An Underactuated Active Transfemoral Prosthesis With Series Elastic Actuators Enables Multiple Locomotion Tasks

Robotic lower limb prostheses have the power to revolutionize mobility by enhancing gait efficiency and facilitating movement. While several design approaches have been explored to create lightweight and energy-efficient devices, the potential of underactuation remains largely untapped in lower limb prosthetics. Taking inspiration from the natural harmony of walking, in this article, we have developed an innovative active transfemoral prosthesis. By incorporating underactuation, our design uses a single power actuator placed near the knee joint and connected to a differential mechanism to drive both the knee and ankle joints. We conduct comprehensive benchtop tests and evaluate the prosthesis with three individuals who have above-knee amputations, assessing its performance in walking, stair climbing, and transitions between sitting and standing. Our evaluation focuses on gathering position and torque data recorded from sensors integrated into the prosthesis and comparing these measurements to biomechanical data of able-bodied locomotion. Our findings highlight the promise of underactuation in advancing lower limb prosthetics and demonstrate the feasibility of our knee–ankle underactuated design in various tasks, showcasing its ability to replicate natural movement

Home-Based Intervention Tool for Cardiac Telerehabilitation: Protocol for a Controlled Trial

Background: Among cardiovascular diseases, adult patients with congenital heart disease represent a population that has been continuously increasing, which is mainly due to improvement of the pathophysiological framing, including the development of surgical and reanimation techniques. However, approximately 20% of these patients will require surgery in adulthood and 40% of these cases will necessitate reintervention for residual defects or sequelae of childhood surgery. In this field, cardiac rehabilitation (CR) in the postsurgical phase has an important impact on the patient by improving psychophysical and clinical recovery in reducing fatigue and dyspnea to ultimately increase survival. In this context, compliance with the rehabilitation program is a key element for the therapeutic benefits of the program. The increase of mobile health care devices and software has greatly extended self-care capabilities across the spectrum of health care activities. Moreover, the possibility of telemonitoring the progress of this self-care provides elements of empowerment and awareness of one's state of health. As a branch of telehealth, CR can be optimized and facilitated using remote telemedicine devices. Objective: The principal goal of the Innovation in Postoperative Rehabilitation Training and Monitoring (IPOTERI) study is to design, realize, and test a composite and integrated system for postsurgical rehabilitation therapies at home specialized for cardiac surgery. The secondary aims are to implement the system in a "real-life" context of postcardiac surgical rehabilitation, and to create a data set and a data collection methodology to prototype data analytics algorithms and artificial intelligence techniques for customizing the rehabilitation pathway. Methods: The IPOTERI method consists of a telemonitoring platform that guarantees continuity of postoperative care, an intelligent home station based on an Android app for the patient with a user-friendly interface to record vital signals (electrocardiogram, blood pressure, oxygen saturation, and body weight) and access the planning of rehabilitation activities, and a decision support system that communicates with hospital medical records to transmit alerts and specific support information for the formulation and updating of the treatment and care plan. Results: The pilot test started in June 2023 (protocol number 20406/2021) including 50 patients who will be monitored for 12-14 weeks using the developed platform, as described in the Procedures subsection of the Methods section. Conclusions: The IPOTERI approach, based on the processing of data recorded during the monitoring of telemedicine devices used at home during the postsurgical rehabilitation of a cardiac patient, together with clinical data from the perioperative and postoperative periods could have positive effects on adherence to the rehabilitation program and clinical improvement as well as result in overall improvement of quality of life. International registered report identifier (irrid): DERR1-10.2196/47951

Experience with HL7 CDA Release 2 and EbXML

The diffusion of health standards, connected to technological infrastructure, finally opens the road to a new way of interconnecting and integrating different clinical solutions. New standards coming from established Organizations such as HL7 and DICOM, are going to be integrated with Communication Organization to build the Health environment Info-structure of the next decade. The purpose of this work is to show how this is possible, using simple and affordable methods: The recently approved HL7 Clinical Document Architecture Release 2 standard for message packaging and the newly approved ebXML 3.0 specifications. These promising standards can be used in conjunction with Web-Services and Web Service Description Language (WSDL) technology. This type of solution allows to be totally independent from the development platform, from the programming language and the operating system used. EbXML is an XML framework for business-to-business (B2B) environment developed by the ebXML Initiative. 1