On the Use of Natural User Interfaces in Physical Rehabilitation: A Web-based Application for Patients with Hip Prosthesis

  • Yves Rybarczyk Intelligent & Interactive Systems Lab, Universidad de Las Américas, Quito, Ecuador CTS/UNINOVA, Nova University of Lisbon, Lisboa, Portugal http://orcid.org/0000-0002-3650-9162
  • Clément Cointe Ecole Normale Supérieure de Paris-Saclay, Cachan, France
  • Tiago Gonçalves Faculdade de Engenharia da Universidade do Porto, Porto, Portugal
  • Vitor Minhoto Faculdade de Engenharia da Universidade do Porto, Porto, Portugal
  • Jan Kleine Deters University of Twente, Enschede, The Netherlands
  • Santiago Villarreal Intelligent & Interactive Systems Lab, Universidad de Las Américas, Quito, Ecuador
  • Arián Aladro Gonzalo Pontificia Universidad Católica del Ecuador, Quito, Ecuador
  • Jonathan Baldeón Research Laboratory in Physiotherapy and Human Movement, Universidad de Las Américas, Quito, Ecuador
  • Danilo Esparza Research Laboratory in Physiotherapy and Human Movement, Universidad de Las Américas, Quito, Ecuador
Keywords: Web development, Artificial Intelligence, Usability, Therapeutic Application

Abstract

This study aims to develop a telemedicine platform for self-motor rehabilitation and remote monitoring by health professionals, in order to enhance recovery in patients after hip replacement. The implementation of such a technology is justified by medical (improvement of the recovery process by the possibility to perform rehabilitation exercises more frequently), economic (reduction of the number of medical appointments and the time patients spend at the hospital), mobility (diminution of the transportation to and from the hospital) and ethics (healthcare democratization and increased empowerment of the patient) purposes. The Kinect camera is used as a Natural User Interface to capture the physical exercises performed at home by the patients. The quality of the movement is evaluated in real-time by an assessment module implemented according to a Hidden-Markov Model approach. The results show a high accuracy in the evaluation of the movements (92% of correct classification). Finally, the usability of the platform is tested through the System Usability Scale (SUS). The overall SUS score is 81 out of 100, which suggests a good usability of the Web application. Further work will focus on the development of additional functionalities and an evaluation of the impact of the platform on the recovery process.

