scholarly journals Concurrent Validity of a Novel Wireless Inertial Measurement System for Assessing Trunk Impairment in People with Stroke

Sensors ◽  
2020 ◽  
Vol 20 (6) ◽  
pp. 1699
Author(s):  
Norah Alhwoaimel ◽  
Martin Warner ◽  
Ann-Marie Hughes ◽  
Federico Ferrari ◽  
Jane Burridge ◽  
...  
Keyword(s):  
Concurrent Validity ◽  
Inertial Sensors ◽  
Small Sample Size ◽  
Rank Correlation ◽  
Objective Measure ◽  
Chronic Stroke ◽  
Small Sample ◽  
Post Stroke ◽  
Trunk Movements ◽  
Discriminant Ability

Background: The Trunk Impairment Scale (TIS) is recommended for clinical research use to assess trunk impairment post-stroke. However, it is observer-dependent and neglects the quality of trunk movements. This study proposes an instrumented TIS (iTIS) using the Valedo system, comprising portable inertial sensors, as an objective measure of trunk impairment post-stroke. Objective: This study investigates the concurrent and discriminant ability of the iTIS in chronic stroke participants. Methods: Forty participants (20 with chronic stroke, 20 healthy, age-matched) were assessed using the TIS and iTIS simultaneously. A Spearman rank correlation coefficient was used to examine concurrent validity. A ROC curve was used to determine whether the iTIS could distinguish between stroke participants with and without trunk impairment. Results: A moderate relationship was found between the observed iTIS parameters and the clinical scores, supporting the concurrent validity of the iTIS. The small sample size meant definitive conclusions could not be drawn about the parameter differences between stroke groups (participants scoring zero and one on the clinical TIS) and the parameter cut-off points. Conclusions: The iTIS can detect small changes in trunk ROM that cannot be observed clinically. The iTIS has important implications for objective assessments of trunk impairment in clinical practice.

scholarly journals Method for instrumentation of orthotic joints for measurement of internal joint loads

2017 ◽  
Vol 3 (1) ◽  
pp. 35-38
Author(s):  
David Hochmann ◽  
Lucien Opitz
Keyword(s):  
Gait Analysis ◽  
Cross Talk ◽  
Inertial Sensors ◽  
Small Sample Size ◽  
Fem Simulation ◽  
Small Sample ◽  
Safety Testing ◽  
Internal Joint ◽  
Custom Made ◽  
Joint Loads

Abstract:Introduction:The lack of knowledge of mechanical loads in orthotic joints can lead to oversized or breaking components. Previous studies suffer from small sample size and technical limitations. The goal of this study was to develop and validate a method that allows the direct measurement of moments in sagittal, frontal and transverse planes in knee and ankle joints of existing custom made orthoses.Methods:We developed a modular measurement system based on standard joint components, which were instrumented with strain gauges. To ensure sufficient signals and reduce cross talk an iterative approach based on FEM simulation was utilized. The system also contains inertial sensors for mobile gait analysis.Results:Instrumented joints show good results regarding linearity, hysteresis and cross talk. First pilot trials with post-polio and ICP patients demonstrated that joint loads depend on several factors and not solely on body weight. If combined with conventional gait analysis, measurement results can characterize the individual muscle situation of the patient.Conclusion:A novel method for obtaining data on loads in orthotic components was developed and validated. It provides the basis to develop safety testing standards and clinical guidelines, as well as allowing individual optimization of orthotic devices.

P112 CORRELATION OF FECAL CALPROTECTIN TO COLONOSCOPIC FINDINGS FOR DETECTION OF RECURRENCE OF CROHN’S DISEASE IN THE POST-OPERATIVE SETTING AT A SINGLE ACADEMIC CENTER

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S17-S17
Author(s):  
Anil Sharma ◽  
Georgia Morrison ◽  
Kian Keyashian ◽  
Rebecca Matro
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Small Sample Size ◽  
Rank Correlation ◽  
Fecal Calprotectin ◽  
Small Sample ◽  
Operating Characteristics ◽  
Repeat Surgery ◽  
Endoscopic Recurrence ◽  
Noninvasive Biomarkers

