Analyzing human motion is an active research area, with various applications. In this work, we focus on human motion analysis in the context of physical rehabilitation using a robot coach system. Computer-aided assessment of physical rehabilitation entails evaluation of patient performance in completing prescribed rehabilitation exercises, based on processing movement data captured with a sensory system, such as RGB and RGB-D cameras. As 2D and 3D human pose estimation from RGB images had made impressive improvements, we aim to compare the assessment of physical rehabilitation exercises using movement data obtained from both RGB-D camera (Microsoft Kinect) and estimation from RGB videos (OpenPose and BlazePose algorithms). A Gaussian Mixture Model (GMM) is employed from position (and orientation) features, with performance metrics defined based on the log-likelihood values from GMM. The evaluation is performed on a medical database of clinical patients carrying out low back-pain rehabilitation exercises, previously coached by robot Poppy.
This study investigates the application of novel model architectures and large-scale foundational models in temporal series analysis of lower limb rehabilitation motion data, aiming to leverage advancements in machine learning and artificial intelligence to empower active rehabilitation guidance strategies for post-stroke patients in limb motor function recovery. Utilizing the SIAT-LLMD dataset of lower limb movement data proposed by the Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, we systematically elucidate the implementation and analytical outcomes of the innovative xLSTM architecture and the foundational model Lag-Llama in short-term temporal prediction tasks involving joint kinematics and dynamics parameters. The research provides novel insights for AI-enabled medical rehabilitation applications, demonstrating the potential of cutting-edge model architectures and large-scale models in rehabilitation medicine temporal prediction. These findings establish theoretical foundations for future applications of personalized rehabilitation regimens, offering significant implications for the development of customized therapeutic interventions in clinical pract
Physical rehabilitation exercises suggested by healthcare professionals can help recovery from various musculoskeletal disorders and prevent re-injury. However, patients' engagement tends to decrease over time without direct supervision, which is why there is a need for an automated monitoring system. In recent years, there has been great progress in quality assessment of physical rehabilitation exercises. Most of them only provide a binary classification if the performance is correct or incorrect, and a few provide a continuous score. This information is not sufficient for patients to improve their performance. In this work, we propose an algorithm for error classification of rehabilitation exercises, thus making the first step toward more detailed feedback to patients. We focus on skeleton-based exercise assessment, which utilizes human pose estimation to evaluate motion. Inspired by recent algorithms for quality assessment during rehabilitation exercises, we propose a Transformer-based model for the described classification. Our model is inspired by the HyperFormer method for human action recognition, and adapted to our problem and dataset. The evaluation is done on the KERAAL d
Medicine, including fields in healthcare and life sciences, has seen a flurry of quantum-related activities and experiments in the last few years (although biology and quantum theory have arguably been entangled ever since Schrödinger's cat). The initial focus was on biochemical and computational biology problems; recently, however, clinical and medical quantum solutions have drawn increasing interest. The rapid emergence of quantum computing in health and medicine necessitates a mapping of the landscape. In this review, clinical and medical proof-of-concept quantum computing applications are outlined and put into perspective. These consist of over 40 experimental and theoretical studies. The use case areas span genomics, clinical research and discovery, diagnostics, and treatments and interventions. Quantum machine learning (QML) in particular has rapidly evolved and shown to be competitive with classical benchmarks in recent medical research. Near-term QML algorithms have been trained with diverse clinical and real-world data sets. This includes studies in generating new molecular entities as drug candidates, diagnosing based on medical image classification, predicting patient pe
What does Artificial Intelligence (AI) have to contribute to health care? And what should we be looking out for if we are worried about its risks? In this paper we offer a survey, and initial evaluation, of hopes and fears about the applications of artificial intelligence in medicine. AI clearly has enormous potential as a research tool, in genomics and public health especially, as well as a diagnostic aid. It's also highly likely to impact on the organisational and business practices of healthcare systems in ways that are perhaps under-appreciated. Enthusiasts for AI have held out the prospect that it will free physicians up to spend more time attending to what really matters to them and their patients. We will argue that this claim depends upon implausible assumptions about the institutional and economic imperatives operating in contemporary healthcare settings. We will also highlight important concerns about privacy, surveillance, and bias in big data, as well as the risks of over trust in machines, the challenges of transparency, the deskilling of healthcare practitioners, the way AI reframes healthcare, and the implications of AI for the distribution of power in healthcare ins
