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Zhao K, Wen H, Guo Y, Scano A, Zhang Z. Feasibility of recurrence quantification analysis (RQA) in quantifying dynamical coordination among muscles. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Fuchs R, Van Praet KM, Bieck R, Kempfert J, Holzhey D, Kofler M, Borger MA, Jacobs S, Falk V, Neumuth T. A system for real-time multivariate feature combination of endoscopic mitral valve simulator training data. Int J Comput Assist Radiol Surg 2022; 17:1619-1631. [PMID: 35294716 PMCID: PMC9463288 DOI: 10.1007/s11548-022-02588-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 02/24/2022] [Indexed: 11/29/2022]
Abstract
Purpose For an in-depth analysis of the learning benefits that a stereoscopic view presents during endoscopic training, surgeons required a custom surgical evaluation system enabling simulator independent evaluation of endoscopic skills. Automated surgical skill assessment is in dire need since supervised training sessions and video analysis of recorded endoscope data are very time-consuming. This paper presents a first step towards a multimodal training evaluation system, which is not restricted to certain training setups and fixed evaluation metrics. Methods With our system we performed data fusion of motion and muscle-action measurements during multiple endoscopic exercises. The exercises were performed by medical experts with different surgical skill levels, using either two or three-dimensional endoscopic imaging. Based on the multi-modal measurements, training features were calculated and their significance assessed by distance and variance analysis. Finally, the features were used automatic classification of the used endoscope modes. Results During the study, 324 datasets from 12 participating volunteers were recorded, consisting of spatial information from the participants’ joint and right forearm electromyographic information. Feature significance analysis showed distinctive significance differences, with amplitude-related muscle information and velocity information from hand and wrist being among the most significant ones. The analyzed and generated classification models exceeded a correct prediction rate of used endoscope type accuracy rate of 90%. Conclusion The results support the validity of our setup and feature calculation, while their analysis shows significant distinctions and can be used to identify the used endoscopic view mode, something not apparent when analyzing time tables of each exercise attempt. The presented work is therefore a first step toward future developments, with which multivariate feature vectors can be classified automatically in real-time to evaluate endoscopic training and track learning progress. Supplementary Information The online version contains supplementary material available at 10.1007/s11548-022-02588-1.
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Affiliation(s)
- Reinhard Fuchs
- Innovation Center Computer Assisted Surgery, University of Leipzig, Leipzig, Germany.
| | - Karel M Van Praet
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Richard Bieck
- Innovation Center Computer Assisted Surgery, University of Leipzig, Leipzig, Germany
| | - Jörg Kempfert
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - David Holzhey
- Department of Cardiovascular Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Markus Kofler
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Michael A Borger
- Department of Cardiovascular Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Stephan Jacobs
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Volkmar Falk
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.,Department of Cardiovascular Surgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Translational Cardiovascular Technologies, Institute of Translational Medicine, Department of Health Sciences and Technology, Swiss Federal Institute of Technology (ETH) Zurich, Zurich, Switzerland
| | - Thomas Neumuth
- Innovation Center Computer Assisted Surgery, University of Leipzig, Leipzig, Germany
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Ödemiş E, Baysal CV. Development of a participation assessment system based on multimodal evaluation of user responses for upper limb rehabilitation. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.103066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Chatain C, Ramdani S, Vallier JM, Gruet M. Recurrence quantification analysis of force signals to assess neuromuscular fatigue in men and women. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Golahmadi AK, Khan DZ, Mylonas GP, Marcus HJ. Tool-tissue forces in surgery: A systematic review. Ann Med Surg (Lond) 2021; 65:102268. [PMID: 33898035 PMCID: PMC8058906 DOI: 10.1016/j.amsu.2021.102268] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 11/30/2022] Open
Abstract
Background Excessive tool-tissue interaction forces often result in tissue damage and intraoperative complications, while insufficient forces prevent the completion of the task. This review sought to explore the tool-tissue interaction forces exerted by instruments during surgery across different specialities, tissues, manoeuvres and experience levels. Materials & methods A PRISMA-guided systematic review was carried out using Embase, Medline and Web of Science databases. Results Of 462 articles screened, 45 studies discussing surgical tool-tissue forces were included. The studies were categorized into 9 different specialities with the mean of average forces lowest for ophthalmology (0.04N) and highest for orthopaedic surgery (210N). Nervous tissue required the least amount of force to manipulate (mean of average: 0.4N), whilst connective tissue (including bone) required the most (mean of average: 45.8). For manoeuvres, drilling recorded the highest forces (mean of average: 14N), whilst sharp dissection recorded the lowest (mean of average: 0.03N). When comparing differences in the mean of average forces between groups, novices exerted 22.7% more force than experts, and presence of a feedback mechanism (e.g. audio) reduced exerted forces by 47.9%. Conclusions The measurement of tool-tissue forces is a novel but rapidly expanding field. The range of forces applied varies according to surgical speciality, tissue, manoeuvre, operator experience and feedback provided. Knowledge of the safe range of surgical forces will improve surgical safety whilst maintaining effectiveness. Measuring forces during surgery may provide an objective metric for training and assessment. Development of smart instruments, robotics and integrated feedback systems will facilitate this. This review explores tool-tissue forces during surgery, a new and expanding field. Forces were lowest in ophthalmology (0.04N) and highest in orthopaedics (210N). Forces were lowest during sharp dissection (0.03N) and highest when drilling (14N). Being an expert (vs. novice) and having feedback mechanisms (e.g. haptic) reduced exerted forces. Development of force metrics will facilitate training, assessment & novel technology.