Abstract Introduction Patients with Crohn’s disease (CD) who undergo a first surgery are at higher risk of having a subsequent surgery in light of recurrence of disease. Significant evidence suggests that a postoperative colonoscopy evaluating recurrence at the anastomosis using the Rugeerts score (RS) can predict risk of repeat surgery. Given the invasive nature of colonoscopy, there has been increasing interest in using noninvasive biomarkers to predict disease recurrence. Studies have shown variability in the operating characteristics of the fecal calprotectin (FC) assay with sensitivities and specificities for detecting recurrence ranging widely from 48–95 and 58–79%, respectively. A recent meta-analysis demonstrated a pooled sensitivity of 70% when using an optimal FC cut-off of 150 ug/g. We sought to delineate how FC correlates with RS at our institution and to identify a cutoff for significant recurrence. Methods We performed a retrospective review of adult patients with CD who underwent ileocecectomy followed by a colonoscopy within 18 months of surgery, with the additional inclusion of FC testing within 2 weeks of the colonoscopy. Patients were identified at our institution via ICD 9 and 10 codes and the electronic medical record. The primary outcome of interest was a comparison of mean FC for those without endoscopic recurrence (defined as RS i0-i1) to those with significant endoscopic recurrence (defined as RS i2-i4). Other variables assessed included gender, disease location and phenotype, and extent of surgery (Table 1). Results A total of 12 patients met the inclusion criteria. 7 patients (58.3%) were female. Age at time of surgery ranged from 21 to 73 years (mean 37.9). Only 1 patient (8.3%) had a nonstricturing, nonpenetrating phenotype. After surgery, 11 patients were on biologic or combination therapy and 1 patient was not on any medical therapy. 5 patients (42%) demonstrated endoscopic recurrence by RS with mean FC of 883.7 ug/g, as compared to mean FC of 83.6 ug/g for those without recurrence. There was a positive correlation between FC and RS with a Spearman’s rank correlation coefficient of 0.86 (p = 0.0004). Conclusions Our results demonstrate a strong correlation between FC and RS. Using a cutoff for FC of 150 ug/g, we demonstrate sensitivity and specificity of 100%. This further supports the possibility of using FC as a surrogate to possibly defer colonoscopy in those post-operative CD patients with low FC. Study limitations include the retrospective nature and small sample size, recognizing that in years past FC was not as readily available or used in this setting. Future considerations include larger, prospective studies looking at FC and other noninvasive biomarkers in this post-operative setting.

Abstract P212: Admission National Institutes of Health Stroke Scale Associated With Higher Rates of Post Stroke Depression Independent of Imaging Characteristics

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Muhammad M Alvi ◽  
Ashley Petrone ◽  
Jessica Frey
Keyword(s):  
Small Vessel Disease ◽  
Small Sample Size ◽  
Small Sample ◽  
National Institutes Of Health ◽  
Stroke Recovery ◽  
Post Stroke ◽  
Imaging Characteristics ◽  
Significant Difference ◽  
Patient Health ◽  
Post Stroke Depression

Introduction: The etiology of post-stroke depression (PSD) is still not fully understood. It is well known that leukoaraiosis is associated with cognitive decline and depression, but currently unclear if lacunar strokes, thought to be caused by small vessel disease, have higher rates of PSD. A better understanding of PSD etiology can lead to improved treatment of PSD and subsequently better stroke recovery. Methodology: Out of 159 patients that were successfully contacted via phone within 3 months of discharge, there were 22 identified as having an acute stroke or TIA and scored ≥ 2 on the Patient Health Questionnaire (PHQ) assessment. MRI brain was reviewed for stroke size, location, periventricular and deep white matter fazekas score, number of microbleeds, and chronic lacunar strokes. Admission and discharge National Institutes of Health (NIH) stroke scale and stroke etiology were also recorded. Results: There was a significantly positive correlation between NIH score at admission and PHQ2 score (r = 0.184, p =0.044), demonstrating that patients with NIH ≥ 6 are 4.6 times more likely to develop PSD than a patient with NIH < 6 (Odds ratio (OR) = 4.6, CI [1.284-16.591]). There was no significant difference between PSD incidence in stroke size or location. Although not statistically significant, there was a suggestion of more PSD seen in cortical, cardioembolic, and cryptogenic strokes as well as fazekas score ≥ 2 and old lacunar infarcts. The table summarizes characteristics of the 7 TIA and 15 stroke patients suffering from PSD with PHQ ≥ 2: Conclusion: Initial NIH significantly predicted PSD irrespective of leukoaraiosis. This study was limited by the small sample size which could be due to under-diagnosis of PSD. In conclusion, admission NIH is associated with higher rates of PSD, but the underlying etiology is likely multifactorial given the suggestion of higher rates of PSD with higher fazekas score, and cortical, cardioembolic, and cryptogenic strokes.

scholarly journals Locomotion Mode Recognition with Inertial Signals for Hip Joint Exoskeleton

