scholarly journals Design and Construction of a Bilateral Haptic System for the Remote Assessment of the Stiffness and Range of Motion of the Hand

2016 ◽  
Author(s):  
Fabio Oscari ◽  
Roberto Oboe ◽  
Omar Daud ◽  
Stefano Masiero ◽  
Giulio Rosati
Keyword(s):  
Range Of Motion ◽  
Clinical Tests ◽  
Medical Assessment ◽  
Haptic System ◽  
Rehabilitation Centers ◽  
Remote Assessment ◽  
Recorded Data ◽  
Clinical Conditions ◽  
Assessment Scales ◽  
Standard Framework

The use of haptic devices in rehabilitation of impaired limbs has become rather popular, given the proven effectiveness in promoting recovery. In a standard framework, such devices are used in rehabilitation centers, where patients interact with virtual tasks, presented on a screen. To track their sessions, kinematic/dynamic parameters or performance scores are recorded. However, as Internet access is now available at almost every home, and in order to reduce the hospitalization time of the patient, the idea of doing rehabilitation at home is gaining wide consent. Medical care programs can be synchronized with the home rehabilitation device; patient data can be sent to the central server that could redirect to the therapist laptop (tele-healthcare). The controversial issue is that the recorded data do not actually represent the clinical conditions of the patients according to the medical assessment scales, forcing them to frequently undergo clinical tests at the hospital. To respond to this demand, we propose the use of a bilateral master/slave haptic system that could allow the clinician, who interacts with the master, to assess remotely and in real time the clinical conditions of the patient that uses the home rehabilitation device as the slave. In this paper, we describe a proof of concept to highlight the main issues of such an application, limited to one degree of freedom, and to the measure of the stiffness and range of motion of the hand.

scholarly journals Design and Construction of a Bilateral Haptic System for the Remote Assessment of the Stiffness and Range of Motion of the Hand

Sensors ◽  
2016 ◽  
Vol 16 (10) ◽  
pp. 1633 ◽  
Author(s):  
Fabio Oscari ◽  
Roberto Oboe ◽  
Omar Daud Albasini ◽  
Stefano Masiero ◽  
Giulio Rosati
Keyword(s):  
Range Of Motion ◽  
Haptic System ◽  
Remote Assessment ◽  
Design And Construction

The Management of Pain In Animals on The Clinic Floor

2019 ◽  
Vol 2 (1) ◽  
pp. 230-246
Author(s):  
J. O. Omamegbe ◽  
F. C. Nwinyi
Keyword(s):  
Care Delivery ◽  
Clinical Manifestations ◽  
Clinical Procedures ◽  
Veterinary Practitioner ◽  
Animal Pain ◽  
Surgical Pain ◽  
Pain Assessment Scales ◽  
Inflammatory Drugs ◽  
Clinical Conditions ◽  
Assessment Scales

Most animals presented for veterinary care are suffering or will suffer from some pain during restraint, clinical examination, samples collection, diagnostic imaging, parenteral drug administration or clinical procedures et cetera. The Veterinarian is ethically, morally and professionally enjoined to recognize and alleviate such pain. Although most studies on animal pain have been focused on mostly post surgical pain in dogs and cats, animals afflicted with most common external or internal, infectious and non-infectious disease conditions also suffer from pain. Identifying animals in pain alone is difficult except if a Veterinarian with a penchant for the management of pain in animals actively looks out for it in patients. The measurement of pain in animals poses even more difficulties for the Veterinarian than its identification mainly because animals are unable to communicate the locations, the temporal occurance and the severities of the pain they feel just as they don’t of other clinical manifestations. Therefore, animals in pain rely on their owners, handlers or keepers et cetera who actually don’t know how or where it hurts them to provide such details to the Veterinaruan. To complicate matters, the use of validated pain assessment scales in animals is fraught with serious limitations except to some less extent, for the visual analog and the simple descriptive scales which seem applicable in real clinic situations. A multi-modal mode of management in which opioids, non-steroidal anti-inflammatory drugs, local anesthetics, α 2 – adrenergic agonists, NDMA receptor antagonists and ketamine delivered through a variety of routes, at varied dosages and regimens, is advocated for pain management in animals. The need to regularly review the state of the patient vis-à-vis the need to modify the treatment module and regimen cannot be over emphasized when and if a clinical case is under consideration. This may involve the change of medications, the addition of more medications, the reduction in the number of medication, changes in dosages and the regimen in use from time to time. This discuss is aimed at the general Veterinary practitioner who is presented daily with different species and breeds of animals suffering from varieties of clinical conditions or which will undergo a variety of clinical procedures capable of causing pain in the course of veterinary health care delivery in diverse clinic settings.

