Objective Assessment of Walking Impairments in Myotonic Dystrophy by Means of a Wearable Technology and a Novel Severity Index

Myotonic dystrophy type 1 (DM1) is a genetic inherited autosomal dominant disease characterized by multisystem involvement, including muscle, heart, brain, eye, and endocrine system. Although several methods are available to evaluate muscle strength, endurance, and dexterity, there are no validated outcome measures aimed at objectively evaluating qualitative and quantitative gait alterations. Advantageously, wearable sensing technology has been successfully adopted in objectifying the assessment of motor disabilities in different medical occurrences, so that here we consider the adoption of such technology specifically for DM1. In particular, we measured motor tasks through inertial measurement units on a cohort of 13 DM1 patients and 11 healthy control counterparts. The motor tasks consisted of 16 meters of walking both at a comfortable speed and fast pace. Measured data consisted of plantar-flexion and dorsi-flexion angles assumed by both ankles, so to objectively evidence the footdrop behavior of the DM1 disease, and to define a novel severity index, termed SI-Norm2, to rate the grade of walking impairments. According to the obtained results, our approach could be useful for a more precise stratification of DM1 patients, providing a new tool for a personalized rehabilitation approach.

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Assessing the Severity of Acute Pancreatitis with CT Severity Index and Other Conventional Methods in a Tertiary Care Hospital in Tamil Nadu, India – A Comparative Cross-Sectional Study

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/642 ◽

2021 ◽

Vol 8 (41) ◽

pp. 3541-3546

Author(s):

Jayaprakash Subramani ◽

Rajesh Prabhu ◽

Jagadeesapandian Palpandi

Keyword(s):

Computed Tomography ◽

Acute Pancreatitis ◽

Predictive Value ◽

Tamil Nadu ◽

Objective Assessment ◽

Tertiary Care ◽

Severity Index ◽

Apache Ii ◽

Care Hospital ◽

Male Predominance

BACKGROUND Acute pancreatitis is not uncommon in surgical practice with variable clinical presentation. Because of its potential notable catastrophic complications, it is mandatory to assess the severity at the earliest. In recent times, the decision making in the management is quite difficult due to its complications and outcome. So, an objective assessment of severity based on clinical and laboratory scoring verses computed tomography (CT) severity is still debate, hence the need for study. The purpose of this study was to compare the efficiency of CT severity index verses APACHE II and Ranson criteria in predicting the severity of acute pancreatitis. METHODS A total number of 36 consecutive cases of acute pancreatitis who were admitted between January 2013 and December 2014 in Apollo Specialty Hospitals – Madurai were included in the study. Written informed consent was obtained from all study participants. RESULTS In our study, out of 36 patients, 30 (83.33 %) were males and 6 (16.66 %) were females. The sex distribution shows a clear male predominance. Most of the patients in the present study belonged to the middle age group. Alcohol was the most common cause accounting for 41.7 % of the cases followed by the billiary pathology. CT severity index was the superior tool for prediction of the prognosis and early complications. CONCLUSIONS When using contrast enhanced computed tomography, it was found that there was a significant correlation between the development of organ failure and severity of pancreatitis. The specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of Ranson and acute physiology and chronic health evaluation – II (APACHE II) at 48 hours of admission with acute pancreatitis does not correlate in determining the severity of acute pancreatitis. KEYWORDS Acute Pancreatitis, Severity Markers, CT Severity Index

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A Wearable System to Objectify Assessment of Motor Tasks for Supporting Parkinson’s Disease Diagnosis

Sensors ◽

10.3390/s20092630 ◽

2020 ◽

Vol 20 (9) ◽

pp. 2630 ◽

Cited By ~ 2

Author(s):

