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1.
J Neurophysiol ; 130(1): 168-178, 2023 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-37341419

RESUMO

The present study investigates the statistics and spectral content of natural vestibular stimuli experienced by healthy human subjects during three unconstrained activities. More specifically, we assessed how the characteristics of vestibular inputs are altered during the operation of a complex human-machine interface (a flight in a helicopter simulator) compared with more ecological tasks, namely a walk in an office space and a seated visual exploration task. As previously reported, we found that the power spectra of vestibular stimuli experienced during self-navigation could be modeled by two power laws but noted a potential effect of task intensity on the transition frequency between the two fits. In contrast, both tasks that required a seated position had power spectra that were better described by an inverted U shape in all planes of motion. Taken together, our results suggest that 1) walking elicits stereotyped vestibular inputs whose power spectra can be modeled by two power laws that intersect at a task intensity-dependent frequency; 2) body posture induces changes in the frequency content of vestibular information; 3) pilots tend to operate their aircraft in a way that does not generate highly nonecological vestibular stimuli; and 4) nevertheless, human-machine interfaces used as a means of manual navigation still impose some unnatural, contextual constraints on their operators.NEW & NOTEWORTHY Building upon previously published research, this study assesses and compares the vestibular stimuli experienced by healthy subjects in natural tasks and during the interaction with a complex machine: a helicopter simulator. Our results suggest the existence of an anatomical filter, meaning that body posture shapes vestibular spectral content. Our findings further indicate that operators control their machine within a constrained operating range such that they experience vestibular stimulations that are as ecological as possible.


Assuntos
Vestíbulo do Labirinto , Humanos , Postura , Movimento (Física) , Aeronaves , Orientação Espacial
2.
Exp Brain Res ; 239(5): 1359-1380, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33675378

RESUMO

Even for a stereotyped task, sensorimotor behavior is generally variable due to noise, redundancy, adaptability, learning or plasticity. The sources and significance of different kinds of behavioral variability have attracted considerable attention in recent years. However, the idea that part of this variability depends on unique individual strategies has been explored to a lesser extent. In particular, the notion of style recurs infrequently in the literature on sensorimotor behavior. In general use, style refers to a distinctive manner or custom of behaving oneself or of doing something, especially one that is typical of a person, group of people, place, context, or period. The application of the term to the domain of perceptual and motor phenomenology opens new perspectives on the nature of behavioral variability, perspectives that are complementary to those typically considered in the studies of sensorimotor variability. In particular, the concept of style may help toward the development of personalised physiology and medicine by providing markers of individual behaviour and response to different stimuli or treatments. Here, we cover some potential applications of the concept of perceptual-motor style to different areas of neuroscience, both in the healthy and the diseased. We prefer to be as general as possible in the types of applications we consider, even at the expense of running the risk of encompassing loosely related studies, given the relative novelty of the introduction of the term perceptual-motor style in neurosciences.


Assuntos
Aprendizagem , Humanos
3.
J Clin Monit Comput ; 35(5): 993-1005, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-32661827

RESUMO

Assessing the depth of anesthesia (DoA) is a daily challenge for anesthesiologists. The best assessment of the depth of anesthesia is commonly thought to be the one made by the doctor in charge of the patient. This evaluation is based on the integration of several parameters including epidemiological, pharmacological and physiological data. By developing a protocol to record synchronously all these parameters we aim at having this evaluation made by an algorithm. Our hypothesis was that the standard parameters recorded during anesthesia (without EEG) could provide a good insight into the consciousness level of the patient. We developed a complete solution for high-resolution longitudinal follow-up of patients during anesthesia. A Hidden Markov Model (HMM) was trained on the database in order to predict and assess states based on four physiological variables that were adjusted to the consciousness level: Heart Rate (HR), Mean Blood Pressure (MeanBP) Respiratory Rate (RR), and AA Inspiratory Concentration (AAFi) all without using EEG recordings. Patients undergoing general anesthesia for hernial inguinal repair were included after informed consent. The algorithm was tested on 30 patients. The percentage of error to identify the actual state among Awake, LOC, Anesthesia, ROC and Emergence was 18%. This protocol constitutes the very first step on the way towards a multimodal approach of anesthesia. The fact that our first classifier already demonstrated a good predictability is very encouraging for the future. Indeed, this first model was merely a proof of concept to encourage research ways in the field of machine learning and anesthesia.


