This study focuses on situations where the variables contain quantitative (QT) and qualitative (QL) aspects. The idea is to consider crisp or Fuzzy Windowing (FW) for the QL and QT scales, respectively. Exploratory methods requiring QT data as input can be replaced with some alternatives, as Multiple Correspondence Analysis (MCA). A metric based on the absolute value of differences having been proposed with Taxicab MCA (TMCA), a comparative analysis is tested on 95 variables where the QL scale corresponds to the hand is/is not on the steering wheel. MCA and TMCA yield low differences, both methods show that the main factor effect is the individual and the most discriminating variables are related to efforts.

Background Total hip arthroplasty (THA) is the standard treatment for end-stage hip osteoarthritis, providing pain relief and functional improvement, yet gait deficits often persist despite good radiological and clinical outcomes. Minimally invasive approaches, such as the direct anterior (DAA) and anterolateral (ALA) techniques, are hypothesized to enhance early recovery compared with the conventional posterior approach (PA). We aimed to determine the impact of surgical approach on early gait restoration and patient-centered outcomes after THA. Methods A prospective cohort of 189 participants undergoing primary unilateral THA for severe osteoarthritis was evaluated: DAA (n = 63), PA (n = 61), ALA (n = 65). Assessments were performed pre-operatively and 3 months post-operatively using the WHO-ICF framework: radiographic parameters and Oxford Hip Score (OHS) for body structure/function; 3-dimensional instrumented gait analysis for activity (spatiotemporal, kinematics, kinetics, mechanical work, and energy cost); and the Short Form 36 Health Survey (SF-36) physical and mental scores for participation. Paired-ANOVA tested treatment effects and between-approach differences (P <0.05). Principal-component analysis explored relationships between biomechanical and clinical outcomes. Results THA significantly improved OHS, SF-36 scores, step length, sagittal hip/pelvic kinematics, hip-flexion moment, pendular recovery, and reduced external mechanical work and metabolic cost of walking (all P <0.05). Clinical and participation gains were similar across approaches, but gait analysis revealed approach-specific advantages: ALA showed greater step-length gain and lower energy cost, whereas DAA exhibited larger reductions in external work and better pendular recovery. Conclusions THA markedly enhances function and quality of life regardless of approach, yet minimally invasive DAA and ALA confer earlier biomechanical benefits in gait efficiency compared with PA. Combining gait analysis with clinical scores highlights these mechanistic differences and supports targeted rehabilitation strategies to optimize locomotor recovery after THA.

This article presents an adaptive haptic control framework for a dynamic manual wheelchair simulator designed for urban accessibility analysis. Unlike conventional simulators relying on fixed resistance models, the proposed approach continuously adapts to variations in human-wheelchair interaction dynamics. A seven-DOF reference model generates trajectories for straight-line, turning, slope, and cross-slope maneuvers, driving a motion platform and haptic ergometer through coordinated force feedback. The control architecture combines online friction estimation with a Takagi–Sugeno (T–S) fuzzy $H_\infty$ controller. Gradient-based adaptation laws estimate unknown contact friction parameters with Lyapunov-guaranteed convergence. Since T–S premise variables are unmeasurable, membership functions are reconstructed online from estimated parameters. Friction uncertainty, input saturation, and external disturbances are handled jointly; input-to-state stability is certified via linear matrix inequalities, with the small-gain condition numerically verified at a safety factor of 3.57. Experimental validation with seven participants across user weights (40–80 kg) shows tracking-error reductions of 58%–82% over MRAC and 65%–90% over model predictive control-linear parameter-varying at 100 Hz. Realism ratings reach 90%–95% for straight-line, slope, and braking scenarios, but drop to 45%–58% in cross-slope due to longitudinal-only friction modeling. Future work targets lateral friction modeling and platform synchronization.

