1
|
Ujjan JA, Morani W, Memon N, Mohanasundaram S, Nuhmani S, Singh BK. Force Platform-Based Intervention Program for Individuals Suffering with Neurodegenerative Diseases like Parkinson. Comput Math Methods Med 2022; 2022:1636263. [PMID: 35082910 PMCID: PMC8786539 DOI: 10.1155/2022/1636263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/13/2021] [Accepted: 12/17/2021] [Indexed: 12/11/2022]
Abstract
The term "neurodegenerative disease" refers to a set of illnesses that primarily affect brain's neurons. Substantia nigra (a midbrain dopaminergic nucleus) with lack of hormone called dopamine causes Parkinson's disease (PD), a neurological disorder. PD leads to tremor, stiffness, impaired posture and balance, and loss of automatic movements. Patient with Parkinson's often develops a parkinsonian gait that includes a tendency to lean forward, small quick steps as if hurrying forward, and reduced swinging of the arms. They also may have trouble initiating or continuing movement. Gait analysis is often used to diagnose neurodegenerative illnesses and determine their stage. In this study, we attempt to investigate postural balance, and of gait signals for Parkinson's patients, also, we incorporate interim rehabilitation technique. We included 25 PD patients who had 2.5 to 3 IV score of Hoehn and Yahr scale. A ten-minute walk test has been performed to observe primary and secondary results of dual task interference on gait velocities, and gait time motion vector for right and left legs was observed. Two experimental ground conditions include three conditions of trunk alignment, that is, erect on a regular basis (RE), trunk dorsiflexion 30° (TF1), and trunk dorsiflexion 50° (TF2) were analysed. We identified the walking speed of PD patients was decreased, and trunk dorsiflexion variables influence the gait pattern of Parkinson's disease patients, where higher 95% CI for TF1 condition was reported. The regular erect trunk showed swing time reduction (0.7%) in PD, so the higher unified PD rating scale (UPDRS) values have significant difference in swing phase time in Parkinson's patients. The average Hoehn and Yahr scale (H&Y scale) was 4.3 ± 2.5 reported in the study participants. In a 10-week follow-up evaluation, the stance duration was shown to be substantial, as was the slower speed gait in the baseline condition. Excessive flexion was discovered in our investigation at the lower limb joints, particularly the knee and ankle. Patients with Parkinson's disease had similar maximum dorsiflexion and minimum plantarflexion values in stance. The trunk fraction conditions were found significant in patients after rehabilitation training. The best response to rehabilitation treatment was seen when the trunk was rotated. When steps and posture distribution analysis performed, we found that the trunk flexure 1 (p < 0.05), and trunk flexure 2 (p < 0.01) were shown significant values. When GRF threshold characteristics are employed, mean accuracy improves by 52%. Regardless of gait posture, the step regular trunk flexure had significantly higher posture than the corresponding level steps, with a considerable rise in the 50 in trunk dorsiflexion 2 gait relative to the step "L." This study shows that there was some significant improvement observed in the gait parameters among patients with PD's which shows positive impact of the intervention. Furthermore, rehabilitation programmes can aid and improve poor gait features in patients with Parkinson's disease, especially those who are in the early stages of the condition. This gait and balance research provides a rationale for intervention treatments, and their use in clinical practise enhances evidence of therapeutic efficacy. However, prolonged follow-up is needed to determine whether the advantages will remain all across disease's course, and future studies may recommend a specific rehabilitation technique based on gait analysis results.
