SciCombinator

Discover the most talked about and latest scientific content & concepts.

Journal: Medical engineering & physics

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Functional electrical stimulation (FES) has shown effectiveness in restoring upper-limb movement post-stroke when applied to assist participants' voluntary intention during repeated, motivating tasks. Recent clinical trials have used advanced controllers that precisely adjust FES to assist functional reach and grasp tasks with FES applied to three muscle groups, showing significant reduction in impairment. The system reported in this paper advances the state-of-the-art by: (1) integrating an FES electrode array on the forearm to assist complex hand and wrist gestures; (2) utilising non-contact depth cameras to accurately record the arm, hand and wrist position in 3D; and (3) employing an interactive touch table to present motivating virtual reality (VR) tasks. The system also uses iterative learning control (ILC), a model-based control strategy which adjusts the applied FES based on the tracking error recorded on previous task attempts. Feasibility of the system has been evaluated in experimental trials with 2 unimpaired participants and clinical trials with 4 hemiparetic, chronic stroke participants. The stroke participants attended 17, 1 hour training sessions in which they performed functional tasks, such as button pressing using the touch table and closing a drawer. Stroke participant results show that the joint angle error norm reduced by an average of 50.3% over 6 attempts at each task when assisted by FES.

Concepts: Clinical trial, Participation, Stroke, Traumatic brain injury, Effectiveness, Task, Virtual reality, Baseball

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In this study, we present a method for measuring functional magnetic resonance imaging (fMRI) signal complexity using fuzzy approximate entropy (fApEn) and compare it with the established sample entropy (SampEn). Here we use resting state fMRI dataset of 86 healthy adults (41 males) with age ranging from 19 to 85 years. We expect the complexity of the resting state fMRI signals measured to be consistent with the Goldberger/Lipsitz model for robustness where healthier (younger) and more robust systems exhibit more complexity in their physiological output and system complexity decrease with age. The mean whole brain fApEn demonstrated significant negative correlation (r = -0.472, p<0.001) with age. In comparison, SampEn produced a non-significant negative correlation (r = -0.099, p = 0.367). fApEn also demonstrated a significant (p < 0.05) negative correlation with age regionally (frontal, parietal, limbic, temporal and cerebellum parietal lobes). There was no significant correlation regionally between the SampEn maps and age. These results support the Goldberger/Lipsitz model for robustness and have shown that fApEn is potentially a sensitive new method for the complexity analysis of fMRI data.

Concepts: Brain, Measurement, Brain tumor, Magnetic resonance imaging, Cerebrum, Snake scales, Control theory, Frontal lobe

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Implant loosening - commonly linked with elevated initial micromotion - is the primary indication for total ankle replacement (TAR) revision. Finite element modelling has not been used to assess micromotion of TAR implants; additionally, the biomechanical consequences of TAR malpositioning - previously linked with higher failure rates - remain unexplored. The aim of this study was to estimate implant-bone micromotion and peri-implant bone strains for optimally positioned and malpositioned TAR prostheses, and thereby identify fixation features and malpositioning scenarios increasing the risk of loosening. Finite element models simulating three of the most commonly used TAR devices (BOX(®), Mobility(®) and Salto(®)) implanted into the tibia/talus and subjected to physiological loads were developed. Mobility and Salto demonstrated the largest micromotion of all tibial and talar components, respectively. Any malpositioning of the implant creating a gap between it and the bone resulted in a considerable increase in micromotion and bone strains. It was concluded that better primary stability can be achieved through fixation nearer to the joint line and/or while relying on more than a single peg. Incomplete seating on the bone may result in considerably elevated implant-bone micromotion and bone strains, thereby increasing the risk for TAR failure.