Background Hip osteoarthritis causes pain, reduced mobility, and functional limitations. Total hip arthroplasty relieves pain, but functional deficits may persist for months. Nordic walking, a low-impact gait modality using poles, may improve functional performance and physical activity in individuals with hip osteoarthritis and potentially after surgery. Methods This scoping review followed PRISMA-ScR guidelines. Seven databases were searched from 2000 to February 2026 to identify studies evaluating Nordic walking in adults with hip osteoarthritis or total hip arthroplasty. Eligible designs included randomized controlled trials and cohort follow-up studies reporting performance-based (PBOM) and patient-reported outcomes (PROM). Data extraction followed PICOT criteria. Methodological quality was assessed using the Cochrane Risk of Bias tool and PEDro scale. Findings Eight randomized controlled trials (468 participants) were included. Methodological quality ranged from moderate to high, with limitations in blinding. Nordic walking improved PBOM, including Timed Up and Go, 6-min walk test, stair climbing, and chair-rise performance. Gait adaptations included increased step length and reduced pelvic compensation. PROM (WOMAC, Harris Hip Score, PASE) also improved, particularly in physical function and activity levels. Only one study assessed post-arthroplasty patients, suggesting Nordic walking is safe and does not increase hip joint loading. Interpretation Nordic walking improves functional performance and patient-reported outcomes in hip osteoarthritis. Evidence after total hip arthroplasty remains limited. Further high-quality studies are needed to determine its efficacy and optimal use in postoperative rehabilitation.

Exoskeletons are set to play an important role in the future of rehabilitation processes, and safe interactions are therefore seen as a fundamental prerequisite. This article contributes by presenting a novel assistance modulation strategy to best meet the patients needs as well as a dedicated stability analysis to ensure operational safety. Using exact nonlinear model transformation, a polytopic quasi-LPV model of the closed-loop dynamics allows us to present stability conditions, written as LMI constraints. In addition, the impact of noise and model uncertainties is considered in a robustness analysis that paves the way for a secure rehabilitation process. Copyright (c) 2025 The Authors. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Complete Spinal Cord Injury (SCI) affects the conduction of sensory and muscular signals. Muscular activity and sensitive feedback are then reduced (or even lost) which significantly impairs the ability to maintain postural stability while sitting. During rehabilitation protocol, subjects with SCI learn new strategies to stabilize seated position by engaging the upper limbs. Quantifying active and passive joint torques is important to understand how the strategy has been produced and to propose, in further studies, new approaches in controlling sitting balance during rehabilitation exercises. Since direct measurement of human torques is prohibited for ethical issues, our methodology is based on a nonlinear asymmetric model called "Trunk-2-Arms" (T2A) which is an extension of previous works, from 3 to 5 degrees-of-freedom. A cascade of nonlinear local observers is proposed with a guarantee of convergence for the full model state error. Some simulations and data-based results are proposed in order to show the effectiveness of the approach. Copyright (c) 2025 The Authors. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/)

OBJECTIVE:The aim of this study was to identify the factors that might influence clinician adoption of telerehabilitation for post orthopaedic surgery knee and hip patients. METHOD:Semi-structured interviews were conducted with 17 clinicians (doctors, physiotherapists, teachers of adapted physical activity). These interviews were guided by an interview framework inspired by Unified theory of acceptance and use of technology 2 (UTAUT2). The System Usability Scale (SUS) was used to assess clinicians' perception of usability. RESULTS:The interviews highlighted the facilitators perceived by the clinicians, such as the extension of the benefits of physical activity, the personalised follow-up of patients (via gamification), the complementarity to conventional therapy, and the cost. The results also highlighted perceived barriers, including the fact of using only telerehabilitation and the risk of injury. SUS results were not influenced by the subject' gender, age, or experience. The average SUS score of clinicians was 74 ± 13.2, which represents good acceptance of the device. CONCLUSION:A key factor for adherence is a user-centered design. Individualised programs based on gamification would benefit users by promoting a participative approach between clinicians and patients, fostering autonomy. Clinicians should set achievable goals, with clinicians motivating patients to stay engaged in physical activity, ensuring long-term benefits. Telerehabilitation will undoubtedly become a crucial part of future rehabilitation care.

