Mixed reality and sensor real-time feedback to increase muscle engagement during deep core exercising

Abstract

In lower extremity amputee rehabilitation programs, difficult-to-master targeted activation of deep core muscles and pursed-lip breathing training are prescribed to treat poor movement quality and to improve recovery after amputation. Non-invasive wireless sensors and mixed reality (MR) technologies are proposed as a solution. The main aim was to validate a novel rehabilitation technology by exploring whether a combined verbal and visual mixed reality feedback (VF + MR) will initiate a greater change in muscle electrical activation magnitude compared to verbal feedback only (VF) during exercising. The second objective was to evaluate the effectiveness of specific exercise program targeted to engage specifically deep core muscles. Pre-post-test cross-over study involved electromyographic activity (EMG) analysis from Transversus Abdominis (TA) and Multifidus (MF) muscles and self-reported questionnaires to evaluate the efficiency of MR feedback. Anthropometric data, state of health, subjective low back pain (Oswestry Disability Index), and physical activity level (IPAQ) estimation were analysed. The data from 13 patients following unilateral transtibial and transfemoral amputation showed a significant EMG increase in (VF + MR) for Chair Lean (p = 0.03) and Bent Leg Raise (p = 0.0005) exercises for TA muscle. Even though there was no significant difference in Back Bridge and Side Plank exercises, 6 to 10 participants depending on the exercise, had an increase of EMG in the range of 50–400% for both – TA and MF muscles. The proposed solution has a high potential for increasing motivation, self-awareness, and muscle engagement during exercises, based on EMG and self-reported questionnaire data.