Concepts: Finite element method, Implants, Dental implant, Failure rate, The Implant, Finite element method in structural mechanics, Order theory, Result

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The plantar soft tissue is a highly functional viscoelastic structure involved in transferring load to the human body during walking. A Soft Tissue Response Imaging Device was developed to apply a vertical compression to the plantar soft tissue whilst measuring the mechanical response via a combined load cell and ultrasound imaging arrangement. Accuracy of motion compared to input profiles; validation of the response measured for standard materials in compression; variability of force and displacement measures for consecutive compressive cycles; and implementation in vivo with five healthy participants. Static displacement displayed average error of 0.04 mm (range of 15 mm), and static load displayed average error of 0.15 N (range of 250 N). Validation tests showed acceptable agreement compared to a Houndsfield tensometer for both displacement (CMC > 0.99 RMSE > 0.18 mm) and load (CMC > 0.95 RMSE < 4.86 N). Device motion was highly repeatable for bench-top tests (ICC = 0.99) and participant trials (CMC = 1.00). Soft tissue response was found repeatable for intra (CMC > 0.98) and inter trials (CMC > 0.70). The device has been shown to be capable of implementing complex loading patterns similar to gait, and of capturing the compressive response of the plantar soft tissue for a range of loading conditions in vivo.

Concepts: Participation, Measurement, Tissues, Continuum mechanics, Human body, Materials science, Soft tissue, Design

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Gait is an important clinical assessment tool since changes in gait may reflect changes in general health. Measurement of gait is a complex process which has been restricted to the laboratory until relatively recently. The application of an inexpensive body worn sensor with appropriate gait algorithms (BWM) is an attractive alternative and offers the potential to assess gait in any setting. In this study we investigated the use of a low-cost BWM, compared to laboratory reference using a robust testing protocol in both younger and older adults. We observed that the BWM is a valid tool for estimating total step count and mean spatio-temporal gait characteristics however agreement for variability and asymmetry results was poor. We conducted a detailed investigation to explain the poor agreement between systems and determined it was due to inherent differences between the systems rather than inability of the sensor to measure the gait characteristics. The results highlight caution in the choice of reference system for validation studies. The BWM used in this study has the potential to gather longitudinal (real-world) spatio-temporal gait data that could be readily used in large lifestyle-based intervention studies, but further refinement of the algorithm(s) is required.

Concepts: Algorithm, Evaluation, Measurement, Assessment, Clinical psychology, Cultural studies, Microelectromechanical systems

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We investigated the effects of isolated meniscectomy on tibiofemoral skeletal kinematics and cartilage contact arthrokinematics in vivo. We recruited nine patients who had undergone isolated medial or lateral meniscectomy, and used a dynamic stereo-radiography (DSX) system to image the patients' knee motion during decline walking. A volumetric model-based tracking process determined 3D tibiofemoral kinematics from the recorded DSX images. Cartilage contact arthrokinematics was derived from the intersection between tibial and femoral cartilage models co-registered to the bones. The kinematics and arthrokinematics were analyzed for early stance and loading response phase (30% of a gait cycle), comparing the affected and intact knees. Results showed that four patients with medial meniscectomy had significantly greater contact centroid excursions in the meniscectomized medial compartments while five patients with lateral meniscectomy had significantly greater cartilage contact area and lateral shift of contact centroid path in the meniscectomized lateral compartments, comparing to those of the same compartments in the contralateral intact knees. No consistent difference however was identified in the skeletal kinematics. The current study demonstrated that cartilage-based intra-articular arthrokinematics is more sensitive and insightful than the skeletal kinematics in assessing the meniscectomy effects.

