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Tanabe H, Shiraishi T, Sato H, Nihei M, Inoue T, Kuwabara C. A concept for emotion recognition systems for children with profound intellectual and multiple disabilities based on artificial intelligence using physiological and motion signals. Disabil Rehabil Assist Technol 2024; 19:1319-1326. [PMID: 36695503 DOI: 10.1080/17483107.2023.2170478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 11/28/2022] [Accepted: 01/16/2023] [Indexed: 01/26/2023]
Abstract
PURPOSE This study proposes a concept for emotion recognition systems for children with profound intellectual and multiple disabilities (PIMD) based on artificial intelligence (AI) using physiological and motion signals. METHODS First, the heartbeat interval (R-R interval, RRI) of a child with PIMD was measured, and the correlation between the RRI and emotion was briefly tested in a preliminary experiment. Then, a concept based on AI for emotion recognition systems for children with PIMD was created using physiological and motion signals, and an emotion recognition system based on the proposed concept was developed using a random forest classifier taking as inputs the RRI, eye gaze, and other data acquired using low physical burden sensors. Subsequently, the developed emotion recognition system was evaluated, validating the proposed concept. Finally, we proposed a validated concept for emotion recognition systems. RESULTS A correlation was found between the RRI and emotion. The emotion recognition system was created based on the proposed concept and tested. According to the results, the recognition rate of "negative" and "not negative" of 70.4% ± 6.1% (Mean ± S.D.) of the developed emotion recognition system was higher than 48.5% ± 5.0% of an unfamiliar person used as a control. CONCLUSION The results indicate that the proposed concept for emotion recognition systems is useful for communicating with children with PIMD.
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Affiliation(s)
- Hiroki Tanabe
- Graduate School of Environment and Information Sciences, Yokohama National University, Yokohama, Japan
| | - Toshihiko Shiraishi
- Graduate School of Environment and Information Sciences, Yokohama National University, Yokohama, Japan
| | - Haruhiko Sato
- Department of Rehabilitation, Kansai Medical University, Hirakata, Japan
| | - Misato Nihei
- Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa, Japan
| | - Takenobu Inoue
- Department of Assistive Technology, Research Institute of National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
| | - Chika Kuwabara
- Center for Developmental Disabilities of Yokosuka, Yokosuka, Japan
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Petersen BA, Erickson KI, Kurowski BG, Boninger ML, Treble-Barna A. Emerging methods for measuring physical activity using accelerometry in children and adolescents with neuromotor disorders: a narrative review. J Neuroeng Rehabil 2024; 21:31. [PMID: 38419099 PMCID: PMC10903036 DOI: 10.1186/s12984-024-01327-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 02/21/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Children and adolescents with neuromotor disorders need regular physical activity to maintain optimal health and functional independence throughout their development. To this end, reliable measures of physical activity are integral to both assessing habitual physical activity and testing the efficacy of the many interventions designed to increase physical activity in these children. Wearable accelerometers have been used for children with neuromotor disorders for decades; however, studies most often use disorder-specific cut points to categorize physical activity intensity, which lack generalizability to a free-living environment. No reviews of accelerometer data processing methods have discussed the novel use of machine learning techniques for monitoring physical activity in children with neuromotor disorders. METHODS In this narrative review, we discuss traditional measures of physical activity (including questionnaires and objective accelerometry measures), the limitations of standard analysis for accelerometry in this unique population, and the potential benefits of applying machine learning approaches. We also provide recommendations for using machine learning approaches to monitor physical activity. CONCLUSIONS While wearable accelerometers provided a much-needed method to quantify physical activity, standard cut point analyses have limitations in children with neuromotor disorders. Machine learning models are a more robust method of analyzing accelerometer data in pediatric neuromotor disorders and using these methods over disorder-specific cut points is likely to improve accuracy of classifying both type and intensity of physical activity. Notably, there remains a critical need for further development of classifiers for children with more severe motor impairments, preschool aged children, and children in hospital settings.