Assuntos
Estado de Consciência , Eletroencefalografia , Algoritmos , Anestesia Geral , Anestesiologistas , Humanos
4.
J Neurophysiol ; 123(6): 2269-2284, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32319842

RESUMO

Humans exhibit various motor styles that reflect their intra- and interindividual variability when implementing sensorimotor transformations. This opens important questions, such as, At what point should they be readjusted to maintain optimal motor control? Do changes in motor style reveal the onset of a pathological process and can these changes help rehabilitation and recovery? To further investigate the concept of motor style, tests were carried out to quantify posture at rest and motor control in 18 healthy subjects under four conditions: walking at three velocities (comfortable walking, walking at 4 km/h, and race walking) and running at maximum velocity. The results suggest that motor control can be conveniently decomposed into a static component (a stable configuration of the head and column with respect to the gravitational vertical) and dynamic components (head, trunk, and limb movements) in humans, as in quadrupeds, and both at rest and during locomotion. These skeletal configurations provide static markers to quantify the motor style of individuals because they exhibit large variability among subjects. Also, using four measurements (jerk, root mean square, sample entropy, and the two-thirds power law), it was shown that the dynamics were variable at both intra- and interindividual levels during locomotion. Variability increased following a head-to -toe gradient. These findings led us to select dynamic markers that could define, together with static markers, the motor style of a subject. Finally, our results support the view that postural and motor control are subserved by different neuronal networks in frontal, sagittal, and transversal planes.NEW & NOTEWORTHY During human locomotion, motor control can be conveniently decomposed into a static and dynamic components. Variable dynamics were observed at both the intra- and interindividual levels during locomotion. Variability increased following a head-to-toe gradient. Finally, our results support the view that postural and motor control are subserved by different neuronal networks in the frontal, sagittal, and transversal planes.


Assuntos
Fenômenos Biomecânicos/fisiologia , Atividade Motora/fisiologia , Rede Nervosa/fisiologia , Corrida/fisiologia , Caminhada/fisiologia , Adulto , Feminino , Humanos , Individualidade , Masculino , Pessoa de Meia-Idade , Adulto Jovem
5.
Sensors (Basel) ; 20(7)2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-32235667

RESUMO

The automatic detection of gait events (i.e., Initial Contact (IC) and Final Contact (FC)) is crucial for the characterisation of gait from Inertial Measurements Units. In this article, we present a method for detecting steps (i.e., IC and FC) from signals of gait sequences of individuals recorded with a gyrometer. The proposed approach combines the use of a dictionary of templates and a Dynamic Time Warping (DTW) measure of fit to retrieve these templates into input signals. Several strategies for choosing and learning the adequate templates from annotated data are also described. The method is tested on thirteen healthy subjects and compared to gold standard. Depending of the template choice, the proposed algorithm achieves average errors from 0.01 to 0.03 s for the detection of IC, FC and step duration. Results demonstrate that the use of DTW allows achieving these performances with only one single template. DTW is a convenient tool to perform pattern recognition on gait gyrometer signals. This study paves the way for new step detection methods: it shows that using one single template associated with non-linear deformations may be sufficient to model the gait of healthy subjects.


Assuntos
Marcha/fisiologia , Locomoção/fisiologia , Adulto , Algoritmos , Feminino , Humanos , Masculino , Adulto Jovem
6.
Sensors (Basel) ; 19(14)2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31336957

RESUMO

Gait assessment and quantification have received an increased interest in recent years. Embedded technologies and low-cost sensors can be used for the longitudinal follow-up of various populations (neurological diseases, elderly, etc.). However, the comparison of two gait trials remains a tricky question as standard gait features may prove to be insufficient in some cases. This article describes a new algorithm for comparing two gait trials recorded with inertial measurement units (IMUs). This algorithm uses a library of step templates extracted from one trial and attempts to detect similar steps in the second trial through a greedy template matching approach. The output of our method is a similarity index (SId) comprised between 0 and 1 that reflects the similarity between the patterns observed in both trials. Results on healthy and multiple sclerosis subjects show that this new comparison tool can be used for both inter-individual comparison and longitudinal follow-up.

