Search Results (14)

Healthcare professionals (namely, occupational therapists) face ergonomic risk factors that may lead to work-related musculoskeletal disorders (WRMSD). Ergonomic assessments are crucial to mitigate this occupational issue. Wearable devices are a potential solution for such assessments, providing continuous measurement of biomechanical and physiological parameters. Ergo4workers (E4W) is a mobile application designed to integrate data from independent wearable sensors—motion capture system, surface electromyography, force platform, and smartwatch—to provide an overview of the posture and workload of occupational therapists. It can help identify poor work practices and raise awareness about ergonomic risk factors. This paper describes the development of E4W by following a User-Centred Design (UCD) approach. The initial stage focused on specifying the context of use in collaboration with six occupational therapists. Then the app was implemented using WordPress. Three iterations of the UCD cycle were performed. The usability test of prototype 1 was carried out in a laboratory environment, while the others were tested in a real healthcare work environment. The Cognitive Walkthrough was applied in the usability tests of prototypes 1 and 2. The System Usability Scale evaluated prototype 3. Results evidenced positive feedback, reflecting an easy-to-use and intuitive smartphone app that does not interfere with daily work activities. Full article

Background and Objectives: Depression is a leading cause of disability globally, with treatment challenges including limited access, stigma, and poor adherence. Gamification, which applies game elements such as points, levels, and storytelling into non-game contexts, offers a promising strategy to enhance engagement and augment traditional treatments. Our research is the first study designed to explore the implementation of gamification within the Malaysian context. The objective was to explore the feasibility of implementation of gamification as an adjunctive treatment for adults with depression. Materials and Methods: Focus group discussions were held with five mental health professionals and ten patients diagnosed with moderate depression. The qualitative component assessed perceptions of gamified interventions, while quantitative measures evaluated participants’ depressive and anxiety symptomatology. Results: Three key themes were identified: (1) understanding of gamification as a treatment option, (2) factors influencing its acceptance, and (3) characteristics of a practical and feasible intervention. Clinicians saw potential in gamification to boost motivation, support psychoeducation, and encourage self-paced learning, but they expressed concerns about possible addiction, stigma, and the complexity of gameplay for some patients. Patients spoke of gaming as a source of comfort, escapism, and social connection. Acceptance was shaped by engaging storylines, intuitive design, balanced difficulty, therapist guidance, and clear safety measures. Both groups agreed that gamification should be used in conjunction with standard treatments, be culturally sensitive, and be presented as a meaningful therapeutic approach rather than merely as entertainment. Conclusions: Gamification emerges as an acceptable and feasible supplementary approach for managing depression in Malaysia. Its success depends on culturally sensitive design, robust clinical oversight, and seamless integration with existing care pathways. Future studies should investigate long-term outcomes and establish guidelines for the safe and effective implementation of this approach. We recommend targeted investment into culturally adapted gamified tools, including training, policy development, and collaboration with key stakeholders to realistically implement gamification as a mental health intervention in Malaysia. Full article

Currently, high-tech assistive technologies (ATs), particularly Socially Assistive Robots (SARs), virtual reality (VR) and conversational AI (ConvAI), are considered very useful in supporting professionals in Speech and Language Therapy (SLT) for children with communication disorders. However, despite a positive public perception, therapists face difficulties when integrating these technologies into practice due to technical challenges and a lack of user-friendly interfaces. To address this gap, a design-based research approach has been employed to streamline the integration of SARs, VR and ConvAI in SLT, and a new software platform called “ATLog” has been developed for designing interactive and playful learning scenarios with ATs. ATLog’s main features include visual-based programming with graphical interface, enabling therapists to intuitively create personalized interactive scenarios without advanced programming skills. The platform follows a subprocess-oriented design, breaking down SAR skills and VR scenarios into microskills represented by pre-programmed graphical blocks, tailored to specific treatment domains, therapy goals, and language skill levels. The ATLog platform was evaluated by 27 SLT experts using the Technology Acceptance Model (TAM) and System Usability Scale (SUS) questionnaires, extended with additional questions specifically focused on ATLog structure and functionalities. According to the SUS results, most of the experts (74%) evaluated ATLog with grades over 70, indicating high acceptance of its usability. Over half (52%) of the experts rated the additional questions focused on ATLog’s structure and functionalities in the A range (90–100), while 26% rated them in the B range (80–89), showing strong acceptance of the platform for creating and running personalized interactive scenarios with ATs. According to the TAM results, experts gave high grades for both perceived usefulness (44% in the A range) and perceived ease of use (63% in the A range). Full article

