Discriminative Information Added by Wearable Sensors for Early Screening - a Case Study on Diabetic Peripheral Neuropathy

2019 ◽  
Author(s):  
Shanshan Chen ◽  
Le Kang ◽  
You Lu ◽  
Ningjian Wang ◽  
Yingli Lu ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Wearable Sensors ◽  
Early Screening

Traumatic Digital Amputations of the Foot Inflicted by Pet Cat upon Individual with Diabetic Peripheral Neuropathy

2013 ◽  
Vol 103 (5) ◽  
pp. 441-444 ◽  
Author(s):  
William Hoffman ◽  
Kenneth Donovan
Keyword(s):  
Peripheral Neuropathy ◽  
Lower Extremity ◽  
Diabetic Peripheral Neuropathy ◽  
Relevant Literature ◽  
Pet Ownership ◽  
Common Cause ◽  
Potential Risks

Diabetic peripheral neuropathy (DPN) is a common cause of many lower-extremity complications. This case study illustrates the potential perils of pet ownership associated with diabetes and neuropathy. The case describes an incident resulting in traumatic digital amputations inflicted by a patient’s pet feline while she was sleeping. In presenting this case, the potential risks of pet ownership for patients with DPN are discussed along with a review of the relevant literature. (J Am Podiatr Med Assoc 103(5): 441–444, 2013)

scholarly journals CHARACTERISTICS OF THE GAIT INITIATION PHASE IN OLDER ADULTS WITH DIABETIC PERIPHERAL NEUROPATHY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S474-S474
Author(s):  
Gu Eon Kang ◽  
Hung Nguyen ◽  
Mohsen Zahiri ◽  
He Zhou ◽  
Changhong Wang ◽  
...  
Keyword(s):  
Older Adults ◽  
Steady State ◽  
Peripheral Neuropathy ◽  
Diabetic Peripheral Neuropathy ◽  
Wearable Sensors ◽  
Center Of Mass ◽  
Gait Initiation ◽  
Initiation Phase ◽  
Upright Standing ◽  
Risk Of Falls

Abstract Impairment in steady-state gait in older adults with diabetic peripheral neuropathy (OADPN) is well-known, however little attention has been paid to the gait initiation phase in which postural transitions occur from upright standing to steady-state gait. Given the risk of falls in the gait initiation phase in older adults, knowing its characteristics may be as important as steady-state gait. The aim of this study was to investigate kinematic characteristics of the gait initiation phase in OADPN compared to healthy older adults (HOA). Thirteen OADPN (72.9±6.1 years; 33.0±4.8 kg/m2), and 11 HOA (71.8±2.7 years; 26.5±4.3 kg/m2; no cardiovascular, neurological or orthopedic condition, no history of falling) performed gait on level ground for minimum 10 meters at self-selected comfortable speed. We collected kinematic data using five wearable sensors (LEGSysTM, BioSensics LLC, Watertown, MA) attached on the shanks, thighs and lower back. We used previously validated algorithm to analyze kinematic parameters for the gait initiation phase. Our statistical model showed that the number of steps, stride velocity, gait cycle time, double limb support and mediolateral center-of-mass sway during the gait initiation phase is significantly different between HOA (2.4±0.7 steps; 1.16±0.15 m/s; 1.12±0.10 seconds; 20.3±4.8%; 4.0±1.5°, respectively) and OADPN (4.0±2.1 steps; 0.92±0.29 m/s; 1.23±0.12 seconds; 29.2±10.3%; 7.0±2.9°, respectively) (all p<0.05). The results suggest that OADPN take more, slower and more unstable steps to reach steady-state gait from upright standing compared to HOA. The results also provide implications for needs to develop new interventions targeting the gait initiation phase in OADPN.

