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Angelucci A, Canali S, Aliverti A. Digital technologies for step counting: between promises of reliability and risks of reductionism. Front Digit Health 2023; 5:1330189. [PMID: 38152629 PMCID: PMC10751316 DOI: 10.3389/fdgth.2023.1330189] [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: 10/30/2023] [Accepted: 11/30/2023] [Indexed: 12/29/2023] Open
Abstract
Step counting is among the fundamental features of wearable technology, as it grounds several uses of wearables in biomedical research and clinical care, is at the center of emerging public health interventions and recommendations, and is gaining increasing scientific and political importance. This paper provides a perspective of step counting in wearable technology, identifying some limitations to the ways in which wearable technology measures steps and indicating caution in current uses of step counting as a proxy for physical activity. Based on an overview of the current state of the art of technologies and approaches to step counting in digital wearable technologies, we discuss limitations that are methodological as well as epistemic and ethical-limitations to the use of step counting as a basis to build scientific knowledge on physical activity (epistemic limitations) as well as limitations to the accessibility and representativity of these tools (ethical limitations). As such, using step counting as a proxy for physical activity should be considered a form of reductionism. This is not per se problematic, but there is a need for critical appreciation and awareness of the limitations of reductionistic approaches. Perspective research should focus on holistic approaches for better representation of physical activity levels and inclusivity of different user populations.
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Torres-Castro R, Pascual H, Alonso A, Gimeno-Santos E, Palomo M, Barberà JA, Bigorra J, Batlle J, Masip-Bruin X, Blanco I. Use of automatic 6-minute walking test recording system in patients with chronic respiratory diseases. Pulmonology 2023:S2531-0437(23)00166-6. [PMID: 37783641 DOI: 10.1016/j.pulmoe.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/27/2023] [Accepted: 08/31/2023] [Indexed: 10/04/2023] Open
Affiliation(s)
- R Torres-Castro
- Department of Pulmonary Medicine, Hospital Clínic, University of Barcelona, Barcelona, Spain; Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | - H Pascual
- CRAAX Lab, Universitat Politècnica de Catalunya, Vilanova i la Geltru, Spain
| | - A Alonso
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - E Gimeno-Santos
- Department of Pulmonary Medicine, Hospital Clínic, University of Barcelona, Barcelona, Spain; Instituto de Salud Global (ISGlobal), Barcelona, Spain; Biomedical Research Networking Center on Respiratory Diseases (CIBERES); Madrid, Spain
| | - M Palomo
- Department of Pulmonary Medicine, Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - J A Barberà
- Department of Pulmonary Medicine, Hospital Clínic, University of Barcelona, Barcelona, Spain; Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Biomedical Research Networking Center on Respiratory Diseases (CIBERES); Madrid, Spain
| | - J Bigorra
- Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Instituto de Salud Global (ISGlobal), Barcelona, Spain
| | - J Batlle
- Innovation Consultant-Techno & Innovative Solutions, SLU; Vilanova i la Geltrú, Spain
| | - X Masip-Bruin
- CRAAX Lab, Universitat Politècnica de Catalunya, Vilanova i la Geltru, Spain
| | - I Blanco
- Department of Pulmonary Medicine, Hospital Clínic, University of Barcelona, Barcelona, Spain; Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; Biomedical Research Networking Center on Respiratory Diseases (CIBERES); Madrid, Spain.
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Recio-Garcia JA, Diaz-Agudo B, Acuaviva A. Becalm: Intelligent Monitoring of Respiratory Patients. IEEE J Biomed Health Inform 2023; 27:3806-3817. [PMID: 37192034 DOI: 10.1109/jbhi.2023.3276638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
The Becalm project is an open and low-cost solution for the remote monitoring of respiratory support therapies like the ones used in COVID-19 patients. Becalm combines a decision-making system based on Case-Based Reasoning with a low-cost, non-invasive mask that enables the remote monitoring, detection, and explanation of risk situations for respiratory patients. This paper first describes the mask and the sensors that allow remote monitoring. Then, it describes the intelligent decision-making system that detects anomalies and raises early warnings. This detection is based on the comparison of cases that represent patients using a set of static variables plus the dynamic vector of the patient time series from sensors. Finally, personalized visual reports are created to explain the causes of the warning, data patterns, and patient context to the healthcare professional. To evaluate the case-based early-warning system, we use a synthetic data generator that simulates patients' clinical evolution from the physiological features and factors described in healthcare literature. This generation process has been verified with a real dataset and allows the validation of the reasoning system with noisy and incomplete data, threshold values, and life/death situations. The evaluation demonstrates promising results and good accuracy (0.91) for the proposed low-cost solution to monitor respiratory patients.
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Angelucci A, Aliverti A. An IMU-Based Wearable System for Respiratory Rate Estimation in Static and Dynamic Conditions. Cardiovasc Eng Technol 2023; 14:351-363. [PMID: 36849621 PMCID: PMC9970135 DOI: 10.1007/s13239-023-00657-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 01/24/2023] [Indexed: 03/01/2023]
Abstract
PURPOSE Breathing parameters change with activity and posture, but currently available solutions can perform measurements only during static conditions. METHODS This article presents an innovative wearable sensor system constituted by three inertial measurement units to simultaneously estimate respiratory rate (RR) in static and dynamic conditions and perform human activity recognition (HAR) with the same sensing principle. Two units are aimed at detecting chest wall breathing-related movements (one on the thorax, one on the abdomen); the third is on the lower back. All units compute the quaternions describing the subject's movement and send data continuously with the ANT transmission protocol to an app. The 20 healthy subjects involved in the research (9 men, 11 women) were between 23 and 54 years old, with mean age 26.8, mean height 172.5 cm and mean weight 66.9 kg. Data from these subjects during different postures or activities were collected and analyzed to extract RR. RESULTS Statistically significant differences between dynamic activities ("walking slow", "walking fast", "running" and "cycling") and static postures were detected (p < 0.05), confirming the obtained measurements are in line with physiology even during dynamic activities. Data from the reference unit only and from all three units were used as inputs to artificial intelligence methods for HAR. When the data from the reference unit were used, the Gated Recurrent Unit was the best performing method (97% accuracy). With three units, a 1D Convolutional Neural Network was the best performing (99% accuracy). CONCLUSION Overall, the proposed solution shows it is possible to perform simultaneous HAR and RR measurements in static and dynamic conditions with the same sensor system.
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Affiliation(s)
- Alessandra Angelucci
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Piazza Leonardo Da Vinci 32, 20133, Milan, Italy.
| | - Andrea Aliverti
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Piazza Leonardo Da Vinci 32, 20133, Milan, Italy
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Cai J, Xu H, Jiang S, Sung J, Sawhney R, Broadley S, Sun J. Effectiveness of telemonitoring intervention on glycaemic control in patients with type 2 diabetes mellitus: A systematic review and meta-analysis. Diabetes Res Clin Pract 2023; 201:110727. [PMID: 37217016 DOI: 10.1016/j.diabres.2023.110727] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 02/18/2023] [Accepted: 05/18/2023] [Indexed: 05/24/2023]
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a rising global health concern that requires long-term treatment and close monitoring. Telemonitoring has been shown to be a promising tool to facilitate patient-physician interaction and improve glycaemic control. METHOD Randomised controlled trials (RCT) of telemonitoring in T2DM published between 1990 and 2021 were searched through multiple electronic databases. The primary outcome variables included HbA1c and fasting blood glucose (FBG), and BMI was a secondary outcome variable. RESULTS Thirty RCT with a total of 4,678 participants were included in this study. Twenty-six studies reported on HbA1c, which was shown to be significantly lower in participants on telemonitoring when compared to conventional care. Ten studies investigated FBG which collectively showed no statistically significant difference. Subgroup analysis demonstrated the effect of telemonitoring on glycaemic control is influenced by a range of factors concerning system practicality, user engagement, patient characteristics and disease education. CONCLUSION Telemonitoring exhibited a great potential to improve T2DM management. Several technical features and patient factors may influence the effectiveness of telemonitoring. Further studies are needed to verify the findings and address limitations before its implementation into routine practice.