Collapse
Affiliation(s)
- Javed Ahmed Ujjan
- College of Animal Sciences & Technology, Northwest A & F University, China
- Department of Zoology, Shah Abdul Latif University, Khairpur, Sindh, Pakistan
| | | | - Naz Memon
- Mehran University of Engineering and Technology, Jamshoro, Pakistan
| | - Sugumar Mohanasundaram
- Department of Biochemistry, Sri Sankara Arts and Science College, Enathur, Kanchipuram, Tamilnadu, India
| | - Shibili Nuhmani
- Department of Physical Therapy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | |
Collapse
|
2
|
Rosenblum U, Kribus-Shmiel L, Zeilig G, Bahat Y, Kimel-Naor S, Melzer I, Plotnik M. Novel methodology for assessing total recovery time in response to unexpected perturbations while walking. PLoS One 2020; 15:e0233510. [PMID: 32492029 PMCID: PMC7269230 DOI: 10.1371/journal.pone.0233510] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 05/06/2020] [Indexed: 11/18/2022] Open
Abstract
Walking stability is achieved by adjusting the medio-lateral and anterior-posterior dimensions of the base of support (step length and step width, respectively) to contain an extrapolated center of mass. We aimed to calculate total recovery time after different types of perturbations during walking, and use it to compare young and older adults following different types of perturbations. Walking trials were performed in 12 young (age 26.92 ± 3.40 years) and 12 older (age 66.83 ± 1.60 years) adults. Perturbations were introduced at different phases of the gait cycle, on both legs and in anterior-posterior or medio-lateral directions, in random order. A novel algorithm was developed to determine total recovery time values for regaining stable step length and step width parameters following the different perturbations, and compared between the two participant groups under low and high cognitive load conditions, using principal component analysis (PCA). We analyzed 829 perturbations each for step length and step width. The algorithm successfully estimated total recovery time in 91.07% of the runs. PCA and statistical comparisons showed significant differences in step length and step width recovery times between anterior-posterior and medio-lateral perturbations, but no age-related differences. Initial analyses demonstrated the feasibility of comparisons based on total recovery time calculated using our algorithm.
Collapse
Affiliation(s)
- Uri Rosenblum
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel HaShomer, Israel
- Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Lotem Kribus-Shmiel
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel HaShomer, Israel
| | - Gabi Zeilig
- Department of Neurological Rehabilitation, Sheba Medical Center, Tel HaShomer, Israel
- Department of Physical and Rehabilitation Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yotam Bahat
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel HaShomer, Israel
| | - Shani Kimel-Naor
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel HaShomer, Israel
| | - Itshak Melzer
- Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Meir Plotnik
- Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel HaShomer, Israel
- Department of Physiology and Pharmacology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
- * E-mail:
| |
Collapse
|
3
|
Tijssen M, Hernlund E, Rhodin M, Bosch S, Voskamp JP, Nielen M, Serra Braganςa FM. Automatic hoof-on and -off detection in horses using hoof-mounted inertial measurement unit sensors. PLoS One 2020; 15:e0233266. [PMID: 32492034 PMCID: PMC7269263 DOI: 10.1371/journal.pone.0233266] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 05/03/2020] [Indexed: 11/24/2022] Open
Abstract
For gait classification, hoof-on and hoof-off events are fundamental locomotion characteristics of interest. These events can be measured with inertial measurement units (IMUs) which measure the acceleration and angular velocity in three directions. The aim of this study was to present two algorithms for automatic detection of hoof-events from the acceleration and angular velocity signals measured by hoof-mounted IMUs in walk and trot on a hard surface. Seven Warmblood horses were equipped with two wireless IMUs, which were attached to the lateral wall of the right front (RF) and hind (RH) hooves. Horses were walked and trotted on a lead over a force plate for internal validation. The agreement between the algorithms for the acceleration and angular velocity signals with the force plate was evaluated by Bland Altman analysis and linear mixed model analysis. These analyses were performed for both hoof-on and hoof-off detection and for both algorithms separately. For the hoof-on detection, the angular velocity algorithm was the most accurate with an accuracy between 2.39 and 12.22 ms and a precision of around 13.80 ms, depending on gait and hoof. For hoof-off detection, the acceleration algorithm was the most accurate with an accuracy of 3.20 ms and precision of 6.39 ms, independent of gait and hoof. These algorithms look highly promising for gait classification purposes although the applicability of these algorithms should be investigated under different circumstances, such as different surfaces and different hoof trimming conditions.
