Biotechnical system of personalized rehabilitation of patients with limited motor functions

The article considers a rehabilitation biotechnical system with an adaptable virtual reality intended for rehabilitation of patients with impaired motor functions of the lower limbs in rehabilitation complexes with combined feedback. The biotechnical system has the following functional modules: formation of controlled effects on the patient, control of controlled effects, rehabilitation management and information support. During rehabilitation, the patient's muscle fatigue and its dynamics are monitored. This made it possible to make adjustments to the rehabilitation block program during a rehabilitation session and manage the procedure for adapting virtual reality to the patient's functional state, as well as to carry out mathematical modeling of rehabilitation course scenarios. A model for planning a rehabilitation course using biofeedback intended for a biotechnical system with virtual reality is proposed. An experimental group was formed to assess the effectiveness of rehabilitation of post-stroke patients with paretic lower limbs. The rehabilitation results in this group showed that the choice of virtual reality content adapted to the patient allows increasing the effectiveness of rehabilitation according to the LEFS scale by 11%. Experimental studies of the effectiveness of muscle fatigue control during rehabilitation have been conducted. It is confirmed by testing the statolocomotor sphere according to the Tinetti scale, the indicators of which, on average, exceeded the indicators in the comparison group by 10%. Inclusion of adaptive virtual reality and muscle fatigue monitoring in the rehabilitation process leads to earlier restoration of impaired balance function, motor activity and social rehabilitation.

1. Poverennova I.E., Zakharov A.V., Khivintseva E.V., Pyatin V.F., Kolsanov A.V., Chaplygin S.S., Osminina E.A., Lahov A.S. Рreliminary results of study on efficacy of a virtual reality technique for restoration of lower extremity motor function in patients in acute stage of stroke. Saratov Journal of Medical Scientific Research. 2019;15(1):172–176. (In Russ.).

2. Kunelskay N.L., Ivanova G.E., Baybakova E.V., Guseva A.L., Parfenov V.A., Zamergrad M.V., Zaitseva O.V., Melnikov O.A., Shmonin A.A., Maltseva M.N. Vestibular rehabilitation for peripheral vestibular hypofunction: an interdisciplinary consensus. Russian Bulletin of Otorhinolaryngology. 2024;89(1):52–63. (In Russ.).

3. Volovik M.G., Borzikov V.V., Kuznetsov A.N., Bazarov D.I., Polyakova A.G. Virtual Reality Technology in Complex Medical Rehabilitation of Patients with Disabilities (Review). Modern Technologies in Medicine. 2018;10(4):173–182. (In Russ.). https://doi.org/10.17691/stm2018.10.4.21

4. Zapesotskaya I.V., Nikolayenko R.V., Chuikova Zh.V. Modern technologies and development using virtual reality for the rehabilitation of motor disorders. The Collection of Humanitarian Studies. 2020;(1):31–35. (In Russ.). https://doi.org/10.21626/j-chr/2020-1(22)/4

5. Yin C., Hsueh Y.-H., Yeh C.-Y., Lo H.-C., Lan Y.-T. A Virtual Reality-Cycling Training System for Lower Limb Balance Improvement. BioMed Research International. 2016;2016. https://doi.org/10.1155/2016/9276508

6. Trifonov A.A., Petrunina E.V., Filist S.A., Kuzmin A.A., Zhilin V.V. Biotechnical System with Virtual Reality in Rehabilitation Complexes with Artificial Feedback. Proceedings of the Southwest State University. Series: Control, Computer Engineering, Information Science. Medical Instruments Engineering. 2019;9(4):49–66. (In Russ.).

7. Miroshnikov A.V., Shatalova O.V., Stadnichenko N.S., Shulga L.V. Classifications of Biological Objects Based on Multi-Dimensional Bioimpedance Analysis. Proceedings of the Southwest State University. Series: Control, Computer Engineering, Information Science. Medical Instruments Engineering. 2020;10(3/4):29–49. (In Russ.).

8. Shatalova O.V. Iteration multiparameter model of bioimpedance in vivo experiments. Proceedings of the Southwest State University. Series: Control, Computer Engineering, Information Science. Medical Instruments Engineering. 2019;9(1):26–38. (In Russ.)

9. Miroshnikov A.V., Shatalova O.V., Efremov M.A., Stadnichenko N.S., Novoselov A.Yu., Pavlenko A.V. Method for Classification of the Functional State of Living Systems Based on Recurrent Voigt Models. Proceedings of the Southwest State University. Series: Control, Computer Engineering, Information Science. Medical Instruments Engineering. 2022;12(2):59–75. (In Russ.).