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Affiliation(s)
- Jinxuan Cai
- School of Medicine and Dentistry Griffith University, Q4215, Australia.
| | - Huaying Xu
- School of Medicine and Dentistry Griffith University, Q4215, Australia.
| | - Stephen Jiang
- School of Medicine and Dentistry Griffith University, Q4215, Australia.
| | - Jerry Sung
- School of Medicine and Dentistry Griffith University, Q4215, Australia.
| | - Rakshat Sawhney
- School of Medicine and Dentistry Griffith University, Q4215, Australia.
| | - Simon Broadley
- School of Medicine and Dentistry Griffith University, Q4215, Australia; Menzies Health Institute Queensland, Griffith University, Q4215, Australia; Department of Neurology, Gold Coast University Hospital, Q4222, Australia.
| | - Jing Sun
- School of Medicine and Dentistry Griffith University, Q4215, Australia; Menzies Health Institute Queensland, Griffith University, Q4215, Australia; Institute for Integrated and Intelligent System, Griffith University, Q4222, Australia.
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Angelucci A, Greco M, Canali S, Marelli G, Avidano G, Goretti G, Cecconi M, Aliverti A. Fitbit Data to Assess Functional Capacity in Patients Before Elective Surgery: Pilot Prospective Observational Study. J Med Internet Res 2023; 25:e42815. [PMID: 37052980 PMCID: PMC10141298 DOI: 10.2196/42815] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 02/03/2023] [Accepted: 02/22/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Preoperative assessment is crucial to prevent the risk of complications of surgical operations and is usually focused on functional capacity. The increasing availability of wearable devices (smartwatches, trackers, rings, etc) can provide less intrusive assessment methods, reduce costs, and improve accuracy. OBJECTIVE The aim of this study was to present and evaluate the possibility of using commercial smartwatch data, such as those retrieved from the Fitbit Inspire 2 device, to assess functional capacity before elective surgery and correlate such data with the current gold standard measure, the 6-Minute Walk Test (6MWT) distance. METHODS During the hospital visit, patients were evaluated in terms of functional capacity using the 6MWT. Patients were asked to wear the Fitbit Inspire 2 for 7 days (with flexibility of -2 to +2 days) after the hospital visit, before their surgical operation. Resting heart rate and daily steps data were retrieved directly from the smartwatch. Feature engineering techniques allowed the extraction of heart rate over steps (HROS) and a modified version of Non-Exercise Testing Cardiorespiratory Fitness. All measures were correlated with 6MWT. RESULTS In total, 31 patients were enrolled in the study (n=22, 71% men; n=9, 29% women; mean age 76.06, SD 4.75 years). Data were collected between June 2021 and May 2022. The parameter that correlated best with the 6MWT was the Non-Exercise Testing Cardiorespiratory Fitness index (r=0.68; P<.001). The average resting heart rate over the whole acquisition period for each participant had r=-0.39 (P=.03), even if some patients did not wear the device at night. The correlation of the 6MWT distance with the HROS evaluated at 1% quantile was significant, with Pearson coefficient of -0.39 (P=.04). Fitbit step count had a fair correlation of 0.59 with 6MWT (P<.001). CONCLUSIONS Our study is a promising starting point for the adoption of wearable technology in the evaluation of functional capacity of patients, which was strongly correlated with the gold standard. The study also identified limitations in the availability of metrics, variability of devices, accuracy and quality of data, and accessibility as crucial areas of focus for future studies.
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Affiliation(s)
- Alessandra Angelucci
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
| | - Massimiliano Greco
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Department of Anesthesiology and Intensive Care, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Stefano Canali
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
- META - Social Sciences and Humanities for Science and Technology, Politecnico di Milano, Milano, Italy
| | - Giovanni Marelli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
| | - Gaia Avidano
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
| | - Giulia Goretti
- Department of Anesthesiology and Intensive Care, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Maurizio Cecconi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Italy
- Department of Anesthesiology and Intensive Care, IRCCS Humanitas Research Hospital, Rozzano, Italy
| | - Andrea Aliverti
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
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Owens RL, Derom E, Ambrosino N. Supplemental oxygen and noninvasive ventilation. Eur Respir Rev 2023; 32:220159. [PMID: 36948502 PMCID: PMC10032613 DOI: 10.1183/16000617.0159-2022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/27/2022] [Indexed: 03/24/2023] Open
Abstract
The respiratory system attempts to maintain normal levels of oxygen and carbon dioxide. However, airflow limitation, parenchymal abnormalities and dysfunction of the respiratory pump may be compromised in individuals with advanced COPD, eventually leading to respiratory failure, with reduced arterial oxygen tension (hypoxaemia) and/or increased arterial carbon dioxide tension (P aCO2 ; hypercapnia). Hypoxaemia may persist in individuals with severe COPD despite smoking cessation and optimisation of pharmacotherapy. Long-term oxygen therapy (LTOT) can improve survival in those with severe daytime hypoxaemia, whereas those with less severe hypoxaemia may only have improved exercise capacity and dyspnoea. Changes in respiratory physiology that occur during sleep further predispose to hypoxaemia, particularly in individuals with COPD. However, the major cause of hypoxaemia is hypoventilation. Noninvasive ventilation (NIV) may reduce mortality and need for intubation in individuals with COPD and acute hypercapnic respiratory failure. However, NIV may also improve survival and quality of life in individuals with stable, chronic hypercapnia and is now suggested for those with prolonged hypercapnia (e.g. P aCO2 >55 mmHg 2-6 weeks after hospital discharge) when clinically stable and after optimisation of medical therapy including LTOT if indicated. Many questions remain about the optimal mode, settings and goal of NIV therapy.
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Affiliation(s)
- Robert L Owens
- Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, La Jolla, CA, USA
| | - Eric Derom
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - Nicolino Ambrosino
- Istituti Clinici Scientifici Maugeri, IRCCS, Scientific Institute of Montescano, Montescano, Italy
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8
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Tele-Medicine: The Search of the Holy Grail. Arch Bronconeumol 2023:S0300-2896(23)00026-1. [PMID: 36803936 DOI: 10.1016/j.arbres.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 01/27/2023] [Accepted: 01/30/2023] [Indexed: 02/10/2023]
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9
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Pennati F, Angelucci A, Morelli L, Bardini S, Barzanti E, Cavallini F, Conelli A, Di Federico G, Paganelli C, Aliverti A. Electrical Impedance Tomography: From the Traditional Design to the Novel Frontier of Wearables. SENSORS (BASEL, SWITZERLAND) 2023; 23:1182. [PMID: 36772222 PMCID: PMC9921522 DOI: 10.3390/s23031182] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
Electrical impedance tomography (EIT) is a medical imaging technique based on the injection of a current or voltage pattern through electrodes on the skin of the patient, and on the reconstruction of the internal conductivity distribution from the voltages collected by the electrodes. Compared to other imaging techniques, EIT shows significant advantages: it does not use ionizing radiation, is non-invasive and is characterized by high temporal resolution. Moreover, its low cost and high portability make it suitable for real-time, bedside monitoring. However, EIT is also characterized by some technical limitations that cause poor spatial resolution. The possibility to design wearable devices based on EIT has recently given a boost to this technology. In this paper we reviewed EIT physical principles, hardware design and major clinical applications, from the classical to a wearable setup. A wireless and wearable EIT system seems a promising frontier of this technology, as it can both facilitate making clinical measurements and open novel scenarios to EIT systems, such as home monitoring.
