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There is a lack of knowledge about the accuracy of the Conventional Gait Model (CGM), compared to the true bone motion. Accuracy is hindered by both marker misplacement and soft-tissue artefact (STA). The effect of the lateral knee marker (KNE) misplacement and STA was determined from a secondary analysis of 13 subjects equipped with a total knee prothesis for which simultaneous dual-plane fluoroscopy and marker-based motion capture was available. In average, STA alone led to 3.3°, 2.9° and 6.7° errors for knee flexion, knee abduction, and the absolute hip rotation respectively. In comparison, marker misplacement led to 0.9°, 4.0° and 12.3° errors for the same kinematics. We showed that STA alone may lead to knee flexion-adduction cross-talk. This finding has clinical repercussions for the use of knee cross talk as a qualitative indicator of knee axis alignment. Our study showed that cumulative effects of marker misplacement and STA affect the transverse plane angles, making challenging to track internal/external rotation with less than 5° of errors.
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Artefactos , Marcha , Humanos , Articulación de la Rodilla , Rodilla , Extremidad Inferior , Fenómenos BiomecánicosRESUMEN
Accurate assessment of the type, duration, and intensity of physical activity (PA) in daily life is considered very important because of the close relationship between PA level, health, and well-being. Therefore, the assessment of PA using lightweight wearable sensors has gained interest in recent years. In particular, the use of activity monitors could help to measure the health-related effects of specific PA interventions. Our study, named as Run4Vit, focuses on evaluating the acute and longterm effects of an eight-week running intervention on PA behaviour and vitality. To achieve this goal, we developed an algorithm to detect running and estimate instantaneous cadence using a single trunk-fixed accelerometer. Cadence was computed using time and frequency domain approaches. Validation was performed over a wide range of locomotion speeds using an open-source gait database. Across all subjects, the cadence estimation algorithms achieved a mean bias and precision of - 0.01 ± 0.69 steps/min for the temporal method and 0.02 ± 1.33 steps/min for the frequency method. The running detection algorithm demonstrated very good performance, with an accuracy of 98% and a precision superior to 99%. These algorithms could be used to extract metrics related to the multiple dimensions of PA, and provide reliable outcome measures for the Run4Vit longitudinal running intervention program. Clinical Relevance- This work aims at validating a multi-dimensional physical activity (PA) classification algorithm for assessing the acute and long-term effects of eight weeks running intervention on PA behaviours and vitality.
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Marcha , Caminata , Acelerometría/métodos , Ejercicio Físico , Monitores de Ejercicio , HumanosRESUMEN
Walking/gait speed is a key measure for daily mobility characterization. To date, various studies have attempted to design algorithms to estimate walking speed using an inertial sensor worn on the lower back, which is considered as a proper location for activity monitoring in daily life. However, these algorithms were rarely compared and validated on the same datasets, including people with different preferred walking speed. This study implemented several original, improved, and new algorithms for estimating cadence, step length and eventually speed. We designed comprehensive cross-validation to compare the algorithms for walking slow, normal, fast, and using walking aids. We used two datasets, including reference data for algorithm validation from an instrumented mat (40 subjects) and shanks-worn inertial sensors (88 subjects), with normal and impaired walking patterns. The results showed up to 50% performance improvements. Training of algorithms on data from people with different preferred speeds led to better performance. For the slow walkers, an average RMSE of 2.5 steps/min, 0.04 m, and 0.10 m/s were respectively achieved for cadence, step length, and speed estimation. For normal walkers, the errors were 3.5 steps/min, 0.08 m, and 0.12 m/s. An average RMSE of 1.3 steps/min, 0.05 m, and 0.10 m/s were also observed on fast walkers. For people using walking aids, the error significantly increased up to an RMSE of 14 steps/min, 0.18 m, and 0.27 m/s. The results demonstrated the robustness of the proposed combined speed estimation approach for different speed ranges. It achieved an RMSE of 0.10, 0.18, 0.15, and 0.32 m/s for slow, normal, fast, and using walking aids, respectively.