One of the most frequent and severe aftermaths of a stroke is the loss of upper limb functionality. Therapy started in the sub-acute phase proved more effective, mainly when the patient participates actively. Recently, a novel set of rehabilitation and support robotic devices, known as supernumerary robotic limbs, have been introduced. This work investigates how a surface electromyography (sEMG) based control strategy would improve their usability in rehabilitation, limited so far by input interfaces requiring to subjects some level of residual mobility. After briefly introducing the phenomena hindering post-stroke sEMG and its use to control robotic hands, we describe a framework to acquire and interpret muscle signals of the forearm extensors. We applied it to drive a supernumerary robotic limb, the SoftHand-X, to provide Task-Specific Training (TST) in patients with sub-acute stroke. We propose and describe two algorithms to control the opening and closing of the robotic hand, with different levels of user agency and therapist control. We experimentally tested the feasibility of the proposed approach on four patients, followed by a therapist, to check their ability to operate th
Post-stroke patient rehabilitation requires precise, personalized treatment plans. Natural Language Processing (NLP) offers potential to extract valuable exercise information from clinical notes, aiding in the development of more effective rehabilitation strategies. Objective: This study aims to develop and evaluate a variety of NLP algorithms to extract and categorize physical rehabilitation exercise information from the clinical notes of post-stroke patients treated at the University of Pittsburgh Medical Center. A cohort of 13,605 patients diagnosed with stroke was identified, and their clinical notes containing rehabilitation therapy notes were retrieved. A comprehensive clinical ontology was created to represent various aspects of physical rehabilitation exercises. State-of-the-art NLP algorithms were then developed and compared, including rule-based, machine learning-based algorithms, and large language model (LLM)-based algorithms (ChatGPT). Analysis was conducted on a dataset comprising 23,724 notes with detailed demographic and clinical characteristics. The rule-based NLP algorithm demonstrated superior performance in most areas, particularly in detecting the 'Right Side'
Physical rehabilitation is essential to recovery from joint replacement operations. As a representation, total knee arthroplasty (TKA) requires patients to conduct intensive physical exercises to regain the knee's range of motion and muscle strength. However, current joint replacement physical rehabilitation methods rely highly on therapists for supervision, and existing computer-assisted systems lack consideration for enabling self-monitoring, making at-home physical rehabilitation difficult. In this paper, we investigated design recommendations that would enable self-monitored rehabilitation through clinical observations and focus group interviews with doctors and therapists. With this knowledge, we further explored Virtual Reality(VR)-based visual presentation and supplemental haptic motion guidance features in our implementation VReHab, a self-monitored and multimodal physical rehabilitation system with VR and vibrotactile and pneumatic feedback in a TKA rehabilitation context. We found that the third point of view real-time reconstructed motion on a virtual avatar overlaid with the target pose effectively provides motion awareness and guidance while haptic feedback helps enhan
This paper tackles the challenge of automatically assessing physical rehabilitation exercises for patients who perform the exercises without clinician supervision. The objective is to provide a quality score to ensure correct performance and achieve desired results. To achieve this goal, a new graph-based model, the Dense Spatio-Temporal Graph Conv-GRU Network with Transformer, is introduced. This model combines a modified version of STGCN and transformer architectures for efficient handling of spatio-temporal data. The key idea is to consider skeleton data respecting its non-linear structure as a graph and detecting joints playing the main role in each rehabilitation exercise. Dense connections and GRU mechanisms are used to rapidly process large 3D skeleton inputs and effectively model temporal dynamics. The transformer encoder's attention mechanism focuses on relevant parts of the input sequence, making it useful for evaluating rehabilitation exercises. The evaluation of our proposed approach on the KIMORE and UI-PRMD datasets highlighted its potential, surpassing state-of-the-art methods in terms of accuracy and computational time. This resulted in faster and more accurate lear
Current medical retrieval-augmented generation (RAG) approaches overlook evidence-based medicine (EBM) principles, leading to two key gaps: (1) the lack of PICO alignment between queries and retrieved evidence, and (2) the absence of evidence hierarchy considerations during reranking. We present SR-RAG, an EBM-adapted GraphRAG framework that integrates the PICO framework into knowledge graph construction and retrieval, and proposes Bayesian Evidence Tier Reranking (BETR) to calibrate ranking scores by evidence grade without predefined weights. Validated in sports rehabilitation, we release a knowledge graph (357,844 nodes, 371,226 edges) and a benchmark of 1,637 QA pairs. SR-RAG achieves 0.812 evidence recall@10, 0.830 nugget coverage, 0.819 answer faithfulness, 0.882 semantic similarity, and 0.788 PICOT match accuracy, substantially outperforming five baselines. Five expert clinicians rated the system 4.66--4.84 on a 5-point Likert scale, and system rankings are preserved on a human-verified gold subset (n=80).
