Search Results (36)

Background/Objectives: Distal biceps tendon rupture (DBTR) significantly impairs upper-limb function, particularly in movements requiring elbow flexion and forearm supination. This condition continues to attract clinical interest due to its complex biomechanics, evolving surgical strategies, and the growing emphasis on comprehensive rehabilitation. Contemporary evidence highlights the value of a multidisciplinary approach that integrates precise surgical repair with structured, progressive physiotherapy to optimize outcomes effectively. Methods: We performed a comprehensive review of the literature by searching PubMed/MEDLINE, and a narrative review format was adopted to synthesize the available evidence. Results: Studies comparing single-incision and double-incision techniques show that both achieve excellent outcomes, although the decision should be tailored to patient-specific factors, surgeon expertise, and the reported complication risk, which may vary between 5% and 63%. Regardless of technique, restoring tendon integrity is essential for regaining normal strength and supination capability. Rehabilitation following DBTR repair relies on a phased and carefully monitored program. Early physiotherapy focuses on a controlled range of motion and the prevention of stiffness while protecting the repair. As healing progresses, strengthening exercises targeting the biceps, triceps, and brachialis are introduced, alongside endurance training to enhance overall functional capacity. Evidence strongly supports early mobilization protocols, where active motion and graded resistance are initiated within the first postoperative week, resulting in faster and more complete functional recovery compared to prolonged immobilization. Conclusions: Long-term outcomes after DBTR repair are consistently favorable. Most patients return to full activity or sport at an average of 5.4 months, although timelines vary with rehabilitation intensity and baseline fitness. Notably, 93–100% recover their pre-injury activity level, including participation in competitive sports. Full article

This investigation examined whether mirror visual feedback modulates crossover fatigue magnitude during unilateral handgrip exertion and whether efficacy demonstrates age-dependent and muscle-group-specific characteristics. Thirty-three participants stratified by developmental stage (adults: n = 17, 24.64 ± 5.38 years; children: n = 16, 11.87 ± 0.79 years) completed a randomized controlled crossover protocol incorporating three visual feedback conditions: mirror reflection of the exercised limb, occluded vision (no-mirror), and passive rest control. Participants performed unilateral dominant handgrip fatigue induction (20 × 6 s maximal voluntary isometric contractions) while bilateral force production was quantified pre-intervention and post-intervention across handgrip, elbow flexion, and elbow extension domains. Linear mixed-effects models with participant-specific random intercepts and slopes quantified Condition × Time × Limb interactions. In the non-exercised contralateral limb, linear mixed-effects models demonstrated that under the mirror condition, non-dominant handgrip force was maintained at rest-equivalent levels relative to control (+0.02 kg, 95% CI [−1.15, +1.17], p = 0.987, dz =+ 0.003), whereas vision occlusion induced significant crossover fatigue (−3.37 kg [−4.40, −2.35], p < 0.001, dz =− 1.16). All contrasts represent within-subject difference-of-differences in non-dominant limb change score (Post − Pre) extracted from the full factorial LMM via emmeans within the Limb = Non-dominant stratum pooled across age groups. The mirror versus no-mirror comparison yielded +3.38 kg [+2.43, +4.34], p < 0.001, dz =+ 1.26. Age-stratified analyses confirmed comparable effect magnitudes (adults: dz =+ 1.40; children: dz =+ 1.33). Muscle-group specificity emerged for handgrip but not elbow flexion (p = 0.068) or extension (p = 0.156). Age Group × Condition × Time × Limb interactions were non-significant (all p > 0.16), providing no evidence of age moderation within the tested developmental range. Mirror visual feedback constitutes an effective countermeasure against crossover fatigue in distal upper limb musculature. The magnitude of mirror-induced attenuation did not differ between children (aged 10–13 years) and adults within our sample, with no statistically detectable age moderation within the tested developmental range; formal equivalence testing was not conducted. Effects demonstrated anatomical selectivity, favoring hand musculature over proximal elbow musculature. Full article