Robotic walking assistance devices support the rehabilitation of patients with neurological impairments. However, most commercialized systems rely on treadmill-based walking, which may not reflect real-world environments. This study aimed to evaluate the usability of a newly developed over-ground walking assistance robot (OWAR-MW) based on mecanum wheels compared with a commercial system (Andago) from the perspectives of physical therapists and patients with stroke. Nine physical therapists and nine stroke patients participated. Each participant walked 100 m using both the OWAR-MW and Andago systems. Subsequently, a satisfaction survey was conducted across three categories—safety, operability and functionality, and convenience—using a questionnaire adapted from the standard usability testing guidelines for walking assistive devices. Additionally, in-depth interviews were conducted to explore user experience and improvement needs. In both participant groups, the OWAR-MW showed a tendency for lower satisfaction scores than Andago across all categories. Stroke patients reported significantly lower scores in all three categories (safety: 4.90 vs. 4.04, operability and functionality: 4.83 vs. 4.33, convenience: 4.87 vs. 4.49, p < 0.05), whereas therapists noted a significant difference only in safety (4.02 vs. 3.37, p < 0.05). Key issues identified included a lack of handles, delay in actuator response, low motion detection sensitivity, non-intuitive controls, and discomfort caused by the harness, particularly the thigh straps. OWAR-MW demonstrated usability limitations in its current prototype form. Technical improvements in user interface, control accuracy, and harness design are necessary before clinical application. This study provides valuable feedback for the future development of user-centered rehabilitation robotics. Full article

This study explores how aesthetic relational knowing (ARK), as assessed by the ARK-T scale, is used by psychotherapists of different psychotherapeutic models. The ARK-T, a tool based on Gestalt therapy principles, evaluates three core factors of this therapeutic competence: body awareness, affective empathy, and intuitive resonance. A sample of 158 therapists from various approaches, including Gestalt therapy, cognitive–behavioral, systemic–relational, and psychodynamic models, participated in the study. The results show that while body awareness and affective empathy vary in emphasis, depending on the therapeutic approach, intuitive resonance emerges as a shared competence among therapists across orientations. These findings suggest that ARK, particularly the therapist’s capacity to attune to the client’s emotional and relational dynamics, may be a core component of effective therapy. The study highlights the significance of these relational competences in fostering effective therapeutic outcomes across diverse psychotherapeutic frameworks. Full article

This work presents the design of a new game controller device and the development of two exergames (Peter Jumper and Andromeda) for upper limb rehabilitation. The eJamar controller is a novel electromechanical device designed to measure wrist and hand movements, such as pronation/supination, flexion/extension, and ulnar/radial deviation, enabling users to perform control actions in the exergames. One of eJamar’s most significant features is its ability to measure hand grip strength, a function not available in commercial gaming controllers. The exergame Peter Jumper involves a character jumping over obstacles in various environments, promoting hand grip exercises. The exergame Andromeda involves shooting enemy ships, promoting coordination between hand movements and grip strength, making it suitable for different rehabilitation techniques. A testing protocol was applied with eight healthy participants (5F and 3M), who completed a survey evaluating gameplay, usability, and satisfaction of the system. The results demonstrated that the developed exergames are intuitive and easy to play, with participants reporting that a therapist’s presence is not required for gameplay. Hence, it suggests that the developed system can improve the rehabilitation process, promoting wrist–arm movements and grasping actions. Full article

