Joint Angle Estimation during Shoulder Abduction Exercise Using Contactless Technology

Author:

Khanghah Ali Barzegar1,Fernie Geoff1,Fekr Atena Roshan1

Affiliation:

1. Toronto Rehabilitation Institute, University Health Network

Abstract

Abstract Background Tele-rehabilitation, also known as tele-rehab, uses communication technologies to provide rehabilitation services from a distance. The COVID-19 pandemic has highlighted the importance of tele-rehab, where the in-person visits declined and the demand for remote healthcare rises. Tele-rehab offers enhanced accessibility, convenience, cost-effectiveness, flexibility, care quality, continuity, and communication. However, the current systems are often not able to perform a comprehensive movement analysis. To address this, we propose and validate a novel approach using depth technology and skeleton tracking algorithms. Methods Our data involved 14 participants (8 females, 6 males) performing shoulder abduction exercises. We collected depth videos from a LiDAR camera and motion data from a Motion Capture (Mocap) system as our ground truth. The data was collected at distances of 2 m, 2.5 m, and 3.5 m from the LiDAR sensor for both arms. Our innovative approach integrates LiDAR with the Cubemos and Mediapipe skeleton tracking frameworks, enabling the assessment of 3D joint angles. We validated the system by comparing the estimated joint angles versus Mocap outputs. Personalized calibration was applied using various regression models to enhance the accuracy of the joint angle calculations. Results The Cubemos skeleton tracking system outperformed Mediapipe in joint angle estimation with higher accuracy and fewer errors. The proposed system showed a strong correlation with Mocap results, although some deviations were present due to noise. Precision decreased as distance from the camera increased. Calibration significantly improved performance. Linear regression models consistently outperformed nonlinear models, especially at shorter distances. Conclusion This study showcases the potential of a marker-less system, to proficiently track body joints and upper-limb angles. Signals from the proposed system and the Mocap system exhibited robust correlation, with Mean Absolute Errors (MAEs) consistently below 10°. LiDAR's depth feature enabled accurate computation of in-depth angles beyond the reach of traditional RGB cameras. Altogether, this emphasizes the depth-based system's potential for precise joint tracking and angle calculation in tele-rehab applications.

Publisher

Research Square Platform LLC

Reference40 articles.

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3. Prvu Bettger, Janet and Resnik, Linda J (2020) Telerehabilitation in the Age of {COVID}-19: An Opportunity for Learning Health System Research. Physical Therapy 100(11): 1913--1916 https://doi.org/10.1093/ptj/pzaa151, Full Text PDF:C\:\\Users\\Ali Barzegar Kh\\Zotero\\storage\\NPSVM7HY\\Prvu Bettger and Resnik - 2020 - Telerehabilitation in the Age of COVID-19 An Oppo.pdf:application/pdf;Snapshot:C\:\\Users\\Ali Barzegar Kh\\Zotero\\storage\\KL3V3ZP5\\5894240.html:text/html, 2020-10-30, 2023-01-08, Physical Therapy, The {COVID}-19 pandemic has impacted all aspects of health care delivery. To protect health care workers and patients across the country from the risk of disease transmission, rules, regulations and reimbursement policies were altered to enable widespread use of telecommunications technology in lieu of in-person clinical visits.1 As a result, the delivery of rehabilitation in many settings was drastically and suddenly altered with physical therapists utilizing telehealth modalities in new ways and with new populations.2 The shift to telerehabilitation provides a tremendous learning opportunity. This point of view provides an overview of how a learning health care system ({LHS}) approach to the study of telerehabilitation can promote innovation in optimal health care delivery and fuel new scientific discovery., Telerehabilitation in the Age of {COVID}-19, https://doi.org/10.1093/ptj/pzaa151, 1538-6724

