Smart Floor Mats for a Health Monitoring System Based on Textile Pressure Sensing: Development and Usability Study.

BACKGROUND: The rise in single-person households has resulted in social problems like loneliness and isolation, commonly known as "death by loneliness." Various factors contribute to this increase, including a desire for independent living and communication challenges within families due to societal changes. Older individuals living alone are particularly susceptible to loneliness and isolation due to limited family communication and a lack of social activities. Addressing these issues is crucial, and proactive solutions are needed. It is important to explore diverse measures to tackle the challenges of single-person households and prevent deaths due to loneliness in our society. OBJECTIVE: Non-face-to-face health care service systems have gained widespread interest owing to the rapid development of smart home technology. Particularly, a health monitoring system must be developed to manage patients' health status and send alerts for dangerous situations based on their activity. Therefore, in this study, we present a novel health monitoring system based on the auto-mapping method, which uses real-time position sensing mats. METHODS: The smart floor mats are operated as piezo-resistive devices, which are composed of a carbon nanotube-based conductive textile, electrodes, main processor circuit, and a mat. The developed smart floor system acquires real-time position information using a multiconnection method between the modules based on the auto-mapping algorithm, which automatically creates a spatial map. The auto-mapping algorithm allows the user to freely set various activity areas through floor mapping. Then, the monitoring system was evaluated in a room with an area of 41.3 m2, which is embedded with the manufactured floor mats and monitoring application. RESULTS: This monitoring system automatically acquires information on the total number, location, and direction of the mats and creates a spatial map. The position sensing mats can be easily configured with a simple structure by using a carbon nanotube-based piezo-resistive textile. The mats detect the activity in real time and record location information since they are connected through auto-mapping technology. CONCLUSIONS: This system allows for the analysis of patients' behavior patterns and the management of health care on the web by providing important basic information for activity patterns in the monitoring system. The proposed smart floor system can serve as the foundation for smart home applications in the future, which include health care, intelligent automation, and home security, owing to its advantages of low cost, large area, and high reliability.

Sensing a problem: Proof of concept for characterizing and predicting agitation.

INTRODUCTION: Agitation, experienced by patients with dementia, is difficult to manage and stressful for caregivers. Currently, agitation is primarily assessed by caregivers or clinicians based on self-report or very brief periods of observation. This limits availability of comprehensive or sensitive enough reporting to detect early signs of agitation or identify its precipitants. The purpose of this article is to provide proof of concept for characterizing and predicting agitation using a system that continuously monitors patients' activities and living environment within memory care facilities. METHODS: Continuous and unobtrusive monitoring of a participant is achieved using behavioral sensors, which include passive infrared motion sensors, door contact sensors, a wearable actigraphy device, and a bed pressure mat sensor installed in the living quarters of the participant. Environmental sensors are also used to continuously assess temperature, light, sound, and humidity. Episodes of agitation are reported by nursing staff. Data collected for 138 days were divided by 8-hour nursing shifts. Features from agitated shifts were compared to those from non-agitated shifts using t-tests. RESULTS: A total of 37 episodes of agitation were reported for a male participant, aged 64 with Alzheimer's disease, living in a memory care unit. Participant activity metrics (eg, transitions within the living room, sleep scores from the bedmat, and total activity counts from the actigraph) significantly correlated with occurrences of agitation at night (P < 0.05). Environmental variables (eg, humidity) also correlated with the occurrences of agitation at night (P < 0.05). Higher activity levels were also observed in the evenings before agitated nights. DISCUSSION: A platform of sensors used for unobtrusive and continuous monitoring of participants with dementia and their living space seems feasible and shows promise for characterization of episodes of agitation and identification of behavioral and environmental precipitants of agitation.

Level of Agreement Between Human-Rated and Instrumented Balance Error Scoring System Scores.

Clinicians have used the Balance Error Scoring System (BESS) to quantify postural control for concussion management. However, the reliability of the human rated BESS has varied prompting the development of instrumented BESSs. A cross-sectional design was used to determine the level of agreement (LOA) between human rated and instrumented BESS scores. Sixty participants completed the BESS on video. An instrumented mat was used to quantify BESS errors while a live human rater simultaneously scored the BESS. A second human rated BESS performance via video. Bland-Altman LOA analyses evaluated agreement between scoring methods (Mat-Human, Mat-Video, Video-Live) for each stance. Mean biases between scores, for each stance, with 95% confidence intervals (95%CIs) were calculated. Agreement between scoring methods was not assessed for the Firm-Double-Limb stance because very few errors were recorded. Agreement between both human raters and the mat was poor based on mean bias estimates > ± 1 and/or wide 95%CIs for all stances including BESS-Total. Agreement between the human raters was better, having displayed consistently smaller mean bias estimates and tighter 95%CIs for all stances and BESS Total. As a result, human rated and instrumented BESS scores may not be comparable. One method should be used to measure BESS errors for consistency.

Could Pressure Distribution Under Race-Exercise Saddles Affect Limb Kinematics and Lumbosacral Flexion in the Galloping Racehorse?