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Affiliation(s)
- Aida Kafai Golahmadi
- Imperial College London School of Medicine, London, United Kingdom.,HARMS Laboratory, The Hamlyn Centre, Department of Surgery & Cancer, Imperial College London, London, United Kingdom
| | - Danyal Z Khan
- National Hospital for Neurology and Neurosurgery, London, United Kingdom.,Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom
| | - George P Mylonas
- HARMS Laboratory, The Hamlyn Centre, Department of Surgery & Cancer, Imperial College London, London, United Kingdom
| | - Hani J Marcus
- National Hospital for Neurology and Neurosurgery, London, United Kingdom.,Wellcome/EPSRC Centre for Interventional and Surgical Sciences, University College London, London, United Kingdom
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Gaudez C, Mouzé-Amady M. Which subject-related variables contribute to movement variability during a simulated repetitive and standardised occupational task? Recurrence quantification analysis of surface electromyographic signals. ERGONOMICS 2021; 64:366-382. [PMID: 33026299 DOI: 10.1080/00140139.2020.1834148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 10/04/2020] [Indexed: 06/11/2023]
Abstract
Movement variability is a component of human movement. This study applied recurrence quantification analysis (RQA) on electromyographic signals to determine the effects of two types of variables on movement variability during a short, simulated repetitive and standardised occupational clip-fitting task. The electrical activity of six muscles in the dominant upper limb was recorded in 21 participants. Variables related to the task performance (insertion force and movements performed when fitting clips) affected RQA measures: recurrence rate (RR), percentage of determinism (DET) and diagonal line length entropy (ENT). Variables related to participant's characteristics (sex, age, and BMI) affected only DET and ENT. A constrasting variability was observed such as a high-DET value combined with a high-ENT value and inversely. Variables affected mainly the recurrences organisation of the more distal muscles. Even if movement variability is complex, it should be considered by ergonomists and work place designers to better understanding of operators' movements. Practitioner summary: It is essential to consider the complexity of operators' movement variability to understand their activities. Based on intrinsic movement variability knowledge, ergonomists and work place designers will be able to modulate the movement variability by acting on workstation designs and occupational organisation with the aim of preserving operators' health. Abbreviations: RR: recurrence rate; DET: percentage of determinism; ENT: diagonal line length entropy; BMI: body mass index; FDS: flexor digitorum superficialis; EXT: extensor digitorum communis; BIC: biceps brachii; TRI: triceps brachii; DEL: deltoideus anterior; TRA: trapezius pars descendens; F: female; M: male; S: supinated; P: pronated; CM: continuous movement; DM: discontinuous movement.
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Affiliation(s)
- Clarisse Gaudez
- INRS - Institut National de Recherche et de Sécurité, Vandoeuvre cedex, France
| | - Marc Mouzé-Amady
- INRS - Institut National de Recherche et de Sécurité, Vandoeuvre cedex, France
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Stephenson ML, Ostrander AG, Norasi H, Dorneich MC. Shoulder Muscular Fatigue From Static Posture Concurrently Reduces Cognitive Attentional Resources. HUMAN FACTORS 2020; 62:589-602. [PMID: 31216186 DOI: 10.1177/0018720819852509] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE The goal of this work is to determine whether muscular fatigue concurrently reduces cognitive attentional resources in technical tasks for healthy adults. BACKGROUND Muscular fatigue is common in the workplace but often dissociated with cognitive performance. A corpus of literature demonstrates a link between muscular fatigue and cognitive function, but few investigations demonstrate that the instigation of the former degrades the latter in a way that may affect technical task completion. For example, laparoscopic surgery increases muscular fatigue, which may risk attentional capacity reduction and undermine surgical outcomes. METHOD A total of 26 healthy participants completed a dual-task cognitive assessment of attentional resources while concurrently statically fatiguing their shoulder musculature until volitional failure, in a similar loading pattern observed in laparoscopic procedures. Continuous and discrete monitoring task performance was recorded to reflect attentional resources. RESULTS Electromyography of the anterior deltoid and descending trapezius, as well as self-assessment surveys indicated fatigue occurrence; continuous tracking error, tracking velocity, and response time significantly increased with muscular fatigue. CONCLUSION Muscular fatigue concurrently degrades cognitive attentional resources. APPLICATION Complex tasks that rely on muscular and cognitive performance should consider interventions to reduce muscular fatigue to also preserve cognitive performance.
