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Here, the authors present a low cost telerehabilitation system made up of a commercial red-green-blue depth (RGBD) camera and a web-based platform. The authors goal is to monitor and assess subject movement providing acceptable and usable at-home remote rehabilitation services without the presence of a clinician. Clinical goals, defined by physiotherapists, are firstly translated into motion analysis features. A Takagi Sugeno fuzzy inference system (FIS) is then proposed to evaluate and combine these features into scores. In this stage, the 'collaborative design' paradigm is used in depth and complete manner: the contribution of the clinician is not limited only to the rules definition but enters in the core of the evaluation algorithm through the definition of the fuzzy rules. A case study on low back pain rehabilitation involving 40 subjects, 5 exercises, and 4 physiotherapists is then presented to the effectiveness of the proposed system. Results of the validation of the system aimed at the assessment of the reliability of the proposed approach show high correlations between clinician evaluation and FIS scores. In this scenario, due to the high correlation, each FIS could represent a virtual alter-ego of the physiotherapist which enable a real time and free second opinion. [ABSTRACT FROM AUTHOR]

Background Usually, clinical evaluation of facial reanimation provides accurate information about contraction of the mimetic muscles and phonation but fails to identify smile recovery and to quantify the motility of the lower third of the face during a smile. The purpose of this study was to verify that, in longstanding facial palsy, the modified temporalis muscle transfer (MTMT) can result in the ability to smile, not only voluntarily with chewing, but also spontaneously with a sudden emotional stimulus, and to confirm that a symmetric smile can be obtained. Methods Ten patients of the treated group (group T; 4 women and 6 men) were randomly selected from a population of 24 patients with longstanding facial palsy treated by MTMT. Five normal subjects of the control group (group C; 3 women and 2 men) were enrolled as the control population. Functional outcomes after transposed temporalis muscle were examined and measured through clinical assessment by using a scored smile symmetry grading system, video recording, and surface electromyography (sEMG). In addition, the voluntary smile test (VST) and the not-voluntary smile test (NVST) were performed to study voluntary and spontaneous smiling. Results Subjects in the VST group (group T) were able to smile voluntarily and the expression was characterized by symmetry. In the NVST group, they were able to smile spontaneously and the symmetry of the smile was maintained for 8 subjects and only partially for 2 subjects. During both tests, the temporalis muscle of the treated side and the orbicularis oris muscle of the not-treated side were activated during smiling, indicating spontaneous activity of the transposed temporalis muscle with an emotional stimulus. For the control group, smiles during VST and NVST were symmetric and the temporalis muscles were not activated during smiling, whereas the orbicularis oris muscles were. Conclusion Our study shows that the Morrison MTMT is able to restore the voluntary smile ability. Particularly, this technique allows for recovery of the spontaneous smile with symmetry. This assessment would seem to suggest that the transposed temporalis muscle might adapt from a chewing to a mimetic muscle. © 2016 Wiley Periodicals, Inc. Head Neck 38: E1535-E1543, 2016 [ABSTRACT FROM AUTHOR]