Collapse
Affiliation(s)
- M. Tijssen
- Department Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - E. Hernlund
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - M. Rhodin
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - S. Bosch
- Inertia Technology B.V., Enschede, The Netherlands
- Department of Computer Science, Pervasive Systems Group, University of Twente, Enschede, The Netherlands
| | - J. P. Voskamp
- Rosmark Consultancy, Wekerom, The Netherlands
- Department Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - M. Nielen
- Department Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - F. M. Serra Braganςa
- Department Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| |
Collapse
|
4
|
Jeong IC, Healy R, Bao B, Xie W, Madeira T, Sussman M, Whitman G, Schrack J, Zahradka N, Hoyer E, Brown C, Searson PC. Assessment of Patient Ambulation Profiles to Predict Hospital Readmission, Discharge Location, and Length of Stay in a Cardiac Surgery Progressive Care Unit. JAMA Netw Open 2020; 3:e201074. [PMID: 32181827 PMCID: PMC7078761 DOI: 10.1001/jamanetworkopen.2020.1074] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
IMPORTANCE Promoting patient mobility during hospitalization is associated with improved outcomes and reduced risk of hospitalization-associated functional decline. Therefore, accurate measurement of mobility with high-information content data may be key to improved risk prediction models, identification of at-risk patients, and the development of interventions to improve outcomes. Remote monitoring enables measurement of multiple ambulation metrics incorporating both distance and speed. OBJECTIVE To evaluate novel ambulation metrics in predicting 30-day readmission rates, discharge location, and length of stay using a real-time location system to continuously monitor the voluntary ambulations of postoperative cardiac surgery patients. DESIGN, SETTING, AND PARTICIPANTS This prognostic cohort study of the mobility of 100 patients after cardiac surgery in a progressive care unit at Johns Hopkins Hospital was performed using a real-time location system. Enrollment occurred between August 29, 2016, and April 4, 2018. Data analysis was performed from June 2018 to December 2019. MAIN OUTCOMES AND MEASURES Outcome measures included 30-day readmission, discharge location, and length of stay. Digital records of all voluntary ambulations were created where each ambulation consisted of multiple segments defined by distance and speed. Ambulation profiles consisted of 19 parameters derived from the digital ambulation records. RESULTS A total of 100 patients (81 men [81%]; mean [SD] age, 63.1 [11.6] years) were evaluated. Distance and speed were recorded for more than 14 000 segments in 840 voluntary ambulations, corresponding to a total of 127.8 km (79.4 miles) using a real-time location system. Patient ambulation profiles were predictive of 30-day readmission (sensitivity, 86.7%; specificity, 88.2%; C statistic, 0.925 [95% CI, 0.836-1.000]), discharge to acute rehabilitation (sensitivity, 84.6%; specificity, 86.4%; C statistic, 0.930 [95% CI, 0.855-1.000]), and length of stay (correlation coefficient, 0.927). CONCLUSIONS AND RELEVANCE Remote monitoring provides a high-information content description of mobility, incorporating elements of step count (ambulation distance and related parameters), gait speed (ambulation speed and related parameters), frequency of ambulation, and changes in parameters on successive ambulations. Ambulation profiles incorporating multiple aspects of mobility enables accurate prediction of clinically relevant outcomes.
Collapse
Affiliation(s)
- In cheol Jeong
- inHealth, Johns Hopkins Individualized Health Initiative, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ryan Healy
- Department of Critical Care and Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Benjamin Bao
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland
| | - William Xie
- Department of Computer Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Tim Madeira
- Department of Critical Care and Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Marc Sussman
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Glenn Whitman
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jennifer Schrack
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Nicole Zahradka
- inHealth, Johns Hopkins Individualized Health Initiative, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Erik Hoyer
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Charles Brown
- Department of Critical Care and Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Peter C. Searson
- inHealth, Johns Hopkins Individualized Health Initiative, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Department of Materials Science and Engineering, Johns Hopkins University, Baltimore, Maryland
| |
Collapse
|
5
|
McCrum C, Lucieer F, van de Berg R, Willems P, Pérez Fornos A, Guinand N, Karamanidis K, Kingma H, Meijer K. The walking speed-dependency of gait variability in bilateral vestibulopathy and its association with clinical tests of vestibular function. Sci Rep 2019; 9:18392. [PMID: 31804514 PMCID: PMC6895118 DOI: 10.1038/s41598-019-54605-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 11/13/2019] [Indexed: 11/09/2022] Open
Abstract
Understanding balance and gait deficits in vestibulopathy may help improve clinical care and our knowledge of the vestibular contributions to balance. Here, we examined walking speed effects on gait variability in healthy adults and in adults with bilateral vestibulopathy (BVP). Forty-four people with BVP, 12 healthy young adults and 12 healthy older adults walked at 0.4 m/s to 1.6 m/s in 0.2 m/s increments on a dual belt, instrumented treadmill. Using motion capture and kinematic data, the means and coefficients of variation for step length, time, width and double support time were calculated. The BVP group also completed a video head impulse test and examinations of ocular and cervical vestibular evoked myogenic potentials and dynamic visual acuity. Walking speed significantly affected all gait parameters. Step length variability at slower speeds and step width variability at faster speeds were the most distinguishing parameters between the healthy participants and people with BVP, and among people with BVP with different locomotor capacities. Step width variability, specifically, indicated an apparent persistent importance of vestibular function at increasing speeds. Gait variability was not associated with the clinical vestibular tests. Our results indicate that gait variability at multiple walking speeds has potential as an assessment tool for vestibular interventions.
