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1.
Sensors (Basel) ; 24(13)2024 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-39000951

RESUMEN

Hand-intensive work is strongly associated with work-related musculoskeletal disorders (WMSDs) of the hand/wrist and other upper body regions across diverse occupations, including office work, manufacturing, services, and healthcare. Addressing the prevalence of WMSDs requires reliable and practical exposure measurements. Traditional methods like electrogoniometry and optical motion capture, while reliable, are expensive and impractical for field use. In contrast, small inertial measurement units (IMUs) may provide a cost-effective, time-efficient, and user-friendly alternative for measuring hand/wrist posture during real work. This study compared six orientation algorithms for estimating wrist angles with an electrogoniometer, the current gold standard in field settings. Six participants performed five simulated hand-intensive work tasks (involving considerable wrist velocity and/or hand force) and one standardised hand movement. Three multiplicative Kalman filter algorithms with different smoothers and constraints showed the highest agreement with the goniometer. These algorithms exhibited median correlation coefficients of 0.75-0.78 for flexion/extension and 0.64 for radial/ulnar deviation across the six subjects and five tasks. They also ranked in the top three for the lowest mean absolute differences from the goniometer at the 10th, 50th, and 90th percentiles of wrist flexion/extension (9.3°, 2.9°, and 7.4°, respectively). Although the results of this study are not fully acceptable for practical field use, especially for some work tasks, they indicate that IMU-based wrist angle estimation may be useful in occupational risk assessments after further improvements.


Asunto(s)
Algoritmos , Muñeca , Humanos , Muñeca/fisiología , Masculino , Adulto , Femenino , Rango del Movimiento Articular/fisiología , Fenómenos Biomecánicos , Movimiento/fisiología , Mano/fisiología , Articulación de la Muñeca/fisiología
2.
J Clin Hypertens (Greenwich) ; 26(7): 842-849, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38980252

RESUMEN

Adequate management of nocturnal hypertension is crucial to reduce the risk of organ damage and cardiovascular events. The EARLY-NH study was a prospective, open-label, multicenter study conducted in Japanese patients with nocturnal hypertension who received esaxerenone treatment for 12 weeks. This post hoc analysis aimed to assess (1) the relationship between changes in morning home systolic blood pressure (SBP), bedtime home SBP, and nighttime home SBP based on changes in SBP and achievement rates of target SBP levels; and (2) the correlation between nighttime home SBP measurements using brachial and wrist home BP monitoring (HBPM) devices. This analysis evaluated 82 patients who completed the 12-week treatment period. Among those who achieved target morning home SBP (<135 mmHg) and target bedtime home SBP (<135 mmHg), the brachial HBPM device showed achievement rates of 63.6% and 56.4%, respectively, for target nighttime home SBP (<120 mmHg). The wrist device showed achievement rates of 66.7% and 63.4%, respectively, for the same targets. Significant correlations were observed between both devices for nighttime home SBP measurements at baseline (r = 0.790), Week 12 (r = 0.641), and change from baseline to Week 12 (r = 0.533) (all, p < .001). In this patient population, approximately 60% of individuals who reached target morning or bedtime home SBP levels <135 mmHg exhibited well-controlled nighttime home SBP. Although nighttime home SBP measurements obtained using both brachial and wrist HBPM devices displayed a significant correlation, the wrist device needs to be examined in more detail for clinical use.


Asunto(s)
Antihipertensivos , Monitoreo Ambulatorio de la Presión Arterial , Presión Sanguínea , Ritmo Circadiano , Hipertensión , Muñeca , Humanos , Masculino , Femenino , Monitoreo Ambulatorio de la Presión Arterial/métodos , Monitoreo Ambulatorio de la Presión Arterial/instrumentación , Persona de Mediana Edad , Estudios Prospectivos , Hipertensión/tratamiento farmacológico , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Anciano , Antihipertensivos/uso terapéutico , Ritmo Circadiano/fisiología , Presión Sanguínea/fisiología , Presión Sanguínea/efectos de los fármacos , Japón , Resultado del Tratamiento
3.
Eur J Sport Sci ; 24(7): 987-998, 2024 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-38956788

