The role of non-invasive camera technology for gait analysis in patients with vestibular disorders

Purpose of the study Current balance assessments performed in clinical settings do not provide objective measurements of gait. Further, objective gait analysis typically requires expensive, large and dedicated laboratory facilities. The aim of this pilot study was to develop and assess a low-cost, non-invasive camera technology for gait analysis, to assist the clinical assessment of patients with vestibular disorders. Materials and methods used This is a prospective, case-controlled study that was developed jointly by the local Neurotology Department and the Centre for Sports Engineering Research. Eligible participants were approached and recruited at the local Neurotology Clinic. The gait assessment included two repetitions of a straight 7-metre walk. The gait analysis system, comprised of a camera (P3215-V, Axis Communications, Sweden) and analysis software was installed in an appropriately sized clinic room. Parameters extruded were walking velocity, step velocity, step length, cadence and step count per meter. The effect sizes (ESB) were calculated using the MatLab and were considered large, medium or small if >0.8, 0.5 and 0.2 respectively. This study was granted ethical approval by the Coventry and Warwickshire Research Ethics Committee (15/WM/0448). Results Six patients with vestibular dysfunction (P group) and six age-matched healthy volunteers (V group) were recruited in this study. The average velocity of gait for P group was 1189.1 ± 69.0 mm·s-1 whereas for V group it was 1351.4 ± 179.2 mm·s-1, (ESB: -0.91). The mean step velocities were 1353.1 ± 591.8 mm·s-1 and 1434.0 ± 396.5 mm·s-1 for P and V groups respectively (ESB: -0.20). The average cadence was 2.3 ± 0.9 Hz and 2.0 ± 0.5 Hz for P and V groups respectively (ESB: 0.60). The mean step length was 620.5 ± 150.7 mm for the P group and 728.5 ± 86.0 mm for the V group (ESB = -1.26). The average step count per meter was 1.7 ± 0.3 and 1.4 ± 0.1 for P and V groups respectively (ESB = 3.38). Conclusion This pilot study used a low-cost, non-invasive camera technology to identify changes in gait characteristics. Further, gait measurements were obtained without the application of markers or sensors to patients (i.e. non-invasive), thus allowing current, clinical practice to be supplemented by objective measurement, with minimal procedural impact. Further work needs to be undertaken to refine the device and produce normative data. In the future, similar technologies could be used in the community setting, providing an excellent diagnostic and monitoring tool for balance patients

Investigating autistic traits, sensory experiences and personality: a mixed methods approach

