinicians, and dental technicians, ensuring treatment alignment and predictable outcomes. The accuracy of transferring diagnostic trial restorations to the oral cavity is essential to maintain the integrity of the planned design. Various fabrication techniques, including conventional silicone matrices and computer-aided design/computer-aided manufacturing (CAD-CAM)-based methods, have been developed to improve transfer precision. However, there is limited evidence directly comparing their dimensional accuracy. This randomized in vivo study aimed to evaluate and compare the accuracy of four commonly used techniques—condensation silicone, addition PVS silicone, transparent PVS silicone, and CAD-CAM combination matrices—by assessing their linear and volumetric discrepancies. Methods: Twenty patients requiring aesthetic rehabilitation of their anterior maxillary teeth participated. The sequence of matrix usage was determined through randomization. Four techniques for transferring diagnostic trial restorations were evaluated: (1) condensation silicone matrix, (2) addition polyvinyl siloxane (PVS) silicone matrix, (3) transparent PVS silicone matrix, and (4) CAD-CAM combination matrix. Dimensional accuracy was assessed by comparing intraoral scans (IOSs) of the transferred restorations to the original diagnostic wax-up. Linear discrepancies were measured at four buccal landmarks (cervical, medial, lower medial, and incisal), and volumetric deviation was evaluated using reverse engineering alignment software. Results: Significant differences were observed among the groups in both linear and volumetric discrepancies (p < 0.05). The CAD-CAM combination matrix showed superior volumetric accuracy, with minimal deviations from the diagnostic wax-up. The addition PVS silicone matrix demonstrated consistent linear accuracy, particularly at the cervical and medial landmarks. The condensation silicone matrix exhibited moderate performance across both linear and volumetric accuracy. The transparent PVS silicone matrix showed the highest variability, with greater volumetric deviations. Conclusions: The study highlights that the choice of matrix material and technique significantly impacts the dimensional accuracy of diagnostic trial restoration transfers. The CAD-CAM combination matrix and the addition PVS silicone matrix demonstrated superior advantages compared to the other techniques. Clinicians should consider the specific requirements of each case, including accuracy and ease of use, when selecting a transfer technique for aesthetic rehabilitations. Full article

Background: The treatment of head and neck cancer primarily involves surgical tumor removal combined with radiotherapy and/or chemotherapy. It often leads to significant side effects, impacting the anatomical structures of the oral cavity and resulting in major functional, esthetic, and socio-relational alterations. Case presentation: This clinical report aims to demonstrate the effectiveness of a hospital-based approach incorporating general anesthesia (GA) and computer-aided design and manufacturing (CAD/CAM) technology in the oral rehabilitation of a 58-year-old woman in remission from intraoral squamous cell carcinoma of the mandibular symphysis. The patient presented with oral pain, radiation-induced caries, reduced occlusal vertical dimension, and severely compromised teeth. Treatment Approach: The treatment plan included the removal of two non-restorable teeth, root canal treatment for the remaining teeth, and the placement of ceramic crowns and a partial removable prosthesis. Due to the complexity of the case and the patient’s limitations, the treatment was performed under GA, allowing for a staged approach. Digital technologies, including intraoral scanning and CAD-CAM, enhanced precision and patient comfort. This approach facilitated tooth preservation and minimized the number of extractions while achieving satisfactory functional and esthetic outcomes. Conclusion: The case highlights the value of GA and digital techniques in managing special-needs patients with a history of irradiated head and neck cancer. Full article

Wildlife Rehabilitation Centres emerged with the purpose of recovering individuals, as a tool for environmental education and monitoring the balance of ecosystems. The White Stork (Ciconia ciconia) is one of the many species that are admitted to rehabilitation centres all around the world, due to traumatic amputations. This work presents the development of 3D-printed orthopedic prostheses aimed at partially restoring biomechanical function and enabling the reintegration of amputated birds into their natural habitat. Conducted at the Green Balkans Wildlife Rehabilitation and Breeding Center in Bulgaria, three prosthetic prototypes were created using epoxy resin, polylactic acid (PLA), and polyamide, based on detailed anatomical measurements. The process involved 3D Computer-Aided Design (CAD), biomechanical analysis, and performance evaluation, focusing on locomotion, feeding, and flight. Results showed improved prosthetic efficacy, with birds adapting within 1–5 days, resuming normal behaviours, and regaining flight. Of the 12 birds analyzed, 3 were released into the wild, with 1 tracked via GPS, marking the first documented case of an amputated bird with a prosthesis monitored post-release, covering over 470 km in 15 days. This study highlights the potential of 3D printing in conservation medicine, offering alternatives to euthanasia and open new perspectives in the global context of biodiversity preservation. Full article

