Search

Drop foot is a syndrome characterised by the difficulty in lifting the front part of the foot, caused by the weakness or disability of muscles responsible for foot dorsiflexion. Ankle Foot Orthosis (AFO) is an orthopaedic support used in drop foot patients to support and maintain the foot and ankle in the proper position during movement, improving the gait pattern. In this study we investigated the effect and clinical relevance of the use of an AFO on walking ability in patients suffering drop foot syndrome. Two Machine Learning (ML) algorithms were implemented on Knime Analytic Platform: Decision Tree (DT) and Random Forest (RF). They were used on a set of spatio-temporal gait variables assessed by means of the IMU-based wearable system for gait analysis, namely Opal Mobility Lab by APDM, on 19 patients with unilateral drop foot syndrome, in two separate conditions: wearing or not the AFO. The following evaluation metrics were used to evaluate the performances of the two tree-based ML models: Recall, Precision, Sensitivity, Specificity, F-measure, Accuracy and Area under the Receiver Operating Characteristic Curve (AucRoc). Moreover a Feature Importance analysis was carried out. Results demonstrate RF was perfect in distinguishing the two classes - walking with and without AFO - while DT achieved a slightly lower classification score but still of high discriminative power, confirming the effective incidence of the use of the AFO on walking pattern. The following parameters were identified as the most informative by the Feature Importance analysis: stance and swing phase duration, cadence, step duration and stride length.

Ataxia and Parkinson's Disease (PD) are two of the neurodegenerative diseases more studied in recent years. To identify and/or monitor the progression of such pathologies, several quantitative gait analysis investigations have been performed. Albeit several publications have presented and discussed the results of this strategy in case of such pathologies (considered individually and/or compared to healthy subjects), to the best of the authors' knowledge two or more pathologies have been scarcely investigated simultaneously from the point of view of quantitative gait analysis. To this aim, the main objective of this paper is to presents a new strategy to classify and/or monitor the disease progression of Ataxia and PD using quantitative gait analysis tools and, additionally, machine learning strategies. Specifically, a group of 43 and 22 PD and ataxic patients, respectively, was enrolled and subjected to a quantitative gait analysis investigation - using a microelectromechanical system (the OPAL) - as a result of which ten spatiotemporal quantitative features were automatically extracted. These parameters were fed to five tree-based machine learning algorithms which demonstrated to successfully distinguish Ataxia (following an oversampling step) and PD patients, showing promising metrics, e.g., accuracies and sensitivities up to 81% and 86% The findings obtained suggest the proposed strategy could drive new research questions in the field and be of direct practical relevance in the clinical setting.

Studies and reviews show that the vast majority of students around the world use heavy and uncomfortable backpacks, which could negatively affect their musculoskeletal development or at least generate a non-physiological functional overload. In this regard, non-invasive analyses were carried out on a sample of 150 healthy students aged between 14 and 15 years using a wearable inertial device for gait analysis: G-Walk System by BTS Bioengineering. Each student performed a gait analysis session consisting in a walk of 15 meters along a straight path in two different conditions: free walk and walk with backpack. A backpack with a sturdy backrest, wide and padded straps and abdominal belt with buckle was chosen. The weight inside the backpack was fixed at 9.3 kg in accordance with scientific studies conducted by Stefano Negrini of ISICO (Istituto Scientifico Italiano Colonna Vertebrale). Aim of this work is to understand, through an accurate analysis both instrumental and statistical, if we can talk about differential influence of musculoskeletal type generated by a school backpack full load compared to no backpack, trying to find out if and how much this affects walking both in terms of space-time parameters and detachment from normality values, and in terms of kinematic parameters such as pelvic rotations angles. Results showed a statistically significant difference between the space-time parameters computed in the two different study conditions, moreover a qualitative and quantitative difference was found for kinematic parameters too, which could imply potential musculoskeletal disorders associated with prolonged and long-lasting use of heavy and uncomfortable backpacks. This study has the ambition to raise awareness of this issue in order to extend legislative limits to the “working” environment of children, that is the school, as it is done for working environments adults (D. lgs 81/08 related to manual maintenance of loads).