This paper presents RehabHub, a home-based exergaming system that integrates standardized physical assessment directly into gameplay by using a common webcam and MediaPipe for real-time pose estimation. The system quantifies upper-limb movement quality, specifically abduction, shoulder flexion, and elbow flexion based on FMA-UE guidelines, by applying Dynamic Time Warping (DTW) together with a Z-score-based scoring model that relies on data from non-clinical adult participants. A pilot study, which included movements simulated with a 5-kg resistance band, evaluated three feature-extraction methods. The findings indicate that the single-angle method provides the clearest distinction between normal and abnormal movements, particularly for abduction and elbow flexion. In the case of shoulder flexion, the score separation was less distinct because of movement variability and posture-related angle fluctuations, which suggests that further refinement of feature design is needed. The cloud-based platform supports remote monitoring and gives caregivers access to both performance scores and recorded exercise videos. Overall, the results demonstrate the feasibility of a low-cost webcam-based assessment integrated into exergaming, and they highlight important trends for improving abnormal-movement detection in home rehabilitation systems. Full article

This Data Descriptor provides an open, anonymized dataset describing anthropometric and physical fitness outcomes in undergraduate students enrolled in a Physical Activity and Sport Sciences degree program. The dataset included 156 participants (28 females and 128 males) and reported sex, age, body mass, stature, and body mass index, alongside standardized field-based tests covering flexibility, muscular endurance, strength, and jump performance. Hip flexibility was assessed using the Thomas test on both sides. Trunk extensor endurance was measured using the Biering–Sørensen test, and upper-body strength–endurance was assessed using a dead-hang test. Upper limb strength was recorded as elbow flexion strength. Lower limb power was evaluated using vertical jump tests, including Abalakov, squat jump, and countermovement jump, and a derived indicator (IE) was provided to facilitate comparisons across jump modalities. The data are distributed as a machine-readable CSV file accompanied by a detailed data dictionary describing the variables, units, and missingness. The dataset is intended to support the reproducible reporting of normative fitness profiles in sports science students, facilitate teaching and benchmarking in exercise science contexts, and enable secondary analyses exploring associations between anthropometry and physical performance. For reproducible inferential comparisons, users may apply Welch’s two-sample t-test for sex-based differences. Full article

Background/Objectives: Non-traumatic (degenerative) rotator cuff tendinopathy with partial supraspinatus tear (NT-RCTT) is a common source of shoulder pain and disability. Comparative evidence between radial extracorporeal shock wave therapy (rESWT) and multimodal physical therapy modalities (PTMs) remains scarce. Methods: In this single-center randomized controlled trial, 60 adults with MRI-confirmed NT-RCTT were assigned (1:1) to rESWT (one session weekly for six weeks; 2000 impulses per session, 2 bar air pressure, positive energy flux density 0.08 mJ/mm²; 8 impulses per second) or a multimodal PTM program (interferential current, shortwave diathermy and magnetothermal therapy; five sessions weekly for six weeks). All participants performed standardized home exercises. The primary outcome was the American Shoulder and Elbow Surgeons (ASES) total score; secondary outcomes included pain (visual analog scale, VAS), satisfaction, range of motion (ROM), supraspinatus tendon (ST) thickness and acromiohumeral distance (AHD). Assessments were conducted at baseline, and at week 6 (W6) and week 12 (W12) post-baseline. Results: Both interventions significantly improved all outcomes, but rESWT produced greater and faster effects. Mean ASES total scores increased by 31 ± 5 points with rESWT versus 26 ± 6 with PTMs (p < 0.05). VAS pain decreased from 5.2 ± 0.7 to 1.0 ± 0.7 with rESWT and from 5.2 ± 0.8 to 1.7 ± 0.8 with PTMs (p < 0.01). rESWT achieved higher satisfaction and larger gains in abduction, flexion and external rotation. Ultrasound showed reduced ST thickness and increased AHD after rESWT but not after PTMs. No serious adverse events occurred. Conclusions: rESWT yielded superior pain relief, functional recovery and tendon remodeling compared with a multimodal PTM program, with markedly lower treatment time and excellent tolerability. Full article

