Focal Spot, Summer 1993

https://digitalcommons.wustl.edu/focal_spot_archives/1064/thumbnail.jp

Gait analysis methods in rehabilitation

Introduction: Brand's four reasons for clinical tests and his analysis of the characteristics of valid biomechanical tests for use in orthopaedics are taken as a basis for determining what methodologies are required for gait analysis in a clinical rehabilitation context. Measurement methods in clinical gait analysis: The state of the art of optical systems capable of measuring the positions of retro-reflective markers placed on the skin is sufficiently advanced that they are probably no longer a significant source of error in clinical gait analysis. Determining the anthropometry of the subject and compensating for soft tissue movement in relation to the under-lying bones are now the principal problems. Techniques for using functional tests to determine joint centres and axes of rotation are starting to be used successfully. Probably the last great challenge for optical systems is in using computational techniques to compensate for soft tissue measurements. In the long term future it is possible that direct imaging of bones and joints in three dimensions (using MRI or fluoroscopy) may replace marker based systems. Methods for interpreting gait analysis data: There is still not an accepted general theory of why we walk the way we do. In the absence of this, many explanations of walking address the mechanisms by which specific movements are achieved by particular muscles. A whole new methodology is developing to determine the functions of individual muscles. This needs further development and validation. A particular requirement is for subject specific models incorporating 3-dimensional imaging data of the musculo-skeletal anatomy with kinematic and kinetic data. Methods for understanding the effects of intervention: Clinical gait analysis is extremely limited if it does not allow clinicians to choose between alternative possible interventions or to predict outcomes. This can be achieved either by rigorously planned clinical trials or using theoretical models. The evidence base is generally poor partly because of the limited number of prospective clinical trials that have been completed and more such studies are essential. Very recent work has started to show the potential of using models of the mechanisms by which people with pathology walk in order to simulate different potential interventions. The development of these models offers considerable promise for new clinical applications of gait analysis

Focal Spot, Winter 2006/2007

https://digitalcommons.wustl.edu/focal_spot_archives/1104/thumbnail.jp

Grid simulation services for the medical community

The first part of this paper presents a selection of medical simulation applications, including image reconstruction, near real-time registration for neuro-surgery, enhanced dose distribution calculation for radio-therapy, inhaled drug delivery prediction, plastic surgery planning and cardio-vascular system simulation. The latter two topics are discussed in some detail. In the second part, we show how such services can be made available to the clinical practitioner using Grid technology. We discuss the developments and experience made during the EU project GEMSS, which provides reliable, efficient, secure and lawful medical Grid services

Focal Spot, Spring 1998

https://digitalcommons.wustl.edu/focal_spot_archives/1078/thumbnail.jp

Accuracy assessment of global and local atrophy measurement techniques with realistic simulated longitudinal data

The main goal of this work was to assess the accuracy of several well-known methods which provide global (BSI and SIENA) or local (Jacobian integration) estimates of longitudinal atrophy in brain structures using Magnetic Resonance images. For that purpose, we have generated realistic simulated images which mimic the patterns of change obtained from a cohort of 19 real controls and 27 probable Alzheimer's disease patients. SIENA and BSI results correlate very well with gold standard data (BSI mean absolute error < 0.29%; SIENA < 0.44%). Jacobian integration was guided by both fluid and FFD-based registration techniques and resulting deformation fields and associated Jacobians were compared, region by region, with gold standard ones. The FFD registration technique provided more satisfactory results than the fluid one. Mean absolute error differences between volume changes given by the FFD-based technique and the gold standard were: sulcal CSF < 2.49%; lateral ventricles < 2.25%; brain < 0.36%; hippocampi < 1.42%

Matching pursuit-based compressive sensing in a wearable biomedical accelerometer fall diagnosis device

There is a significant high fall risk population, where individuals are susceptible to frequent falls and obtaining significant injury, where quick medical response and fall information are critical to providing efficient aid. This article presents an evaluation of compressive sensing techniques in an accelerometer-based intelligent fall detection system modelled on a wearable Shimmer biomedical embedded computing device with Matlab. The presented fall detection system utilises a database of fall and activities of daily living signals evaluated with discrete wavelet transforms and principal component analysis to obtain binary tree classifiers for fall evaluation. 14 test subjects undertook various fall and activities of daily living experiments with a Shimmer device to generate data for principal component analysis-based fall classifiers and evaluate the proposed fall analysis system. The presented system obtains highly accurate fall detection results, demonstrating significant advantages in comparison with the thresholding method presented. Additionally, the presented approach offers advantageous fall diagnostic information. Furthermore, transmitted data accounts for over 80% battery current usage of the Shimmer device, hence it is critical the acceleration data is reduced to increase transmission efficiency and in-turn improve battery usage performance. Various Matching pursuit-based compressive sensing techniques have been utilised to significantly reduce acceleration information required for transmission.Scopu