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Bioengineering
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Smartphone- or Tablet-Based Technologies for Balance and Gait Rehabilitation
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Smartphone- or Tablet-Based Technologies for Balance and Gait Rehabilitation

A special issue of Bioengineering (ISSN 2306-5354). This special issue belongs to the section "Biomechanics and Sports Medicine".

Deadline for manuscript submissions: 30 November 2024 | Viewed by 13177

Special Issue Editor

Dr. Beom-Chan Lee

E-Mail Website
Guest Editor
Department of Health and Human Performance, University of Houston, 3875 Holman St. Rm 104 Garrison, Houston, TX, USA
Interests: smartphone-based balance rehabilitation; telerehabilitation; biofeedback; biomechanics; neuroscience

Special Issue Information

Dear Colleagues,

Smartphone- or tablet-based technologies have the immense potential to be used as screening or rehabilitation tools to improve balance and gait impairments. Recent advances in mobile devices, wearable sensors, telecommunications, and internet of things (IoT) technologies have made major contributions to improving the effects of conventional balance and gait rehabilitation regimens and advancing the facilitation of user-specific diagnostics and tailored rehabilitation training.

This Special Issue on "Smartphone- or Tablet-based Technologies for Balance and Gait Rehabilitation" will therefore focus on original research papers and comprehensive reviews dealing with cutting-edge technological developments and assessments in smartphone- or tablet-based technologies for balance and gait rehabilitation. Topics of interest for this Special Issue include, but are not limited to, the following:

  1. Innovative or advanced smartphone- or tablet-based technologies for balance and gait rehabilitation;
  2. Novel methodologies to reinforce adherence to balance and gait rehabilitation regimens via gamification (i.e., exergame);
  3. Innovative or advancing tools to improve the diagnosis of balance and gait impairments;
  4. Investigation of wearable sensors to improve smartphone- or tablet-based balance and gait rehabilitation technologies;
  5. Investigations of smartphone- or tablet-based technologies for telerehabilitation or telemonitoring;
  6. Assessments of sensory biofeedback for smartphone- or tablet-based balance and gait rehabilitation technologies;
  7. Effects of smartphone- or tablet-based balance and gait rehabilitation for different populations (e.g., older adults, individuals with movement impairments, neurological disorders, etc.).

All research areas are considered relevant as long as they involve technological innovation and/or experimental validation.

Dr. Beom-Chan Lee
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Bioengineering is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • smartphone- or tablet-based technologies for balance and gait rehabilitation
  • exergame
  • diagnostic tools for balance and gait impairments
  • wearable sensors
  • telerehabilitation or telemonitoring
  • sensory biofeedback
  • aging or neurological disorders

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Published Papers (7 papers)

