Three-dimensional printing in healthcare / Impresión 3D en cuidado de la salud

ABSTRACT This work aims to briefly present the cutting edge of 3D printing innovation in healthcare. This technology is used for surgical planning, medical education, bioprinting of tissues, and medical equipment spare parts in fields like pharmacology, prosthetics, surgery, and regenerative medicine. A review of the last decade was made in the search engines of PubMed and Espacenet. Three authors reviewed titles, abstracts, and keywords separately to identify studies appropriate to the topic. After the initial examination, complete texts of identified relevant studies were obtained and classified according to the authors. Results were synthesized in a narrative literature review. The revision showed that 3D printing has become of common use in the healthcare system since it allows medical personnel to implement customized solutions for each patient, thus reducing the probability of a false diagnostic or treatment. Major applications among the advantages and disadvantages of 3D printing in healthcare were presented. Nowadays, the main challenge in 3D printing is the cost of the equipment and its manufacturing. In the future, the challenges in cost could be reduced, but processing requirements and limited materials may still need further work.

RESUMEN Este artículo pretende mostrar breve y rápidamente la vanguardia del empleo de la impresión 3D en salud. La impresión 3D se utiliza para planificación quirúrgica, educación médica, bioimpresión de tejidos e impresión de repuestos de equipos médicos en campos como farmacología, prótesis, cirugía, ingeniería de tejidos y medicina regenerativa. Se realizó una revisión de publicaciones en la última década en los motores de búsqueda PubMed y Espacenet. Tres autores examinaron de forma independiente títulos y resúmenes para identificar estudios relevantes. Se obtuvieron los textos completos y se clasificaron de acuerdo con todos los autores. Los resultados se sintetizaron en una revisión narrativa de la literatura. La revisión mostró que la impresión 3D se ha vuelto de uso común en el sistema de atención médica, ya que permite al personal médico implementar soluciones personalizadas para cada paciente, lo que reduce la probabilidad de un diagnóstico o tratamiento falso. Se presentaron las principales aplicaciones, así como ventajas y desventajas de la impresión 3D en salud. Hoy en día, el principal desafío en la impresión 3D es el costo del equipo y su fabricación. En el futuro, los desafíos en costos podrían reducirse, pero los desafíos de procesamiento y materiales requieren mayor desarrollo.

Validation of the instrumented evaluation of spatio-temporal gait parameters in patients with motor incomplete spinal cord injury.

This corrects the article DOI: 10.1038/sc.2017.4.

Validation of the instrumented evaluation of spatio-temporal gait parameters in patients with motor incomplete spinal cord injury.

STUDY DESIGN: Observational, descriptive, transversal. OBJECTIVES: To evaluate the validity and reliability of spatio-temporal gait parameters measured by GaitRite in motor incomplete spinal cord-injured (SCI) patients. SETTING: National Institute of Rehabilitation, Mexico city. METHODS: 23 motor subacute and chronic incomplete SCI American Spinal Cord Injury Association Impairment Scale (AIS) D subjects were measured. The 10-meter walking test (10 MWT), 6-minute walking test (6 MWT), Walking Index for Spinal Cord Injury II (WISCI-II), Spinal Cord Independence Measure III (SCIM-III) and the GaitRite evaluation were carried out concurrently in order to determine validity. The 10 MWT and GaitRite evaluation were performed at different occasions in order to determine test-retest reliability. RESULTS: GaitRite offers a valid and reliable way to measure the mobility, symmetry and stability characteristics of gait SCI subjects. GaitRite precision and sensitivity is approximately three times better than clinical tests. Clinical tests cannot address the stability properties of gait. Subjects' higher gait velocity is related to more independence (SCIM-III), lower use of walking aids (WISCI-II), better performance in lower extremities motor score (LEMS) and better gait's mobility. CONCLUSIONS: Spatio-temporal gait parameters measured by GaitRite are both valid and reliable. Further studies are necessary to establish sensitivity of the instrument.

Estimation of temporal gait parameters using Bayesian models on acceleration signals.

The purpose of this study is to develop a system capable of performing calculation of temporal gait parameters using two low-cost wireless accelerometers and artificial intelligence-based techniques as part of a larger research project for conducting human gait analysis. Ten healthy subjects of different ages participated in this study and performed controlled walking tests. Two wireless accelerometers were placed on their ankles. Raw acceleration signals were processed in order to obtain gait patterns from characteristic peaks related to steps. A Bayesian model was implemented to classify the characteristic peaks into steps or nonsteps. The acceleration signals were segmented based on gait events, such as heel strike and toe-off, of actual steps. Temporal gait parameters, such as cadence, ambulation time, step time, gait cycle time, stance and swing phase time, simple and double support time, were estimated from segmented acceleration signals. Gait data-sets were divided into two groups of ages to test Bayesian models in order to classify the characteristic peaks. The mean error obtained from calculating the temporal gait parameters was 4.6%. Bayesian models are useful techniques that can be applied to classification of gait data of subjects at different ages with promising results.