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Wattananon P, Kongoun S, Chohan A, Richards J. The use of statistical parametric mapping to determine altered movement patterns in people with chronic low back pain. J Biomech 2023; 153:111601. [PMID: 37126886 DOI: 10.1016/j.jbiomech.2023.111601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 04/18/2023] [Accepted: 04/21/2023] [Indexed: 05/03/2023]
Abstract
Kinematics studies have generally focused on the quantity of movement using discrete parameters such as maximum and minimum angles to compare between people with chronic low back pain (CLBP) and healthy individuals. However, discrete parameters cannot be used to fully describe movement patterns and segmental contributions. This study aimed to explore the use of Statistical Parametric Mapping (SPM) to characterize quality of movement by examining if differences in movement patterns exist between groups, and within-group segmental contributions, during active movement tests. Twenty-one individuals with CLBP and nine healthy individuals were recruited. Inertial Measurement Unit (IMUs) were attached at thoracic (T3) and lumbar (L1) spine, and pelvis (S1) to collect active trunk flexion, extension, rotation, and lateral bend. SPM was used to analyze between-group movement patterns and within-group segmental contributions. SPM revealed no significant differences (P > 0.05) between groups. However, a greater lumbar contribution (P < 0.001) was observed during 10-40% of flexion followed by a greater pelvic contribution (P < 0.001) during 60-90% of flexion, while a greater lumbar than thoracic contribution (P < 0.001) was observed during flexion and the return to upright position in individuals with CLBP. Individuals with CLBP used a greater thoracic contribution compared to lumbar contribution (P < 0.001) during rotation, while a greater lumbar contribution compared to pelvic contribution was observed (P < 0.001) during lateral bending. Our findings suggest that SPM approach was able to detect differences in thoracic, lumbar, and pelvic velocity contributions and timings between segments in individuals with CLBP. These findings may help improving inter-rater reliability of clinical observations.
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Affiliation(s)
- Peemongkon Wattananon
- Spine Biomechanics Laboratory, Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom 73170, Thailand.
| | - Sasithorn Kongoun
- Spine Biomechanics Laboratory, Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom 73170, Thailand.
| | - Ambreen Chohan
- Allied Health Research Unit, University of Central Lancashire, Preston, Lancashire PR1 2HE, United Kingdom.
| | - Jim Richards
- Allied Health Research Unit, University of Central Lancashire, Preston, Lancashire PR1 2HE, United Kingdom.
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Höher J, Lischke B, Petersen W, Mengis N, Niederer D, Stein T, Stoffels T, Prill R, Schmidt-Lucke C. Sensor-based telerehabilitation system increases patient adherence after knee surgery. PLOS DIGITAL HEALTH 2023; 2:e0000175. [PMID: 36812639 PMCID: PMC9937459 DOI: 10.1371/journal.pdig.0000175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 12/02/2022] [Indexed: 02/19/2023]
Abstract
OBJECTIVES Implementing evidence-based recommendations with the option of patient-individualised and situation-specific adaptations in telerehabilitation may increase adherence with improved clinical outcome. METHODS As part of a registry-embedded hybrid design (part 1), digital medical device (DMD)-usage in a home-based setting was analysed in a multinational registry. The DMD combines an inertial motion-sensor system with instructions for exercises and functional tests on smartphones. A prospective, single-blinded, patient-controlled, multicentre intervention study (DRKS00023857) compared implementation capacity of the DMD to standard physiotherapy (part 2). Usage patterns by health care providers (HCP) were assessed (part 3). RESULTS AND CONCLUSION Registry raw data (10,311 measurements) were analysed from 604 DMD-users, demonstrating clinically expected rehabilitation progression post knee injuries. DMD-users performed tests for range-of-motion, coordination and strength/speed enabling insight to stage-specific rehabilitation (χ2 = 44.9, p<0.001). Intention-to-treat-analysis (part 2) revealed DMD-users to have significantly higher adherence to the rehabilitation intervention compared to the matched patient-control-group (86% [77-91] vs. 74% [68-82], p<0.05). DMD-users performed recommended exercises at home with higher intensity (p<0.05). HCP used DMD for clinical decision making. No adverse events related to the DMD were reported. Adherence to standard therapy recommendations can be increased using novel high quality DMD with high potential to improve clinical rehabilitation outcome, enabling evidence-based telerehabilitation.