Background: Cognitive bias may appear in occupational therapists’ interpretation of physical examinations. Since different strategies for decision making have been shown to reduce bias, its quantification is an essential first step towards awareness and bias reduction. Our aims: (1) quantify cognitive bias by testing the differences in occupational therapists’ assessment of lateral pinch force modulation between young and older adults, and between women and men; and (2) to test for a correlation between the tendency to bypass an intuitive response and the degree of cognitive bias. Methods: Occupational therapists (n = 37; age 40.3 ± 11.4 years) used a visual analogue scale to rate pre-recorded simulations of the digital output of lateral pinch modulation videos of different levels of abilities coupled with videos of young/old men/woman pressing the force sensor. They filled out the Cognitive Reflection Test and the Rational-Experiential Inventory-40. Results: Subjects showed higher bias towards old individuals compared to young ones (p < 0.001), but with no sex bias (p = 0.119). Rational ability correlated with cognitive bias of assessment of lateral pinch modulation in old individuals (r = 0.537, p < 0.001). Discussion: Occupational therapists might underestimate the physical abilities of older adults. Biased evaluation might cause assignment of redundant exercises and therefore loss of time, effort, and resources. Full article

This study aims to investigate the presence of intuition and responsiveness in early students and in experienced students and psychotherapists, which is understood as the ability to integrate bodily sensitivity and cognition of what is experienced with the patient (aesthetic relational knowing—ARK). The study compares how the therapist’s felt sense of the phenomenological intersubjective field and aesthetic relational competence differs between a group of experienced students and psychotherapists and a group of beginners. The sample consisted of 128 participants (20 M; 108 F), finally divided into two groups: “experienced students and psychotherapists” and “beginners”. The Aesthetic Relational Knowledge Scale (ARKS), a questionnaire consisting of 58 items targeting three factors (empathy, body awareness, and resonance), was administered. Statistical analyses were conducted to assess (i) differences between the two groups (through Student’s t and Cohen’s d for effect sizes), (ii) the influence of the level of training for each ARK factor using analyses of covariance for testing the possible influence of demographic variables, and (iii) logistic regressions to compare the influence of the three factors of the ARK model on the group variable with groups as a categorical variable. Significant differences between the two groups were found in body awareness and resonance. Body awareness was found to be the variable best discriminating between the beginners and the experienced students and psychotherapists. Despite being non-significant, there is a tendency suggesting that empathy appears more relevant at the beginning of training. The study shows the importance of training for the development of the therapist’s intuition and responsiveness, especially in the factors of body awareness and resonance. The results indicate the importance of assessing and supporting the aesthetic and field resonance of therapists in training, increasing quality and depth of the therapist’s responsiveness. This study is limited by a correlational design using self-report and on a limited sample, but it shows that the ARKS can monitor the effectiveness of training related to Gestalt therapeutic competencies. Full article

Electromyography (EMG) is a multidisciplinary field that brings together allied health (kinesiology and physical therapy) and the engineering sciences (biomedical and electrical). Since the physical sciences are used in the measurement of a biological process, the presentation of the theoretical foundations of EMG is most conveniently conducted using math and physics. However, given the multidisciplinary nature of EMG, a course will most likely include students from diverse backgrounds, with varying levels of math and physics. This is a pedagogical paper that outlines an approach for teaching foundational concepts in EMG to kinesiologists and physical therapists that uses a combination of analogies, visual descriptions, and qualitative analysis of biophysical concepts to develop an intuitive understanding for those who are new to surface EMG. The approach focuses on muscle fiber action potentials (MFAPs), motor unit action potentials (MUAPs), and compound muscle action potentials (CMAPs) because changes in these waveforms are much easier to identify and describe in comparison to the surface EMG interference pattern (IP). Full article

Some apps serve as assistive technologies or digital therapeutic tools that can be used by rehabilitation professionals in the motor disability context, bringing benefits to therapists and people with disabilities. However, websites or catalogs do not provide reliable information, easy search, and intuitive access to these apps, causing access information difficulties. Therefore, this work proposes to develop a digital catalog of software focused on motor disability. This work performed a systematic search of websites and catalogs related to motor disability, a systematic search of the apps that the digital catalog would show, and a quality evaluation of selected apps using the Mobile Application Rating Scale tool. The digital catalog was developed with the information obtained in the previous phases combining the Prototyping and User Experience criteria, then assessed by final users, software testers, and a web accessibility evaluation tool. The catalog obtained a satisfactory quality score based on the end-users’ and therapists’ satisfaction when finding technological resources to use in their professional and health-care activities. This research aims to contribute to those interested in developing software for people with disabilities and encouraging them to create and design their implementations based on this study. Full article