Current musculoskeletal models often oversimplify the neural strategies underlying muscle activation, potentially leading to unsatisfactory estimates of muscle forces. Numerous studies in motor control have established that the central nervous system synchronizes muscle activation by sending a common drive to synergistic muscles, measurable through intermuscular coherence - the frequency correlation between two EMG signals. As interest grows in understanding how muscles synchronize during movement coordination, leveraging intermuscular coherence into musculoskeletal models represents an innovative approach. This could enhance the accuracy of muscle effort estimation and introduce a physiologically meaningful component of motor control. In this study, we introduce a new method that decomposes EMG signals into common and independent components, informed by intermuscular coherence, and integrates them into an EMG-driven model to estimate muscle moments. Using data from twenty-four healthy subjects performing horizontal upper limb extensions, we estimated moments of the four main muscles actuating the elbow and compared these estimations with those from a traditional EMG-driven model informed by full-wave rectified signal envelopes. Our results demonstrate that incorporating intermuscular coherence significantly enhanced kinetic data tracking and improved the robustness of muscle moment estimations against variations in model parameters, addressing a major limitation of traditional EMG-driven models. Furthermore, antagonist muscle moments were more accurately represented, resulting in more realistic co-contraction index values. By integrating neural control strategies via intermuscular coherence into musculoskeletal models, the proposed approach offers a more accurate representation of muscle coordination. We recommend that future neuromusculoskeletal models incorporate intermuscular coherence to improve physiological realism of muscle effort estimations.

The human-computer interaction community has largely defended the use of an iterative process in which the users and stakeholders participate in all activities throughout the development of an interactive system. This work can become challenging when users have an evolving profiles in degenerative diseases (e.g. Parkinson’s and Alzheimer’s). The needs of the users at the start of the process may no longer be the same at the end when the system is validated. As consequence, it is important to integrate users in different stages of the disease in the whole process. The involvement of stakeholders (such as healthcare professionals, family members and caregivers) is also crucial for the better understanding of the user’s needs and their evolving profile. This article presents how we deal with the evolving user profile in the development of a communication aid software for people with Parkinson’s disease. To that end, we have customized the ISO 9241-210 human-centred process with a series of human-computer studies from a broad to a more focused goal. It presents this process and the complementary studies carried out with 97 people with Parkinson’s disease, 5 relatives/caregivers and 5 health professionals. In light of the insights gained from this experience, we have formulated several recommendations for human-centred design in the context of a user with an evolving profile. These recommendations outline a human-centred approach to guide the development of software applications for users with evolving profiles.

ObjectiveThe aim of this study was to identify the factors that might influence patients' adoption of telerehabilitation post-orthopaedic surgery knee and hip.MethodSemi-structured interviews were conducted with 20 total hip arthroplasty (THA; n = 6) and total knee arthroplasty (TKA; n = 14) patients. These interviews were guided by an interview framework inspired by the Unified theory of acceptance and use of technology 2 (UTAUT2). The System Usability Scale (SUS) was used to assess patients' perception of usability.ResultsThe interviews highlighted facilitators perceived by the subjects, such as reinforcement and motivation to practice physical activity, personalised follow-up from clinicians (via gamification), complementarity to conventional therapy and cost (urban travel). The results also revealed perceived barriers, including the risk of injury and lack of relationship with the professional. These factors need to be considered in user-centred design. SUS results were not influenced by the subject gender, or age. The results obtained for the SUS indicate an average score of 54.6 ± 19.6, meaning that potential usability is slightly acceptable.ConclusionUser-centred design is essential for adherence. Individualised and gamified programmes could improve patient care by encouraging participation and autonomy. Setting achievable goals and clinician support help maintain engagement, ensuring the long-term benefits of exercise. These key points could increase mass participation and thus improve telerehabilitation care.

