Technologies in Home-Based Digital Rehabilitation: Scoping Review.

BACKGROUND: Due to growing pressure on the health care system, a shift in rehabilitation to home settings is essential. However, efficient support for home-based rehabilitation is lacking. The COVID-19 pandemic has further exacerbated these challenges and has affected individuals and health care professionals during rehabilitation. Digital rehabilitation (DR) could support home-based rehabilitation. To develop and implement DR solutions that meet clients' needs and ease the growing pressure on the health care system, it is necessary to provide an overview of existing, relevant, and future solutions shaping the constantly evolving market of technologies for home-based DR. OBJECTIVE: In this scoping review, we aimed to identify digital technologies for home-based DR, predict new or emerging DR trends, and report on the influences of the COVID-19 pandemic on DR. METHODS: The scoping review followed the framework of Arksey and O'Malley, with improvements made by Levac et al. A literature search was performed in PubMed, Embase, CINAHL, PsycINFO, and the Cochrane Library. The search spanned January 2015 to January 2022. A bibliometric analysis was performed to provide an overview of the included references, and a co-occurrence analysis identified the technologies for home-based DR. A full-text analysis of all included reviews filtered the trends for home-based DR. A gray literature search supplemented the results of the review analysis and revealed the influences of the COVID-19 pandemic on the development of DR. RESULTS: A total of 2437 records were included in the bibliometric analysis and 95 in the full-text analysis, and 40 records were included as a result of the gray literature search. Sensors, robotic devices, gamification, virtual and augmented reality, and digital and mobile apps are already used in home-based DR; however, artificial intelligence and machine learning, exoskeletons, and digital and mobile apps represent new and emerging trends. Advantages and disadvantages were displayed for all technologies. The COVID-19 pandemic has led to an increased use of digital technologies as remote approaches but has not led to the development of new technologies. CONCLUSIONS: Multiple tools are available and implemented for home-based DR; however, some technologies face limitations in the application of home-based rehabilitation. However, artificial intelligence and machine learning could be instrumental in redesigning rehabilitation and addressing future challenges of the health care system, and the rehabilitation sector in particular. The results show the need for feasible and effective approaches to implement DR that meet clients' needs and adhere to framework conditions, regardless of exceptional situations such as the COVID-19 pandemic.

Identification of temporal factors related to shot performance for indoor recurve archery.

The purpose of this study was to investigate the temporal phases of the archery shot cycle that distinguish the arrows distance from centre, in an attempt to understand critical factors that affect performance. Fifteen archers of varying ability each performed 30 shots at 18 m. Fourteen potential predictor variables were measured for statistical modelling by stepwise multiple linear regression. The results show that pre-shot time (pre-performance routine), follow-through time (post-performance routine), aiming time, speed of the arrow and the %variation in clicker-release time, account for 7.7% of the variation in predicting shot performance. The results have implications for practice demonstrating factors that coaches should focus on to develop their athletes. Further work on pre-, but more importantly, post-performance routines are needed generally within sport research as they are lacking and have been shown to be important contributing factors in a number of sports.

Perception of Muscular Effort During Dynamic Elbow Extension in Multiple Sclerosis.

OBJECTIVE: To investigate the perception of muscular effort in individuals with multiple sclerosis (MS) and healthy controls during dynamic contractions. DESIGN: Case-control study. SETTING: MS day care center. PARTICIPANTS: Individuals with MS (n=28) and controls (n=28) (N=56). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Perceived muscular effort during dynamic elbow extensions was rated at 9 different weight intensities (10%-90% of 1-repetition maximum) in a single-blind, randomized order using the OMNI-Resistance Exercise Scale. Muscle activity of the triceps brachii muscle (lateral head) was measured via surface electromyography and normalized to maximal voluntary excitation. RESULTS: According to OMNI-level ratings, significant main effects were found for the diagnostic condition (F=27.33, P<.001, η(2)=.11), indicating 0.7 (95% confidence interval [CI], 0.3-1.1) lower mean OMNI-level ratings for MS, and for the intensity level (F=46.81, P<.001, η(2)=.46), showing increased OMNI-level ratings for increased intensity levels for both groups. Furthermore, significant main effects were found for the diagnostic condition (F=16.52, P<.001, η(2)=.07), indicating 7.1% (95% CI, -8.6 to 22.8) higher maximal voluntary excitation values for MS, and for the intensity level (F=33.09, P<.001, η(2)=.36), showing higher relative muscle activities for increasing intensity levels in both groups. CONCLUSIONS: Similar to controls, individuals with MS were able to differentiate between different intensities of weight during dynamic elbow extensions when provided in a single-blind, randomized order. Therefore, perceived muscular effort might be considered to control resistance training intensities in individuals with MS. However, training intensity for individuals with MS should be chosen at approximately 1 OMNI level lower than recommended, at least for dynamic elbow extension exercises.

