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Publications

Publications by Nuno Feixa Rodrigues

2020

Application of AR and VR in hand rehabilitation: A systematic review

Authors
Pereira, MF; Prahm, C; Kolbenschlag, J; Oliveira, E; Rodrigues, NF;

Publication
Journal of Biomedical Informatics

Abstract
Background: The human hand is the part of the body most frequently injured in work related accidents, accounting for a third of all accidents at work and often involving surgery and long periods of rehabilitation. Several applications of Augmented Reality (AR) and Virtual Reality (VR) have been used to improve the rehabilitation process. However, there is no sound evidence about the effectiveness of such applications nor the main drivers of therapeutic success. Objectives: The objective of this study was to review the efficacy of AR and VR interventions for hand rehabilitation. Methods: A systematic search of publications was conducted in October 2019 in IEEE Xplore, Web of Science, Cochrane library, and PubMed databases. Search terms were: (1) video game or videogame, (2) hand, (3) rehabilitation or therapy and (4) VR or AR. Articles were included if (1) were written in English, (2) were about VR or AR applications, (3) were for hand rehabilitation, (4) the intervention had tests on at least ten patients with injuries or diseases which affected hand function and (5) the intervention had baseline or intergroup comparisons (AR or VR intervention group versus conventional physical therapy group). PRISMA protocol guidelines were followed to filter and assess the articles. Results: From the eight selected works, six showed improvements in the intervention group, and two no statistical differences between groups. We were able to identify motivators of patients’ adherence, namely real-time feedback to the patients, challenge, and increased individualized difficulty. Automated tracking, easy integration in the home setting and the recording of accurate metrics may increase the scalability and facilitate healthcare professionals’ assessments. Conclusions: This systematic review provided advantages and drivers for the success of AR/VR application for hand rehabilitation. The available evidence suggests that patients can benefit from the use of AR or VR interventions for hand rehabilitation. © 2020 Elsevier Inc.

2019

Automatic left ventricular segmentation in 4D interventional ultrasound data using a patient-specific temporal synchronized shape prior

Authors
Morais, P; Queiros, S; Pereira, C; Moreira, AHJ; Baptista, MJ; Rodrigues, NF; D'hooge, J; Barbosa, D; Vilaca, JL;

Publication
MEDICAL IMAGING 2019: IMAGE PROCESSING

Abstract
The fusion of pre-operative 3D magnetic resonance (MR) images with real-time 3D ultrasound (US) images can be the most beneficial way to guide minimally invasive cardiovascular interventions without radiation. Previously, we addressed this topic through a strategy to segment the left ventricle (LV) on interventional 3D US data using a personalized shape prior obtained from a pre-operative MR scan. Nevertheless, this approach was semi-automatic, requiring a manual alignment between US and MR image coordinate systems. In this paper, we present a novel solution to automate the abovementioned pipeline. In this sense, a method to automatically detect the right ventricular (RV) insertion point on the US data was developed, which is subsequently combined with pre-operative annotations of the RV position in the MR volume, therefore allowing an automatic alignment of their coordinate systems. Moreover, a novel strategy to ensure a correct temporal synchronization of the US and MR models is applied. Finally, a full evaluation of the proposed automatic pipeline is performed. The proposed automatic framework was tested in a clinical database with 24 patients containing both MR and US scans. A similar performance between the proposed and the previous semi-automatic version was found in terms of relevant clinical measurements. Additionally, the automatic strategy to detect the RV insertion point showed its effectiveness, with a good agreement against manually identified landmarks. Overall, the proposed automatic method showed high feasibility and a performance similar to the semi-automatic version, reinforcing its potential for normal clinical routine.