Objectives: To evaluate the clinical performance of BioHPP^® (Biocompatible High-Performance Polymer) superstructures in full-arch implant-prosthetic rehabilitations following the Toronto-Branemark protocol, focusing on biomechanical and biological outcomes. Methods: A 70-year-old edentulous male patient underwent full-arch implant-prosthetic rehabilitation using BioHPP^® superstructures fabricated through a CAD-CAM workflow. Radiological and clinical evaluations were conducted to plan implant placement and assess outcomes after one-year of follow-up. The primary endpoints included prosthetic stability, peri-implant bone resorption, and patient-reported satisfaction. Results: The BioHPP^® superstructure demonstrated effective stress distribution, leading to minimal peri-implant bone resorption and improved implant stability. Clinical evaluations showed excellent prosthetic fit and functionality, with no complications during the observation period. Radiological analyses confirmed the absence of prosthetic misfits, while patient-reported outcomes indicated high levels of comfort and aesthetic satisfaction. Conclusions: BioHPP^® superstructures offer a promising alternative to traditional materials for full-arch implant-prosthetic rehabilitations, providing significant biomechanical and aesthetic advantages. These findings suggest that BioHPP^® may enhance clinical outcomes, though further research with larger cohorts and longer follow-up periods is required to validate its long-term reliability. Full article

Background: The present article describes a step-by-step maximally digitalized workflow protocol with computer-aided design and computer-aided manufacturing (CAD/CAM) in partial-arch edentulous patients rehabilitated with fixed dental prostheses and removable partial dentures (FDPs and RPDs). Methods: Facial digitalization, intraoral scans, and functional mandibular movement recordings were used to create a 4D virtual patient on commercially available CAD software. The fixed components including post-and-cores, both metal–ceramic with extra-coronal attachment and monolithic zirconia crowns, and the RPDs were manufactured by computer numerical controlled direct milling. Results: This innovative digital approach using the virtual patient and the superimposition of interim RPDs fitted in the mouth has been used to provide fixed and removable rehabilitation to the patient without clinical complications with 2 years of follow-up. Conclusions: Within the limitations of this report, the developed combined prosthesis fabrication technique allowed optimization of the production by decreasing the clinical steps and laboratory procedures in partial-arch edentulous rehabilitated with FDPs and RPDs. Full article

Multiple sclerosis (MS) is an autoimmune demyelinating disease of the central nervous system with unknown etiology, resulting in various impairments that necessitate continuous rehabilitation to enhance functionality, quality of life, and motor function, including through Virtual Reality (VR) therapy. Comparing tasks in virtual environments and their potential skill transfer to real-world settings could aid in optimizing treatment programs to improve motor performance in individuals with MS. This study aimed to determine whether practicing acquisition and retention phases using two distinct interfaces (concrete—Touch Screen or abstract—Kinect system) affects performance in a subsequent task using a different interface (transfer phase). A randomized clinical trial was conducted with 56 volunteers with MS and 41 controls. Participants engaged in a computer game where they burst as many bubbles as possible within 10 s per attempt. After the acquisition and retention phases, all participants switched interfaces (e.g., those using Kinect switched to Touchscreen and vice versa). Significant performance improvements were observed in both groups during the acquisition phase, which were maintained in the retention phase. Although the abstract interface was more challenging for both groups, only the MS group that practiced with the abstract interface successfully transferred their improvements to the concrete interface. Thus, despite the increased difficulty of the abstract task during practice, it led to better performance transfer when required to complete a subsequent concrete task, suggesting that abstract devices may be beneficial in clinical practice for improving motor function in people with MS. Full article