Balance Rehabilitation

2013 ◽  
Vol 103 (6) ◽  
pp. 498-507 ◽  
Author(s):  
Gurtej S. Grewal ◽  
Rashad Sayeed ◽  
Michael Schwenk ◽  
Manish Bharara ◽  
Robert Menzies ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Ankle Joint ◽  
Visual Feedback ◽  
Diabetic Peripheral Neuropathy ◽  
Postural Stability ◽  
Wearable Sensors ◽  
Center Of Mass ◽  
Sensor Technology ◽  
Body Sway ◽  
Balance Rehabilitation

Background: Individuals with diabetic peripheral neuropathy frequently experience concomitant impaired proprioception and postural instability. Conventional exercise training has been demonstrated to be effective in improving balance but does not incorporate visual feedback targeting joint perception, which is an integral mechanism that helps compensate for impaired proprioception in diabetic peripheral neuropathy. Methods: This prospective cohort study recruited 29 participants (mean ± SD: age, 57 ± 10 years; body mass index [calculated as weight in kilograms divided by height in meters squared], 26.9 ± 3.1). Participants satisfying the inclusion criteria performed predefined ankle exercises through reaching tasks, with visual feedback from the ankle joint projected on a screen. Ankle motion in the mediolateral and anteroposterior directions was captured using wearable sensors attached to the participant’s shank. Improvements in postural stability were quantified by measuring center of mass sway area and the reciprocal compensatory index before and after training using validated body-worn sensor technology. Results: Findings revealed a significant reduction in center of mass sway after training (mean, 22%; P = .02). A higher postural stability deficit (high body sway) at baseline was associated with higher training gains in postural balance (reduction in center of mass sway) (r = −0.52, P < .05). In addition, significant improvement was observed in postural coordination between the ankle and hip joints (mean, 10.4%; P = .04). Conclusions: The present research implemented a novel balance rehabilitation strategy based on virtual reality technology. The method included wearable sensors and an interactive user interface for real-time visual feedback based on ankle joint motion, similar to a video gaming environment, for compensating impaired joint proprioception. These findings support that visual feedback generated from the ankle joint coupled with motor learning may be effective in improving postural stability in patients with diabetic peripheral neuropathy. (J Am Podiatr Med Assoc 103(6): 498–507, 2013)

scholarly journals Using Plantar Electrical Stimulation to Improve Postural Balance and Plantar Sensation Among Patients With Diabetic Peripheral Neuropathy: A Randomized Double Blinded Study

2017 ◽  
Vol 11 (4) ◽  
pp. 693-701 ◽  
Author(s):  
Bijan Najafi ◽  
Talal K. Talal ◽  
Gurtej Singh Grewal ◽  
Robert Menzies ◽  
David G. Armstrong ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Peripheral Neuropathy ◽  
Effect Size ◽  
Diabetic Peripheral Neuropathy ◽  
Motor Performance ◽  
Wearable Sensors ◽  
Center Of Mass ◽  
Ankle Brachial Index ◽  
Plantar Stimulation ◽  
Double Blinded

Objective: People with diabetic peripheral neuropathy (DPN) often exhibit deteriorations in motor-performance mainly due to lack of plantar-sensation. The study explored effectiveness of plantar electrical-stimulation therapy to enhance motor-performance among people with DPN. Design and methods: Using a double-blinded model, 28 volunteers with DPN (age: 57.8 ± 10.2 years) were recruited and randomized to either intervention (IG: n = 17) or control (CG: n = 11) group. Both groups received identical plantar-stimulation devices for six weeks of daily use at home; however, only the IG devices were set to deliver stimulation. Balance (ankle, hip, and center of mass [COM] sway) and gait (stride velocity [SV], stride time [ST], stride length [SL], and cadence) were measured using validated wearable sensors. Outcomes were assessed at baseline and at six-week. Clinical assessment including vascular as measured by ankle-brachial-index (ABI) and plantar-sensation as quantified by vibratory plantar threshold (VPT) were also measured at baseline and six weeks. Results: No difference were observed between groups for baseline characteristics ( P > .050). Posttherapy, ankle and COM sway with eyes open were significantly improved ( P < .05, Cohen’s effect size d = 0.67-0.76) in the IG with no noticeable changes in CG. All gait parameters were significantly improved in the IG with highest effect size observed for cadence ( d = 1.35, P = .000). Results revealed improvement in VPT ( P = .004, d = 1.15) with significant correlation with stride velocity improvement ( r = .56, P = .037). ABI was improved in the IG in particulate among those with ABI>1.20 ( P = .041, d = 0.99) Conclusion: This study suggests that daily home use of plantar electrical-stimulation may be a practical means to enhance motor-performance and plantar-sensation in people with DPN.

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