RESUMEN

Physical activity (PA) during childhood and adolescence is important for the accrual of maximal peak bone mass. The precise dose that benefits bone remains unclear as methods commonly used to analyze PA data are unsuitable for measuring bone-relevant PA. Using improved accelerometry methods, this study identified the amount and intensity of PA most strongly associated with bone outcomes in 11-12-year-olds. Participants (n = 770; 382 boys) underwent tibial peripheral quantitative computed tomography to assess trabecular and cortical density, endosteal and periosteal circumference and polar stress-strain index. Seven-day wrist-worn raw acceleration data averaged over 1-s epochs was used to estimate time accumulated above incremental PA intensities (50 milli-gravitational unit (mg) increments from 200 to 3000 mg). Associations between time spent above each 50 mg increment and bone outcomes were assessed using multiple linear regression, adjusted for age, sex, height, weight, maturity, socioeconomic position, muscle cross-sectional area and PA below the intensity of interest. There was a gradual increase in mean R2 change across all bone-related outcomes as the intensity increased in 50 mg increments from >200 to >700 mg. All outcomes became significant at >700 mg (R2 change = 0.6%-1.3% and p = 0.001-0.02). Any further increases in intensity led to a reduction in mean R2 change and associations became non-significant for all outcomes >1500 mg. Using more appropriate accelerometry methods (1-s epochs; no a priori application of traditional cut-points) enabled us to identify that ∼10 min/day of PA >700 mg (equivalent to running ∼10 km/h) was positively associated with pQCT-derived measures of bone density, geometry and strength in 11-12-year-olds.


Asunto(s)
Acelerometría , Densidad Ósea , Ejercicio Físico , Humanos , Niño , Masculino , Estudios Transversales , Femenino , Ejercicio Físico/fisiología , Australia , Tibia/fisiología , Tibia/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Muñeca/fisiología , Muñeca/diagnóstico por imagen
4.
BMC Musculoskelet Disord ; 25(1): 463, 2024 Jun 13.
Artículo en Inglés | MEDLINE | ID: mdl-38872094

RESUMEN

BACKGROUND: Double crush syndrome refers to a nerve in the proximal region being compressed, affecting its proximal segment. Instances of this syndrome involving ulnar and cubital canals during ulnar neuropathy are rare. Diagnosis solely through clinical examination is challenging. Although electromyography (EMG) and nerve conduction studies (NCS) can confirm neuropathy, they do not incorporate inching tests at the wrist, hindering diagnosis confirmation. We recently encountered eight cases of suspected double compression of ulnar nerve, reporting these cases along with a literature review. METHODS: The study included 5 males and 2 females, averaging 45.6 years old. Among them, 4 had trauma history, and preoperative McGowan stages varied. Ulnar neuropathy was confirmed in 7 cases at both cubital and ulnar canal locations. Surgery was performed for 4 cases, while conservative treatment continued for 3 cases. RESULTS: In 4 cases with wrist involvement, 2 showed ulnar nerve compression by a fibrous band, and 1 had nodular hyperplasia. Another case displayed ulnar nerve swelling with muscle covering. Among the 4 surgery cases, 2 improved from preoperative McGowan stage IIB to postoperative stage 0, with significant improvement in subjective satisfaction. The remaining 2 cases improved from stage IIB to IIA, respectively, with moderate improvement in subjective satisfaction. In the 3 cases receiving conservative treatment, satisfaction was significant in 1 case and moderate in 2 cases. Overall, there was improvement in hand function across all 7 cases. CONCLUSION: Typical outpatient examinations make it difficult to clearly differentiate the two sites, and EMG tests may not confirm diagnosis. Therefore, if a surgeon lacks suspicion of this condition, diagnosis becomes even more challenging. In cases with less than expected postoperative improvement in clinical symptoms of cubital tunnel syndrome, consideration of double crush syndrome is warranted. Additional tests and detailed EMG tests, including inching tests at the wrist, may be necessary. We aim to raise awareness double crush syndrome with ulnar nerve, reporting a total of 7 cases to support this concept.


Asunto(s)
Síndrome de Aplastamiento , Síndromes de Compresión del Nervio Cubital , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Síndrome de Aplastamiento/cirugía , Síndrome de Aplastamiento/diagnóstico , Síndrome de Aplastamiento/complicaciones , Síndrome de Aplastamiento/fisiopatología , Codo/inervación , Codo/cirugía , Electromiografía , Conducción Nerviosa/fisiología , Resultado del Tratamiento , Nervio Cubital/cirugía , Nervio Cubital/fisiopatología , Síndromes de Compresión del Nervio Cubital/cirugía , Síndromes de Compresión del Nervio Cubital/diagnóstico , Síndromes de Compresión del Nervio Cubital/etiología , Síndromes de Compresión del Nervio Cubital/fisiopatología , Muñeca/inervación
5.
J Sports Sci ; 42(8): 708-719, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38861612

RESUMEN

This study aimed to investigate inter- and intra-athlete technique variability in pre-elite and elite Australian fast bowlers delivering new ball conventional swing bowling. Ball grip angle and pelvis, torso, shoulder, elbow, wrist, upper arm, forearm, and hand kinematics were investigated at the point of ball release for inswing and outswing deliveries. Descriptive evaluations of group and individual data and k-means cluster analyses were used to assess inter- and intra-bowler technique variability. Inter-athlete technique and ball grip variability were identified, demonstrating that skilled bowlers use individualised strategies to generate swing. Functional movement variability was demonstrated by intra-athlete variability in successful swing bowling trials. Bowlers demonstrated stable technique parameters in large proximal body segments of the pelvis and torso, providing a level of repeatability to their bowling action. Greater variation was observed in bowling arm kinematics, allowing athletes to manipulate the finger and ball position to achieve the desired seam orientation at the point of ball release. This study demonstrates that skilled bowlers use individualised techniques and grips to generate swing and employ technique variations in successive deliveries. Coaches should employ individualised training strategies and use constraints-led approaches in training environments to encourage bowlers to seek adaptive movement solutions to generate swing.