While automatic monitoring and coaching of exercises are showing encouraging results in non-medical applications, they still have limitations such as errors and limited use contexts. To allow the development and assessment of physical rehabilitation by an intelligent tutoring system, we identify in this article four challenges to address and propose a medical dataset of clinical patients carrying out low back-pain rehabilitation exercises. The dataset includes 3D Kinect skeleton positions and orientations, RGB videos, 2D skeleton data, and medical annotations to assess the correctness, and error classification and localisation of body part and timespan. Along this dataset, we perform a complete research path, from data collection to processing, and finally a small benchmark. We evaluated on the dataset two baseline movement recognition algorithms, pertaining to two different approaches: the probabilistic approach with a Gaussian Mixture Model (GMM), and the deep learning approach with a Long-Short Term Memory (LSTM). This dataset is valuable because it includes rehabilitation relevant motions in a clinical setting with patients in their rehabilitation program, using a cost-effectiv
The rising number of the elderly incurs growing concern about healthcare, and in particular rehabilitation healthcare. Assistive technology and assistive robotics in particular may help to improve this process. We develop a robot coach capable of demonstrating rehabilitation exercises to patients, watch a patient carry out the exercises and give him feedback so as to improve his performance and encourage him. The HRI of the system is based on our study with a team of rehabilitation therapists and with the target population.The system relies on human motion analysis. We develop a method for learning a probabilistic representation of ideal movements from expert demonstrations. A Gaussian Mixture Model is employed from position and orientation features captured using a Microsoft Kinect v2. For assessing patients' movements, we propose a real-time multi-level analysis to both temporally and spatially identify and explain body part errors. This analysis combined with a classification algorithm allows the robot to provide coaching advice to make the patient improve his movements. The evaluation on three rehabilitation exercises shows the potential of the proposed approach for learning an
This paper presents GARD, an upper limb end-effector rehabilitation device developed for stroke patients. GARD offers assistance force along or towards a 2D trajectory during physical therapy sessions. GARD employs a non-backdrivable mechanism with novel motor velocity-control-based algorithms, which offers superior control precision and stability. To our knowledge, this innovative technical route has not been previously explored in rehabilitation robotics. In alignment with the new design, GARD features two novel control algorithms: Implicit Euler Velocity Control (IEVC) algorithm and a generalized impedance control algorithm. These algorithms achieve O(n) runtime complexity for any arbitrary trajectory. The system has demonstrated a mean absolute error of 0.023mm in trajectory-following tasks and 0.14mm in trajectory-restricted free moving tasks. The proposed upper limb rehabilitation device offers all the functionalities of existing commercial devices with superior performance. Additionally, GARD provides unique functionalities such as area-restricted free moving and dynamic Motion Restriction Map interaction. This device holds strong potential for widespread clinical use, poten
In recent years, gamification has become very popular for rehabilitating different cognitive and motor problems. It has been shown that rehabilitation is effective when it starts early enough and it is intensive and repetitive. However, the success of rehabilitation depends also on the motivation and perseverance of patients during treatment. Adding serious games to the rehabilitation procedure will help the patients to overcome the monotonicity of the treatment procedure. On the other hand, if a variety of games can be used with a robotic rehabilitation system, it will help to define tasks with different levels of difficulty with greater variety. In this paper we introduce a procedure for connecting a rehabilitation robot to several web-based games. In other words, an interface is designed that connects the robot to a computer through a USB port. To validate the usefulness of the proposed approach, a researcher designed survey was used to get feedback from several users. The results demonstrate that having several games besides rehabilitation makes the procedure of rehabilitation entertaining.