Collapse
Affiliation(s)
- Christopher McCrum
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands.
- Institute of Movement and Sport Gerontology, German Sport University Cologne, Cologne, Germany.
| | - Florence Lucieer
- Division of Balance Disorders, Department of Otolaryngology, Head and Neck Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Raymond van de Berg
- Division of Balance Disorders, Department of Otolaryngology, Head and Neck Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Faculty of Physics, Tomsk State University, Tomsk, Russian Federation
| | - Paul Willems
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Angélica Pérez Fornos
- Service of Otorhinolaryngology and Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Nils Guinand
- Service of Otorhinolaryngology and Head and Neck Surgery, Department of Clinical Neurosciences, Geneva University Hospitals, Geneva, Switzerland
| | - Kiros Karamanidis
- Sport and Exercise Science Research Centre, School of Applied Sciences, London South Bank University, London, UK
| | - Herman Kingma
- Division of Balance Disorders, Department of Otolaryngology, Head and Neck Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Faculty of Physics, Tomsk State University, Tomsk, Russian Federation
| | - Kenneth Meijer
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| |
Collapse
|
6
|
Josiński H, Świtoński A, Michalczuk A, Grabiec P, Pawlyta M, Wojciechowski K. Assessment of Local Dynamic Stability in Gait Based on Univariate and Multivariate Time Series. Comput Math Methods Med 2019; 2019:6917658. [PMID: 31428185 PMCID: PMC6683834 DOI: 10.1155/2019/6917658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 06/26/2019] [Accepted: 07/03/2019] [Indexed: 11/21/2022]
Abstract
The ability of the locomotor system to maintain continuous walking despite very small external or internal disturbances is called local dynamic stability (LDS). The importance of the LDS requires constantly working on different aspects of its assessment method which is based on the short-term largest Lyapunov exponent (LLE). A state space structure is a vital aspect of the LDS assessment because the algorithm of the LLE computation for experimental data requires a reconstruction of a state space trajectory. The gait kinematic data are usually one- or three-dimensional, which enables to construct a state space based on a uni- or multivariate time series. Furthermore, two variants of the short-term LLE are present in the literature which differ in length of a time span, over which the short-term LLE is computed. Both a state space structure and the consistency of the observations based on values of both short-term LLE variants were analyzed using time series representing the joint angles at ankle, knee, and hip joints. The short-term LLE was computed for individual joints in three state spaces constructed on the basis of either univariate or multivariate time series. Each state space revealed walkers' locally unstable behavior as well as its attenuation in the current stride. The corresponding conclusions made on the basis of both short-term LLE variants were consistent in ca. 59% of cases determined by a joint and a state space. Moreover, the authors present an algorithm for estimation of the embedding dimension in the case of a multivariate gait time series.
Collapse
Affiliation(s)
- Henryk Josiński
- Institute of Informatics, Silesian University of Technology, Akademicka 16, 44-100 Gliwice, Poland
| | - Adam Świtoński
- Institute of Informatics, Silesian University of Technology, Akademicka 16, 44-100 Gliwice, Poland
| | - Agnieszka Michalczuk
- Institute of Informatics, Silesian University of Technology, Akademicka 16, 44-100 Gliwice, Poland
| | - Piotr Grabiec
- Centre for Research and Development, Polish-Japanese Academy of Information Technology, Aleja Legionów 2, 41-902 Bytom, Poland
| | - Magdalena Pawlyta
- Centre for Research and Development, Polish-Japanese Academy of Information Technology, Aleja Legionów 2, 41-902 Bytom, Poland
| | - Konrad Wojciechowski
- Centre for Research and Development, Polish-Japanese Academy of Information Technology, Aleja Legionów 2, 41-902 Bytom, Poland
| |
Collapse
|
7
|