Asunto(s)
Críquet , Destreza Motora , Torso , Humanos , Masculino , Fenómenos Biomecánicos , Destreza Motora/fisiología , Adulto Joven , Torso/fisiología , Críquet/fisiología , Australia , Movimiento/fisiología , Pelvis/fisiología , Estudios de Tiempo y Movimiento , Mano/fisiología , Muñeca/fisiología , Adulto , Hombro/fisiología , Extremidad Superior/fisiología
6.
Artículo en Inglés | MEDLINE | ID: mdl-38865234

RESUMEN

Hand neuroprostheses restore voluntary movement in people with paralysis through neuromodulation protocols. There are a variety of strategies to control hand neuroprostheses, which can be based on residual body movements or brain activity. There is no universally superior solution, rather the best approach may vary from patient to patient. Here, we propose a protocol based on an immersive virtual reality (VR) environment that simulates the use of a hand neuroprosthesis to allow patients to experience and familiarize themselves with various control schemes in clinically relevant tasks and choose the preferred one. We used our VR environment to compare two alternative control strategies over 5 days of training in four patients with C6 spinal cord injury: (a) control via the ipsilateral wrist, (b) control via the contralateral shoulder. We did not find a one-fits-all solution but rather a subject-specific preference that could not be predicted based only on a general clinical assessment. The main results were that the VR simulation allowed participants to experience the pros and cons of the proposed strategies and make an educated choice, and that there was a longitudinal improvement. This shows that our VR-based protocol is a useful tool for personalization and training of the control strategy of hand neuroprostheses, which could help to promote user comfort and thus acceptance.


Asunto(s)
Mano , Parálisis , Traumatismos de la Médula Espinal , Realidad Virtual , Humanos , Masculino , Adulto , Traumatismos de la Médula Espinal/rehabilitación , Parálisis/rehabilitación , Femenino , Persona de Mediana Edad , Muñeca , Hombro , Prótesis Neurales , Prioridad del Paciente
7.
Antimicrob Resist Infect Control ; 13(1): 57, 2024 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-38840171

RESUMEN

AIM: Although uncommon, infections associated with peripheral intravenous catheters (PIVCs) may be responsible for severe life-threatening complications and increase healthcare costs. Few data are available on the relationship between PIVC insertion site and risk of infectious complications. METHODS: We performed a post hoc analysis of the CLEAN 3 database, a randomized 2 × 2 factorial study comparing two skin disinfection procedures (2% chlorhexidine-alcohol or 5% povidone iodine-alcohol) and two types of medical devices (innovative or standard) in 989 adults patients requiring PIVC insertion before admission to a medical ward. Insertion sites were grouped into five areas: hand, wrist, forearm, cubital fossa and upper arm. We evaluated the risk of risk of PIVC colonization (i.e., tip culture eluate in broth showing at least one microorganism in a concentration of at least 1000 Colony Forming Units per mL) and/or local infection (i.e., organisms growing from purulent discharge at PIVC insertion site with no evidence of associated bloodstream infection), and the risk of positive PIVC tip culture (i.e., PIVC-tip culture eluate in broth showing at least one microorganism regardless of its amount) using multivariate Cox models. RESULTS: Eight hundred twenty three PIVCs with known insertion site and sent to the laboratory for quantitative culture were included. After adjustment for confounding factors, PIVC insertion at the cubital fossa or wrist was associated with increased risk of PIVC colonization and/or local infection (HR [95% CI], 1.64 [0.92-2.93] and 2.11 [1.08-4.13]) and of positive PIVC tip culture (HR [95% CI], 1.49 [1.02-2.18] and 1.59 [0.98-2.59]). CONCLUSION: PIVC insertion at the wrist or cubital fossa should be avoided whenever possible to reduce the risk of catheter colonization and/or local infection and of positive PIVC tip culture.


