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Şipal MS, Yıldırım S, Akıncı MG, Dincer S, Akyüz M. Enhancing balance and mobility in incomplete spinal cord injury with an overground gait trainer. Spinal Cord Ser Cases 2024; 10:52. [PMID: 39075059 PMCID: PMC11286738 DOI: 10.1038/s41394-024-00668-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 07/17/2024] [Accepted: 07/23/2024] [Indexed: 07/31/2024] Open
Abstract
STUDY DESIGN Prospective intervention study. OBJECTIVES The study aimed to assess the effect of Andago on balance, overground walking speed, independence levels, fear of falling, and quality of life in patients with acute motor incomplete Spinal Cord Injury. SETTING The study was conducted in Ankara/Türkiye. METHODS Five participants, classified as AIS D, underwent an eight-week treatment regimen, including three days a week of Andago-assisted walking and balance exercises, supplemented by two days a week of 40-minute sessions of conventional in-bed exercises. RESULTS Berg Balance Scale scores increased significantly by 129% (p = 0.043). Overground walking speed calculated from 10MWT improved by 33% (p = 0.042). WISCI II levels improved significantly compared to baseline scores (p = 0.041). In the mobility subscale of SCIM III, the total SCIM III scores increased significantly (p = 0.042, p = 0.043, respectively). However, there was no significant improvement in WHOQOL-BREF scores (p = 0.080). CONCLUSIONS The use of Andago facilitated functional progress in patients with acute incomplete SCI, emphasizing the importance of challenging balance and walking activities in triggering motor learning.
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Affiliation(s)
- Meriç Selim Şipal
- Physical Medicine and Rehabilitation Hospital, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Türkiye.
| | - Sinem Yıldırım
- Physical Medicine and Rehabilitation Hospital, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Türkiye
| | - Meltem Güneş Akıncı
- Physical Medicine and Rehabilitation Hospital, Ankara Bilkent City Hospital, University of Health Sciences, Ankara, Türkiye
| | - Sezen Dincer
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ankara Medipol University, Ankara, Türkiye
| | - Müfit Akyüz
- Department of Physical Medicine and Rehabilitation, Karabuk University, Faculty of Medicine, Karabük, Türkiye
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2
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Albanese GA, Bucchieri A, Podda J, Tacchino A, Buccelli S, De Momi E, Laffranchi M, Mannella K, Holmes MWR, Zenzeri J, De Michieli L, Brichetto G, Barresi G. Robotic systems for upper-limb rehabilitation in multiple sclerosis: a SWOT analysis and the synergies with virtual and augmented environments. Front Robot AI 2024; 11:1335147. [PMID: 38638271 PMCID: PMC11025362 DOI: 10.3389/frobt.2024.1335147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/30/2024] [Indexed: 04/20/2024] Open
Abstract
The robotics discipline is exploring precise and versatile solutions for upper-limb rehabilitation in Multiple Sclerosis (MS). People with MS can greatly benefit from robotic systems to help combat the complexities of this disease, which can impair the ability to perform activities of daily living (ADLs). In order to present the potential and the limitations of smart mechatronic devices in the mentioned clinical domain, this review is structured to propose a concise SWOT (Strengths, Weaknesses, Opportunities, and Threats) Analysis of robotic rehabilitation in MS. Through the SWOT Analysis, a method mostly adopted in business management, this paper addresses both internal and external factors that can promote or hinder the adoption of upper-limb rehabilitation robots in MS. Subsequently, it discusses how the synergy with another category of interaction technologies - the systems underlying virtual and augmented environments - may empower Strengths, overcome Weaknesses, expand Opportunities, and handle Threats in rehabilitation robotics for MS. The impactful adaptability of these digital settings (extensively used in rehabilitation for MS, even to approach ADL-like tasks in safe simulated contexts) is the main reason for presenting this approach to face the critical issues of the aforementioned SWOT Analysis. This methodological proposal aims at paving the way for devising further synergistic strategies based on the integration of medical robotic devices with other promising technologies to help upper-limb functional recovery in MS.