7.
Sensors (Basel) ; 18(11)2018 Nov 19.
Artigo em Inglês | MEDLINE | ID: mdl-30463240

RESUMO

This article presents a method for step detection from accelerometer and gyrometer signals recorded with Inertial Measurement Units (IMUs). The principle of our step detection algorithm is to recognize the start and end times of the steps in the signal thanks to a predefined library of templates. The algorithm is tested on a database of 1020 recordings, composed of healthy subjects and patients with various neurological or orthopedic troubles. Simulations on more than 40,000 steps show that the template-based method achieves remarkable results with a 98% recall and a 98% precision. The method adapts well to pathological subjects and can be used in a medical context for robust step estimation and gait characterization.

8.
J Neurosci ; 33(16): 6845-56, 2013 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-23595743

RESUMO

Adolescent idiopathic scoliosis in humans is often associated with vestibulomotor deficits. Compatible with a vestibular origin, scoliotic deformations were provoked in adult Xenopus frogs by unilateral labyrinthectomy (UL) at larval stages. The aquatic ecophysiology and absence of body-weight-supporting limb proprioceptive signals in amphibian tadpoles as a potential sensory substitute after UL might be the cause for a persistent asymmetric descending vestibulospinal activity. Therefore, peripheral vestibular lesions in larval Xenopus were used to reveal the morphophysiological alterations at the cellular and network levels. As a result, spinal motor nerves that were modulated by the previously intact side before UL remained permanently silent during natural vestibular stimulation after the lesion. In addition, retrograde tracing of descending pathways revealed a loss of vestibular neurons on the ipsilesional side with crossed vestibulospinal projections. This loss facilitated a general mass imbalance in descending premotor activity and a permanent asymmetric motor drive to the axial musculature. Therefore, we propose that the persistent asymmetric contraction of trunk muscles exerts a constant, uncompensated differential mechanical pull on bilateral skeletal elements that enforces a distortion of the soft cartilaginous skeletal elements and bone shapes. This ultimately provokes severe scoliotic deformations during ontogenetic development similar to the human syndrome.


Assuntos
Lateralidade Funcional/fisiologia , Doenças Neurodegenerativas/etiologia , Plasticidade Neuronal/fisiologia , Escoliose/etiologia , Medula Espinal/fisiologia , Vestíbulo do Labirinto/lesões , Vestíbulo do Labirinto/fisiologia , Doenças do Nervo Vestibulococlear/complicações , Animais , Modelos Animais de Doenças , Potenciais Evocados/fisiologia , Feminino , Fluoresceínas/metabolismo , Técnicas In Vitro , Larva , Masculino , Doenças Musculares/etiologia , Vias Neurais , Transtornos de Sensação/etiologia , Estatísticas não Paramétricas , Fatores de Tempo , Xenopus
9.
Physiol Rep ; 11(3): e15374, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36780905

