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Smart Phones, Smart TVs, But Smart Shirts??

Technology has transformed the field of physiotherapy, offering new ways to diagnose and treat injuries, monitor progress, and enhance patient outcomes. From virtual reality systems that simulate real-life scenarios to gaming software which are to be used therapeutically. Technology is helping physiotherapists provide more effective and personalized care to their patients. That being said, it is still quite shocking when you hear something like a smart shirt. Can clothing really be smart? Can a shirt really be therapeutic? Let’s find out!

 With the rise of wearable technology, smart shirts are becoming increasingly popular among fitness enthusiasts, athletes, and health-conscious individuals. The Double Aid or DAid smart textile shirt system for upper limb movement monitoring is part of the DAid smart textile clothing collection. The collection was developed at Riga Technical University within the framework of the European Regional Development Fund project “Smart textile systems for Medicine and Sports.” 

But what is the necessity of such a high-end/ over-fashionable product? For patients with subacromial pain syndrome, the physiotherapeutic intervention with the use of the DAid smart shirt prototype as objective feedback will achieve equivalent or better functional tests and self-reported outcome measurement results compared to conventional methods. Muscle function around the shoulder girdle can be impaired by pain, which leads to abnormal movement e.g. elevation. Movement faults should be assessed specifically, therefore individual sport rehabilitation strategies can be implemented. Smart garments are efficient for upper body movement assessment. The smart shirt system is based on textile stretch sensors that are positioned over the typical movement fault sites for movement detection and monitoring. The information from the textile stretch sensors is used as visual feedback by the wearer for movement corrections

The DAid Smart shirt presents a tight shirt with four embedded highly sensitive knitted strain sensors. Sensor reactions are transferred via sewn electroconductive pathways to an electronic device acquiring the data and then via Bluetooth to a computer or tablet. The specific placement of the sensor provides independence of the sensors’ reactions to the patient’s shoulder elevation-depression movements. 

Hill et al reported that shoulder pain affects 22.3% of people, with a significant detrimental impact on health-related quality of life and physical functioning. There is a high prevalence of shoulder pain in the populations of overhead athletes, with reports of 12% in amateur golf (McHardy, Pollard and Luo, 2007 ), 16% in volleyball (Clarsen et al., 2014), 22% to 36%% in elite handball (Myklebust et al., 2011) and 24% in high-level adolescent tennis, which increases to 50% in middle-aged tennis players (Abrams et al, 2012). The prevalence of shoulder pain is even higher in swimmers, ranging between 40% and 91% (Wanivenhaus et al., 2012). Evidence suggests that muscle function around the shoulder girdle can be impaired by pain and pathology. Altered timing (latency) of electromyographic (EMG) activity has been identified in muscles of the scapula and the glenohumeral joint. Motion analysis studies have identified abnormal movements of the scapula which include elevation, internal rotation of the scapula, and anterior tilt. Alterations in the dynamic control of scapula-thoracic joints are important factors in shoulder pathology. 

Literature supports the need for a specific assessment of movement faults, so individual rehabilitation strategies can be implemented. This can be easily achieved through the use of this smart technology. There is a wide range of healthcare applications to smart garments, specifically smart shirts, including rehabilitation, prevention of shoulder injury in overhead sports and enhance physical therapy treatment, e.g., for treating shoulder musculoskeletal disorders and pain. One of the main parts of smart garments is the sensing system which can include one or several sensing elements for posture and joint motion control and assessment. The smart garment system is efficient for upper body movement assessment during simple tasks and a customized smart shirt can be an objective and convenient device for shoulder motion capture and monitoring during advanced motor tasks. 

A study conducted by Guna Semjonova reported that – 

DAid Smart shirt is reliable and valid for the assessment of the right and left side shoulder girdle elevation motions. The DAid smart shirt has great potential as a low-cost, easily implemented device for assessing abnormal shoulder motions such as shoulder girdle elevation during upper limb rehabilitation tasks. The system is suitable for assessing changes in upper limb motions over time, such as disease progression or improvement due to intervention.

By encouraging correct movement patterns and reducing strain on the shoulders, the shirts have the potential to prevent and treat shoulder injuries. Additionally, the shirts can enhance sports performance by improving posture and reducing fatigue. Overall, DAid smart shirts have the potential to revolutionize the way we approach shoulder health and sports performance, offering a promising tool for athletes and individuals with shoulder conditions. For both the patient and physiotherapist, it can be used as an effective assisting device in addition to conventional physiotherapy for shoulder girdle motion capture and monitoring during shoulder rehabilitation tasks. The DAid smart shirt motion assessment method is objective, which helps to quantify kinematic parameters and turn data into knowledge-based data. Also, for a rehabilitation specialist, such as a physical therapist, this is an effective assisting device, because the therapist must not control the patient’s shoulder girdle stability during arm movement all the therapy time, as a result, the therapy process is optimized, but still effective. 

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