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Affiliation(s)
| | - Anna Bucchieri
- Rehab Technologies Lab, Istituto Italiano di Tecnologia, Genoa, Italy
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Jessica Podda
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
| | - Andrea Tacchino
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
| | - Stefano Buccelli
- Rehab Technologies Lab, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Elena De Momi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Matteo Laffranchi
- Rehab Technologies Lab, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Kailynn Mannella
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | | | | | | | - Giampaolo Brichetto
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
- AISM Rehabilitation Center Liguria, Italian Multiple Sclerosis Society (AISM), Genoa, Italy
| | - Giacinto Barresi
- Rehab Technologies Lab, Istituto Italiano di Tecnologia, Genoa, Italy
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3
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Gu Z, Tan H, Zhang H, Zhou R. Assessment of Chinese rehabilitation assistance system for disabled children. Front Public Health 2023; 11:1098908. [PMID: 37780433 PMCID: PMC10536962 DOI: 10.3389/fpubh.2023.1098908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Using the social support theory for reference, a subject-object influencing mechanism model of China's rehabilitation assistance system for disabled children is built based on the survey data on 1,698 disabled children in 243 designated rehabilitation institutions in Hu'nan Province as well as the topic of the assessment and optimization of the rehabilitation assistance system for disabled children. The analysis using the structural equation modeling reveals that the inclusive welfare effect of the rehabilitation assistance system for disabled children has emerged, and disabled children receiving free rehabilitation in the designated institutions have achieved good rehabilitation results as a whole, however, disabled children of different age groups have generational differences in the rehabilitation effects, and the preferential aspect of the system needs to be strengthened. Government support, institutional support, and social support have positive non-equilibrium effects in enhancing the rehabilitation effects of disabled children. Institutional support plays a partial mediating role between government support, family support, and disabled children's rehabilitation effects, showing that the current social support system for the rehabilitation assistance of disabled children is experiencing structural, social and kernel changes, to evolve from the traditional closed and disconnected one-way resource support to open, coordinated, and interactive multi-support, and gradually become a comprehensive and efficient interactive support system with families as the foundation, institutions as the main body, and the government as the core.
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Affiliation(s)
- Zhongyuan Gu
- School of Public Administration, Central South University, Changsha, China
| | - Hong Tan
- School of Public Administration, Sichuan University, Chengdu, China
| | - Haomiao Zhang
- School of Public Administration, Sichuan University, Chengdu, China
| | - Rong Zhou
- Rehabilitation Research Center for the Disabled, Hunan Disabled Persons' Federation, Changsha, China
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4
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Bucchieri A, Tessari F, Buccelli S, Barresi G, De Momi E, Laffranchi M, De Michieli L. Human-Centered Functional Task Design for Robotic Upper-Limb Rehabilitation. IEEE Int Conf Rehabil Robot 2023; 2023:1-6. [PMID: 37941270 DOI: 10.1109/icorr58425.2023.10304738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Robotic rehabilitation has demonstrated slight positive effects compared to traditional care, but there is still a lack of targeted high-level control strategies in the current state-of-the-art for minimizing pathological motor behaviors. In this study, we analyzed upper-limb motion capture data from healthy subjects performing a pick-and-place task to identify task-specific variability in postural patterns. The results revealed consistent behaviors among subjects, presenting an opportunity to develop a novel extraction method for variable volume references based solely on observations from healthy individuals. These human-centered references were tested on a simulated 4 degrees-of-freedom upper-limb exoskeleton, showing its compliant adaptation to the path considering the variance in healthy subjects' motor behavior.