Cervical orthoses, vital for neck immobilization in medical care and sports, often struggle to provide adequate support due to individual neck shape and size variations. This study addresses this issue by developing a specific computer-aided orthosis design software tailored for creating customized 3D-printed cervical orthoses. The self-developed software embedded anatomical and rehabilitation knowledge into the orthosis design process, ensuring consistency and reducing manual modification. Finite element analysis of cervical orthoses determined that a minimum thickness of 5 mm PLA (polylactic acid) material is necessary to meet safety requirements. This study highlights the automation potential of customized computer-aided orthosis design and underscores the potential to revolutionize orthopedic care. We also applied easy-to-access 3D printing technology to fabricate well-fitting and immobilized cervical orthoses. These customized cervical orthoses offer a promising future with the advantages of being cost-effective, lightweight, immobility, comfortable, easy to wear, and minimal accessories to meet clinical needs, enhancing patient comfort and compliance and providing reassurance about the economic benefits of the technology. Full article

Falls are a major issue for those over the age of 65 years worldwide. Objective assessment of fall risk is rare in clinical practice. The most common methods of assessment are time-consuming observational tests (clinical tests). Computer-aided diagnosis could be a great help. A popular clinical test for fall risk is the five times sit-to-stand. The time taken to complete the test is the most commonly used metric to identify the most at-risk patients. However, tracking the movement of skeletal joints can provide much richer insights. We use markerless motion capture, allied with a representational model, to identify those at risk of falls. Our method uses an LSTM autoencoder to derive a distance measure. Using this measure, we introduce a new scoring system, allowing individuals with differing falls risks to be placed on a continuous scale. Evaluating our method on the KINECAL dataset, we achieved an accuracy of 0.84 in identifying those at elevated falls risk. In addition to identifying potential fallers, our method could find applications in rehabilitation. This aligns with the goals of the KINECAL Dataset. KINECAL contains the recordings of 90 individuals undertaking 11 movements used in clinical assessments. KINECAL is labelled to disambiguate age-related decline and falls risk. Full article

The present case report presents a digital workflow for designing an aesthetic rehabilitation of the upper anterior teeth in an adult male. The patient suffered from a gummy smile resulting from an unfavorable ratio between upper lip length and gingiva/tooth display. In addition, the tooth shapes, color, and position were not accepted by the patient. The treatment planning included gingivectomy based on a digitally designed PMMA guide performed using a soft tissue SOGA laser (Shenzhen Soga Technology Co., Ltd., Shenzhen, China). The preparation was guided by the plastic guides for preparation control created digitally in Exocad software (Rijeka 3.1. Darmstadt, Germany) and printed in three-dimensional plastic. Next, both arches and maximum intercuspation were scanned. The milled lithium disilicate veneers were manufactured using CAD-computer-aided manufacturing (CAM) equipment. The restorations were cemented using a translucent light-cure resin cement (RelyX Universal, 3M ESPE, St. Paul, MN, USA). Next, occlusion adjustment and polishing were executed. Based on the present case report, it can be assumed that the application of digital techniques allows us to achieve an aesthetic and functional result with reduced work time and errors. Emphasizing the clinical impact, these methods enhance patient satisfaction and treatment accuracy in intricate aesthetic rehabilitations. Full article

Scars following burns can often prove complex to manage, particularly when crossing joints or special areas such as the head and neck, due to contractures. This case report discusses the individualised care and rehabilitation provided to a burn patient with a learning disability. The patient suffered both full and partial thickness burns equating to a total body surface area (%TBSA) of 7% of the face, neck, and anterior chest via the self-ignition of clothing. Acute treatment was provided at a regional burn unit followed by further in-patient care and rehabilitation at our burn facility. A motion rehabilitation instrument was employed to manage potential orofacial contracture; however, due to the patient’s impaired social functioning, this device was found to be unsuitable. Subsequently, a bespoke mouth-opening device replicating an ice lolly was fabricated utilising computer-aided design (CAD), enhancing the patient’s understanding along with encouraging independence. Microstomia was a risk in this case; however, this was prevented via the discussed regime, and successful patient rehabilitation was achieved. Full article