Asunto(s)
Infecciones Relacionadas con Catéteres , Cateterismo Periférico , Humanos , Femenino , Masculino , Cateterismo Periférico/efectos adversos , Infecciones Relacionadas con Catéteres/prevención & control , Infecciones Relacionadas con Catéteres/microbiología , Persona de Mediana Edad , Anciano , Clorhexidina , Adulto , Desinfección/métodos , Povidona Yodada , Factores de Riesgo , Antiinfecciosos Locales , Contaminación de Equipos , Muñeca/microbiología
8.
Artículo en Inglés | MEDLINE | ID: mdl-38913522

RESUMEN

Various measures have been proposed to quantify upper-limb use through wrist-worn inertial measurement units. The two most popular traditional measures of upper-limb use - thresholded activity counts (TAC) and the gross movement (GM) score suffer from high sensitivity and low specificity, and vice versa. We previously proposed a hybrid version of these two measures - the GMAC - that showed better overall detection performance than TAC and GM. In this paper, we answer two critical questions to improve the GMAC measure's usefulness: (a) can it be implemented using only the accelerometer data? (b) what are its optimal parameter values? Here, we propose a modified GMAC using only the accelerometer data and optimize its parameters to develop: (a) a generic measure that is both limb- and subject-independent, and (b) limb-specific measures that were only subject-independent. The optimized GMAC showed better detection performance than the previous GMAC and surprisingly had comparable performance to the best-performing machine learning-based measure (random forest inter-subject model). In hemiparetic data, its performance was similar to the previous GMAC and the random forest inter-subject model; the limb-specific GMAC measure, however, had a better performance than the generic measure. The optimized limb-specific GMAC is a simple, interpretable alternative to a machine learning-based inter-subject model. The optimized GMAC can be a valuable measure for offline or real-time detection and feedback of upper limb use. The preliminary results of this study, based on a small dataset, need to be validated on a larger dataset to evaluate its generalizability.


Asunto(s)
Algoritmos , Aprendizaje Automático , Extremidad Superior , Muñeca , Humanos , Masculino , Femenino , Movimiento/fisiología , Adulto , Reproducibilidad de los Resultados , Acelerometría/instrumentación , Sensibilidad y Especificidad , Dispositivos Electrónicos Vestibles , Adulto Joven
9.
Zhongguo Zhen Jiu ; 44(6): 699-702, 2024 Jun 12.
Artículo en Chino | MEDLINE | ID: mdl-38867634

RESUMEN

The paper introduces professor WANG Haidong's clinical experience in treatment of wrist rheumatoid arthritis with acupotomy mobilization at the muscle regions (sinews/fascia) of three yang meridians of hand. Professor WANG Haidong believes that wrist rheumatoid arthritis belongs to the disorder of meridian muscle regions and is especially associated with the damage of the muscle regions of three yang meridians of hand running through the wrist. Under the guidance of meridian muscle region theory, on the basis of modern anatomy, and the treatment principle, "needling the affected areas may treat disorders of sinews/fascia and dysfunction of meridians simultaneously", acupotomy mobilization is adopted to balance sinews/fascia and bones, operated directly at the involved meridian muscle regions. Besides the foci (palpable knotted sites) on the distribution of muscle regions, acupoints along the affected meridians are stimulated in combination. With this therapy, after determining the location of illness, both the disorder of sinews/fascia and that of meridians can be treated.


Asunto(s)
Puntos de Acupuntura , Terapia por Acupuntura , Artritis Reumatoide , Meridianos , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Artritis Reumatoide/terapia , Mano/fisiopatología , Músculo Esquelético , Muñeca/fisiopatología
10.
Sensors (Basel) ; 24(11)2024 May 24.
Artículo en Inglés | MEDLINE | ID: mdl-38894155

RESUMEN

Nocturnal scratching substantially impairs the quality of life in individuals with skin conditions such as atopic dermatitis (AD). Current clinical measurements of scratch rely on patient-reported outcomes (PROs) on itch over the last 24 h. Such measurements lack objectivity and sensitivity. Digital health technologies (DHTs), such as wearable sensors, have been widely used to capture behaviors in clinical and real-world settings. In this work, we develop and validate a machine learning algorithm using wrist-wearing actigraphy that could objectively quantify nocturnal scratching events, therefore facilitating accurate assessment of disease progression, treatment effectiveness, and overall quality of life in AD patients. A total of seven subjects were enrolled in a study to generate data overnight in an inpatient setting. Several machine learning models were developed, and their performance was compared. Results demonstrated that the best-performing model achieved the F1 score of 0.45 on the test set, accompanied by a precision of 0.44 and a recall of 0.46. Upon satisfactory performance with an expanded subject pool, our automatic scratch detection algorithm holds the potential for objectively assessing sleep quality and disease state in AD patients. This advancement promises to inform and refine therapeutic strategies for individuals with AD.