4. Fiani, Brian and Siddiqi, Imran and Lee, Sharon C and Dhillon, Lovepreet (2020) Telerehabilitation: Development, Application, and Need for Increased Usage in the {COVID}-19 Era for Patients with Spinal Pathology. Cureus 12(9): e10563 https://doi.org/10.7759/cureus.10563, Cureus, PMC7577310, 33101809, 2023-01-08, Cureus, The coronavirus disease 2019 ({COVID}-19) pandemic has triggered governments worldwide to implement severe restrictions on physical therapy protocols in order to better control the spread of the virus. One of the mechanisms of providing physical therapy patient care during this era is via telemedicine. Telerehabilitation or telerehab is a technological visual-audio system that serves patients, including those with a spine injury, ailment, or postoperatively, with neurological deficits. In this scoping review, we discuss the development of telerehab, the technological advances in the field, and the usage of telerehab specifically pertaining to spine patients, and comment on the advancement of telerehab in the time of {COVID}-19. There is preliminary evidence that suggests that the adoption of telerehab in lieu of face-to-face interventions is beneficial for reducing pain and improving physical function in patients afflicted with chronic nonmalignant musculoskeletal pain from low back pain, lumbar stenosis, neck pain, and osteoarthritis. Availability is important, as the necessary technology should be accessible to all participants. Safety and security should be addressed, as the passage of patient data over the Internet requires secure confidentiality. Ease-of-use is crucial to promote practicality, user-friendly operation, and adherence to therapy. The combination of evidence-based methodologies with cost-effective services will serve as a basis for the further expansion of vital telerehab services and increases reimbursement by health insurance providers., Telerehabilitation, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7577310/, 2168-8184

5. Fatoye, Francis and Gebrye, Tadesse and Fatoye, Clara and Mbada, Chidozie E and Olaoye, Mistura I and Odole, Adesola C and Dada, Olumide (2020) The Clinical and Cost-Effectiveness of Telerehabilitation for People With Nonspecific Chronic Low Back Pain: Randomized Controlled Trial. {JMIR} {mHealth} and {uHealth} 8(6): e15375 https://doi.org/10.2196/15375, Full Text:C\:\\Users\\Ali Barzegar Kh\\Zotero\\storage\\ANN637FX\\Fatoye et al. - 2020 - The Clinical and Cost-Effectiveness of Telerehabil.pdf:application/pdf, PMC7381065, 32357128, 2020-06-24, 2023-01-08, {JMIR} Mhealth Uhealth, Background Telerehabilitation can facilitate multidisciplinary management for people with nonspecific chronic low back pain ({NCLBP}). It provides health care access to individuals who are physically and economically disadvantaged. Objective This study aimed to evaluate the clinical and cost-effectiveness of telerehabilitation compared with a clinic-based intervention for people with {NCLBP} in Nigeria. Methods A cost-utility analysis alongside a randomized controlled trial from a health care perspective was conducted. Patients with {NCLBP} were assigned to either telerehabilitation-based {McKenzie} therapy ({TBMT}) or clinic-based {McKenzie} therapy ({CBMT}). Interventions were carried out 3 times weekly for a period of 8 weeks. Patients ’ level of disability was measured using the Oswestry Disability Index ({ODI}) at baseline, week 4, and week 8. To estimate the health-related quality of life of the patients, the {ODI} was mapped to the short-form six dimensions instrument to generate quality-adjusted life years ({QALYs}). Health care resource use and costs were assessed based on the {McKenzie} extension protocol in Nigeria in 2019. Descriptive and inferential data analyses were also performed to assess the clinical effectiveness of the interventions. Bootstrapping was conducted to generate the point estimate of the incremental cost-effectiveness ratio ({ICER}). Results A total of 47 patients ({TBMT}, n=21 and {CBMT}, n=26), with a mean age of 47 ({SD} 11.6) years for telerehabilitation and 50 ({SD} 10.7) years for the clinic-based intervention, participated in this study. The mean cost estimates of {TBMT} and {CBMT} interventions per person were 22,200 naira ({US} \$61.7) and 38,200 naira ({US} \$106), respectively. {QALY} gained was 0.085 for {TBMT} and 0.084 for {CBMT}. The {TBMT} arm was associated with an additional 0.001 {QALY} (95% {CI} 0.001 to 0.002) per participant compared with the {CBMT} arm. Thus, the {ICER} showed that the {TBMT} arm was less costly and more effective than the {CBMT} arm. Conclusions The findings of the study suggested that telerehabilitation for people with {NCLBP} was cost saving. Given the small number of participants in this study, further examination of effects and costs of the interventions is needed within a larger sample size. In addition, future studies are required to assess the cost-effectiveness of this intervention in the long term from the patient and societal perspective., The Clinical and Cost-Effectiveness of Telerehabilitation for People With Nonspecific Chronic Low Back Pain, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7381065/, 2291-5222

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