This case report details the successful rehabilitation of a 31-year-old male Asian elephant (Elephas maximus) presenting with an abnormal left forelimb gait following chronic traumatic injury. The elephant exhibited a distinctive circumduction gait with a semicircular arc movement, characterized by limited flexion at the elbow and carpus, along with compensatory proximal shrugging during the swing phase. Diagnostic evaluations revealed joint space narrowing and ligament fibrosis, while biomechanical gait analysis using inertial measurement units highlighted significant asymmetries between affected and unaffected limbs. An interprofessional team developed a comprehensive rehabilitation protocol that integrated peripheral magnetic stimulation, task-specific therapeutic walking with adjustable obstacles, and progressive strengthening exercises. At the eight-week follow-up, improvements were observed in cross-correlation coefficients of limb movement and imaging assessments, indicating enhanced symmetry and structural improvements with reduced fibrosis. However, persistent discrepancies in elbow functions suggest that further targeted rehabilitation may be warranted. This report underscores the potential of a coordinated interprofessional approach to restore functional gait patterns in elephants and offers valuable insights for future rehabilitative strategies in managing complex musculoskeletal injuries in large mammals. Full article

The Pilates breathing technique is theorized to improve neuromuscular efficiency, but its specific effects on peripheral muscles have not been thoroughly investigated. This study evaluated how Pilates breathing influenced the neuromuscular efficiency of the biceps brachii muscle during submaximal elbow flexion in comparison to regular breathing. Fifty-eight healthy adults without prior experience with the Pilates method of exercise performed concentric and eccentric elbow contractions at 20%, 40%, and 60% of their maximal voluntary isometric contraction under two breathing conditions: the specialized Pilates breathing pattern (executing movements exclusively during expiration) and normal breathing patterns. Muscle activity was measured using surface electromyography, with neuromuscular efficiency quantified as the relationship between muscle electrical activity and force production. The results revealed significantly improved neuromuscular efficiency during Pilates breathing at all tested intensity levels, with the most substantial enhancement observed at 60% of maximal effort. The eccentric phase of movement demonstrated greater efficiency gains compared to the concentric phase. These findings indicate that the distinct breathing pattern used in Pilates can independently enhance neuromuscular performance in the biceps brachii. This study suggests that incorporating Pilates breathing techniques could be beneficial in rehabilitation programs and strength training regimens to optimize both muscle function and movement efficiency. Additional research is recommended to examine the long-term effects and practical applications in clinical and athletic settings. Full article

The Internet of Things (IoT) is gaining increasing attention in healthcare due to its potential to enable continuous monitoring of patients, both at home and in controlled medical environments. In this paper, we explore the integration of IoT with human-robotics in the context of motor rehabilitation for groups of patients performing moderate physical routines, focused on balance, stretching, and posture. Specifically, we propose the I-TROPHYTS framework, which introduces a step-change in motor rehabilitation by advancing towards more sustainable medical services and personalized diagnostics. Our framework leverages wearable sensors to monitor patients’ vital signs and edge computing to detect and estimate motor routines. In addition, it incorporates a humanoid robot that mimics the actions of a physiotherapist, adapting motor routines in real-time based on the patient’s condition. All data from physiotherapy sessions are modeled using an ontology, enabling automatic reasoning and planning of robot actions. In this paper, we present the architecture of the proposed framework, which spans four layers, and discuss its enabling components. Furthermore, we detail the current deployment of the IoT system for patient monitoring and automatic identification of motor routines via Machine Learning techniques. Our experimental results, collected from a group of volunteers performing balance and stretching exercises, demonstrate that we can achieve nearly 100% accuracy in distinguishing between shoulder abduction and shoulder flexion, using Inertial Measurement Unit data from wearable IoT devices placed on the wrist and elbow of the test subjects. Full article

We aimed to compare the effects of practical learning using an educational robot arm (Samothrace: SAMO) and a student simulating a patient in students’ acquisition of therapeutic motion techniques. For this study, twenty-five fourth-year students and eight therapists were included. Students were randomly assigned to the robot practice (Robo) group (n = 13) or conventional practice (Human) group (n = 12), wherein students practiced among themselves. The experimental procedure comprised a pre-practice test, practice, and post-practice test. We calculated the peak angle ratio, peak velocity, and movement time during flexion and extension using the elbow joint angle data. Machine learning was performed on students’ pre-practice and used therapists’ data to create identifiers that distinguish students and therapists to determine whether the students’ skills improved to the level of a therapist. However, regarding other kinematics data, there were no main effects or interactions between groups pre- and post-practice. Identifiers were created from machine learning of kinematics data pre-practice, and the effect was evaluated post-practice. A higher number of students in the Robo group were determined to possess skills at a therapist’s level. This study suggests the effectiveness of a simulation robot that can reproduce a patient’s pathological motions in educating students on upper limb exercise therapy. Full article