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Zhu Q, Wu T, Wang N. From Piezoelectric Nanogenerator to Non-Invasive Medical Sensor: A Review. BIOSENSORS 2023; 13:113. [PMID: 36671948 PMCID: PMC9856170 DOI: 10.3390/bios13010113] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/01/2023] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
Piezoelectric nanogenerators (PENGs) not only are able to harvest mechanical energy from the ambient environment or body and convert mechanical signals into electricity but can also inform us about pathophysiological changes and communicate this information using electrical signals, thus acting as medical sensors to provide personalized medical solutions to patients. In this review, we aim to present the latest advances in PENG-based non-invasive sensors for clinical diagnosis and medical treatment. While we begin with the basic principles of PENGs and their applications in energy harvesting, this review focuses on the medical sensing applications of PENGs, including detection mechanisms, material selection, and adaptive design, which are oriented toward disease diagnosis. Considering the non-invasive in vitro application scenario, discussions about the individualized designs that are intended to balance a high performance, durability, comfortability, and skin-friendliness are mainly divided into two types: mechanical sensors and biosensors, according to the key role of piezoelectric effects in disease diagnosis. The shortcomings, challenges, and possible corresponding solutions of PENG-based medical sensing devices are also highlighted, promoting the development of robust, reliable, scalable, and cost-effective medical systems that are helpful for the public.
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Affiliation(s)
- Qiliang Zhu
- Center for Green Innovation, School of Mathematics and Physics, University of Science and Technology Beijing, Beijing 100083, China
| | - Tong Wu
- Center for Green Innovation, School of Mathematics and Physics, University of Science and Technology Beijing, Beijing 100083, China
- National Institute of Metrology, Beijing 100029, China
| | - Ning Wang
- Center for Green Innovation, School of Mathematics and Physics, University of Science and Technology Beijing, Beijing 100083, China
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Pierucci P. Tele-consultation: A new promised land? Pulmonology 2023; 29:2-3. [PMID: 36182660 PMCID: PMC9805545 DOI: 10.1016/j.pulmoe.2022.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 08/16/2022] [Indexed: 01/28/2023] Open
Affiliation(s)
- P Pierucci
- Cardiothoracic Department, Respiratory and Critical care Unit Bari Policlinic University Hospital, Italy; Section of Respiratory Diseases, Dept. of Basic Medical Science Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Italy.
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12
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Buekers J, Arbillaga-Etxarri A, Gimeno-Santos E, Donaire-Gonzalez D, Chevance G, Aerts JM, Garcia-Aymerich J. Heart rate and oxygen uptake kinetics obtained from continuous measurements with wearable devices during outdoor walks of patients with COPD. Digit Health 2023; 9:20552076231162989. [PMID: 36937691 PMCID: PMC10017947 DOI: 10.1177/20552076231162989] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 02/23/2023] [Indexed: 03/16/2023] Open
Abstract
Objective Continuous physiological measurements during a laboratory-based exercise test can provide physiological biomarkers, such as heart rate (HR) and oxygen uptake (V̇O2) kinetics, that carry clinically relevant information. In contrast, it is not clear how continuous data generated by wearable devices during daily-life routines could provide meaningful biomarkers. We aimed to determine whether valid HR and V̇O2 kinetics can be obtained from measurements with wearable devices during outdoor walks in patients with chronic obstructive pulmonary disease (COPD). Methods HR (Polar Belt) and V̇O2(METAMAX3B) were measured during 93 physical activity transitions performed by eight patients with COPD during three different outdoor walks (ntr = 77) and a 6-minute walk test (ntr = 16). HR and V̇O2 kinetics were calculated every time a participant started a walk, finished a walk or walked upstairs. HR and V̇O2 kinetics were considered valid if the response magnitude and model fit were adequate, and model parameters were reliable. Results Continuous measurements with wearable devices provided valid HR kinetics when COPD patients started or finished (range 63%-100%) the different outdoor walks and valid V̇O2 kinetics when they finished (range 63%-100%) an outdoor walk. The amount of valid kinetics and kinetic model performance was comparable between outdoor walks and a laboratory-based exercise test (p > .05). Conclusion We envision that the presented approach could improve telemonitoring applications of patients with COPD by providing regular, unsupervised assessments of HR kinetics during daily-life routines. This could allow to early identify a decline in the patients' dynamic physiological functioning, physical fitness and/or health status.
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Affiliation(s)
- Joren Buekers
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Measure, Model & Manage Bioresponses (M3-BIORES), Department of Biosystems, KU Leuven, Leuven, Belgium
- Joren Buekers, ISGlobal, Doctor Aiguader 88, 08003 Barcelona, Spain.
| | | | - Elena Gimeno-Santos
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Respiratory Clinic Institute, Hospital Clinic of Barcelona, Barcelona, Spain
| | - David Donaire-Gonzalez
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology (EEPI), Utrecht University, Utrecht, the Netherlands
| | | | - Jean-Marie Aerts
- Measure, Model & Manage Bioresponses (M3-BIORES), Department of Biosystems, KU Leuven, Leuven, Belgium
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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Angelucci A, Li Z, Stoimenova N, Canali S. The paradox of the artificial intelligence system development process: the use case of corporate wellness programs using smart wearables. AI & SOCIETY 2022:1-11. [PMID: 36185063 PMCID: PMC9511446 DOI: 10.1007/s00146-022-01562-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 09/12/2022] [Indexed: 11/23/2022]
Abstract
Artificial intelligence (AI) systems have been widely applied to various contexts, including high-stake decision processes in healthcare, banking, and judicial systems. Some developed AI models fail to offer a fair output for specific minority groups, sparking comprehensive discussions about AI fairness. We argue that the development of AI systems is marked by a central paradox: the less participation one stakeholder has within the AI system's life cycle, the more influence they have over the way the system will function. This means that the impact on the fairness of the system is in the hands of those who are less impacted by it. However, most of the existing works ignore how different aspects of AI fairness are dynamically and adaptively affected by different stages of AI system development. To this end, we present a use case to discuss fairness in the development of corporate wellness programs using smart wearables and AI algorithms to analyze data. The four key stakeholders throughout this type of AI system development process are presented. These stakeholders are called service designer, algorithm designer, system deployer, and end-user. We identify three core aspects of AI fairness, namely, contextual fairness, model fairness, and device fairness. We propose a relative contribution of the four stakeholders to the three aspects of fairness. Furthermore, we propose the boundaries and interactions between the four roles, from which we make our conclusion about the possible unfairness in such an AI developing process.
