Collaborative design of a telerehabilitation system enabling virtual second opinion based on fuzzy logic

In this paper we present a low cost telerehabilitation system made up of a commercial RGB-D camera and a web-based platform. Our goal is to monitor and assess subject movement providing acceptable and usable at-home remote rehabilitation ser- vices without the presence of a clinician. Clinical goals, defined by physiotherapists, are firstly translated into motion analysis features. A Takagi Sugeno Fuzzy Inference System (FIS) is then proposed to evaluate and combine these features into scores. In this stage the “collaborative design” paradigm is used in depth and complete manner: the contribution of the clinician is not limited only to the rules definition but enters in the core of the evaluation algorithm through the definition of the fuzzy rules. A case study on low back pain rehabilitation involving 40 subjects, 5 exercises and 4 physiotherapists is then presented to effectiveness of the proposed system. Results of the validation of the system aimed at the assessment of the reliability of the proposed approach show high correlations between clinician evaluation and FIS scores. In this scenario, due to the high correlation, each FIS could represent a virtual alter-ego of the physiotherapist which enable a real time and free second opinion.