Search Results (626)

Wearable inertial sensing and markerless vision are increasingly integrated to enable objective assessment of locomotor and postural function for sports telerehabilitation, intelligent physiotherapy, and athlete performance monitoring. Before such multimodal systems can be translated to clinical practice, their fusion, optimization, and temporal modeling strategies require validation under controlled conditions with reliable ground truth. This study presents a unified multimodal framework that hierarchically integrates inertial measurement unit (IMU) signals and RGB visual information through kernelized representation learning, adaptive multimodal fusion, evolutionary feature optimization, and deep temporal classification. The IMU branch employs Kernelized Extreme Learning Machine (KELM) denoising, Kernelized Canonical Correlation Fusion (KCCF), entropy-guided adaptive windowing, and complementary time-series descriptors (MINIROCKET, TS-CHIEF, and r-STSF). Concurrently, the RGB branch combines anisotropic diffusion filtering, HRNet-based silhouette extraction, DensePose R-CNN, Mesh Graphormer, and Multi-Model Pose-Flow Fusion (MPFF) to learn robust visual representations. Both modalities are integrated through Weighted Canonical Feature Fusion (WCFF) and optimized using a Genetic Algorithm for feature selection and adaptive modality weighting before temporal modeling with cluster-based alignment, Gaussian Process Sequence Modeling, and DeepConvLSTM. As the selected benchmarks do not provide complete inertial recordings, the inertial modality is established according to the adopted experimental protocol to support multimodal fusion analysis. Under 5-fold subject-independent cross-validation, the framework achieves accuracies of 86.56 ± 0.31% on SoccerDiffusion and 88.04 ± 0.25% on HumanoidRobotPose. Although evaluated on humanoid robotic benchmarks, the proposed framework provides a methodological basis for future wearable-enabled clinical movement assessment, remote rehabilitation, and athlete monitoring, while validation on synchronized human inertial-visual datasets remains an important direction for future research. Full article

Background and Objectives: Traumatic brain injury (TBI) is one of the leading causes of long-term disability among adults, with consequences for balance, postural stability, and quality of life. Addressing balance disorders in TBI patients requires a tailored and continuous care approach; the existing literature underlines a general framework for physiotherapy treatments, but no clear profile of technique, dosage and timing of intervention emerges. The present scoping review, therefore, aimed at mapping physiotherapy approaches to balance in TBI population, highlighting their potential effects and role through care pathways. Materials and Methods: A scoping review was conducted, according to PRISMA Extension for Scoping Reviews, with the aim of mapping physical therapy approaches to treat balance disorders in adult patients with TBI. A specific search string for each database was formulated through a PCC (Population, Concept, Context) framework. The search, limited to articles in English and published between 2015 and 2025, was conducted across five databases (PubMed, PEDro, Scopus, Embase, and Web of Science), including experimental studies, observational designs, and `case reports. Results: From the initial selection of 1052 records, six studies were included: five randomized controlled trials and a case report, published between 2016 and 2022. Results presented high heterogeneity of physiotherapy programs and outcome variations; interventions identified included virtual reality, video game therapy, adapted physical exercise, ballistic training, rapid-resistance elliptical training, and rhythmic auditory stimulation. These studies reported variable improvements in balance and mobility, not even with significant inter-group differences. Conclusions: Several techniques showed preliminary evidence in pre/post improvements of balance for TBI patients, including strength exercise, aerobic training and virtual-mediated approaches such as video game therapy and virtual reality. Rhythmic auditory stimulation has unclear effects. Future studies are needed to define the impact of each balance recovery strategy according to the baseline characteristics of the patient. Full article