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Affiliation(s)
- Jürgen Höher
- Sportsclinic Cologne, Cologne, Germany
- Department for Orthopedics and Sports Traumatology, Merheim Hospital Cologne, University of Witten-Herdecke, Germany
| | - Betty Lischke
- MEDIACC (Medico-academic Consultings), Berlin, Germany
| | | | | | - Daniel Niederer
- Department of Sports Medicine and Exercise Physiology, Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt, Frankfurt am Main, Germany
| | - Thomas Stein
- Department of Sports Medicine and Exercise Physiology, Institute of Occupational, Social and Environmental Medicine, Goethe-University Frankfurt, Frankfurt am Main, Germany
- SPORTHOLOGICUM Frankfurt—Center for Sport and Joint Injuries, Frankfurt am Main, Germany
| | - Thomas Stoffels
- OC Stadtmitte—Practice for Orthopedics & Surgery, Berlin, Germany
| | - Robert Prill
- Center of Orthopaedics and Traumatology, Brandenburg Medical School, University Hospital Brandenburg/Havel, Germany
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Proof-of-Concept Study of the Use of Accelerometry to Quantify Knee Joint Movement and Assist with the Diagnosis of Juvenile Idiopathic Arthritis. TECHNOLOGIES 2022. [DOI: 10.3390/technologies10040076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Abstract
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood. Seven children and young people (CYP) with a diagnosis of JIA and suspected active arthritis of a single knee joint were recruited for this proof-of-concept study. The presence of active arthritis was confirmed by clinical examination. Four tri-axial accelerometers were integrated individually in elastic bands and placed above and below each knee. Participants performed ten periodic flexion-extensions of each knee joint while lying down, followed by walking ten meters in a straight path. The contralateral (non-inflamed) knee joint acted as a control. Accelerometry data were concordant with the results of clinical examination in six out of the seven patients recruited. There was a significant difference between the accelerometry measured range of movement (ROM, p-value = 0.032) of the knees with active arthritis and the healthy contralateral knees during flexion-extension. No statistically significant difference was identified between the ROM of the knee joints with active arthritis and healthy knee joints during the walking test. The study demonstrated that accelerometry may help in differentiating between healthy knee joints and those with active arthritis; however, further research is required to confirm these findings.
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Wood DS, Jensen K, Crane A, Lee H, Dennis H, Gladwell J, Shurtz A, Fullwood DT, Seeley MK, Mitchell UH, Christensen WF, Bowden AE. Accurate Prediction of Knee Angles during Open-Chain Rehabilitation Exercises Using a Wearable Array of Nanocomposite Stretch Sensors. SENSORS 2022; 22:s22072499. [PMID: 35408112 PMCID: PMC9003122 DOI: 10.3390/s22072499] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 03/20/2022] [Accepted: 03/21/2022] [Indexed: 01/14/2023]
Abstract
In this work, a knee sleeve is presented for application in physical therapy applications relating to knee rehabilitation. The device is instrumented with sixteen piezoresistive sensors to measure knee angles during exercise, and can support at-home rehabilitation methods. The development of the device is presented. Testing was performed on eighteen subjects, and knee angles were predicted using a machine learning regressor. Subject-specific and device-specific models are analyzed and presented. Subject-specific models average root mean square errors of 7.6 and 1.8 degrees for flexion/extension and internal/external rotation, respectively. Device-specific models average root mean square errors of 12.6 and 3.5 degrees for flexion/extension and internal/external rotation, respectively. The device presented in this work proved to be a repeatable, reusable, low-cost device that can adequately model the knee's flexion/extension and internal/external rotation angles for rehabilitation purposes.