Physiological Demands of Simulated Off-Road Cycling Competition.

The purpose of the study was to measure the demands of off-road cycling via portable spirometry, leg-power output (PO), heart rate (HR) and blood lactate (BLa) concentration. Twenty-four male competitive cyclists (age: 29±7.2 yrs, height: 1.79 ± 0.05 m, body mass: 70.0 ± 4.9 kg, VO2peak: 64.9 ± 7.5 ml·kg(-1)·min(-1)) performed simulated mountain bike competitions (COMP) and laboratory tests (LabT). From LabT, we determined maximal workload and first and second ventilatory thresholds (VT1, VT2). A high-performance athlete (HPA) was used for comparison with three groups of subjects with different sport-specific performance levels. Load profiles of COMP were also investigated during uphill, flat and downhill cycling. During the COMP, athletes achieved a mean oxygen uptake (VO2COMP) of 57.0 ± 6.8 ml·kg(-1)·min(-1) vs. 71.1 ml·kg(-1)·min(-1) for the HPA. The POCOMP was 2.66±0.43 W·kg(-1) and 3.52 W·kg(-1) for the HPA. POCOMP, VO2COMP and HRCOMP were compared to corresponding variables at the VT2 of LabT. LabT variables correlated with racing time (RTCOMP) and POCOMP (p < 0.01 to <0.001; r-0.59 to -0.80). The VO2peak (LabT) accounted for 65% of variance of a single COMP test. VO2COMP, POCOMP and also endurance variables measured from LabTs were found as important determinants for cross-country performance. The high average VO2COMP indicates that a high aerobic capacity is a prerequisite for successful COMP. Findings derived from respiratory gas measures during COMPs might be useful when designing mountain bike specific training. Key pointsCross- country cycling is characterized by high oxygen costs due to the high muscle mass simultaneously working to fulfill the demands of this kind of sports.Heart rate and blood lactate concentration measures are not sensitive enough to assess the energy requirements of COMP. Therefore, respiratory gas and power output measures are helpful to provide new information to physiological profile of cross- country cycling.An excellent cycling-specific capacity is a prerequisite for successful off-road cycling.Data determined from LabT might be utilized to describe semi-specific abilities of MB- athletes on a cycle ergometer, while data originating from COMP might be useful when designing a mountain bike specific training.

Muscle co-contraction around the knee when walking with unstable shoes.

Walking with unstable shoes has been discussed to decrease joint loading. Typical estimates of joint loading using an inverse dynamic approach only account for net joint moments, not considering the potential role of muscular co-contraction. Therefore, the purpose of this study was to compare muscular co-contraction levels when walking with two different unstable shoe constructions (rocker-bottom and toning shoes) compared to walking with regular shoes. For each shoe condition, 12 healthy subjects walked with both, a regular shoe and with an unstable shoe at self-selected walking speed at a 10-m walkway. Surface EMG data of selected muscles were recorded and time normalized for calculating co-contraction indices (CCI) for opposing muscle groups. Results showed an increase of co-contraction primarily for vastii and gastrocnemius muscles for the first and second half of stance when walking with an unstable shoe construction. Therefore, when using an inverse dynamic approach to analyze joint loading differences between regular shoes and unstable shoes, one should be cautious in interpreting the data, as these methods base their estimates of joint moments upon the net joint torque.

Perception of muscular effort in multiple sclerosis.