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Affiliation(s)
- Bailey A Petersen
- Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
| | - Kirk I Erickson
- AdventHealth Research Institute Department of Neuroscience, AdventHealth, Orlando, FL, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Brad G Kurowski
- Division of Pediatric Rehabilitation Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - M L Boninger
- Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
| | - A Treble-Barna
- Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA
- Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, USA
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Pinto AP, Lemos SL, de Almeida Fagundes A, das Neves MF, Lopes-Martins RÁB, Lima FPS, Lima MO. Transcranial photobiomodulation therapy associated with cardiorespiratory rehabilitation in spastic subjects. Lasers Med Sci 2023; 38:249. [PMID: 37910318 DOI: 10.1007/s10103-023-03922-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/24/2023] [Indexed: 11/03/2023]
Abstract
The objective of this study was to evaluate the effects of cardiorespiratory rehabilitation (CR) and transcranial photobiomodulation (tPBM) on exercise tolerance (ET), heart rate variability (HRV), and peripheral muscle activity in individuals with spasticity. Fifteen participants with spasticity were randomly assigned to two groups: the tPBM group (tPBMG) consisted of eight volunteers who underwent tPBM (on mode) and CR, while the control group (CG) consisted of seven volunteers who underwent simulated tPBM (off mode) and CR. The CR program included 12 weeks of treatment, twice a week for one hour, involving aerobic exercises and lower limb strengthening. For tPBM, a cluster with three lasers (λ = 680 nm, 808 nm), with a power of 100 mW/laser and energy of 36 J, applied to the F7, F8, and Fpz points. The following parameters were evaluated after 8 and 12 weeks: ET, HRV, and surface electromyography (EMG) of the rectus femoris muscle during orthostasis (ORT), isometric squatting (ISOM), and isotonic squatting (ISOT). Both groups showed a 40% increase in ET for the CG and a 30% increase for the tPBMG. The CG had more pronounced parasympathetic modulation alterations during post-exercise effort and recovery compared to the tPBMG. The EMG results showed that the tPBMG exhibited progressive improvement in muscle activity during ISOM and ISOT, as well as a decrease in the interlimb difference. In conclusion, both CR and tPBMG demonstrated improvements in ET. However, tPBMG specifically showed promising effects on HRV modulation and peripheral muscle electrical activity, providing additional benefits compared to CR alone.
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Affiliation(s)
- Ana Paula Pinto
- Sensorimotor Rehabilitation Engineering Laboratory, Research and Development Institute, Paraiba Valley University - UNIVAP, Av. Shishima Hifumi, São José Dos Campos, São Paulo, 2911, Brazil.
| | - Sérgio Luiz Lemos
- Sensorimotor Rehabilitation Engineering Laboratory, Research and Development Institute, Paraiba Valley University - UNIVAP, Av. Shishima Hifumi, São José Dos Campos, São Paulo, 2911, Brazil
| | - Alessandra de Almeida Fagundes
- Sensorimotor Rehabilitation Engineering Laboratory, Research and Development Institute, Paraiba Valley University - UNIVAP, Av. Shishima Hifumi, São José Dos Campos, São Paulo, 2911, Brazil
| | - Marcele Florêncio das Neves
- Sensorimotor Rehabilitation Engineering Laboratory, Research and Development Institute, Paraiba Valley University - UNIVAP, Av. Shishima Hifumi, São José Dos Campos, São Paulo, 2911, Brazil
| | - Rodrigo Álvaro Brandão Lopes-Martins
- Post-Graduate Program in Human Movement and Rehabilitation, Research Group in Biophotonics and Experimental Therapeutics in Health and Esthetics, Universidade Evangélica de Goiás - UniEVANGÉLICA, Anápolis, Goiás, Brazil
| | - Fernanda Pupio Silva Lima
- Sensorimotor Rehabilitation Engineering Laboratory, Research and Development Institute, Paraiba Valley University - UNIVAP, Av. Shishima Hifumi, São José Dos Campos, São Paulo, 2911, Brazil
| | - Mário Oliveira Lima
- Sensorimotor Rehabilitation Engineering Laboratory, Research and Development Institute, Paraiba Valley University - UNIVAP, Av. Shishima Hifumi, São José Dos Campos, São Paulo, 2911, Brazil
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Jørgensen A, Toftager M, Eghøj M, Ried-Larsen M, Bjørk Petersen C. Heart rate responses, agreement and accuracy among persons with severe disabilities participating in the indirect movement program: Team Twin-an observational study. Front Sports Act Living 2023; 5:1213655. [PMID: 37941848 PMCID: PMC10627970 DOI: 10.3389/fspor.2023.1213655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 09/22/2023] [Indexed: 11/10/2023] Open