Clinical Examination of Hip Dysplasia/Instability

2018 ◽  
Vol 66 (4) ◽  
Keyword(s):  
Range Of Motion ◽  
Clinical Examination ◽  
Hip Dysplasia ◽  
Physical Therapist ◽  
Clinical Work ◽  
History Taking ◽  
Clinical Tests ◽  
Hip Instability ◽  
Additional Imaging ◽  
Shoulder Examination

Clinical examination is one of the main skill that clinicians acquire through training and experience, and its contribution to diagnosis is a key addition to history taking. Mike Reiman is a physical therapist, author of the excellent textbook «Orthopedic clinical examination», who just conpleted his PhD (congrats!) under the supervision of Kristian Thorborg (Denmark), looking at the validity of the most frequently used clinical examination tests around the hip area. We tend to think that “specialized” tests have great significance for the examination of a particular structure of pathology, yet as we have already learned from multiple studies on this very question around the shoulder examination tests, this is deceptive. In this article, Dr Reiman looks at what we know for hip instability tests, and the conclusion is not very different. Some tests can help in ruling in a pathology (higher specificity than sensibility), but should by no means be considered decisive. At #SportSuisse2018, he presented his PhD work on femoro-acetabular impingement tests, and the findings are not dissimilar to this article. We should be very careful with the interpretation we make of positive clinical tests. First, the tests should be properly standardized and executed. Second, the clinician must understand when a test is to be interpreted as positive: do we look for pain (reproduces the patient’s complaint or a different pain?), clicking or limitation in range of motion? Not all tests look for the same thing. Third, the clinician must acknowledge the validity of each test. One way to look at it is, that the act of clinical examination must be executed and chosen wisely, whilst the results of the tests can only be interpreted in the context of the history, the aggregate of tests, the additional imaging when advisable and the experience of the clinician. This is the art of clinical work informed by science, but let’s not overstate our findings too “artistically”.

scholarly journals Effects of neuromuscular exercises on q-angle, knee joint stability and ankle mobility of handball athletes.

2020 ◽  
pp. 1-7
Author(s):  
Marcos Vinicius de Sousa Fernandes ◽  
Samuel Ribeiro Carvalho ◽  
Wesley dos Santos Costa ◽  
Ivan Silveira De Avelar ◽  
Deise Aparecida de Almeida Pires Oliveira ◽  
...  
Keyword(s):  
Risk Factors ◽  
Knee Joint ◽  
Range Of Motion ◽  
High Performance ◽  
Intervention Group ◽  
Joint Stability ◽  
Clinical Tests ◽  
Q Angle ◽  
Ankle Mobility ◽  
The Right

Background: The sport, when it comes to matters related to high performance, can lead the athlete to the development of risk factors for injuries. To minimize the effects of high load training, neuromuscular exercises may offer increased joint stability, thereby reducing risk factors, number of injuries, and minimizing the extent and severity of those that may arise. Objective: To evaluate the effects of neuromuscular exercises on Q-angle, knee joint stability and ankle mobility of high performance handball athletes. Methods: This is a controlled clinical trial conducted with 23 athletes (aged 18 to 37 years), randomly divided into intervention (n = 12) and control (n = 11) groups. Athletes were evaluated with clinical tests for knee joint instability. The risk factors evaluated were ankle range of motion (ROM) in the dorsal flexion movement (tibia over the tarsus) and the Q-angle, which are factors related to ankle sprains and anterior cruciate ligament injury, respectively. A protocol of three neuromuscular exercises for lower limb was applied three times a week, lasting approximately six minutes for 12 sessions. Results: All athletes presented Q-angle higher than expected and in the group that underwent neuromuscular exercises there was a significant reduction in right Q-angle (pre: 23.7 ± 2.9º; post: 20.2 ± 2.5º, p = 0.016) and left (pre: 22.5 ± 2.5º; post: 20.1 ± 1.8º, p = 0.021). The range of motion of both ankles did not increase significantly, but there was an average increase of 2.1º in the right ankle and 2.4º in the left of the athletes who participated in the intervention group. Clinical tests indicated improvement in joint stability. Conclusion: A significant reduction in the right and left Q-angle was observed, as well as reducing the frequency of excessive anterior tibial translocation, which may be positively reflected in the knee joint stability.