Background: this study aimed to identify the influence of postural stability on upper-limb bilateral deficit (BLD), and to compare the assessment of strength generated during elbow flexion functionally vs. analytically in the dominant and nondominant arms. Methods: Twenty men participated in two sessions to evaluate the maximum isometric strength of elbow flexion. This evaluation was performed unilaterally with the dominant arm, unilaterally with the non-dominant arm, and bilaterally, both in the sitting position (SiP) and the standing position (StP). Results: The BLD when peak force was considered was lower for StP (−6.44 ± 5.58%) compared to SiP (−10.73 ± 6.17%) (p = 0.007). Regarding peak force, statistically significant differences were observed for comparisons between dominance (p < 0.001) and Position*Dominance (p = 0.02), but mean force differences were only observed for the dominance factor (p < 0.001). Greater mean and peak forces were always produced bilaterally compared to unilaterally (p < 0.001). Conclusions: a decrease in postural stability by performing elbow flexion exercises in a standing position accentuates BLD of peak force. Full article

Background and Objectives: This study focused on the impact of mental fatigue induced by motor imagery on upper limb function, an area with limited research compared to lower limb performance. It aimed to explore how diaphragmatic breathing exercises influence these effects. Materials and Methods: This study included 30 participants, and Group 1 participated in 12 sessions of diaphragmatic breathing exercises under the supervision of a physiotherapist; Group 2 did not receive any intervention. For all the participants, mental fatigue was induced with motor imagery before and after the intervention, and evaluations were performed before and after mental fatigue. Upper extremity functions were evaluated using isometric elbow flexion strength, hand grip strength, upper extremity reaction time and endurance, finger reaction time, the nine-hole peg test, shoulder position sense, light touch-pressure threshold, and two-point discrimination. Results: The study results showed that after mental fatigue, there was a decrease in isometric elbow flexion strength, nondominant hand grip strength, and nondominant upper extremity endurance, and an increase in nondominant tactile sensation (p < 0.05). No changes were found in two-point discrimination, nine-hole peg test time, and position sense on either side (p > 0.05). The effect of mental fatigue on isometric elbow flexion strength and nondominant grip strength showed significant improvement following diaphragmatic breathing exercises (p < 0.05). Conclusions: This study found that mental fatigue from motor imagery can impact elbow flexion, hand grip strength, upper extremity endurance, and tactile sensitivity. Breathing exercises may help improve strength parameters affected by mental fatigue. It is crucial to consider these effects on upper extremity functions in rehabilitation programs. Full article

Due to damage to the network of nerves that regulate the muscles and feeling in the shoulder, arm, and forearm, brachial plexus injuries (BPIs) are known to significantly reduce the function and quality of life of affected persons. According to the World Health Organization (WHO), a considerable share of global disability-adjusted life years (DALYs) is attributable to upper limb injuries, including BPIs. Telehealth can improve access concerns for patients with BPIs, particularly in lower-middle-income nations. This study used deep reinforcement learning (DRL)-assisted telepresence robots, specifically the deep deterministic policy gradient (DDPG) algorithm, to provide in-home elbow rehabilitation with elbow flexion exercises for BPI patients. The telepresence robots were used for a six-month deployment period, and DDPG drove the DRL architecture to maximize patient-centric exercises with its robotic arm. Compared to conventional rehabilitation techniques, patients demonstrated an average increase of 4.7% in force exertion and a 5.2% improvement in range of motion (ROM) with the assistance of the telepresence robot arm. According to the findings of this study, telepresence robots are a valuable and practical method for BPI patients’ at-home rehabilitation. This technology paves the way for further research and development in telerehabilitation and can be crucial in addressing broader physical rehabilitation challenges. Full article

