Ηand dexterities assessment in stroke patients based on augmented reality and machine learning through a box and block test.

A popular and widely suggested measure for assessing unilateral hand motor skills in stroke patients is the box and block test (BBT). Our study aimed to create an augmented reality enhanced version of the BBT (AR-BBT) and evaluate its correlation to the original BBT for stroke patients. Following G-power analysis, clinical examination, and inclusion-exclusion criteria, 31 stroke patients were included in this study. AR-BBT was developed using the Open Source Computer Vision Library (OpenCV). The MediaPipe's hand tracking library uses a palm and a hand landmark machine learning model to detect and track hands. A computer and a depth camera were employed in the clinical evaluation of AR-BBT following the principles of traditional BBT. A strong correlation was achieved between the number of blocks moved in the BBT and the AR-BBT on the hemiplegic side (Pearson correlation = 0.918) and a positive statistically significant correlation (p = 0.000008). The conventional BBT is currently the preferred assessment method. However, our approach offers an advantage, as it suggests that an AR-BBT solution could remotely monitor the assessment of a home-based rehabilitation program and provide additional hand kinematic information for hand dexterities in AR environment conditions. Furthermore, it employs minimal hardware equipment.

An integrated rehabilitation system for the upper limb spasticity assessment and treatment: the Rehabotics passive exoskeletal system.

Limb spasticity is caused by stroke, multiple sclerosis, traumatic brain injury and various central nervous system pathologies such as brain tumors resulting in joint stiffness, loss of hand function and severe pain. This paper presents with the Rehabotics integrated rehabilitation system aiming to provide highly individualized assessment and treatment of the function of the upper limbs for patients with spasticity after stroke, focusing on the developed passive exoskeletal system. The proposed system can: (i) measure various motor and kinematic parameters of the upper limb in order to evaluate the patient's condition and progress, as well as (ii) offer a specialized rehabilitation program (therapeutic exercises, retraining of functional movements and support of daily activities) through an interactive virtual environment. The outmost aim of this multidisciplinary research work is to create new tools for providing high-level treatment and support services to patients with spasticity after stroke.Clinical Relevance- This paper presents a new passive exoskeletal system aiming to provide enhanced treatment and assessment of patients with upper limb spasticity after stroke.

Effects of muscle-equivalent forces on the biomechanical behavior of proximal femur fracture models: a pilot study on artificial bones.

INTRODUCTION: There has been extensive analysis of the influence of muscle forces and their effects on the biomechanical behavior of the proximal femur. Nevertheless, these forces have only been taken into account in a handful of biomechanical studies in the field of traumatology. The aim of this study was to analyze the biomechanical behavior of two typical fracture models of the proximal femur based on muscle-equivalent forces. METHOD: Plate osteosynthesis was performed on two groups of artificial femora to stabilize either a trochanteric osteotomy (n= 5) or a femur shaft osteotomy (n = 5). After fixation axial loading was applied to the constructs first without muscle-equivalent forces and then with the addition of these forces (abductor groups and vastus lateralis). Displacement at the osteotomy site and the stiffness of the whole construct were measured during loading. RESULTS: Comparison of the two loading modes revealed no significant differences for displacement or stiffness for the trochanteric fractures. For the femur shaft fractures, a significant difference was found for displacement (p = 0.023) and stiffness (p = 0.003) with or without muscle-equivalent forces. CONCLUSION: The loading protocol for implant testing on femur shaft fractures should include muscle-equivalent forces. For trochanteric fractures, consideration of muscle forces is not entirely necessary since they will have little effect on the results, for example, when comparing implants.