Various pathologies and physical impairments diminish the capacity to maintain a seated balance, with spinal cord injury serving as a clinical example. Individuals with this condition often lose control of muscles below the injury level and commonly rely on a wheelchair for mobility. The impact of such injuries on seated postural control necessitates the development of new stabilization strategies in response to disturbances. These strategies differ significantly from those used by asymptomatic individuals. Particularly, they rely on upper limb movements as the primary means of control, given the absence of control from the trunk. Reconstructing the produced active joint torques at the shoulder and arm levels or the passive torque at the lumbosacral level is crucial to understand compensatory strategies and developing innovative monitoring techniques in rehabilitation exercises. The methodology starts from a nonlinear model with 5 Degrees of Freedom called “Trunk-2-Arms” (T2A) and proposes an observer based on quasi-LPV and LMI problem synthesis. The design of the observer uses a cascade of 3 models (trunk and the 2 arms) in order to reduce the design complexity. Therefore, local PI-observers are derived that allows to estimate the state and the human joint torques. The global estimation error convergence of the cascaded observer scheme is guaranteed using a separation principle and the Lyapunov theory. The methodology is validated through simulations and using real clinical data collected on 26 SCI people.

BackgroundCharacterization of motor deficits after brain injury is important for rehabilitation personalization. While studies reported abnormalities in the kinematics of paretic and non-paretic elbow extension for patients with brain injuries, kinematic analysis is not sufficient to explore how patients deal with musculoskeletal redundancy and the energetic aspect of movement execution. Conversely, interarticular coordination and movement kinetics can reflect patients' motor strategies. This study investigates motor strategies of paretic and non-paretic upper limb after brain injury to highlight motor deficits or compensation strategies.Methods26 brain-injured hemiplegic patients and 24 healthy controls performed active elbow extensions in the horizontal plane, with both upper limbs for patients and, with the dominant upper limb for controls. Elbow and shoulder kinematics, interarticular coordination, net joint kinetics were quantified.FindingsResults show alterations in kinematics, and a strong correlation between elbow and shoulder angles, as well as time to reach elbow and shoulder peak angular velocity in both upper limbs of patients. Net joint kinetics were lower for paretic limb and highlighted a fragmented motor strategy with increased number of transitions between concentric and eccentric phases.InterpretationIn complement to kinematic results, our kinetic results confirmed patients' difficulties to manage both spatially and temporally the joint degrees of freedom redundancy but revealed a fragmented compensatory motor strategy allowing patients upper limb extension despite quality alteration and decrease in energy efficiency. Motor rehabilitation should improve the management of this fragmentation strategy to improve the performance and the efficiency of active movement after brain injury.

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Social participation is associated with successful aging. However, older adults encounter many barriers for social activities. The study aims for the proposition of solutions in favor of increasing the participation of older adults in daily life activities. A living-lab design was chosen to ensure the active participation of older adults and the stakeholders. The data collected included questionnaires, workshops writings and surveys. A total of 159 older adults and 126 collaborators participated in the study. The results showed a gap between the perception of the geriatric professionals and the reality of the difficulties reported by the older adults. Professionals perceived for 80% that walking was the main issue for mobility while only 23% of older adults said so. Seven topics were investigated: Technology, Nutrition, Health, Housing, Transportation, Social Network and Activities. To maintain autonomy and mobility, Social Network was the most important topic before health and transportation. Older adults and collaborators were unaware of the variety of local existing solutions. That shows malfunctioning in the communication strategy. The study detected contact person among the older adults who are highly motivated and convinced by the action. The collaborators should rely on contact persons for the transmission of the information to their peers.