Sunderland KM, Beaton D, Fraser J, Kwan D, McLaughlin PM, Montero-Odasso M, Peltsch AJ, Pieruccini-Faria F, Sahlas DJ, Swartz RH, Strother SC, Binns MA. The utility of multivariate outlier detection techniques for data quality evaluation in large studies: an application within the ONDRI project. BMC Med Res Methodol 2019; 19:102. [PMID: 31092212 PMCID: PMC6521365 DOI: 10.1186/s12874-019-0737-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 04/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Large and complex studies are now routine, and quality assurance and quality control (QC) procedures ensure reliable results and conclusions. Standard procedures may comprise manual verification and double entry, but these labour-intensive methods often leave errors undetected. Outlier detection uses a data-driven approach to identify patterns exhibited by the majority of the data and highlights data points that deviate from these patterns. Univariate methods consider each variable independently, so observations that appear odd only when two or more variables are considered simultaneously remain undetected. We propose a data quality evaluation process that emphasizes the use of multivariate outlier detection for identifying errors, and show that univariate approaches alone are insufficient. Further, we establish an iterative process that uses multiple multivariate approaches, communication between teams, and visualization for other large-scale projects to follow. METHODS We illustrate this process with preliminary neuropsychology and gait data for the vascular cognitive impairment cohort from the Ontario Neurodegenerative Disease Research Initiative, a multi-cohort observational study that aims to characterize biomarkers within and between five neurodegenerative diseases. Each dataset was evaluated four times: with and without covariate adjustment using two validated multivariate methods - Minimum Covariance Determinant (MCD) and Candès' Robust Principal Component Analysis (RPCA) - and results were assessed in relation to two univariate methods. Outlying participants identified by multiple multivariate analyses were compiled and communicated to the data teams for verification. RESULTS Of 161 and 148 participants in the neuropsychology and gait data, 44 and 43 were flagged by one or both multivariate methods and errors were identified for 8 and 5 participants, respectively. MCD identified all participants with errors, while RPCA identified 6/8 and 3/5 for the neuropsychology and gait data, respectively. Both outperformed univariate approaches. Adjusting for covariates had a minor effect on the participants identified as outliers, though did affect error detection. CONCLUSIONS Manual QC procedures are insufficient for large studies as many errors remain undetected. In these data, the MCD outperforms the RPCA for identifying errors, and both are more successful than univariate approaches. Therefore, data-driven multivariate outlier techniques are essential tools for QC as data become more complex.
Collapse
Affiliation(s)
- Kelly M. Sunderland
- Rotman Research Institute, Baycrest Health Sciences, 3560 Bathurst St, Toronto, Ontario M6A 2E1 Canada
| | - Derek Beaton
- Rotman Research Institute, Baycrest Health Sciences, 3560 Bathurst St, Toronto, Ontario M6A 2E1 Canada
| | - Julia Fraser
- Department of Kinesiology, University of Waterloo, 200 University Ave W, Waterloo, Ontario N2L 3G1 Canada
| | - Donna Kwan
- Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond St, London, Ontario N6A 5C1 Canada
| | - Paula M. McLaughlin
- Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond St, London, Ontario N6A 5C1 Canada
| | - Manuel Montero-Odasso
- Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond St, London, Ontario N6A 5C1 Canada
- Gait and Brain Lab, Parkwood Institute, 550 Wellington Rd, London, Ontario N6C 0A7 Canada
- Lawson Health Research Institute, 750 Base Line Rd E, London, Ontario N6C 2R5 Canada
| | - Alicia J. Peltsch
- Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond St, London, Ontario N6A 5C1 Canada
| | - Frederico Pieruccini-Faria
- Schulich School of Medicine and Dentistry, University of Western Ontario, 1151 Richmond St, London, Ontario N6A 5C1 Canada
- Gait and Brain Lab, Parkwood Institute, 550 Wellington Rd, London, Ontario N6C 0A7 Canada
- Lawson Health Research Institute, 750 Base Line Rd E, London, Ontario N6C 2R5 Canada
| | - Demetrios J. Sahlas
- Department of Medicine, McMaster University, 1280 Main St W, Hamilton, Ontario L8S 4L8 Canada
| | - Richard H. Swartz
- Department of Medicine (Neurology), Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Toronto, Ontario M4N 3M5 Canada
- Faculty of Medicine, University of Toronto, 1 King’s College Cir, Toronto, Ontario M5S 1A8 Canada
| | - Stephen C. Strother
- Rotman Research Institute, Baycrest Health Sciences, 3560 Bathurst St, Toronto, Ontario M6A 2E1 Canada
- Medical Biophysics Department, University of Toronto, 101 College St, Suite 15-701, Toronto, Ontario M5G 1L7 Canada
| | - Malcolm A. Binns
- Rotman Research Institute, Baycrest Health Sciences, 3560 Bathurst St, Toronto, Ontario M6A 2E1 Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, Ontario M5T 3M7 Canada
| |
Collapse
|
8
|