Background: Exercise rehabilitation (ER) has become an important treatment regimen during the recovery phase of acute ischemic stroke (AIS). Optimal exercise prescriptions for post-stroke motor recovery remain controversial. Methods: PubMed, Embase, the Cochrane Library, and Web of Science were systematically searched through November 2025. The Cochrane risk-of-bias (RoB 1) assessment tool was utilized to assess the risk of bias in the original studies. Results: This study included 66 trials comprising 3675 patients. For balance, whole-body tilting postural training (WTPT), unilateral strength training (UST) and robot-assisted unilateral gait training (RAUGT) showed high SUCRA rankings. Activities of daily living likely improved most with robot-assisted Tai Chi training (RATCT), home rehabilitation guidance (HRG) and robot-assisted gait training (RAGT). Fugl-Meyer Assessment (FMA) gains appeared greatest following robot-assisted hand training with electrical stimulation (RAHT + ES), neural inhibition therapy (NIT) and graded motor imagery with electrical stimulation (GMI + ES). Walking endurance seemed most responsive to visual feedback training (VFT), UST and visual aids training (VAT), while functional mobility showed greatest improvement with tilt sensor-assisted gait training with electrical stimulation (TAGT + ES), gait training (GT) and virtual reality therapy with motor imagery (VRT + MI). Conclusions: This study provides the first comprehensive evidence synthesis evaluating the comparative effectiveness of specific exercise modalities across distinct recovery domains after AIS. Rather than supporting generic interventions, the findings highlight the distinct comparative advantages of various emerging technologies and traditional practices. These results offer an evidence-based framework for clinicians to optimize post-stroke rehabilitation protocols and highlight priority areas for future research on dose–response and long-term outcomes. Full article

Background/Objectives: Aquatic therapy is widely used in pediatric rehabilitation because buoyancy and water resistance facilitate movement practice under reduced gravitational load. The Halliwick Method is a prominent approach; however, its effects on balance, motor function, and neuromuscular performance in children and young adults with disabilities have not been comprehensively synthesized. This systematic review summarized the effects of Halliwick aquatic therapy and aquatic exercise on balance, strength, and functional mobility in this population. Methods: This review followed Cochrane and PRISMA 2020 guidelines and was registered in PROSPERO (CRD42025635215). PubMed, MEDLINE Complete, PEDro, Web of Science, and Google Scholar were searched from inception to November 2025. Randomized controlled trials (≥2 weeks; ≥10 participants per trial) involving individuals aged 3–29 years with disabilities were included. Risk of bias was assessed using the Cochrane RoB2 tool. Results: Eight randomized controlled trials (involving 222 participants) met inclusion criteria. Despite heterogeneity in diagnoses and protocols (Halliwick-based hydrotherapy, swimming, strengthening, task-oriented balance training), most studies reported improvements in balance and postural control (BBS/PBS, WOTA2), gross motor function (GMFM), and functional mobility (6MWT, TUG, gait indices). Several trials demonstrated gains in strength, and one reported favorable changes in lower-limb electromyographic activation. Methodological limitations included small samples, limited blinding, variable dosing, and scarce follow-up. Due to heterogeneity in interventions and outcomes, findings were synthesized narratively. Conclusions: Halliwick aquatic therapy and aquatic exercise appear to improve balance, motor function, and neuromuscular performance in children and young adults with disabilities. However, evidence is limited by heterogeneity and methodological constraints. More robust, standardized RCTs with direct muscle and neuromuscular assessments are needed. Full article

Sport-related concussion (SRC) rehabilitation has advanced toward active, multidomain management, yet recovery may still be judged largely through symptom resolution and broad clinical indicators that may not fully capture persistent functional deficits. Emerging evidence suggests subtle disturbances in postural control, gait, and sensorimotor coordination may persist beyond apparent clinical recovery, raising the possibility that unresolved asymmetries represent an underrecognized dimension of dysfunction. This Viewpoint proposes symmetry restoration as a potential rehabilitative construct in SRC management and explores how biofeedback-guided approaches may provide a conceptual framework for identifying, monitoring, and retraining symmetry-related deficits. Drawing from concussion research, motor control theory, rehabilitation science, and biofeedback applications, this article discusses postural and movement asymmetries as possible markers of incomplete recovery, examines visual, wearable, neuromuscular, and auditory biofeedback strategies as potential mechanisms for symmetry-informed rehabilitation, and outlines clinical implications and future research priorities. Rather than proposing symmetry as a stand-alone determinant of recovery, this Viewpoint advances the conceptual proposition that symmetry-oriented approach may complement existing multidomain models by serving as an additional layer of functional assessment alongside symptom reporting, neurocognitive evaluation, vestibular and oculomotor examination, exertional testing, and routine clinical assessment. Within this framework, symmetry-related measures are envisioned not as independent clearance criteria, but as potentially informative indicators of residual sensorimotor function that may help guide rehabilitation progression and contribute to more functionally informed return-to-sport decision making through adjunctive measures such as center-of-pressure behavior, center-of-mass displacement, gait symmetry, stance and swing time asymmetry, limb-loading patterns, interlimb coordination, and muscle activation symmetry. Full article

