22 research outputs found
Advanced Sensing and Image Processing Techniques for Healthcare Applications
This Special Issue aims to attract the latest research and findings in the design, development and experimentation of healthcare-related technologies. This includes, but is not limited to, using novel sensing, imaging, data processing, machine learning, and artificially intelligent devices and algorithms to assist/monitor the elderly, patients, and the disabled population
Kinematics and Robot Design IV, KaRD2021
This volume collects the papers published on the special issue âKinematics and Robot Design IV, KaRD2021â (https://www.mdpi.com/journal/robotics/special_issues/KaRD2021), which is the forth edition of the KaRD special-issue series, hosted by the open-access journal âMDPI Roboticsâ. KaRD series is an open environment where researchers can present their works and discuss all the topics focused on the many aspects that involve kinematics in the design of robotic/automatic systems. Kinematics is so intimately related to the design of robotic/automatic systems that the admitted topics of the KaRD series practically cover all the subjects normally present in well-established international conferences on âmechanisms and roboticsâ. KaRD2021, after the peer-review process, accepted 12 papers. The accepted papers cover some theoretical and many design/applicative aspects
Neuromotor Control of Eccentric Cycling
The purpose of this thesis was to investigate and quantify how eccentric (ECC) cycling influences the modulation of the underlying neuromotor mechanisms.
Study one investigated post-exercise changes in global corticospinal excitability (CSE) by eliciting a motor-evoked potential in a non-exercised upper limb muscle following concentric (CON) and ECC cycling. No significant differences in global CSE were shown between CON and ECC cycling. However, individual responses of global CSE varied between cycling modes and time points. The variability likely related unfamiliarity with non-specific workload prescription of, and limited controllability of muscle actions during, ECC cycling.
Study two addressed the controllability of ECC cycling through modification of a semi-recumbent ECC cycle ergometer to isolate ECC contractions during ECC cycling. The regenerative braking capacity of the built-in electric servo motors were programmed to function as a âtripâ mechanism, isolating ECC muscle actions to the opposing (OPP) phase of ECC cycling. Laboratory testing demonstrated the effectiveness of the âtripâ mechanism in isolating ECC muscle actions during ECC cycling. These results support using this modified ECC cycle ergometer among unfamiliarised participants performing novel ECC cycling.
Study three developed a reliable peak ECC resistance test specific to semi-recumbent ECC cycling. Participants performed six peak ECC torque protocol (PETP) tests on an isokinetic dynamometer in a replicable semi-recumbent ECC cycling position. The PETP test was reliable in determining peak torque (ICC \u3e 0.90) and peak power output (ICC \u3e 0.90) during a single session. The PETP test is the first known maximal test specifically developed for ECC cycling and could be used to more effectively prescribe ECC cycling workloads, due to specificity of measurement compared within commonly used CON cycling tests.
Study four aimed to develop a single-session familiarisation protocol for submaximal ECC cycling, based on naĂŻve participants producing reliable muscle activation patterns at a PETP test-prescribed power output. Participants produced reliable (ICC \u3e 0.50) and lowly variable muscle activation patterns of the primary active muscles, within a single 15 min ECC cycling session. Overall, naĂŻve participants were capable of becoming familiarised with ECC cycling during a single 15 min session.
Study five implemented the newly developed methods, described in studies two, three and four, to investigate modulation of neuromotor excitability in an exercised (i.e., local) and non-exercised (i.e., global) muscle following ECC cycling. The main result showed that neuromotor excitability is differentially modulated by ECC cycling. Specifically, global neuromotor excitability increases following ECC cycling. Alternatively, local neuromotor excitability decreases, likely due to spinal inhibition. The outcomes of this study provide evidence of active neural coupling between the upper and lower limbs during ECC cycling that could be beneficial for neurorehabilitation.