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10 pages, 11872 KiB  
Article
Investigating Eye Movement and Postural Stability Relationships Using Mobile Eye-Tracking and Posturography: A Cross-Sectional Study
by Seo-Yoon Park, Tae-Woo Kang and Dong-Kyun Koo
Bioengineering 2024, 11(8), 742; https://doi.org/10.3390/bioengineering11080742 - 23 Jul 2024
Viewed by 1214
Abstract
Vision and eye movements play a crucial role in maintaining postural stability. This study investigated the relationship between eye movements and postural control in healthy adults using mobile eye-tracking technology and posturography. Forty healthy participants underwent assessments of eye movements using a mobile [...] Read more.
Vision and eye movements play a crucial role in maintaining postural stability. This study investigated the relationship between eye movements and postural control in healthy adults using mobile eye-tracking technology and posturography. Forty healthy participants underwent assessments of eye movements using a mobile eye-tracking system and postural stability using Tetrax posturography under various sensory conditions. Pearson correlation coefficients were computed to examine associations between eye movement parameters and postural control indices. Significant correlations were found between eye movement parameters and postural stability indices. Faster and more consistent horizontal eye movements were associated with better postural stability (r = −0.63, p < 0.05). Eye movement speed variability positively correlated with weight distribution indices under normal eyes open (r = 0.65, p < 0.05) and closed (r = 0.59, p < 0.05) conditions. Coordination of horizontal and vertical eye movements positively correlated with postural control (r = 0.69, p < 0.01). Negative correlations were observed between eye movement coordination and Fourier indices in various frequency bands (p < 0.05) and the stability index under different head positions (p < 0.05). The findings provide insights into sensory integration mechanisms underlying balance maintenance and highlight the importance of integrated sensory processing in postural stability. Eye movement assessments have potential applications in balance evaluation and fall risk prediction. Full article
(This article belongs to the Special Issue Smartphone- or Tablet-Based Technologies for Balance and Gait Rehabilitation)
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12 pages, 452 KiB  
Article
A Virtual Assistant to Guide Early Postoperative Rehabilitation after Reverse Shoulder Arthroplasty: A Pilot Randomized Trial
by José-María Blasco, Marta Navarro-Bosch, José-Enrique Aroca-Navarro, David Hernández-Guillén, Pau Puigcerver-Aranda and Sergio Roig-Casasús
Bioengineering 2024, 11(2), 152; https://doi.org/10.3390/bioengineering11020152 - 2 Feb 2024
Viewed by 1326
Abstract
Introduction: Rehabilitation can improve outcomes after reverse shoulder arthroplasty (RSA). However, low adherence to rehabilitation and compliance rates are some of the main barriers. To address this public health issue, the goal of this research was to pilot test and evaluate the effectiveness [...] Read more.
Introduction: Rehabilitation can improve outcomes after reverse shoulder arthroplasty (RSA). However, low adherence to rehabilitation and compliance rates are some of the main barriers. To address this public health issue, the goal of this research was to pilot test and evaluate the effectiveness of a chatbot to promote adherence to home rehabilitation in patients undergoing RSA. Methods: A randomized pilot trial including patients undergoing RSA and early postoperative rehabilitation was performed. The control group received standard home rehabilitation; the experimental group received the same intervention supervised with a chatbot, with automated interactions that included messages to inform, motivate, and remember the days and exercises for 12 weeks. Compliance with rehabilitation and clinical measures of shoulder function, pain, and quality of life were assessed. Results: 31 patients (17 experimental) with an average age of 70.4 (3.6) completed the intervention. Compliance was higher in the experimental group (77% vs. 65%; OR95% = 2.4 (0.5 to 11.4)). Statistically significant between-group differences with a CI of 95% were found in the QuickDASH questionnaire and self-reported quality of life. No differences were found in the rest of the measures. Conclusions: This pilot study suggests that the chatbot tool can be useful in promoting compliance with early postoperative home rehabilitation in patients undergoing RSA. Future randomized trials with adequate power are warranted to determine the clinical impact of the proposal. Full article
(This article belongs to the Special Issue Smartphone- or Tablet-Based Technologies for Balance and Gait Rehabilitation)
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18 pages, 1839 KiB  
Article
Feasibility of an Application-Based Outpatient Rehabilitation Program for Stroke Survivors: Acceptability and Preliminary Results for Patient-Reported Outcomes
by Annina Bindschedler, Carina Ziller, Eve-Yaël Gerber, Frank Behrendt, Björn Crüts, Katrin Parmar, Hans Ulrich Gerth, Szabina Gäumann, Wiebke Dierkes, Corina Schuster-Amft and Leo H. Bonati
Bioengineering 2024, 11(2), 135; https://doi.org/10.3390/bioengineering11020135 - 29 Jan 2024
Viewed by 1794
Abstract
Background: The majority of stroke survivors experience long-term impairments. Regular physical activity and other lifestyle modifications play an important role in rehabilitation. Outpatient rehabilitation using telemedicine might be suitable to improve functional ability and long-term secondary prevention. The Strokecoach Intervention Program (SIP, Strokecoach [...] Read more.