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Marcha , Velocidad al Caminar , Algoritmos , Humanos , Pierna , CaminataRESUMEN
BACKGROUND: Rehabilitative treatment plans after stroke are based on clinical examinations of functional capacity and patient-reported outcomes. Objective information about daily life performance is usually not available, but it may improve therapy personalization. OBJECTIVE: To show that sensor-derived information about daily life performance is clinically valuable for counseling and the planning of rehabilitation programs for individual stroke patients who live at home. Performance information is clinically valuable if it can be used as a decision aid for the therapeutic management or counseling of individual patients. METHODS: This was an observational, cross-sectional case series including 15 ambulatory stroke patients. Motor performance in daily life was assessed with body-worn inertial sensors attached to the wrists, shanks and trunk that estimated basic physical activity and various measures of walking and arm activity in daily life. Stroke severity, motor function and activity, and degree of independence were quantified clinically by standard assessments and patient-reported outcomes. Motor performance was recorded for an average of 5.03 ± 1.1 h on the same day as the clinical assessment. The clinical value of performance information is explored in a narrative style by considering individual patient performance and capacity information. RESULTS: The patients were aged 59.9 ± 9.8 years (mean ± SD), were 6.5 ± 7.2 years post stroke, and had a National Institutes of Health Stroke Score of 4.0 ± 2.6. Capacity and performance measures showed high variability. There were substantial discrepancies between performance and capacity measures in some patients. CONCLUSIONS: This case series shows that information about motor performance in daily life can be valuable for tailoring rehabilitative therapy plans and counseling according to the needs of individual stroke patients. Although the short recording time (average of 5.03 h) limited the scope of the conclusions, this study highlights the usefulness of objective measures of daily life performance for the planning of rehabilitative therapies. Further research is required to investigate whether information about performance in daily life leads to improved rehabilitative therapy results.
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Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Estudios Transversales , Humanos , Estados Unidos , CaminataRESUMEN
Gastric cancer (GC) is a complex heterogeneous process and the molecular mechanisms underlying its initiation or propagation are still not very well characterized. Aberrant gene expression are key features of cancer. DNA methylation in a promoter region is an important epigenetic mechanism for the gene silencing. Here, the impact of DNA methylation in regulating the expression of miR-125b1 is explored. A total of 285 genetically unrelated subjects including 175 healthy controls and a total of 110 GC patients participated in this study. we performed nested methylation-specific polymerase chain reaction (MS-PCR) to evaluate methylation pattern of miR-125b1 promoter and quantitative real-time polymerase chain reaction (qRT-PCR) to determine the RNA expression changes in GC and normal tissues. The frequency of methylated allele was 24.5% in GC cases but only 10% in normal tissues. Statistically significant correlation between CpG dinucleotide methylation of miR-125b1 promoter and increased risk of gastric adenocarcinoma was observed (OR=2.57; 95%CI 1.60-4.13; P=0.0001). In addition, miR-125b1 promoter methylation correlated with tumor location and stages. miR-125b1 expression was much higher in normal tissue compared to cancerous tissue. However, methylation status of the miR-125b1 promoter was not correlated with miR-125b1 expression in cancerous specimens (p<0.05). In conclusion, this is a first report of miR-125b1 promoter methylation in GC. More research is needed to fully elucidate the underlying molecular mechanisms of GC susceptibility.
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Metilación de ADN , MicroARNs/genética , Neoplasias Gástricas/genética , Estudios de Casos y Controles , Línea Celular Tumoral , Islas de CpG , Regulación Neoplásica de la Expresión Génica , Humanos , Regiones Promotoras GenéticasAsunto(s)
Inhibidor p27 de las Quinasas Dependientes de la Ciclina/genética , Predisposición Genética a la Enfermedad , ARN Largo no Codificante/genética , Neoplasias Gástricas/genética , Anciano , Biomarcadores de Tumor/genética , Femenino , Regulación Neoplásica de la Expresión Génica/genética , Estudios de Asociación Genética , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Neoplasias Gástricas/epidemiología , Neoplasias Gástricas/patologíaAsunto(s)
Colitis Ulcerosa/genética , Predisposición Genética a la Enfermedad , MicroARNs/genética , Polimorfismo de Nucleótido Simple , Proteína p53 Supresora de Tumor/genética , Adulto , Alelos , Antiinflamatorios no Esteroideos/uso terapéutico , Estudios de Casos y Controles , Colitis Ulcerosa/diagnóstico , Colitis Ulcerosa/tratamiento farmacológico , Colitis Ulcerosa/patología , Femenino , Regulación de la Expresión Génica , Frecuencia de los Genes , Heterocigoto , Homocigoto , Humanos , Masculino , Mesalamina/uso terapéutico , RiesgoRESUMEN
Reactive oxygen species (ROS) play a critical role in peptic ulcer disease (PUD). Due to the high rate of ROS production and limited capacity for DNA repair within mitochondria, mtDNA is susceptible to oxidative damage and mutations. mtDNA deletion Δ4977 is one of the most common deletion events identified in mitochondria. We examined the association of 4977-bp mtDNA deletion with PUD. Genotypes were determined in bioptic samples of 150 PUD patients and 190 controls. The 4977-bp mtDNA deletion was found more frequently among patients with PUD (52%) than among controls (22.63%). The strong association between the mtDNA 4977-bp deletion and PUD was confirmed (OR = 3.7; 95% CI, 2.32-5.91; P = 0.0001). The 4977-bp deletion in mitochondrial DNA may be a risk factor for PUD, or may reflect an increase in oxidative stress that commonly accompanies underlying PUD disease. Larger population-based studies are needed to uncover the possible causal relationship between this deletion and peptic ulcer disease.