RESUMO

Neurophysiological tests probing the vestibulo-ocular, colic and spinal pathways are the gold standard to evaluate the vestibular system in clinics. In contrast, vestibular perception is rarely tested despite its potential usefulness in professional training and for the longitudinal follow-up of professionals dealing with complex man-machine interfaces, such as aircraft pilots. This is explored here using a helicopter flight simulator to probe the vestibular perception of pilots. The vestibular perception of nine professional helicopter pilots was tested using a full flight helicopter simulator. The cabin was tilted six times in roll and six times in pitch (-15°, -10°, -5°, 5°, 10° and 15°) while the pilots had no visual cue. The velocities of the outbound displacement of the cabin were kept below the threshold of the semicircular canal perception. After the completion of each movement, the pilots were asked to put the cabin back in the horizontal plane (still without visual cues). The order of the 12 trials was randomized with two additional control trials where the cabin stayed in the horizontal plane but rotated in yaw (-10° and +10°). Pilots were significantly more precise in roll (average error in roll: 1.15 ± 0.67°) than in pitch (average error in pitch: 2.89 ± 1.06°) (Wilcoxon signed-rank test: p < 0.01). However, we did not find a significant difference either between left and right roll tilts (p = 0.51) or between forward and backward pitch tilts (p = 0.59). Furthermore, we found that the accuracies were significantly biased with respect to the initial tilt. The greater the initial tilt was, the less precise the pilots were, although maintaining the direction of the tilt, meaning that the error can be expressed as a vestibular error gain in the ability to perceive the modification in the orientation. This significant result was found in both roll (Friedman test: p < 0.01) and pitch (p < 0.001). However, the pitch trend error was more prominent (gain = 0.77 vs gain = 0.93) than roll. This study is a first step in the determination of the perceptive-motor profile of pilots, which could be of major use for their training and their longitudinal follow-up. A similar protocol may also be useful in clinics to monitor the aging process of the otolith system with a simplified testing device.


Assuntos
Vestíbulo do Labirinto , Humanos , Vestíbulo do Labirinto/fisiologia , Canais Semicirculares/fisiologia , Movimento , Olho , Percepção
10.
Front Hum Neurosci ; 17: 1228195, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38283095

RESUMO

In a recent review, we summarized the characteristics of perceptual-motor style in humans. Style can vary from individual to individual, task to task and pathology to pathology, as sensorimotor transformations demonstrate considerable adaptability and plasticity. Although the behavioral evidence for individual styles is substantial, much remains to be done to understand the neural and mechanical substrates of inter-individual differences in sensorimotor performance. In this study, we aimed to investigate the modulation of perceptual-motor style during locomotion at height in 16 persons with no history of fear of heights or acrophobia. We used an inexpensive virtual reality (VR) video game. In this VR game, Richie's Plank, the person progresses on a narrow plank placed between two buildings at the height of the 30th floor. Our first finding was that the static markers (head, trunk and limb configurations relative to the gravitational vertical) and some dynamic markers (jerk, root mean square, sample entropy and two-thirds power law at head, trunk and limb level) we had previously identified to define perceptual motor style during locomotion could account for fear modulation during VR play. Our second surprising result was the heterogeneity of this modulation in the 16 young, healthy individuals exposed to moving at a height. Finally, 56% of participants showed a persistent change in at least one variable of their skeletal configuration and 61% in one variable of their dynamic control during ground locomotion after exposure to height.

11.
J Neurol ; 270(2): 618-631, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35817988

RESUMO

Nowadays, it becomes of paramount societal importance to support many frail-prone groups in our society (elderly, patients with neurodegenerative diseases, etc.) to remain socially and physically active, maintain their quality of life, and avoid their loss of autonomy. Once older people enter the prefrail stage, they are already likely to experience falls whose consequences may accelerate the deterioration of their quality of life (injuries, fear of falling, reduction of physical activity). In that context, detecting frailty and high risk of fall at an early stage is the first line of defense against the detrimental consequences of fall. The second line of defense would be to develop original protocols to detect future fallers before any fall occur. This paper briefly summarizes the current advancements and perspectives that may arise from the combination of affordable and easy-to-use non-wearable systems (force platforms, 3D tracking motion systems), wearable systems (accelerometers, gyroscopes, inertial measurement units-IMUs) with appropriate machine learning analytics, as well as the efforts to address these challenges.