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Affiliation(s)
- David S. Wood
- Department of Mechanical Engineering, Brigham Young University, Provo, UT 84602, USA; (D.S.W.); (K.J.); (A.C.); (D.T.F.)
| | - Kurt Jensen
- Department of Mechanical Engineering, Brigham Young University, Provo, UT 84602, USA; (D.S.W.); (K.J.); (A.C.); (D.T.F.)
| | - Allison Crane
- Department of Mechanical Engineering, Brigham Young University, Provo, UT 84602, USA; (D.S.W.); (K.J.); (A.C.); (D.T.F.)
| | - Hyunwook Lee
- Department of Exercise Science, Brigham Young University, Provo, UT 84602, USA; (H.L.); (H.D.); (M.K.S.); (U.H.M.)
| | - Hayden Dennis
- Department of Exercise Science, Brigham Young University, Provo, UT 84602, USA; (H.L.); (H.D.); (M.K.S.); (U.H.M.)
| | - Joshua Gladwell
- Department of Statistics, Brigham Young University, Provo, UT 84602, USA; (J.G.); (A.S.); (W.F.C.)
| | - Anne Shurtz
- Department of Statistics, Brigham Young University, Provo, UT 84602, USA; (J.G.); (A.S.); (W.F.C.)
| | - David T. Fullwood
- Department of Mechanical Engineering, Brigham Young University, Provo, UT 84602, USA; (D.S.W.); (K.J.); (A.C.); (D.T.F.)
| | - Matthew K. Seeley
- Department of Exercise Science, Brigham Young University, Provo, UT 84602, USA; (H.L.); (H.D.); (M.K.S.); (U.H.M.)
| | - Ulrike H. Mitchell
- Department of Exercise Science, Brigham Young University, Provo, UT 84602, USA; (H.L.); (H.D.); (M.K.S.); (U.H.M.)
| | - William F. Christensen
- Department of Statistics, Brigham Young University, Provo, UT 84602, USA; (J.G.); (A.S.); (W.F.C.)
| | - Anton E. Bowden
- Department of Mechanical Engineering, Brigham Young University, Provo, UT 84602, USA; (D.S.W.); (K.J.); (A.C.); (D.T.F.)
- Correspondence:
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Engstrand F, Tesselaar E, Gestblom R, Farnebo S. Validation of a smartphone application and wearable sensor for measurements of wrist motions. J Hand Surg Eur Vol 2021; 46:1057-1063. [PMID: 33874816 PMCID: PMC8649412 DOI: 10.1177/17531934211004454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 02/03/2023]
Abstract
We developed a smartphone application to measure wrist motion using the mobile device's built-in motion sensors or connecting it via Bluetooth to a wearable sensor. Measurement of wrist motion with this method was assessed in 33 participants on two occasions and compared with those obtained with a standard goniometer. The test-retest reproducibility in healthy individuals ranged from good to excellent (intraclass correlation (ICC) 0.76-0.95) for all motions, both with and without the wearable sensor. These results improved to excellent (ICC 0.90-0.96) on the second test day, suggesting a learning effect. The day-to-day reproducibility was overall better with the wearable sensor (mean ICC 0.87) compared with the application without using sensor or goniometer (mean ICC 0.82 and 0.60, respectively). This study suggests that smartphone-based measurements of wrist range of motion are feasible and highly accurate, making it a powerful tool for outcome studies after wrist surgery.
