{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T22:32:43Z","timestamp":1792276363334,"version":"4.4.0"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T00:00:00Z","timestamp":1736208000000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Physiotherapy Res Intl"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Purpose<\/jats:title><jats:p>Throwing a baseball involves intense exposure of the arm to high speeds and powerful forces, which contributes to an increasing prevalence of arm injuries among athletes. Traditional rigid exoskeletons and rehabilitation equipment frequently lack portability, safety, ergonomic design, and affordability. Traditional rehabilitation approaches frequently require therapist monitoring, resulting in therapy delays. This paper describes a Pneumatic Artificial Muscle (PAM) based soft robotic sleeve designed for upper limb rehabilitation, with an emphasis on elbow flexion and extension in baseball pitchers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The experiment included five healthy male baseball pitchers aged 20\u201324 with no history of upper limb injuries, ensuring their suitability for testing the effectiveness of the PAM\u2010based sleeve in supporting elbow flexion and extension specific to baseball pitching. The effectiveness of the PAM\u2010based soft sleeve was evaluated utilizing a pre\u2010post design that included surface electromyography (sEMG). Participants were tested for muscle activation and range of motion both with and without the device. The sleeve has two operational modes: Active Surge Flex Mode, which detects movement intention using sEMG and delivers targeted help, and Steady Passive Mode, which allows repetitive flexion and extension without intentional muscle activation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The PAM\u2010based sleeve reduced muscle activation in both triceps and biceps, with reductions of approximately 40% (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05) and 60% (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05), respectively. When activated based on assistance thresholds, triceps and biceps EMG amplitudes were further reduced by 30% (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05) and 50% (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05), respectively. The flexion angle remained consistent between 70 and 90\u00b0, indicating smooth and controlled movements. The Co\u2010Contraction Index (CCI) decreased from 0.31 to 0.12, highlighting a reduction in unnecessary muscle co\u2010activation, thereby improving movement efficiency.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The PAM\u2010based soft robotic sleeve provides a convenient and effective upper limb rehabilitation solution that is specifically designed for baseball pitchers. The sleeve reduces the physical strain of pitchers by reducing muscle activation in both the biceps and triceps, as well as decreasing the Co\u2010Contraction Index (CCI). Its portability, convenience of use, and potential to improve muscle efficiency make it an effective tool for improving rehabilitation outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pri.70025","type":"journal-article","created":{"date-parts":[[2025,1,7]],"date-time":"2025-01-07T10:14:11Z","timestamp":1736244851000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["A Soft Robotic Sleeve for Physiotherapy: Improving Elbow Rehabilitation in Baseball Pitchers"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8468-9356","authenticated-orcid":false,"given":"Muhammad Umair Ahmad","family":"Khan","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering University of Engineering and Technology (UET) Lahore, Narowal Campus  Narowal Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafiz Muhammad Salman","family":"Ajmal","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering University of Engineering and Technology (UET) Lahore, Narowal Campus  Narowal Pakistan"},{"name":"Department of Electrical Engineering University of Engineering and Technology (UET) Lahore, Narowal Campus  Narowal Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hashir Ali","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering University of Engineering and Technology (UET) Lahore, Narowal Campus  Narowal Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areesha","family":"Azam","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering University of Engineering and Technology (UET) Lahore, Narowal Campus  Narowal Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eshaal","family":"Malik","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering University of Engineering and Technology (UET) Lahore, Narowal Campus  Narowal Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,7]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1243\/17543371jset52"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.15758\/ajk.2021.23.1.46"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcot.2021.04.007"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1108\/ir\u201002\u20102020\u20100041"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1109\/ROBIO.2016.7866407"},{"issue":"3","key":"e_1_2_12_7_1","first-page":"116","article-title":"Injury Trends in Major League Baseball over 18 Seasons: 1998\u20102015","volume":"45","author":"Conte S.","year":"2016","journal-title":"American Journal of Orthopsychiatry"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967120969245"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.3390\/mi14071431"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/036354659502300218"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12984\u2010018\u20100383\u2010x"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1109\/LARS\/SBR\/WRE56824.2022.9996030"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v9.i9.112"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/sports11070134"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/jpo.0000000000000277"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11370\u2010023\u201000509\u2010y"},{"key":"e_1_2_12_17_1","volume-title":"Rehabilitation Robotics","author":"Krebs H. 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