Few biomechanical models of sitting stability have been proposed over the last decades and most of them control the trunk position through a lumbar torque. Unfortunately, this type of model is not valid for individuals living with a complete thoracic spinal cord injury (SCI) who generally experience paralysis of their abdominal and lower back muscles. Instead, individuals with SCI often engage their upper limbs as a compensatory strategy to control their sitting position. A new nonlinear biomechanical model is introduced to take into consideration the influence of the upper limbs for sitting control study of people living with SCI. The inherent nonlinearity of the model is taken into account via the Takagi–Sugeno (T‐S) framework. To estimate the internal controlling torques without measurements, an unknown input observer (UIO) is created. Its convergence is expressed by linear matrix inequalities (LMI), which are solved by convex optimization techniques. Numerical simulations with perturbations are used to assess the adequacy of the methodology and preliminary experimental data of one person living with SCI performing a sitting stabilization exercise is used to estimate internal torques of the upper limbs. The main contribution of this work is to provide a way to estimate human joint torques without invasive measurements; the results highlight the validity of both goals of this article, the nonlinear biomechanical modelling and the UIO methodology.

Background: Lower limb osteoarthritis (OA) often generates musculoskeletal pain causing functional impairment and decreasing mobility, autonomy, and quality of life. Patients with OA are commonly prescribed specific care for total hip arthroplasty or total knee arthroplasty (THA or TKA), when patients present symptoms that are refractory to nondrug treatments. Currently, when patients are discharged from orthopedic surgery, they are either referred to a rehabilitation department, or sent directly home with assistance such as remote monitoring by teleconsultation or a mobile application. In recent years, there has been an evolution in digital health and in particular telerehabilitation. To determine utility and effectiveness, the aim of this systematic review was to highlight and evaluate different telerehabilitation programs using new information and communication technologies.Methods: Five databases, ScienceDirect, PubMed, Web of Sciences, Scopus, and Google scholar, were searched until 30 June 30, 2023. All studies written in English and meeting our inclusion criteria were included. Databases were screened for "Total Hip Arthroplasty," "Total Knee Arthroplasty," "Total Hip Replacement," "Total Knee Replacement," "Rehabilitation," "Physical Activity," "Physiotherapy," "Telerehabilitation," "Telecommunication*," "Senior*," and "Elderly" in accordance with PRISMA-ScR guideline.Results: Fourteen articles were selected according to inclusion criteria. Telerehabilitation was offered in seven different ways (video call, applications smartphones, website, etc.). Assessments included were mainly quality of life questionnaires, perceived effort after exercises, field surveys on the tool experience, and physical tests to assess motor functions.Conclusion: This review highlights the importance and relevance of evaluating the contributions and limits of new health technologies to improve patient monitoring and thus enable better remote clinical care.

Despite efforts made, it is still difficult to clearly grasp the situation of disability within companies. Therefore, to overcome this problem, this paper proposes and describes an innovative tool that may facilitate corporate governance. The tool is a serious game developed on an interactive RFID tabletop associated with tangible objects. The serious game is called SG-HANDI. It is designed to be used in disability awareness sessions in companies. It implies directors, managers and employees and proposes a set of challenges to be solved as a team. The objective is to encourage stakeholders to think and act collectively for a more accessible company.

Les démarches de conception centrées sur l’utilisateur sont couramment utilisées lors du développement de systèmes interactifs. Cependant il n’est pas toujours facile d’adapter les démarches existantes quand les utilisateurs cibles ont une déficience intellectuelle. Dans le cadre du projet SAMDI, nous avons adapté de telles démarches pour le développement d’un système d’aide à la mobilité pour ce public. Nous présentons dans cet article la démarche que nous avons suivie en précisant à chaque fois les personnes impliquées, qu’elles soient encadrées ou encadrantes, et les niveaux d’autonomie et de compréhension. Cet article permet de voir qu’il est possible d’impliquer ces personnes, ce qui est important pour favoriser l’utilisabilité aussi bien que l’acceptation des applications visées. Ce travail est en cours, et n’intègre pas encore les évaluations terminales.