Assuntos
Fragilidade , Qualidade de Vida , Humanos , Idoso , Medo , Aprendizado de Máquina
12.
J Neurophysiol ; 107(2): 704-17, 2012 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22049337

RESUMO

Context-specific adaptation (Shelhamer M, Clendaniel R. Neurosci Lett 332: 200-204, 2002) explains that reflexive responses can be maintained with different "calibrations" for different situations (contexts). Which context cues are crucial and how they combine to evoke context-specific adaptation is not fully understood. Gaze stabilization in birds is a nice model with which to tackle that question. Previous data showed that when pigeons (Columba livia) were hung in a harness and subjected to a frontal airstream provoking a flying posture ("flying condition"), the working range of the optokinetic head response [optocollic reflex (OCR)] extended toward higher velocities compared with the "resting condition." The present study was aimed at identifying which context cues are instrumental in recalibrating the OCR. We investigated that question by using vibrating stimuli delivered during the OCR provoked by rotating the visual surroundings at different velocities. The OCR gain increase and the boost of the fast phase velocity observed during the "flying condition" were mimicked by body vibration. On the other hand, the newly emerged relationship between the fast-phase and slow-phase velocities in the "flying condition" was mimicked by head vibration. Spinal cord lesion at the lumbosacral level decreased the effects of body vibration, whereas lesions of the lumbosacral apparatus had no effect. Our data suggest a major role of muscular proprioception in the context-specific adaptation of the stabilizing behavior, while the vestibular system could contribute to the context-specific adaptation of the orienting behavior. Participation of an efferent copy of the motor command driving the flight cannot be excluded.


Assuntos
Adaptação Fisiológica/fisiologia , Columbidae/fisiologia , Sinais (Psicologia) , Nistagmo Optocinético/fisiologia , Reflexo Vestíbulo-Ocular/fisiologia , Animais , Eletrólise/efeitos adversos , Voo Animal , Movimentos da Cabeça , Região Lombossacral/lesões , Região Lombossacral/fisiologia , Neomicina/efeitos adversos , Estimulação Luminosa , Reflexo/fisiologia , Descanso , Traumatismos da Medula Espinal/etiologia , Traumatismos da Medula Espinal/fisiopatologia , Fatores de Tempo , Vibração
13.
Ear Hear ; 33(1): 118-23, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-21904203

RESUMO

OBJECTIVE: To determine in a guinea pig model the factors of invasiveness of a bipolar electrode implanted in the horizontal semicircular canal (HSC) and to evaluate the consequences on hearing of electrical stimulation of the ampullary nerve. DESIGN: Sixteen guinea pigs divided into four groups underwent surgical opening of the HSC of one ear as follows: control (group 1), cyanoacrylate glue application on the HSC opening (group 2), electrode implantation with cyanoacrylate glue on the HSC opening (group 3), and electrode implantation with electrical stimulation (1 hr/day) for 9 days (group 4). Auditory brainstem responses were recorded before and after surgery and after electrical stimulation. The effectiveness of electrical stimulation in producing a horizontal vestibulo-ocular reflex was evaluated by recording eye movement with video-oculography. RESULTS: Group 1 animals showed hearing loss, and in group 2, sealing the HSC opening with cyanoacrylate glue preserved the hearing thresholds. After electrode implantation, seven of the eight animals showed hearing loss compared with preoperative values. Electrical stimulation did not induce additional hearing loss. CONCLUSION: Electrode implantation at the canal level entailed a risk of hearing loss in an animal model, but electrical stimulation of the horizontal ampullary nerve did not further alter hearing function.


Assuntos
Terapia por Estimulação Elétrica/métodos , Eletrodos Implantados , Perda Auditiva/prevenção & controle , Canais Semicirculares/fisiologia , Doenças Vestibulares/terapia , Nervo Vestibular/fisiologia , Animais , Limiar Auditivo/fisiologia , Cianoacrilatos , Modelos Animais de Doenças , Potenciais Evocados Auditivos do Tronco Encefálico/fisiologia , Movimentos Oculares/fisiologia , Cobaias , Audição/fisiologia , Masculino , Complicações Pós-Operatórias/prevenção & controle , Reflexo Vestíbulo-Ocular/fisiologia , Canais Semicirculares/inervação , Doenças Vestibulares/cirurgia
14.
Eur J Ophthalmol ; 32(6): 3258-3266, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35345916