The relatively recent spectrum view of Autism Spectrum Disorder (ASD) with symptoms potentially varying from mild to severe, in combination with high rates of co-morbid conditions, has raised the issue of heterogeneity among individuals with ASD. This has consequent challenges for obtaining consistent research findings and for the diagnosis of those with less severe symptoms or high-functioning ASD. Since evidence has suggested the presence of non-clinical levels of autistic traits within the general population, this thesis aimed to explore these traits in relation to personality and sensory experiences via a mixed methods design, comprising two parts. Part I consisted of two studies aimed at exploring the lived experiences of individuals with ASD and their caregivers, in relation to sensory experiences, in order to inform the subsequent studies. The focus of Part II was to explore autistic traits in the broader population and consisted of three studies. In Part I, Study one comprised a systematic review of studies containing qualitative data from caregivers of individuals with ASD in relation to sensory experiences. Key sensory challenges reported related to: single senses (most commonly touch, taste, movement, and hearing), sensory issues embedded in certain situations, understanding the individual's sensory experiences, strategies to manage sensory issues, and the impacts of an individual’s sensory issues on the family. A discrepancy between caregiver reports of the benefits of sensory based interventions and existing empirical evidence was identified. Study two involved qualitative analyses of sensory experiences, as described by three individuals with a diagnosis of ASD. Three main themes were identified: dominant types of sensory experiences including visual experiences, sounds, tastes and food preferences, tactile experiences, and less dominant senses including smells and movement, and multi-sensory experiences; management of sensory challenges; and participants’ perceptions of change and difference. The first study of Part II, study three, investigated the psychometric properties of the short form of the Autism Quotient (AQ-10) based on two separate non-clinical samples (N1 = 194; N2 = 310), via exploratory and confirmatory factor analyses. Results indicated a 7-item 3-factor solution for the AQ-10, with factors labelled social cues, intentions, and multi-tasking. Since the social cues factor accounted for the largest amount of variance (31%), and other factors together accounted for minimal explained variance (27%), only items comprising social cues were selected as a measure of autistic traits for subsequent analysis and studies. Structural equation modelling was conducted to analyse co-variate paths between social cues and selected personality traits, with findings indicating that social cue reading was not related to trait anger, introversion, or collecting. These results, therefore, challenged stereotypical associations between these constructs and ASD, and were consistent with existing evidence that social aspects of autistic traits are independent from repetitive behaviours, such as collecting. Study four extended these findings through exploration of social cue reading in relation to trait flexibility, anxiety, and sensory experiences. Consistent findings indicated positive associations between inflexibility, anxiety, and auditory and visual hypersensitivity, potentially suggesting that individuals with higher trait inflexibility and anxiety could experience greater sensory sensitivity or vice versa. Finally, study five involved a qualitative analysis of accounts of sensory experiences from a large combined sample (N = 504) of individuals from the general population. Content analysis of responses resulted in six main categories. Similar percentages of individuals scoring low and high on autistic traits (based on social cue reading difficulty) reported challenges relating to single senses (visual, auditory, tactile, and olfactory), people and crowds, and unexpected or unfamiliar stimuli. Unexpectedly, more individuals with low levels of autistic traits reported specific fears and anxiety responses to sensory stimuli, raising questions as to whether those with poorer social cue reading ability are more prone to report generalised anxiety (in line with trait anxiety) or are less aware or avoid reporting responses to sensory stimuli. Overall, the role of trait flexibility is highlighted across Parts I and II as being a central feature in individuals reporting experiences of sensory sensitivities. The collective findings of this program of research have implications for the further development of both clinical interventions and theoretical understandings, in addition to accommodations for individuals with sensory sensitivities and ASD traits. Keywords: autism, autistic traits, ASD, social cues, sensory, inflexibility, trait anger, trait anxiety, collecting interests

Knowledge management framework based on brain models and human physiology

The life of humans and most living beings depend on sensation and perception for the best assessment of the surrounding world. Sensorial organs acquire a variety of stimuli that are interpreted and integrated in our brain for immediate use or stored in memory for later recall. Among the reasoning aspects, a person has to decide what to do with available information. Emotions are classifiers of collected information, assigning a personal meaning to objects, events and individuals, making part of our own identity. Emotions play a decisive role in cognitive processes as reasoning, decision and memory by assigning relevance to collected information. The access to pervasive computing devices, empowered by the ability to sense and perceive the world, provides new forms of acquiring and integrating information. But prior to data assessment on its usefulness, systems must capture and ensure that data is properly managed for diverse possible goals. Portable and wearable devices are now able to gather and store information, from the environment and from our body, using cloud based services and Internet connections. Systems limitations in handling sensorial data, compared with our sensorial capabilities constitute an identified problem. Another problem is the lack of interoperability between humans and devices, as they do not properly understand human’s emotional states and human needs. Addressing those problems is a motivation for the present research work. The mission hereby assumed is to include sensorial and physiological data into a Framework that will be able to manage collected data towards human cognitive functions, supported by a new data model. By learning from selected human functional and behavioural models and reasoning over collected data, the Framework aims at providing evaluation on a person’s emotional state, for empowering human centric applications, along with the capability of storing episodic information on a person’s life with physiologic indicators on emotional states to be used by new generation applications