Motion Smoothness Metrics for Cannulation Skill Assessment: What Factors Matter?

Singh, Sukhwinder; Bible, Joe; Liu, Zhanhe; Zhang, Ziyang; Singapogu, Ravikiran B.

doi:10.3389/frobt.2021.625003

Cited by 9 publications

(11 citation statements)

References 34 publications

(72 reference statements)

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“…Indeed, in a study by Caronni et al [ 32 ], the authors investigated differences in the smoothness of head movements between healthy subjects and patients with idiopathic cervical dystonia, using the same indices here proposed, but obtaining opposite results: in fact, in their study, only the SPARC was able to distinguish between healthy subject and patient with cervical dystonia. The authors interpreted the better behavior of the SPARC in light of the study by Singh et al [ 35 ], which suggested that the SPARC is more sensitive to changes in smaller movements. Given that our protocol involved large movements, this interpretation may also help to explain our findings.…”

Section: Discussionmentioning

confidence: 92%

Evaluation of Gait Smoothness in Patients with Stroke Undergoing Rehabilitation: Comparison between Two Metrics

Germanotta

Iacovelli²,

Aprile³

2022

IJERPH

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The use of quantitative methods to analyze the loss in gait smoothness, an increase in movement intermittency which is a distinguishing hallmark of motor deficits in stroke patients, has gained considerable attention in recent years. In the literature, the spectral arc length (SPARC), as well as metrics based on the measurement of the jerk, such as the log dimensionless jerk (LDLJ), are currently employed to assess smoothness. However, the optimal measure for evaluating the smoothness of walking in stroke patients remains unknown. Here, we investigated the smoothness of the body’s center of mass (BCoM) trajectory during gait, using an optoelectronic system, in twenty-two subacute and eight chronic patients before and after a two-month rehabilitation program. The two measures were evaluated for their discriminant validity (ability to differentiate the smoothness of the BCoM trajectory calculated on the cycle of the affected and unaffected limb, and between subacute and chronic patients), validity (correlation with clinical scales), and responsiveness to the intervention. According to our findings, the LDLJ outperformed the SPARC in terms of the examined qualities. Based on data gathered using an optoelectronic system, we recommend using the LDLJ rather than the SPARC to investigate the gait smoothness of stroke patients.

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Section: Discussionmentioning

confidence: 92%

Evaluation of Gait Smoothness in Patients with Stroke Undergoing Rehabilitation: Comparison between Two Metrics

Germanotta

Iacovelli²,

Aprile³

2022

IJERPH

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“…Given that the mathematics behind these measures is quite different, LDLJ and SPARC likely quantify different aspects of smoothness 23 . Compared to t_LDLJ, t_SPARC seems more sensitive to changes in smaller movements 55 . In addition, t_SPARC is more robust to measurement noise 9 being, therefore, more reliable.…”

Section: Discussionmentioning

confidence: 99%

Smoothness of movement in idiopathic cervical dystonia

Caronni

Arcuri

Carpinella

et al. 2022

Sci Rep

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Smoothness (i.e. non-intermittency) of movement is a clinically important property of the voluntary movement with accuracy and proper speed. Resting head position and head voluntary movements are impaired in cervical dystonia. The current work aims to evaluate if the smoothness of voluntary head rotations is reduced in this disease. Twenty-six cervical dystonia patients and 26 controls completed rightward and leftward head rotations. Patients’ movements were differentiated into “towards-dystonia” (rotation accentuated the torticollis) and “away-dystonia”. Smoothness was quantified by the angular jerk and arc length of the spectrum of angular speed (i.e. SPARC, arbitrary units). Movement amplitude (mean, 95% CI) on the horizontal plane was larger in controls (63.8°, 58.3°–69.2°) than patients when moving towards-dystonia (52.8°, 46.3°–59.4°; P = 0.006). Controls’ movements (49.4°/s, 41.9–56.9°/s) were faster than movements towards-dystonia (31.6°/s, 25.2–37.9°/s; P < 0.001) and away-dystonia (29.2°/s, 22.9–35.5°/s; P < 0.001). After taking into account the different amplitude and speed, SPARC-derived (but not jerk-derived) indices showed reduced smoothness in patients rotating away-dystonia (1.48, 1.35–1.61) compared to controls (1.88, 1.72–2.03; P < 0.001). Poor smoothness is a motor disturbance independent of movement amplitude and speed in cervical dystonia. Therefore, it should be assessed when evaluating this disease, its progression, and treatments.