Musculoskeletal conditions affect millions of people globally; however, conventional treatments pose challenges concerning price, accessibility, and convenience. Many telerehabilitation solutions offer an engaging alternative but rely on complex hardware for body tracking. This work explores the feasibility of a model for 3D Human Pose Estimation (HPE) from monocular 2D videos (MediaPipe Pose) in a physiotherapy context, by comparing its performance to ground truth measurements. MediaPipe Pose was investigated in eight exercises typically performed in musculoskeletal physiotherapy sessions, where the Range of Motion (ROM) of the human joints was the evaluated parameter. This model showed the best performance for shoulder abduction, shoulder press, elbow flexion, and squat exercises. Results have shown a MAPE ranging between 14.9% and 25.0%, Pearson’s coefficient ranging between 0.963 and 0.996, and cosine similarity ranging between 0.987 and 0.999. Some exercises (e.g., seated knee extension and shoulder flexion) posed challenges due to unusual poses, occlusions, and depth ambiguities, possibly related to a lack of training data. This study demonstrates the potential of HPE from monocular 2D videos, as a markerless, affordable, and accessible solution for musculoskeletal telerehabilitation approaches. Future work should focus on exploring variations of the 3D HPE models trained on physiotherapy-related datasets, such as the Fit3D dataset, and post-preprocessing techniques to enhance the model’s performance. Full article

The need for developing a simple and effective assessment tool for muscle mass has been increasing in a rapidly aging society. This study aimed to evaluate the feasibility of the surface electromyography (sEMG) parameters for estimating muscle mass. Overall, 212 healthy volunteers participated in this study. Maximal voluntary contraction (MVC) strength and root mean square (RMS) values of motor unit potentials from surface electrodes on each muscle (biceps brachii, triceps brachii, biceps femoris, rectus femoris) during isometric exercises of elbow flexion (EF), elbow extension (EE), knee flexion (KF), knee extension (KE) were acquired. New variables (MeanRMS, MaxRMS, and RatioRMS) were calculated from RMS values according to each exercise. Bioimpedance analysis (BIA) was performed to determine the segmental lean mass (SLM), segmental fat mass (SFM), and appendicular skeletal muscle mass (ASM). Muscle thicknesses were measured using ultrasonography (US). sEMG parameters showed positive correlations with MVC strength, SLM, ASM, and muscle thickness measured by US, but showed negative correlations with SFM. An equation was developed for ASM: ASM = −26.04 + 20.345 × Height + 0.178 × weight − 2.065 × (1, if female; 0, if male) + 0.327 × RatioRMS(KF) + 0.965 × MeanRMS(EE) (SEE = 1.167, adjusted R² = 0.934). sEMG parameters in controlled conditions may represent overall muscle strength and muscle mass in healthy individuals. Full article

Background: Tai Chi Chuan (TCC) is popular in exercise, but little research has been done on limb and joint strength after the exercise. This study aimed to investigate whether TCC players have different limb and joint strengths in the upper and lower limbs from non-Tai Chi Chuan (NTCC). Methods: Twenty TCC players who have at least one year of experience playing TCC were compared with a group of 25 NTCC participants. A force sensor was used to measure forces in the lower and upper limbs. Maximum forces produced by the lower limbs was measured during a standing position with straight legs or were measured in a seated position. The maximum forces produced by the upper limbs were measured in a standing position at elbow and shoulder levels. Results: The forces of the knee extensors in the TCC group were significantly higher (7.4%) than in the NTCC group; however, the forces of the knee flexors in the TCC group were significantly lower than the NTCC group. The heel-force in hip extension in the NTCC group was significantly higher (9.3%) than in TCC; the toe-force in the plantar flexion in the NTCC was significantly higher than in the TCC group. There were no significant differences between the two groups in the hand-forces in the upper limbs. Conclusions: TCC routine movements strengthen the muscles related to knee extension, which are mainly related to bending knee performance during TCC exercise. For the healthy people between 42 and 78 years old, TCC benefits the enhancement of the strength for knee extension but not for the knee flexion, ankle plantar flexion and hip extension. There is no significant difference between the TCC and NTCC groups on the strength of upper limbs and joints. As a whole, the effect of Tai Chi Chuan exercise on the strengths in the limbs and joints is compromised. In the future, a study with larger sample size than this study is highly recommended. Full article