Study on the Applicability of Digital Twins for Home Remote Motor Rehabilitation.

The COVID-19 pandemic created the need for telerehabilitation development, while Industry 4.0 brought the key technology. As motor therapy often requires the physical support of a patient's motion, combining robot-aided workouts with remote control is a promising solution. This may be realised with the use of the device's digital twin, so as to give it an immersive operation. This paper presents an extensive overview of this technology's applications within the fields of industry and health. It is followed by the in-depth analysis of needs in rehabilitation based on questionnaire research and bibliography review. As a result of these sections, the original concept of controlling a rehabilitation exoskeleton via its digital twin in the virtual reality is presented. The idea is assessed in terms of benefits and significant challenges regarding its application in real life. The presented aspects prove that it may be potentially used for manual remote kinesiotherapy, combined with the safety systems predicting potentially harmful situations. The concept is universally applicable to rehabilitation robots.

Neck and Trunk Muscle Strength in Children With Spinal Muscular Atrophy Is Lower Than in Healthy Controls and Depends on Disease Type.

Background: Neck and trunk muscle strength and relationship with motor function in individuals with spinal muscular atrophy (SMA) is not investigated well. Information on maximum muscle strength that children with SMA may develop considerably expands the possibilities of assessing the effectiveness of pharmacological treatment methods and therapeutic procedures. This study sought to assess neck and trunk muscle strength in patients with SMA and to compare it with values noted in healthy children. Methods: The study involved 56 individuals with SMA aged 5-16 not treated pharmacologically, including 9 patients with SMA type 1 (SMA1), 27 with SMA type 2 (SMA2), and 20 with SMA type 3 (SMA3). The control group included 111 healthy individuals aged 5-16. Neck and trunk muscle strength was assessed by means of a maximum voluntary isometric contraction method with the use of a handheld digital muscle tester MICROFET2. Moreover, relative strength was also calculated by standardising the maximum voluntary isometric contraction according to body mass. The Kruskal-Wallis test, Mann-Whitney U-test, and Spearman's rank correlation were used for statistical analysis. Results: The reliability of the neck and trunk muscle strength measurements with the handheld digital muscle tester was excellent with ICC > 0.9. The values of muscle strength in SMA groups were significantly lower than in the control group. The values of relative torque of the neck muscles expressed in percentage values calculated with regard to the control group were at the level of 47.6-51.6% in SMA1 group, 54.8-58.1% in SMA2 group and 80.6-90.3% in SMA3 group. The percentage values for upper and lower trunk muscle strength were at the level of 42.6-68.4% in SMA1 group, 56.9-75.4% in SMA2 group and 76.7-94.8% in SMA3 group. Conclusion: Handheld dynamometry provides reliable measures of neck and trunk muscle strength in SMA children. Neck and trunk muscle strength in children with SMA is lower than in healthy controls and depends on disease type, which confirms the theory based on clinical observations. Further, study is needed to investigate the effect of pharmacological treatment on the strength of the neck/trunk muscles, and relationship between neck and trunk muscle strength and motor capabilities.