Background: Physical activity plays a vital role in caring for people with multiple sclerosis (MS). Yet, challenges like fatigue, mobility impairment, fall risk, symptom fluctuation, and poor access to rehabilitation often make sustained participation difficult. Adhering to physical activity programmes is tough. Artificial intelligence (AI) may transform wearable, smartphone, clinical, and patient-reported data into interpretable information for monitoring, prediction and individualized support. Objective: Building on the identified need for individualized support, this scoping review mapped original AI-based studies relevant to physical activity, gait, mobility, ambulation, fatigue, fall risk, and real-world functioning in people with MS. Methods: The review followed PRISMA-ScR principles. Search covered records published from 1 January 2016 to 14 May 2026 across biomedical, rehabilitation, technology-oriented, trial registry, and citation-searching sources. Eligible studies included MS or MS-specific data, an explicit AI/ML or model-derived predictive analytics component, and an activity-related clinical domain. Results: The search identified 332 records/reports. After removing 127 duplicates, 205 records were screened, 45 full texts were assessed, and 21 original AI studies met the eligibility criteria. These addressed inertial sensor deep learning, wearable gait speed estimation, postural sway fall risk prediction, connected device prediction of fatigue and health state, smartphone-based ambulation characterization, treadmill or walkway gait classification, chair stand fall status prediction, daily life gait/turning fall prediction, fear-of-falling detection, sensor-derived fatigue prediction, mobile/wearable modelling of MS, and physical activity prediction. Conclusions: AI can extract clinically relevant patterns from gait, wearable, smartphone, connected device, clinical, and patient-reported data in MS. However, evidence does not yet show that AI-supported systems improve physical activity, adherence, fatigue burden, fall risk, quality of life, or functional independence. AI is therefore promising but early, and prospective, externally validated, human-supervised, fatigue-aware, safety-sensitive studies are needed to support clinically meaningful, patient-centred MS rehabilitation and activity planning. Full article

Background: Dysautonomia, including postural orthostatic tachycardia syndrome (POTS) and related orthostatic disorders, is frequently associated with debilitating gastrointestinal (GI) symptoms in adolescents, including chronic nausea, early satiety, postprandial fullness, and functional dysmotility. Despite the significant disease burden, pharmacological options for GI dysmotility in this population remain poorly studied. To our knowledge, no prior case series has described metoclopramide as a targeted prokinetic bridge therapy specifically in adolescents with dysautonomia-associated GI dysmotility symptoms. Case Series Summary: We describe three adolescent females (ages 13, 16, and 16 years) with specialist-confirmed dysautonomia and refractory GI symptoms who were treated with a standardized short-course, low-dose metoclopramide bridge protocol (5 mg three times daily, tapered over approximately 12 weeks). All patients received concurrent multidisciplinary management including dietary modification, neuromodulators, integrative therapies, and behavioral support. All three demonstrated subjective improvement in nausea and GI symptoms, enabling engagement with broader rehabilitative and nutritional interventions. No extrapyramidal symptoms or serious adverse effects were observed. Cumulative metoclopramide doses across all three cases ranged from approximately 770 to 1050 mg—well below the threshold associated with tardive dyskinesia risk in contemporary real-world data. Conclusions: Short-course, low-dose metoclopramide, administered as part of a structured multidisciplinary protocol with explicit safety counseling and planned taper, may serve as a feasible bridge therapy for adolescents with dysautonomia-associated GI dysmotility symptoms. These observations are hypothesis-generating and should be interpreted with caution given the small sample size, concurrent multidisciplinary interventions, and absence of standardized outcome instruments. They support the need for prospective investigation of short-course, weight-dosed metoclopramide use in this specific population. Full article

