Comparison of an Artificial Intelligence-Assisted Rehabilitation Program for Shoulder Musculoskeletal Disorders and the Clinical Decision Making of Therapists

Study Overview
=================
Brief Summary
-----------------
People with shoulder musculoskeletal disorders among middle-aged and older adults have the highest need of rehabilitation services. The population growth and aging society subsequently increase the number of disabled people, the healthcare costs and the needs for healthcare professionals. The evidence exists to support the beneficial effect of exercises on function and quality of life. Traditionally, a rehabilitation program is designed by therapists for each patient depending on their conditions. In recent years, AI is increasingly being employed in the field of physical and rehabilitation medicine, however, there is no study of applying AI in predicting rehabilitation programs for shoulder musculoskeletal disorders. The main purpose of this study is to explore the possibilities of using supervised machine learning approach to predict rehabilitation programs for shoulder musculoskeletal disorders. Twenty-three features are identified based on shoulder range of motion, pain, whether or not perform surgical procedure. Each exercise is considered as a label with a total of twenty-five exercises. Dataset is collected by clinical therapists to develop and train the model. Each patient has to receive at least two months of rehabilitation and two times of evaluation. Logistic regression, support vector machine and random forest are used to build the computational model. Accuracy, precision, recall, F-1 score and AUC are used to evaluate the performance of the computational model in machine learning. After training, we compare the consistency of rehabilitation programs predicted by using machine learning model and the clinical decision making of therapists.

Official Title
-----------------
Comparison of an Artificial Intelligence-Assisted Rehabilitation Program for Shoulder Musculoskeletal Disorders and the Clinical Decision Making of Therapists

Conditions
-----------------
Shoulder Musculoskeletal Disorders, Rehabilitation Programs, Machine Learning

Intervention / Treatment
-----------------
* Other: usual care


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: The International Classification of Diseases, 10th revision (ICD-10) codes were selected before the study started and included the ICD-10 codes M75 (Shoulder lesions), S42 (Fracture of shoulder and upper arm), S43 (Dislocation and sprain of joints and ligaments of shoulder girdle), and S46 (Injury of muscle, fascia and tendon at shoulder and upper arm level) Patients who need rehabilitation after undergoing surgical procedure and are able to perform stretch, active assistive range of motion (AAROM) or supervised active range of motion (AROM) between 20-80 years old Are able to follow motor commands Exclusion Criteria: Patients with central and peripheral nervous system disease, such as cerebrovascular accident (CVA), Parkinson's disease (PD), myasthenia gravis (MG), poliomyelitis Patients who had shoulder contusion, vascular injury, severe crush injury and amputation

Ages Eligible for Study
-----------------
Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| shoulder musculoskeletal group<br>The International Classification of Diseases, 10th revision (ICD-10) codes were selected before the study started and included the ICD-10 codes M75 (Shoulder lesions), S42 (Fracture of shoulder and upper arm), S43 (Dislocation and sprain of joints and ligaments of shoulder girdle), and S46 (Injury of muscle, fascia and tendon at shoulder and upper arm level) | Other: usual care<br>* usual care(rehabilitation program)<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Accuracy | To explore the possibilities of using supervised machine learning approach to predict rehabilitation programs for shoulder musculoskeletal disorders | Change from Baseline at 2 months | 
| Precision | To explore the possibilities of using supervised machine learning approach to predict rehabilitation programs for shoulder musculoskeletal disorders | Change from Baseline at 2 months | 
| Recall | To explore the possibilities of using supervised machine learning approach to predict rehabilitation programs for shoulder musculoskeletal disorders | Change from Baseline at 2 months | 
| F-1 score | To explore the possibilities of using supervised machine learning approach to predict rehabilitation programs for shoulder musculoskeletal disorders | Change from Baseline at 2 months | 
| AUC | To explore the possibilities of using supervised machine learning approach to predict rehabilitation programs for shoulder musculoskeletal disorders | Change from Baseline at 2 months |