Concepts: Bone, Skeletal system, Cartilage, Osteoarthritis, Knee, Joint, Sartorius muscle, Knee examination

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Inverse kinematics is emerging as the optimal method in movement analysis to fit a multi-segment biomechanical model to experimental marker positions. A key part of this process is calibrating the model to the dimensions of the individual being analysed which requires scaling of the model, pose estimation and localisation of tracking markers within the relevant segment coordinate systems. The aim of this study is to propose a generic technique for this process and test a specific application to the OpenSim model Gait2392. Kinematic data from 10 healthy adult participants were captured in static position and normal walking. Results showed good average static and dynamic fitting errors between virtual and experimental markers of 0.8 cm and 0.9 cm, respectively. Highest fitting errors were found on the epicondyle (static), feet (static, dynamic) and on the thigh (dynamic). These result from inconsistencies between the model geometry and degrees of freedom and the anatomy and movement pattern of the individual participants. A particular limitation is in estimating anatomical landmarks from the bone meshes supplied with Gait2392 which do not conform with the bone morphology of the participants studied. Soft tissue artefact will also affect fitting the model to walking trials.

Concepts: Mathematics, Geometry, Anatomy, Biomechanics, Classical mechanics, Estimation, Inverse kinematics, Analytical dynamics

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Total knee arthroplasty (TKA) is a standard treatment for patients with end stage knee Osteoarthritis (OA) to reduce pain and restore function. The aim of this study was to assess pre- and early post-operative physical activity (PA) with Fitbit Flex devices for patients with OA undergoing TKA and determine any benchmarks for expected post-operative activity. Significant correlations of pre-operative step count, post-operative step count, Body Mass Index (BMI) and Short Form 12 Physical Component Summaries (SF-12 PCS) were found. Mean step counts varied by 3,203 steps per day between obese and healthy weight patients, and 3,786 steps per day between those with higher and lower SF-12 PCS scores, suggesting the need for benchmarks for recovery that vary by patient pre-operative factors. A backwards stepwise regression model developed to provide patient specific step count predictions at 6 weeks had an R(2) of 0.754, providing a robust patient specific benchmark for post-operative recovery, while population means from BMI and SF-12 subgroups provide a clinically practical alternative.

Concepts: Regression analysis, Obesity, Mass, Osteoarthritis, Body mass index, Arithmetic mean, Knee replacement, Stepwise regression

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This note describes the design and testing of a programmable pulsatile flow pump using an Arduino micro-controller. The goal of this work is to build a compact and affordable system that can relatively easily be programmed to generate physiological waveforms. The system described here was designed to be used in an in-vitro set-up for vascular access hemodynamics research, and hence incorporates a gear pump that delivers a mean flow of 900 ml/min in a test flow loop, and a peak flow of 1106 ml/min. After a number of simple identification experiments to assess the dynamic behaviour of the system, a feed-forward control routine was implemented. The resulting system was shown to be able to produce the targeted representative waveform with less than 3.6% error. Finally, we outline how to further increase the accuracy of the system, and how to adapt it to specific user needs.

Concepts: English-language films, Control theory, Computer program, Program, Specific Identification, Pumps, Waveform, Waveform viewer

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Pressure ulcers influence people with limited mobility who must spend a long time lying or sitting because these positions create high interfacial pressure between the body and supporting materials. Supporting materials, such as mattresses and cushions, are designed to prevent pressure ulcers by increasing the contact area, reducing the interfacial pressure or reducing the contact time. Foam is the most common supporting material for relieving pressure because it is cheap and easy to change its shape to fit the contour of the body. Past studies showed that BMI, body position and supporting material properties have an impact on relieving pressure; however, there is no study of the main and cross-over effects among these parameters. This study aims to investigate the main and cross-over effects among BMI, body position and supporting material properties on pressure relieving performance using univariate ANOVA and correlation analysis. It was found that body position and foam density were the main effect and BMI and body position, and body position and foam density were the cross-over effects on pressure relief. It was also found that low density Polyurethane (PU) foam of less than 4 cm in thickness as well as the appropriate K2 and K3 moduli are best suited for pressure relief. The actual value of foam thickness and the appropriate K2 and K3 moduli are subject to BMI values and body position. The significance of the outcomes from this study is that it will aid in optimizing the design of supporting materials with varied BMI values and body positions to greatly reduce pressure ulcers for ailing patients.

Concepts: Mass, Sociology, Body mass index, Value, Materials science, Material, Morality, Body weight