Advancements in modern medicine have bolstered the usage of home-based rehabilitation services for patients, particularly those recovering from diseases or conditions that necessitate a structured rehabilitation process. Understanding the technological factors that can influence the efficacy of home-based rehabilitation is crucial for optimizing patient outcomes. As technologies continue to evolve rapidly, it is imperative to document the current state of the art and elucidate the key features of the hardware and software employed in these rehabilitation systems. This narrative review aims to provide a summary of the modern technological trends and advancements in home-based shoulder rehabilitation scenarios. It specifically focuses on wearable devices, robots, exoskeletons, machine learning, virtual and augmented reality, and serious games. Through an in-depth analysis of existing literature and research, this review presents the state of the art in home-based rehabilitation systems, highlighting their strengths and limitations. Furthermore, this review proposes hypotheses and potential directions for future upgrades and enhancements in these technologies. By exploring the integration of these technologies into home-based rehabilitation, this review aims to shed light on the current landscape and offer insights into the future possibilities for improving patient outcomes and optimizing the effectiveness of home-based rehabilitation programs.

Understanding the main factors that can compromise or improve the efficacy of home-based rehabilitation on the perspective of technology requires the review of the features of the equipment used in this area, both in terms of hardware and software. The purpose of this paper is to summarize the most recent technologies implemented into home-based rehabilitation scenario, namely wearable devices, robotic end-effectors, exoskeletons, and the role of artificial intelligence amongst these fields. Evidence is presented to better understand the present state of art of home-based rehabilitation systems, facilitating the exploration of hypothetical healthcare uses for these systems or their possible future upgrades.

In chronic shoulder pain, adaptations in the nervous system such as in motoneuron excitability, could contribute to impairments in scapular muscles, perpetuation and recurrence of pain and reduced improvements during rehabilitation. The present cross-sectional study aims to compare trapezius neural excitability between symptomatic and asymptomatic subjects. In 12 participants with chronic shoulder pain (symptomatic group) and 12 without shoulder pain (asymptomatic group), the H reflex was evoked in all trapezius muscle parts, through C3/4 nerve stimulation, and the M-wave through accessory nerve stimulation. The current intensity to evoke the maximum H reflex, the latency and the maximum peak-to-peak amplitude of both the H reflex and M-wave, as well as the ratio between these two variables, were calculated. The percentage of responses was considered. Overall, M-waves were elicited in most participants, while the H reflex was elicited only in 58–75% or in 42–58% of the asymptomatic and symptomatic participants, respectively. A comparison between groups revealed that the symptomatic group presented a smaller maximum H reflex as a percentage of M-wave from upper trapezius and longer maximal H reflex latency from the lower trapezius (p < 0.05). Subjects with chronic shoulder pain present changes in trapezius H reflex parameters, highlighting the need to consider trapezius neuromuscular control in these individuals’ rehabilitation.

Recent studies show the high prevalence of the use of messaging platform and its growth trend, especially in younger populations (Figueroa Jacinto and Arndt 2018). Messaging apps are used not only to communicate and stay in touch with family and friends, but also to access services. Interactions with commercial purposes, such as making purchases, seeking out assistance and customer support, providing feedback or making reservations are already widely used, but legal and healthcare related areas also present prominent growth (Eeuwen 2017). In this chapter it is our objective to explore how technologies such as natural language processing, speech recognition, text-to-speech, machine learning, and cloud computing can be integrated to develop high quality chatbots for healthcare purposes. Additionally, we will cover an application case based on COVID-19 prevention and management.

Algorithms based on computer vision are commonly used in pre-operative procedures to help health professionals detecting blood vessels, which is also the case with the Deep Inferior Epigastric Perforators (DIEPs). These blood vessels are essential to produce a viable autologous DIEP flap, and the analysis of characteristics such as their location, diameter and course is essential to ensure the success of surgeries. This analysis is made by a team of radiology technicians and then validated by a surgeon, making it a complex process that can take up to 2 hours. The proposed algorithm called Assisted Vascular Analysis (AVA) was developed to ensure a faster alternative to the conventional methods, using automation to identify structures of interest such as the skin, umbilicus and fascia, while also requiring minimum input from the user to segment each DIEP (2 points for the subcutaneous portion and 2 for the intramuscular portion). The AVA feasibility tests where conducted using 6 Computed Tomography Angiographies (CTAs), with a total of 28 DIEP calibers obtained during surgery (ground truths) from patients that underwent breast reconstruction with a DIEP flap. The algorithm was evaluated for its capability to segment the DIEPs and measure their caliber, comparing the results with the ground truth calibers and the manual mapping done by the radiology technicians. The Root Mean Square Error (RMSE) metric shows that the calibers obtained by the AVA algorithm (0.57 millimeters) and the radiology technicians (0.46 millimeters) are very similar, with the radiology technicians gaining a smaller edge of 0.11 millimeters. These results are very promising, since the errors are inferior to the average image resolution (0.88 millimeters). It was also demonstrated that the AVA algorithm is a faster alternative to manual segmentation, taking around 10 minutes to fully analyze each CTA, while the radiology technicians takes around 1 hour to do the DIEP mapping and caliber measurements. In conclusion, AVA is a validated algorithm to segment DIEP vessels and a faster alternative compared with conventional methods.