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“…Three kinds of angle metrics on the basis of the angle time series profile during needle insertion were proposed and used in this study: the average insertion angle (α¯); the number of times the needle angle is changed during cannulation ( #angle_changes ), which denotes needle “digging”; and the log dimensionless jerk of insertion angle ( LDLJ ( α )), which evaluates “smoothness” of needle angle. 13 The details of the calculation of angle metrics are presented in Supplemental Table 1 of the Supplemental Material. Our previous study demonstrated that different segments of the cannulation task elicit segment-specific behavior.…”

Section: Methodsmentioning

confidence: 99%

“…11 In line with this, our team has developed a "smart" cannulation simulator with the ability to comprehensively quantify cannulation skill. [12][13][14][15][16][17] In this work-and to the best of our knowledge, for the first time-we present a simulator-based, quantitative study examining the relationship between needle angles, cannulation outcomes, and cannulation skill from a cohort of nurses and PCTs. Toward this, we introduce three kinds of novel angle metrics on the basis of needle insertion angle profiles during cannulation to quantify cannulation performance.…”

Section: Introductionmentioning

confidence: 99%

Needle Angle Matters: An Investigation of the Effect of Needle Angle on Hemodialysis Cannulation Skill

et al. 2023

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Background: Cannulation is critical for maintaining a functional vascular access for patients on hemodialysis. However, relatively little is known about the quantitative aspects of needle insertion dynamics required for skilled cannulation. In this paper, we introduce three kinds of metrics that quantify needle insertion angle — recognized as important for safe and effective cannulation — during cannulation on an instrumented simulator for skill assessment. Three questions were examined in this study: (1) Are simulator-based needle angle metrics related to cannulation success? (2) Are needle angle metrics related to simulated blood flashback quality? (3) Can needle angle metrics be used to distinguish between high and low skill levels? Methods: Fifty-one cannulators with varying degrees of clinical experience performed cannulation on the instrumented simulator. Each participant cannulated 16 times on different fistulas with varying geometries. During each trial, needle angle along with other sensor data was obtained via a motion sensor placed inside the needle. Data analysis was conducted by relating needle angle over time with our previously validated simulator-based cannulation outcome metrics. Results: Results revealed that all three types of needle angle metrics were useful in predicting the probability of cannulation success. In addition, they were also correlated to flashback quality metrics. Furthermore, these metrics successfully distinguished between high and low performers regardless of whether they were classified using subjective ratings or objective scores. These results indicate that needle insertion angle is an important component of cannulation skill. Conclusions: The simulator-based metrics for needle insertion angle presented in this work measure a key aspect of skilled cannulation. As such, if implemented in a structured way, these metrics could lead to competency-based skill assessment and training for cannulation in the future. Raising the bar of cannulation skill of our clinicians can have a tangible impact on patient outcomes.

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Motion Smoothness Metrics for Cannulation Skill Assessment: What Factors Matter?

Cited by 9 publications

References 34 publications

Evaluation of Gait Smoothness in Patients with Stroke Undergoing Rehabilitation: Comparison between Two Metrics

Evaluation of Gait Smoothness in Patients with Stroke Undergoing Rehabilitation: Comparison between Two Metrics

Smoothness of movement in idiopathic cervical dystonia

Needle Angle Matters: An Investigation of the Effect of Needle Angle on Hemodialysis Cannulation Skill

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