Asunto(s)
Actigrafía , Algoritmos , Dermatitis Atópica , Aprendizaje Automático , Prurito , Muñeca , Humanos , Actigrafía/métodos , Actigrafía/instrumentación , Muñeca/fisiología , Masculino , Femenino , Adulto , Prurito/fisiopatología , Prurito/diagnóstico , Dispositivos Electrónicos Vestibles , Calidad de Vida , Sueño/fisiología , Persona de Mediana Edad
11.
ACS Nano ; 18(20): 12808-12819, 2024 May 21.
Artículo en Inglés | MEDLINE | ID: mdl-38717026

RESUMEN

Considerable progress has already been made in sweat sensors based on electrochemical methods to realize real-time monitoring of biomarkers. However, realizing long-term monitoring of multiple targets at the atomic level remains extremely challenging, in terms of designing stable solid contact (SC) interfaces and fully integrating multiple modules for large-scale applications of sweat sensors. Herein, a fully integrated wristwatch was designed using mass-manufactured sensor arrays based on hierarchical multilayer-pore cross-linked N-doped porous carbon coated by reduced graphene oxide (NPCs@rGO-950) microspheres with high hydrophobicity as core SC, and highly selective monitoring simultaneously for K+, Na+, and Ca2+ ions in human sweat was achieved, exhibiting near-Nernst responses almost without forming an interfacial water layer. Combined with computed tomography, solid-solid interface potential diffusion simulation results reveal extremely low interface diffusion potential and high interface capacitance (598 µF), ensuring the excellent potential stability, reversibility, repeatability, and selectivity of sensor arrays. The developed highly integrated-multiplexed wristwatch with multiple modules, including SC, sensor array, microfluidic chip, signal transduction, signal processing, and data visualization, achieved reliable real-time monitoring for K+, Na+, and Ca2+ ion concentrations in sweat. Ingenious material design, scalable sensor fabrication, and electrical integration of multimodule wearables lay the foundation for developing reliable sweat-sensing systems for health monitoring.


Asunto(s)
Sudor , Dispositivos Electrónicos Vestibles , Muñeca , Sudor/química , Factores de Tiempo , Electrólitos/análisis , Grafito/química , Porosidad , Carbono/química , Cationes/química , Humanos , Monitoreo Biológico/instrumentación
12.
Ecotoxicol Environ Saf ; 278: 116349, 2024 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-38714081

RESUMEN

BACKGROUND: Exposures to polyaromatic hydrocarbons (PAHs) contribute to cancer in the fire service. Fire investigators are involved in evaluations of post-fire scenes. In the US, it is estimated that there are up to 9000 fire investigators, compared to approximately 1.1 million total firefighting personnel. This exploratory study contributes initial evidence of PAH exposures sustained by this understudied group using worn silicone passive samplers. OBJECTIVES: Evaluate PAH exposures sustained by fire investigators at post-fire scenes using worn silicone passive samplers. Assess explanatory factors and health risks of PAH exposure at post-fire scenes. METHODS: As part of a cross-sectional study design, silicone wristbands were distributed to 16 North Carolina fire investigators, including eight public, seven private, and one public and private. Wristbands were worn during 46 post-fire scene investigations. Fire investigators completed pre- and post-surveys providing sociodemographic, occupational, and post-fire scene characteristics. Solvent extracts from wristbands were analyzed via gas chromatography-mass spectrometry (GC-MS). Results were used to estimate vapor-phase PAH concentration in the air at post-fire scenes. RESULTS: Fire investigations lasted an average of 148 minutes, standard deviation ± 93 minutes. A significant positive correlation (r=0.455, p<.001) was found between investigation duration and PAH concentrations on wristbands. Significantly greater time-normalized PAH exposures (p=0.039) were observed for investigations of newer post-fire scenes compared to older post-fire scenes. Regulatory airborne PAH exposure limits were exceeded in six investigations, based on exposure to estimated vapor-phase PAH concentrations in the air at post-fire scenes. DISCUSSION: Higher levels of off-gassing and suspended particulates at younger post-fire scenes may explain greater PAH exposure. Weaker correlations are found between wristband PAH concentration and investigation duration at older post-fire scenes, suggesting reduction of off-gassing PAHs over time. Exceedances of regulatory PAH limits indicate a need for protection against vapor-phase contaminants, especially at more recent post-fire scenes.


Asunto(s)
Bomberos , Exposición Profesional , Hidrocarburos Policíclicos Aromáticos , Siliconas , Humanos , Hidrocarburos Policíclicos Aromáticos/análisis , Exposición Profesional/análisis , Estudios Transversales , North Carolina , Adulto , Masculino , Femenino , Persona de Mediana Edad , Monitoreo del Ambiente/métodos , Contaminantes Ocupacionales del Aire/análisis , Cromatografía de Gases y Espectrometría de Masas , Muñeca
13.
Artículo en Inglés | MEDLINE | ID: mdl-38819972

