Comparison between Decision Tree and Genetic Programming to distinguish healthy from stroke postural sway patterns.

Maintaining balance is a motor task of crucial importance for humans to perform their daily activities safely and independently. Studies in the field of Artificial Intelligence have considered different classification methods in order to distinguish healthy subjects from patients with certain motor disorders based on their postural strategies during the balance control. The main purpose of this paper is to compare the performance between Decision Tree (DT) and Genetic Programming (GP) - both classification methods of easy interpretation by health professionals - to distinguish postural sway patterns produced by healthy and stroke individuals based on 16 widely used posturographic variables. For this purpose, we used a posturographic dataset of time-series of center-of-pressure displacements derived from 19 stroke patients and 19 healthy matched subjects in three quiet standing tasks of balance control. Then, DT and GP models were trained and tested under two different experiments where accuracy, sensitivity and specificity were adopted as performance metrics. The DT method has performed statistically significant (P < 0.05) better in both cases, showing for example an accuracy of 72.8% against 69.2% from GP in the second experiment of this paper.

Gait characteristics of persons with incomplete spinal cord injury in shallow water.

OBJECTIVE: To describe the kinematic gait characteristics of individuals with incomplete chronic spinal cord injury in a water environment and to compare these characteristics with those of healthy individuals. DESIGN: Cross-sectional study. SUBJECTS: Nineteen adults divided into 2 groups: individuals (n = 9) with incomplete chronic spinal cord injury (> 1 year), American Spinal Injury Association Impairment Scale (AIS) C or D; and a second group (n = 10) of healthy young adults. The groups were paired up according to body mass and height. METHODS: Participants walked at a self-selected speed in a heated pool with water at the level of the xiphoid process. Participants with spinal cord injury were allowed to hold the researcher's hands. The body segment and joint angle coordinates in the sagittal plane were retrieved with SIMI Motion software. Temporal-spatial variables and joint ranges of motion were compared between groups. RESULTS: Duration of stance phase, stride length and speed differed significantly (p < 0.05) between groups. The ranges of joint motion were not significantly different (p > 0.05), and the joint angle patterns were qualitatively similar between groups. CONCLUSION: The physical properties of water provided the required time for reorganization of gait phases and allowed all individuals with spinal cord injury to walk in the water environment.

Qualidade de vida de mulheres com bexiga hiperativa refratária tratadas com estimulação elétrica do nervo tibial posterior / Quality of life in women with refractory overactive bladder treated with percutaneous tibial nerve stimulation

OBJETIVO: Verificar o impacto do tratamento por estimulação elétrica do nervo tibial posterior (PTNS) na qualidade de vida (QV) de mulheres com bexiga hiperativa (BH). MÉTODOS: Ensaio clínico não controlado com 11 mulheres com presença de contrações não inibidas do detrusor (CNI) no exame urodinâmico, todas anteriormente submetidas ao tratamento com anticolinérgicos, sem resposta. O tratamento fisioterápico constituiu-se de 12 sessões de 30 minutos da PTNS com o eletroestimulador Dualpex 961®, duas vezes na semana. Para avaliar a QV, foram utilizados os questionários King's Health Questionnaire (KHQ) e o "Internacional Consultation on Incontinence Questionnaire - Short-Form" (ICIQ-SF), e os seus escores pré e pós-tratamento foram comparados pelo teste de Wilcoxon para amostras pareadas, com nível de significância de 0,05. RESULTADOS: Observou-se melhora significativa na QV em todos os domínios do KHQ, exceto na percepção geral da saúde (51,36±30,75 versus 37,73±25,63; p=0,068): impacto da incontinência (74,55±27,75 versus 38,18±13,82; p=0,008), limitações das atividades diárias (66,45±25,89 versus 26,91±11,22; p=0,008), limitações físicas (73,91±29,46 versus 30,91±12,79; p=0,008), limitações sociais (39,18±35,60 versus 17,45±12,26; p=0,028), relações pessoais (25,64±29,16 versus 10,45±15,23; p=0,043), emoções (65,82±38,56 versus 26,00±20,45; p=0,005), sono/disposição (39,18±37,51 versus 16,45±18,17; p=0,012) e nas medidas de gravidade (62,00±17,70 versus 33,00±16,59; p=0,003). Os escores do ICIQ-SF demonstraram também melhora na QV (10,09±6,50 versus 3,73±3,00; p=0,008). CONCLUSÕES: A terapia com PTNS foi capaz de melhorar a QV de mulheres com queixa de BH e refratárias ao tratamento medicamentoso. A PTNS mostra-se, portanto, uma boa alternativa terapêutica, além de ser segura e com baixo custo operacional.

OBJECTIVE: To investigate the effect of percutaneous tibial nerve stimulation (PTNS) in the quality of life (QoL) of women with overactive bladder (OAB). METHODS: uncontrolled clinical trial with 11 women that presented overactivity of the detrusor muscle in urodynamic tests. All of the subjects were previously treated with anticholinergic medication, without response. The treatment consisted of 12 PTNS sessions of 30 minutes each, two times a week. The electrical stimulator Dualpex 961® (Quark medical) was used. The instruments chosen to evaluate QoL were the King's Health Questionnaire (KHQ) and the "International Consultation on Incontinence Questionnaire - Short-Form" (ICIQ-SF). The questionnaires were applied before and after the treatment. RESULTS: There was a significant improvement in the following domain scores of the KHQ: incontinence impact (74.55±27.75 versus 38.18±13.82; p=0.008), role limitations (66.45±25.89 versus 26.91±11.22; p=0.008), physical limitations (73.91±29.46 versus 30.91±12.79; p=0.008), social limitations (39.18±35.60 versus 17.45±12.26; p=0.028), personal relationships (25.64±29.16 versus 10.45±15.23; p=0.043), emotions (65.82±38.56 versus 26.00±20.45; p=0.005), sleep/energy (39.18±37.51 versus 16.45±18.17; p=0.012) and severity measures (62.00±17.70 versus 33.00±16.59; p= 0.003), except for general health perception (51.36±30.75 versus 37.73±25.63; p=0.068). In the ICIQ-SF scores it was also possible to observe a significant improvement (10.09±6.50 versus 3.73±3.00; p=0.008). CONCLUSIONS: The PTNS treatment improved the QoL of women with overactive bladder and refractory to anticholinergic medication. Therefore, PTNS can be considered a good alternative for OAB treatment as it is safe and inexpensive compared to other therapeutic approaches.