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Gang Du ◽  
Jinchen Zeng ◽  
Cheng Gong ◽  
Enhao Zheng
Keyword(s):  
Hip Joint ◽  
Gait Cycle ◽  
Inertial Sensors ◽  
Recognition Accuracy ◽  
Small Sample Size ◽  
Small Sample ◽  
Joint Angles ◽  
Practical Applications ◽  
Mode Recognition ◽  
Locomotion Mode

Recognizing locomotion modes is a crucial step in controlling lower-limb exoskeletons/orthoses. Our study proposed a fuzzy-logic-based locomotion mode/transition recognition approach that uses the onrobot inertial sensors for a hip joint exoskeleton (active pelvic orthosis). The method outputs the recognition decisions at each extreme point of the hip joint angles purely relying on the integrated inertial sensors. Compared with the related studies, our approach enables calibrations and recognition without additional sensors on the feet. We validated the method by measuring four locomotion modes and eight locomotion transitions on three able-bodied subjects wearing an active pelvic orthosis (APO). The average recognition accuracy was 92.46% for intrasubject crossvalidation and 93.16% for intersubject crossvalidation. The average time delay during the transitions was 1897.9 ms (28.95% one gait cycle). The results were at the same level as the related studies. On the other side, the study is limited in the small sample size of the subjects, and the results are preliminary. Future efforts will be paid on more extensive evaluations in practical applications.

Abstract W P301: Post Stroke Use of Fluoxetine to Improve Functional Recovery Unrelated to Its Beneficial Effect on Depression

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Alison Krisak
Keyword(s):  
Functional Recovery ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Focal Cerebral Ischemia ◽  
Small Sample Size ◽  
Small Sample ◽  
Future Research ◽  
Post Stroke ◽  
Beneficial Effects ◽  
Valuable Adjunct

Background: Stroke, the most common cause of long-term disability, is an acute event that can develop into a chronic illness. Recent clinical trials demonstrate that selective serotonin reuptake inhibitors (SSRIs) may be a valuable adjunct to rehabilitation. Following a stroke there is spontaneous reorganization of cerebral motor networks in order to compensate for focal cerebral ischemia. SSRIs are able to optimize this process by stimulating neurogenesis in a manner unrelated to its beneficial effects on depression. Initiating an SSRI post stroke can potentially facilitate a patient’s functional recovery promoting improved quality of life. Purpose: The purpose of this literature review is to examine whether administration of an SSRI improves functional recovery in post stroke patients without active depression. Methods: Research published between January 1993 and January 2013 that investigated the use of the SSRI, fluoxetine, to optimize functional recovery after stroke was reviewed. Fluoxetine was chosen due to its favorable safety profile and use in the majority of studies. Only randomized, controlled trials that incorporated concurrent rehabilitation in patients without active depression were examined. Results: The research demonstrated that fluoxetine has a positive treatment effect on functional recovery. However, due to methodological differences the comparison and pooling of data is limited. Study limitations include small sample size, heterogeneity of stroke type and severity, and time of fluoxetine initiation. Also, measures of functional recovery varied as well as rehabilitation programs. Conclusion: In conclusion, the opportunity to improve functional recovery through the use of an SSRI post stroke is promising. Future research should establish a consistent methodology in order to further elucidate the role of SSRIs in reducing disability through its augmentation of neurogenesis. If established as an effective adjunct to post stroke rehabilitation, SSRIs may positively impact long-term outcomes.

Olfactory event-related potentials: a new approach for the evaluation of olfaction in nasopharyngeal carcinoma patients treated with chemo-radiotherapy

2016 ◽  
Vol 130 (5) ◽  
pp. 453-461 ◽  
Author(s):  
B Galletti ◽  
R Santoro ◽  
V K Mannella ◽  
F Caminiti ◽  
L Bonanno ◽  
...  
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Rating Scale ◽  
Small Sample Size ◽  
Subjective Evaluation ◽  
Rank Correlation ◽  
Event Related Potentials ◽  
Small Sample ◽  
Spearman’S Rank Correlation ◽  
Related Potentials ◽  
The Impact

