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Liu C, Kim J, Kwak SS, Hourlier‐Fargette A, Avila R, Vogl J, Tzavelis A, Chung HU, Lee JY, Kim DH, Ryu D, Fields KB, Ciatti JL, Li S, Irie M, Bradley A, Shukla A, Chavez J, Dunne EC, Kim SS, Kim J, Park JB, Jo HH, Kim J, Johnson MC, Kwak JW, Madhvapathy SR, Xu S, Rand CM, Marsillio LE, Hong SJ, Huang Y, Weese‐Mayer DE, Rogers JA. Wireless, Skin-Interfaced Devices for Pediatric Critical Care: Application to Continuous, Noninvasive Blood Pressure Monitoring. Adv Healthc Mater 2021; 10:e2100383. [PMID: 33938638 DOI: 10.1002/adhm.202100383] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 03/22/2021] [Indexed: 12/16/2022]
Abstract
Indwelling arterial lines, the clinical gold standard for continuous blood pressure (BP) monitoring in the pediatric intensive care unit (PICU), have significant drawbacks due to their invasive nature, ischemic risk, and impediment to natural body movement. A noninvasive, wireless, and accurate alternative would greatly improve the quality of patient care. Recently introduced classes of wireless, skin-interfaced devices offer capabilities in continuous, precise monitoring of physiologic waveforms and vital signs in pediatric and neonatal patients, but have not yet been employed for continuous tracking of systolic and diastolic BP-critical for guiding clinical decision-making in the PICU. The results presented here focus on materials and mechanics that optimize the system-level properties of these devices to enhance their reliable use in this context, achieving full compatibility with the range of body sizes, skin types, and sterilization schemes typically encountered in the PICU. Systematic analysis of the data from these devices on 23 pediatric patients, yields derived, noninvasive BP values that can be quantitatively validated against direct recordings from arterial lines. The results from this diverse cohort, including those under pharmacological protocols, suggest that wireless, skin-interfaced devices can, in certain circumstances of practical utility, accurately and continuously monitor BP in the PICU patient population.
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Buchman-Pearle JM, Acker SM. Estimating soft tissue artifact of the thigh in high knee flexion tasks using optical motion Capture: Implications for marker cluster placement. J Biomech 2021; 127:110659. [PMID: 34385050 DOI: 10.1016/j.jbiomech.2021.110659] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 07/19/2021] [Accepted: 07/25/2021] [Indexed: 10/20/2022]
Abstract
Soft tissue artifact in motion capture is widely accepted as a significant source of error in kinematic and kinetic measurements. Non-invasive methods of estimating soft tissue artifact, those requiring only motion capture, provide a feasible method to evaluate marker placement on a segment and enable recommendations for marker configurations which can minimize soft tissue artifact. The purpose of this study was to investigate the effect of thigh marker cluster location on soft tissue artifact during high knee flexion (>120 deg) as unique deformation of soft tissue occurs in this range (e.g. thigh-calf contact). Motion of the pelvis and lower limbs were recorded during squatting and kneeling in fifty participants. Six rigid marker clusters were affixed to the skin on the anterior, lateral, and anterolateral aspect, at the distal and middle third of the thighs. To estimate soft tissue artifact, the functional hip joint center was reconstructed relative to the pelvis cluster and each of the six thigh clusters throughout motion. The difference in the position of these two points was input into Bland-Altman analyses and compared between the thigh clusters. Across the tasks, the total mean difference ranged from 2.81 to 8.95 cm while the lower and upper limits of agreement ranged from -0.79 to 2.54 cm and 5.04 to 17.65 cm, respectively. Using this non-invasive method, the mid-anterolateral cluster was least susceptible to soft tissue artifact and thus would be recommended, while the lateral clusters were most susceptible and should avoided in high knee flexion and similar tasks.
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Affiliation(s)
- Jessa M Buchman-Pearle
- Department of Kinesiology and Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, Ontario, N2L 3G1, Canada.
| | - Stacey M Acker
- Department of Kinesiology and Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, Ontario, N2L 3G1, Canada.
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Sun T, Tasnim F, McIntosh RT, Amiri N, Solav D, Anbarani MT, Sadat D, Zhang L, Gu Y, Karami MA, Dagdeviren C. Decoding of facial strains via conformable piezoelectric interfaces. Nat Biomed Eng 2020; 4:954-972. [PMID: 33093670 DOI: 10.1038/s41551-020-00612-w] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 08/19/2020] [Indexed: 11/09/2022]
Abstract
Devices that facilitate nonverbal communication typically require high computational loads or have rigid and bulky form factors that are unsuitable for use on the face or on other curvilinear body surfaces. Here, we report the design and pilot testing of an integrated system for decoding facial strains and for predicting facial kinematics. The system consists of mass-manufacturable, conformable piezoelectric thin films for strain mapping; multiphysics modelling for analysing the nonlinear mechanical interactions between the conformable device and the epidermis; and three-dimensional digital image correlation for reconstructing soft-tissue surfaces under dynamic deformations as well as for informing device design and placement. In healthy individuals and in patients with amyotrophic lateral sclerosis, we show that the piezoelectric thin films, coupled with algorithms for the real-time detection and classification of distinct skin-deformation signatures, enable the reliable decoding of facial movements. The integrated system could be adapted for use in clinical settings as a nonverbal communication technology or for use in the monitoring of neuromuscular conditions.
