A support method for the contextual interpretation of biomechanical data.

International audienceIn the clinical field, biomechanical data provided by advanced technical devices are still underexploited. Data analysis usually consists of extracting attributes or computing synthetic values from temporal data and exploiting them by means of a monovariable statistical method. This article proposes a method to support clinicians, especially those in orthopedics, in the contextual interpretation of biomechanical data. We propose to characterize temporal biomechanical data by means of fuzzy space-time windows and to induce fuzzy decision trees to map the biomechanical and clinical data related to patients. Then, we present a method for objectively explaining a given clinical characteristic of a particular patient; this method is derived using the fuzzy rule base generated from the trees and a satisfiability measure. We have applied our method to real data in order to provide an objective explanation of the subjective self-evaluation of the functional status of patients with a shoulder prosthesis, and evaluate it by means of the stratified tenfold cross validation method. The mean explanation rate--which corresponds to the mean proportion of the patients belonging to test sets whose functional state is explained by the proposed method--exceeds 80% for more than half of the decision trees, and exceeds 70% for 94% of the trees. By supporting clinicians during the biomechanical data interpretation process, our method helps them take the objective biomechanical measurements in the medical practice into account, particularly in orthopedics. It can also make subjective evaluations more objective by mapping subjective and objective data

Osteoarthritis, entheses, and long bone cross-sectional geometry in the Andes: Usage, history, and future directions.

Akin to approaches encouraged by Verano (1997) in the Andes, and Ortner (2011, 2012) for general paleopathological studies, this article focuses on accurate descriptions and definitions of osteoarthritis, entheses, and long bone cross-sectional geometry. By evaluating these conditions as part of biological responses to abnormal skeletal changes and biomechanical stress, this research discusses each condition's pathogenesis. Further, this article emphasizes a "small data" approach to evaluating these conditions in ancient culturally and biologically related human populations, where the study samples must have good skeletal preservation, where estimates of age and sex need to be included as major factors, and where abnormalities need to be described and evaluated. This article also discusses global clinical and osteological research on ways scholars are currently trying to establish industry-wide methods to evaluate osteoarthritis, entheses, and long bone cross-sectional geometry. Recent studies have focused on rigorous evaluation of methodological techniques, recording protocols, and inter- and intra-observer error problems. Additionally, scholars have focused on physical intensity of movement using biomechanics, evaluated burials of known occupation, and used complex statistical methods to help interpret skeletal changes associated with these conditions. This article also narrows to focus on these conditions within thematic "small data" areas throughout the Andes. This research concludes with describing future directions to understand skeletal changes, such as more multidisciplinary studies between osteologists and pathologists, collaborations with living people to collect CT, x-rays, or computer-aided motion capture, and a stronger focus on how these conditions correlate with intense biomechanical changes in younger individuals

Observing the Observer: experiences with contextual inquiry to design a horse rider assessment interface

Current approaches to the postural assessment of horse riders is highly subjective, with a lack of consistency between practitioners. A technology-based solution would remove the human perspective and enable a more consistent, accurate and objective assessment to be carried out. This paper provides preliminary insights on the use of a customised method based on contextual inquiry for gathering contextual data in an unusual, in the wild context. This will be used to determine a standardised data collection protocol and context-specific interface design for an inertial motion sensor based rider assessment tool

Development of a collaborative model of low back pain: report from the 2017 NASS consensus meeting

Low back pain (LBP) is a multifactorial problem with complex interactions among many biological, psychological and social factors. It is difficult to fully appreciate this complexity because the knowledge necessary to do so is distributed over many areas of expertise that span the biopsychosocial domains.This study describes the collaborative modeling process, undertaken among a group of participants with diverse expertise in LBP, to build a model to enhance understanding and communicate the complexity of the LBP problem.The study involved generating individual models that represented participants' understanding of the LBP problem using fuzzy cognitive mapping (FCM), and 4 subsequent phases of consultation and consensus with the participants to characterize and refine the interpretation of the FCMs.The phases consisted of: proposal of Categories for clustering of model Components; preliminary evaluation of structure, composition and focal areas of participant's FCMs; refinement of Categories and Components with consensus meeting; generation of final structure and composition of individual participant's FCMs. Descriptive statistics were applied to the structural and composition metrics of individual FCMs to aid interpretation.From 38 invited contributors, 29 (76%) agreed to participate. They represented 9 disciplines and 8 countries. Participants' models included 729 Components, with an average of 25 (SD = 7) per model. After the final FCM refinement process (Components from separate FCMs that used similar terms were combined, and Components from an FCM that included multiple terms were separated), there were 147 Components allocated to ten Categories. Although individual models varied in their structure and composition, a common opinion emerged that psychological factors are particularly important in the presentation of LBP. Collectively, Components allocated to the "Psychology" Category were the most central in almost half (14/29) of the individual models.The collaborative modeling process outlined in this paper provides a foundation upon which to build a greater understanding and to communicate the complexity of the LBP problem. The next step is to aggregate individual FCMs into a metamodel and begin disentangling the interactions among its Components. This will lead to an improved understanding of the complexity of LBP, and hopefully to improved outcomes for those suffering from this condition