Erika Rovini ◽

Carlo Maremmani ◽

Filippo Cavallo

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Objective Assessment ◽

Disease Diagnosis ◽

Support Vector ◽

Motor Tasks ◽

Wearable System ◽

Support Tool ◽

Average Accuracy ◽

Open Issue

Objective assessment of the motor evaluation test for Parkinson’s disease (PD) diagnosis is an open issue both for clinical and technical experts since it could improve current clinical practice with benefits both for patients and healthcare systems. In this work, a wearable system composed of four inertial devices (two SensHand and two SensFoot), and related processing algorithms for extracting parameters from limbs motion was tested on 40 healthy subjects and 40 PD patients. Seventy-eight and 96 kinematic parameters were measured from lower and upper limbs, respectively. Statistical and correlation analysis allowed to define four datasets that were used to train and test five supervised learning classifiers. Excellent discrimination between the two groups was obtained with all the classifiers (average accuracy ranging from 0.936 to 0.960) and all the datasets (average accuracy ranging from 0.953 to 0.966), over three conditions that included parameters derived from lower, upper or all limbs. The best performances (accuracy = 1.00) were obtained when classifying all the limbs with linear support vector machine (SVM) or gaussian SVM. Even if further studies should be done, the current results are strongly promising to improve this system as a support tool for clinicians in objectifying PD diagnosis and monitoring.

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Myotonic dystrophy type 1 and endocrine system involvement

Journal of the Neurological Sciences ◽

10.1016/j.jns.2019.10.1424 ◽

2019 ◽

Vol 405 ◽

pp. 319

Author(s):

E. Kacem ◽

S. Sakka ◽

N. Farhat ◽

O. Hdiji ◽

H. Hajkacem ◽

...

Keyword(s):

Myotonic Dystrophy ◽

Endocrine System ◽

Myotonic Dystrophy Type 1 ◽

Myotonic Dystrophy Type ◽

System Involvement

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LIMITED ORTHODONTIC TREATMENT IN MYOTONIC DYSTROPHY II

Romanian Journal of Neurology ◽

10.37897/rjn.2017.4.5 ◽

2017 ◽

Vol 16 (4) ◽

pp. 158-165

Author(s):

Aurelia Magdalena Enache ◽

◽

Alexandru Marghescu ◽

Roxana Antoanela Baluta ◽

Maria Otilia Blajin ◽

...

Keyword(s):

Myotonic Dystrophy ◽

Open Bite ◽

Type Ii ◽

Myotonic Dystrophy Type ◽

Class Iii ◽

Anterior Open Bite ◽

Posterior Crossbite ◽

Diagnostic Signs ◽

Dominant Disease ◽

Craniofacial Features

Rationale. Myotonic dystrophy (MD) is a multisystemic autosomal dominant disease characterized by myotonia and progressive muscular weakness and atrophy. Objective. The purpose of this study was to describe the dental, skeletal and muscular features in a family with myotonic dystrophy type II and to discuss possible therapeutic strategies. Methods and results. This study presents the case of a family (a mother and two daughthers) diagnosed with myotonic dystrophy type II. Beside the medical history and genetic tests, each subject underwent a clinical examination including impression taking, intra- and extraoral photographs and cephalometric analysis. Our investigations revealed alterations in the transversal and vertical planes. Conclusions. Our findings were consistent with previously reported craniofacial features of patients affected by myotonic disorders, and they may be important diagnostic signs of a congenital muscular disease. We found that the most predominant malocclusions were the anterior open bite and posterior crossbite, but the tendency to class III malocclusion is in contradiction with their findings.

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Influence of Basic-Motor Abilities on Efficiency of Realization of Specific Motor Tasks In Swimming

Спортске науке и здравље - АПЕИРОН ◽

10.7251/ssh2001026b ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Osmo Bajrić ◽

Branimir Mikić ◽

Senad Bajrić ◽

Edin Mirvić ◽

Slobodan Goranović

Keyword(s):

