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Bioengineering
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Advances in Physical Therapy and Rehabilitation
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Advances in Physical Therapy and Rehabilitation

A special issue of Bioengineering (ISSN 2306-5354). This special issue belongs to the section "Biomedical Engineering and Biomaterials".

Deadline for manuscript submissions: 30 April 2025 | Viewed by 4756

Special Issue Editor

Dr. Alvaro N. Gurovich

E-Mail Website
Guest Editor
Doctor of Physical Therapy Program, College of Health Sciences, The University of Texas at El Paso, El Paso, TX 79968, USA
Interests: clinical applied physiology; cardiovascular pathophysiology and rehabilitation; exercise-induced blood flow patterns; endothelial function
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In the past few years, the field of physical therapy and rehabilitation has benefitted from close collaboration with engineers to enhance patients’ outcomes and quality of life. From 3D printing for adaptive devices and hearing aids to exoskeletons and virtual reality,  bioengineers have provided important support to the rehabilitation field in general. As these two fields, rehabilitation and engineering, have produced brilliant work in the past, I cannot wait to see what the present and the future have to offer.

This Special Issue will focus on current research advancing any collaborations between rehabilitation and engineering. From the biological perspective, via basic and applied sciences research, to environmental and mechanical factors that play key roles in the recovery of our patients. We welcome manuscripts covering a broad overview of bioengineering research topics to enhance the Physical Therapy and Rehabilitation field. These topics might be related to basic or applied sciences, such as biomechanics, physiology, motor control, or any other factor associated with bioengineering in rehabilitation.

Dr. Alvaro N. Gurovich
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

  • biomedical engineering
  • rehabilitation engineering
  • biomechanics
  • motor control
  • applied physiology
  • 3D printing
  • additive manufacture
  • imaging
  • ultrasound

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Published Papers (5 papers)