Despite a significant growth of interest for e-textile wearable devices in the contest of remote monitoring, there is still a lack of knowledge about the agreement between them and their related gold standard. Aim of this study is to investigate the agreement between a sensorized e-textile sock namely SWEET Sock and the stereophotogrammetry considered the “gold standard” in the context of gait analysis. Twenty-nine free walk acquisitions of three healthy subjects instrumented by both systems were recorded. The study of agreement was performed through different statistical approaches: Paired t-test, Bland-Altman Analysis and Passing-Bablok regression. The result showed that there was not a perfect agreement about each spatiotemporal parameter analysed between the two systems. This result should be taken in correct account before using the two different systems in an interchangeable way, for example to evaluate the patients’ rehabilitation outcome in terms of spatiotemporal parameters.

This paper describes a comparative analysis of a new wearable system based on E-Textile electrodes for noninvasive daylong monitoring of electrocardiogram (ECG). The proposed wearable device, named SWEET Shirt, is capable of measuring electrocardiogram signal through an instrumented T-shirt that uses E-Textile sensors sewn directly onto the fabric, making the system non-invasive for the user. SWEET Shirt measurements have been validated by comparing a subset of ECG-derived parameters to that granted by a standard Holter ECG used in clinical environment. ECG data have been simultaneously collected from the two devices used in the study on two male subjects, in short-term (2 hours) and long-term (24 hours) registrations. Passing-Bablok regression and Bland-Altman plots have been used to assess benchmarking. Statistical analysis pointed out great reliability in short-term measurement, while in long-term registration the great number of artefacts aroused in the signal does not allow very reliable measurements.

The present study was aimed to assess the changes in skin microvascular blood flow (SBF) in newly diagnosed hyperglycemic obese subjects, administered with hypocaloric diet. Adult patients were recruited and divided in three groups: NW group (n=54), NG (n=54) and HG (n=54) groups were constituted by normal weight, normoglycemic and hyperglycemic obese subjects, respectively. SBF was measured by laser Doppler perfusion monitoring technique and oscillations in blood flow were analyzed by spectral methods under baseline conditions, at 3 and 6 months of dietary treatment. Under resting conditions, SBF was lower in HG group than in NG and NW ones. Moreover, all subjects showed blood flow oscillations with several frequency components. In particular, hyperglycemic obese patients revealed lower spectral density in myogenic-related component than normoglycemic obese and normal weight ones. Moreover, postocclusive reactive hyperemia (PORH) was impaired in hyperglycemic obese compared to normoglycemic and normal weigh subjects. After hypocaloric diet, in hyperglycemic obese patients there was an improvement in SBF accompanied by recovery in myogenic-related oscillations and arteriolar responses during PORH. In conclusion, hyperglycemia markedly affected peripheral microvascular function; hypocaloric diet ameliorated tissue blood flow.

Obstructive sleep apnea syndrome (OSAS) has been associated to impaired baroreflex sensitivity (BRS) which has recently been shown to be non-invasively assessed by heart rate turbulence (HRT) analysis. Although HRT seems to be better suited than traditional heart rate variability indexes for autonomic assessment in presence of respiratory and arrhythmic disorders, very few papers addressed its evaluation in OSAS. Aim of the study is to find out whether and to which extend HRT is associated to OSAS severity. We studied HRT in polysomnographic recordings of 221 mild to severe OSAS pts. Results showed that, while HRT onset values did not significantly differ between mild (-0,78±1,50), moderate (-0,89±1,78) and severe (-0,70±1,28) pts., HRT slope significantly decreases (Kruskal-Wallis P value