Background and Clinical Significance: Alien hand syndrome (AHS) is a rare disorder of agency and complex motor control characterized by involuntary, apparently purposeful limb movements experienced as outside voluntary control. Pontine hemorrhage is an uncommon substrate, and its manifestations may overlap with sensory ataxia and other post-stroke movement disorders. Case Presentation: An 86-year-old right-handed man developed right-sided alien hand phenomena after a left pontine hemorrhage. Examination showed dysarthria, limited left gaze, diplopia, preserved muscle strength, marked right-sided proprioceptive impairment, a thalamic-hand-like posture, impaired spatial control, involuntary levitation, intermanual conflict, and purposeful-appearing rubbing movements when distracted. The diagnosis was based on loss of agency and autonomous limb behavior that could not be explained by sensory ataxia alone. Serial CT demonstrated an interval reduction in the size of the pontine hemorrhage; a representative thalamic level CT showed no evident thalamic hemorrhage or gross structural lesion, although a small CT occult ischemic lesion could not be excluded. Repeat MRI was not completed because of severe claustrophobia and anesthesia risk. EEG, formal neuropsychological testing, and standardized functional scales were unavailable. The NIHSS, assessed 15 days after admission to our hospital, was 6 points. No specific pharmacological treatment was initiated. Cognitive-behavioral rehabilitation was recommended, but transportation difficulties prevented regular attendance. Approximately three months after discharge, physician relatives reported resolution of abnormal movements and improved independent gait; no formal post-discharge examination was performed. Conclusions: Pontine hemorrhage may rarely be associated with mixed AHS phenomenology. Disruption of ascending proprioceptive and sensorimotor pathways is plausible, but the absence of advanced imaging and neurophysiological assessment precludes definitive anatomical or causal conclusions. Full article

In this work, we present a novel framework of integrating anthropometric measurement with posture recognition using LabVIEW’s Vision Development Module specifically for yoga poses. Yoga is a practice that originated in India many years ago and is now popular globally, contributing significantly towards balancing the human body and mind. A key challenge is the accurate recognition of yoga poses in real time using contactless techniques. To achieve this, the proposed system works by digitizing yoga poses through anthropometric measurements enhanced through photoanthropometric modeling with Calibrated Bounding Boxes using YOLO version 4 for representing the poses, combined with geometric examinations to normalize bounding box dimensions and proceed for pose variations. The intermediate model developed improves the measurement accuracy, while the final stage handles posture classification in the LabVIEW ML environment for real-time yoga pose recognition. This study focuses on the Tadasana pose. A Microsoft XBOX 360 Kinect sensor was used for capturing the images, which were processed using LabVIEW 2019 Vision IMAQ. An inference model was developed for feature extraction and matching, such that precise posture identification was facilitated with bounding boxes. The experimental results illustrate that the proposed system achieves a pose recognition accuracy, with respect to anthropometric measurements, of 95.4%, thus proving its potential for rehabilitation and health monitoring. Full article

Study Objective: This study investigated the effects of chronic ankle instability (CAI) on axial (neck and trunk) and lower-extremity joint kinematics during a side cutting jump to identify compensatory strategies across the kinetic chain. Methods: Twenty-seven male adults in their 20s participated, including fourteen with CAI and thirteen healthy controls. CAI was defined as a Cumberland Ankle Instability Tool-Korean version (CAIT-K) score ≤ 24 and an Identification of Functional Ankle Instability-Korean version (IdFAI-K) score ≥ 11. Participants performed side cutting jumps on a force plate while three-dimensional joint kinematics were captured using a 14-camera motion system (100 Hz). Eighteen joint angles from the upper body to the ankle were analyzed. Group differences across the movement phase (initial contact to 1 s post-landing) were assessed using Statistical Parametric Mapping (SPM1D) with Bonferroni correction (α = 0.00085). Results: Compared with controls, the CAI group showed smaller neck motions across all planes, which may suggest a potential reliance on visual stabilization. Trunk flexion and rotation were greater, which is consistent with a potential mechanism for impact absorption. At the pelvis and hip, CAI participants displayed increased anterior tilt, greater flexion and internal rotation, and reduced abduction. Notably, at the knee, flexion was significantly greater during the 1.7–32.8% phase (peak d = 1.06, large effect size) with smaller valgus and rotational angles. At the distal level, the ankle showed a significant increase in eversion during the 3.4–15.5% phase (d = 0.00–0.28) and external rotation during the 5.2–13.8% phase (d = 0.28–0.48), representing a compensatory pronation-bias strategy. Conclusions: CAI alters not only ankle function but also global coordination during side cutting jumps, reflecting multi-joint compensatory mechanisms to stabilize posture and modulate kinematic forces. Compensatory strategies involving visual fixation, trunk modulation, and proximal joint adjustments highlight the need for an integrated kinetic chain approach in CAI evaluation and rehabilitation. Full article