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ADN Mitocondrial/genética , Úlcera Péptica/genética , Eliminación de Secuencia , Estudios de Casos y Controles , Humanos , Mitocondrias , Estrés Oxidativo , Especies Reactivas de OxígenoRESUMEN
BACKGROUND: Rates of dislocation following primary total hip arthroplasty (THA) vary from 0.5 to 10%. Dual-mobility cups in THA demonstrate increased stability. Clinical outcomes following THA with dual-mobility cups have been reported, but gait has not been assessed. Therefore we performed a retrospective case control study to answer: (1) is gait better in patients following THA with a dual-mobility cup than in frail, elderly patients of the same age? (2) Are clinical outcomes better in patients following THA with a dual-mobility cup than in frail, elderly patients? (3) What is the dislocation rate following THA with a dual-mobility cup? HYPOTHESIS: We hypothesized that patients who underwent THA with a dual-mobility cup have a better gait compared to frail, elderly patients of the same age. PATIENTS AND METHODS: Twenty patients (22 hips), mean age 79.9±7.7 (range, 62.3-88.3) years were assessed in this retrospective case-control series 5.6±1.4 (range: 4.1-8.8) years following dual-mobility cup THA. A reference group consisted of 72 "frail elderly" patients in a rehabilitation hospital for health problems unrelated to the lower limb, with no lower limb surgery or neurological conditions. Temporal and spatial gait performance were measured with four miniature gyroscopes, mounted on each thigh and calf, while patients walked freely along a 30m corridor. Harris Hip Score, WOMAC, radiological outcomes, and dislocation rate were determined. RESULTS: All gait parameters were better in the dual-mobility group compared to the frail elderly group. The dual-mobility group had a higher cadence (100.3 steps/minute versus 75.6 steps/minute), shorter (relative to gait cycle time) stance (61.6% versus 67.8%), shorter (relative to gait cycle time) double stance (23.3% versus 36.0%), longer stride (1.13m versus 0.80m), and faster walking speed (0.96m/s versus 0.52m/s). Range of motion of the shank, thigh and knee were better in the dual-mobility group. Harris Hip Score was 87.6±13.9 (range 51-100) and WOMAC score was 11.3±12.1 (range 0-34) in the THA group. We observed no dislocations. DISCUSSION: Gait patterns five years following THA with the dual-mobility cup were better or comparable to published study populations. LEVEL OF EVIDENCE: III, retrospective case-control series.