Assessing the performances of a chatbot to collect real-life data of patients with migraine (Preprint)

2020 ◽  
Author(s):  
Benjamin Chaix ◽  
Jean-Emmanuel Bibault ◽  
Guillaume Delamon ◽  
Mickaël Neraal ◽  
Julien Moussalli ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Real Life ◽  
Text Messages ◽  
Remote Diagnosis ◽  
Medical Assessment ◽  
Life Data ◽  
Real Life Data ◽  
Patient Reported ◽  
The Impact ◽  
Assessment Scales

BACKGROUND There are many scales for screening or assessing the impact of a disease. These scales are generally used to diagnose or assess the severity of a disease and are carried out by doctors. The Vik Migraine chatbot helps patients suffering from headaches through personalized text messages, it could be used to collect patient-reported outcomes. OBJECTIVE The aims of this study were (1) to assess the feasibility of collecting a chatbot-mediated reference scale, (2) perform a remote diagnosis of the severity of the migraines and (3) assess the patient satisfaction and engagement with the chatbot. METHODS This study was conducted in France from December 2019 to March 2020. Voluntary users of the chatbot Vik Migraine were recruited online. They had to be adults and suffer from chronic migraines. An adapted version of the IHS questionnaire was presented to the participants by text messages. The Lickert scale ranging from 1 to 5 was used to assess overall satisfaction with the use of Vik Migraine. RESULTS We included 636 participants with migraines or headaches. A total of 89.94% (572) participants had fully completed the IHS questionnaire (8 items), 4.72% (30) had partially completed it and 5.35% (34) had refused to complete it. The evaluation of overall satisfaction shows that a total of 80.7% (513) of users agreed or strongly agreed with the affirmation that Vik Migraine provides quality answers about the pathology or its information. CONCLUSIONS We hypothesized that a virtual assistant built to support migraine patients could be used to retrieve patient data remotely, such as medical assessment scales. The study confirmed this hypothesis and showed that users were strongly engaged through to chatbot: out of the total number of participants, we observed a very low number of uncompleted questionnaires.

scholarly journals Accuracy of remote diagnoses using intraoral scans captured in approximate true color: a pilot and validation study in teledentistry

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sabrina Steinmeier ◽  
Daniel Wiedemeier ◽  
Christoph H. F. Hämmerle ◽  
Sven Mühlemann
Keyword(s):  
Validation Study ◽  
Three Dimensional ◽  
Gingival Recession ◽  
Tooth Wear ◽  
Test Sample ◽  
Cross Sectional ◽  
Remote Assessment ◽  
Furcation Involvement ◽  
Clinical Conditions ◽  
True Color

Abstract Background Intraoral scans (IOS) provide three-dimensional images with approximate true colors representing a possible tool in teledentistry for remote examination. The aim of the present cross-sectional validation study was, therefore, to evaluate the levels of agreement between remote diagnoses derived from IOS and diagnoses based on clinical examinations for assessing dental and periodontal conditions. Methods The test sample comprised 10 patients representing different clinical conditions. Following the acquisition of IOS (Trios, 3Shape), a full-mouth dental and periodontal examination was done and periapical radiographs were taken. Ten dentists were asked to perform dental and periodontal scorings for each of the ten patients on a tablet computer presenting the IOS. Scores included diagnosis of gingivitis/periodontitis, and evaluated presence as well as amount of plaque and calculus, and presence of teeth exhibiting gingival recession, furcation involvement, erosion, tooth wear, stain, and non-carious cervical lesion, as well as presence of decayed, filled, and crowned teeth and implants. In a second round of assessments, the periapical radiographs were provided and the dentists were able to change the scores. The time for the remote assessment was recorded. The agreement between remote and clinical scorings (reference) was then analyzed descriptively. Results The mean time for the tele assessment was 3.17 min and the additional consultation of the radiographs accounted for another 1.48 min. The sensitivity and specificity values were 0.61 and 0.39 for gingivitis and 0.67 and 0.33 for periodontitis, with no relevant changes when radiographs were provided for the diagnosis of periodontitis (0.72 and 0.28). The agreement for dichotomized dental and periodontal indices ranged between 78 and 95%. With the provision of radiographs, the remote examiners were able to detect existing filled teeth, crowned teeth, and implants, whereas the detection of decayed teeth (70%) was not improved. Conclusions The remote examination using IOS was effective in detecting dental findings, whereas periodontal conditions could not be assessed with the same accuracy. Still, remote assessment of IOS would allow a time-efficient screening and triage of patients. Improvement of the image quality of IOS may further allow to increase the accuracy of remote assessments in dentistry. According to the Swiss Regulation this investigation is not a clinical trial and therefore no registration in a WHO-registry is needed.

