Nintendo® Wii Fit based sleepiness tester detects impairment of postural steadiness due to 24h of wakefulness

Tietäväinen, Aino; Gates, Fred; Meriläinen, Antti; Mandel, Jeff E.; Hæggström, Edward

doi:10.1016/j.medengphy.2013.08.007

Cited by 10 publications

(9 citation statements)

References 19 publications

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“…The decrease in the patients' postural steadiness (evidenced as an increase in sway regularity) has been associated with increased cognitive involvement in maintaining stable posture [11]. We previously demonstrated that this is also true when maintaining sedation impaired balance [8] and sleep-deprived balance [12]. The results in the current study are in agreement with previous findings that propofol impairs postural steadiness, but less so than midazolam [3,4].…”

Section: Resultssupporting

confidence: 91%

A simple posturographic method detects the difference in recovery of patients receiving endoscopic sedation with propofol vs. midazolam

Je¹,

Tietäväinen²,

Otero³

et al. 2017

Med Res Innov

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Background: Measurement of the residual effects of sedatives on fitness for ambulation is typically performed with subjective measures, if at all. Previous efforts to objectively measure these effects employed dynamic posturography with expensive equipment that is not easily brought to the bedside and carries a risk of patient injury. A simple test employing consumer off-the-shelf technology that exposes the patient to no more risk than standing still might permit a more reliable assessment of fitness for discharge. We have previously shown that a simple tester, using a Nintendo Wii® Balance board and software that determined fuzzy sample entropy of postural sway can separate outpatients' postural steadiness before (PRE) and after (POST) endoscopy with midazolam/fentanyl conscious sedation. Propofol/fentanyl monitored anesthesia care also alters balance, but recovery is known to be more rapid. We hypothesized that the ability to detect decrements in postural steadiness with fuzzy sample entropy following monitored anesthesia care would be less than that seen in conscious sedation.

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Section: Resultssupporting

confidence: 91%

A simple posturographic method detects the difference in recovery of patients receiving endoscopic sedation with propofol vs. midazolam

Je¹,

Tietäväinen²,

Otero³

et al. 2017

Med Res Innov

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“…These measures typically describe mean sway amplitude, velocity, and frequency 7 . Previously posturographic measurements have been used to quantify effects of aging 7–9 , state of alertness 10–12 , use of anesthetic drugs 13–15 , and conditions, such as multiple sclerosis 16, 17 , and Parkinson’s disease 18, 19 .…”

Section: Introductionmentioning

confidence: 99%

Bayesian inference of physiologically meaningful parameters from body sway measurements

Tietäväinen

Gutmann

Keski-Vakkuri

et al. 2017

Sci Rep

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The control of the human body sway by the central nervous system, muscles, and conscious brain is of interest since body sway carries information about the physiological status of a person. Several models have been proposed to describe body sway in an upright standing position, however, due to the statistical intractability of the more realistic models, no formal parameter inference has previously been conducted and the expressive power of such models for real human subjects remains unknown. Using the latest advances in Bayesian statistical inference for intractable models, we fitted a nonlinear control model to posturographic measurements, and we showed that it can accurately predict the sway characteristics of both simulated and real subjects. Our method provides a full statistical characterization of the uncertainty related to all model parameters as quantified by posterior probability density functions, which is useful for comparisons across subjects and test settings. The ability to infer intractable control models from sensor data opens new possibilities for monitoring and predicting body status in health applications.Upright stance is inherently unstable due to the physics of an inverted pendulum-like body and due to the internal perturbations of an individual, such as noise in afferent (sensory) and efferent (motor) nerve pathways, respiration, and hemodynamics [1][2][3][4] . Balance is controlled by co-operating visual, vestibular, and somatosensory systems. The sensory information is integrated in the central nervous system (CNS), which determines the actions needed to maintain balance and which commands the musculoskeletal system to execute corrective actions to maintain an upright stance.Factors that affect the CNS and skeletal muscles also influence postural steadiness. Therefore, quantifying postural steadiness during upright stance may provide insight into the physiological state of a person. In one kind of posturographic measurement a person stands erect on a force plate while the plate measures the net center-of-pressure (COP) along the mediolateral (ML) and anteriorposterior (AP) directions. The COP signal is closely related to the 2D center-of-mass (COM) signal 5,6 , the time-varying vertical projection of the 3D body's center-of-mass. Traditionally COP signals are quantified by statistical sway measures extracted from raw data. These measures typically describe mean sway amplitude, velocity, and frequency 7 . Previously posturographic measurements have been used to quantify effects of aging 7-9 , state of alertness 10-12 , use of anesthetic drugs [13][14][15] , and conditions, such as multiple sclerosis 16,17 , and Parkinson's disease 18,19 . Upright stance can be modeled using an inverted pendulum model that depicts the human body as a rigid rod pivoting around its floor-anchored end. The pendulum may have either one or more links that depict human joints, such as ankles, hips, and knees. A single-link (ankle) model is simple and common, and it can be used to describe quiet, upright stance 9...

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“…It is thus an important traffi c safety issue to fi nd a robust, objective (as opposed to subjective reports such as the Stanford Sleepiness Scale) (Hoddes et al, 1973) and practical way to estimate the amount of time a person has been awake (time since awakening or TA). Posturography is an interesting candidate (Haeggström et al, 2006;Morad et al, 2007;Forsman et al, 2010;Smith et al, 2012;Tietavainen et al, 2013) because it yields objective measures and can be performed by means of cheap and easily transportable devices such as force platforms. Basically, posturography is the measurement of human posture (Winter, 1995).…”

Section: Introductionmentioning

confidence: 99%

“…However, simple measurements of the amount of sway, such as the standard deviation, area, and velocity of COP trajectories during conventional normal upright standing, are not always signifi cantly correlated with TA and novel measurements, such as fractal dimension and critical time from a stabilogram diffusion plot, have been proposed because they achieved a higher correlation with TA (Haeggström et al, 2006;Morad et al, 2007;Smith et al, 2012;Tietavainen et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Robust evaluation of time since awakening using force platform posturography

Pham

Mello

Narciso

et al. 2014

Rev. Bras. Eng. Bioméd.

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Introduction: Sleepiness is responsible for a considerable proportion of traffi c accidents. It is thus an important traffi c safety issue to fi nd a robust, objective and practical way to estimate the amount of time a person has been awake. To attempt to meet this goal, we investigated the relationship between sleepiness and posture control. Methods: Subjects were kept awake for 36 hours and posturographic data during quiet standing were collected every two hours by means of a force platform. The standing surface (rigid surface or foam surface) and visual (eyes open or eyes closed) conditions were manipulated. Results: In the more challenging conditions (with foam surface and/or eyes closed), the body sway variables derived from the center of the pressure measurement increased signifi cantly when time since awakening became greater than 21 h in almost all subjects. Conclusion: Based on this result, we propose a practical protocol that could robustly assess whether time since awakening was greater than 21 h.

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Nintendo® Wii Fit based sleepiness tester detects impairment of postural steadiness due to 24h of wakefulness

Cited by 10 publications

References 19 publications

A simple posturographic method detects the difference in recovery of patients receiving endoscopic sedation with propofol vs. midazolam

A simple posturographic method detects the difference in recovery of patients receiving endoscopic sedation with propofol vs. midazolam

Bayesian inference of physiologically meaningful parameters from body sway measurements

Robust evaluation of time since awakening using force platform posturography

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