Organizations: Department of Medical Imaging, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China · Faculty of Electronic and Information Engineering, Xi'an Jiaotong University, Xi'an, 710049, China · School of Future Technology, Xi'an Jiaotong University, Xi'an, 710049, China · School of Artificial Intelligence, Xidian University, Xi'an, 710126, China · Xi'an North Qinghua Electromechanical Co., Ltd., Xi'an,710025, China
Abstract
Rehabilitation scoring systems are most useful when their outputs can be reviewed and interpreted within clinical workflows. This study presents PhaseAware, a compact framework for continuous rehabilitation quality assessment that combines a temporal backbone with phase- and body-group descriptors through a backbone-conditioned gated residual pathway. The model was evaluated on the UI-PRMD deep-squat protocol and further tested on the KIMORE squatting subset. On UI-PRMD, PhaseAware achieved an RMSE of 0.0230, corresponding to an 88.9% reduction relative to the accepted baseline. It also maintained favorable performance on KIMORE, suggesting that the phase-aware design transfers across related squatting protocols. In addition to score prediction, PhaseAware generates structured review cues based on phase- and body-level sensitivity, highlighting the movement stages and body regions most relevant to each prediction. The architecture employs a backbone-conditioned gated residual mechanism to stabilize feature representation, supporting use in resource-constrained settings. These cues are intended to support clinician review, boundary-case monitoring, and human-in-the-loop triage rather than autonomous decision-making. Overall, PhaseAware offers a practical and interpretable approach to rehabilitation scoring that may help integrate automated assessment into information systems while preserving clinician oversight.
Autonomous rehabilitation systems must not only recognize human motion but also provide structured feedback to support users without continuous therapist supervision. This paper presents a telerehabilitation pipeline that integrates skeleton-based exercise quality assessment and short-term motion prediction into a two-module system operating on marker-free RGB video. A self-attentive Bidirectional LSTM performs exercise quality classification using MMD-NCA metric learning, while a graph-based motion prediction module computes per-joint position errors between predicted and observed poses, generating spatially localized deviation signals. Each module is evaluated independently on established benchmarks: the classifier achieves 96.45% mean-class accuracy on squat sequences from the PROZIS dataset, and the adopted STARS predictor achieves a mean MPJPE of 75.8 mm at 560 ms on Human3.6M, outperforming graph and recurrent baselines across all prediction horizons. The framework is designed for eventual deployment in assistive robotics and home-based rehabilitation contexts; end-to-end integration and clinical validation are important directions for future work. By combining motion recognition and prediction in a single system, this work contributes a step toward autonomous, feedback-driven telerehabilitation, for more accessible and scalable rehabilitation solutions.
Tailoring stroke rehabilitation requires assessing how movements are organized, not merely if they succeed. Currently, this assessment is a rate-limiting bottleneck. Instruments like the Action Research Arm Test (ARAT) compress rich behavioral observations into single ordinal endpoints, discarding the movement-quality details that distinguish recovery from compensation. Automated alternatives typically chase accuracy on noisy, single-observer labels to output opaque scores - a technology-centric approach that rarely reaches clinical practice. To address this, we present xAARA: an engine designed to augment rather than replace clinical judgment. From multi-view video, xAARA returns ARAT assessments with calibrated uncertainty and explanations across task, movement-phase, and movement-quality levels. Treating clinical scoring as an ill-posed inference problem, xAARA composes 692 calibrated multimodal models via a Dynamic Bayesian Network with entropy-based gating. It qualifies results against clinical validity rules and defers low-confidence cases. In 105 stroke survivors (788 exercises), xAARA achieved 94.2% task accuracy (Cohen's kappa=0.934) and 81.3% movement-phase accuracy (kappa=0.727), reducing predictive uncertainty by 96.1% compared to single-clinician scoring. For subjective cases, it matched at least one rater 100% of the time and never returned out-of-range scores. Four independent clinicians validated the assessments and indicated willingness to adopt the system. We argue that principled uncertainty quantification and clinician-aligned explainability are the critical bridges moving automated assessment from technical demonstration to a deployable clinical tool.
The Action Research Arm Test (ARAT) is a widely-used upper limb outcome measure in neurorehabilitation, but its ordinal scoring is subjective and suffers from limited sensitivity and specificity. We evaluated whether artificial-intelligence (AI)-based markerless motion capture (MMC), embedded into ARAT assessments during clinical routine, accurately reconstructs upper limb movement and yields valid, objective kinematic metrics carrying clinically meaningful information beyond the ordinal score. Across 47 sessions from 20 mixed-neurological patients (1,174 ARAT tasks), biomechanical reconstruction was accurate and robust across impairment levels, and kinematic metrics showed the discrimination pattern expected of a construct-valid measure. In longitudinal case studies, the metrics added the specificity and sensitivity the ordinal score lacks: a domain decomposition exposed patient-specific recovery profiles underlying equal ARAT gains (specificity), and kinematic improvement continued to be detected after the ARAT had saturated (sensitivity). MMC in clinical routine can thus provide valid, objective, sensitive, and specific kinematic measurement complementing ordinal scoring.