Author Biographies

Yves Rybarczyk, Intelligent & Interactive Systems Lab, Universidad de Las Américas, Quito, Ecuador CTS/UNINOVA, Nova University of Lisbon, Lisboa, Portugal
Yves Rybarczyk is a professor at the Nova University of Lisbon (Portugal) and head of the Intelligent & Interactive Systems Lab (SI2 Lab), Universidad de las Américas (Ecuador). In 2004, he received a PhD degree in Robotics from the University of Evry (France) for his work on the “Modelling and implementation of human-like behaviours to improve Human-Robot Cooperation in teleoperation”. His research interests focus on Human-Machine Interaction and Artificial Intelligence. He has participated in many national and international scientific projects. He is the author and co-author of over 60 publications and has supervised several student’s theses. Besides scientific papers, Rybarczyk’s group has produced interactive applications and tools for educational and therapeutic purposes. He is also member of the steering committee of eNTERFACE workshops on Multimodal Interactions and reviewer in renowned scientific journals and conferences.
Clément Cointe, Ecole Normale Supérieure de Paris-Saclay, Cachan, France
Clément Cointe is a student at Ecole Normale Supérieure in Cachan (France). After three years of bachelor's degree in Engineering Sciences, he specialized in Electronics to obtain a master’s degree in Electrical Engineering and Automatic Control. He is currently pursuing a master's degree in higher education for Engineering Sciences. He has been involved in the ePHoRt project since his internship at the Universidad de Las Americas (Ecuador) with Pr. Yves Rybarczyk (starting date: May 2017).
Tiago Gonçalves, Faculdade de Engenharia da Universidade do Porto, Porto, Portugal
Tiago Gonçalves is a Bioengineering MSc. student at Faculty of Engineering of the University of Porto (Portugal). He got a BSc. Degree from Biotechnology College of the Portuguese Catholic University of Porto. He is interested in Physiological Signal Processing, Biomedical Image Analysis, Computer Aided Diagnosis and e-Health Systems. He did an internship at the University of Twente, where he worked on the development of membranes for haemodialysis in the Biomaterials Science and Technology Institute.
Vitor Minhoto, Faculdade de Engenharia da Universidade do Porto, Porto, Portugal
Vitor Minhoto is a Bioengineering MSc. Student at Faculty of Engineering of the University of Porto (FEUP, Portugal). His areas of interest are Biomechanics, Robotics, Graphical Interfaces Design, and Game Development. He has some experience in Web Design, Microcontrollers Programing, and Control. Also, he is part of the FEUP IEEE Student Branch staff.
Jan Kleine Deters, University of Twente, Enschede, The Netherlands
Jan Kleine Deters is currently finalizing his master thesis on the “automatic assessment of therapeutic exercises” at the Human Media Interaction Lab at the University of Twente (The Netherlands). He has a bachelor in Industrial Design. His research interest lies on new computational techniques to enhance or create innovative interaction types for a broad user base. He is interested in using low-cost technologies, because it pushes the creativity and makes sure that the developed systems have the potential to impact a lot of people around the globe.
Santiago Villarreal, Intelligent & Interactive Systems Lab, Universidad de Las Américas, Quito, Ecuador
Santiago Villarreal is a professor at the Universidad de las Américas (Ecuador), where he teaches software development. He is also a member of the Intelligent & Interactive Systems Lab (SI2), collaborating on the development of the ePHoRt tele-rehabilitation platform. His areas of interest are Artificial Intelligence, Multi-Agent System, and Distributed Constraint Satisfaction Problem. He holds a Bachelor’s degree in Computer Science and a Master’s degree in Web Intelligence from Jean Monnet University (France).
Arián Aladro Gonzalo, Pontificia Universidad Católica del Ecuador, Quito, Ecuador
Arián Aladro is a PhD candidate in Health and Sport Science at the University of Zaragoza (Spain), where he works on motor learning and physiological stress. He has a bachelor in Physical Conditioning and a master in Human Movement Sciences awarded by the University of Costa Rica (Costa Rica). He is currently a professor in Biomechanical and Sport Rehabilitation at the Faculty of Nursing, Pontifical Catholic University of Ecuador (Ecuador). He has authored/co-authored peer-reviewed papers in the fields of Social Networks and Physical Activity Promotion, Musculoskeletal Disorder, Motor Performance, and Aerobic Exercise and Psychosocial Stress.
Jonathan Baldeón, Research Laboratory in Physiotherapy and Human Movement, Universidad de Las Américas, Quito, Ecuador
Jonathan Baldeón is a Physical Therapy student at Faculty of Health Sciences of the Universidad de las Américas (UDLA, Ecuador). He currently works as assistant researcher in the Laboratory of Physiotherapy and Human Movement of the UDLA. He is interested in Orthopedic Manual Therapy, Biomechanics, and Movement Sciences.
Danilo Esparza, Research Laboratory in Physiotherapy and Human Movement, Universidad de Las Américas, Quito, Ecuador
Danilo Esparza is a professor at the Universidad de Las Américas (Ecuador) and a physical therapist. He received a PhD in Physical Activity and Sport Science from the University of Orleans (France). His areas of interest are the analysis of Movement Kinematic, Musculoskeletal Pain, and Motor Control and Learning.

References

Antón, D., Go-i, A., & Illarramendi, A. (2015). Exercise recognition for Kinect-based telerehabilitation. Methods of Information in Medicine, (54), 145-155.

Brook, G., Barry, G., Jackson, D., Mhiripiri, D., Olivier, P., & Rochester, L. (2014). Accuracy of the Microsoft Kinect sensor for measuring movement in people with Parkinson's disease. Gait & Posture, (39), 1062-1068.

Brooke, J. (1996). SUS – A quick and dirty usability scale. Usability Evaluation in Industry. London: Taylor & Francis, pp. 189-194.

Carrasco, G., Rybarczyk, Y., Cardoso, T., & Martins, I.P. (2013). A serious game for multimodal training of physician novices. Proceedings of the 6th International Conference of Education, Research and Innovation. Seville, Spain.