Using optical motion capture and wearable sensors is a common way to analyze impaired movement in individuals with neurological and musculoskeletal disorders. However, using optical motion sensors and wearable sensors is expensive and often requires highly trained professionals to identify specific impairments. In this work, we proposed a graph convolutional neural network that mimics the intuition of physical therapists to identify patient-specific impairments based on video of a patient. In addition, two modeling approaches are compared: a graph convolutional network applied solely on skeleton input data and a graph convolutional network accompanied with a 1-dimensional convolutional neural network (1D-CNN). Experiments on the dataset showed that the proposed method not only improves the correlation of the predicted gait measure with the ground truth value (speed = 0.791, gait deviation index (GDI) = 0.792) but also enables faster training with fewer parameters. In conclusion, the proposed method shows that the possibility of using video-based data to treat neurological and musculoskeletal disorders with acceptable accuracy instead of depending on the expensive and labor-intensive optical motion capture systems. Full article

Ankle injuries are among the most common injuries in sport and daily life. However, for their recovery, it is important for patients to perform rehabilitation exercises. These exercises are usually done with a therapist’s guidance to help strengthen the patient’s ankle joint and restore its range of motion. However, in order to share the load with therapists so that they can offer assistance to more patients, and to provide an efficient and safe way for patients to perform ankle rehabilitation exercises, we propose a framework that integrates learning techniques with a 3-PRS parallel robot, acting together as an ankle rehabilitation device. In this paper, we propose to use passive rehabilitation exercises for dorsiflexion/plantar flexion and inversion/eversion ankle movements. The therapist is needed in the first stage to design the exercise with the patient by teaching the robot intuitively through learning from demonstration. We then propose a learning control scheme based on dynamic movement primitives and iterative learning control, which takes the designed exercise trajectory as a demonstration (an input) together with the recorded forces in order to reproduce the exercise with the patient for a number of repetitions defined by the therapist. During the execution, our approach monitors the sensed forces and adapts the trajectory by adding the necessary offsets to the original trajectory to reduce its range without modifying the original trajectory and subsequently reducing the measured forces. After a predefined number of repetitions, the algorithm restores the range gradually, until the patient is able to perform the originally designed exercise. We validate the proposed framework with both real experiments and simulation using a Simulink model of the rehabilitation parallel robot that has been developed in our lab. Full article

In order to improve the convenience and practicability of home rehabilitation training for post-stroke patients, this paper presents a cloud-based upper limb rehabilitation system based on motion tracking. A 3-dimensional reachable workspace virtual game (3D-RWVG) was developed to achieve meaningful home rehabilitation training. Five movements were selected as the criteria for rehabilitation assessment. Analysis was undertaken of the upper limb performance parameters: relative surface area (RSA), mean velocity (MV), logarithm of dimensionless jerk (LJ) and logarithm of curvature (LC). A two-headed convolutional neural network (TCNN) model was established for the assessment. The experiment was carried out in the hospital. The results show that the RSA, MV, LC and LJ could reflect the upper limb motor function intuitively from the graphs. The accuracy of the TCNN models is 92.6%, 80%, 89.5%, 85.1% and 87.5%, respectively. A therapist could check patient training and assessment information through the cloud database and make a diagnosis. The system can realize home rehabilitation training and assessment without the supervision of a therapist, and has the potential to become an effective home rehabilitation system. Full article

Vision-based Pose Estimation (VPE) represents a non-invasive solution to allow a smooth and natural interaction between a human user and a robotic system, without requiring complex calibration procedures. Moreover, VPE interfaces are gaining momentum as they are highly intuitive, such that they can be used from untrained personnel (e.g., a generic caregiver) even in delicate tasks as rehabilitation exercises. In this paper, we present a novel master–slave setup for hand telerehabilitation with an intuitive and simple interface for remote control of a wearable hand exoskeleton, named HX. While performing rehabilitative exercises, the master unit evaluates the 3D position of a human operator’s hand joints in real-time using only a RGB-D camera, and commands remotely the slave exoskeleton. Within the slave unit, the exoskeleton replicates hand movements and an external grip sensor records interaction forces, that are fed back to the operator-therapist, allowing a direct real-time assessment of the rehabilitative task. Experimental data collected with an operator and six volunteers are provided to show the feasibility of the proposed system and its performances. The results demonstrate that, leveraging on our system, the operator was able to directly control volunteers’ hands movements. Full article