Biomechanical analysis of backstroke to breaststroke turns in age-group swimmers: An intervention study (The interplay between the kinematics, dynamometric, hydrodynamics and electromyography factors)

Compreender a aquisição de experiência em habilidades de viragens na perspetiva de um jovem nadador em desenvolvimento, geralmente requer o desenvolvimento de uma relação e interação entre as características do movimento efetivo e o processo de ensino-aprendizagem. No entanto, poucas análises biomecânicas de viragens em nadadores de grupos de idade foram conduzidas para facilitar o diagnóstico biomecânico e a intervenção científica em técnicas de viragem nado costas para bruços. Os objetivos desta Tese foram: (1) identificar as características biomecânicas determinantes em cada uma das quatro diferentes técnicas de viragens de nado costas para bruços e (ii) investigar o efeito de 16 treinos de interferência contextuais sistemáticos de 40 minutos cada (quatro semanas), seguido de prática bloqueada, em série e aleatória sobre como facilitar e aprender as técnicas de viragem de nado de costas para nado bruços. Uma abordagem multidisciplinar, incluindo um sistema de captura de movimento, uma plataforma de força tri-axial subaquática personalizada, eletromiografia de superfície (EMG) e uma abordagem dinâmica inversa utilizando variáveis hidrodinâmicas, foi usada para atingir esse objetivo. Começamos (no primeiro estudo) identificando as principais características biomecânicas e determinantes das viragens open, somersault, bucket e crossover. O comportamento eletromiográfico (EMG) e as variáveis cinemáticas selecionadas das quatro técnicas de viragem foram comparadas no segundo estudo, com ênfase particular na eficácia de rotação e no empurrada da parede. O terceiro estudo comparou as características hidrodinâmicas e a estratégia de arrancamento relacionadas à eficácia fase de saída da viragem. O quarto estudo empregou os modelos de aprendizado de máquina linear e baseado em árvore para identificar os modelos altamente realistas de desempenho das viragens com base em variáveis temporais, cinemáticas e cinéticas abrangentes (incluindo hidrodinâmicas). Finalmente, vimos como um programa de intervenção de quatro semanas que ofereceu aumentos sistemáticos na interferência contextual permite que nadadores de grupos de idade melhorem as técnicas de viragens de nado de costas para nado bruços. Os resultados apontaram que um programa de intervenção de quatro semanas melhorou as técnicas de giro de nado de costas para peito de nadadores de grupos de idade. De acordo com os modelos lineares e não lineares previstos, o desempenho de torneamento otimizado foi alcançado por um compromisso e continuidade entre as fases de entrada e saída das viragens. A eficácia de virada foi diretamente influenciada pelas contribuições da velocidade de aproximação à parede e habilidades de rotação na melhoria da velocidade de rolamento e força de empurrão. A atividade eletromiográfica integrada de oito músculos foi semelhante em quatro variantes de rotação, o eretor da espinha e o gastrocnémio medial foram os mais ativados, com viragem crossover tendo os maiores valores de Iemg na rotação e empurre. Uma comparação de medidas cinéticas revela que a viragem bucket tem um pico de força mais alto, enquanto um impulso horizontal mais alto leva a uma velocidade de empurre mais alta na viragem crossover. A viragem somersault apresentou um deslizamento ligeiramente mais profundo, enquanto as características hidrodinâmicas e a estratégia de saída, como determinantes da eficácia da saída na viragem, não diferiram significativamente entre as quatro técnicas de viragem. PALAVRAS-CHAVE: NATACAO, FAIXAS ETARIA, BIOMECHANICA, VIRAGENSUnderstanding the acquisition of expertise in turning skills from the perspective of a developing young swimmer generally requires the development of a relationship and interaction between characteristics of effective movement and the teaching-learning process. However, few turning biomechanical analyses on age-group swimmers have been conducted to facilitate biomechanical diagnosis and scientific intervention in backstroke to breaststroke turning techniques. The objective of this Thesis were twofold: (i) to identify the biomechanical features that have the greatest influence in each of the four different backstroke to breaststroke turning techniques and (ii) to investigate the effect of four weeks and 16 systematically contextual interference training sessions of 40 minutes each, followed by blocked, serial, and random practice on facilitating learning of the backstroke to breaststroke turning techniques. A multidisciplinary approach, including a motion capture system, a customized underwater tri-axial force plate, surface electromyography (EMG) and an inverse dynamic approach utilizing hydrodynamic variables, was used to accomplish this goal. We began (in the first study) by identifying the key biomechanical features and determinants of open, somersault, bucket, and crossover turning performance. The electromyographic (EMG) behavior and selected kinematic variables of the four backstroke to breaststroke turning techniques were compared in the second study, with a particular emphasis on rotation and push-off efficacy. The third analysis compared the hydrodynamic characteristics and pull-out strategy related to turn out efficacy. The fourth study employed the linear and tree-based machine learning models to identify the highly realistic models of backstroke to breaststroke turn performance based on comprehensive temporal, kinematic, kinetic (including hydrodynamic) variables. Finally, we looked at how a four-week intervention program that offered systematic increases in contextual interference allows age-group swimmers to improve backstroke to breaststroke turning techniques. Results pointed out that a four-week intervention program improved age-group swimmers' backstroke to breaststroke turning techniques. According to the linear and nonlinear predicted models, optimized turning performance was achieved by a compromise and continuity between the turn-in and turn-out phases. Turn-in efficacy was directly influenced by the contributions of approaching velocity to the wall and rotating abilities in improving rolling velocity and pushing-off force. The integrated electromyographic activity of eight muscles was similar across four turning techniques. The erector spinae and gastrocnemius medialis were the most activated muscles, with the crossover turn having the highest rotation and push-off iEMG values. A comparison of kinetic measures reveals that the bucket turn has a higher peak force, while a higher horizontal impulse leads to higher push-off velocity in the crossover turn. The somersault has a slightly deeper gliding depth, while hydrodynamic characteristics and pull-out strategy, as determinants of turn-out efficacy, did not differ between turning techniques