RESUMO

INTRODUCTION: While paramacular retinal atrophy (PRA) is known to be found in 48% of eyes of adults and 42% of eyes of children with homozygous SCD (SS-SCD), the aim of this study is to assess the association between PRA and red blood cell (RBC) deformability, hematological markers and brain imaging abnormalities in SS-SCD. METHODS: This study is a subset of DREAM2, a prospective observational study performed between August 2015 and August 2016. Children (5-17 years) with SS-SCD and no history of large vessel vasculopathy, were included. Ophthalmological characteristics including visual acuity, fundus examination, OCT of central and temporal retina (with several retinal thickness measurements) were explored in relation with RBC deformability (ektacytometry), hematological and biochemical (hemolysis parameters), and neurological (cerebral oxygenation estimated by Near Infrared Spectroscopy, brain magnetic resonance imaging) investigations. RESULTS: 17 children (5 boys; mean age: 13 years) with complete ophthalmological investigations were included in the analysis; 8 exhibited PRA. RBC deformability was found to be significantly lower in children with PRA for measurements made at 1.69 Pa (0.16 a.u ± 0.02 vs 0.21 a.u ± 0.03, p = 0.02) and above, as well as cerebral oxygenation (59.25% ± 9.9 vs 71.53% ± 4.9, p = 0.02). A significant positive correlation was found between temporal retinal thickness and hemoglobin level (ρ = 0.65, p = 0.007), hematocrit (ρ = 0.53, p = 0.04) and RBC deformability at 3 Pa (ρ = 0.75, p = 0.005) and above. CONCLUSIONS: These results suggest that PRA could be an early marker of systemic severity and cerebral oxygenation in SCD. Whether it could help predicting cerebral vasculopathy requires further investigations.


Assuntos
Anemia Falciforme , Doenças Retinianas , Adolescente , Adulto , Anemia Falciforme/complicações , Anemia Falciforme/diagnóstico , Atrofia/patologia , Criança , Hemoglobinas , Humanos , Masculino , Retina/patologia , Doenças Retinianas/diagnóstico , Doenças Retinianas/etiologia , Doenças Retinianas/patologia , Tomografia de Coerência Óptica/métodos
15.
Exp Brain Res ; 210(3-4): 423-36, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21331527

RESUMO

Numerous studies in rodents have shown that the functional efficacy of several neurotransmitter receptors and the intrinsic membrane excitability of central vestibular neurons, as well as the organization of synaptic connections within and between vestibular nuclei can be modified during postnatal development, after a lesion of peripheral vestibular organs or in vestibular-deficient mutant animals. This review mainly focuses on the intrinsic membrane properties of neurons of the medial vestibular nuclei of rodents, their postnatal maturation, and changes following experimental or congenital alterations in vestibular inputs. It also presents the concomitant modifications in the distribution of these neurons into different neuron types, which has been based on their membrane properties in relation to their anatomical, biochemical, or functional properties. The main points discussed in this review are that (1) the intrinsic membrane properties can be used to distinguish between two dominant types of neurons, (2) the system remains plastic throughout the whole life of the animal, and finally, (3) the intracellular calcium concentration has a major effect on the intrinsic membrane properties of central vestibular neurons.


Assuntos
Membrana Celular/fisiologia , Modelos Neurológicos , Células Receptoras Sensoriais/citologia , Núcleos Vestibulares/citologia , Potenciais de Ação/fisiologia , Animais , Animais Recém-Nascidos , Cálcio/metabolismo , Técnicas In Vitro , Camundongos , Camundongos Mutantes , Modelos Estatísticos , Plasticidade Neuronal/fisiologia , Ratos , Roedores , Células Receptoras Sensoriais/fisiologia , Núcleos Vestibulares/crescimento & desenvolvimento
16.
PLoS One ; 16(2): e0246790, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33630865