10. Komlev I.A., Shatalova O.V., Degtyaryov S.V., Serebrovskiy A.V. Prediction and assessment of severity of cardiac ischemia, based on hybrid fuzzy models. Proceedings of the Southwest State University. Series: Control, Computer Engineering, Information Science. Medical Instruments Engineering. 2019;9(1):133–145. (In Russ.).

11. Petrunina E.V., Tomakova R.A., Filist S.A. Gibridnye metody i modeli dlya biotekhnicheskikh sistem s adaptivnym upravleniem diagnosticheskimi i reabilitatsionnymi protsessami. Kursk: SouthWest State University; 2022. 249 p. (In Russ.).

12. Filist S.A., Trifonov A.A., Kuzmin A.A., Petrunina E.V., Shekhine M.T. Adaptive biotechnical system with a robotic device for the restoration of motor functions of the lower extremities in post-stroke patients. Modeling, Optimization and Information Technology. 2021;9(3). (In Russ.). https://doi.org/10.26102/2310-6018/2021.34.3.022

13. Philist S.A., Petrunina E.V., Trifonov A.A., Serebrovsky A.V. Code images of electric cell information signal signals for controlling robot-technical devices by means of brain-computer interface. Modeling, Optimization and Information Technology. 2019;7(1). (In Russ.). https://doi.org/10.26102/2310-6018/2019.24.1.025

14. Trifonov A.A., Filist S.A., Kuzmin A.A., Zhilin V.V., Petrunina E.V. Two-level neural network model of electromiosignal decoder in exoscelete verticalization control system. Prikaspiiskii zhurnal: upravlenie i vysokie tekhnologii. 2020;(4):99–111. (In Russ.).

15. Trifonov A.A., Philist S.A., Petrunina E.V., Kuzmin A.A., Safronov R.I., Krikunova E.V. Method and Algorithms for Decoding Electrophysiological Signals in Biotechnical Systems of Rehabilitation Type. Proceedings of the Southwest State University. Series: Control, Computer Engineering, Information Science. Medical Instruments Engineering. 2021;11(3):48–77. (In Russ.).

16. Filist S.A., Pshenichnyi A.E., Shatalova O.V., Safronov R.I., Petrunina E.V., Ermakov D.A. Sposob reabilitatsii patsientov s narusheniem dvigatel'noi aktivnosti s ispol'zovaniem personifitsirovannogo kontenta klipov virtual'noi real'nosti. Patent Russian Federation, No. 2830938. 2024. (In Russ.).

17. Herrera V.A.S., Romero J.F.A., Moreno M.A. Algorithm of detection and alert of muscle fatigue in paraplegic patients, by Digital Signal Processing of Surface Electromyogram. In: IWSSIP 2010 – 17th International Conference on Systems, Signals and Image Processing, 17–19 June 2010, Rio de Janeiro, Brazil. Rio de Janeiro: Fluminense Federal University; 2010. pp. 530–533.

18. Trifonov A.A., Petrunina E.V., Kuzmin A.A., Protasova Z.U., Lazurina L.P. Methods and means of providing rehabilitation procedures through a biotechnical system with biological feedback and a fuzzy control module. Sistemnyi analiz i upravlenie v biomeditsinskikh sistemakh. 2021;20(3):71–83. (In Russ.). https://doi.org/10.36622/VSTU.2021.20.3.010

19. Binkley J.M., Stratford P.W., Lott S.A., Riddle D.L. The Lower Extremity Functional Scale (LEFS): scale development, measurement properties, and clinical application. North American Orthopaedic Rehabilitation Research Network. Physical Therapy. 1999;79(4):371–383.

20. Kostenko E.V., Petrova L.V., Rylsky A.V., Eneeva M.A. Effectiveness of correction of post-stroke motor disorders using the methods of functional electrostimulation and BFB-stabilometric postural control. Journal of Neurology and Psychiatry. 2019;119(1):23–30. (In Russ.). https://doi.org/10.17116/jnevro201911901123

21. Evseev S.P., Kurdybailo S.F., Malyshev A.I., Gerasimova G.V., Potapchuk A.A., Polyakov D.S. Fizicheskaya reabilitatsiya invalidov s porazheniem oporno-dvigatel'noi sistemy. Moscow: Sovetskii sport; 2010. 488 p. (In Russ.).