Back pain is frequently recognized in racehorses, but saddle fit and design are rarely assessed. In sport horses, relationships between horse-saddle interaction, back pain, and altered kinematics are established, but few studies investigating horse-saddle interaction in racehorses exist. We hypothesized that reducing pressures under saddles at thoracic (T) vertebrae 10-13 in galloping racehorses is associated with improved limb and lumbosacral kinematics. The objectives of the study were to (1) determine pressure magnitude/distribution under 3 frequently used race-exercise saddles and a saddle designed to reduce peak pressures at T10-13 on racehorses at gallop and (2) compare limb and lumbosacral kinematics at gallop between 4 saddle types. Four Thoroughbred racehorses were galloped overground at standardized speed wearing half-tree, three-quarter-tree, full-tree race-exercise saddles (saddles H/Q/T), and a saddle designed to reduce paraspinal pressure at T10-13 (saddle F), in a cross-over design. Pressure distribution under saddles was recorded using a pressure-mat system and gait features using high-speed motion capture. Results were compared between saddle types within horses. Maximum peak pressures at T10-13 occurred at trailing forelimb vertical, but pressure distribution varied significantly between saddle types. Peak pressures, femur angle to vertical, and hip-flexion angle were significantly different between saddle types (P ≤ .0001-.02). Saddle F had significantly lower peak pressures at T10-13, greater hip flexion, femur angle to vertical, and forelimb and hindlimb protraction than saddles H, Q, and T. These findings suggest the femur has greater protraction in saddles with lower pressures at T10-13, indicating the importance of race-exercise saddle design. Saddles with lower pressures at T10-13 could potentially allow increased range of spinal motion and altered muscle use, supporting improved hindlimb function.

Evaluation and comparison of pain questionnaires for clinical screening of osteoarthritis in cats.

BACKGROUND: Feline osteoarthritis (OA) is a common cause of long-standing pain and physical dysfunction. Performing a physical examination of a cat is often challenging. There is a need for disease-specific questionnaires or the so-called clinical metrology instruments (CMIs) to facilitate diagnosis and evaluation of treatment of feline OA. The CMI provides the owners an assessment of the cat's behavioural and lifestyle changes in the home environment. The purpose of the study was to evaluate readability, internal consistency, reliability and discriminatory ability of four CMIs. METHODS: This is a prospective, cross-sectional study with 142 client-owned cats. Feline OA was diagnosed based on medical history, orthopaedic examination and radiography. RESULTS: The results indicate that all four instruments have sound readability, internal consistency, are reliable over time and have good discriminatory ability. Preliminary cut-off values with optimal sensitivity and specificity were suggested for each instrument. The osteoarthritic cats showed significant changes in behavioural response to pain during orthopaedic examination, compared with sound cats. CONCLUSION: The results indicate that all four questionnaires make an important contribution in a clinical setting, and that the cat's behavioural response to pain during physical examination should be a parameter to take into account as a possible indication of chronic pain.

Biometric Data Comparison Between Lewis and Sprague Dawley Rats.

Introduction: Pressure mapping systems are often used for indirect assessment of kinematic gait parameter differences after repair of critical peripheral nerve defects in small animal models. However, there does not appear to be any literature that studies the differences in normal gait pattern of Sprague Dawley rats compared to Lewis rats using a Tekscan VH4 pressure mat system. The purpose of this study is to assess the gait profile of Lewis and Sprague Dawley rats generated by Tekscan's VH4 system to detect similarities and/or differences in gait parameters involving both force and temporal variables. Materials and Methods: The gait profile of 14 Lewis and 14 Sprague Dawley rats was recorded using a Tekscan VH4 pressure map system with two successful walks per animal and gait parameter data was normalized for mean variance between the two rodent strains. Results: The results showed that temporal and normalized force parameters were not significantly different between the two types of rats. Maximum force, contact area, stride length, and adjusted pressure variables were significantly different between the two strains, likely attributed to the body size and weight differential between the strains. Variation in some of these parameters were considered due to differences in overall body size between the two strains, variations in gait kinematics between individual rodent subjects, and the limitations of the current experimental design. Conclusion: For future in vivo models, either Sprague Dawley or Lewis rat strains would be acceptable animal models when comparing base-line gait profiles using the Tekscan VH4 pressure map system when assessing critical defect repairs of peripheral nerves.

Pressure Mat Analysis of Walk and Trot Gait Characteristics in 66 Normal Small, Medium, Large, and Giant Breed Dogs.