RESUMO

Falling in Parkinsonian syndromes (PS) is associated with postural instability and consists a common cause of disability among PS patients. Current posturographic practices record the body's center-of-pressure displacement (statokinesigram) while the patient stands on a force platform. Statokinesigrams, after appropriate processing, can offer numerous posturographic features. This fact, although beneficial, challenges the efforts for valid statistics via standard univariate approaches. In this work, 123 PS patients were classified into fallers (PSF) or non-faller (PSNF) based on the clinical assessment, and underwent simple Romberg Test (eyes open/eyes closed). We developed a non-parametric multivariate two-sample test (ts-AUC) based on machine learning, in order to examine statokinesigrams' differences between PSF and PSNF. We analyzed posturographic features using both multiple testing with p-value adjustment and ts-AUC. While ts-AUC showed significant difference between groups (p-value = 0.01), multiple testing did not agree with this result (eyes open). PSF showed significantly increased antero-posterior movements as well as increased posturographic area compared to PSNF. Our study highlights the superiority of ts-AUC compared to standard statistical tools in distinguishing PSF and PSNF in multidimensional space. Machine learning-based statistical tests can be seen as a natural extension of classical statistics and should be considered, especially when dealing with multifactorial assessments.


Assuntos
Acidentes por Quedas , Aprendizado de Máquina , Modelos Neurológicos , Transtornos Parkinsonianos/fisiopatologia , Equilíbrio Postural , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Transtornos Parkinsonianos/patologia
17.
Contemp Clin Trials Commun ; 22: 100786, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34159279

RESUMO

The aging of the population is leading to an increase in the number of people with loss of autonomy, placing a strain on the health care system. Its prevention at early stages such as the frailty stage would allow an improvement in the quality of life of seniors while limiting health care expenses. The "Atout Age" prevention program set up by the health public authorities of Reunion Island for retired people and the new frailty assessment tools based on mathematical machine learning algorithms could improve the ambulatory care of senior citizens. At present, referral care remains hospital with comprehensive geriatric assessment and there is a lack of evidence of the effectiveness of a prevention pathway for loss of autonomy in primary care. For these reasons, the 5P program "Personalized and Participative Primary Prevention Pathway" has been started in order to obtain scientific evidence. In this article, we present the objectives, design and first results, used in the 5P program up to the implementation of a clinical trial in general practice. The program is articulated in 3 phases. A first phase to evaluate the acceptability of innovative screening tools for frailty. A second pilot phase evaluates the feasibility of a large-scale ambulatory clinical trial in general practice. The last phase described in this article, is a multisite, pseudo-randomized, controlled clinical trial measuring the impact of the "Atout Age" workshops on the physical performance and the quality of life of seniors compared with their usual ambulatory follow-up.

18.
Physiol Rep ; 9(22): e15067, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34826208

RESUMO

Postural control is often quantified by recording the trajectory of the center of pressure (COP)-also called stabilogram-during human quiet standing. This quantification has many important applications, such as the early detection of balance degradation to prevent falls, a crucial task whose relevance increases with the aging of the population. Due to the complexity of the quantification process, the analyses of sway patterns have been performed empirically using a number of variables, such as ellipse confidence area or mean velocity. This study reviews and compares a wide range of state-of-the-art variables that are used to assess the risk of fall in elderly from a stabilogram. When appropriate, we discuss the hypothesis and mathematical assumptions that underlie these variables, and we propose a reproducible method to compute each of them. Additionally, we provide a statistical description of their behavior on two datasets recorded in two elderly populations and with different protocols, to hint at typical values of these variables. First, the balance of 133 elderly individuals, including 32 fallers, was measured on a relatively inexpensive, portable force platform (Wii Balance Board, Nintendo) with a 25-s open-eyes protocol. Second, the recordings of 76 elderly individuals, from an open access database commonly used to test static balance analyses, were used to compute the values of the variables on 60-s eyes-open recordings with a research laboratory standard force platform.


