Clinical decision support system to electrostimulation treatments for muscle rehabilitation in the elderly

Abstract

The aging population poses increasing challenges to healthcare systems, particularly regarding long-term muscular rehabilitation services for the elderly. Conditions such as sarcopenia and knee osteoarthritis, which are common in this age group, compromise mobility and quality of life, making rehabilitation es sential for ensuring active aging. Neuromuscular electrical stimulation has proven to be an effective inter vention, but its proper application depends on personalized parameterization and continuous monitoring. This PhD project presents an innovative solution to this scenario: a Clinical Decision Support System (CDSS) aimed at electrostimulation treatments. Developed within the scope of the NanoStim project, CDSS integrates Industry 4.0 technologies to create an efficient, portable, and cost-effective wearable system, allowing treatment to be conducted at home, with increased accessibility and reduced clinical visits. A system architecture with sensitive data protection for home treatment scenarios is proposed. The system processes real-time muscle fatigue metrics, interprets knee extension exercises, and adjusts electrostimulation in a personalized manner. Three experimental studies validated CDSS. In the first, the system demonstrated the ability to synchronize biofeedback data and remove artifacts from the elec tromyographic signal. In the second, the accuracy of the mobile application in processing muscle fatigue metrics in real-time was demonstrated. In the third, the CDSS was compared with a gold-standard motion capture system, and responsive electrostimulation modes based on real-time biofeedback were tested. Finally, a statistical correlation analysis was conducted between the fatigue levels predicted by the CDSS and the participants’ subjective feedback. The CDSS received ethical approvals from different institutions and clearance for sensitive data storage. The analyzed results show that CDSS has the potential to inno vate in the field of remote muscular rehabilitation and improve the quality of life for the elderly through personalized treatments.