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For routine pretreatment verification of innovative treatment techniques such as (intensity modulated) dynamic arc therapy and helical TomoTherapy, an on-line and reliable method would be highly desirable. The present solution proposed by TomoTherapy, Inc. (Madison, WI) relies on film dosimetry in combination with up to two simultaneous ion chamber point dose measurements. A new method is proposed using a 2D ion chamber array (Seven29, PTW, Freiburg, Germany) inserted in a dedicated octagonal phantom, called Octavius. The octagonal shape allows easy positioning for measurements in multiple planes. The directional dependence of the response of the detector was primarily investigated on a dual energy (6 and 18 MV) Clinac 21EX (Varian Medical Systems, Palo Alto, CA) as no fixed angle incidences can be calculated in the Hi-Art TPS of TomoTherapy. The array was irradiated from different gantry angles and with different arc deliveries, and the dose distributions at the level of the detector were calculated with the AAA (Analytical Anisotropic Algorithm) photon dose calculation algorithm implemented in Eclipse (Varian). For validation on the 6 MV TomoTherapy unit, rotational treatments were generated, and dose distributions were calculated with the Hi-Art TPS. Multiple cylindrical ion chamber measurements were used to cross-check the dose calculation and dose delivery in Octavius in the absence of the 2D array. To compensate for the directional dependence of the 2D array, additional prototypes of Octavius were manufactured with built-in cylindrically symmetric compensation cavities. When using the Octavius phantom with a 2 cm compensation cavity, measurements with an accuracy comparable to that of single ion chambers can be achieved. The complete Octavius solution for quality assurance of rotational treatments consists of: The 2D array, two octagonal phantoms (with and without compensation layer), an insert for nine cylindrical ion chambers, and a set of inserts of various tissue equivalent materials of different densities. The combination of the 2D array with the Octavius phantom proved to be a fast and reliable method for pretreatment verification of rotational treatments. Quality control of TomoTherapy patients was reduced to a total of approximately 25 min per patient.

The all-in validation program allows a systematic approach in monitoring the different levels of RA treatments. With the systematic approach comes a better understanding of both the capabilities and the limits of the used solution. The program can be useful for implementation, but also for the validation of major upgrades.

No abstract

The identification of the initial contact (IC) and toe off (TO) events are crucial components of running gait analyses. To evaluate running gait in real-world settings, robust gait event detection algorithms that are based on signals from wearable sensors are needed. In this study, algorithms for identifying gait events were developed for accelerometers that were placed on the foot and low back and validated against a gold standard force plate gait event detection method. These algorithms were automated to enable the processing of large quantities of data by accommodating variability in running patterns. An evaluation of the accuracy of the algorithms was done by comparing the magnitude and variability of the difference between the back and foot methods in different running conditions, including different speeds, foot strike patterns, and outdoor running surfaces. The results show the magnitude and variability of the back-foot difference was consistent across running conditions, suggesting that the gait event detection algorithms can be used in a variety of settings. As wearable technology allows for running gait analyses to move outside of the laboratory, the use of automated accelerometer-based gait event detection methods may be helpful in the real-time evaluation of running patterns in real world conditions.

The purpose of this study was to classify runners in sex-specific groups as either competitive or recreational based on center of mass (CoM) accelerations. Forty-one runners participated in the study (25 male and 16 female), and were labeled as competitive or recreational based on age, sex, and race performance. Three-dimensional acceleration data were collected during a 5-minute treadmill run, and 24 features were extracted. Support vector machine classification models were used to examine the utility of the features in discriminating between competitive and recreational runners within each sex-specific subgroup. Competitive and recreational runners could be classified with 82.63 % and 80.4 % in the male and female models, respectively. Dominant features in both models were related to regularity and variability, with competitive runners exhibiting more consistent running gait patterns, but the specific features were slightly different in each sex-specific model. Therefore, it is important to separate runners into sex-specific competitive and recreational subgroups for future running biomechanical studies. In conclusion, we have demonstrated the ability to analyze running biomechanics in competitive and recreational runners using only CoM acceleration patterns. A runner, clinician, or coach may use this information to monitor how running patterns change as a result of training.

The purpose of this study was to use wearable technology data to quantify alterations in subject-specific running patterns throughout a marathon race and to determine if runners could be clustered into subgroups based on similar trends in running gait alterations throughout the marathon. Using a wearable sensor, data were collected for cadence, braking, bounce, pelvic rotation, pelvic drop, and ground contact time for 27 runners. A composite index was calculated based on the “typical” data (4–14 km) for each runner and evaluated for 14 individual 2-km sections thereafter to detect “atypical” data (ie, higher indices). A cluster analysis assigned all runners to a subgroup based on similar trends in running alterations. Results indicated that the indices became significantly higher starting at 20 to 22 km. Cluster 1 exhibited lower indices than cluster 2 throughout the marathon, and the only significant difference in characteristics between clusters was that cluster 1 had a lower age–grade performance score than cluster 2. In summary, this study presented a novel method to investigate the effects of fatigue on running biomechanics using wearable technology in a real-world setting. Recreational runners with higher age–grade performance scores had less atypical running patterns throughout the marathon compared with runners with lower age–grade performance scores.

No abstract