Maria Lopes

Shoulder rehabilitation is a process that requires physical therapy sessions to recover the mobility of the affected limbs. However, these sessions are often limited by the availability and cost of specialized technicians, as well as the patient’s travel to the session locations. This paper presents a novel smartphone-based approach using a pose estimation algorithm to evaluate the quality of the movements and provide feedback, allowing patients to perform autonomous recovery sessions. This paper reviews the state of the art in wearable devices and camera-based systems for human body detection and rehabilitation support and describes the system developed, which uses MediaPipe to extract the coordinates of 33 key points on the patient’s body and compares them with reference videos made by professional physiotherapists using cosine similarity and dynamic time warping. This paper also presents a clinical study that uses QTM, an optoelectronic system for motion capture, to validate the methods used by the smartphone application. The results show that there are statistically significant differences between the three methods for different exercises, highlighting the importance of selecting an appropriate method for specific exercises. This paper discusses the implications and limitations of the findings and suggests directions for future research.

Neuromuscular re-education through therapeutic exercise has a determinant role in chronic shoulder pain rehabilitation. Smartphones are an interesting strategy to extend the rehabilitation to a home-based scenario as it can increase the attraction and involvement of users by providing feedback. Objective: To analyze the concurrent validity of a smartphone’s application based on 2D video analysis against the gold-standard 3D optoelectronic system for assessing movement quality during upper limb therapeutic exercises. Methods: Fifteen young adults were evaluated while executing two different shoulder exercises with a smartphone’s 2D video and a 3D optoelectronic system simultaneously in two conditions: (1) with the supervision and instructions of a physiotherapist (guided exercise), and (2) without the feedback of the physiotherapist (non-guided exercise). The data obtained during the guided and non-guided exercises were compared to calculate the movement quality index based on the approximation of the non-guided exercise to the guided exercise for the head, trunk, and shoulder’s range of movement. The agreement of the movement quality index assessed with the smartphone application and the optoelectronic system was carried out through Bland–Altman analysis. Results: The Bland–Altman analysis indicates the range of agreement and bias tendency. This tendency demonstrates that the percentage of difference between the two methods increases as the movement quality index decreases. Conclusions: There is agreement between the movement quality evaluated by a gold-standard method and the developed application, although the proposed method appears to have less sensitivity for evaluating movements with lower quality index.

Background: Scars interfere with the motor system; however, the influence of c-section scars has not been described yet. The aim of this study is to relate the presence of abdominal scars from a caesarean section with changes in postural control—stability and orientation and abdominal and lumbar neuromuscular control in the orthostatic position. Methods: Cross-sectional analytical observational study comparing healthy primiparous women with caesarean delivery (n = 9) and physiologic delivery (n = 12) who have delivered more than one year before. The relative electromyographic activity of the rectus abdominis, transverse abdominis/oblique internus and lumbar multifidus muscles, antagonist co-activation, the ellipse area, amplitude, displacement, velocity, standard deviation, and spectral power of the centre of pressure, and thoracic and lumbar curvatures, were evaluated in the standing position in both groups, through an electromyographic system, a pressure platform and spinal mouse system. In the “caesarean delivery” group, scar mobility was evaluated using a modified adheremeter. Results: Significant differences in CoP medial-lateral velocity and mean velocity were observed between groups (p < 0.050), while no significant differences were in the level of muscle activity, antagonist co-activation, and thoracic and lumbar curvatures (p > 0.05). Conclusions: The information provided by the pressure signal seems to identify postural impairments in women with c-sections.