Abstract
Introduction Heart rate (HR) monitors are rarely used by people living with disabilities (PLWD), and their accuracy is undocumented. Thus, this study aims to describe the HR response during the Team Twin co-running program and, secondly, to assess the agreement and accuracy of using HR monitors among PLWD. Methods This 16-week single-arm observational study included 18 people with various disabilities. During the study, the subjects wore a Garmin Vivosmart 4 watch (wrist). To evaluate the agreement and accuracy we applied Garmin's HRM-DUAL™ chest-worn HR monitors for comparison with the Vivosmart 4. The HR response analysis was performed descriptively and with a mixed regression model. The HR agreement and accuracy procedure was conducted on a subsample of five subjects and analyzed using Lin's concordance analysis, Bland and Altman's limits of agreement, and Cohen's kappa analysis of intensity zone agreement. This study was prospectively registered at Clinical Trials.gov (NCT04536779). Results The subjects had a mean age of 35 (±12.6), 61% were male, 72% had cerebral palsy were 85% had GMFCS V-IV. HR was monitored for 202:10:33 (HH:MM:SS), with a mean HR of 90 ± 17 bpm during training and race. A total of 19% of the time was spent in intensity zones between light and moderate (30%-59% HR reserve) and 1% in vigorous (60%-84% HR reserve). The remaining 80% were in the very light intensity zone (<29% HR reserve). HR was highest at the start of race and training and steadily decreased. Inter-rater agreement was high (k = 0.75), limits of agreement were between -16 and 13 bpm, and accuracy was acceptable (Rc = 0.86). Conclusion Disability type, individual, and contextual factors will likely affect HR responses and the agreement and accuracy for PLWD. The Vivosmart 4, while overall accurate, had low precision due to high variability in the estimation. These findings implicate the methodical and practical difficulties of utilizing HR monitors to measure HR and thus physical activity in adapted sports activities for severely disabled individuals.
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Affiliation(s)
- Andreas Jørgensen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Mette Toftager
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Martin Eghøj
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Mathias Ried-Larsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Centre for Physical Activity Research, Copenhagen University Hospital—Rigshospitalet, Copenhagen, Denmark
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Gąsior JS, Zamunér AR, Madeyska M, Tomik A, Niszczota C, Williams CA, Werner B. Heart Rate Variability in Individuals with Down Syndrome: A Scoping Review with Methodological Considerations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:941. [PMID: 36673696 PMCID: PMC9859252 DOI: 10.3390/ijerph20020941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/31/2022] [Accepted: 01/01/2023] [Indexed: 06/17/2023]
Abstract
Individuals with Down syndrome (DS) present similar heart rate variability (HRV) parameters at rest but different responses to selected movement maneuvers in comparison to individuals without DS, which indicates reduced vagal regulation. The present study undertakes a scoping review of research on HRV in individuals with DS, with special attention paid to the compliance of the studies with standards and methodological paper guidelines for HRV assessment and interpretation. A review was performed using PubMed, Web of Science and CINAHL databases to search for English language publications from 1996 to 2020 with the MESH terms "heart rate variability" and "down syndrome", with the additional inclusion criteria of including only human participants and empirical investigations. From 74 studies, 15 were included in the review. None of the reviewed studies met the recommendations laid out by the standards and guidelines for providing the acquisition of RR intervals and necessary details on HRV analysis. Since authors publishing papers on this research topic do not adhere to the prescribed standards and guidelines when constructing the methodology, results of the research papers on the topic are not directly comparable. Authors need to design the study methodology more robustly by following the aforementioned standards, guidelines and recommendations.