Background: The majority of stroke survivors experience long-term impairments. Regular physical activity and other lifestyle modifications play an important role in rehabilitation. Outpatient rehabilitation using telemedicine might be suitable to improve functional ability and long-term secondary prevention. The Strokecoach Intervention Program (SIP, Strokecoach GmbH, Cologne, Germany) comprises training, coaching and monitoring with the aim of improving or at least maintaining functional independence and preventing further stroke through more targeted physical activity. The SIP is provided as blended care, which refers to the integrated and coordinated delivery of healthcare services that combines traditional in-person interactions with technology-mediated interventions, optimizing the use of both face-to-face and virtual modalities to enhance patient outcomes. Objective: The aim of this study was to evaluate the acceptance of the SIP by the participants and its practical application, as well as to obtain initial indications of effects of the SIP on the basis of patient-related outcome measures, blood pressure measurements and recording of physical activity in parallel with the intervention. Methods: Data from individuals with stroke participating in the SIP were analyzed retrospectively. Within the SIP, participants received an application-based training program, were instructed to measure their blood pressure daily and to wear an activity tracker (pedometer). During the intervention period of either 6 or 12 weeks, the participants were supported and motivated by a personal coach via a messenger application. The primary outcomes of the analysis were recruitment, acceptance of and satisfaction with the SIP. Secondary outcomes included functional measures, mobility and health-related quality of life. Results: A total of 122 individuals with stroke could be recruited for the SIP. A total of 96 out of 122 were able to start the program (54% female, mean age 54.8 (SD = 13.1), 6.1 (SD = 6.6) years after stroke onset) and 88 completed the SIP. Participants wore the activity tracker on 66% and tracked their blood pressure on 72% of their intervention days. A further analyzed subgroup of 38 participants showed small improvements in patient-reported outcomes such as health-related quality of life (SF-36) with an increase of 12 points in the subdomain mental health, vitality (12.6) and physical functioning (9.1). However, no statistically significant improvements were found in other performance-based measures (Timed Up and Go test, gait speed). Conclusions: This study showed that a blended therapy approach for stroke survivors with mild to moderate impairments in the chronic phase is feasible and was highly accepted by participants, who benefitted from the additional coaching. Full article
(This article belongs to the Special Issue Smartphone- or Tablet-Based Technologies for Balance and Gait Rehabilitation)
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14 pages, 1059 KiB  
Article
Concurrent Validity of the Ergotex Device for Measuring Low Back Posture
by Marco A. García-Luna, Jose M. Jimenez-Olmedo, Basilio Pueo, Carmen Manchado and Juan M. Cortell-Tormo
Bioengineering 2024, 11(1), 98; https://doi.org/10.3390/bioengineering11010098 - 20 Jan 2024
Cited by 3 | Viewed by 1450
Abstract
Highlighting the crucial role of monitoring and quantifying lumbopelvic rhythm for spinal curvature, the Ergotex IMU, a portable, lightweight, cost-effective, and energy-efficient technology, has been specifically designed for the pelvic and lumbar area. This study investigates the concurrent validity of the Ergotex device [...] Read more.
Highlighting the crucial role of monitoring and quantifying lumbopelvic rhythm for spinal curvature, the Ergotex IMU, a portable, lightweight, cost-effective, and energy-efficient technology, has been specifically designed for the pelvic and lumbar area. This study investigates the concurrent validity of the Ergotex device in measuring sagittal pelvic tilt angle. We utilized an observational, repeated measures design with healthy adult males (mean age: 39.3 ± 7.6 y, body mass: 82.2 ± 13.0 kg, body height: 179 ± 8 cm), comparing Ergotex with a 3D optical tracking system. Participants performed pelvic tilt movements in anterior, neutral, and posterior conditions. Statistical analysis included paired samples t-tests, Bland–Altman plots, and regression analysis. The findings show minimal systematic error (0.08° overall) and high agreement between the Ergotex and optical tracking, with most data points falling within limits of agreement of Bland–Altman plots (around ±2°). Significant differences were observed only in the anterior condition (0.35°, p < 0.05), with trivial effect sizes (ES = 0.08), indicating that these differences may not be clinically meaningful. The high Pearson’s correlation coefficients across conditions underscore a robust linear relationship between devices (r > 0.9 for all conditions). Regression analysis showed a standard error of estimate (SEE) of 1.1° with small effect (standardized SEE < 0.26 for all conditions), meaning that the expected average deviation from the true value is around 1°. These findings validate the Ergotex as an effective, portable, and cost-efficient tool for assessing sagittal pelvic tilt, with practical implications in clinical and sports settings where traditional methods might be impractical or costly. Full article
(This article belongs to the Special Issue Smartphone- or Tablet-Based Technologies for Balance and Gait Rehabilitation)
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12 pages, 3242 KiB  
Article
Development and Application of a Stability Index Estimation Algorithm Based on Machine Learning for Elderly Balance Ability Diagnosis in Daily Life
by Jeong-Woo Seo, Taehong Kim, Joong Il Kim, Youngjae Jeong, Kyoung-Mi Jang, Junggil Kim and Jun-Hyeong Do
Bioengineering 2023, 10(8), 943; https://doi.org/10.3390/bioengineering10080943 - 8 Aug 2023
Cited by 2 | Viewed by 1409
Abstract
Background: The stability index estimation algorithm was derived and applied to develop and implement a balance ability diagnosis system that can be used in daily life. Methods: The system integrated an approach based on sensory function interaction, called the clinical test of sensory [...] Read more.
