Research and Clinical Validation of a Wearable Device-Based Remote Rehabilitation System for Postoperative Rotator Cuff Injury

Use a goniometer to measure the subject's shoulder flexion, extension, adduction, abduction, internal rotation, and external rotation exercises to test the range of motion of the shoulder in each direction, with the unit in degrees (°).

For the starting position, male subjects perform a standard push-up, while female subjects perform a knee push-up, keeping their back flat. The distance between the hands is 36 inches. One hand remains in support while the other hand swings to touch the supporting hand and then returns to the starting position. Then switch the supporting hand and repeat the movement. One repetition is counted when the swinging hand leaves the ground, touches the supporting hand, and returns to the starting position. Record the number of full-effort hand touches completed by the subject within 15 seconds, and repeat the test 3 times.

The subjects were asked to make fists with both hands, placing their thumbs inside the fists. Then, the subjects were required to position one shoulder in maximum adduction, extension, and internal rotation, while the other shoulder was in maximum abduction, flexion, and external rotation, and both hands needed to be placed on the back in a smooth movement. Throughout the process, both hands remained clenched in fists. The tester measured the distance between the two closest bony prominences of the hands on the back. The test was repeated three times.

The subjects performed shoulder flexion, extension, adduction, abduction, internal rotation, and external rotation movements, resisting resistance to perform isometric contractions, and their muscle strength was measured.

Using the Delsys surface electromyography (EMG) test device to measure the surface EMG signals of shoulder muscles such as the anterior, middle, and posterior deltoid, serratus anterior, upper, middle, and lower trapezius, and supraspinatus during maximal voluntary contraction tests, with the unit of measurement being '%BW'.

It mainly assesses the functional status of the shoulder joint, with higher scores indicating better shoulder function. This includes muscle strength (25 points), pain level (15 points), ability to perform daily activities (20 points), and range of motion of the joint (40 points), for a total of 100 points. Lower scores indicate poorer shoulder joint function.

The patient assessment section consists of pain (50%) and cumulative daily activities (50%), forming the scoring part. The total score is 100 points, with higher scores indicating better shoulder function. Scoring method: Pain score = (10 - VAS score) × 5; Function score = total score of 10 items × 5 / 3; Total score = Pain score + Function score.

Using a patient self-assessment questionnaire, it consists of 21 questions divided into 5 sections: Signs (questions 1-6), Exercise and Leisure Activities (questions 7-10), Work (questions 11-14), Lifestyle (questions 15-18), and Emotions (questions 19-21). Each question is evaluated using a 100mm VAS, with a maximum score of 100, where 0 indicates normal and 100 indicates abnormal.

The total score ranges from 0 to 2100, with 0 indicating normal; the higher the score, the worse the shoulder function.