Musculoskeletal disorders are the most common form of occupational ill-health. Neck pain is one of the most prevalent musculoskeletal disorders experienced by computer workers. Wrong postural habits and non-compliance of the workstation to ergonomics guidelines are the leading causes of neck pain. These factors may also alter respiratory functions. Health and safety interventions can reduce neck pain and, more generally, the symptoms of musculoskeletal disorders and reduce the consequent economic burden. In this work, a multi-parametric wearable system based on two fiber Bragg grating sensors is proposed for monitoring neck movements and breathing activity of computer workers. The sensing elements were positioned on the neck, in the frontal and sagittal planes, to monitor: (i) flexion-extension and axial rotation repetitions, and (ii) respiratory frequency. In this pilot study, five volunteers were enrolled and performed five repetitions of both flexion-extension and axial rotation, and ten breaths of both quite breathing and tachypnea. Results showed the good performances of the proposed system in monitoring the aforementioned parameters when compared to optical reference systems. The wearable system is able to well-match the trend in time of the neck movements (both flexion-extension and axial rotation) and to estimate mean and breath-by-breath respiratory frequency values with percentage errors ≤6.09% and ≤1.90%, during quiet breathing and tachypnea, respectively.

Stroke survivors with chronic paralysis often have difficulties to perform various activities of daily living (ADLs), such as preparing a meal or eating and drinking independently. Recently, it was shown that a brain/neural hand exoskeleton can restore hand and finger function, but many stroke survivors suffer from motor deficits affecting their whole upper limb. Therefore, novel hybrid electroencephalography/electrooculography (EEG/EOG)-based brain/neural control paradigms were developed for guiding a whole-arm exoskeleton. It was unclear, however, whether hemiplegic stroke survivors are able to reliably use such brain/neural-controlled device. Here, we tested feasibility, safety, and user-friendliness of EEG/EOG-based brain/neural robotic control across five hemiplegic stroke survivors engaging in a drinking task that consisted of several subtasks (e.g., reaching, grasping, manipulating, and drinking). Reliability was assumed when at least 75% of subtasks were initialized within 3 s. Fluent control was assumed if average “time to initialize” each subtask ranged below 3 s. System's safety and user-friendliness were rated using Likert-scales. All chronic stroke patients were able to operate the system reliably and fluently. No undesired side effects were reported. Four participants rated the system as very user-friendly. These results show that chronic stroke survivors are capable of using an EEG/EOG-controlled semiautonomous whole-arm exoskeleton restoring ADLs.

Wearable devices for physiological parameters monitoring are gaining broad acceptance due to their ease of use, comfortability, and reliability. Among all human joints, the knee joint is the most involved in day-to-day activities. Monitoring the knee joint movements may allow outlining an optimized and patient-specific rehabilitation process and may perform a quantitative assessment of the improvements made. In this work, we propose a washable and reusable wearable system based on a conductive textile for knee flexion-extension monitoring. We performed a biomechanical analysis to guide the design of the sensing element, to perform its metrological characterization, and to optimize its integration into a wearable knee guard. We tested the developed system on 5 healthy volunteers performing 3 different rehabilitation exercises in terms of number of flexion-extension performed and of the knee angle. This assessment was performed using a motion capture system as a reference. The results are promising and in good agreement with the reference system and enable the system to be suitable for its application in rehabilitation and day-to-day monitoring.