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Affiliation(s)
- Alessandra Angelucci
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Ziyue Li
- The Cologne Institute of Information Systems, Faculty of Management, Economics and Social Sciences, University of Cologne, Cologne, Germany
- Department of Industrial Engineering and Decision Analytics, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Niya Stoimenova
- Department of Industrial Design, Delft University of Technology, Delft, Netherlands
| | - Stefano Canali
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
- META—Social Sciences and Humanities for Science and Technology, Politecnico di Milano, Milan, Italy
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Moita J, Brito U, Rodrigues C, Ferreira L, Vieira JR, Catarino A, Morais A, Hespanhol V, Cordeiro CR. Chronic obstructive pulmonary disease exacerbations' management in Portuguese hospitals - EvaluateCOPDpt, a multicentre, observational, prospective study. Pulmonology 2022:S2531-0437(22)00155-6. [PMID: 36115826 DOI: 10.1016/j.pulmoe.2022.07.007] [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: 02/25/2022] [Revised: 07/15/2022] [Accepted: 07/16/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION AND OBJECTIVES In order to improve the quality of chronic obstructive pulmonary disease (COPD) patients' care, better knowledge of clinical practice and the factors associated with patient outcomes are needed. This study aimed to evaluate the relation between clinical practice and the outcomes of patients admitted for COPD exacerbations in Portuguese hospitals. MATERIALS AND METHODS Observational, multicentre, prospective study with a 60-days follow-up period, in 11 hospitals, including patients aged ≥ 30 years, admitted to hospital for at least 24 hours due to an acute exacerbation of COPD. Demographic and clinical data were collected, including sex, age, smoking habits, hospitalisations, pulmonary function, comorbidities, COPD symptoms, and treatment. Sixty days after discharge, COPD exacerbations management, outcome measures, and readmission data were evaluated through a structured phone follow-up interview. RESULTS 196 patients were included (85.7% male, mean age 71.2 years), the majority admitted through the emergency service. Ex-smokers and current smokers accounted for 51% and 36%, respectively. On admission, 72.4% were on LAMA, 54.6% on LABA, and 45.5% were on LABA/LAMA. Inhaled corticosteroids (ICS) were used in 37.3% and systemic steroids (SCS) in 10.3%. 35.7 % had had at least one exacerbation, with hospitalisation, in the previous year. There was no spirometry data for 23.2%. On hospitalisation, 98.5% of patients were treated with oxygen and 38.3% with non-invasive ventilation. Additionally, 93.4% used SCS and 60.2% ICS. Antibiotics were administered to 85.2%. 95.4% of patients were discharged; 9 died, 5 of whom had a COPD-related death. The median length of stay was 12 days for discharged patients and 33 days for patients who died. At discharge, 79.1% were prescribed with LAMA, 63.6% SCS, 61.5% LABA and 55.6% LAMA+LABA. 26,2% were prescribed with ICS+LABA+LAMA. At follow-up, 44.4% had a scheduled medical appointment within the 60 days after being discharged, and 28.3% were later readmitted due to exacerbation, of whom 52.8% were hospitalised. CONCLUSIONS The severity of COPD, particularly in exacerbations, is directly related to impaired lung function and quality of life, mortality, and significant health system costs. Knowledge about COPD exacerbations' management in acute hospital admissions in Portugal may help stimulate a national discussion and review of existing data to engage clinicians, policymakers, managers, and patients, raising awareness and promoting action on COPD.
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Affiliation(s)
- J Moita
- Pulmonology Unit, Coimbra Hospital and University Centre, Coimbra, Portugal.
| | - U Brito
- Pulmonology Unit, Algarve Hospital and University Centre, Faro, Portugal
| | - C Rodrigues
- Pulmonology Unit, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - L Ferreira
- Pulmonology Unit, Sousa Martins Hospital, Guarda, Portugal
| | - J R Vieira
- Pulmonology Unit, Garcia de Orta Hospital, Almada, Portugal
| | - A Catarino
- Pulmonology Unit, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - A Morais
- Pulmonology Unit, São João Hospital and University Centre, Porto, Portugal
| | - V Hespanhol
- Pulmonology Unit, São João Hospital and University Centre, Porto, Portugal
| | - C R Cordeiro
- University Clinic of Pulmonology, Faculty of Medicine, University of Coimbra, Portugal; Clinical Academic Centre of Coimbra, Portugal
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15
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Ambrosino N, Aliverti A. Use of Technology in Respiratory Medicine. Arch Bronconeumol 2022; 59:197-198. [PMID: 36153215 DOI: 10.1016/j.arbres.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 09/05/2022] [Indexed: 11/20/2022]
Affiliation(s)
- Nicolino Ambrosino
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Montescano, Pavia, Italy.
| | - Andrea Aliverti
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milano, Italy
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16
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Bernasconi S, Angelucci A, Aliverti A. A Scoping Review on Wearable Devices for Environmental Monitoring and Their Application for Health and Wellness. SENSORS (BASEL, SWITZERLAND) 2022; 22:5994. [PMID: 36015755 PMCID: PMC9415849 DOI: 10.3390/s22165994] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
This scoping review is focused on wearable devices for environmental monitoring. First, the main pollutants are presented, followed by sensing technologies that are used for the parameters of interest. Selected examples of wearables and portables are divided into commercially available and research-level projects. While many commercial products are in fact portable, there is an increasing interest in using a completely wearable technology. This allows us to correlate the pollution level to other personal information (performed activity, position, and respiratory parameters) and thus to estimate personal exposure to given pollutants. The fact that there are no univocal indices to estimate outdoor or indoor air quality is also an open problem. Finally, applications of wearables for environmental monitoring are discussed. Combining environmental monitoring with other devices would permit better choices of where to perform sports activities, especially in highly polluted areas, and provide detailed information on the living conditions of individuals.
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17
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Abineza C, Balas VE, Nsengiyumva P. A machine-learning-based prediction method for easy COPD classification based on pulse oximetry clinical use. JOURNAL OF INTELLIGENT & FUZZY SYSTEMS 2022. [DOI: 10.3233/jifs-219270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Chronic Obstructive Pulmonary Disease (COPD) is a progressive, obstructive lung disease that restricts airflow from the lungs. COPD patients are at risk of sudden and acute worsening of symptoms called exacerbations. Early identification and classification of COPD exacerbation can reduce COPD risks and improve patient’s healthcare and management. Pulse oximetry is a non-invasive technique used to assess patients with acutely worsening symptoms. As part of manual diagnosis based on pulse oximetry, clinicians examine three warning signs to classify COPD patients. This may lack high sensitivity and specificity which requires a blood test. However, laboratory tests require time, further delayed treatment and additional costs. This research proposes a prediction method for COPD patients’ classification based on pulse oximetry three manual warning signs and the resulting derived few key features that can be obtained in a short time. The model was developed on a robust physician labeled dataset with clinically diverse patient cases. Five classification algorithms were applied on the mentioned dataset and the results showed that the best algorithm is XGBoost with the accuracy of 91.04%, precision of 99.86%, recall of 82.19%, F1 measure value of 90.05% with an AUC value of 95.8%. Age, current and baseline heart rate, current and baseline pulse ox. (SPO2) were found the top most important predictors. These findings suggest the strength of XGBoost model together with the availability and the simplicity of input variables in classifying COPD daily living using a (wearable) pulse oximeter.
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Affiliation(s)
- Claudia Abineza
- African Center of Excellence in Internet of Things, University of Rwanda, Kigali, Rwanda
| | - Valentina E. Balas
- Department of Automatics and Applied Software, “Aurel Vlaicu” University, Arad, Romania
| | - Philibert Nsengiyumva
- African Center of Excellence in Internet of Things, University of Rwanda, Kigali, Rwanda
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18
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Ambrosino N. Long COVID: Impact and Comprehensive Management. A Never Ending Story? Arch Bronconeumol 2022; 58:469-470. [PMID: 35095170 PMCID: PMC8784615 DOI: 10.1016/j.arbres.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 01/07/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Nicolino Ambrosino
- Chief Editor of Pulmonology
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Montescano, Pavia, Italy
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19
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Meddar JM, Ponnapalli A, Azhar R, Turchioe MR, Duran AT, Creber RM. A Structured Review of Commercially Available Cardiac Rehabilitation mHealth Applications Using the Mobile Application Rating Scale. J Cardiopulm Rehabil Prev 2022; 42:141-147. [PMID: 35135963 PMCID: PMC11086945 DOI: 10.1097/hcr.0000000000000667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE This study systematically evaluated the quality and functionalities of patient-facing, commercially available mobile health (mHealth) apps for cardiac rehabilitation (CR). METHODS We performed our search in two of the most widely used commercial mobile app stores: Apple iTunes Appstore and Google Play Store (Android apps). Six search terms were used to query relevant CR apps: "cardiac rehabilitation," "heart disease and remote therapy," "heart failure exercise," "heart therapy and cardiac recovery," "cardiac recovery," and "heart therapy." App quality was evaluated using the Mobile Application Rating Scale (MARS). App functionality was evaluated using the IQVIA functionality scale, and app content was evaluated against the American Heart Association guidelines for CR. Apps meeting our inclusion criteria were downloaded and evaluated by two to three reviewers, and interclass correlations between reviewers were calculated. RESULTS We reviewed 3121 apps and nine apps met our inclusion criteria. On average, the apps scored a 3.0 on the MARS (5-point Likert scale) for overall quality. The two top-ranking mHealth apps for CR for all three quality, functionality, and consistency with evidence-based guidelines were My Cardiac Coach and Love My Heart for Women, both of which scored ≥4.0 for behavior change. CONCLUSION Overall, the quality and functionality of free apps for mobile CR was high, with two apps performing the best across all three quality categories. High-quality CR apps are available that can expand access to CR for patients with cardiovascular disease.