Objectives: To document temporospatial variables and gait symmetry measured by the GAITRite® system for normal, healthy dogs at the walk and trot with the leash side recorded. Study Design: Observational, prospective, cohort study. Sample Population: 66 healthy dogs of various common breeds with no evidence of lameness that were small (< 10 kg), medium (10- < 25 kg), large (25- < 40 kg), or giant (≥40 kg). Methods: Dogs walked and trotted at their preferred velocity on a pressure sensing walkway system. Video observation confirmed inclusion criteria were met for three valid trials at each gait for each dog. Coefficients of variance were used to summarize the data for analysis. Fore and hindlimb ratios were compared. Gait symmetry was assessed with the leash on the left and right side. Results: Coefficients of variation for gait parameters ranged from 20 to 28% for all except velocity and hind reach. There was no statistically significant difference in differences in fore and hindlimb ratios for stance %, GLS, TPI, or step:stride ratio, across weight categories or between walk and trot. Less than 8% of normal dogs had a GLS score < 90 (indicating lameness). Leash side did influence gait symmetry, since GLS, TPI, and step:stride all had statistically significant differences in means between leash side, irrelevant of the weight category or gait. Conclusions and Clinical Relevance: This system allowed simple, reliable gait assessment and values reported may be considered normal reference ranges for temporospatial variables collected with this system within the weight ranges and gaits reported. Controlling leash side and patient size is recommended for therapeutic intervention studies.

Application of ideal pressure distribution in development process of automobile seats.

BACKGROUND: In designing a car seat the ideal pressure distribution is important as it is the largest contact surface between the human and the car. Because of obstacles hindering a more general application of the ideal pressure distribution in seating design, multidimensional measuring techniques are necessary with extensive user tests. OBJECTIVE: The objective of this study is to apply and integrate the knowledge about the ideal pressure distribution in the seat design process for a car manufacturer in an efficient way. METHODS: Ideal pressure distribution was combined with pressure measurement, in this case pressure mats. In order to integrate this theoretical knowledge of seating comfort in the seat development process for a car manufacturer a special user interface was defined and developed. RESULTS: The mapping of the measured pressure distribution in real-time and accurately scaled to actual seats during test setups directly lead to design implications for seat design even during the test situation. Detailed analysis of the subject's feedback was correlated with objective measurements of the subject's pressure distribution in real time. Therefore existing seating characteristics were taken into account as well. CONCLUSIONS: A user interface can incorporate theoretical and validated 'state of the art' models of comfort. Consequently, this information can reduce extensive testing and lead to more detailed results in a shorter time period.

Do cats with a cranial cruciate ligament injury and osteoarthritis demonstrate a different gait pattern and behaviour compared to sound cats?

BACKGROUND: Osteoarthritis (OA) is a common cause of chronic pain and dysfunction in older cats. The majority of cats with OA do not show signs of overt lameness, yet cats with orthopaedic disease are known to redistribute their body weight from the affected limb. OA can cause changes in the cat's behaviour, which is often misinterpreted as signs of aging. The aim of the present study was to investigate if cats with a previous cranial cruciate ligament (CCL) injury perform differently on the pressure mat and exhibit different behaviour compared to sound cats according to the owner´s subjective assessment. Ten cats with a previous CCL injury were assessed with a pressure mat system and their owners were asked to complete an assessment questionnaire. The results were compared to those of 15 sound cats, matched to have the same weight and body condition score. RESULTS: The front/hind limb index for peak vertical force (PVF) was significantly higher for CCL cats, and there was a decreased PVF and vertical impulse (VI) on the affected hindlimb compared to the unaffected one. The results indicate that cats with a previous CCL injury put less weight, on the affected hindlimb but for a longer time. There was a significantly higher owner assessment questionnaire score for the group of cats with CCL injury compared to sound cats. CONCLUSIONS: Cats with a previous CCL injury have a different gait pattern compared to sound cats and a different behaviour according to owner subjective assessment. It is of great importance that further studies are performed to investigate the long term effects of CCL injury as a cause of pain and physical dysfunction, and its role in the development of OA in cats. Improved assessment tools for chronic pain caused by OA in cats are needed, both to facilitate diagnosis and to evaluate pain-relieving treatment.

Clinical effects of buprenorphine on open field behaviour and gait symmetry in healthy and lame weaned piglets.

Lameness in pigs decreases animal welfare and economic profit for the farmer. An important reason for impaired welfare in lame animals is pain due to lameness. No direct measurement of pain is possible in animals, and methods to indirectly detect and quantify the amount of pain an animal is experiencing are urgently needed. In this study, two methods to assess pain associated with lameness in pigs were evaluated to determine if they were sensitive enough to detect a lameness reduction as an effect of an experimental analgesic medication. Asymmetry associated with lameness was objectively quantified using pressure mat kinetic parameters: peak vertical force (PVF), load rate (LR), vertical impulse (VI) and peak vertical pressure (PVP). Locomotor activity was assessed in an open field test. A dose of 0.04 mg/kg buprenorphine, a strong analgesic, was used to treat 10 lame pigs, while eight other lame pigs, treated with physiological saline solution, served as controls. Buprenorphine decreased lameness-associated asymmetry for pressure mat LR (P = 0.002), VI (P = 0.003) and PVP (P = 0.001) and increased activity of the lame pigs in the open field (P = 0.023), while saline-treated animals did not show any changes in asymmetry and became less active in the open field (P <0.001). It was concluded that measurement of gait asymmetry by pressure mat analysis and locomotor activity in an open field test are both sensitive enough to detect the analgesic effects of buprenorphine when used to treat moderate to severe clinical pain in a relatively small group of affected pigs. The methods used in this study may also provide promising additional tools for future research into early pain recognition and lameness treatment in pigs.