Using interpretative phenomenological analysis to inform physiotherapy practice: An introduction with reference to the lived experience of cerebellar ataxia

The attached file is a pre-published version of the full and final paper which can be found at the link below.This article has been made available through the Brunel Open Access Publishing Fund.Qualitative research methods that focus on the lived experience of people with health conditions are relatively underutilised in physiotherapy research. This article aims to introduce interpretative phenomenological analysis (IPA), a research methodology oriented toward exploring and understanding the experience of a particular phenomenon (e.g., living with spinal cord injury or chronic pain, or being the carer of someone with a particular health condition). Researchers using IPA try to find out how people make sense of their experiences and the meanings they attach to them. The findings from IPA research are highly nuanced and offer a fine grained understanding that can be used to contextualise existing quantitative research, to inform understanding of novel or underresearched topics or, in their own right, to provoke a reappraisal of what is considered known about a specified phenomenon. We advocate IPA as a useful and accessible approach to qualitative research that can be used in the clinical setting to inform physiotherapy practice and the development of services from the perspective of individuals with particular health conditions.This article is available through the Brunel Open Access Publishing Fund

Rehabilitation professionals' perceptions of the use of new visualisation software tools with people with stroke

Purpose: Theenvisageprogramme of research was funded to explore and evaluate the use of visualisation software tools using biomechanical data within rehabilitation. Three work packages were developed to evaluate the impact of the tools within stroke rehabilitation. The research presented here aimed at exploring the perceptions of rehabilitation therapists about the use of the visualisation software tools in the context of future randomised controlled trials and stroke rehabilitation practice. Methods: Sixteen therapists working in a range of stroke rehabilitation contexts participated in semi-structured interviews. Interview questions explored their current practice, and the perceived impact of the new visualisation technologies on their workplace environment and practice. Framework analysis was used to analyse the textual data. Results: In general, the stroke therapists were enthusiastic about the potential application of the visualisation software tools. Three themes were identified through qualitative framework analysis: potential uses of the visualisation tools; integration within current service provision; and trial involvement. Conclusions: The study highlights important contextual considerations which may impact significantly on the success of novel technologies in stroke rehabilitation. Normalisation process theory was proposed as a useful process evaluation methodology to optimise both trial evaluation and future service implementation