To conclude, this thesis presents new knowledge about the modulation of neuromotor mechanisms following ECC cycling and provides researchers and clinicians new methods with which to control ECC cycling and therefore, improve the application of future findings
Cognitive-motor interference in people with multiple sclerosis: a kinematic approach to clarify the effect of cognitive load on walking performance
The simultaneous performance of cognitive tasks during locomotion (or cognitive-motor dual-task) is known to cause performance deficits in either one of, or both tasks. Furthermore, these performance decrements are exacerbated by the presence of motor impairments and cognitive dysfunctions characteristic of numerous neurological diseases, such as multiple sclerosis (MS). In this regard the assessment of walking while performing a cognitive task may represent a relevant outcome measure, because it allows measuring, in a laboratory setting, individualâs ability to cope with walking challenging situations similar to everyday living. The first aim of this thesis is to provide an experimental setup, based on the use of optoelectronic stereophotogrammetry, for obtaining quantitative evaluation of walking biomechanics and motor strategies during dual-task performance in both healthy adults and people with MS (pwMS). Then, this experimental methodology is tested as suitable method not only for detecting, measuring and characterizing disability, but also for testing intervention effectiveness in clinical practice. Specifically, the study is focused on the assessment of spatiotemporal parameters and lower limb kinematics during single- (normal pace walking) and dual-task (walking while performing a discrimination and decision-making). This thesis is composed of four experiments. The first two aimed to measure the effect of cognitive-motor interference on walking biomechanics in terms of spatiotemporal parameters and lower limb joint kinematics. In this regard, a sample of pwMS stratified by disability level (low disability, EDSS 1.0-2.5, n=37; mild to moderate disability, EDSS 3.0-6.0, n=44) and a sample of age- and gender-matched healthy adults (n=41) underwent a 3D kinematic evaluation of single- and dual-task performance using a motion capture system. Differences between conditions and groups were investigated using a two-way repeated ANOVA. The results reported that gait speed and stride length were sensitive motor variables in detecting differences from single- to dual-task condition in both pwMS and unaffected individuals, whereas spatiotemporal parameters closely related to balance control (e.g. step width, double support phase duration) were sensitive to changes only in pwMS with moderate disability. Moreover, those patients showed significant changes in the kinematics of distal joint (shank-foot) and proximal joint (hip), including a reduction in ankle plantarflexion and hip extension peak at the terminal stance phase. These observed changes in more impaired patients are compensatory mechanism to stabilize body posture and allow safe locomotion during complicate dual-task activities. Finally, the other two experiments were designed to provide a clinical application of this methodology, as a tool for quantitatively assessing biomechanics changes after an innovative therapeutic intervention. In this regard, a sample of pwMS (n=34) with mild to moderate disability participated in a bicentric clinical trial. As per protocol, pwMS completed an intervention consisting of either active or sham multiple sessions of transcranial direct current stimulation (tDCS) combined with physical activity, aimed to improve walking performance. Following repeated application of active tDCS, the results obtained from the quantitative gait analysis showed greater improvements in gait velocity, step length and walking endurance. This improvement measured in walking had corresponding effects on walking dual-task performance. In fact, the dual-task cost of gait parameters was significantly reduced after the active tDCS intervention. In conclusion, the quantitative assessment of walking impairments during the execution of functional task in pwMS can support a deep learning of both movement features and motor strategies, which should have implications for the design and validation of clinical intervention aimed at improving functional walking
A Systematic Review and Meta-Analysis of the Incidence of Injury in Professional Female Soccer
The epidemiology of injury in male professional football is well documented and has been used as a basis to monitor injury trends and implement injury prevention strategies. There are no systematic reviews that have investigated injury incidence in womenâs professional football. Therefore, the extent of injury burden in womenâs professional football remains unknown. PURPOSE: The primary aim of this study was to calculate an overall incidence rate of injury in senior female professional soccer. The secondary aims were to provide an incidence rate for training and match play. METHODS: PubMed, Discover, EBSCO, Embase and ScienceDirect electronic databases were searched from inception to September 2018. Two reviewers independently assessed study quality using the Strengthening the Reporting of Observational Studies in Epidemiology statement using a 22-item STROBE checklist. Seven prospective studies (n=1137 professional players) were combined in a pooled analysis of injury incidence using a mixed effects model. Heterogeneity was evaluated using the Cochrane Q statistic and I2. RESULTS: The epidemiological incidence proportion over one season was 0.62 (95% CI 0.59 - 0.64). Mean total incidence of injury was 3.15 (95% CI 1.54 - 4.75) injuries per 1000 hours. The mean incidence of injury during match play was 10.72 (95% CI 9.11 - 12.33) and during training was 2.21 (95% CI 0.96 - 3.45). Data analysis found a significant level of heterogeneity (total Incidence, X2 = 16.57 P < 0.05; I2 = 63.8%) and during subsequent sub group analyses in those studies reviewed (match incidence, X2 = 76.4 (d.f. = 7), P <0.05; I2 = 90.8%, training incidence, X2 = 16.97 (d.f. = 7), P < 0.05; I2 = 58.8%). Appraisal of the study methodologies revealed inconsistency in the use of injury terminology, data collection procedures and calculation of exposure by researchers. Such inconsistencies likely contribute to the large variance in the incidence and prevalence of injury reported. CONCLUSIONS: The estimated risk of sustaining at least one injury over one football season is 62%. Continued reporting of heterogeneous results in population samples limits meaningful comparison of studies. Standardising the criteria used to attribute injury and activity coupled with more accurate methods of calculating exposure will overcome such limitations
Pedaling Asymmetry During Lower Limb Pedaling After Stroke
