RESUMEN
Depression is a common mental illness characterized by sadness, lack of interest, or pleasure. According to the DSM-5, there are nine symptoms, from which an individual must present 4 or 5 in the last two weeks to fulfill the diagnosis criteria of depression. Nevertheless, the common methods that health care professionals use to assess and monitor depression symptoms are face-to-face questionnaires leading to time-consuming or expensive methods. On the other hand, smart homes can monitor householders' health through smart devices such as smartphones, wearables, cameras, or voice assistants connected to the home. Although the depression disorders at smart homes are commonly oriented to the senior sector, depression affects all of us. Therefore, even though an expert needs to diagnose the depression disorder, questionnaires as the PHQ-9 help spot any depressive symptomatology as a pre-diagnosis. Thus, this paper proposes a three-step framework; the first step assesses the nine questions to the end-user through ALEXA or a gamified HMI. Then, a fuzzy logic decision system considers three actions based on the nine responses. Finally, the last step considers these three actions: continue monitoring through Alexa and the HMI, suggest specialist referral, and mandatory specialist referral.
Asunto(s)
Cuestionario de Salud del Paciente , Salud Poblacional , Depresión/diagnóstico , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Lógica Difusa , Humanos , Encuestas y CuestionariosRESUMEN
INTRODUCTION: There is limited data in the scientific literature using quantitative methods to assess response of golfer's cramp to intervention. The objective of this pilot study was to use quantitative measures to study the effect of propranolol and looking at the hole when putting. METHODS: 14 golfers completed 50 10' putts (10 each x 5 conditions): two-handed looking at the ball, right hand only looking at the ball, two-handed looking at the hole, then following a single 10 mg oral dose of propranolol two-handed and right hand only putts looking at the ball. Quantitative measurements of putter movement and surface EMG to assess wrist muscle co-contraction were measured. RESULTS: Based on video review of the putting, five golfers with dystonic golfer's cramp and nine with non-dystonic yips were compared. Those with dystonic golfer's cramp had more putts with the yips and yips with co-contraction when two-handed putting looking at the ball, no increase when putting right hand only, less smoothness of putter movement, and all of these improved following propranolol and when looking at the hole. The non-dystonic group had an increase in yipped putts and yipped putts with co-contraction putting right hand only and no improvement with either intervention. CONCLUSION: Yipped putts with co-contraction, right hand only putting, and smoothness of putter movement differed between dystonic golfer's cramp and non-dystonic yips. Propranolol and looking at the hole only improved dystonic golfer's cramp putting. This is the first pilot study of oral medication treatment for this task-specific dystonia.
Asunto(s)
Antagonistas Adrenérgicos beta/farmacología , Traumatismos en Atletas , Trastornos Distónicos , Golf/lesiones , Calambre Muscular , Propranolol/farmacología , Desempeño Psicomotor , Muñeca/fisiopatología , Antagonistas Adrenérgicos beta/administración & dosificación , Anciano , Traumatismos en Atletas/complicaciones , Traumatismos en Atletas/tratamiento farmacológico , Traumatismos en Atletas/fisiopatología , Trastornos Distónicos/tratamiento farmacológico , Trastornos Distónicos/etiología , Trastornos Distónicos/fisiopatología , Electromiografía , Humanos , Masculino , Persona de Mediana Edad , Contracción Muscular/efectos de los fármacos , Contracción Muscular/fisiología , Calambre Muscular/tratamiento farmacológico , Calambre Muscular/etiología , Calambre Muscular/fisiopatología , Evaluación de Resultado en la Atención de Salud , Proyectos Piloto , Propranolol/administración & dosificación , Desempeño Psicomotor/efectos de los fármacos , Desempeño Psicomotor/fisiologíaRESUMEN
PURPOSE: To determine whether quantitative methods could separate golfers with a possible dystonic cause of the "yips" from those that appear to be nondystonic. METHODS: Twenty-seven golfers completed 10 two-handed and 10 right hand-only putts. Surface EMG assessed forearm muscle co-contraction and motion detectors monitored wrist and putter movements. Based on a videotape review, golfers were grouped into those with yips of dystonic etiology, those with the yips nondystonic, and those with no yips. RESULTS: On video review of two-handed putting, five golfers had yips that appeared to be dystonic, nine had yips that did not appear to be dystonic, and 13 had no yips. During two-handed putting co-occurrence of a yipped putt and wrist flexor/extensor and/or pronator/supinator co-contraction was significantly more frequent in those with dystonic yips. The dystonic group had no increase in the number of yipped putts or yips with co-contraction when putting right hand only, whereas the nondystonic group had significantly more yipped putts and more yipped putts with co-contraction with right hand only. CONCLUSIONS: Quantitative methods were identified that appear to identify golfers with a dystonic etiology for the yips. It is not just the frequency of yips nor just specific motion patterns alone, rather it is also a combination of yips with co-occurring co-contraction when putting with two hands, and then right hand only, that distinguished this possible etiology. Despite being a small study, identifying a dystonic pattern, even in a nonpressure indoor setting, may aid in assessment and possible monitoring of treatment.