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Affiliation(s)
- Tao Sun
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Farita Tasnim
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Rachel T McIntosh
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA.,Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Nikta Amiri
- Department of Mechanical and Aerospace Engineering, University at Buffalo, Buffalo, NY, USA
| | - Dana Solav
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA.,Faculty of Mechanical Engineering, Technion Israel Institute of Technology, Haifa, Israel
| | | | - David Sadat
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Lin Zhang
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Yuandong Gu
- Institute of Microelectronics, Agency for Science, Technology and Research (A*STAR), Singapore, Singapore
| | - M Amin Karami
- Department of Mechanical and Aerospace Engineering, University at Buffalo, Buffalo, NY, USA
| | - Canan Dagdeviren
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA.
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Camomilla V, Bonci T. A joint kinematics driven model of the pelvic soft tissue artefact. J Biomech 2020; 111:109998. [PMID: 32891015 DOI: 10.1016/j.jbiomech.2020.109998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 08/06/2020] [Accepted: 08/08/2020] [Indexed: 10/23/2022]
Abstract
When skin-markers trajectories are used in human movement analysis, compensating for their relative movement with respect to the underlying bone (soft tissue artefact, STA) is essential for accurate bone-pose estimation; information about the artefact is required in the form of a mathematical model. Such model, not available for pelvic artefacts, could allow pelvic STA compensation in routine gait analysis by embedding it in skeletal kinematics estimators and developing ad-hoc optimization problems for the estimate of subject-specific model parameters. It was developed as driven by adjacent body segment kinematics. Model architecture feasibility was tested; its compensation effectiveness was assessed evaluating the error in pelvic orientation after removing the modelled artefact from the measured one. Five volunteers with a wide body mass range (BMI: 22-37) underwent MRI scans to reconstruct subject-specific pelvic digital bone models. Multiple anatomical calibrations performed in different static postures, as occurring during walking and star-arc movements, registering the bone-models with points digitized through stereophotogrammetry over pelvic bony prominences, allowed to define the relevant poses of a pelvis-embedded anatomical coordinate system. Such approach allowed to measure STAs over several pelvic anatomical landmarks, for each posture and subject. Model parameters were estimated by minimizing the least squares difference between measured and modelled STAs. The measured STAs were appropriately modelled with subject-specific calibrations, both in terms of shape (correlation coefficient: median [inter-quartile-range]: 0.72 [0.36]) and amplitude (root mean square residual: 3.0 [3.2] mm). Consequently, the overall error in pelvic orientation vector (5.1 [4.4] deg) was reduced after removing the modelled artefacts (2.5 [1.9] deg).
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Affiliation(s)
- Valentina Camomilla
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome "Foro Italico", Roma, Italy; Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza de Bosis 15, 00135 Roma, Italy.
| | - Tecla Bonci
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome "Foro Italico", Roma, Italy; Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Piazza de Bosis 15, 00135 Roma, Italy; Department of Mechanical Engineering, The University of Sheffield, Sir Frederick Mappin Building, Mappin Street, Sheffield S1 3JD, UK; INSIGNEO Institute for In Silico Medicine, The University of Sheffield, The Pam Liversidge Building, Sir Frederick Mappin Building, Mappin Street, Sheffield S1 3JD, UK
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Polovinets O, Wolf A, Wollstein R. Force transmission through the wrist during performance of push-ups on a hyperextended and a neutral wrist. J Hand Ther 2019; 31:322-330. [PMID: 28684196 DOI: 10.1016/j.jht.2017.04.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 04/24/2017] [Accepted: 04/26/2017] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Cross-sectional cohort. INTRODUCTION Push-ups are used ubiquitously to evaluate and strengthen the upper body. They are usually performed in 1 of 2 main ways: with the wrist in hyperextension and with the wrist in a neutral position. PURPOSE OF THE STUDY The purpose of our study was to compare the dynamic forces in the wrist during the 2 push-up styles. METHODS Fourteen volunteers performed push-ups in 2 different patterns: on a hyperextended wrist and a neutral wrist (NW). Two force plates and a motion capture system were used to measure the ground reaction forces (GRFs) and the kinematics of the upper extremity during push-ups. Kinematic and kinetic analyses were performed using Matlab software (Mathworks, Natick, MA). RESULTS The GRF vector was distributed differently during the different types of push-ups. For both methods, the total GRF carried by the upper dominant extremity was larger than those of the nondominant extremity. In the NW configuration, the GRF vector was more uniform throughout the push-up in the vertical direction. The horizontal distance between the capitate bone location and the GRF origin was smaller in hyperextension. The forces traveled more dorsally over a wider area and more ulnarly in the hyperextended wrist. DISCUSSION Forces are transmitted differently through the wrist in the 2 methods. Push-ups on an NW are likely safer because ligaments may be preferentially loaded in hyperextension. Further study may delineate the differences in the anatomic location of force transmission and the long-term clinical effect on the wrist. CONCLUSIONS This study supports the performance of push-ups on a wrist in neutral flexion extension; both to enable patients after surgery or injury to strengthen the upper body and prevent injury and long-term wear in the wrist. The knowledge gained from this study may assist in outlining guidelines for push-up performance. LEVEL OF EVIDENCE Diagnostic level 2a.