AbstractObjective:Olfactory dysfunction is a possible side effect of chemo-radiotherapy performed in patients affected by nasopharyngeal carcinoma. Self-rating measurements and olfactory event-related potentials were used and compared in order to evaluate the impact of this treatment on the olfactory system.Methods:Nine patients underwent subjective evaluation of olfactory function (using visual analogue scales for olfactory symptoms and quality of life, and a six-item Hyposmia Rating Scale), and a quantitative and objective measurement (olfactory event-related potentials).Results:Spearman's rank correlation analyses highlighted significant relationships between the clinical scales and olfactory event-related potentials. Inter-group analyses showed significant differences in the latency and in the amplitude of olfactory event-related potentials between patients and controls.Conclusion:Taking into account the small sample size and the lack of pre-treatment assessment, olfactory event-related potentials seemed to allow a more objective diagnosis of unilateral and bilateral olfactory loss. Moreover, olfactory event-related potentials and subjective scales results were concordant.

scholarly journals Post-stroke fatigue: a scoping review

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 242 ◽  
Author(s):  
Ghazaleh Aali ◽  
Avril Drummond ◽  
Roshan das Nair ◽  
Farhad Shokraneh
Keyword(s):  
Clinical Practice ◽  
Scoping Review ◽  
Current Knowledge ◽  
Small Sample Size ◽  
Small Sample ◽  
Risk Of Bias ◽  
Observational Research ◽  
Stroke Severity ◽  
Level Of Evidence ◽  
Post Stroke

Background: Post-stroke fatigue (PSF) is one of the most common and frustrating outcomes of stroke. It has a high prevalence and it can persist for many years after stroke. PSF itself contributes to a wider range of undesirable outcomes that affect all aspects of daily life. The aim of this review was to identify and summarise the most recent research on PSF, in order to update the evidence base. Methods: We updated an existing review (Hinkle et al. 2017) systematically searching CINAHL, MEDLINE, PsycINFO, and PubMed to cover new research studies between 1st March 2016 and the search date (19th January 2020). We included interventional and observational research, and clinical practice guidelines that were not covered in the original review. After duplicate removal in EndNote, two reviewers screened the search results in Rayyan, and data from eligible full texts were extracted onto an Excel spreadsheet. Finally, we used RobotReviewer and a human reviewer to assess the risk of bias of randomised trials for this scoping review. Results: We identified 45 records for 30 studies (14 observational, 10 interventional studies, and 6 guidelines). Apart from one, the interventional studies were single-centred, had high risk of bias and small sample size (median 50). They investigated exercise, pharmacotherapy, psychotherapy, education, and light therapy. Observational studies mainly reported the factors related to PSF including co-morbidities, depression and anxiety, quality of life, activities of daily living, stroke severity, medication use and polypharmacy, polymorphism, pain, apathy, limb heaviness, neuroticism, mobility, and thyroid-stimulating hormone. Guidelines either did not report on PSF or, when reported, their recommendations were supported by little or low level of evidence. Conclusion: Although we identified a number of recent studies which have added to our current knowledge on PSF, none are robust enough to change current clinical practice.

scholarly journals Deception in everyday life of Japanese young adults: a reanalysis

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Jun’ichiro Murai ◽  
Yasuhiro Daiku
Keyword(s):  
Everyday Life ◽  
Small Sample Size ◽  
Rank Correlation ◽  
Small Sample ◽  
Future Research ◽  
Research Directions ◽  
Diary Method ◽  
Future Research Directions ◽  
The Subject ◽  
The Mean

AbstractVery little research has focused on the subject of lying in everyday life, despite the benefits such study would provide. In this paper, we reanalyze the data from Murai’s work in 2000, which examined the telling of lies and the perception of being lied to in daily life by using a diary method in which participants recorded events in a diary for a certain period of time as directed by the researcher. Our reanalysis led us to three key findings. First, we found one prolific liar in the data. This is relevant because previous deception studies have only discussed the existence of “a few prolific liars” in Asia through one-shot surveys, whereas we confirm it through the reanalysis of the data collected by the diary method. Second, we did not find any significant rank correlation between the number of lies told and the number of perceptions of lies, nor was there evidence of any “prolific lie perceivers”. Third, we found that the mean percentage of the subjective accuracy of recording was roughly 80%, which demonstrates the accuracy of the diary method. In this paper, we report our findings, discuss the limitations (in particular, the small sample size), and mention future research directions using the diary method in deception studies.

scholarly journals Post-stroke fatigue: a scoping review

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 242 ◽  
Author(s):  
Ghazaleh Aali ◽  
Avril Drummond ◽  
Roshan das Nair ◽  
Farhad Shokraneh
Keyword(s):  
Clinical Practice ◽  
Scoping Review ◽  
Current Knowledge ◽  
Small Sample Size ◽  
Small Sample ◽  
Risk Of Bias ◽  
Observational Research ◽  
Stroke Severity ◽  
Level Of Evidence ◽  
Post Stroke