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Affiliation(s)
- Fredrik Engstrand
- Department of Hand Surgery, Plastic Surgery,
and Burns, Linköping University, Linköping, Sweden
| | - Erik Tesselaar
- Department of Medical Radiation Physics,
Linköping University, Linköping Sweden
| | - Rickard Gestblom
- Department of Hand Surgery, Plastic Surgery,
and Burns, Linköping University, Linköping, Sweden
| | - Simon Farnebo
- Department of Hand Surgery, Plastic Surgery,
and Burns, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical
Sciences, Linköping University, Linköping, Sweden
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Rose MJ, Costello KE, Eigenbrot S, Torabian K, Kumar D. Inertial measurement units and application for remote healthcare in hip and knee osteoarthritis: a narrative review (Preprint). JMIR Rehabil Assist Technol 2021; 9:e33521. [PMID: 35653180 PMCID: PMC9204569 DOI: 10.2196/33521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 02/18/2022] [Accepted: 05/06/2022] [Indexed: 11/16/2022] Open
Abstract
Background Measuring and modifying movement-related joint loading is integral to the management of lower extremity osteoarthritis (OA). Although traditional approaches rely on measurements made within the laboratory or clinical environments, inertial sensors provide an opportunity to quantify these outcomes in patients’ natural environments, providing greater ecological validity and opportunities to develop large data sets of movement data for the development of OA interventions. Objective This narrative review aimed to discuss and summarize recent developments in the use of inertial sensors for assessing movement during daily activities in individuals with hip and knee OA and to identify how this may translate to improved remote health care for this population. Methods A literature search was performed in November 2018 and repeated in July 2019 and March 2021 using the PubMed and Embase databases for publications on inertial sensors in hip and knee OA published in English within the previous 5 years. The search terms encompassed both OA and wearable sensors. Duplicate studies, systematic reviews, conference abstracts, and study protocols were also excluded. One reviewer screened the search result titles by removing irrelevant studies, and 2 reviewers screened study abstracts to identify studies using inertial sensors as the main sensing technology and a primary outcome related to movement quality. In addition, after the March 2021 search, 2 reviewers rescreened all previously included studies to confirm their relevance to this review. Results From the search process, 43 studies were determined to be relevant and subsequently included in this review. Inertial sensors have been successfully implemented for assessing the presence and severity of OA (n=11), assessing disease progression risk and providing feedback for gait retraining (n=7), and remotely monitoring intervention outcomes and identifying potential responders and nonresponders to interventions (n=14). In addition, studies have validated the use of inertial sensors for these applications (n=8) and analyzed the optimal sensor placement combinations and data input analysis for measuring different metrics of interest (n=3). These studies show promise for remote health care monitoring and intervention delivery in hip and knee OA, but many studies have focused on walking rather than a range of activities of daily living and have been performed in small samples (<100 participants) and in a laboratory rather than in a real-world environment. Conclusions Inertial sensors show promise for remote monitoring, risk assessment, and intervention delivery in individuals with hip and knee OA. Future opportunities remain to validate these sensors in real-world settings across a range of activities of daily living and to optimize sensor placement and data analysis approaches.
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Affiliation(s)
- Michael J Rose
- Department of Physical Therapy & Athletic Training, Boston University College of Health & Rehabilitation Sciences: Sargent College, Boston, MA, United States
| | - Kerry E Costello
- Department of Physical Therapy & Athletic Training, Boston University College of Health & Rehabilitation Sciences: Sargent College, Boston, MA, United States
- Division of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, MA, United States
| | - Samantha Eigenbrot
- Department of Physical Therapy & Athletic Training, Boston University College of Health & Rehabilitation Sciences: Sargent College, Boston, MA, United States
| | - Kaveh Torabian
- Department of Physical Therapy & Athletic Training, Boston University College of Health & Rehabilitation Sciences: Sargent College, Boston, MA, United States
| | - Deepak Kumar
- Department of Physical Therapy & Athletic Training, Boston University College of Health & Rehabilitation Sciences: Sargent College, Boston, MA, United States
- Division of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, MA, United States
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Billiaert K, Al-Yassary M, Antonarakis GS, Kiliaridis S. Measuring the difference in natural head position between the standing and sitting positions using an inertial measurement unit. J Oral Rehabil 2021; 48:1144-1149. [PMID: 34293214 PMCID: PMC9290966 DOI: 10.1111/joor.13233] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/30/2021] [Accepted: 07/17/2021] [Indexed: 12/04/2022]
Abstract
Aims The purpose of this study was to compare the natural head position (NHP) in the sitting position to the NHP in a standing position using inertial measurement unit (IMU) and lateral photographs. Matierials & Methods Twenty healthy young adult volunteers were asked to look at a mirror located at 1 metre in front of their eyes while being recorded with the IMU system. Lateral photographs were also taken. This procedure was undertaken for the standing and sitting positions, on two separate occasions within a one‐week interval. Results A strong correlation was found between the IMU system and the lateral photographs (r > .99) with regard to the pitch axis, the absolute mean difference was 0.4 ± 0.5 (p = .99) for both standing and sitting positions. We found that in the sitting position the head was elevated by 2.5 ± 2.4 (p < .05) more than in the standing position, but no significant differences were observed for the other two axes (roll and yaw). Conclusion The IMU system is comparable to lateral photographs for pitch assessment. Except for a slight elevation of the head in the sitting position, no clinical differences were observed for the NHP when comparing the standing and sitting positions.