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5
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Dragusanu M, Troisi D, Villani A, Prattichizzo D, Malvezzi M. Design and Prototyping of an Underactuated Hand Exoskeleton With Fingers Coupled by a Gear-Based Differential. Front Robot AI 2022; 9:862340. [PMID: 35425814 PMCID: PMC9001897 DOI: 10.3389/frobt.2022.862340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 02/24/2022] [Indexed: 11/13/2022] Open
Abstract
Exoskeletons and more in general wearable mechatronic devices represent a promising opportunity for rehabilitation and assistance to people presenting with temporary and/or permanent diseases. However, there are still some limits in the diffusion of robotic technologies for neuro-rehabilitation, notwithstanding their technological developments and evidence of clinical effectiveness. One of the main bottlenecks that constrain the complexity, weight, and costs of exoskeletons is represented by the actuators. This problem is particularly evident in devices designed for the upper limb, and in particular for the hand, in which dimension limits and kinematics complexity are particularly challenging. This study presents the design and prototyping of a hand finger exoskeleton. In particular, we focus on the design of a gear-based differential mechanism aimed at coupling the motion of two adjacent fingers and limiting the complexity and costs of the system. The exoskeleton is able to actuate the flexion/extension motion of the fingers and apply bidirectional forces, that is, it is able to both open and close the fingers. The kinematic structure of the finger actuation system has the peculiarity to present three DoFs when the exoskeleton is not worn and one DoF when it is worn, allowing better adaptability and higher wearability. The design of the gear-based differential is inspired by the mechanism widely used in the automotive field; it allows actuating two fingers with one actuator only, keeping their movements independent.
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Affiliation(s)
- Mihai Dragusanu
- Department of Information Engineering and Mathematics, University of Siena, Siena, Italy
| | - Danilo Troisi
- Information Engineering Department, University of Pisa, Pisa, Italy
| | - Alberto Villani
- Department of Information Engineering and Mathematics, University of Siena, Siena, Italy
| | - Domenico Prattichizzo
- Department of Information Engineering and Mathematics, University of Siena, Siena, Italy
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genova, Italy
| | - Monica Malvezzi
- Department of Information Engineering and Mathematics, University of Siena, Siena, Italy
- *Correspondence: Monica Malvezzi,
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Akbari A, Haghverd F, Behbahani S. Robotic Home-Based Rehabilitation Systems Design: From a Literature Review to a Conceptual Framework for Community-Based Remote Therapy During COVID-19 Pandemic. Front Robot AI 2021; 8:612331. [PMID: 34239898 PMCID: PMC8258116 DOI: 10.3389/frobt.2021.612331] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 06/01/2021] [Indexed: 01/24/2023] Open
Abstract
During the COVID-19 pandemic, the higher susceptibility of post-stroke patients to infection calls for extra safety precautions. Despite the imposed restrictions, early neurorehabilitation cannot be postponed due to its paramount importance for improving motor and functional recovery chances. Utilizing accessible state-of-the-art technologies, home-based rehabilitation devices are proposed as a sustainable solution in the current crisis. In this paper, a comprehensive review on developed home-based rehabilitation technologies of the last 10 years (2011-2020), categorizing them into upper and lower limb devices and considering both commercialized and state-of-the-art realms. Mechatronic, control, and software aspects of the system are discussed to provide a classified roadmap for home-based systems development. Subsequently, a conceptual framework on the development of smart and intelligent community-based home rehabilitation systems based on novel mechatronic technologies is proposed. In this framework, each rehabilitation device acts as an agent in the network, using the internet of things (IoT) technologies, which facilitates learning from the recorded data of the other agents, as well as the tele-supervision of the treatment by an expert. The presented design paradigm based on the above-mentioned leading technologies could lead to the development of promising home rehabilitation systems, which encourage stroke survivors to engage in under-supervised or unsupervised therapeutic activities.