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Research

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10 pages, 1064 KiB  
Article
Sex-Specific Analysis of Carotid Artery Through Bilateral 3D Modeling via MRI and DICOM Processing
by Pedro Martinez, Jose Roberto Torres, Daniel Conde, Manuel Gomez and Alvaro N. Gurovich
Bioengineering 2025, 12(2), 142; https://doi.org/10.3390/bioengineering12020142 - 1 Feb 2025
Viewed by 490
Abstract
The present study explores the anatomical differences between sexes of the carotid artery using non-invasive magnetic resonance imaging (MRI) and a DICOM processing protocol. Bilateral three-dimensional models of the carotid artery were constructed for 20 healthy young adults, 10 males and 10 females, [...] Read more.
The present study explores the anatomical differences between sexes of the carotid artery using non-invasive magnetic resonance imaging (MRI) and a DICOM processing protocol. Bilateral three-dimensional models of the carotid artery were constructed for 20 healthy young adults, 10 males and 10 females, in order to evaluate key anatomical landmarks; these include the bifurcation diameter and angle, as well as the internal and external carotid arteries (ICA and ECA) for both sides (left and right). The results show that males exhibit larger bifurcation and ECA diameters, which could indicate reduced endothelial shear stress (ESS). However, as there is no previously observed sex difference in ESS between sexes, compensatory factors might be in play, such as blood pressure. This underscores the interaction between vascular geometry and stroke risk disparities; future research is encouraged to analyze diverse demographics and employ flow modeling techniques to further asses the connection between anatomical differences within a given population and vascular outcomes. Full article
(This article belongs to the Special Issue Advances in Physical Therapy and Rehabilitation)
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13 pages, 2644 KiB  
Article
Reverse Shoulder Arthroplasty Baseplate Stability Is Affected by Bone Density and the Type and Amount of Augmentation
by Daniel Ritter, Patric Raiss, Patrick J. Denard, Brian C. Werner, Manuel Kistler, Celina Lesnicar, Micheal van der Merwe, Peter E. Müller, Matthias Woiczinski, Coen A. Wijdicks and Samuel Bachmaier
Bioengineering 2025, 12(1), 42; https://doi.org/10.3390/bioengineering12010042 - 8 Jan 2025
Viewed by 664
Abstract
Objective: This study evaluated the effects of bony increased offset (BIO) and metallic augments (MAs) on primary reverse shoulder arthroplasty (RSA) baseplate stability in cadaveric specimens with variable bone densities. Methods: Thirty cadaveric specimens were analyzed in an imaging and biomechanical investigation. Computed [...] Read more.
Objective: This study evaluated the effects of bony increased offset (BIO) and metallic augments (MAs) on primary reverse shoulder arthroplasty (RSA) baseplate stability in cadaveric specimens with variable bone densities. Methods: Thirty cadaveric specimens were analyzed in an imaging and biomechanical investigation. Computed tomography (CT) scans allowed for preoperative RSA planning and bone density analysis. Three correction methods of the glenoid were used: (1) corrective reaming with a standard baseplate, which served as the reference group (n = 10); (2) MA-RSA (n = 10); and (3) angled BIO-RSA (n = 10). Each augment group consisted of 10° (n = 5) and 20° (n = 5) corrections. Biomechanical testing included cyclic loading in an articulating setup, with optical pre- and post-cyclic micromotion measurements in a rocking horse setup. Results: There were no differences in bone density between groups based on CT scans (p > 0.126). The BIO-RSA group had higher variability in micromotion compared to the MA-RSA and reference groups (p = 0.013), and increased total micromotion compared to the reference group (p = 0.039). Both augmentations using 20° corrections had increased variance in rotational stability compared to the reference group (p = 0.043). Micromotion correlated with the subchondral bone density in the BIO-RSA group (r = −0.63, p = 0.036), but not in the MA-RSA (p > 0.178) or reference (p > 0.117) groups. Conclusions: Time-zero baseplate implant fixation is more variable with BIO-RSA and correlates with bone density. Corrections of 20° with either augmentation approach increase variability in rotational micromotion. The preoperative quantification of bone density may be useful before utilizing 20° of correction, especially when adding a bone graft in BIO-RSAs. Full article
(This article belongs to the Special Issue Advances in Physical Therapy and Rehabilitation)
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15 pages, 1463 KiB  
Article
Cybersickness in People with Multiple Sclerosis Exposed to Immersive Virtual Reality
by Massimiliano Pau, Federico Arippa, Bruno Leban, Micaela Porta, Giulia Casu, Jessica Frau, Lorena Lorefice, Giancarlo Coghe and Eleonora Cocco
Bioengineering 2024, 11(2), 115; https://doi.org/10.3390/bioengineering11020115 - 24 Jan 2024
Cited by 4 | Viewed by 1764
Abstract
Together with the wide range of possible benefits for the rehabilitation/training of people with multiple sclerosis (pwMS) and other neurologic conditions, exposure to immersive virtual reality (VR) has often been associated with unpleasant symptoms, such as transient dizziness, headache, nausea, disorientation and impaired [...] Read more.
Together with the wide range of possible benefits for the rehabilitation/training of people with multiple sclerosis (pwMS) and other neurologic conditions, exposure to immersive virtual reality (VR) has often been associated with unpleasant symptoms, such as transient dizziness, headache, nausea, disorientation and impaired postural control (i.e., cybersickness). Since these symptoms can significantly impact the safety and tolerability of the treatment, it appears important to correctly estimate their presence and magnitude. Given the existing data scarcity, this study aims to assess the existence and severity of possible adverse effects associated with exposure to immersive VR in a cohort of pwMS using both objective measurements of postural control effectiveness and subjective evaluations of perceived symptoms. To this aim, postural sway under upright quiet posture (in the presence and absence of visual input) of 56 pwMS with an Expanded Disability Status Scale score (EDSS) in the range of 0–6.5 (mean EDSS 2.3) and 33 unaffected individuals was measured before and after a 10-min immersive VR session and at 10 min follow-up on the basis of center of pressure (COP) trajectories. The severity of cybersickness symptoms associated with VR exposure was also self-rated by the participants using the Italian version of the Simulator Sickness Questionnaire (SSQ). Temporary impairments of postural control in terms of significantly increased sway area were observed after the VR session only in pwMS with mild–moderate disability (i.e., EDSS in the range of 2.5–6.5) in the presence of visual input. No changes were observed in pwMS with low disability (EDSS 0–2) and unaffected individuals. In contrast, when the visual input was removed, there was a decrease in sway area (pwMS with mild–moderate disability) and COP path length relating to the use of VR (pwMS with mild–moderate disability and unaffected individuals), thus suggesting a sort of “balance training effect”. Even in this case, the baseline values were restored at follow-up. All participants, regardless of their status, experienced significant post-VR side effects, especially in terms of blurred vision and nausea. Taken together, the findings of the present study suggest that a short immersive VR session negatively (eyes open) and positively (eyes closed) impacts the postural control of pwMS and causes significant disorientation. However, such effects are of limited duration. While it is reasonable to state that immersive VR is sufficiently safe and tolerable to not be contraindicated in the rehabilitation/training of pwMS, in order to reduce possible negative effects and maximize the efficacy, safety and comfort of the treatment, it appears necessary to develop specific guidelines that consider important factors like individual susceptibility, maximum exposure time according to the specific features of the simulation, posture to adopt and protocols to assess objective and perceived effects on participants. Full article
(This article belongs to the Special Issue Advances in Physical Therapy and Rehabilitation)
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Review