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Affiliation(s)
- Jakub S. Gąsior
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland
| | | | - Margaret Madeyska
- Pediatric Cardiology and General Pediatrics Clinic, Jan Polikarp Brudziński Pediatric Hospital, 02-091 Warsaw, Poland
| | - Anna Tomik
- Faculty of Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland
| | - Cezary Niszczota
- Pediatric Cardiology and General Pediatrics Clinic, Jan Polikarp Brudziński Pediatric Hospital, 02-091 Warsaw, Poland
| | - Craig A. Williams
- Children’s Health & Exercise Research Centre, Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter EX1 2LU, UK
| | - Bożena Werner
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland
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Højberg LM, Helge EW, Pingel J, Wienecke J. The Health Effects of 14 Weeks of Physical Activity in a Real-Life Setting for Adults with Intellectual Disabilities. TRANSLATIONAL SPORTS MEDICINE 2022; 2022:6817318. [PMID: 38655171 PMCID: PMC11022770 DOI: 10.1155/2022/6817318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 10/28/2022] [Accepted: 11/03/2022] [Indexed: 04/26/2024]
Abstract
Background The life expectancy of individuals with intellectual disabilities (ID) is reduced compared to the general population, and one of the main contributors to earlier death is inactivity. Aim To investigate how 14 weeks of physical activity (PA) in a real-life setting affects cardiovascular fitness, body composition and bone health of adults with ID. Methods Adults with ID were recruited into a PA-group (N = 52) or a control group (CON, N = 14). The PA-group participated in 14 weeks of PA, and body composition, cardiovascular fitness and bone health were assessed before and after the intervention. Outcomes and Results. Cardiovascular fitness and body composition improved from pre to post within the PA-group: Heart rates (HR) during the last 30 seconds of two increments of a treadmill test, were reduced (3.2 km/h: -4.4 bpm, p < 0.05; 4.8 km/h: -7.5 bpm, p < 0.001) and fat mass was reduced (-1.02 kg, p < 0.05). A between-group difference in favour of the PA-group, were observed in whole body bone mineral density (BMD) (0.024 g/cm2, p < 0.05). Conclusions and Implications. Fourteen weeks of PA performed in a real-life setting increased cardiovascular fitness, reduced fat mass and improved BMD in the weight-bearing skeleton in the PA-group. Increased and regular PA seems to be a promising tool to promote physical health in adults with ID.
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Affiliation(s)
- Laurits Munk Højberg
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Eva Wulff Helge
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
| | - Jessica Pingel
- Department of Neuroscience, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jacob Wienecke
- Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Copenhagen, Denmark
- Department of Sport and Social Sciences, Norwegian School of Sport Science, Oslo, Norway
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Perpetuini D, Russo EF, Cardone D, Palmieri R, Filippini C, Tritto M, Pellicano F, De Santis GP, Pellegrino R, Calabrò RS, Filoni S, Merla A. Psychophysiological Assessment of Children with Cerebral Palsy during Robotic-Assisted Gait Training through Infrared Imaging. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15224. [PMID: 36429941 PMCID: PMC9690262 DOI: 10.3390/ijerph192215224] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 11/09/2022] [Accepted: 11/16/2022] [Indexed: 06/16/2023]
Abstract
Cerebral palsy (CP) is a non-progressive neurologic pathology representing a leading cause of spasticity and concerning gait impairments in children. Robotic-assisted gait training (RAGT) is widely employed to treat this pathology to improve children's gait pattern. Importantly, the effectiveness of the therapy is strictly related to the engagement of the patient in the rehabilitation process, which depends on his/her psychophysiological state. The aim of the study is to evaluate the psychophysiological condition of children with CP during RAGT through infrared thermography (IRT), which was acquired during three sessions in one month. A repeated measure ANOVA was performed (i.e., mean value, standard deviation, and sample entropy) extracted from the temperature time course collected over the nose and corrugator, which are known to be indicative of the psychophysiological state of the individual. Concerning the corrugator, significant differences were found for the sample entropy (F (1.477, 5.907) = 6.888; p = 0.033) and for the mean value (F (1.425, 5.7) = 5.88; p = 0.047). Regarding the nose tip, the sample entropy showed significant differences (F (1.134, 4.536) = 11.5; p = 0.041). The findings from this study suggests that this approach can be used to evaluate in a contactless manner the psychophysiological condition of the children with CP during RAGT, allowing to monitor their engagement to the therapy, increasing the benefits of the treatment.