Indoor companion, rehabilitation, logistics, laboratory transport, and service robot scenarios require mobile platforms that can follow a human operator safely and flexibly under lighting changes, occlusion, texture-poor corridors, and dynamic pedestrian environments. Vision-, LiDAR-, and UWB-based following systems can provide high perception capability, but their deployment cost, environmental dependence, and sensing complexity remain limiting factors for low-perception-dependence applications. This paper presents a passive following system for a Mecanum-wheel mobile platform based on gimbal posture perception and orthogonal odometry fusion. A rope-tensioned two-axis gimbal is mounted above a 300 mm × 300 mm × 150 mm omnidirectional chassis, and a six-axis inertial sensor installed at the top of the gimbal detects pitch and roll changes induced by user traction. A piecewise posture-to-velocity mapping model with a dead zone, saturation, low-pass filtering, and acceleration limiting converts the user’s traction intention into planar velocity commands in the vehicle coordinate frame. To reduce pose errors caused by Mecanum-wheel slip and discontinuous roller-ground contact, two orthogonal passive odometry wheels and inertial attitude estimation are fused to provide planar position feedback for closed-loop following. A prototype was implemented using an Infineon TRAVEO CYT4BB77 controller, TI DRV8701E motor drivers, six-axis IMUs, magnetic encoders, and an embedded display interface. Experiments evaluated attitude estimation accuracy, planar localization accuracy, passive following performance, gyroscope compensation, and open-loop/closed-loop following. The compensated attitude module achieved a static yaw drift of 0.45 deg/h and a dynamic attitude RMSE below 0.56 deg. Orthogonal odometry fusion produced an average positioning error of 3.8 mm over a 3000 mm linear displacement, reducing error by approximately 84.6% compared with pure Mecanum-wheel drive odometry. In a 5000 mm forward traction task, closed-loop following reduced the average distance error from 38.6 mm to 11.5 mm compared with open-loop attitude mapping. The results indicate that the proposed gimbal-orthogonal odometry architecture provides a compact, intuitive, and environment-robust solution for passive following on omnidirectional mobile platforms. Full article

Background: Postural problems such as head forward posture, thoracic hyperkyphosis, and lumbar hyperlordosis, when seen together, further complicate postural control, increasing the importance of comprehensive approaches in treatment. This study aims to examine the effect of 6 weeks of telerehabilitation with web-based exercises and compare the home-based exercises in individuals with postural problems. Trial Design: A Randomized Controlled Study. Methods: A total of 34 volunteers with postural deformity among young adults were randomly divided into telerehabilitation (n = 17) and control (n = 17) groups. Craniovertebral, thoracic kyphosis, and lumbar lordosis angles of all individuals were evaluated with a smartphone application (Clinometer+ Bubble), hamstring and pectoral muscle shortness with a goniometer, and trunk muscle endurance with endurance tests created by McGill and Sorenson. Whilst the tele-rehabilitation group was provided with a video-based exercise program, the control group was advised to follow the same exercise program at home. Exercises were performed 3 days a week for 6 weeks, as 1-h sessions. Participants in the telerehabilitation group were followed up with a synchronized video conference. Results: A significant difference was observed in the telerehabilitation group in muscle shortness and the endurance tests (p < 0.05). Only a significant difference in left (p = 0.03) and right (p = 0.04) muscle shortness was observed in the home exercise group. Significant differences were observed in Craniovertebral and lumbar lordosis angles between groups (p < 0.05), with the telerehabilitation group showing better outcomes. The kyphosis angle, muscle shortness, and endurance test results between groups were found to be similar (p > 0.05). Conclusions: Six weeks of telerehabilitation can improve muscle shortness and trunk endurance in young adults with postural deformities. Both the exercise program using telerehabilitation and the home exercise program were beneficial for individuals with postural problems, with more favorable effects observed in the telerehabilitation group. Full article