Motor Skills ◽

Statistical Significance ◽

Plantar Flexion ◽

Motor Tasks ◽

Motor Abilities ◽

Younger Age ◽

Long Jump ◽

Motor Tests ◽

The Impact ◽

Criterion Variables

The research was conducted on a sample of 70 respondents-swimmers aged 13-15 years of swimming clubs from Sarajevo Canton/Federation of BiH, with the aim of determining the significance and magnitude of the impact of selected basic motor skills on the implementation of specific motor tasks in swimming (navigability in place, sliding length with reflection from water, start from starting block, parallel). The study used 10 variables to assess basic motor skills, which were the input or predictor set of variables, and three variables to assess the efficiency of specific motor tasks in swimming as a criterion, each variable from the battery of specific motor tasks was considered as a criterion on the predictor set of basic-motor variables. Three mini regression analyzes were applied to determine the statistical significance and relative influence of basic motor skills on the realization of specific motor tasks in swimming (buoyancy in place, length of sliding with reflection from water, start from the starting block, parallel). The results of regression analyzes indicate that the greatest influence on the overall efficiency in the implementation of specific motor tests in swimming, looking at all criterion variables together, from the set of basic-motor variables, as a predictor set, show the following variables: stick twist-MFLISK MFLPRK, plantar flexion-MFLPL, long jump from place-MFESDM, agility on the ground-MKOKNT and shelter in lying-MRCZTL. The results obtained in this research can be useful for teachers and swimming trainers who work with younger age categories for the purpose of better programming of training work and selection of training content.

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748 Impact of Deep Transcranial Magnetic Stimulation on Insomnia Comorbid with Treatment Resistant Depression

SLEEP ◽

10.1093/sleep/zsab072.745 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A292-A292

Author(s):

Amit Chopra ◽

Suzanne Kodya

Keyword(s):

Transcranial Magnetic Stimulation ◽

Magnetic Stimulation ◽

Objective Assessment ◽

Severity Index ◽

Systematic Research ◽

Treatment Resistant Depression ◽

Treatment Resistant ◽

Resistant Depression ◽

The Impact ◽

Insomnia Severity

Abstract Introduction Deep Transcranial Magnetic Stimulation (dTMS) is an FDA-approved non-invasive brain stimulation treatment for management of treatment-resistant depression (TRD). However, the efficacy of dTMS on Insomnia, a commonly prevalent and one of the most refractory symptoms of depression, is not clearly established. Our study aims to assess the impact of dTMS on outcomes of insomnia comorbid with TRD. Methods Single center retrospective study examining mood and insomnia outcomes in TRD patients (n=25), with greater than 3 failed psychotropic medication trials, undergoing dTMS for unipolar major depression.. Questionnaires including Patient Health Questionnaire (PHQ-9), Insomnia Severity Index (ISS),Generalized Anxiety Disorder-7 (GAD-7) were compared at baseline and at the end of dTMS treatment course. Results TRD patients with ‘low insomnia’ (n=12; ISS=7.9) and ‘high insomnia’ (n=13; ISS=20) were examined in terms of mood and insomnia ouctomes. No significant differences at baseline were noted between two groups in terms of demographic, mood, and anxiety variables. Depression and anxiety symptoms for patients in ‘Low Insomnia’ group significantly improved from baseline to final dTMS session- PHQ-9 [t(11) = 6.021, p < .0001]], GAD-7 [t(11) = 2.389, p = .036]. TRD patients in ‘High Insomnia’ group also reported significant improvements in depression [t(12) = 5.596, p < .0001], anxiety [t(12) = 2.743, p = .018], and insomnia [t(12) = 6.057, p < .0001]] at final dTMS session as compared to baseline. Non-responders in ‘High Insomnia’ group did not achieve statistically significant improvements in either depression or insomnia outcomes. Conclusion Insomnia comorbid with TRD responds to treatment with dTMS irrespective of the insomnia severity at baseline. Prospective research with the use of objective assessment measures for insomnia is warranted to confirm these findings. Non-response to insomnia was associated with poor mood outcomes as well in TRD patients. The probable mechanistic action of insomnia improvement in patients with TRD undergoing dTMS is unclear and further systematic research to understand the clinical and neural correlates of insomnia response with dTMS is needed. Support (if any) N/A