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Affiliation(s)
- David Perpetuini
- Department of Neuroscience and Imaging, University G. D’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | | | - Daniela Cardone
- Department of Engineering and Geology, University G. D’Annunzio of Chieti-Pescara, 65127 Pescara, Italy
| | - Roberta Palmieri
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, Institute of Child Neuropsychiatry, University of Bari, 70121 Bari, Italy
| | - Chiara Filippini
- Department of Neuroscience and Imaging, University G. D’Annunzio of Chieti-Pescara, 66100 Chieti, Italy
| | | | - Federica Pellicano
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy
| | - Grazia Pia De Santis
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy
| | - Raffaello Pellegrino
- Department of Scientific Research, Campus Ludes, Off-Campus Semmelweis University, 6912 Lugano, Switzerland
| | | | - Serena Filoni
- Padre Pio Foundation and Rehabilitation Centers, 71013 San Giovanni Rotondo, Italy
| | - Arcangelo Merla
- Department of Engineering and Geology, University G. D’Annunzio of Chieti-Pescara, 65127 Pescara, Italy
- ITAB, Institute for Advanced Biomedical Technologies, 66100 Chieti, Italy
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Bekteshi S, Karlsson P, De Reyck L, Vermeerbergen K, Konings M, Hellin P, Aerts JM, Hallez H, Dan B, Monbaliu E. Eye movements and stress during eye-tracking gaming performance in children with dyskinetic cerebral palsy. Dev Med Child Neurol 2022; 64:1402-1415. [PMID: 35393636 DOI: 10.1111/dmcn.15237] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 03/15/2022] [Accepted: 03/15/2022] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to explore eye movements and stress during eye-tracking gaming performance in children with dyskinetic cerebral palsy (CP) compared with typically developing children, and associations between eye-tracking performance, eye movements, stress, and participants' characteristics. METHOD This cohort study included 12 children with dyskinetic CP aged 5 to 12 years (mean age 8 years 7 months, standard deviation [SD] 2 years 3 months) and 23 typically developing children aged 5 to 13 years (mean age 9 years 0 months, SD 2 years 7 months). Participants played 10 eye-tracking games. Tobii X3-120 and Tobii Pro Lab were used to record and analyse eye movements. Stress was assessed through heart rate variability (HRV), recorded during rest, and eye-tracking performance using the Bittium Faros360° ECG Holter device. Eye-tracking performance was measured using gaming completion time. Fixation and saccade variables were used to quantify eye movements, and time- and frequency-domain variables to quantify HRV. Non-parametric statistics were used. RESULTS Gaming completion time was significantly different (p < 0.001) between groups, and it was negatively correlated with experience (rs = -0.63, p = 0.029). No significant differences were found between groups in fixation and saccade variables. HRV significantly changed from rest to eye-tracking performance only in typically developing children and not in children with dyskinetic CP. INTERPRETATION Children with dyskinetic CP took longer to perform the 10 games, especially the inexperienced users, indicating the importance of the early provision of eye-tracking training opportunities. It seems that eye-tracking tasks are not a source of increased stress and effort in children with dyskinetic CP. WHAT THIS PAPER ADDS Participants with dyskinetic cerebral palsy (CP) took twice as long to perform 10 eye-tracking games than typically developing peers. Participants with dyskinetic CP with previous eye-tracking experience performed the games faster. Fixation and saccade variables were not significantly different between children with and without dyskinetic CP. Heart rate variability showed no differences between rest and performance in participants with dyskinetic CP. Gross Motor Function Classification System, Manual Ability Classification System, and Viking Speech Scale levels were not correlated to the eye movements or stress variables.