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Affiliation(s)
- Kelly Billiaert
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Mustafa Al-Yassary
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Gregory S Antonarakis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Stavros Kiliaridis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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Van de Kleut ML, Bloomfield RA, Teeter MG, Athwal GS. Monitoring daily shoulder activity before and after reverse total shoulder arthroplasty using inertial measurement units. J Shoulder Elbow Surg 2021; 30:1078-1087. [PMID: 32771607 PMCID: PMC7409802 DOI: 10.1016/j.jse.2020.07.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/13/2020] [Accepted: 07/19/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND The purpose of this study was to use at-home, portable, continuous monitoring technologies to record arm motion and activity preoperatively and postoperatively after reverse total shoulder arthroplasty (RTSA). METHODS Thirty-three patients indicated for RTSA were monitored preoperatively and 3 and 12 months postoperatively. Inertial measurement units were placed on the sternum and upper arm of the operative limb, recording humeral motion relative to the torso for the duration of a waking day. Elevation events per hour (EE/h) > 90°, time spent at >90°, and activity intensity were calculated and compared between time points. Patient-reported outcome measures were also collected at all time points. RESULTS At 3 (P = .040) and 12 (P = .010) months after RTSA, patients demonstrated a significantly greater number of EE/h > 90° compared with preoperatively. There were no significant differences (P ≥ .242) in the amount of time spent at different elevation angles at any time point or in arm activity intensity. Overall, 95% of the day was spent at elevation angles < 60°, and 90% of the day was spent in a low- or moderate-intensity state. Pearson correlations demonstrated relationships between forward elevation and the number of EE/h (r = 0.395, P = .001) and the number of EE/h > 90° (r = 0.493, P < .001). CONCLUSION After RTSA, patients significantly increase the frequency of arm elevation to higher angles. However, we found no differences in the amount of time spent at different elevation angles. Overall, after RTSA, >95% of the day was spent at elevation angles < 60° and <1% of the day was spent at >90° of elevation.
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Affiliation(s)
- Madeleine L Van de Kleut
- Imaging Research Laboratories, Robarts Research Institute, London, ON, Canada; School of Biomedical Engineering, Western University, London, ON, Canada; Lawson Health Research Institute, London, ON, Canada
| | - Riley A Bloomfield
- Imaging Research Laboratories, Robarts Research Institute, London, ON, Canada; Department of Electrical and Computer Engineering, Western University, London, ON, Canada
| | - Matthew G Teeter
- Imaging Research Laboratories, Robarts Research Institute, London, ON, Canada; Lawson Health Research Institute, London, ON, Canada; Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada; Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - George S Athwal
- Lawson Health Research Institute, London, ON, Canada; Division of Orthopaedic Surgery, Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada.