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Objective Assessment of Chronic Pain in Horses Using the Horse Chronic Pain Scale (HCPS): A Scale-Construction Study

Animals ◽

10.3390/ani11061826 ◽

2021 ◽

Vol 11 (6) ◽

pp. 1826

Author(s):

Johannes P. A. M. van Loon ◽

Lucia Macri

Keyword(s):

Chronic Pain ◽

Facial Expression ◽

Objective Assessment ◽

Intraclass Correlation ◽

Diagnostic Procedures ◽

Pain Scale ◽

Treatment Regimens ◽

Observer Reliability ◽

Healthy Control ◽

And Control

The objective assessment of chronic pain is of utmost importance for improving welfare and quality of life in horses. Freedom from disease and pain is one of the ‘five freedoms’ that are necessary for animal welfare. The aim of this study was to develop a pain scale for the assessment of chronic pain in horses (Horse Chronic Pain Scale; HCPS), which is based on behavioural and facial expressions. The scale was used to assess 53 horses (26 horses diagnosed with chronic painful conditions by means of clinical examination and additional diagnostic procedures (consisting of osteoarthritis, chronic laminitis, chronic back and neck problems, chronic dental disorders) and 27 healthy control animals). Animals were assessed once daily for three consecutive days by two observers that were blinded to the condition of the animals and were unaware of any analgesic treatment regimens. The HCPS consists of two parts, the Horse Chronic Pain Composite Pain Scale (HCP CPS, with behavioural parameters) and the EQUUS-FAP (Equine Utrecht University Scale for Facial Assessment of Pain). The HCP CPS had good inter-observer reliability (intraclass correlation coefficient (ICC) = 0.84, p < 0.001), while the EQUUS-FAP component (with facial expression-based parameters) had poor inter-observer reliability (ICC = 0.45, p < 0.05). The inter-observer reliability of the combined HCPS was good (ICC = 0.78, p < 0.001). The HCPS revealed significant differences between horses with chronic painful conditions and control horses on 2 out of 3 days (p < 0.05). In conclusion, we tested a composite pain scale for the assessment of chronic pain in horses based on behavioural and facial expression-based parameters. Further studies are needed to validate this pain scale before it can be used in practice.

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Diurnal Rhythm Robustness in Individuals With PTSD and Insomnia and The Association With Sleep

Journal of Biological Rhythms ◽

10.1177/0748730420984563 ◽

2021 ◽

pp. 074873042098456

Author(s):

Luis Mascaro ◽

Andrew J. K. Phillips ◽

Jacob W. Clark ◽

Laura D. Straus ◽

Sean P. A. Drummond

Keyword(s):

Diurnal Rhythm ◽

Sleep Disturbances ◽

Severity Index ◽

Sleep Time ◽

Individual Variability ◽

Diurnal Rhythms ◽

Relative Amplitude ◽

Clinical Samples ◽

Functional Impairments ◽

Healthy Control

Posttraumatic stress disorder (PTSD) and insomnia are characterized by sleep disturbances and daytime functional impairments. Actigraphy metrics can quantify diurnal rhythms via interdaily stability, intradaily variability, relative amplitude, and sleep regularity. Here, we (a) compared diurnal rhythms in PTSD, insomnia, and healthy control samples using linear mixed modeling; (b) compared inter-individual variability of diurnal rhythms between groups using variance ratio tests; and (c) examined correlations between diurnal rhythms and sleep measures within the clinical samples. Participants ( N = 98) wore wrist-activity monitors for one week and completed the Insomnia Severity Index and Pittsburgh Sleep Quality Index. Both clinical samples displayed significantly lower interdaily stability, relative amplitude, and sleep regularity compared with controls. Individuals with PTSD and insomnia did not differ on mean diurnal rhythm metrics. Both clinical samples showed more inter-individual variability in relative amplitude compared with controls, and the individuals with PTSD were distinguished from those with insomnia by greater inter-individual variability in interdaily stability and relative amplitude. Relative amplitude in the clinical samples was positively correlated with objective sleep efficiency and total sleep time. This is the first study to compare individuals with PTSD and insomnia on measures of diurnal rhythms, revealing those with PTSD and insomnia to have less robust and more variable diurnal rhythms compared with controls. Individuals with PTSD differed from those with insomnia in inter-individual variability of diurnal rest-activity stability and amplitude, highlighting this population as particularly heterogenous. Diurnal rhythm robustness might be considered an intervention target in insomnia and PTSD populations.