Emerging evidence suggests that respiratory frequency (f_R) is a valid marker of physical effort. This has stimulated interest in developing devices that allow athletes and exercise practitioners to monitor this vital sign. The numerous technical challenges posed by breathing monitoring in sporting scenarios (e.g., motion artifacts) require careful consideration of the variety of sensors potentially suitable for this purpose. Despite being less prone to motion artifacts than other sensors (e.g., strain sensors), microphone sensors have received limited attention so far. This paper proposes the use of a microphone embedded in a facemask for estimating f_R from breath sounds during walking and running. f_R was estimated in the time domain as the time elapsed between consecutive exhalation events retrieved from breathing sounds every 30 s. Data were collected from ten healthy subjects (both males and females) at rest and during walking (at 3 km/h and 6 km/h) and running (at 9 km/h and 12 km/h) activities. The reference respiratory signal was recorded with an orifice flowmeter. The mean absolute error (MAE), the mean of differences (MOD), and the limits of agreements (LOAs) were computed separately for each condition. Relatively good agreement was found between the proposed system and the reference system, with MAE and MOD values increasing with the increase in exercise intensity and ambient noise up to a maximum of 3.8 bpm (breaths per minute) and −2.0 bpm, respectively, during running at 12 km/h. When considering all the conditions together, we found an MAE of 1.7 bpm and an MOD ± LOAs of −0.24 ± 5.07 bpm. These findings suggest that microphone sensors can be considered among the suitable options for estimating f_R during exercise.

Low back pain (LBP) is one of the musculoskeletal disorders that most affects workers. Among others, one of the working categories which mainly experiences such disease are video terminal workers. As it causes exploitation of the National Health Service and absenteeism in workplaces, LBP constitutes a relevant socio-economic burden. In such a scenario, a prompt detection of wrong seating postures can be useful to prevent the occurrence of this disorder. To date, many tools capable of monitoring the spinal range of motions (ROMs) are marketed, but most of them are unusable in working environments due to their bulkiness, discomfort and invasiveness. In the last decades, fiber optic sensors have made their mark allowing the creation of light and compact wearable systems. In this study, a novel wearable device embedding a Fiber Bragg Grating sensor for the detection of lumbar flexion-extensions (F/E) in seated subjects is proposed. At first, the manufacturing process of the sensing element was shown together with its mechanical characterization, that shows linear response to strain with a high correlation coefficient (R² > 0.99) and a sensitivity value (S_ε) of 0.20 nm∙mε⁻¹. Then, the capability of the wearable device in measuring F/E in the sagittal body plane was experimentally assessed on a small population of volunteers, using a Motion Capture system (MoCap) as gold standard showing good ability of the system to match the lumbar F/E trend in time. Additionally, the lumbar ROMs were evaluated in terms of intervertebral lumbar distances (Δ${\mathrm{d}}_{\mathrm{L}3-\mathrm{L}1}$ ) and angles, exhibiting moderate to good agreement with the MoCap outputs (the maximum Mean Absolute Error obtained is ~16% in detecting ${\mathsf{\Delta }\mathrm{d}}_{\mathrm{L}3-\mathrm{L}1}$ ). The proposed wearable device is the first attempt for the development of FBG-based wearable systems for workers’ safety monitoring.

The upper extremities limitation represents one of the essential functional impairments in patients with cervical spinal cord injury. Electromechanics assisted devices and robots are increasingly used in neurorehabilitation to help functional improvement in patients with neurological diseases. This review aimed to systematically report the evidence-based, state-of-art on clinical applications and robotic-assisted arm training (RAT) in motor and functional recovery in subjects affected by cervical spinal cord injury. The present study has been carried out within the framework of the Italian Consensus Conference on “Rehabilitation assisted by robotic and electromechanical devices for persons with disability of neurological origin” (CICERONE). PubMed/MEDLINE, Cochrane Library, and Physiotherapy Evidence Database (PEDro) databases were systematically searched from inception to September 2021. The 10-item PEDro scale assessed the study quality for the RCT and the AMSTAR-2 for the systematic review. Two different authors rated the studies included in this review. If consensus was not achieved after discussion, a third reviewer was interrogated. The five-item Oxford CEBM scale was used to rate the level of evidence. A total of 11 studies were included. The selected studies were: two systematic reviews, two RCTs, one parallel-group controlled trial, one longitudinal intervention study and five case series. One RCT was scored as a high-quality study, while the systematic review was of low quality. RAT was reported as feasible and safe. Initial positive effects of RAT were found for arm function and quality of movement in addition to conventional therapy. The high clinical heterogeneity of treatment programs and the variety of robot devices could severely affect the generalizability of the study results. Therefore, future studies are warranted to standardize the type of intervention and evaluate the role of robotic-assisted training in subjects affected by cervical spinal cord injury.