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14 pages, 2358 KiB  
Review
The Role of AMPS in Parkinson’s Disease Management: Scoping Review and Meta-Analysis
by Roberto Tedeschi, Danilo Donati and Federica Giorgi
Bioengineering 2025, 12(1), 21; https://doi.org/10.3390/bioengineering12010021 - 29 Dec 2024
Viewed by 589
Abstract
Background: Automated Mechanical Peripheral Stimulation (AMPS) is emerging as a potential therapeutic tool for managing motor and non-motor symptoms in individuals with Parkinson’s disease (PD), particularly in terms of improving gait, balance, and autonomic regulation. This scoping review aims to synthesize current evidence [...] Read more.
Background: Automated Mechanical Peripheral Stimulation (AMPS) is emerging as a potential therapeutic tool for managing motor and non-motor symptoms in individuals with Parkinson’s disease (PD), particularly in terms of improving gait, balance, and autonomic regulation. This scoping review aims to synthesize current evidence on AMPS’s effectiveness for these outcomes. Methods: A review was conducted on MEDLINE, Cochrane Central, Scopus, PEDro, and Web of Science. Studies were included if they examined AMPS interventions for PD patients and reported outcomes related to gait, balance, neurological function, or autonomic regulation. Data extraction focused on study design, intervention details, sample characteristics, and key outcomes. Quality was assessed using the PEDro and RoB-2 scales. Results: Six randomized controlled trials met the inclusion criteria. AMPS consistently improved gait kinematic parameters, including step length and gait velocity, and reduced gait asymmetry. In addition, increased brain connectivity between motor regions was correlated with enhanced gait speed, suggesting neuroplastic effects. Some studies reported improved autonomic regulation, with enhanced heart rate variability and blood pressure stability. However, limitations such as small sample sizes, short follow-ups, and varied protocols affected the consistency of the findings. Conclusions: AMPS shows potential as an adjunct therapy for PD, improving gait, balance, and possibly autonomic function. These preliminary findings will support further research into establishing standardized protocols, confirming long-term efficacy, and exploring AMPS’s impact on non-motor symptoms. With robust evidence, AMPS could complement existing PD management strategies and improve patient outcomes. Full article
(This article belongs to the Special Issue Advances in Physical Therapy and Rehabilitation)
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Other

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13 pages, 560 KiB  
Systematic Review
Relevance of Leg Rehabilitation to Modulating Neurogenic Lower Urinary Tract Symptoms: A Systematic Review
by Gianluca Ciardi, Donatella Giraudo, Milena Fontana, Chiara Citterio, Paola Gandolfi and Gianfranco Lamberti
Bioengineering 2025, 12(2), 127; https://doi.org/10.3390/bioengineering12020127 - 29 Jan 2025
Viewed by 445
Abstract
Neurogenic lower urinary tract dysfunction (NLUTD) is a secondary complication of a wide range of neurological disorders, which affects patients’ everyday life and self-efficacy. Some brain imaging studies have shown an overlap between motor activation of the pelvic floor and lower limbs. This [...] Read more.
Neurogenic lower urinary tract dysfunction (NLUTD) is a secondary complication of a wide range of neurological disorders, which affects patients’ everyday life and self-efficacy. Some brain imaging studies have shown an overlap between motor activation of the pelvic floor and lower limbs. This systematic review sought to examine the possibility of improving overactive bladder outcomes through a conservative approach based on lower limb training. We conducted a systematic literature review, following the PRISMA guidelines. The following databases were searched: PEDro, PubMed, TRIP, Cochrane Library, EDS base index, Google Scholar, and CINAHL. The PEDro Scale and Cochrane Risk of Bias Assessment Tool were used to assess the overall study quality and sources of bias. A total of 5567 records were retrieved through the systematic search, of which 104 were sought for retrieval; two cohort studies and one randomized controlled trial were finally included. Urodynamics and specific bladder functionality questionnaires showed preliminary evidence of improvement following lower limb stimulation, implemented according to different treatment types (exoskeleton training and weight-suspension walking training). Lower limb-focused exercises showed promising results for improving bladder function, despite the small number of studies and small sample sizes. Future research should confirm this hypothesis using larger samples. Full article
(This article belongs to the Special Issue Advances in Physical Therapy and Rehabilitation)
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