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Affiliation(s)
| | | | - Saeed Behbahani
- Department of Mechanical Engineering, Isfahan University of Technology, Isfahan, Iran
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Gao S, Hou Y, Ma R, Kaudimba KK, Jin L, Wang H, Wang R. A Novel Management Platform Based on Personalized Home Care Pathways for Medicine Management and Rehabilitation of Persons With Parkinson's Disease-Requirements and Implementation Plan of the Care-PD Program. Front Neurol 2021; 12:672208. [PMID: 34113314 PMCID: PMC8186830 DOI: 10.3389/fneur.2021.672208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/12/2021] [Indexed: 12/12/2022] Open
Abstract
As the percentage of the aging population increases, the incidence of Parkinson's disease (PD) in China is increasing year by year. PD is both a public health and social problem facing the government and society as a whole. Persons with PD need reasonable medication management and rehabilitation strategies after a clear diagnosis. A proper home care plan can effectively slow the progression of PD. However, people with PD lack an effective way to manage their illnesses and cannot achieve the recommended clinical path in a family environment. Medication management, condition monitoring, and rehabilitation training are important components of the home care plan for PD. Persons with PD require strategies that delay the development of the disease and to adhere to treatment, which would contribute to improving their quality of life. Thus, we developed a small program called Care-PD to build a medicine management and service platform for PD. The development of Care-PD is a multi-dimensional model designed for PD, which is funded by the National Key R&D Program of China (No. 2018YFC1314700), and includes services such as medication management, symptom monitoring, professional counseling, home life, and community communication. Care-PD can become a key technology that increases the compliance of persons with PD with home care plans and improve measures to control the disease. In this article, we describe the medication management and services for PD based on the Care-PD program and its structure. The small program will improve the adverse conditions faced by persons with PD by combining the latest technology and clinical approaches. Meanwhile, we describe a verification strategy to evaluate the effectiveness of the Care-PD program as a comprehensive management strategy for PD.
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Affiliation(s)
- Song Gao
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Yuning Hou
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Renyan Ma
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | | | - Lingjing Jin
- Department of Neurology, Tongji Hospital, Tongji University, Shanghai, China
| | - Han Wang
- Department of Neurology, Peking Union Medical College Hospital, Beijing, China
| | - Ru Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
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8
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Qi CY, Wang Y. Why Is Rehabilitation Assistance Policy for Children With Disabilities Deviated in Supply-Demand? A Case Study in Mainland China. Front Public Health 2021; 9:666333. [PMID: 33898385 PMCID: PMC8059547 DOI: 10.3389/fpubh.2021.666333] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 03/12/2021] [Indexed: 11/13/2022] Open
Abstract
Children with disabilities have most potential for salvage rehabilitation, and their rehabilitation results are concerned with their entire life process. Although, the Chinese state has established a targeted Rehabilitation Assistance System for Disabled Children and has expanded the provision of rehabilitation services, a severe deviation between supply and demand remains. Existing studies have focused relatively more on policy content and less on the policy context, at the macro-structural level. However, using the case of the ZW Rehabilitation Center in City J, this study divided the deviation into exclusion errors and inclusion errors, and used the policy context approach to explore the reasons for the deviation. We found that the behaviors of the participants in rehabilitation services exist in a dynamic interaction between the regulatory context, the normative context, and the cognitive context. The joint forces of the three contexts produce both exclusion errors and inclusion errors, which are the underlying reasons for the inaccurate execution of the targeted policy. The results of this research can provide enlightenment for improving rehabilitation policy.
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Affiliation(s)
- Cai Yun Qi
- Department of Labor and Social Security, School of Philosophy and Sociology, Jilin University, Changchun, China
| | - Yuan Wang
- Department of Labor and Social Security, School of Philosophy and Sociology, Jilin University, Changchun, China
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Zhao S, Liu J, Gong Z, Lei Y, OuYang X, Chan CC, Ruan S. Wearable Physiological Monitoring System Based on Electrocardiography and Electromyography for Upper Limb Rehabilitation Training. SENSORS (BASEL, SWITZERLAND) 2020; 20:E4861. [PMID: 32872111 PMCID: PMC7506771 DOI: 10.3390/s20174861] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 08/25/2020] [Accepted: 08/25/2020] [Indexed: 01/16/2023]
Abstract
Secondary injuries are common during upper limb rehabilitation training because of uncontrollable physical force and overexciting activities, and long-time training may cause fatigue and reduce the training effect. This study proposes a wearable monitoring device for upper limb rehabilitation by integrating electrocardiogram and electromyogram (ECG/EMG) sensors and using data acquisition boards to obtain accurate signals during robotic glove assisting training. The collected ECG/EMG signals were filtered, amplified, digitized, and then transmitted to a remote receiver (smart phone or laptop) via a low-energy Bluetooth module. A software platform was developed for data analysis to visualize ECG/EMG information, and integrated into the robotic glove control module. In the training progress, various hand activities (i.e., hand closing, forearm pronation, finger flexion, and wrist extension) were monitored by the EMG sensor, and the changes in the physiological status of people (from excited to fatigue) were monitored by the ECG sensor. The functionality and feasibility of the developed physiological monitoring system was demonstrated by the assisting robotic glove with an adaptive strategy for upper limb rehabilitation training improvement. The feasible results provided a novel technique to monitor individual ECG and EMG information holistically and practically, and a technical reference to improve upper limb rehabilitation according to specific treatment conditions and the users' demands. On the basis of this wearable monitoring system prototype for upper limb rehabilitation, many ECG-/EMG-based mobile healthcare applications could be built avoiding some complicated implementation issues such as sensors management and feature extraction.