RESUMEN

In Huntington's disease (HD), wearable inertial sensors could capture subtle changes in motor function. However, disease-specific validation of methods is necessary. This study presents an algorithm for walking bout and gait event detection in HD using a leg-worn accelerometer, validated only in the clinic and deployed in free-living conditions. Seventeen HD participants wore shank- and thigh-worn tri-axial accelerometers, and a wrist-worn device during two-minute walk tests in the clinic, with video reference data for validation. Thirteen participants wore one of the thigh-worn tri-axial accelerometers (AP: ActivPAL4) and the wrist-worn device for 7 days under free-living conditions, with proprietary AP data used as reference. Gait events were detected from shank and thigh acceleration using the Teager-Kaiser energy operator combined with unsupervised clustering. Estimated step count (SC) and temporal gait parameters were compared with reference data. In the clinic, low mean absolute percentage errors were observed for stride (shank/thigh: 0.6/0.9%) and stance (shank/thigh: 3.3/7.1%) times, and SC (shank/thigh: 3.1%). Similar errors were observed for proprietary AP SC (3.2%), with higher errors observed for the wrist-worn device (10.9%). At home, excellent agreement was observed between the proposed algorithm and AP software for SC and time spent walking (ICC [Formula: see text]). The wrist-worn device overestimated SC by 34.2%. The presented algorithm additionally allowed stride and stance time estimation, whose variability correlated significantly with clinical motor scores. The results demonstrate a new method for accurate estimation of HD gait parameters in the clinic and free-living conditions, using a single accelerometer worn on either the thigh or shank.


Asunto(s)
Acelerometría , Algoritmos , Trastornos Neurológicos de la Marcha , Enfermedad de Huntington , Dispositivos Electrónicos Vestibles , Humanos , Enfermedad de Huntington/fisiopatología , Enfermedad de Huntington/diagnóstico , Masculino , Femenino , Persona de Mediana Edad , Acelerometría/instrumentación , Adulto , Reproducibilidad de los Resultados , Trastornos Neurológicos de la Marcha/fisiopatología , Trastornos Neurológicos de la Marcha/diagnóstico , Trastornos Neurológicos de la Marcha/etiología , Trastornos Neurológicos de la Marcha/rehabilitación , Marcha/fisiología , Diseño de Equipo , Anciano , Monitoreo Ambulatorio/instrumentación , Monitoreo Ambulatorio/métodos , Muñeca , Caminata/fisiología , Fenómenos Biomecánicos , Sensibilidad y Especificidad
14.
J Neuroeng Rehabil ; 21(1): 82, 2024 May 20.
Artículo en Inglés | MEDLINE | ID: mdl-38769565

RESUMEN

BACKGROUND: Assessments of arm motor function are usually based on clinical examinations or self-reported rating scales. Wrist-worn accelerometers can be a good complement to measure movement patterns after stroke. Currently there is limited knowledge of how accelerometry correlate to clinically used scales. The purpose of this study was therefore to evaluate the relationship between intermittent measurements of wrist-worn accelerometers and the patient's progression of arm motor function assessed by routine clinical outcome measures during a rehabilitation period. METHODS: Patients enrolled in in-hospital rehabilitation following a stroke were invited. Included patients were asked to wear wrist accelerometers for 24 h at the start (T1) and end (T2) of their rehabilitation period. On both occasions arm motor function was assessed by the modified Motor Assessment Scale (M_MAS) and the Motor Activity Log (MAL). The recorded accelerometry was compared to M_MAS and MAL. RESULTS: 20 patients were included, of which 18 completed all measurements and were therefore included in the final analysis. The resulting Spearman's rank correlation coefficient showed a strong positive correlation between measured wrist acceleration in the affected arm and M-MAS and MAL values at T1, 0.94 (p < 0.05) for M_MAS and 0.74 (p < 0.05) for the MAL values, and a slightly weaker positive correlation at T2, 0.57 (p < 0.05) for M_MAS and 0.46 - 0.45 (p = 0.06) for the MAL values. However, no correlation was seen for the difference between the two sessions. CONCLUSIONS: The results confirm that the wrist acceleration can differentiate between the affected and non-affected arm, and that there is a positive correlation between accelerometry and clinical measures. Many of the patients did not change their M-MAS or MAL scores during the rehabilitation period, which may explain why no correlation was seen for the difference between measurements during the rehabilitation period. Further studies should include continuous accelerometry throughout the rehabilitation period to reduce the impact of day-to-day variability.


