Development of a network system combined with ambulatory and non-conscious physiological measurements for supporting challenged kids - a new proposal of a gait monitoring system for use in rehabilitation.

Various physiological measurement techniques have been developed to support healthcare and daily living of adult including elderly. However, in light of the rapid growth of the declining birth rate, promotion in care and life support for children are not enough. Especially in rehabilitation for disabled children, i.e., challenged kids, it is important for therapist to evaluate the efficacy of rehabilitation and the health condition. Share of these information with educational, welfare, and government institutions are also needed for accurate life support. Therefore, the quantitative data of the activities and daily health status are helpful. From these viewpoints, we are developing a new network system for monitoring the activities and the health status of children using ambulatory and non-conscious physiological measurements as well as data browse at anytime and anywhere. Firstly, we propose a wearable gait monitoring system to support evaluation for the efficacy of rehabilitation. In this study, the present system can successfully detect the characteristics of postural changes in children with disorder of movement, demonstrating its usefulness and availability to the evaluation for the effect of the brace attached to the subject's lower limb.

Dysfunctional cortical connectivity during the auditory oddball task in patients with schizophrenia.

BACKGROUND: We studied the imaginary coherence (IC) of gamma frequency oscillations between brain regions of male schizophrenia patients during an auditory oddball task using magnetoencephalography (MEG) and electroencephalography (EEG). METHODS: Subjects were 10 right-handed male schizophrenia patients, evaluated by the positive and negative symptom scale (PANSS), and 10 healthy controls. Functional connectivity during the auditory oddball task was reconstructed in low (30-50 Hz) and high (50-100 Hz) gamma bands, and represented by imaginary coherence (IC) based on significant oscillatory power changes. We calculated correlations between PANSS scores and IC. RESULTS: In the high gamma band, IC between left occipital and right prefrontal lobe areas during the time window 750-1000 ms from stimulus onset showed negative correlations with total negative scores, total positive scores, the sum of positive and negative scores in PANSS, conceptual disorganization, and social avoidance scores. In the low gamma band, IC between the same areas from 250-500 ms also showed a negative correlation with the conceptual disorganization score. In the same time window, IC between left occipital and right frontoparietal lobe areas in the low gamma band showed a positive correlation with hallucinatory behavior; IC between right temporal pole and left prefrontal lobe areas showed a positive correlation with delusion scores, although these ICs were decreased relative to controls. CONCLUSIONS: Functional disconnection of high and low gamma bands in auditory oddball task may play an important role in the auditory processing in schizophrenia patients.

Development of a ubiquitous healthcare monitoring system combined with non-conscious and ambulatory physiological measurements and its application to medical care.

The demand for ubiquitous healthcare monitoring has been increasingly raised for prevention of lifestyle-related diseases, acute life support or chronic therapies for inpatients and/or outpatients having chronic disorder and home medical care. From these view points, we developed a non-conscious healthcare monitoring system without any attachment of biological sensors and operations of devices, and an ambulatory postural changes and activities monitoring system. Furthermore in this study, in order to investigate those applicability to the ubiquitous healthcare monitoring, we have developed a new healthcare monitoring system combined with the non-conscious and the ambulatory measurements developed by us. In patients with chronic cardiovascular disease or stroke, the daily health conditions such as pulse, respiration, activities and so on, could be continuously measured in the hospital, the rehabilitation room and subject's own home, using the present system. The results demonstrated that the system appears useful for the ubiquitous healthcare monitoring not only at medical facility, but also during daily living at home.

A fully automated health-care monitoring at home without attachment of any biological sensors and its clinical evaluation.

Daily monitoring of health condition is important for an effective scheme for early diagnosis, treatment and prevention of lifestyle-related diseases such as adiposis, diabetes, cardiovascular diseases and other diseases. Commercially available devices for health care monitoring at home are cumbersome in terms of self-attachment of biological sensors and self-operation of the devices. From this viewpoint, we have been developing a non-conscious physiological monitor installed in a bath, a lavatory, and a bed for home health care and evaluated its measurement accuracy by simultaneous recordings of a biological sensors directly attached to the body surface. In order to investigate its applicability to health condition monitoring, we have further developed a new monitoring system which can automatically monitor and store the health condition data. In this study, by evaluation on 3 patients with cardiac infarct or sleep apnea syndrome, patients' health condition such as body and excretion weight in the toilet and apnea and hypopnea during sleeping were successfully monitored, indicating that the system appears useful for monitoring the health condition during daily living.

PC-based rehabilitation tool for the elderly.

The elderly can sometimes find rehabilitation training to be very boring, but if the participants are motivated or having fun, they will continue to exercise. Prevention is the most important issue for health care insurance in Japan, and since suitable training will improve the quality of life, we developed personal computer (PC)-based rehabilitation tools to help the elderly maintain balance and muscle strength. After using the balance-training device, the subjects were able to keep better balance, and the muscle-training device resulted in an energy expenditure of around 2 METs fewer than walking. The results indicate that PC-based rehabilitation tools are effective for maintaining physical exercise.

Examining the influence of the cerebral cortex in range of motion exercise using MEG.

In rehabilitating stroke patients, many therapists use range of motion exercise (ROM-ex) at early post onset. There are three general types of ROM-ex: passive, active, and active-assistive ROM-ex is used to prevent joint contracture in paralyzed limbs and to assist in recovery of the central nervous system (CNS). However, its effect on CNS recovery is unclear. Therefore, this study compared the influence of different tasks, including passive and active ROM-ex and imagined extension/flexion at the elbow, on the cerebral cortex. The subjects were six healthy volunteers. We used a magnetoencephalogram (MEG) to measure cerebral cortex activity. In the active ROM-ex task, we confirmed a dipole in the motor area in all subjects. It has been suggested that this dipole is activity of the motor-related field (MRF). By contrast, in the passive ROM-ex experiment, we did not confirm a dipole in the cortex. In addition, in the experiment with no joint motion, in which the subject only imagined moving the elbow joint from flexion to extension, it was possible to estimate a dipole in the motor area. Therefore, an imaginary task might be a possible method of activation when voluntary movement is impossible.

The influence of floor material on standing and walking by hemiplegic patients.

In this study, we evaluated the influence of floor materials on standing and walking in hemiplegic patients. To monitor body motion during standing and walking without any constraint, we used a measurement system that consisted of an accelerometer device, a telemeter system, and a personal computer. The posture angles in the antero-posterior and lateral directions were calculated from the low frequency component of the acceleration signal to evaluate body motion. Experiments were performed with six poststroke hemiplegic patients. We modified the time up and go test introduced by Podsiadle. The patients executed the task on three different floor materials: wooden flooring, linoleum, and carpet. The posture angle pattern on carpet differed from those on wooden flooring and linoleum. Therefore, the floor material influenced body motion. We suspect that this difference in movement corresponds to the hardness of the material.