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Perelgut ME, Polus JS, Lanting BA, Teeter MG. The effect of femoral stem collar on implant migration and clinical outcomes following direct anterior approach total hip arthroplasty. Bone Joint J 2020; 102-B:1654-1661. [PMID: 33249909 DOI: 10.1302/0301-620x.102b12.bjj-2019-1428.r1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
AIMS The direct anterior (DA) approach has been associated with rapid patient recovery after total hip arthroplasty (THA) but may be associated with more frequent femoral complications including implant loosening. The objective of this study was to determine whether the addition of a collar to the femoral stem affects implant migration, patient activity, and patient function following primary THA using the DA approach. METHODS Patients were randomized to either a collared (n = 23) or collarless (n = 26) cementless femoral stem implanted using the DA approach. Canal fill ratio (CFR) was measured on the first postoperative radiographs. Patients underwent a supine radiostereometric analysis (RSA) exam postoperatively on the day of surgery and at two, four, six, 12, 26, and 52 weeks postoperatively. Patient-reported outcome measures (Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index, the 12-item Short Form Health Survey Mental and Physical Score, and University of California, Los Angeles (UCLA) Activity Score) were measured preoperatively and at each post-surgery clinic visit. Activity and function were also measured as the weekly average step count recorded by an activity tracker, and an instrumented timed up-and-go (TUG) test in clinic, respectively. RESULTS Comparing the RSA between the day of surgery baseline exam to two weeks postoperatively, subsidence was significantly lower (mean difference 2.23 mm (SD 0.71), p = 0.023) with collared stems, though these patients had a greater CFR (p = 0.048). There was no difference (p = 0.426) in subsidence between stems from a two-week baseline through to one year postoperatively. There were no clinically relevant differences in PROMs; and there was no difference in the change in activity (p = 0.078) or the change in functional capacity (p = 0.664) between the collared stem group and the collarless stem group at any timepoint. CONCLUSION Presence of a collar on the femoral stem resulted in reduced subsidence during the first two postoperative weeks following primary THA using the DA approach. However, the clinical implications are unclear, and larger studies examining patient activity and outcomes are required. Cite this article: Bone Joint J 2020;102-B(12):1654-1661.
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Affiliation(s)
- Maxwell E Perelgut
- School of Biomedical Engineering, Western University, London, Ontario, Canada.,Imaging Research Laboratories, Robarts Research Institute, Western University, London, Ontario, Canada
| | - Jennifer S Polus
- School of Biomedical Engineering, Western University, London, Ontario, Canada.,Imaging Research Laboratories, Robarts Research Institute, Western University, London, Ontario, Canada
| | - Brent A Lanting
- Division of Orthopaedic Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Matthew G Teeter
- School of Biomedical Engineering, Western University, London, Ontario, Canada.,Imaging Research Laboratories, Robarts Research Institute, Western University, London, Ontario, Canada.,Division of Orthopaedic Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.,Surgical Innovation Program, Lawson Health Research Institute, London, Ontario, Canada
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10
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Müller P, Del Ama AJ, Moreno JC, Schauer T. Adaptive multichannel FES neuroprosthesis with learning control and automatic gait assessment. J Neuroeng Rehabil 2020; 17:36. [PMID: 32111245 PMCID: PMC7048130 DOI: 10.1186/s12984-020-0640-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 12/31/2019] [Indexed: 11/26/2022] Open
Abstract
Background FES (Functional Electrical Stimulation) neuroprostheses have long been a permanent feature in the rehabilitation and gait support of people who had a stroke or have a Spinal Cord Injury (SCI). Over time the well-known foot switch triggered drop foot neuroprosthesis, was extended to a multichannel full-leg support neuroprosthesis enabling improved support and rehabilitation. However, these neuroprostheses had to be manually tuned and could not adapt to the persons’ individual needs. In recent research, a learning controller was added to the drop foot neuroprosthesis, so that the full stimulation pattern during the swing phase could be adapted by measuring the joint angles of previous steps. Methods The aim of this research is to begin developing a learning full-leg supporting neuroprosthesis, which controls the antagonistic muscle pairs for knee flexion and extension, as well as for ankle joint dorsi- and plantarflexion during all gait phases. A method was established that allows a continuous assessment of knee and foot joint angles with every step. This method can warp the physiological joint angles of healthy subjects to match the individual pathological gait of the subject and thus allows a direct comparison of the two. A new kind of Iterative Learning Controller (ILC) is proposed which works independent of the step duration of the individual and uses physiological joint angle reference bands. Results In a first test with four people with an incomplete SCI, the results showed that the proposed neuroprosthesis was able to generate individually fitted stimulation patterns for three of the participants. The other participant was more severely affected and had to be excluded due to the resulting false triggering of the gait phase detection. For two of the three remaining participants, a slight improvement in the average foot angles could be observed, for one participant slight improvements in the averaged knee angles. These improvements where in the range of 4circat the times of peak dorsiflexion, peak plantarflexion, or peak knee flexion. Conclusions Direct adaptation to the current gait of the participants could be achieved with the proposed method. The preliminary first test with people with a SCI showed that the neuroprosthesis can generate individual stimulation patterns. The sensitivity to the knee angle reset, timing problems in participants with significant gait fluctuations, and the automatic ILC gain tuning are remaining issues that need be addressed. Subsequently, future studies should compare the improved, long-term rehabilitation effects of the here presented neuroprosthesis, with conventional multichannel FES neuroprostheses.