Asunto(s)
Acelerometría , Brazo , Rehabilitación de Accidente Cerebrovascular , Humanos , Acelerometría/instrumentación , Masculino , Femenino , Persona de Mediana Edad , Anciano , Rehabilitación de Accidente Cerebrovascular/métodos , Rehabilitación de Accidente Cerebrovascular/instrumentación , Brazo/fisiopatología , Brazo/fisiología , Muñeca/fisiología , Dispositivos Electrónicos Vestibles , Actividad Motora/fisiología , Adulto , Accidente Cerebrovascular/fisiopatología , Accidente Cerebrovascular/diagnóstico , Anciano de 80 o más Años
15.
BMC Med Imaging ; 24(1): 101, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38693510

RESUMEN

Bone strength depends on both mineral content and bone structure. Measurements of bone microstructure on specimens can be performed by micro-CT. In vivo measurements are reliably performed by high-resolution peripheral computed tomography (HR-pQCT) using dedicated software. In previous studies from our research group, trabecular bone properties on CT data of defatted specimens from many different CT devices have been analyzed using an Automated Region Growing (ARG) algorithm-based code, showing strong correlations to micro-CT.The aim of the study was to validate the possibility of segmenting and measuring trabecular bone structure from clinical CT data of fresh-frozen human wrist specimens. Data from micro-CT was used as reference. The hypothesis was that the ARG-based in-house built software could be used for such measurements.HR-pQCT image data at two resolutions (61 and 82 µm isotropic voxels) from 23 fresh-frozen human forearms were analyzed. Correlations to micro-CT were strong, varying from 0.72 to 0.99 for all parameters except trabecular termini and nodes. The bone volume fraction had correlations varying from 0.95 to 0.98 but was overestimated compared to micro-CT, especially at the lower resolution. Trabecular separation and spacing were the most stable parameters with correlations at 0.80-0.97 and mean values in the same range as micro-CT.Results from this in vitro study show that an ARG-based software could be used for segmenting and measuring 3D trabecular bone structure from clinical CT data of fresh-frozen human wrist specimens using micro-CT data as reference. Over-and underestimation of several of the bone structure parameters must however be taken into account.


Asunto(s)
Algoritmos , Hueso Esponjoso , Microtomografía por Rayos X , Humanos , Hueso Esponjoso/diagnóstico por imagen , Anciano , Masculino , Femenino , Persona de Mediana Edad , Muñeca/diagnóstico por imagen , Programas Informáticos , Anciano de 80 o más Años
16.
Int J Med Robot ; 20(3): e2640, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38794828

RESUMEN

BACKGROUND: Accurately estimating the 6D pose of snake-like wrist-type surgical instruments is challenging due to their complex kinematics and flexible design. METHODS: We propose ERegPose, a comprehensive strategy for precise 6D pose estimation. The strategy consists of two components: ERegPoseNet, an original deep neural network model designed for explicit regression of the instrument's 6D pose, and an annotated in-house dataset of simulated surgical operations. To capture rotational features, we employ an Single Shot multibox Detector (SSD)-like detector to generate bounding boxes of the instrument tip. RESULTS: ERegPoseNet achieves an error of 1.056 mm in 3D translation, 0.073 rad in 3D rotation, and an average distance (ADD) metric of 3.974 mm, indicating an overall spatial transformation error. The necessity of the SSD-like detector and L1 loss is validated through experiments. CONCLUSIONS: ERegPose outperforms existing approaches, providing accurate 6D pose estimation for snake-like wrist-type surgical instruments. Its practical applications in various surgical tasks hold great promise.


Asunto(s)
Redes Neurales de la Computación , Instrumentos Quirúrgicos , Muñeca , Humanos , Muñeca/cirugía , Diseño de Equipo , Fenómenos Biomecánicos , Algoritmos , Procedimientos Quirúrgicos Robotizados/instrumentación , Procedimientos Quirúrgicos Robotizados/métodos , Imagenología Tridimensional/métodos , Rotación , Reproducibilidad de los Resultados , Cirugía Asistida por Computador/instrumentación , Cirugía Asistida por Computador/métodos , Análisis de Regresión
17.
Transl Psychiatry ; 14(1): 219, 2024 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-38806490

RESUMEN

Depression is characterized by reduced physical activity and sleep-wake cycle disturbances, often considered important features of the disease. While a few studies have suggested that self-reported reduced physical activity and sleep-wake cycle disturbances might both be linked to depression vulnerability, actigraphy-based measures in vulnerable samples remain largely unexplored. This study relied on actigraphy-based parameters to test whether these disturbances characterize depression vulnerability. Seven-day actigraphy data were collected from 20 (13 female) university students with a high vulnerability to depression, which was determined by the presence of a family history of the condition but no current symptoms, and 32 (21 female) controls with neither a family history of depression nor current depressive symptoms. Daily physical activity, namely gross motor activity, was quantified as average daily acceleration and time spent engaging in moderate-vigorous physical activity (MVPA). The sleep-wake cycle and circadian rhythms were assessed as total sleep duration per night (in hours), sleep within sleep period time (in hours), sleep efficiency (%), and relative amplitude (i.e., the difference between the activity during the day and the night, which reflects circadian rhythms amplitude). Results showed that individuals with a familial risk for depression exhibited reduced daily acceleration and time spent in MVPA relative to the control group, particularly on the weekend during their free time away from scheduled activities. On the other hand, the two groups were comparable in terms of sleep estimates. Taken together, reduced physical activity, but not sleep-wake disturbances, seem to be associated with vulnerability to depression and might be a viable target for identification and prevention efforts.