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Artroplastia de Reemplazo de Cadera/instrumentación , Marcha , Luxación de la Cadera/etiología , Articulación de la Cadera/fisiopatología , Prótesis de Cadera , Anciano , Anciano de 80 o más Años , Artroplastia de Reemplazo de Cadera/efectos adversos , Estudios de Casos y Controles , Femenino , Estudios de Seguimiento , Anciano Frágil , Prótesis de Cadera/efectos adversos , Humanos , Inestabilidad de la Articulación/etiología , Articulación de la Rodilla/fisiopatología , Masculino , Persona de Mediana Edad , Radiografía , Rango del Movimiento Articular , Estudios Retrospectivos , Resultado del Tratamiento , CaminataRESUMEN
The goal of this article is to characterise front-crawl swimming skill based on variability pattern of technique descriptors. Nine national level and nine recreational swimmers performed three 300 m trials in a 50 m outdoor pool, at 70%, 80% and 90% of their front-crawl 400 m personal best time. Using wearable inertial measurement units (IMUs) and validated algorithms we assessed the variability of technique descriptors at each arm cycle (139 ± 17 per trial). We calculated the duration of pull, push and non-propulsive phases, index of coordination (IdC), stroke length, stroke rate and intra-cyclic velocity variation. To track intra-trial technique variability, we calculated the Cauchy index to quantify the stability of multidimensional technique descriptors in space-time. Skilled swimmers, having access to divers motor solutions, achieved significantly higher velocities at similar intensities and similar IdC (P < 0.01) with more stable motor pattern (smaller Cauchy index). Besides, the similarity of intra-cyclic velocity variation at different intensities denotes that skilled swimmers used a wider dynamic range of velocity. We also introduced cycle velocity variation as a new metric of propulsive pattern repeatability and showed cycle velocity variation changes is correlated to the Cauchy index (rx,y = 0.72, P < 0.01). These findings indicate that IdC can be used as a predictor of performance only when swimmers of homogeneous expertise level are studied and suggest the scrutiny of both intra-cyclic velocity variation and cycle velocity variation as a requisite to study the motor adaptations of the swimmer in facing new constraints.
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Brazo/fisiología , Destreza Motora/fisiología , Natación/fisiología , Acelerometría/métodos , Adaptación Fisiológica , Adolescente , Fenómenos Biomecánicos , Femenino , Humanos , Masculino , Acondicionamiento Físico Humano , Estudios de Tiempo y Movimiento , Adulto JovenRESUMEN
Kinematic functional evaluation with body-worn sensors provides discriminative and responsive scores after shoulder surgery, but the optimal movements' combination has not yet been scientifically investigated. The aim of this study was the development of a simplified shoulder function kinematic score including only essential movements. The P Score, a seven-movement kinematic score developed on 31 healthy participants and 35 patients before surgery and at 3, 6 and 12 months after shoulder surgery, served as a reference. Principal component analysis and multiple regression were used to create simplified scoring models. The candidate models were compared to the reference score. ROC curve for shoulder pathology detection and correlations with clinical questionnaires were calculated. The B-B Score (hand to the Back and hand upwards as to change a Bulb) showed no difference to the P Score in time*score interaction (P > .05) and its relation with the reference score was highly linear (R(2) > .97). Absolute value of correlations with clinical questionnaires ranged from 0.51 to 0.77. Sensitivity was 97% and specificity 94%. The B-B and reference scores are equivalent for the measurement of group responses. The validated simplified scoring model presents practical advantages that facilitate the objective evaluation of shoulder function in clinical practice.
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Movimiento/fisiología , Examen Físico/métodos , Índice de Severidad de la Enfermedad , Hombro/fisiología , Hombro/fisiopatología , Adulto , Fenómenos Biomecánicos , Femenino , Humanos , Húmero/fisiología , Húmero/fisiopatología , Masculino , Persona de Mediana Edad , Análisis de Componente Principal , Análisis de Regresión , Hombro/cirugía , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del TratamientoRESUMEN
Automatic fall detection will reduce the consequences of falls in the elderly and promote independent living, ensuring people can confidently live safely at home. Inertial sensor technology can distinguish falls from normal activities. However, <;7% of studies have used fall data recorded from elderly people in real life. The FARSEEING project has compiled a database of real life falls from elderly people, to gain new knowledge about fall events. We have extracted temporal and kinematic parameters to further improve the development of fall detection algorithms. A total of 100 real-world falls were analysed. Subjects with a known fall history were recruited, inertial sensors were attached to L5 and a fall report, following a fall, was used to extract the fall signal. This data-set was examined, and variables were extracted that include upper and lower impact peak values, posture angle change during the fall and time of occurrence. These extracted parameters, can be used to inform the design of fall-detection algorithms for real-world falls detection in the elderly.