Dyspnoea during daily physical activity, despite optimized and maximized drug therapy, is a phenomenon commonly observed in patients with chronic heart failure (CHF).The purpose of this study was to assess the usefulness of a period of rehabilitation in the control of dyspnoea in a group of patients with CHF. The worsening of symptoms may be related to changes in polmunary function parameterst. It has been evaluated their possible relationship with the systolic function and / or diastolic function of the left ventricle and assessed which parameter of polmunary function can be considered a predictor of acute cardiac events and mortality in these patients. Patients with CHF but without chronic obstructive pulmonary and with dyspnoea can provide a baseline a ventilatory pattern next to normal. The improvement of dyspnoea after rehabilitation in some patients is associated with a restrictive respiratory pattern due to a modification of polmunary function following a mechanism desufflation lung. This polmunary hyperinflation in patients with CHF may be the cause of dyspnoea and may mask the restrictive ventilatory pattern typical of these patients and predicting the increased mortality from any cause and hospitalizations for cardiovascular causes more than traditional predictors based on the study of systolic and diastolic function of left ventricle. La dispnea durante attività fisiche routinarie in pazienti con scompenso cardiaco cronico, nonostante una terapia farmacologica ottimizzata e massimizzata, è un fenomeno conosciuto Questo studio ha valutato se un periodo di riabilitazione cardiorespiratoria riduce la dispnea in questi pazienti e se questa è legata alle modificazioni dei parametri di funzionalità respiratoria e la loro eventuale relazione con la funzione sistolica e/o diastolica del ventricolo sinistro. Infine, abbiamo valutato se in questi pazienti le modificazioni di alcuni parametri di funzionalità respiratoria possano essere considerati fattori predittivi di morbidità cardiovascolare e mortalità. Alcuni pazienti con scompenso cardiaco cronico esenti da malattia ostruttiva polmonare ma dispnoici presentano un pattern respiratorio basale apparentemente vicino alla normalità. La scomparsa della dispnea dopo riabilitazione può associarsi ad un pattern respiratorio di tipo restrittivo dovuto alla modificazione dei volumi polmonari statici attraverso un meccanismo di desufflazione polmonare. Tali osservazioni suggeriscono che l’iperinflazione polmonare in questi pazienti causa la dispnea durante le attività fisiche routinarie e maschera il pattern ventilatorio restrittivo tipico di questi pazienti predicendo l’aumento della mortalità per qualunque causa e le ospedalizzazioni per cause cardiovascolari più dei classici predittori basati sullo studio della funzione sistolica e diastolica del ventricolo sinistro.

A minimally invasive low-cost actigraph, with simple on-line movements features extraction, but with performance enhanced by off-line post-processing, is proposed. Despite its cost significantly lower, the proposed actigraph has performance similar to commercially available solutions. Moreover, its open downloading system and wireless integration capabilities make it apposite for telemedicine home care settings. The proposed device has been characterized experimentally by comparing its performance with an emerging gold standard in clinical monitoring physical activity assessment. © 2011 IEEE.

In this paper we describe an Italian experience of fetal home monitor, organized using a portable phonocardiography system (product by Pentavox, Hungary), and the method utilized to evaluate its effectiveness in providing quality services and patient satisfaction. Patient satisfaction is an important dimension in the evaluation of quality care delivery. We used phonocardiography technique in our experience of fetal home monitoring as it is non invasive and passive in nature, low-cost and easy to use. A lightweight portable phonocardiograph (Fetaphon-home) was assigned to six selected patients, without effective pregnancy risk to monitor fetal heartbeat, uterine contractions and fetal movements at home or wherever they need it. The selected patients were instructed by trained personnel in the use of the monitoring device. Patients were asked to perform the recording two times a week and to transmit 20-min signal to the reference centre. The home monitoring sessions were performed in addition to the routine surveillance at a gynecologist's office; thus, the home monitoring did not replace clinic visits. The women were requested to fill a satisfaction questionnaire in order to evaluate their quality of life and anxiety state. Preliminary results have shown that home fetal surveillance appreciably reduces the need of travel for patients and consequently their stress. Furthermore, our results suggest that, after a short training, pregnant women are able to record and transmit long traces without troubles. Use of telemedicine system was generally well accepted by pregnant women since it increased the possibility of fetal long-term home surveillance which in turn could increase the efficiency of the service offered to them