Coelho, T., De Oliveira, R., Cardoso, T., Rosas, J., & Rybarczyk, Y. (2014). Body ownership of virtual avatars: an affordance approach of telepresence. Innovative and Creative Development in Multimodal Interaction Systems. Heidelberg: Springer, pp. 3-19.

https://doi.org/10.1007/978-3-642-55143-7_1

Gameiro, J., Cardoso, T., & Rybarczyk, Y. (2014). Kinect-Sign: teaching sign language to listeners through a game. Innovative and Creative Development in Multimodal Interaction Systems. Heidelberg: Springer, pp. 141-159.

https://doi.org/10.1007/978-3-642-55143-7_6

Heiberg, K., & Figved, W. (2016). Physical functioning and prediction of physical activity after total hip arthroplasty: Five-year follow up of a randomized controlled trial. Arthritis Care & Research, (68), 454-462.

https://doi.org/10.1002/acr.22679

Holden, M.K., Dyar, T.A., & Dayan-Cimadoro, L. (2007). Telerehabilitation using a virtual environment improves upper extremity function in patients with stroke. IEEE Transactions on Neural Systems and Rehabilitation Engineering, (15), 36-42.

https://doi.org/10.1109/TNSRE.2007.891388

Jäppinen, A.M., Hämäläinen, H., Kettunen, T., & Piirainen, A. (2016). Postoperative patient education in physiotherapy after hip arthroplasty: Patients' perspective. Musculoskeletal Care. DOI: 10.1002/msc.1153.

https://doi.org/10.1002/msc.1153

Jogi, P., Zecevic, A., Overend, T., Spaulding, S., & Kramer, J. (2016). Force-plate analyses of balance following a balance exercise program during acute post-operative phase in individuals with total hip and knee arthroplasty: a randomized clinical trial. SAGE Open Medicine, (4), 1-9.

https://doi.org/10.1177/2050312116675097

Kleine Deters, J., & Rybarczyk, Y. (2018). Hidden Markov Model approach for the assessment of tele-rehabilitation exercises. International Journal of Artificial Intelligence, (16), 1-19.

Mahapatra, A., Tusar, K.M., Pankaj, K.S., & Banshidhar, M. (2014). Human recognition system for outdoor videos using Hidden Markov Model. International Journal of Electronics and Communications, (68), 227-236.

https://doi.org/10.1016/j.aeue.2013.08.011

Ni, S., Jiang, W., Guo, L., Jin, Y., Jiang, T., Zhao, Y., & Zhao, J. (2015). Cryotherapy on postoperative rehabilitation of joint arthroplasty. Knee Surgery, Sports Traumatology, Arthroscopy, (23), 3354-3361.

https://doi.org/10.1007/s00167-014-3135-x

Papadopoulos, G.T., Axenopoulos, A., & Daras, P. (2014). Real-time skeleton-tracking-based human action recognition using Kinect data. Lecture Notes in Computer Science: MultiMedia Modeling, (8325). Heidelberg: Springer.

https://doi.org/10.1007/978-3-319-04114-8_40

Peter, W., Nelissen, R., & Vlieland, T. (2014). Guideline recommendations for post-acute postoperative physiotherapy in total hip and knee arthroplasty: are they used in daily clinical practice? Musculoskeletal Care, (12), 125-131.

https://doi.org/10.1002/msc.1067

Plantard, P., Shum, H., Le Pierres, A.S., & Multon, F. (2016). Validation of an ergonomic assessment method using Kinect data in real workplace conditions. Applied Ergonomics, (65), 562-569.

Rybarczyk, Y., Kleine Deters, J., Cointe, C., & Esparza, D. (2018). Smart Web-based platform to support physical rehabilitation. Sensors, (18), 1344.

https://doi.org/10.3390/s18051344

Rybarczyk, Y., & Gonçalves, M.J. (2016). WebLisling: a web-based therapeutic platform for the rehabilitation of aphasic patients. IEEE Latin America Transactions, (14), 3921-3927.

https://doi.org/10.1109/TLA.2016.7786381

Rybarczyk, Y., & Vernay, D. (2016). Educative therapeutic tool to promote the empowerment of disabled people. IEEE Latin America Transactions, (14), 3410-3417.

https://doi.org/10.1109/TLA.2016.7587649

Sauro, J. (2011). A Practical Guide to the System Usability Scale: Background, Benchmarks and Practices. Denver: CreateSpace.

Schega, L., Bertram, D., Fölsch, C., Hamacher, D., & Hamacher, D. (2014). The influence of visual feedback on the mental representation of gait in patients with THR: a new approach for an experimental rehabilitation strategy. Applied Psychophysiology and Biofeedback, (39), 37-43.

https://doi.org/10.1007/s10484-014-9239-8

Tsukagoshi, R., Tateuchi, H., Fukumoto, Y., Ibuki, S., Akiyama, H., So, K., Kuroda, Y., Okumura, H., & Ichihashi, N. (2014). Functional performance of female patients more than 6 months after total hip arthroplasty shows greater improvement with weight-bearing exercise than with non-weight-bearing exercise. Randomized controlled trial. European Journal of Physical and Rehabilitation Medicine, (50), 665-675.

Published
2018-07-04