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Accidentes por Caídas , Vértebras Lumbares/fisiopatología , Monitoreo Ambulatorio/instrumentación , Anciano , Algoritmos , Fenómenos Biomecánicos , Humanos , Postura , Factores de TiempoRESUMEN
BACKGROUND & OBJECTIVES: ZCL is a growing threat in many rural areas of Iran which involves 17 out of 31 provinces. This study was conducted from April to November 2011 for evaluation of the efficacy of phostoxin and zinc phosphide against rodents. METHODS: Rodent control operations were carried out using phostoxin and zinc phosphide. To evaluate the effect of rodent control operation on the main vector density, an entomological survey was carried out. The effects of the operation on the disease incidence were also evaluated. RESULTS: After intervention, the reduction rate of rodent burrows was 32.68% in the village treated with phostoxin and 58.14% in the village treated with zinc phosphide. The number of rodent holes in the control area showed 6.66-fold increase at the end of the study. The incidence of the disease decreased to 19.23 and 11.40 in areas treated with phostoxin and zinc phosphide, respectively. A total of 4243 adult sandflies were collected and identified. The most common and dominant species was Phlebotomus papatasi. In the village treated with phostoxin, the density of P. papatasi in outdoors was lower than indoors. Nevertheless, the density of P. papatasi in the village treated with zinc phosphide was higher in outdoors. INTERPRETATION & CONCLUSION: It is concluded that phostoxin is less effective and has low safety in comparison with zinc phosphide, so that this rodenticide can be used only in special situations such as lack or ineffective rodenticides and only in the colonies far from human and animal dwelling places in small scales.
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Compuestos de Aluminio/administración & dosificación , Leishmaniasis Cutánea/prevención & control , Control de Plagas/métodos , Plaguicidas , Fosfinas/administración & dosificación , Compuestos de Zinc/administración & dosificación , Animales , Humanos , Incidencia , Irán/epidemiología , Leishmaniasis Cutánea/epidemiología , Phlebotomus/crecimiento & desarrolloRESUMEN
With the progress of technologies of recent years, methods have become available that use wearable sensors and ambulatory systems to measure aspects of--particular axial--motor function. As Parkinson's disease (PD) can be considered a model disorder for motor impairment, a significant number of studies have already been performed with these patients using such techniques. In general, motion sensors such as accelerometers and gyroscopes are used, in combination with lightweight electronics that do not interfere with normal human motion. A fundamental advantage in comparison with usual clinical assessment is that these sensors allow a more quantitative, objective, and reliable evaluation of symptoms; they have also significant advantages compared to in-lab technologies (e.g., optoelectronic motion capture) as they allow long-term monitoring under real-life conditions. In addition, based on recent findings particularly from studies using functional imaging, we learned that non-motor symptoms, specifically cognitive aspects, may be at least indirectly assessable. It is hypothesized that ambulatory quantitative assessment strategies will allow users, clinicians, and scientists in the future to gain more quantitative, unobtrusive, and everyday relevant data out of their clinical evaluation and can also be designed as pervasive (everywhere) and intensive (anytime) tools for ambulatory assessment and even rehabilitation of motor and (partly) non-motor symptoms in PD.
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Acelerometría/métodos , Enfermedad de Parkinson/diagnóstico , Examen Físico/métodos , Humanos , Persona de Mediana Edad , Movimiento (Física) , Enfermedad de Parkinson/fisiopatologíaRESUMEN
This study aims to design a wearable system for kinetics measurement of multi-segment foot joints in long-distance walking and to investigate its suitability for clinical evaluations. The wearable system consisted of inertial sensors (3D gyroscopes and 3D accelerometers) on toes, forefoot, hindfoot, and shank, and a plantar pressure insole. After calibration in a laboratory, 10 healthy elderly subjects and 12 patients with ankle osteoarthritis walked 50m twice wearing this system. Using inverse dynamics, 3D forces, moments, and power were calculated in the joint sections among toes, forefoot, hindfoot, and shank. Compared to those we previously estimated for a one-segment foot model, the sagittal and transverse moments and power in the ankle joint, as measured via multi-segment foot model, showed a normalized RMS difference of less than 11%, 14%, and 13%, respectively, for healthy subjects, and 13%, 15%, and 14%, for patients. Similar to our previous study, the coronal moments were not analyzed. Maxima-minima values of anterior-posterior and vertical force, sagittal moment, and power in shank-hindfoot and hindfoot-forefoot joints were significantly different between patients and healthy subjects. Except for power, the inter-subject repeatability of these parameters was CMC>0.90 for healthy subjects and CMC>0.70 for patients. Repeatability of these parameters was lower for the forefoot-toes joint. The proposed measurement system estimated multi-segment foot joints kinetics with acceptable repeatability but showed difference, compared to those previously estimated for the one-segment foot model. These parameters also could distinguish patients from healthy subjects. Thus, this system is suggested for outcome evaluations of foot treatments.