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Affiliation(s)
- John M Meddar
- Department of Population Health Sciences, New York University Grossman School of Medicine, New York (Mr Meddar); Department of Population Health Sciences, Weill Cornell Medicine, New York, New York (Mr Ponnapalli, Ms Azhar, and Drs Turchioe and Creber); and Center for Behavioral Cardiovascular Health, Columbia Irving Medical Center, New York, New York (Dr Duran)
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20
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Congrete S, Metersky ML. Telemedicine and Remote Monitoring as an Adjunct to Medical Management of Bronchiectasis. Life (Basel) 2021; 11:life11111196. [PMID: 34833072 PMCID: PMC8622988 DOI: 10.3390/life11111196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 10/28/2021] [Accepted: 11/02/2021] [Indexed: 11/16/2022] Open
Abstract
The limited resources and the practice of social distancing during the COVID pandemic create a paradigm shift in the utilization of telemedicine in healthcare. However, the implementation of best practices is hampered in part by a lack of literature devoted to telehealth in bronchiectasis. In this commentary, we examine multiple approaches to structuring of telemedicine care for patients with bronchiectasis, highlight current evidence-based interventions that can be incorporated into the management of bronchiectasis, and describe our experience with telemedicine at the University of Connecticut Center for Bronchiectasis Care during the COVID-19 pandemic. The structural model must be adapted to different local dynamics and available technologies with careful attention to patient characteristics and access to technology to avoid the potential paradoxical effects of increasing patients’ burden and healthcare disparities in underserved populations.
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21
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Mannée DC, de Jongh F, van Helvoort H. Telemonitoring Techniques for Lung Volume Measurement: Accuracy, Artifacts and Effort. Front Digit Health 2021; 2:559483. [PMID: 34713036 PMCID: PMC8521879 DOI: 10.3389/fdgth.2020.559483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 08/12/2020] [Indexed: 11/13/2022] Open
Abstract
Telemonitoring becomes more important in pulmonary research. It can be used to decrease the pressure on the health care system, to lower the costs of health care and to increase quality of life of patients. Previous studies show contradictory results regarding the effectiveness of telemonitoring. According to multiple researchers, inefficiency can be a result of poor study design, low data quality and usability issues. To counteract these issues, this review proves for an in-depth explanation of four (potential) telemonitoring systems in terms of work principle, accuracy, disturbing factors and usability. The evaluated systems are portable spirometry/breath-by-breath analyzers, respiratory inductance and magnetic plethysmography and electrical impedance tomography. These insights can be used to select the optimal technique for a specific purpose in future studies.
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Affiliation(s)
| | - Frans de Jongh
- Pulmonary Department, Medisch Spectrum Twente, Enschede, Netherlands
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22
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Using Telemedicine to Monitor the Patient with Chronic Respiratory Failure. Life (Basel) 2021; 11:life11111113. [PMID: 34832989 PMCID: PMC8620445 DOI: 10.3390/life11111113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/10/2021] [Accepted: 10/19/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Advances in management have improved mortality of individuals with chronic respiratory failure (CRF), leading to an increase in need for long-term oxygen therapy and/or ventilatory support. These individuals require frequent visits and monitoring of their physiological parameters as well as of the functioning of their devices, such as ventilators or oxygen concentrators. Telemedicine is a clinical application of Information Communication Technology connecting patients to specialised care consultants. This narrative review aims to explore the current available telemonitoring options for individuals with CRF and reported or potential results. Methods: The research focused on EMBASE, CINALH, PubMed, and Scopus databases. Papers published between 2003 and 2021 in English were considered. Results: Different sensors, transmission devices and systems, and interventions are used with promising but not conclusive clinical results. However, legal problems are still unsolved, and economic advantages for health care systems, although potentially high, are still under debate. Conclusions: Telemonitoring systems for individuals with CRF are increasingly used; with promising results still to be clarified, legal, economical and organisational issues must be defined.
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23
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Contini M, Angelucci A, Aliverti A, Gugliandolo P, Pezzuto B, Berna G, Romani S, Tedesco CC, Agostoni P. Comparison between PtCO 2 and PaCO 2 and Derived Parameters in Heart Failure Patients during Exercise: A Preliminary Study. SENSORS (BASEL, SWITZERLAND) 2021; 21:6666. [PMID: 34640985 PMCID: PMC8512849 DOI: 10.3390/s21196666] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 12/13/2022]
Abstract
Evaluation of arterial carbon dioxide pressure (PaCO2) and dead space to tidal volume ratio (VD/VT) during exercise is important for the identification of exercise limitation causes in heart failure (HF). However, repeated sampling of arterial or arterialized ear lobe capillary blood may be clumsy. The aim of our study was to estimate PaCO2 by means of a non-invasive technique, transcutaneous PCO2 (PtCO2), and to verify the correlation between PtCO2 and PaCO2 and between their derived parameters, such as VD/VT, during exercise in HF patients. 29 cardiopulmonary exercise tests (CPET) performed on a bike with a ramp protocol aimed at achieving maximal effort in ≈10 min were analyzed. PaCO2 and PtCO2 values were collected at rest and every 2 min during active pedaling. The uncertainty of PCO2 and VD/VT measurements were determined by analyzing the error between the two methods. The accuracy of PtCO2 measurements vs. PaCO2 decreases towards the end of exercise. Therefore, a correction to PtCO2 that keeps into account the time of the measurement was implemented with a multiple regression model. PtCO2 and VD/VT changes at 6, 8 and 10 min vs. 2 min data were evaluated before and after PtCO2 correction. PtCO2 overestimates PaCO2 for high timestamps (median error 2.45, IQR -0.635-5.405, at 10 min vs. 2 min, p-value = 0.011), while the error is negligible after correction (median error 0.50, IQR = -2.21-3.19, p-value > 0.05). The correction allows removing differences also in PCO2 and VD/VT changes. In HF patients PtCO2 is a reliable PaCO2 estimation at rest and at low exercise intensity. At high exercise intensity the overall response appears delayed but reproducible and the error can be overcome by mathematical modeling allowing an accurate estimation by PtCO2 of PaCO2 and VD/VT.