Assuntos
Acidentes por Quedas , Algoritmos , Equilíbrio Postural , Idoso , Fenômenos Biomecânicos , Bases de Dados Factuais , Humanos , Medição de Risco
19.
Front Bioeng Biotechnol ; 9: 782740, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35127666

RESUMO

Measuring the quality of movement is a need and a challenge for clinicians. Jerk, defined as the quantity of acceleration variation, is a kinematic parameter used to assess the smoothness of movement. We aimed to assess and compare jerk metrics in asymptomatic participants for 3 important movement characteristics that are considered by clinicians during shoulder examination: dominant and non-dominant side, concentric and eccentric contraction mode, and arm elevation plane. In this pilot study, we measured jerk metrics by using Xsens® inertial measurement units strapped to the wrists for 11 different active arm movements (ascending and lowering phases): 3 bilateral maximal arm elevations in sagittal, scapular and frontal plane; 2 unilateral functional movements (hair combing and low back washing); and 2 unilateral maximal arm elevations in sagittal and scapular plane, performed with both arms alternately, right arm first. Each arm movement was repeated 3 times successively and the whole procedure was performed 3 times on different days. The recorded time series was segmented with semi-supervised algorithms. Comparisons involved the Wilcoxon signed rank test (p < 0.05) with Bonferroni correction. We included 30 right-handed asymptomatic individuals [17 men, mean (SD) age 31.9 (11.4) years]. Right jerk was significantly less than left jerk for bilateral arm elevations in all planes (all p < 0.05) and for functional movement (p < 0.05). Jerk was significantly reduced during the concentric (ascending) phase than eccentric (lowering) phase for bilateral and unilateral right and left arm elevations in all planes (all p < 0.05). Jerk during bilateral arm elevation was significantly reduced in the sagittal and scapular planes versus the frontal plane (both p < 0.01) and in the sagittal versus scapular plane (p < 0.05). Jerk during unilateral left arm elevation was significantly reduced in the sagittal versus scapular plane (p < 0.05). Jerk metrics did not differ between sagittal and scapular unilateral right arm elevation. Using inertial measurement units, jerk metrics can well describe differences between the dominant and non-dominant arm, concentric and eccentric modes and planes in arm elevation. Jerk metrics were reduced during arm movements performed with the dominant right arm during the concentric phase and in the sagittal plane. Using IMUs, jerk metrics are a promising method to assess the quality of basic shoulder movement.

20.
J Neurosci ; 29(40): 12477-83, 2009 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-19812323

RESUMO

Human idiopathic scoliosis is characterized by severe deformations of the spine and skeleton. The occurrence of vestibular-related deficits in these patients is well established but it is unclear whether a vestibular pathology is the common cause for the scoliotic syndrome and the gaze/posture deficits or if the latter behavioral deficits are a consequence of the scoliotic deformations. A possible vestibular origin was tested in the frog Xenopus laevis by unilateral removal of the labyrinthine endorgans at larval stages. After metamorphosis into young adult frogs, X-ray images and three-dimensional reconstructed micro-computer tomographic scans of the skeleton showed deformations similar to those of scoliotic patients. The skeletal distortions consisted of a curvature of the spine in the frontal and sagittal plane, a transverse rotation along the body axis and substantial deformations of all vertebrae. In terrestrial vertebrates, the initial postural syndrome after unilateral labyrinthectomy recovers over time and requires body weight-supporting limb proprioceptive information. In an aquatic environment, however, this information is absent. Hence, the lesion-induced asymmetric activity in descending spinal pathways and the resulting asymmetric muscular tonus persists. As a consequence the mostly cartilaginous skeleton of the frog tadpoles progressively deforms. Lack of limb proprioceptive signals in an aquatic environment is thus the element, which links the Xenopus model with human scoliosis because a comparable situation occurs during gestation in utero. A permanently imbalanced activity in descending locomotor/posture control pathways might be the common origin for the observed structural and behavioral deficits in humans as in the different animal models of scoliosis.


Assuntos
Modelos Animais de Doenças , Escoliose/etiologia , Doenças Vestibulares/complicações , Animais , Orelha Interna/cirurgia , Lateralidade Funcional , Processamento de Imagem Assistida por Computador , Larva/crescimento & desenvolvimento , Postura , Radiografia , Escoliose/diagnóstico por imagem , Xenopus laevis
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