Background: The stability index estimation algorithm was derived and applied to develop and implement a balance ability diagnosis system that can be used in daily life. Methods: The system integrated an approach based on sensory function interaction, called the clinical test of sensory interaction with balance. A capacitance and resistance sensing type force mat was fabricated, and a stability index prediction algorithm was developed and applied using the center of pressure variables. The stability index prediction algorithm derived a center of pressure variable for 103 elderly people by Nintendo Wii Balance Board to predict the stability index of the balance system (Biodex SD), and the accuracy of this approach was confirmed. Results: As a result of testing with the test set, the linear regression model confirmed that the r-value ranged between 0.943 and 0.983. To confirm the similarity between the WBB and the flexible force mat, each measured center of pressure value was inputted and calculated in the developed regression model, and the result of the correlation coefficient validation confirmed an r-value of 0.96. Conclusion: The system developed in this study will be applicable to daily life in the home in the form of a floor mat. Full article
(This article belongs to the Special Issue Smartphone- or Tablet-Based Technologies for Balance and Gait Rehabilitation)
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18 pages, 999 KiB  
Systematic Review
A Systematic Review of the Effects of Interactive Telerehabilitation with Remote Monitoring and Guidance on Balance and Gait Performance in Older Adults and Individuals with Neurological Conditions
by Catherine Park and Beom-Chan Lee
Bioengineering 2024, 11(5), 460; https://doi.org/10.3390/bioengineering11050460 - 6 May 2024
Viewed by 2755
Abstract
Recognizing the growing interests and benefits of technology-assisted interactive telerehabilitation in various populations, the aim of this review is to systematically review the effects of interactive telerehabilitation with remote monitoring and guidance for improving balance and gait performance in older adults and individuals [...] Read more.
Recognizing the growing interests and benefits of technology-assisted interactive telerehabilitation in various populations, the aim of this review is to systematically review the effects of interactive telerehabilitation with remote monitoring and guidance for improving balance and gait performance in older adults and individuals with neurological conditions. The study protocol for this systematic review was registered with the international prospective register of systematic reviews (PROSPERO) with the unique identifier CRD42024509646. Studies written in English published from January 2014 to February 2024 in Web of Science, Pubmed, Scopus, and Google Scholar were examined. Of the 247 identified, 17 were selected after initial and eligibility screening, and their methodological quality was assessed with the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies. All 17 studies demonstrated balance and gait performance improvement in older adults and in individuals with stroke, Parkinson’s disease, and multiple sclerosis following 4 or more weeks of interactive telerehabilitation via virtual reality, smartphone or tablet apps, or videoconferencing. The findings of this systematic review can inform the future design and implementation of interactive telerehabilitation technology and improve balance and gait training exercise regimens for older adults and individuals with neurological conditions. Full article
(This article belongs to the Special Issue Smartphone- or Tablet-Based Technologies for Balance and Gait Rehabilitation)
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17 pages, 979 KiB  
Systematic Review
A Systematic Review of the Long-Term Effects of Using Smartphone- and Tablet-Based Rehabilitation Technology for Balance and Gait Training and Exercise Programs
by Chihyeong Lee, Jooeun Ahn and Beom-Chan Lee
Bioengineering 2023, 10(10), 1142; https://doi.org/10.3390/bioengineering10101142 - 28 Sep 2023
Cited by 5 | Viewed by 2031
Abstract
Recent advances in wearable motion sensors, mobile devices, the Internet of Things, and telecommunications have created new potential for telerehabilitation. Recognizing that there is no systematic review of smartphone- or tablet-based balance and gait telerehabilitation technology for long-term use (i.e., four weeks or [...] Read more.
Recent advances in wearable motion sensors, mobile devices, the Internet of Things, and telecommunications have created new potential for telerehabilitation. Recognizing that there is no systematic review of smartphone- or tablet-based balance and gait telerehabilitation technology for long-term use (i.e., four weeks or more), this systematic review summarizes the effects of smartphone- or tablet-based rehabilitation technology on balance and gait exercise and training in balance and gait disorders. The review examined studies written in English published from 2013 to 2023 in Web of Science, Pubmed, Scopus, and Google Scholar. Of the 806 studies identified, 14 were selected, and the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-sectional Studies was applied to evaluate methodological quality. The systematic review concluded that all 14 studies found balance and gait performance improvement after four weeks or more of balance and gait telerehabilitation. Ten of the 14 studies found that carry-over effects (improved functional movements, muscle strength, motor capacity, cognition, and reduced fear of falling and anxiety levels) were maintained for weeks to months. The results of the systematic review have positive technical and clinical implications for the next-generation design of rehabilitation technology in balance and gait training and exercise programs. Full article
(This article belongs to the Special Issue Smartphone- or Tablet-Based Technologies for Balance and Gait Rehabilitation)
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