BRIEF RESEARCH REPORT article
Front. Rehabil. Sci.
Sec. Rehabilitation Engineering
Volume 6 - 2025 | doi: 10.3389/fresc.2025.1657543
This article is part of the Research TopicDigitalisation and AI in Orthopedic Surgery and Rehabilitation 4.0 - Volume IIView all 4 articles
Enhanced Rehabilitation after Total Joint Replacement Using a Wearable High-Density Surface Electromyography System
Provisionally accepted
- 1Saarland University, Saarbrücken, Germany
- 2Universitat des Saarlandes - Campus Homburg, Homburg, Germany
- 3Universitätsklinikum des Saarlandes, Klinik für Orthopädie und Orthopädische Chirurgie, Homburg/Saar, Germany
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Abstract Introduction: Neuromuscular recovery after total joint arthroplasty remains insufficiently understood, and current tools for assessing muscle function lack the resolution to monitor detailed recovery dynamics. High-Density surface Electromyography (HD-sEMG) enables spatiotemporal analysis of muscle activation and may support individualized rehabilitation. However, its clinical application in orthopedic settings remains limited. Methods: This exploratory study presents a methodological framework for applying wearable 64-channel HD-sEMG system to monitor neuromuscular recovery in patients undergoing total knee or hip arthroplasty. HD-sEMG data were recorded during standardized mobilization exercises at multiple pre-and postoperative time points. A custom signal processing pipeline was developed, encompassing artifact suppression, dimensionality reduction, feature extraction, and the derivation of five functional indices summarizing key aspects of muscle performance. Results: Initial clinical application demonstrated the feasibility of the approach. The functional indices revealed distinct recovery dynamics across patients and showed promising alignment with patient-reported outcome measures. Individual case analyses suggested the potential of HD-sEMG to differentiate between restitution and dysfunctional compensation patterns. Discussion: This study provides a structured, exploratory foundation for longitudinal HD-sEMG research in orthopedic rehabilitation. While not yet suited for clinical decision-making, the proposed framework offers methodological tools for future investigations of neuromuscular recovery trajectories and may contribute to the development of personalized, data-driven rehabilitation strategies.
Keywords: HD-sEMG, Electromyograhy (EMG), Rehabilitation, TJA, Wearable EMG system, neuromuscular recovery, Rehabilitation monitoring, Functional indices
Received: 11 Jul 2025; Accepted: 29 Sep 2025.
Copyright: © 2025 Morsch, Böckenförde, Wolf, Landgraeber and Strauss. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Richard Morsch, richard_alexander.morsch@uni-saarland.de
Daniel J. Strauss, daniel.strauss@uni-saarland.de
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