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Affiliation(s)
- Mauro Contini
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (M.C.); (P.G.); (B.P.); (G.B.); (S.R.); (C.C.T.); (P.A.)
| | - Alessandra Angelucci
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milan, Italy;
| | - Andrea Aliverti
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milan, Italy;
| | - Paola Gugliandolo
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (M.C.); (P.G.); (B.P.); (G.B.); (S.R.); (C.C.T.); (P.A.)
| | - Beatrice Pezzuto
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (M.C.); (P.G.); (B.P.); (G.B.); (S.R.); (C.C.T.); (P.A.)
| | - Giovanni Berna
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (M.C.); (P.G.); (B.P.); (G.B.); (S.R.); (C.C.T.); (P.A.)
| | - Simona Romani
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (M.C.); (P.G.); (B.P.); (G.B.); (S.R.); (C.C.T.); (P.A.)
| | - Calogero Claudio Tedesco
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (M.C.); (P.G.); (B.P.); (G.B.); (S.R.); (C.C.T.); (P.A.)
| | - Piergiuseppe Agostoni
- Centro Cardiologico Monzino, IRCCS, 20138 Milan, Italy; (M.C.); (P.G.); (B.P.); (G.B.); (S.R.); (C.C.T.); (P.A.)
- Cardiovascular Section, Department of Clinical Sciences and Community Health, University of Milano, 20122 Milan, Italy
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24
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Role of new digital technologies and telemedicine in pulmonary rehabilitation : Smart devices in the treatment of chronic respiratory diseases. Wien Klin Wochenschr 2021; 133:1201-1207. [PMID: 34460006 PMCID: PMC8599213 DOI: 10.1007/s00508-021-01930-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 07/23/2021] [Indexed: 10/28/2022]
Abstract
BACKGROUND Asthma and chronic obstructive pulmonary diseases are conditions characterized by a variable progression. Some individuals experience longer asymptomatic periods while others acute worsening periods and/or exacerbations triggered by symptom multiplication factors. Medications are adjusted to the patients' respiratory function, self-assessment of health and emerging certain physical changes. A more effective treatment may be applied by real-time data registered during the patient's everyday life. AIM AND METHODS Introducing new modern digital technology in pulmonary rehabilitation (PR) to help tracking the patients' medication, thus we systematically reviewed the latest publications on telemedicine and pulmonary telerehabilitation. CONCLUSION The use of the latest digital technologies in PR is very exciting and offers great opportunities while treating patients affected by specific conditions. On the one hand, adherence to medication can be improved in patients with chronic respiratory diseases by using these new state of the art devices; on the other hand, digital devices will also be able to monitor various physiological parameters of patients during their usual everyday activities. Data can be stored on a smartphone and shared with the provider. Relying on this information, physicians will be able to tailor medications and dosage to the specific needs of individual patients. Telerehabilitation may be a sustainable solution to the growing burden of chronic respiratory disease worldwide. However, PR must keep its cornerstones, such as education and motivations, which are most successful when conducted in person. Many issues remain to be resolved in the future, e.g. cybersecurity while using smart devices since they offer unique opportunities for PR.
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25
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Winck JC, Scala R. Non-invasive respiratory support paths in hospitalized patients with COVID-19: proposal of an algorithm. Pulmonology 2021; 27:305-312. [PMID: 33516668 PMCID: PMC7816939 DOI: 10.1016/j.pulmoe.2020.12.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 12/13/2020] [Accepted: 12/17/2020] [Indexed: 02/06/2023] Open
Abstract
COVID-19 related Acute Respiratory Failure, may be successfully treated with Conventional Oxygen therapy, High Flow Nasal Cannula, Continuous Positive Airway Pressure or Bi-level Positive-Pressure ventilation. Despite the accumulated data in favor of the use of different Non-invasive Respiratory therapies in COVID-19 related Acute Respiratory Failure, it is not fully understood when start, escalate and de-escalate the best respiratory supportive option for the different timing of the disease. Based on the current published experience with Non-invasive Respiratory therapies in COVID-19 related Acute Respiratory Failure, we propose an algorithm in deciding when to start, when to stop and when to wean different NIRT. This strategy may help clinicians in better choosing NIRT during this second COVID-19 wave and beyond.
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Affiliation(s)
- J C Winck
- Facultyof Medicine-Porto University, Portugal.
| | - R Scala
- Pulmonology and Respiratory Intensive Care Unit, S Donato Hospital, Arezzo, Italy
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26
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Shah NM, Kaltsakas G. Telemedicine in the management of patients with chronic respiratory failure. Breathe (Sheff) 2021; 17:210008. [PMID: 34295411 PMCID: PMC8291909 DOI: 10.1183/20734735.0008-2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 03/12/2021] [Indexed: 12/20/2022] Open
Abstract
Patients with chronic respiratory failure are often required to attend multiple hospital appointments, which may be difficult due to their physical disabilities and the amount of equipment they are required to bring. Their caregivers often struggle with the lack of immediate care available when the patient suffers difficulties at home. Telemedicine is an opportunity to bridge the gap between home and healthcare professionals by allowing the healthcare team to reach into patients' homes to provide more frequent support. The evidence for the use of telemedicine in patients with chronic respiratory failure remains equivocal. Although the uptake of telemedicine has been slow, the SARS-CoV-2 pandemic has resulted in the rapid dissemination of telemedicine to allow the delivery of care to vulnerable patients while reducing the need for their attendance in hospital. Logistical and legal challenges to the delivery of telemedicine remain, but the pandemic may serve as a driver to ameliorate these challenges and facilitate wider use of this technology to improve the experience of patients with chronic respiratory failure. Educational aims To provide an overview of the rationale for delivering care via telemedicine for patients with chronic respiratory failure.To provide the evidence base for establishing a telemedicine service.To highlight the potential opportunities and challenges in delivering a telemedicine service for patients with chronic respiratory failure.
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Affiliation(s)
- Neeraj M Shah
- Lane Fox Respiratory Service, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Lane Fox Clinical Respiratory Physiology Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Centre for Human and Applied Physiological Sciences (CHAPS), King's College London, London, UK
| | - Georgios Kaltsakas
- Lane Fox Respiratory Service, St Thomas' Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Lane Fox Clinical Respiratory Physiology Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Centre for Human and Applied Physiological Sciences (CHAPS), King's College London, London, UK
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27
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Paneroni M, Vitacca M, Bernocchi P, Bertacchini L, Scalvini S. Feasibility of tele-rehabilitation in survivors of COVID-19 pneumonia. Pulmonology 2021; 28:152-154. [PMID: 33893061 PMCID: PMC8045455 DOI: 10.1016/j.pulmoe.2021.03.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/26/2021] [Accepted: 03/27/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- M Paneroni
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, Brescia, Italy.
| | - M Vitacca
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, Brescia, Italy.
| | - P Bernocchi
- Istituti Clinici Scientifici Maugeri IRCCS, Continuity of Care of the Institute of Lumezzane, Brescia, Italy.
| | - L Bertacchini
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, Brescia, Italy.
| | - S Scalvini
- Istituti Clinici Scientifici Maugeri IRCCS, Continuity of Care of the Institute of Lumezzane, Brescia, Italy; Istituti Clinici Scientifici Maugeri IRCCS, Cardiac Rehabilitation of the Institute of Lumezzane, Brescia, Italy.
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28
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Angelucci A, Kuller D, Aliverti A. A Home Telemedicine System for Continuous Respiratory Monitoring. IEEE J Biomed Health Inform 2021; 25:1247-1256. [PMID: 32750977 DOI: 10.1109/jbhi.2020.3012621] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This article presents a continuous home telemonitoring system for chronic respiratory patients using 5G connectivity developed in partnership with Vodafone as a part of the 5G Trial in Milan established by the Italian Ministry of Economic Development. The system features a wearable respiratory and activity monitor, an environmental sensor and a pulse oximeter sending the data through a 5G router to a Multi-Edge Computing server, incorporated in the Vodafone 5G infrastructure, where they are stored and accessible for visualization. In particular, activity, respiratory and environmental data are continuously streamed and collected. The solution has been tested on 18 healthy volunteers during non-supervised recordings lasting at least 48 hours. The combination of recognized activities and associated respiratory parameters provided statistically significant variations in breathing patterns between one activity and the other, thus giving more complete information to the clinicians than previously studied telemedicine systems based on spot-checks. In particular, statistically significant differences are found in tidal volume and minute ventilation between horizontal and vertical postures (p < 0.001) and between vertical postures and dynamic activities (p < 0.001); the respiratory rate shows statistically significant differences between horizontal and vertical postures (p < 0.001). Some environmental parameters have different mean values between day and night, such as carbon dioxide (p < 0.001). Trials on patients are needed to further study this telemedicine solution and make it commercially available in the future. The main further technical development suggested is the use of commercial 5G smartphones as routers, in order to make the system usable outside of home settings.