Postural control is a multilevel adaptive system that stabilizes the body in space through dynamic sensory rebalancing and predictive neuromotor regulation. This review synthesizes current data on the neural mechanisms of balance maintenance, individual strategies for integrating multisensory information, and the role of immersive virtual reality as a controlled experimental and neuromodulation platform, synthesising evidence from 73 studies across neuroscience, cognitive psychology, and VR-based rehabilitation. Particular attention is paid to the cognitive style of “field dependence/independence”, which reflects stable preferences for the dominance of visual or vestibular-proprioceptive signals and consistently predicts the selection of postural strategies. We show that traditional averaged models ignore interpersonal variability, whereas immersive VR allows for the parametric induction of sensory conflicts, quantitative assessment of sensory dependence profiles, and facilitates the study of adaptive reorganization at the cortical, brainstem, and spinal levels. The review substantiates the need to move from standardized protocols to personalized approaches in diagnostics and neurorehabilitation that consider individual patterns of input rebalancing. The integration of behavioural metrics with neurophysiological markers in a VR environment provides a foundation for developing predictive balance models and targeted training interventions. However, the translational application of VR-based approaches requires careful consideration of methodological limitations, including cybersickness, hardware latency, and ecological validity, to ensure robust and generalisable outcomes. Full article

Resisted sidestepping is widely implemented in rehabilitation and strength training, and exercise prescription is often guided by recommendations based on surface electromyography (EMG) patterns and intuitive assumptions about how elastic-band placement and posture influence hip loading. EMG provides valuable insight into neuromuscular strategies, but it does not, by itself, specify the direction or magnitude of joint-level mechanical demand. In this opinion article, we argue that exercise prescription is strengthened when EMG findings are interpreted within a joint-kinetic framework, in which the net external joint moment, calculated via inverse dynamics, defines the mechanical demand imposed by the task. Using resisted sidestepping as the central example and drawing on previously published three-dimensional inverse-dynamics findings, we address a common misconception that placing an elastic band around the forefeet necessarily imposes an external hip moment toward medial rotation that can help target “hip lateral rotator” muscles. Available inverse-dynamics evidence indicates that, under typical execution with slight hip and knee flexion, forefoot-band sidestepping imposes a resultant external hip moment toward lateral rotation, thereby requiring a net internal muscular moment toward medial rotation to maintain alignment and perform the task. We further highlight that posture and resistance configuration modulate how demand is distributed across joint movement planes. Specifically, band placement alters the moment arms of the elastic resistance relative to different hip joint axes and therefore influences how changes in band stiffness are translated into transverse- and frontal-plane hip loading. Thus, band placement, posture, and resistance magnitude should be selected according to the intended joint-level loading objective rather than inferred from EMG patterns alone. Although illustrated with sidestepping, this reasoning is relevant to many resistance and rehabilitation exercises in which EMG-only interpretations, without consideration of external forces and joint kinetics, may lead to incomplete or incorrect inferences about joint loading and musculoskeletal function. Full article

Exoskeletons are widely utilized across various domains, including biomedical and rehabilitative engineering. In clinical applications, precise joint torque evaluation is critical to ensuring exoskeleton efficiency, especially when assisting patients with impaired mobility. This work presents a straightforward inverse-dynamics framework to compute human joint torques using motion capture and force plate data. Estimating these torques is a key requirement for exoskeleton systems to deliver appropriate and individualized assistive support. A key innovation of the proposed model is the explicit integration of a three-link chain—comprising the thigh, shank, and foot—treated as a cohesive multi-segment limb. By formally incorporating the foot segment, the model enables a more rigorous representation of ground reaction forces (GRF) and the dynamic migration of the center of pressure (COP). The proposed framework was validated against OpenSim 4.0 using benchmark datasets involving walking, squatting, and drop-jump maneuvers. The results demonstrated strong agreement with OpenSim, yielding normalized root mean square errors of approximately 10% across major lower-limb joints during walking. In contrast, the squatting posture provided a significant magnitude offset, despite maintaining close temporal phase alignment. Beyond torque estimation, the results provide insight into the sensitive interplay among COP trajectories, foot geometry, and GRF orientation. The proposed framework offers a computationally efficient tool for biomechanical analysis and provides a practical foundation for future lower-limb exoskeleton and assistive robotic applications. Full article