Gait analysis based on full-body motion capture technology (MoCap) can be used in rehabilitation to aid in decision making during treatments or therapies. In order to promote the use of MoCap gait analysis based on inertial measurement units (IMUs) or optical technology, it is necessary to overcome certain limitations, such as the need for magnetically controlled environments, which affect IMU systems, or the need for additional instrumentation to detect gait events, which affects IMUs and optical systems. We present a MoCap gait analysis system called Move Human Sensors (MH), which incorporates proposals to overcome both limitations and can be configured via magnetometer-free IMUs (MH-IMU) or clusters of optical markers (MH-OPT). Using a test–retest reliability experiment with thirty-three healthy subjects (20 men and 13 women, 21.7 ± 2.9 years), we determined the reproducibility of both configurations. The assessment confirmed that the proposals performed adequately and allowed us to establish usage considerations. This study aims to enhance gait analysis in daily clinical practice.
Balance disorders have a high prevalence among elderly people in developed countries, and falls resulting from balance disorders involve high healthcare costs. Therefore, tools and indicators are necessary to assess the response to treatments. Therefore, the aim of this study is to detect relevant changes through minimal detectable change (MDC) values in patients with balance disorders, specifically with vertigo. A test-retest of a static and dynamic balance test was conducted on 34 healthy young volunteer subjects using a portable stabilometric platform. Afterwards, in order to show the MDC applicability, eight patients diagnosed with balance disorders characterized by vertigo of vestibular origin performed the balance test before and after a treatment, contrasting the results with the assessment by a specialist physician. The balance test consisted of four tasks from the Romberg test for static balance control, assessing dynamic postural balance through the limits of stability (LOS). The results obtained in the test-retest show the reproducibility of the system as being similar to or better than those found in the literature. Regarding the static balance variables with the lowest MDC value, we highlight the average velocity of the center of pressure (COP) in all tasks and the root mean square (RMS), the area, and the mediolateral displacement in soft surface, with eyes closed. In LOS, all COP limits and the average speed of the COP and RMS were highlighted. Of the eight patients assessed, an agreement between the specialist physician and the balance test results exists in six of them, and for two of the patients, the specialist physician reported no progression, whereas the balance test showed worsening. Patients showed changes that exceeded the MDC values, and these changes were correlated with the results reported by the specialist physician. We conclude that (at least for these eight patients) certain variables were sufficiently sensitive to detect changes linked to balance progression. This is intended to improve decision making and individualized patient monitoring.
Figure 2. Descriptive and statistical analysis. Ã Significant differences in t-test between groups. ÃÃ Tasks pooled by Tukey paired comparison. % Variation in percent. per task with respect to CSRT.
In the rehabilitation field, clinicians are continually struggling to assess improvements in patients following interventions. In this paper, we propose an approach to use gait analysis based on inertial motion capture (MoCap) to monitor individuals during rehabilitation. Gait is a cyclical movement that generates a sufficiently large data sample in each capture session to statistically compare two different sessions from a single patient. Using this crucial idea, 21 heterogeneous patients with hemiplegic spasticity were assessed using gait analysis before and after receiving treatment with botulinum toxin injections. Afterwards, the two sessions for each patient were compared using the magnitude-based decision statistical method. Due to the challenge of classifying changes in gait variables such as improvements or impairments, assessing each patient’s progress required an interpretative process. After completing this process, we determined that 10 patients showed overall improvement, five patients showed overall impairment, and six patients did not show any overall change. Finally, the interpretation process was summarized by developing guidelines to aid in future assessments. In this manner, our approach provides graphical information about the patients’ progress to assess improvement following intervention and to support decision-making. This research contributes to integrating MoCap-based gait analysis into rehabilitation.
Given the exponential availability of data in health centers and the massive sensorization that is expected, there is an increasing need to manage and analyze these data in an effective way. For this purpose, data mining (DM) and machine learning (ML) techniques would be helpful. However, due to the specific characteristics of the field of healthcare, a suitable DM and ML methodology adapted to these particularities is required. The applied methodology must structure the different stages needed for data-driven healthcare, from the acquisition of raw data to decision-making by clinicians, considering the specific requirements of this field. In this paper, we focus on a case study of cervical assessment, where the goal is to predict the potential presence of cervical pain in patients affected with whiplash diseases, which is important for example in insurance-related investigations. By analyzing in detail this case study in a real scenario, we show how taking care of those particularities enables the generation of reliable predictive models in the field of healthcare. Using a database of 302 samples, we have generated several predictive models, including logistic regression, support vector machines, k-nearest neighbors, gradient boosting, decision trees, random forest, and neural network algorithms. The results show that it is possible to reliably predict the presence of cervical pain (accuracy, precision, and recall above 90%). We expect that the procedure proposed to apply ML techniques in the field of healthcare will help technologists, researchers, and clinicians to create more objective systems that provide support to objectify the diagnosis, improve test treatment efficacy, and save resources.
Background An estimated 20% to 30% of the global population has suffered a vertiginous episode. Among them, 20% do not receive a clear diagnosis. Improved methods, indicators and metrics are necessary to assess the sensory systems related to balance, especially when patients are undergoing treatment for vertiginous episodes. Patients with balance disorders should be monitored for changes at the individual level to gather objective information. In this study, we evaluate the use of the MCQ-Balance (Measure, Classify and Qualify) assessment for examining a patient’s balance progression using tests to measure static balance control and dynamic postural balance with a stabilometric platform. Materials and Methods The MCQ-Balance assessment comprises three stages: (i) measuring the progression of each variable between two separate and consecutive days (called sessions) using the Magnitude-Based Decision analysis; (ii) classifying the progression of the patient’s balance with a score; and (iii) qualifying the progression of the patient’s balance from the resulting scores using a set of rules. This method was applied to 42 patients with balance disorders of peripheral or central origin characterised by vertigo as the cardinal symptom. Balance progression was measured using the MCQ-Balance assessment over the course of three months, and these results were compared with the assessment of a clinical expert. Results The MCQ-Balance assessment showed an accuracy of 83.4% and a Cohen’s Kappa coefficient of 0.752 compared to the assessment of a clinical expert. Conclusion The MCQ-Balance assessment facilitates the monitoring of patient balance and provides objective information that has the potential to improve medical decision making and the adjustment of individual treatment.
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