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Pierucci P, Santomasi C, Ambrosino N, Portacci A, Diaferia F, Hansen K, Odemyr M, Jones S, Carpagnano GE. Patient's treatment burden related to care coordination in the field of respiratory diseases. Breathe (Sheff) 2021; 17:210006. [PMID: 34295410 PMCID: PMC8291948 DOI: 10.1183/20734735.0006-2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/21/2021] [Indexed: 12/30/2022] Open
Abstract
The management of respiratory diseases requires various levels of care: multidisciplinary teams, educational and behavioural interventions, self-management and home-based technical support are vital to ensure adequate care management. However, it is often difficult to access these networks due to fragmentation of patient care and treatment burden. Care coordination aims to ensure patients have a central role and that there is continuity of care among various levels and professionals involved. Moreover, the coronavirus disease pandemic has caused strain on the global healthcare system, with care coordination becoming increasingly important in increasing the resilience of health systems, supporting healthcare professionals and ensuring the right treatment and adequate level of care for these patients.
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Affiliation(s)
- Paola Pierucci
- Cardiothoracic Dept, Respiratory and Critical Care Unit Bari Policlinic University Hospital, Bari, Italy
- "Aldo Moro" Bari University School of Medicine, Bari, Italy
| | - Carla Santomasi
- Cardiothoracic Dept, Respiratory and Critical Care Unit Bari Policlinic University Hospital, Bari, Italy
- "Aldo Moro" Bari University School of Medicine, Bari, Italy
| | - Nicolino Ambrosino
- Istituti Clinici Scientifici Maugeri IRCCS, Pneumologia Riabilitativa, Istituto di Montescano, Montescano, Italy
| | - Andrea Portacci
- Cardiothoracic Dept, Respiratory and Critical Care Unit Bari Policlinic University Hospital, Bari, Italy
- "Aldo Moro" Bari University School of Medicine, Bari, Italy
| | - Fabrizio Diaferia
- Cardiothoracic Dept, Respiratory and Critical Care Unit Bari Policlinic University Hospital, Bari, Italy
- "Aldo Moro" Bari University School of Medicine, Bari, Italy
| | - Kjeld Hansen
- European Lung Foundation Chair, Sheffield, UK
- Dept of Technology, Kristiana University College Oslo, Norway
| | - Mikaela Odemyr
- European Lung Foundation Council Member and Patient Advisory Committee Chair, Sheffield, UK
| | - Steve Jones
- European Lung Foundation Council Member, Sheffield, UK
- Action for Pulmonary Fibrosis, Peterborough, UK
- EU IPFF, Brussels, Belgium
| | - Giovanna E Carpagnano
- Cardiothoracic Dept, Respiratory and Critical Care Unit Bari Policlinic University Hospital, Bari, Italy
- "Aldo Moro" Bari University School of Medicine, Bari, Italy
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30
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Ferry OR, Moloney EC, Spratt OT, Whiting GFM, Bennett CJ. A Virtual Ward Model of Care for Patients With COVID-19: Retrospective Single-Center Clinical Study. J Med Internet Res 2021; 23:e25518. [PMID: 33529157 PMCID: PMC7879714 DOI: 10.2196/25518] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 12/23/2020] [Accepted: 01/10/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND COVID-19 has necessitated the implementation of innovative health care models in preparation for an influx of patients. A virtual ward model delivers clinical care remotely to patients in isolation. We report on an Australian cohort of patients with COVID-19 treated in a virtual ward. OBJECTIVE The aim of this study was to describe and evaluate the safety and efficacy of a virtual ward model of care for an Australian cohort of patients with COVID-19. METHODS Retrospective clinical assessment was performed for 223 patients with confirmed COVID-19 treated in a virtual ward in Brisbane, Australia, from March 25 to May 15, 2020. Statistical analysis was performed for variables associated with the length of stay and hospitalization. RESULTS Of 223 patients, 205 (92%) recovered without the need for escalation to hospital care. The median length of stay in the virtual ward was 8 days (range 1-44 days). In total, 18 (8%) patients were referred to hospital, of which 6 (33.3%) were discharged after assessment at the emergency department. Furthermore, 12 (5.4%) patients were admitted to hospital, of which 4 (33.3%) required supplemental oxygen and 2 (16.7%) required mechanical ventilation. No deaths were recorded. Factors associated with escalation to hospital care were the following: hypertension (odds ratio [OR] 3.6, 95% CI 1.28-9.87; P=.01), sputum production (OR 5.2, 95% CI 1.74-15.49; P=.001), and arthralgia (OR 3.8, 95% CI 1.21-11.71; P=.02) at illness onset and a polymerase chain reaction cycle threshold of ≤20 on a diagnostic nasopharyngeal swab (OR 5.0, 95% CI 1.25-19.63; P=.02). CONCLUSIONS Our results suggest that a virtual ward model of care to treat patients with COVID-19 is safe and efficacious, and only a small number of patients would potentially require escalation to hospital care. Further studies are required to validate this model of care.
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Affiliation(s)
- Olivia R Ferry
- Metro North Hospital and Health Service, Brisbane, Australia
| | - Emma C Moloney
- Metro North Hospital and Health Service, Brisbane, Australia
| | - Owen T Spratt
- Metro North Hospital and Health Service, Brisbane, Australia
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31
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Angelucci A, Cavicchioli M, Cintorrino IA, Lauricella G, Rossi C, Strati S, Aliverti A. Smart Textiles and Sensorized Garments for Physiological Monitoring: A Review of Available Solutions and Techniques. SENSORS (BASEL, SWITZERLAND) 2021; 21:814. [PMID: 33530403 PMCID: PMC7865961 DOI: 10.3390/s21030814] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 12/11/2022]
Abstract
Several wearable devices for physiological and activity monitoring are found on the market, but most of them only allow spot measurements. However, the continuous detection of physiological parameters without any constriction in time or space would be useful in several fields such as healthcare, fitness, and work. This can be achieved with the application of textile technologies for sensorized garments, where the sensors are completely embedded in the fabric. The complete integration of sensors in the fabric leads to several manufacturing techniques that allow dealing with both the technological challenges entailed by the physiological parameters under investigation, and the basic requirements of a garment such as perspiration, washability, and comfort. This review is intended to provide a detailed description of the textile technologies in terms of materials and manufacturing processes employed in the production of sensorized fabrics. The focus is pointed at the technical challenges and the advanced solutions introduced with respect to conventional sensors for recording different physiological parameters, and some interesting textile implementations for the acquisition of biopotentials, respiratory parameters, temperature and sweat are proposed. In the last section, an overview of the main garments on the market is depicted, also exploring some relevant projects under development.
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Affiliation(s)
- Alessandra Angelucci
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, 20133 Milan, Italy; (M.C.); (I.A.C.); (G.L.); (C.R.); (S.S.); (A.A.)