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Affiliation(s)
| | | | - Juan C Moreno
- Instituto Cajal, Spanish National Research Council (CSIC), Madrid, Spain
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11
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Lisiński P, Wareńczak A, Hejdysz K, Sip P, Gośliński J, Owczarek P, Jonak J, Goślińska J. Mobile Applications in Evaluations of Knee Joint Kinematics: A Pilot Study. SENSORS (BASEL, SWITZERLAND) 2019; 19:E3675. [PMID: 31450854 PMCID: PMC6749278 DOI: 10.3390/s19173675] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/22/2019] [Accepted: 08/22/2019] [Indexed: 01/12/2023]
Abstract
Because medical professionals lack the means to monitor exercises performed by patients in their home environment directly, there is a strong case for introducing technological solutions into this domain. They include methods that use wireless inertial sensors, which emit signals recorded and processed by special applications that work with mobile devices. This paper's aim is (a) to evaluate whether such sensors are suitable for qualitative and quantitative motion analysis, and (b) to determine the repeatability of results over a few recordings. Knee joint activity was analysed using a system of inertial sensors connected through a Wi-Fi network to mobile devices. The tested individuals did eight different activities, all of which engaged the knee joint. Each excercise was repeated three times. Study results did not reveal any statistically significant differences between the three measurements for most of the studied parameters. Furthermore, in almost every case, there were no statistically significant differences between the results of the right and left lower limb (p > 0.05). This study shows that easy use and repeatability of results combined with the feature of quantitative and qualitative analysis make the examined method useful for functional evaluations of the knee joint.
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Affiliation(s)
- Przemysław Lisiński
- Department of Rehabilitation and Physiotherapy, Poznan University of Medical Sciences, 28 Czerwca 1956 Str., No 135/147, 60-545 Poznań, Poland
| | - Agnieszka Wareńczak
- Department of Rehabilitation and Physiotherapy, Poznan University of Medical Sciences, 28 Czerwca 1956 Str., No 135/147, 60-545 Poznań, Poland
| | - Krystyna Hejdysz
- Department of Rehabilitation and Physiotherapy, Poznan University of Medical Sciences, 28 Czerwca 1956 Str., No 135/147, 60-545 Poznań, Poland
| | - Paweł Sip
- Department of Rehabilitation and Physiotherapy, Poznan University of Medical Sciences, 28 Czerwca 1956 Str., No 135/147, 60-545 Poznań, Poland
| | | | - Piotr Owczarek
- Aisens Sp. z o. o., Lubeckiego 23A, 60-348 Poznań, Poland
| | - Justyna Jonak
- Department of Politics and International Relations, University of Southampton, Southampton SO17 1BJ United Kingdom, UK
| | - Jagoda Goślińska
- Department of Rehabilitation and Physiotherapy, Poznan University of Medical Sciences, 28 Czerwca 1956 Str., No 135/147, 60-545 Poznań, Poland.
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