Accelerometer approach for anticipatory postural adjustments assessment during step initiation in patients with leprosy.

Anticipatory postural adjustments (APAs) involve a complex coordination of sensorimotor information that can be impaired in diseases that affect nerve conduction. Assessing APAs typically requires costly video recording technology, posing a challenge to the study of postural changes. This hurdle is compounded in impoverished communities affected by diseases such as leprosy, which often receive limited government support. Recent years have seen the validation of inertial sensors in wearable devices and smartphones for APA analysis in diverse populations, including adults, the elderly and people with Parkinson's disease. This progress offers economically efficient alternatives for the study of APA in leprosy. Do patterns of activation of anticipatory postural adjustment differ between leprosy patients and healthy controls? We also investigated the validity and replicability of APAs recorded in leprosy patients using inertial measurements and video capture recordings. Thirty healthy individuals in the control group and 30 individuals with leprosy in the leprosy group performed ten gait initiation trials. To record the APA for gait initiation, the participants stood on a 2 m platform. Each participant was informed that the experimenter would give an signal, after which the participant would initiate a two-step walk on the platform. Inertial recordings (low-cost method) and video capture recordings (gold-standard method) from center of mass displacements were used to extract the APA before gait initiation. The results show that APAs are similar between groups (control and leprosy), but leprosy patients have less consistent APAs. In addition, this study highlights the reproducibility and high correlation between the values of variables obtained from both instruments, the video recording as gold standard method and portable digital inertial sensor as a low-cost alternative method. These promising findings support the use of affordable inertial sensors to track and record APAs in underserved populations that lack easy access to gold standard methods such as video recording. This approach has the potential to improve the therapeutic care and rehabilitation of these patients. Although not currently part of official protocols for leprosy patients, this assessment method could prove particularly valuable in situations where significant sensorimotor impairments are suspected or documented.

Virtual Reality in Improving Anticipatory Postural Adjustments to Step Initiation in Individuals with Knee Osteoarthritis: A Randomized Controlled Trial.

Background: Virtual reality (VR) has been suggested as a new therapeutic approach in various sectors of rehabilitation, including the treatment of patients with knee osteoarthritis (OA), and one of its treatment goals is to improve the gait pattern and walking ability of patients. Objective: This study aimed to evaluate if VR, along with conventional physiotherapy treatment (CT), has superior effects to kinesiotherapy alone on pain, physical capacity, balance, and the parameters of anticipatory postural adjustments (APAs) in patients with knee OA. Design: This study is a single-blind randomized controlled trial. Setting: Secondary care at Hospital SARAH Network of Rehabilitation Hospitals, Brazil. Participants: Forty participants (31 women and 9 men) with knee OA in at least one knee and able to ambulate independently. Intervention: A rehabilitation program (8 consecutive weeks, 50-minute session, twice a week). Patients were randomized into the intervention groups CT or VR. Main Outcome Measures: Primary-latency of APA, amplitude of APA, and time to reach the maximum acceleration amplitude. Secondary-balance control by Mini-Balance Evaluation Systems Test, pain, and physical capacity by Western Ontario and McMaster Universities Arthritis Index. Results: The results of the study showed that conventional treatment significantly improved pain intensity, physical capacity, and balance in individuals with knee OA; however, only the group that used VR showed improvement in the APA parameters. Conclusion: This study demonstrated that VR associated with conventional treatment improved APAs in patients with knee OA.

Wearable-based assessment of anticipatory postural adjustments during step initiation in patients with knee osteoarthritis.

Older adults with moderate to severe knee osteoarthritis (KOA) exhibit adaptive strategy for initiating walking, known as anticipatory postural adjustments (APAs). While video motion kinematics has been the traditional way of measuring APAs, it can be difficult to transport and install, making it impractical for medical settings. Inertial sensors have become a more popular method for evaluating APAs, but no prior research has used accelerometers to measure gait initiation in individuals with KOA. The study aimed to assess the validity and reliability of a wearable accelerometer device for measuring APAs older adults with and without KOA. 25 individuals with KOA and 10 healthy individuals underwent evaluation using a wearable commercially available accelerometer (MetamotionC) and a video motion capture system. Reflective markers were placed on the lumbar vertebra and calcaneus. Participants were asked to initiate a step, and the researchers measured the APAlatency and APAamplitude of each subject. APAlatency showed an very large to almost perfect correlation in both groups (CG:r = 0.82; p = 0.003 and KOA r = 0.98; p < 0.00001) between the instruments, while APAamplitude had a moderate to very large correlation (CG: r = 0.65; p = 0.04and KOA: r = 0.80; p < 0.00001). Overall, the measurements showed fair to high reliability for intraclass correlation for video and accelerometer variables. Significant group effect was found for both variables: APAlatency (F1, 66 = 7.3; p = 0.008) and APAamplitude (F1,66 = 9.5; p = 0.00). The wearable tri-axial accelerometer is a valid and reliable for assessing APAs during gait initiation in individuals with KOA, and this population exhibits lower APAs when initiating a step.

Microbiome and oral squamous cell carcinoma: a possible interplay on iron metabolism and its impact on tumor microenvironment.

There is increasing evidence showing positive association between changes in oral microbiome and the occurrence of oral squamous cell carcinoma (OSCC). Alcohol- and nicotine-related products can induce microbial changes but are still unknown if these changes are related to cancerous lesion sites. In an attempt to understand how these changes can influence the OSCC development and maintenance, the aim of this study was to investigate the oral microbiome linked with OSCC as well as to identify functional signatures and associate them with healthy or precancerous and cancerous sites. Our group used data of oral microbiomes available in public repositories. The analysis included data of oral microbiomes from electronic cigarette users, alcohol consumers, and precancerous and OSCC samples. An R-based pipeline was used for taxonomic and functional prediction analysis. The Streptococcus spp. genus was the main class identified in the healthy group. Haemophilus spp. predominated in precancerous lesions. OSCC samples revealed a higher relative abundance compared with the other groups, represented by an increased proportion of Fusobacterium spp., Prevotella spp., Haemophilus spp., and Campylobacter spp. Venn diagram analysis showed 52 genera exclusive of OSCC samples. Both precancerous and OSCC samples seemed to present a specific associated functional pattern. They were menaquinone-dependent protoporphyrinogen oxidase pattern enhanced in the former and both 3',5'-cyclic-nucleotide phosphodiesterase (purine metabolism) and iron(III) transport system ATP-binding protein enhanced in the latter. We conclude that although precancerous and OSCC samples present some differences on microbial profile, both microbiomes act as "iron chelators-like" potentially contributing to tumor growth.