BACKGROUND: Resistance exercise is effective in improving muscle strength and preventing muscle weakness in multiple sclerosis (MS) patients. Control of resistance training intensity based on perceived muscular effort is applicable to healthy individuals, yet there is no evidence of its utility for MS patients. OBJECTIVE: To compare perception of muscular effort in MS patients to healthy controls. METHODS: Based on their perception of muscular effort, twenty-five MS patients and twenty-eight controls adjusted static elbow extension tasks according to five levels on the OMNI-Resistance Exercise Scale. Elbow extension strength and muscle activity were measured via load cell dynamometer and surface electromyography (EMG) and related to each participant's maximal voluntary contraction (MVC) strength and muscle activity. Two-way analysis of variance was used to evaluate statistical significance. RESULTS: There were no statistically significant differences between MS patients and healthy controls, they produced similar relative torque values (F1 = 0.196; p > 0.05) and extensor muscle activities (F(2,617) = 1.556; p > 0.05) across all effort levels. CONCLUSION: No differences were found in the perception of muscular effort in MS patients and the age-matched control group. Future studies should explore, whether rating of perceived exertion is an effective instrument to control resistance training intensity in MS patients.

Accuracy of the LPM tracking system considering dynamic position changes.

This study investigates the accuracy of the tracking system LPM (local position measurement). The goal was to determine detailed error values of the system in the context of sports performance analyses. Six moderately trained male soccer players (amateur level) performed 276 runs on three different courses at six different speeds. Additionally, ten small-sided game plays were carried out. All runs and game plays were recorded with the LPM tracking system and the motion capture system VICON simultaneously. VICON served as the reference system. The absolute error of all LPM position estimations was on average 23.4±20.7 cm. The estimation for average velocities varied between 0.01 km h(-1) and 0.23 km h(-1), the maximum speed estimations differed by up to 2.71 km h(-1). In addition, the results showed that the accuracy of the LPM system is highly dependent on the instantaneous dynamics of the player and decreases in the margins of the observation field. These dependencies were quantified. Considering commonly used applications of position tracking systems in sports (Leser, Ogris, & Baca, 2011), the accuracy of LPM is acceptable for position and velocity estimations. The system provides valuable results for average velocities but seems to be far less reliable when dealing with high dynamic movements and measuring instantaneous velocities.

A three-dimensional analysis of finger and bow string movements during the release in archery.

The aim of this paper was to examine finger and bow string movements during archery by investigating a top Austrian athlete (FITA score = 1233) under laboratory conditions. Maximum lateral bow string deflection and angular displacements for index, third, and ring fingers between the full draw position and the end of the release were quantified using a motion tracking system. Stepwise multiple regression analyses were used to determine whether bow string deflection and finger movements are predictive for scoring. Joint ranges of motion during the shot itself were large in the proximal and distal interphalangeal joints, and much smaller in the metacarpophalangeal joints. Contrary to our expectations, greater deflection leads to higher scores (R2 = .18, p < .001) and the distal interphalangeal joint of the third finger weakly predicts the deflection (R2 = .11, p < .014). More variability in the joint angles of the third finger was found in bad shots than in good shots. Findings in this study let presume that maximum lateral bow string deflection does not adversely affect the archer's performance.

Ubiquitous computing in sports: A review and analysis.

Ubiquitous (pervasive) computing is a term for a synergetic use of sensing, communication and computing. Pervasive use of computing has seen a rapid increase in the current decade. This development has propagated in applied sport science and everyday life. The work presents a survey of recent developments in sport and leisure with emphasis on technology and computational techniques. A detailed analysis on new technological developments is performed. Sensors for position and motion detection, and such for equipment and physiological monitoring are discussed. Aspects of novel trends in communication technologies and data processing are outlined. Computational advancements have started a new trend - development of smart and intelligent systems for a wide range of applications - from model-based posture recognition to context awareness algorithms for nutrition monitoring. Examples particular to coaching and training are discussed. Selected tools for monitoring rules' compliance and automatic decision-making are outlined. Finally, applications in leisure and entertainment are presented, from systems supporting physical activity to systems providing motivation. It is concluded that the emphasis in future will shift from technologies to intelligent systems that allow for enhanced social interaction as efforts need to be made to improve user-friendliness and standardisation of measurement and transmission protocols.