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32
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Dorça A, Sarmet M, Maldaner V. The influence of the non-invasive ventilation mask interface on the upper airway of patients with amyotrophic lateral sclerosis. Pulmonology 2021; 27:359-361. [PMID: 33408044 DOI: 10.1016/j.pulmoe.2020.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 12/05/2020] [Accepted: 12/06/2020] [Indexed: 02/03/2023] Open
Affiliation(s)
- Alessandra Dorça
- Universidade Federal de Goiás, Department of Health Sciences, Goiânia, Brazil
| | - Max Sarmet
- Hospital de Apoio de Brasília, Tertiary Referral Center of Neuromuscular Diseases, Brasília, Brazil; University of Brasília (UnB), Graduate Department of Health Sciences and Technologies, Brasília, Brazil.
| | - Vinicius Maldaner
- Hospital de Apoio de Brasília, Tertiary Referral Center of Neuromuscular Diseases, Brasília, Brazil; Centro Universitário UniEvangélica, Graduate Department of Human Movement and Rehabilitation Program, Anápolis, Brazil
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33
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Colombo V, Aliverti A, Sacco M. Virtual reality for COPD rehabilitation: a technological perspective. Pulmonology 2020; 28:119-133. [PMID: 33358425 DOI: 10.1016/j.pulmoe.2020.11.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 11/24/2020] [Accepted: 11/30/2020] [Indexed: 10/22/2022] Open
Abstract
Virtual Reality (VR) is a promising technology for implementing personalized, motivating and controlled rehabilitation scenarios. Although its clear potential benefits, VR has been poorly investigated in pulmonary rehabilitation. This review analyses the state of the art, by searching the scientific and grey literature, regarding the use of VR for the rehabilitation of patients with chronic obstructive pulmonary disease, providing a technological perspective. First, the main characteristics of the included systems are presented in terms of visualization devices, way of interaction and type of feedback they provide. Then, results of the selected studies are reported considering feasibility, safety, usability and user experience as outcomes. Finally, the main findings are discussed and future directions for research are outlined.
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Affiliation(s)
- V Colombo
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing - National Research Council, via Previati 1/E, 23900, Lecco, Italy; Departmentof Electronics, Information and Bioengineering -Politecnico di Milano, via Ponzio 34, 20133, Milano, Italy.
| | - A Aliverti
- Departmentof Electronics, Information and Bioengineering -Politecnico di Milano, via Ponzio 34, 20133, Milano, Italy
| | - M Sacco
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing - National Research Council, via Previati 1/E, 23900, Lecco, Italy
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34
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Nicolò A, Massaroni C, Schena E, Sacchetti M. The Importance of Respiratory Rate Monitoring: From Healthcare to Sport and Exercise. SENSORS (BASEL, SWITZERLAND) 2020; 20:E6396. [PMID: 33182463 PMCID: PMC7665156 DOI: 10.3390/s20216396] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/05/2020] [Accepted: 11/08/2020] [Indexed: 12/11/2022]
Abstract
Respiratory rate is a fundamental vital sign that is sensitive to different pathological conditions (e.g., adverse cardiac events, pneumonia, and clinical deterioration) and stressors, including emotional stress, cognitive load, heat, cold, physical effort, and exercise-induced fatigue. The sensitivity of respiratory rate to these conditions is superior compared to that of most of the other vital signs, and the abundance of suitable technological solutions measuring respiratory rate has important implications for healthcare, occupational settings, and sport. However, respiratory rate is still too often not routinely monitored in these fields of use. This review presents a multidisciplinary approach to respiratory monitoring, with the aim to improve the development and efficacy of respiratory monitoring services. We have identified thirteen monitoring goals where the use of the respiratory rate is invaluable, and for each of them we have described suitable sensors and techniques to monitor respiratory rate in specific measurement scenarios. We have also provided a physiological rationale corroborating the importance of respiratory rate monitoring and an original multidisciplinary framework for the development of respiratory monitoring services. This review is expected to advance the field of respiratory monitoring and favor synergies between different disciplines to accomplish this goal.
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Affiliation(s)
- Andrea Nicolò
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy;
| | - Carlo Massaroni
- Unit of Measurements and Biomedical Instrumentation, Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Rome, Italy; (C.M.); (E.S.)
| | - Emiliano Schena
- Unit of Measurements and Biomedical Instrumentation, Department of Engineering, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Rome, Italy; (C.M.); (E.S.)
| | - Massimo Sacchetti
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy;
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35
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Jácome C, Marques A, Oliveira A, Rodrigues LV, Sanches I. Pulmonary telerehabilitation: An international call for action. Pulmonology 2020; 26:335-337. [PMID: 32591279 PMCID: PMC7311341 DOI: 10.1016/j.pulmoe.2020.05.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 01/27/2023] Open
Affiliation(s)
- C Jácome
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto (FMUP), Porto, Portugal; Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), University of Porto Faculty of Medicine, Porto, Portugal.
| | - A Marques
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; iBiMED - Institute of Biomedicine, Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - A Oliveira
- Lab3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences, University of Aveiro (ESSUA), Aveiro, Portugal; School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada; West Park Healthcare Centre, Toronto, ON, Canada
| | - L V Rodrigues
- Pulmonology Department, Unidade Local de Saúde da Guarda E.P.E. - Hospital Sousa Martins, Portugal; Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
| | - I Sanches
- Pulmonology Department, Centro Hospitalar Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal
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36
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Vitacca M. Will the COVID tsunami be able to impose tele-rehabilitation as a system opportunity? Pulmonology 2020; 26:338-339. [PMID: 32907785 PMCID: PMC7474960 DOI: 10.1016/j.pulmoe.2020.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 08/19/2020] [Indexed: 12/28/2022] Open
Affiliation(s)
- Michele Vitacca
- Istituti Clinici Scientifici Maugeri IRCCS, Respiratory Rehabilitation of the Institute of Lumezzane, Brescia, Italy.
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37
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Benfante A, Scichilone N. Prioritizing care for severe asthma during SARS-CoV-2 pandemic. Pulmonology 2020; 27:189-190. [PMID: 33208299 PMCID: PMC7444931 DOI: 10.1016/j.pulmoe.2020.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 08/14/2020] [Accepted: 08/14/2020] [Indexed: 12/21/2022] Open
Affiliation(s)
- A Benfante
- Dipartimento Universitario di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Division of Respiratory Medicine, "Paolo Giaccone" University Hospital, University of Palermo, Palermo, Italy
| | - N Scichilone
- Dipartimento Universitario di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro" (PROMISE), Division of Respiratory Medicine, "Paolo Giaccone" University Hospital, University of Palermo, Palermo, Italy.
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38
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Comparison between the Airgo™ Device and a Metabolic Cart during Rest and Exercise. SENSORS 2020; 20:s20143943. [PMID: 32679882 PMCID: PMC7412454 DOI: 10.3390/s20143943] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 07/09/2020] [Accepted: 07/13/2020] [Indexed: 11/17/2022]
Abstract
The aim of this study is to compare the accuracy of Airgo™, a non-invasive wearable device that records breath, with respect to a gold standard. In 21 healthy subjects (10 males, 11 females), four parameters were recorded for four min at rest and in different positions simultaneously by Airgo™ and SensorMedics 2900 metabolic cart. Then, a cardio-pulmonary exercise test was performed using the Erg 800S cycle ergometer in order to test Airgo™'s accuracy during physical effort. The results reveal that the relative error median percentage of respiratory rate was of 0% for all positions at rest and for different exercise intensities, with interquartile ranges between 3.5 (standing position) and 22.4 (low-intensity exercise) breaths per minute. During exercise, normalized amplitude and ventilation relative error medians highlighted the presence of an error proportional to the volume to be estimated. For increasing intensity levels of exercise, Airgo™'s estimate tended to underestimate the values of the gold standard instrument. In conclusion, the Airgo™ device provides good accuracy and precision in the estimate of respiratory rate (especially at rest), an acceptable estimate of tidal volume and minute ventilation at rest and an underestimation for increasing volumes.
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