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Affiliation(s)
- Saranda Bekteshi
- KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium
| | - Petra Karlsson
- University of Sydney, Cerebral Palsy Alliance, Sydney, Australia
| | - Lieselot De Reyck
- KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium
| | - Karen Vermeerbergen
- KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium
| | - Marco Konings
- KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium
| | | | - Jean-Marie Aerts
- KU Leuven, Department of Biosystems, Division of Animal and Human Health Engineering, Measure, Model and Manage Bioresponse (M3-BIORES), Leuven, Belgium
| | - Hans Hallez
- KU Leuven, Bruges Campus, Department of Computer Science, Mechatronics Research Group, Bruges, Belgium
| | - Bernard Dan
- Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Elegast Monbaliu
- KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium
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Azouz HG, AbdelMohsen AM, Abdel Ghany HM, Mohamed RM. Evaluation of autonomic nervous system in children with spastic cerebral palsy: clinical and electophysiological study. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2021. [DOI: 10.1186/s43166-021-00092-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Cerebral palsy (CP) is the most prevalent severe motor disability among children. The aim of this work was to assess autonomic dysfunction in children with cerebral palsy clinically and electrophysiologically.
Results
Age of the studied children ranged from 4 to 12 years. Quadriplegic type of spastic cerebral palsy constituted 82.5% of CP children while diplegic type constituted 17.5%. Based on Gross Motor Function Classification System (GMFCS), the majority of children were in levels 4 and 5. The prevalence of autonomic dysfunction symptoms were 80% for thermoregulatory abnormalities (cold extremities), 65% for chronic constipation, 52.5% for sleep disturbance, 47.5% for loss of appetite, 40% for sweating abnormalities, 25% for recurrent nausea and/or vomiting, 22.5% for increased sensitivity to light or dark and 15% for bloating. As regards sympathetic skin response, 19 CP children had unobtainable response in both upper and lower limbs while 5 children had unobtainable response in lower limbs only. All of them were in levels 4 and 5 of GMFCS. Postural hypotension was present in 20% of CP children. Mean Heart rate of CP children was significantly increased more than healthy children upon head tilt test.
Conclusions
Autonomic dysfunction has been objectively proven in CP children through absent sympathetic skin response, presence of orthostatic tachycardia and postural hypotension.
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Bekteshi S, Nica IG, Gakopoulos S, Konings M, Maes R, Cuyvers B, Aerts JM, Hallez H, Monbaliu E. Exercise load and physical activity intensity in relation to dystonia and choreoathetosis during powered wheelchair mobility in children and youth with dyskinetic cerebral palsy. Disabil Rehabil 2021; 44:4794-4805. [PMID: 33970729 DOI: 10.1080/09638288.2021.1921064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To explore the relation between exercise load, physical activity intensity, and movement disorders during powered wheelchair (PW) mobility in people with severe dyskinetic cerebral palsy (DCP). METHODS Ten participants with DCP, 6-21 years old, users of a head/foot steering system were included. Dystonia and choreoathetosis were assessed using the Dyskinesia Impairment Mobility Scale (DIMS), heart rate (HR) was used to assess the exercise load of the tasks on the participants, and the accelerometry-based activity index (AI) to measure the physical activity intensity and energy expenditure during mobility task performance. RESULTS Neck- and distal arm dystonia showed significant correlations with HR (0.64 < rs < 0.77; 0.009 < p < 0.048), whereas neck- and proximal arm choreoathetosis with AI (0.64 < rs < 0.76, 0.011 < p < 0.044). Total-body AI was strongly correlated to the AI of the arms (0.66 < rs < 0.90, < 0.001 < p < 0.038), but not to the AI of the head. CONCLUSIONS During PW mobility tasks, dystonia is associated to exercise load and choreoathetosis to physical activity intensity and energy