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Affiliation(s)
- Olga Polovinets
- Department of Mechanical Engineering, Technion Israel Institute of Technology, Haifa, Israel
| | - Alon Wolf
- Department of Mechanical Engineering, Technion Israel Institute of Technology, Haifa, Israel
| | - Ronit Wollstein
- Department of Mechanical Engineering, Technion Israel Institute of Technology, School of Medicine, Haifa, Israel; Department of Plastic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
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Solav D, Moerman KM, Jaeger AM, Herr HM. A Framework for Measuring the Time-Varying Shape and Full-Field Deformation of Residual Limbs Using 3-D Digital Image Correlation. IEEE Trans Biomed Eng 2019; 66:2740-2752. [PMID: 30676943 DOI: 10.1109/tbme.2019.2895283] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Effective prosthetic socket design following lower limb amputation depends upon the accurate characterization of the shape of the residual limb as well as its volume and shape fluctuations. OBJECTIVE This study proposes a novel framework for the measurement and analysis of residual limb shape and deformation, using a high-resolution and low-cost system. METHODS A multi-camera system was designed to capture sets of simultaneous images of the entire residuum surface. The images were analyzed using a specially developed open-source three-dimensional digital image correlation (3D-DIC) toolbox, to obtain the accurate time-varying shapes as well as the full-field deformation and strain maps on the residuum skin surface. Measurements on a transtibial amputee residuum were obtained during knee flexions, muscle contractions, and swelling upon socket removal. RESULTS It was demonstrated that 3D-DIC can be employed to quantify with high resolution time-varying residuum shapes, deformations, and strains. Additionally, the enclosed volumes and cross-sectional areas were computed and analyzed. CONCLUSION This novel low-cost framework provides a promising solution for the in vivo evaluation of residuum shapes and strains, as well as has the potential for characterizing the mechanical properties of the underlying soft tissues. SIGNIFICANCE These data may be used to inform data-driven computational algorithms for the design of prosthetic sockets, as well as of other wearable technologies mechanically interfacing with the skin.
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Solav D, Camomilla V, Cereatti A, Barré A, Aminian K, Wolf A. Bone orientation and position estimation errors using Cosserat point elements and least squares methods: Application to gait. J Biomech 2017; 62:110-116. [DOI: 10.1016/j.jbiomech.2017.01.026] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 01/14/2017] [Accepted: 01/17/2017] [Indexed: 11/24/2022]
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Assessment of the lower limb soft tissue artefact at marker-cluster level with a high-density marker set during walking. J Biomech 2017; 62:21-26. [DOI: 10.1016/j.jbiomech.2017.04.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 04/26/2017] [Accepted: 04/30/2017] [Indexed: 11/15/2022]
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Chest Wall Kinematics Using Triangular Cosserat Point Elements in Healthy and Neuromuscular Subjects. Ann Biomed Eng 2017; 45:1963-1973. [PMID: 28451990 DOI: 10.1007/s10439-017-1840-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 04/21/2017] [Indexed: 10/19/2022]
Abstract
Optoelectronic plethysmography (OEP) is a noninvasive method for assessing lung volume variations and the contributions of different anatomical compartments of the chest wall (CW) through measurements of the motion of markers attached to the CW surface. The present study proposes a new method for analyzing the local CW kinematics from OEP measurements based on the kinematics of triangular Cosserat point elements (TCPEs). 52 reflective markers were placed on the anterior CW to create a mesh of 78 triangles according to an anatomical model. Each triangle was characterized by a TCPE and its kinematics was described using four time-variant scalar TCPE parameters. The total CW volume ([Formula: see text]) and the contributions of its six compartments were also estimated, using the same markers. The method was evaluated using measurements of ten healthy subjects, nine patients with Pompe disease, and ten patients with Duchenne muscular dystrophy (DMD), during spontaneous breathing (SB) and vital capacity maneuvers (VC) in the supine position. TCPE parameters and compartmental volumes were compared with [Formula: see text] by computing the phase angles [Formula: see text] (for SB) and the correlation r (for VC) between them. Analysis of [Formula: see text] and r of the outward translation parameter [Formula: see text] of each TCPE revealed that for healthy subjects it provided similar results to those obtained by compartmental volumes, whereas for the neuromuscular patients the TCPE method was capable of detecting local asynchronous and paradoxical movements also in cases where they were undistinguished by volumes. Therefore, the TCPE approach provides additional information to OEP that may enhance its clinical evaluation capabilities.
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