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Articulación del Tobillo/fisiopatología , Pie/fisiología , Monitoreo Ambulatorio/métodos , Osteoartritis/fisiopatología , Caminata/fisiología , Anciano , Fenómenos Biomecánicos , Femenino , Marcha/fisiología , Humanos , Cinética , Masculino , Persona de Mediana EdadRESUMEN
Despite its medical relevance, accurate recognition of sedentary (sitting and lying) and dynamic activities (e.g. standing and walking) remains challenging using a single wearable device. Currently, trunk-worn wearable systems can differentiate sitting from standing with moderate success, as activity classifiers often rely on inertial signals at the transition period (e.g. from sitting to standing) which contains limited information. Discriminating sitting from standing thus requires additional sources of information such as elevation change. The aim of this study is to demonstrate the suitability of barometric pressure, providing an absolute estimate of elevation, for evaluating sitting and standing periods during daily activities. Three sensors were evaluated in both calm laboratory conditions and a pilot study involving seven healthy subjects performing 322 sitting and standing transitions, both indoor and outdoor, in real-world conditions. The MS5611-BA01 barometric pressure sensor (Measurement Specialties, USA) demonstrated superior performance to counterparts. It discriminates actual sitting and standing transitions from stationary postures with 99.5% accuracy and is also capable to completely dissociate Sit-to-Stand from Stand-to-Sit transitions.
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Acelerometría/instrumentación , Presión Atmosférica , Monitoreo Ambulatorio/instrumentación , Movimiento/fisiología , Postura/fisiología , Actividades Cotidianas , Adulto , Ambiente , Femenino , Humanos , Masculino , Proyectos Piloto , Caminata/fisiologíaRESUMEN
Ligament balance is an important and subjective task performed during total knee arthroplasty (TKA) procedure. For this reason, it is desirable to develop instruments to quantitatively assess the soft-tissue balance since excessive imbalance can accelerate prosthesis wear and lead to early surgical revision. The instrumented distractor proposed in this study can assist surgeons on performing ligament balance by measuring the distraction gap and applied load. Also the device allows the determination of the ligament stiffness which can contribute a better understanding of the intrinsic mechanical behavior of the knee joint. Instrumentation of the device involved the use of hall-sensors for measuring the distractor displacement and strain gauges to transduce the force. The sensors were calibrated and tested to demonstrate their suitability for surgical use. Results show the distraction gap can be measured reliably with 0.1mm accuracy and the distractive loads could be assessed with an accuracy in the range of 4N. These characteristics are consistent with those have been proposed, in this work, for a device that could assist on performing ligament balance while permitting surgeons evaluation based on his experience. Preliminary results from in vitro tests were in accordance with expected stiffness values for medial collateral ligament (MCL) and lateral collateral ligament (LCL).
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Artroplastia de Reemplazo de Rodilla/instrumentación , Elasticidad , Articulación de la Rodilla/fisiopatología , Articulación de la Rodilla/cirugía , Ligamentos/fisiopatología , Ligamentos/cirugía , Artroplastia de Reemplazo de Rodilla/métodos , Fenómenos Biomecánicos , Calibración , Ligamentos Colaterales/fisiopatología , Diseño de Equipo , Fémur , Humanos , Periodo Intraoperatorio , Ligamento Colateral Medial de la Rodilla/fisiopatología , Movimiento/fisiología , Reproducibilidad de los Resultados , TibiaRESUMEN
BACKGROUND: The demand for geriatric rehabilitation will drastically increase over the next years. It will be increasingly important to demonstrate the efficacy and effectiveness of geriatric rehabilitation. One component is the use of objective and valid assessment procedures. These should be understandable to patients, relevant for goal attainment, and able to document change. A number of currently used physical capacity measures have floor effects. The use of body-fixed sensor technology for monitoring physical activity is a possible supplement for the assessment during geriatric rehabilitation to overcome floor effects and directly monitor improvement of mobility as a component of geriatric rehabilitation in many patients. METHODS: The observational study with a pre-post design examined 65 consecutive geriatric hip fracture inpatients. Measurements were performed on admission and 2 weeks later. The capacity measures included gait speed, chair rise time, a balance test, 2-Minute-Walk test and the Timed-Up-and-Go test. Physical activity was measured over 9 h using body-fixed sensor technology and expressed as cumulated walking and walking plus standing (time on feet). RESULTS: Body-fixed sensors allowed direct measurement of physical activity in all patients available for testing. Cumulated walking and standing (time on feet) increased from a median 83.6 to 102.6 min. Cumulated walking increased from a median 7.0 to 16.3 min. The comparison with the physical capacity measures demonstrated a modest to fair correlation (rs = 0.455 and 0.653). This indicates that physical capacity measures are not the same construct as physical activity. CONCLUSION: Body-fixed sensor-based assessment of physical activity was feasible even in geriatric patients with severe mobility problems and decreased the number of patients with missing data both on admission and 2 weeks later. Body-fixed sensor data documented change in activity level.