expenditure. Findings highlight the difficulties in measuring exercise load and activity intensity in PW users with DCP due to the involuntary hypertonic and/or hyperkinetic hallmark of the movement disorders. Nevertheless, a relaxed surrounding with minimal distractions during PW training may increase learning efficiency. Future studies with a bigger sample size are highly recommended to fully establish the relationship between the variables and to allow generalizability of results.Implications for rehabilitationDystonia is positively related to heart rate during powered mobility, which may be explained by the hypertonic hallmark of dystonia causing an increase in exercise load.Choreoathetosis is positively related to the physical activity index during powered mobility where the hyperkinetic hallmark of choreoathetosis may lead to an increase in physical activity intensity and energy expenditure.Arm overflow movements are the component which contribute the most to total-body activity index, thus, minimizing these movements may lower the overall energy expenditure during powered mobility.Mobility training in a relaxed surrounding with minimal distractions and minimized arm overflow movements may lead to a less-demanding powered wheelchair mobility experience and increased learning efficiency.
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Affiliation(s)
- Saranda Bekteshi
- KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium
| | - Ioana Gabriela Nica
- KU Leuven, Department of Biosystems, Division of Animal and Human Health Engineering, Measure, Model and Manage Bioresponse (M3-BIORES), Leuven, Belgium
| | - Sotirios Gakopoulos
- KU Leuven, Bruges Campus, Department of Computer Science, Mechatronics Research Group, Bruges, Belgium
| | - Marco Konings
- KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium
| | - Rozanne Maes
- KU Leuven, Department of Biosystems, Division of Animal and Human Health Engineering, Measure, Model and Manage Bioresponse (M3-BIORES), Leuven, Belgium
| | - Benoit Cuyvers
- KU Leuven, Department of Biosystems, Division of Animal and Human Health Engineering, Measure, Model and Manage Bioresponse (M3-BIORES), Leuven, Belgium
| | - Jean-Marie Aerts
- KU Leuven, Department of Biosystems, Division of Animal and Human Health Engineering, Measure, Model and Manage Bioresponse (M3-BIORES), Leuven, Belgium
| | - Hans Hallez
- KU Leuven, Bruges Campus, Department of Computer Science, Mechatronics Research Group, Bruges, Belgium
| | - Elegast Monbaliu
- KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium
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Riquelme I, do Rosário RS, Vehmaskoski K, Natunen P, Montoya P. Autonomous nervous system regulation of pain in children with cerebral palsy. Brain Inj 2021; 35:356-362. [PMID: 33682539 DOI: 10.1080/02699052.2020.1863469] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Aim: Children with cerebral palsy (CP) have increased pain sensitivity and recurrent pain episodes; however, pain is underreported in children with intellectual impairment. Cardiac autonomic regulation is imbalanced in chronic pain conditions and neurological disorders. This study aims at exploring the autonomous nervous system regulation of pain in children with CP compared with typically developing peers (TDP).Method: Heart rate variability (HRV) was recorded during 24 hours in 26 children with CP and 26 TDP, and examined offline at baseline (sleeping, seated rest) and during spontaneous pain events. Pain and fatigue, HRV indices (linear indices on time - IBI, SDNN, RMSSD - and frequency domains - high, low, and very low frequency - and non-linear indices - Hurst coefficient and multiscale entropy) were computed.Results: Children with CP showed comparable HRV during daily conditions and similar reductions after pain events than their TDP, regardless of their level of intellectual impairment. Interpretation: Children with CP have an intact autonomic regulation in acute pain events. HRV could be an accurate pain biomarker in children with CP and intellectual disability.What this paper adds: Autonomic regulation in acute pain is efficient in children with cerebral palsy.Heart rate variability indices can be reliable pain biomarkers in intellectual impairment.