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Future directions for integrative objective assessment of eating using wearable sensing technology

10.31232/osf.io/udwf2 ◽

2020 ◽

Author(s):

Andy Skinner ◽

Zoi Toumpakari ◽

Christopher J Stone ◽

Laura Johnson

Keyword(s):

Nutritional Assessment ◽

Objective Assessment ◽

Eating Behaviour ◽

Dietary Factors ◽

Portion Size ◽

Size Estimation ◽

New Methods ◽

Sensing Technology ◽

Wide Range ◽

Passive Data

Established methods for nutritional assessment suffer from a number of important limitations. Diaries are burdensome to complete, food frequency questionnaires only capture average food intake, and both suffer from difficulties in self estimation of portion size and biases resulting from misreporting. Online and app versions of these methods have been developed, but issues with misreporting and portion size estimation remain. New methods utilising passive data capture are required that address reporting bias, extend timescales for data collection, and transform what is possible for measuring habitual intakes. Digital and sensing technologies are enabling the development of innovative and transformative new methods in this area that will provide a better understanding of eating behaviour and associations with health. In this article we describe how wrist-worn wearables, on-body cameras, and body-mounted biosensors can be used to capture data about when, what and how much people eat and drink. We illustrate how these new techniques can be integrated to provide complete solutions for the passive, objective assessment of a wide range of traditional dietary factors, as well as novel measures of eating architecture, within person variation in intakes, and food/nutrient combinations within meals. We also discuss some of the challenges these new approaches will bring.

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THE GAIT ANALYSIS OF PREGNANT WOMEN

Biomedical Engineering Applications Basis and Communications ◽

10.4015/s1016237202000103 ◽

2002 ◽

Vol 14 (02) ◽

pp. 67-70 ◽

Cited By ~ 8

Author(s):

TSAN-HSUN HUANG ◽

SHENG-CHE LIN ◽

CHIN-SHAN HO ◽

CHIA-YUEN YU ◽

YOU-LI CHOU

Keyword(s):

Gait Analysis ◽

Pregnant Women ◽

Plantar Flexion ◽

Endocrine System ◽

Optimization Method ◽

Gait Pattern ◽

Knee Extension ◽

Significant Finding ◽

Joint Center ◽

Hip Extension

During pregnancy, a woman changes obviously in body weight, body shape, and endocrine system. Those changes make the posture and gait pattern of the pregnant women different from those of the non-pregnant women. At the same time, activities of daily living become more difficult. But there was still no published paper discussing the posture and gait changes of the pregnant women in details and in a whole. In this study, we used the optimization method to define the hip joint center of the pregnant women. The optimization method could compensate the lack of the anthropometric data of the pregnant women. Due to the variations of physiological changes in the pregnant women, it was difficulty to standardize the gait analysis of pregnant women, even in the same gestational age. The results revealed that there really was some correlation between the significant finding of gait analysis and sacroiliac pain of the pregnant women. The sacroiliac pain often occurred in the following conditions of gait analysis: (1) when the hip extension moment increased; (2) when the knee extension moment decreased; (3) when the angle of ankle plantar-flexion decreased; and (4) when the sacroiliac ajoint torsion increased. The gait analysis of the pregnant is a feasible, but complicated method for study. The data of gait analysis were also compare with questionnaires for further analysis.

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