2019

Automatic strategy for extraction of anthropometric measurements for the diagnostic and evaluation of deformational plagiocephaly from infant's models

Authors
Oliveira, B; Torres, HR; Veloso, F; Vilhena, E; Rodrigues, NF; Fonseca, JC; Morais, P; Vilaca, JL;

Publication
MEDICAL IMAGING 2019: COMPUTER-AIDED DIAGNOSIS

Abstract
Deformational Plagiocephaly (DP) refers to an asymmetrical distortion of an infant's skull resulting from external forces applied over time. The diagnosis of this condition is performed using asymmetry indexes that are estimated from specific anatomical landmarks, whose are manually defined on head models acquired using laser scans. However, this manual identification is susceptible to intra-/inter-observer variability, being also time-consuming. Therefore, automatic strategies for the identification of the landmarks and, consequently, extraction of asymmetry indexes, are claimed. A novel pipeline to automatically identify these landmarks on 3D head models and to estimate the relevant cranial asymmetry indexes is proposed. Thus, a template database is created and then aligned with the unlabelled patient through an iterative closest point (ICP) strategy. Here, an initial rigid alignment followed by an affine one are applied to remove global misalignments between each template and the patient. Next, a non-rigid alignment is used to deform the template information to the patient-specific shape. The final position of each landmark is computed as a local weight average of all candidate results. From the identified landmarks, a head's coordinate system is automatically estimated and later used to estimate cranial asymmetry indexes. The proposed framework was evaluated in 15 synthetic infant head's model. Overall, the results demonstrated the accuracy of the identification strategy, with a mean average distance of 2.8 +/- 0.6 mm between the identified landmarks and the ground-truth. Moreover, for the estimation of cranial asymmetry indexes, a performance comparable to the inter-observer variability was achieved.

2022

Designing a Music-Based Game for Training Pattern Recognition Control of a Myoelectric Prosthesis

Authors
Bessa, D; Rodrigues, NF; Oliveira, E; Kolbenschlag, J; Prahm, C;

Publication
Biosystems and Biorobotics

Abstract
Access to early myoelectric training can be a crucial step in mastering prosthesis control. Controlling a prothesis is a cognitively demanding task with high rejection rates. Serious games not only provide patients with an opportunity to train their myoelectric control, but also help maintain their engagement throughout the extensive rehabilitation process. This work proposes a novel serious game design to train machine learning based myoelectric control, implemented in the form of a music-based app. The prototype of the game was evaluated by seven able-bodied participants and three clinical professionals with regard to system usability and motivation. Results showed positive outcomes in motivation, and a need for specific system usability improvements. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

2020

Designing a Serious Game for Myoelectric Prosthesis Control

Authors
Bessa, D; Rodrigues, NF; Oliveira, E; Kolbenschag, J; Prahm, C;

Publication
2020 IEEE 8th International Conference on Serious Games and Applications for Health, SeGAH 2020

Abstract
As an amputee, learning how to control a myoelectric prosthesis is a difficult task. One of the main issues with conventional, highly repetitive, rehabilitation methods is the lack of engagement and motivation of the patients that often leads to high rejection rates of the prosthetic device. This work proposes and implements a novel serious game design, improving previous work, as music-based app. The prototype was evaluated by seven able-bodied participants with regard system usability and engagement. Results suggest positive outcomes in motivation, but room for improvement in system usability. © 2020 IEEE.

2020

Designing Effective User Interface Experiences for a Self-Service Kiosk to Reduce Emergency Department Crowding

Authors
Pacheco, P; Santos, F; Coimbra, J; Oliveira, E; Rodrigues, NF;

Publication
2020 IEEE 8th International Conference on Serious Games and Applications for Health, SeGAH 2020

Abstract
Emergency department crowding has been steadily increasing, with a significant part due to non-emergent pathologies. We developed a self-service kiosk to be used by patients while waiting from triage to treatment room allocation, which collects clinical history, usual medication, main complaint and, also collects vital signs. This information is processed and presented in a comprehensive way to the medical staff in order to accelerate diagnostics and treatment selection. This work describes and analyzes the results of the usability evaluation of this kiosk, taking into account the average time per screen, the average time of a complete kiosk session, the application design and the user interaction with devices and the system. The kiosk was tested in several environments with different types of users, allowing the identification of causes of problems and difficulties experienced, as well as solutions to improve the solution. © 2020 IEEE.

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