Background: Post-stroke fatigue (PSF) is one of the most common and frustrating outcomes of stroke. It has a high prevalence and it can persist for many years after stroke. PSF itself contributes to a wider range of undesirable outcomes that affect all aspects of daily life. The aim of this review was to identify and summarise the most recent research on PSF, in order to update the evidence base. Methods: We updated an existing review (Hinkle et al. 2017) systematically searching CINAHL, MEDLINE, PsycINFO, and PubMed to cover new research studies between 1st March 2016 and the search date (19th January 2020). We included interventional and observational research, and clinical practice guidelines that were not covered in the original review. After duplicate removal in EndNote, two reviewers screened the search results in Rayyan, and data from eligible full texts were extracted onto an Excel spreadsheet. Finally, we used RobotReviewer and a human reviewer to assess the risk of bias of randomised trials for this scoping review. Results: We identified 45 records for 30 studies (14 observational, 10 interventional studies, and 6 guidelines). Apart from one, the interventional studies were single-centred, had high risk of bias and small sample size (median 50). They investigated exercise, pharmacotherapy, psychotherapy, education, and light therapy. Observational studies mainly reported the factors related to PSF including co-morbidities, depression and anxiety, quality of life, activities of daily living, stroke severity, medication use and polypharmacy, polymorphism, pain, apathy, limb heaviness, neuroticism, mobility, and thyroid-stimulating hormone. Guidelines either did not report on PSF or, when reported, their recommendations were supported by little or low level of evidence. Conclusion: Although we identified a number of recent studies which have added to our current knowledge on PSF, none are robust enough to change current clinical practice.

scholarly journals Screening for Cognitive Impairment After Stroke: Validation of the Chinese Version of the Quick Mild Cognitive Impairment Screen

2021 ◽  
Vol 12 ◽  
Author(s):  
Yangfan Xu ◽  
Lingrong Yi ◽  
Yangyang Lin ◽  
Suiying Peng ◽  
Weiming Wang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Diagnostic Accuracy ◽  
Sample Size ◽  
Small Sample Size ◽  
Small Sample ◽  
Chinese Version ◽  
Cognitive Screening ◽  
Post Stroke ◽  
Normal Cognition

Background: Screening for post-stroke cognitive impairment (PSCI) is necessary because stroke increases the incidence of and accelerates premorbid cognitive decline. The Quick Mild Cognitive Impairment (Qmci) screen is a short, reliable and accurate cognitive screening instrument but is not yet validated in PSCI. We compared the diagnostic accuracy of a Chinese version of the Qmci screen (Qmci-CN) compared with the widely-used Chinese versions of the Montreal Cognitive Assessment (MoCA-CN) and Mini-Mental State Examination (MMSE-CN).Methods: We recruited 34 patients who had recovered from a stroke in rehabilitation unit clinics in 2 university hospitals in China: 11 with post-stroke dementia (PSD), 15 with post-stroke cognitive impairment no dementia (PSCIND), and 8 with normal cognition (NC). Classification was made based on clinician assessment supported by a neuropsychological battery, independent of the screening test scores. The Qmci-CN, MoCA-CN, and MMSE-CN screens were administered randomly by a trained rater, blind to the diagnosis.Results: The mean age of the sample was 63 ± 13 years and 61.8% were male. The Qmci-CN had statistically similar diagnostic accuracy in differentiating PSD from NC, an area under the curve (AUC) of 0.94 compared to 0.99 for the MoCA-CN (p = 0.237) and 0.99 for the MMSE-CN (p = 0.293). The Qmci-CN (AUC 0.91), MoCA-CN (AUC 0.94), and MMSE-CN (AUC 0.79) also had statistically similar accuracy in separating PSD from PSCIND. The MoCA-CN more accurately distinguished between PSCIND and normal cognition than the Qmci-CN (p = 0.015). Compared to the MoCA-CN, the administration times of the Qmci-CN (329s vs. 611s, respectively, p &lt; 0.0001) and MMSE-CN (280 vs. 611s, respectively, p &lt; 0.0001) were significantly shorter.Conclusion: The Qmci-CN is accurate in identifying PSD and separating PSD from PSCIND in patients post-stroke following rehabilitation and is comparable to the widely-used MoCA-CN, albeit with a significantly shorter administration time. The Qmci-CN had relatively poor accuracy in identifying PSCIND from NC and hence may lack accuracy for certain subgroups. However, given the small sample size, the study is under-powered to show superiority of one instrument over another. Further study is needed to confirm these findings in a larger sample size and in other settings (countries and languages).

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