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Affiliation(s)
| | | | - Hamid Norasi
- 228928 122562 1177 Iowa State University, Ames, USA
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Beneduzzi J, Herbella FAM, Schlottmann F, Patti MG. Cognitive Assessment of Surgeons During Surgical Procedures: Influence of Time and Intraoperative Complications. World J Surg 2018; 43:143-148. [PMID: 30105636 DOI: 10.1007/s00268-018-4764-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Surgeon's performance may be influenced by several factors that may affect skills and judgement, which ultimately represents surgeon´s cognition. Cognition refers to all forms of knowing and awareness, such as perceiving, conceiving, remembering, reasoning, judging, imagining, and problem solving. This report aims to evaluate the effect of operative time and operative complications on surgeon´s cognition. METHODS Forty-six surgeons (mean age 31 years, 78% males) assigned to an operation expected to last for at least 2 h, volunteered for the study. All participants underwent 3 cognitive tests at the beginning of the operation and hourly, until the end of the procedure: (a) concentration (serial sevens, counting down from 100 by sevens); (b) visual (fast counting, counting the number of circles with the same color among a series of circles); and (c) motor (trail making, connecting a set of numbered dots). Intraoperative complications were recorded. RESULTS The visual test had a stable behavior along time. Concentration and motor tests tend to be performed faster. Intraoperative complications occurred in 5 (11%) cases (3 hemorrhage and 2 organ injuries). Performance time was stable for concentration and motor tests but visual test tends to be performed faster in cases with an intraoperative complication. CONCLUSION Our results showed that (1) time does not jeopardize surgeons' cognition, but rather surgeons learned to perform the tests faster, and (2) complications do not decrease surgeons' cognition.
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Affiliation(s)
- Juliana Beneduzzi
- Department of Surgery, Escola Paulista de Medicina, Rua Diogo de Faria 1087, cj 301, São Paulo, SP, 04037-003, Brazil
| | - Fernando A M Herbella
- Department of Surgery, Escola Paulista de Medicina, Rua Diogo de Faria 1087, cj 301, São Paulo, SP, 04037-003, Brazil.
| | | | - Marco G Patti
- University of North Carolina at Chapel Hill, Chapel Hill, USA
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McCully KK, Prins P, Mistry K, Willingham TB. Muscle-specific endurance of the trapezius muscles using electrical twitch mechanomyography. Shoulder Elbow 2018; 10:136-143. [PMID: 29560041 PMCID: PMC5851126 DOI: 10.1177/1758573217726269] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 07/03/2017] [Accepted: 07/19/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Symptoms of fatigue and pain are often reported for the trapezius muscle in the shoulder. The present study evaluated endurance in the trapezius muscles of healthy participants using electric twitch mechanomyography (ETM). METHODS Surface electrodes and a tri-axial accelerometer were placed over the left trapezius muscle. Muscles were stimulated for 3 min each at 2 Hz, 4 Hz and 6 Hz. Maintenance of acceleration during muscle twitches was used to calculate an endurance index (EI). Subjects (n = 9) were tested on two separate days to assess reproducibility of the trapezius EI measurements. The endurance measurements were made on the wrist flexor and vastus lateralis muscles for comparison. Near infrared spectroscopy was used to measure muscle oxygenation (HbO2) during the stimulation protocol (n = 8). RESULTS Mean (SD) EI was 84.9% (8.7%), 63.3% (19.1%) and 41.7% (20.0%) for 2 Hz, 4 Hz and 6 Hz, respectively. The coefficients of variation were 7.4%, 11.3% and 24.0% for 2 Hz, 4 Hz and 6 Hz, respectively. EI values were significantly lower in the trapezius compared to arm and leg muscles (p < 0.05). HbO2 values were unchanged from resting values with electrical stimulation. CONCLUSIONS The EI as measured by ETM may provide a reproducible method of evaluating function in trapezius muscles that is not influenced by oxygen saturation.
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Affiliation(s)
- Kevin K. McCully
- Kevin McCully, Department of Kinesiology, University of Georgia, 330 River Road, Athens, GA 30602, USA.
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A systematic review on fatigue analysis in triceps brachii using surface electromyography. Biomed Signal Process Control 2018. [DOI: 10.1016/j.bspc.2017.10.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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