Costamagna E, Thies SB, Kenney LPJ, Howard D, Lindemann U, Klenk J, Baker R. Objective measures of rollator user stability and device loading during different walking scenarios. PLoS One 2019; 14:e0210960. [PMID: 30699170 PMCID: PMC6353162 DOI: 10.1371/journal.pone.0210960] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 01/05/2019] [Indexed: 11/19/2022] Open
Abstract
Walking aids are widely used by older adults, however, alarmingly, their use has been linked to increased falls-risk, yet clinicians have no objective way of assessing user stability. This work aims to demonstrate the application of a novel methodology to investigate how the type of walking task, the amount of body weight supported by the device (i.e., device loading), and task performance strategy affect stability of rollator users. In this context, ten users performed six walking tasks with an instrumented rollator. The combined stability margin "SM" was calculated, which considers user and rollator as a combined system. A Friedman Test was used to investigate the effects of task on SM and a least-squares regression model was applied to investigate the relationship between device loading and SM. In addition, the effects of task performance strategy on SM were explored. As a result, it was found that: the minimum SM for straight line walking was higher than for more complex tasks (p<0.05); an increase in device loading was associated with an increase in SM (p<0.05); stepping up a kerb with at least 1 rollator wheel in ground contact at all times resulted in higher SM than lifting all four wheels simultaneously. Hence, we conclude that training should not be limited to straight line walking but should include various everyday tasks. Within person, SM informs on which tasks need practicing, and which strategy facilitates stability, thereby enabling person-specific guidance/training. The relevance of this work lies in an increase in walking aid users, and the costs arising from fall-related injuries.
Collapse
Affiliation(s)
- Eleonora Costamagna
- Centre for Health Sciences Research, School of Health & Society, Salford University, Salford, United Kingdom
- * E-mail:
| | - Sibylle B. Thies
- Centre for Health Sciences Research, School of Health & Society, Salford University, Salford, United Kingdom
| | - Laurence P. J. Kenney
- Centre for Health Sciences Research, School of Health & Society, Salford University, Salford, United Kingdom
| | - David Howard
- School of Computing, Science and Engineering, Salford University, Salford, United Kingdom
| | - Ulrich Lindemann
- Department of Geriatrics and Clinic for Geriatric Rehabilitation, Robert-Bosch- Hospital, Stuttgart, Germany
| | - Jochen Klenk
- Department of Geriatrics and Clinic for Geriatric Rehabilitation, Robert-Bosch- Hospital, Stuttgart, Germany
| | - Rose Baker
- School of Business, Salford University, Salford, United Kingdom
| |
Collapse
|
9
|
Raffalt PC, Yentes JM. Introducing Statistical Persistence Decay: A Quantification of Stride-to-Stride Time Interval Dependency in Human Gait. Ann Biomed Eng 2018; 46:60-70. [PMID: 28948419 PMCID: PMC5756114 DOI: 10.1007/s10439-017-1934-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Accepted: 09/20/2017] [Indexed: 01/17/2023]
Abstract
Stride-to-stride time intervals during human walking are characterised by predictability and statistical persistence quantified by sample entropy (SaEn) and detrended fluctuation analysis (DFA) which indicates a time dependency in the gait pattern. However, neither analyses quantify time dependency in a physical or physiological interpretable time scale. Recently, entropic half-life (ENT½) has been introduced as a measure of the time dependency on an interpretable time scale. A novel measure of time dependency, based on DFA, statistical persistence decay (SPD), was introduced. The present study applied SaEn, DFA, ENT½, and SPD in known theoretical signals (periodic, chaotic, and random) and stride-to-stride time intervals during overground and treadmill walking in healthy subjects. The analyses confirmed known properties of the theoretical signals. There was a significant lower predictability (p = 0.033) and lower statistical persistence (p = 0.012) during treadmill walking compared to overground walking. No significant difference was observed for ENT½ and SPD between walking condition, and they exhibited a low correlation. ENT½ showed that predictability in stride time intervals was halved after 11-14 strides and SPD indicated that the statistical persistency was deteriorated to uncorrelated noise after ~50 strides. This indicated a substantial time memory, where information from previous strides affected the future strides.
Collapse
Affiliation(s)
- P C Raffalt
- Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - J M Yentes
- Center for Research in Human Movement Variability, Department of Biomechanics, University of Nebraska Omaha, Omaha, NE, USA.
| |
Collapse
|