Asunto(s)
Actigrafía , Depresión , Ejercicio Físico , Humanos , Femenino , Masculino , Adulto Joven , Adulto , Ritmo Circadiano/fisiología , Sueño/fisiología , Predisposición Genética a la Enfermedad , Muñeca
18.
Sensors (Basel) ; 24(10)2024 May 19.
Artículo en Inglés | MEDLINE | ID: mdl-38794079

RESUMEN

Modular control of the muscle, which is called muscle synergy, simplifies control of the movement by the central nervous system. The purpose of this study was to explore the synergy in both the frequency and movement domains based on the non-negative Tucker decomposition (NTD) method. Surface electromyography (sEMG) data of 8 upper limb muscles in 10 healthy subjects under wrist flexion (WF) and wrist extension (WE) were recorded. NTD was selected for exploring the multi-domain muscle synergy from the sEMG data. The results showed two synergistic flexor pairs, Palmaris longus-Flexor Digitorum Superficialis (PL-FDS) and Extensor Carpi Radialis-Flexor Carpi Radialis (ECR-FCR), in the WF stage. Their spectral components are mainly in the respective bands 0-20 Hz and 25-50 Hz. And the spectral components of two extensor pairs, Extensor Digitorum-Extensor Carpi Ulnar (ED-ECU) and Extensor Carpi Radialis-Brachioradialis (ECR-B), are mainly in the respective bands 0-20 Hz and 7-45 Hz in the WE stage. Additionally, further analysis showed that the Biceps Brachii (BB) muscle was a shared muscle synergy module of the WE and WF stage, while the flexor muscles FCR, PL and FDS were the specific synergy modules of the WF stage, and the extensor muscles ED, ECU, ECR and B were the specific synergy modules of the WE stage. This study showed that NTD is a meaningful method to explore the multi-domain synergistic characteristics of multi-channel sEMG signals. The results can help us to better understand the frequency features of muscle synergy and shared and specific synergies, and expand the study perspective related to motor control in the nervous system.


Asunto(s)
Electromiografía , Movimiento , Músculo Esquelético , Muñeca , Humanos , Músculo Esquelético/fisiología , Masculino , Muñeca/fisiología , Adulto , Movimiento/fisiología , Femenino , Adulto Joven , Procesamiento de Señales Asistido por Computador
19.
Artículo en Inglés | MEDLINE | ID: mdl-38791764

RESUMEN

(1) Background: An elevated wrist circumference may indicate excess weight and cardiometabolic risk. The present study aims to identify wrist circumference cutoff points (WrC) to determine excess weight levels and predict cardiometabolic risk in adults. (2) Methods: A cross-sectional study was conducted with adults aged 20 to 59 years old, attending the outpatient clinic at University Hospital/Federal University of Sergipe HU/UFS-EBSERH. Demographic, anthropometric, biochemical, and blood pressure (BP) data were collected. Cardiometabolic risk was assessed, according to the global risk score (ERG) and Framingham score criteria. The descriptive analysis included calculating medians and frequencies of anthropometric, demographic, biochemical, and blood pressure variables. The gender and age of adult groups were compared using the Mann-Whitney test. Spearman's correlation coefficient and multiple regression analysis were used to assess the association between wrist circumference (WrC) and the variables mentioned above. The predictive validity of WrC in identifying excess weight levels and cardiometabolic risk was analyzed using the ROC curve. The sample consisted of 1487 adults aged 20 to 59 years, 55.7% of whom were female; (3) Results: WrC correlated positively with other adiposity indicators such as waist circumference and Body Mass Index. WrC was the anthropometric indicator most significantly associated with cardiometabolic risk factors. WrC cutoff points identified by the study for determining excess weight were categorized by gender and age group. For males aged 20 to 40 years and >40 years, respectively, the cutoff points for overweight were 17.1 cm and 17.3 cm, and for obesity, 17.9 cm and 17.5 cm. For females aged 20 to 40 years and >40 years, respectively, the cutoff points for overweight were 15.6 cm and 15.4 cm, and for obesity, 16.1 cm and 16 cm (4). Conclusions: Wrist circumference showed a significant correlation with other adiposity indicators and can be used to identify adults with excess weight and predict cardiometabolic risk.


Asunto(s)
Sobrepeso , Muñeca , Humanos , Adulto , Masculino , Femenino , Persona de Mediana Edad , Estudios Transversales , Muñeca/anatomía & histología , Adulto Joven , Sobrepeso/epidemiología , Factores de Riesgo , Enfermedades Cardiovasculares/epidemiología , Antropometría , Índice de Masa Corporal , Factores de Riesgo Cardiometabólico
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