scholarly journals Accuracy of remote diagnoses using intraoral scans captured in approximate true color: a pilot and validation study in teledentistry

2020 ◽  
Author(s):  
Sabrina Jenny Steinmeier ◽  
Daniel Wiedemeier ◽  
Christoph HF Hämmerle ◽  
Sven Mühlemann
Keyword(s):  
Validation Study ◽  
Three Dimensional ◽  
Gingival Recession ◽  
Tooth Wear ◽  
Test Sample ◽  
Cross Sectional ◽  
Remote Assessment ◽  
Furcation Involvement ◽  
Clinical Conditions ◽  
True Color

Abstract Background: Intraoral scans (IOS) provide three-dimensional images with approximate true colors representing a possible tool in teledentistry for remote examination. The aim of the present cross-sectional validation study was, therefore, to evaluate the levels of agreement between remote diagnoses derived from IOS and diagnoses based on clinical examinations for assessing dental and periodontal conditions.Methods: The test sample comprised 10 patients representing different clinical conditions. Following the acquisition of IOS (Trios, 3Shape), a full-mouth dental and periodontal examination was done and periapical radiographs were taken. Ten dentists were asked to perform dental and periodontal scorings for each of the ten patients on a tablet computer presenting the IOS. Scores included diagnosis of gingivitis/periodontitis, and evaluated presence as well as amount of plaque and calculus, and presence of teeth exhibiting gingival recession, furcation involvement, erosion, tooth wear, stain, and non-carious cervical lesion, as well as presence of decayed, filled, and crowned teeth and implants. In a second round of assessments, the periapical radiographs were provided and the dentists were able to change the scores. The time for the remote assessment was recorded. The agreement between remote and clinical scorings (reference) was then analyzed descriptively.Results: The mean time for the tele assessment was 3.17 minutes and the additional consultation of the radiographs accounted for another 1.48 minutes. The sensitivity and specificity values were 0.61 and 0.39 for gingivitis and 0.67 and 0.33 for periodontitis, with no relevant changes when radiographs were provided for the diagnosis of periodontitis (0.72 and 0.28). The agreement for dichotomized dental and periodontal indices ranged between 78 and 95%. With the provision of radiographs, the remote examiners were able to detect existing filled teeth, crowned teeth, and implants, whereas the detection of decayed teeth (70%) was not improved.Conclusions: The remote examination using IOS was effective in detecting dental findings, whereas periodontal conditions could not be assessed with the same accuracy. Still, remote assessment of IOS would allow a time-efficient screening and triage of patients. Improvement of the image quality of IOS may further allow to increase the accuracy of remote assessments in dentistry.According to the Swiss Regulation this investigation is not a clinical trial and therefore no registration in a WHO-registry is needed.

scholarly journals Disease prevalence among young dogs in Grand Tunis, Tunisia: A retrospective study

2019 ◽  
Vol 12 (4) ◽  
pp. 489-495
Author(s):  
Ghada Tagorti
Keyword(s):  
Retrospective Study ◽  
Control Strategies ◽  
Disease Prevalence ◽  
Wet Season ◽  
Traumatic Injuries ◽  
X Ray ◽  
National School ◽  
Recorded Data ◽  
Clinical Conditions ◽  
And Control

Aim: A retrospective study was undertaken to determine the occurrence, and the distribution of the most common clinical conditions of young dogs encountered at the National School of Veterinary Medicine clinic, Tunisia, from September 2012 to July 2013, based on sex, age, breeds, and season variation. Materials and Methods: A total of 515 cases were examined, and 11 clinical conditions were recorded. Clinical examination was performed. X-ray examination and necropsy were carried out only when needed. Results: Of the 515, 298 cases (57.86%) were male, while 217 (42.14%) were female. The breed-wise difference in the occurrence of various health problems was statistically significant. Nevertheless, no significant association was found between the occurrence of a disease and age. The commonly found clinical conditions were traumatic injuries (22.72%), ectoparasitic infections (20.58%), and gastroenteritis (13.40%). The occurrence of diseases was the highest (60.19%) in the wet season (September-February) followed by 39.81% in the dry season (March-July). Conclusion: The current study presents the first recorded data about the major clinical conditions of young dogs in Tunisia. These findings can be used to develop more effective disease management and control strategies.

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