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Affiliation(s)
- Shumi Zhao
- Sino-German College of Intelligent Manufacturing, Shenzhen Technology University, Shenzhen 518118, China; (J.L.); (Y.L.); (C.C.C.); (S.R.)
| | - Jianxun Liu
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong 999077, China;
| | - Zidan Gong
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong 999077, China;
| | - Yisong Lei
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong 999077, China;
| | - Xia OuYang
- Department of Electrical Engineering, The Hong Kong Polytechnic University, Hong Kong 518118, China;
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, MN 55455, USA
| | - Chi Chiu Chan
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong 999077, China;
| | - Shuangchen Ruan
- Institute of Textiles and Clothing, The Hong Kong Polytechnic University, Hong Kong 999077, China;
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Abstract
Over one billion people in the world suffer from some form of disability. Nevertheless, according to the World Health Organization, people with disabilities are particularly vulnerable to deficiencies in services, such as health care, rehabilitation, support, and assistance. In this sense, recent technological developments can mitigate these deficiencies, offering less-expensive assistive systems to meet users’ needs. This paper reviews and summarizes the research efforts toward the development of these kinds of systems, focusing on two social groups: older adults and children with autism.
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Abstract
In this paper, we present in depth the hardware components of a low-cost cognitive assistant. The aim is to detect the performance and the emotional state that elderly people present when performing exercises. Physical and cognitive exercises are a proven way of keeping elderly people active, healthy, and happy. Our goal is to bring to people that are at their homes (or in unsupervised places) an assistant that motivates them to perform exercises and, concurrently, monitor them, observing their physical and emotional responses. We focus on the hardware parts and the deep learning models so that they can be reproduced by others. The platform is being tested at an elderly people care facility, and validation is in process.
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Martinez-Martin E, Costa A, Cazorla M. PHAROS 2.0-A PHysical Assistant RObot System Improved. SENSORS 2019; 19:s19204531. [PMID: 31635278 PMCID: PMC6832539 DOI: 10.3390/s19204531] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/15/2019] [Accepted: 10/15/2019] [Indexed: 11/16/2022]
Abstract
There are great physical and cognitive benefits for older adults who are engaged in active aging, a process that should involve daily exercise. In our previous work on the PHysical Assistant RObot System (PHAROS), we developed a system that proposed and monitored physical activities. The system used a social robot to analyse, by means of computer vision, the exercise a person was doing. Then, a recommender system analysed the exercise performed and indicated what exercise to perform next. However, the system needed certain improvements. On the one hand, the vision system captured the movement of the person and indicated whether the exercise had been done correctly or not. On the other hand, the recommender system was based purely on a ranking system that did not take into account temporal evolution and preferences. In this work, we propose an evolution of PHAROS, PHAROS 2.0, incorporating improvements in both of the previously mentioned aspects. In the motion capture aspect, we are now able to indicate the degree of completeness of each exercise, identifying the part that has not been done correctly, and a real-time performance correction. In this way, the recommender system receives a greater amount of information and so can more accurately indicate the exercise to be performed. In terms of the recommender system, an algorithm was developed to weigh the performance, temporal evolution and preferences, providing a more accurate recommendation, as well as expanding the recommendation to a batch of exercises, instead of just one.
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Affiliation(s)
| | - Angelo Costa
- ALGORITMI Center, University of Minho, 4704-553 Braga, Portugal.
| | - Miguel Cazorla
- RoViT, University of Alicante, 03690 San Vicente del Raspeig (Alicante), Spain.
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