Advanced by rich perception and precise execution, robots possess immense potential to provide professional and customized rehabilitation exercises for patients with mobility impairments caused by strokes. Autonomous robotic rehabilitation significantly reduces human workloads in the long and tedious rehabilitation process. However, training a rehabilitation robot is challenging due to the data scarcity issue. This challenge arises from privacy concerns (e.g., the risk of leaking private disease and identity information of patients) during clinical data access and usage. Data from various patients and hospitals cannot be shared for adequate robot training, further compromising rehabilitation safety and limiting implementation scopes. To address this challenge, this work developed a novel federated joint learning (FJL) method to jointly train robots across hospitals. FJL also adopted a long short-term memory network (LSTM)-Transformer learning mechanism to effectively explore the complex tempo-spatial relations among patient mobility conditions and robotic rehabilitation motions. To validate FJL's effectiveness in training a robot network, a clinic-simulation combined experiment was
3D data from high-resolution volumetric imaging is a central resource for diagnosis and treatment in modern medicine. While the fast development of AI enhances imaging and analysis, commonly used visualization methods lag far behind. Recent research used extended reality (XR) for perceiving 3D images with visual depth perception and touch but used restrictive haptic devices. While unrestricted touch benefits volumetric data examination, implementing natural haptic interaction with XR is challenging. The research question is whether a multisensory XR application with intuitive haptic interaction adds value and should be pursued. In a study, 24 experts for biomedical images in research and medicine explored 3D medical shapes with 3 applications: a multisensory virtual reality (VR) prototype using haptic gloves, a simple VR prototype using controllers, and a standard PC application. Results of standardized questionnaires showed no significant differences between all application types regarding usability and no significant difference between both VR applications regarding presence. Participants agreed to statements that VR visualizations provide better depth information, using the hand
To allow the development and assessment of physical rehabilitation by an intelligent tutoring system, we propose a medical dataset of clinical patients carrying out low back-pain rehabilitation exercises and benchmark on state of the art human movement analysis algorithms. This dataset is valuable because it includes rehabilitation motions in a clinical setting with patients in their rehabilitation program. This paper introduces the Keraal dataset, a clinically collected dataset to enable intelligent tutoring systems (ITS) for rehabilitation. It addresses four challenges in exercise monitoring: motion assessment, error recognition, spatial localization, temporal localization
Robotic systems are increasingly used in rehabilitation to provide high intensity training for patients with motor impairment. The results of controlled trials involving human subjects confirm the effectiveness of robot-enhanced methods and prove them to be marginally superior over standard manual therapy in some cases. Although very promising, this line of research is still in its infancy and further studies are required to fully understand the potential benefits of using robotic devices such as exoskeletons. Exoskeletons have been widely studied due to their capability in providing more control over paretic limb as well as the complexities involved in their design and control. This paper briefly discusses the main challenges in development of rehabilitation exoskeletons and elaborates more on how some of these issues are addressed in the design of CLEVERarm, a recently developed upper limb rehabilitation exoskeleton. The paper is concluded with several remarks on the current challenges in wide-spread use of exoskeletons in medical facilities, and a vision for the future of these technologies in rehabilitation medicine.
Computer-aided assessment of physical rehabilitation entails evaluation of patient performance in completing prescribed rehabilitation exercises, based on processing movement data captured with a sensory system. Despite the essential role of rehabilitation assessment toward improved patient outcomes and reduced healthcare costs, existing approaches lack versatility, robustness, and practical relevance. In this paper, we propose a deep learning-based framework for automated assessment of the quality of physical rehabilitation exercises. The main components of the framework are metrics for quantifying movement performance, scoring functions for mapping the performance metrics into numerical scores of movement quality, and deep neural network models for generating quality scores of input movements via supervised learning. The proposed performance metric is defined based on the log-likelihood of a Gaussian mixture model, and encodes low-dimensional data representation obtained with a deep autoencoder network. The proposed deep spatio-temporal neural network arranges data into temporal pyramids, and exploits the spatial characteristics of human movements by using sub-networks to process
Many neurological conditions, e.g., a stroke, can cause patients to experience upper limb (UL) motor impairments that hinder their daily activities. For such patients, while rehabilitation therapy is key for regaining autonomy and restoring mobility, its long-term nature entails ongoing time commitment and it is often not sufficiently engaging. Virtual reality (VR) can transform rehabilitation therapy into engaging game-like tasks that can be tailored to patient-specific activities, set goals, and provide rehabilitation assessment. Yet, most VR systems lack built-in methods to track progress over time and alter rehabilitation programs accordingly. We propose using arm kinematic modeling and capability maps to allow a VR system to understand a user's physical capability and limitation. Next, we suggest two use cases for the VR system to utilize the user's capability map for tailoring rehabilitation programs. Finally, for one use case, it is shown that the VR system can emphasize and assess the use of specific UL joints.