Citation: Neves, H.; Cruz, A.; Bernardes, R.A.; Cardoso, R.; Pimentel, M.; Duque, F.M.; Lopes, E.; Veiga, D.; Malça, C.; Durães, R.; et al. Ablefit: Development of an Advanced System for Rehabilitation. Biomedinformatics 2023, 3, 164–176. https://doi.org/10.3390/ biomedinformatics3010012 Academic Editors: Pan Zheng and Bin Wang Received: 28 December 2022 Revised: 7 February 2023 Accepted: 21 February 2023 Published: 1 March 2023 Copyright: © 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). Article Ablefit: Development of an Advanced System for Rehabilitation Hugo Neves 1,2, * , Arménio Cruz 1 , Rafael A. Bernardes 1 , Remy Cardoso 1 ,Mónica Pimentel 1 , Filipa Margarida Duque 1 , Eliana Lopes 1 , Daniela Veiga 1 ,Cândida Malça 3,4 ,Rúben Durães 5 , Gustavo Corrente 6 , Pedro Parreira 1 , João Apóstolo 1,2 and Vitor Parola 1,2, * 1 Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3000 Coimbra, Portugal 2 Portugal Centre for Evidence Based Practice: A JBI Centre of Excellence (PCEBP), 3000 Coimbra, Portugal 3 Mechanical Engineering Department, Institute of Engineering (ISEC), Polytechnic Institute of Coimbra (IPC), 3030 Coimbra, Portugal 4 Centre for Rapid and Sustainable Product Development (CDRSP), Polytechnic Institute of Leiria (IPL), 2430 Marinha Grande, Portugal 5 ORTHOS XXI, Unipessoal Lda, 4809 Guimarães, Portugal 6 WISEWARE, Lda., 3830 Ílhavo, Portugal * Correspondence: hugoneves@esenfc.pt (H.N.); vitorparola@esenfc.pt (V.P.) Abstract: Bedridden patients risk presenting several problems caused by prolonged immobility, leading to a long recovery process. There is thus a need to develop solutions that ensure the implementation of physical rehabilitation programs in a controlled and interactive way. In this context, the ABLEFIT project aims to develop a medical device to physically rehabilitate bedridden patients with prolonged immobility. A partnership was established between the school of nursing, business enterprises and an engineering institute to develop a prototype. After creating the prototype, a pre-clinical experimental usability study was created using the user-centred multi-method approach (User and Human-Centered Design) to assess the device’s functionality, ergonomics and safety. The pre-clinical stage was initiated with a sample of 12 health professionals (that manipulated the device’s functionalities) and 10 end-users (who used the device). During the pre-clinical stage, the need to incorporate in the final version joint stabilizers was observed. Another important finding was the importance of the continuous monitorization of vital signs on Ablefit, namely, heart rate and SPO 2 . Therefore, the development of the Ablefit system allows the monitoring of a set of variables and conditions inherent to immobility. At the same time, this device will be a dynamic solution (using gamification and simulation technologies) by generating personalized rehabilitation plans. Keywords: rehabilitation; rehabilitation exercise; programs; bedridden persons 1. Introduction Immobility is a major public health concern, commonly triggering complications, such as pneumonia, pressure ulcers and deep vein thrombosis [1]. These complications are strongly related to hospital mortality rates or even post-discharge [2,3]. Addition- ally, hospitals can spend up to 25% of their internal resources just to manage bedridden patients [4]. The previously mentioned scenario, which is of great concern for patients and families and a potent disruptor of health services’ economic balance, can be mitigated through an adequate and efficient physical rehabilitation approach. In fact, recent studies have highlighted that early mobilization and rehabilitation techniques, particularly respira- tory exercises, are effective in improving physical function at discharge [5–7]. To date, technology has been a favourite ally to healthcare services [8], namely, rehabilitation tech- nology, which aims to help people with physical disabilities increase their independence [9]. Biomedinformatics 2023, 3, 164–176. https://doi.org/10.3390/biomedinformatics3010012 https://www.mdpi.com/journal/biomedinformatics