Human-in-the-Loop AI, Distributed Sensing System, and LOLE.K Robotic Beds for Personalized Cardiac Rehabilitation: The ACCELERATE Study Protocol

Prolonged postoperative immobilization is the primary cause of Intensive Care Unit Acquired Weakness (ICUAW), affecting over 40% of cardiac valve patients, prolonging hospital stay. The ACCELERATE project introduces a frontier solution integrating the LOLE.K robotic bed, multi-sensor monitoring, and AI predictive algorithms supporting early rehabilitation. The robotic bed enables dynamic mobilization protocols improving peripheral oxygenation, reducing cardiac stress, and facilitating pulmonary drainage. The digital framework operates within the Human-in-the-Loop (HITL) paradigm to support decision-making processes; by fusing in real-time multimodal parameters from the multi-sensor monitoring system, including hemodynamic data and infrared thermographic maps of body perfusion, machine learning (ML) models can predict metrics associated to the clinical outcomes, as individual physiological responses to postural transitions. The algorithm does not replace human medical supervision but generates information exploitable for personalized postural recommendations that the clinician validates before actuation, ensuring safety and continuous learning from clinical feedback. The adoption of this technological ecosystem aims to transform postoperative management into precision personalized medicine, ensuring early and targeted rehabilitation. Primary objectives include improving patient quality of life and functional recovery, reducing hospital length of stay, and demonstrating scalability and cost-effectiveness of this AI-driven approach across cardiac surgery departments.