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Affiliation(s)
- Inmaculada Riquelme
- University Institute of Health Sciences Research (Iunics-idispa), University of the Balearic Islands, Palma De Mallorca, Spain.,Department of Nursing and Physiotherapy, University of the Balearic Islands, Palma De Mallorca, Spain
| | | | - Kari Vehmaskoski
- School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland
| | - Pekka Natunen
- School of Health and Social Studies, JAMK University of Applied Sciences, Jyväskylä, Finland
| | - Pedro Montoya
- University Institute of Health Sciences Research (Iunics-idispa), University of the Balearic Islands, Palma De Mallorca, Spain
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12
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Hoffmann B, Flatt AA, Silva LEV, Młyńczak M, Baranowski R, Dziedzic E, Werner B, Gąsior JS. A Pilot Study of the Reliability and Agreement of Heart Rate, Respiratory Rate and Short-Term Heart Rate Variability in Elite Modern Pentathlon Athletes. Diagnostics (Basel) 2020; 10:E833. [PMID: 33081149 PMCID: PMC7602793 DOI: 10.3390/diagnostics10100833] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 10/13/2020] [Accepted: 10/14/2020] [Indexed: 01/18/2023] Open
Abstract
Research on reliability of heart rate variability (HRV) parameters in athletes has received increasing attention. The aims of this study were to examine the inter-day reliability of short-term (5 min) and ultra-short-term (1 min) heart rate (HR), respiratory rate (RespRate) and HRV parameters, agreement between short-term and ultra-short-term parameters, and association between differences in HR, RespRate and HRV parameters in elite modern pentathletes. Electrocardiographic recordings were performed in stable measurement conditions with a week interval between tests. Relative reliability was evaluated by intra-class correlation coefficients, absolute reliability was evaluated by within-subject coefficient of variation, and agreement was evaluated using Bland-Altman (BA) plot with limits of agreement and defined a priori maximum acceptable difference. Short-term HR, RespRate, log transformed (ln) root mean square of successive normal-to-normal interval differences (lnRMSSD), ln high frequency (lnHF) and SD2/SD1 HRV indices and ultra-short-term HR, RespRate and lnRMSSD presented acceptable, satisfactory inter-day reliability. Although there were no significant differences between short-term and ultra-short-term HR, RespRate and lnRMSSD, no parameter showed acceptable differences with BA plots. Differences in time-domain and non-linear HRV parameters were more correlated with differences in HR than with differences in RespRate. Inverse results were observed for frequency-domain parameters. Short-term HR, RespRate, lnRMSSD, lnHF, and SD2/SD1 and ultra-short-term HR, RespRate and lnRMSSD could be used as reliable parameters in endurance athletes. However, practitioners should interpret changes in HRV parameters with regard to concomitant differences in HR and RespRate and caution should be taken before considering 5 min and 1 min parameters as interchangeable.
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Affiliation(s)
- Bartosz Hoffmann
- Physiotherapy Division, Faculty of Medical Sciences, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Andrew A. Flatt
- Biodynamics and Human Performance Center, Department of Health Sciences and Kinesiology, Georgia Southern University (Armstrong Campus), Savannah, GA 31419, USA;
| | - Luiz Eduardo Virgilio Silva
- Department of Internal Medicine of Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 14049-900, SP, Brazil;
| | - Marcel Młyńczak
- Faculty of Mechatronics, Institute of Metrology and Biomedical Engineering, Warsaw University of Technology, 02-525 Warsaw, Poland;
| | - Rafał Baranowski
- Department of Heart Rhythm Disorders, National Institute of Cardiology, 04-628 Warsaw, Poland;
| | - Ewelina Dziedzic
- Medical Faculty, Lazarski University in Warsaw, 02-662 Warsaw, Poland;
| | - Bożena Werner
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Jakub S. Gąsior
- Department of Pediatric Cardiology and General Pediatrics, Medical University of Warsaw, 02-091 Warsaw, Poland;
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