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Actigrafía/instrumentación , Terapia por Ejercicio , Fijación Interna de Fracturas/rehabilitación , Fracturas de Cadera/diagnóstico , Fracturas de Cadera/rehabilitación , Monitoreo Ambulatorio/instrumentación , Actividad Motora , Actigrafía/métodos , Anciano , Anciano de 80 o más Años , Diseño de Equipo , Análisis de Falla de Equipo , Estudios de Factibilidad , Femenino , Fracturas de Cadera/cirugía , Humanos , Masculino , Persona de Mediana Edad , Monitoreo Ambulatorio/métodos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Resultado del TratamientoRESUMEN
A child's natural gait pattern may be affected by the gait laboratory environment. Wearable devices using body-worn sensors have been developed for gait analysis. The purpose of this study was to validate and explore the use of foot-worn inertial sensors for the measurement of selected spatio-temporal parameters, based on the 3D foot trajectory, in independently walking children with cerebral palsy (CP). We performed a case control study with 14 children with CP aged 6-15 years old and 15 age-matched controls. Accuracy and precision of the foot-worn device were measured using an optical motion capture system as the reference system. Mean accuracy ± precision for both groups was 3.4 ± 4.6 cm for stride length, 4.3 ± 4.2 cm/s for speed and 0.5 ± 2.9° for strike angle. Longer stance and shorter swing phases with an increase in double support were observed in children with CP (p=0.001). Stride length, speed and peak angular velocity during swing were decreased in paretic limbs, with significant differences in strike and lift-off angles. Children with cerebral palsy showed significantly higher inter-stride variability (measured by their coefficient of variation) for speed, stride length, swing and stance. During turning trajectories speed and stride length decreased significantly (p<0.01) for both groups, whereas stance increased significantly (p<0.01) in CP children only. Foot-worn inertial sensors allowed us to analyze gait spatiotemporal data outside a laboratory environment with good accuracy and precision and congruent results with what is known of gait variations during linear walking in children with CP.
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Acelerometría/instrumentación , Parálisis Cerebral/diagnóstico , Pie/fisiopatología , Trastornos Neurológicos de la Marcha/diagnóstico , Adolescente , Fenómenos Biomecánicos , Estudios de Casos y Controles , Parálisis Cerebral/complicaciones , Parálisis Cerebral/fisiopatología , Niño , Femenino , Trastornos Neurológicos de la Marcha/etiología , Trastornos Neurológicos de la Marcha/fisiopatología , Humanos , MasculinoRESUMEN
In clinical settings, the cervical range of motion (ROM) is commonly used to assess cervical spine function. This study aimed at assessing cervical spine mobility based on head and thorax kinematics measured with a wearable inertial system (WS). Sequences of imposed active head movements (lateral bending, axial rotation and flexion-extension) were recorded in ten controls and 13 patients who had undergone an arthrodesis. Orientation of the head relative to the thorax was computed in terms of 3D helical angles and compared with the values obtained using an optoelectronic reference system (RS). Movement patterns from WS and RS showed excellent concurrent validity (CMC up to 1.00), but presented slight differences of bias (mean bias<2.5°) and dispersion (mean dispersion<4.2°). ROM obtained using WS also showed some differences compared to RS (mean difference<5.7°), within the range of those reported in literature. WS enabled the observation of the same significant differences between controls and patients as RS. Moreover, ROM from WS presented good test-retest repeatability (ICC between 0.63 and 0.99 and SEM<6.2°). In conclusion, WS can provide angles and ROM comparable to those obtained with RS and relevant for the cervical assessment after treatment.