People with stroke pedal asymmetrically. There may be differences in their pedaling kinetics between their non-paretic and paretic lower limbs and compared to healthy age matched controls. Previous studies have measured pedaling related impairments and impairments with interlimb coordination using electromyography (EMG). These studies did not use torque as a measurement for pedaling related impairments and interlimb coordination impairments. Pedaling symmetry in the laboratory measuring the torque and work production will fill the gaps of the knowledge about motor compensation during lower limb pedaling. As well, pedaling symmetry has not been measured during fMRI because of the inability to measure torque during fMRI pedaling. The purpose of this study was to redesign a torque measurement device used for pedaling safely in an MR environment and measure impairments of the paretic limb during pedaling and impaired interlimb symmetry. To achieve this purpose, a torque measurement system was redesigned for accurate and precise torque measurements. Participants were asked to pedal on a novel pedaling device, at low loads (work \u3c 40 J), outfitted with the torque measurement system in both the laboratory and an MRI. During either session, there were no differences in pedaling symmetry between groups. The stroke group showed significantly more negative work with greater minimum torque in their paretic limb during both sessions. Similar symmetry measurements between groups suggest that at low loads there is not enough resistance or too low of a work load to exacerbate the asymmetries in pedaling. However, the increased negative work and greater minimum work in the paretic limb suggest that the strategy the stroke group uses for their paretic limb is different than that of their non-paretic limb or controls. Stroke group positive work was correlated with the Fugl Meyer and the symmetry was correlated with Fugl Meyer. These data suggest that the Fugl Meyer may be a predictor of higher positive work and a symmetry index close to 0. Overall, this study describes the design of a torque measuring device that can be used in an MR environment and provides insight into the impaired interlimb symmetry and pedaling dynamics after stroke
Epidemiology of Injury in English Women's Super league Football: A Cohort Study
INTRODUCTION: The epidemiology of injury in male professional football has been well documented (Ekstrand, HĂ€gglund, & WaldĂ©n, 2011) and used as a basis to understand injury trends for a number of years. The prevalence and incidence of injuries occurring in womens super league football is unknown. The aim of this study is to estimate the prevalence and incidence of injury in an English Super League Womenâs Football squad. METHODS: Following ethical approval from Leeds Beckett University, players (n = 25) signed to a Womenâs Super League Football club provided written informed consent to complete a self-administered injury survey. Measures of exposure, injury and performance over a 12-month period was gathered. Participants were classified as injured if they reported a football injury that required medical attention or withdrawal from participation for one day or more. Injuries were categorised as either traumatic or overuse and whether the injury was a new injury and/or re-injury of the same anatomical site RESULTS: 43 injuries, including re-injury were reported by the 25 participants providing a clinical incidence of 1.72 injuries per player. Total incidence of injury was 10.8/1000 h (95% CI: 7.5 to 14.03). Participants were at higher risk of injury during a match compared with training (32.4 (95% CI: 15.6 to 48.4) vs 8.0 (95% CI: 5.0 to 10.85)/1000 hours, p 28 days) of which there were three non-contact anterior cruciate ligament (ACL) injuries. The epidemiological incidence proportion was 0.80 (95% CI: 0.64 to 0.95) and the average probability that any player on this team will sustain at least one injury was 80.0% (95% CI: 64.3% to 95.6%) CONCLUSION: This is the first report capturing exposure and injury incidence by anatomical site from a cohort of English players and is comparable to that found in Europe (6.3/1000 h (95% CI 5.4 to 7.36) Larruskain et al 2017). The number of ACL injuries highlights a potential injury burden for a squad of this size. Multi-site prospective investigations into the incidence and prevalence of injury in womenâs football are require
Motor Compensation During Lower Limb Pedaling After Stroke
Long-term motor dysfunction in the lower limb is common after stroke. One potential contributor is motor compensation, a behavior in which functions originally performed by the paretic limb are performed by the non-paretic limb. Compensation in chronic stroke may contribute to long-term motor dysfunction by limiting functional ability, impairing future recovery, and eliciting maladaptive neuroplasticity. The purpose of this dissertation was to describe the impact of compensation on motor function and brain activation during lower limb pedaling and identify elements that produce this behavior. To achieve this purpose, we evaluated muscle activation and motor performance when compensation was prevented. During unilateral pedaling, paretic muscle activation increased but motor performance deteriorated. During bilateral uncoupled pedaling, paretic muscle activation further increased. However, subjects were unable to coordinate movements of the legs, and motor performance further deteriorated. These results suggest that compensation improves motor performance but limits paretic motor output. Because motor performance was worse during bilateral uncoupled than unilateral pedaling, impaired interlimb coordination may be a primary factor leading to compensation. As a follow-up, we determined whether altered interlimb spinal reflex pathways contribute to impaired interlimb coordination after stroke. Interlimb cutaneous reflexes were elicited during pedaling, and we assessed whether the amplitude was altered. Interlimb reflex was altered, particularly in bifunctional muscles and at pedaling transitions. Reflex alterations were correlated with impairments in interlimb coordination and compensation. These data suggest that stroke-related changes in interlimb reflex pathways undermine interlimb coordination. Finally, we assessed whether altered motor commands and performance, such as seen with compensation, are related to decreased pedaling-related brain activation after stroke. Brain activation was measured during volitional pedaling and during passive pedaling, when between-group differences were minimized. Between-group differences in brain activation persisted during passive pedaling, suggesting that altered motor commands and pedaling performance do not account for reduced brain activation after stroke. Overall, these studies provide insight into rehabilitative interventions that may decrease long-term motor dysfunction in the lower limb after stroke. One potential strategy is to enhance paretic muscle activity by preventing compensation while simultaneously employing efforts to improve interlimb coordination, possibly by manipulating interlimb reflex pathways
On the reliability and repeatability of surface electromyography factorization by muscle synergies in daily life activities
Muscle synergy theory is a new appealing approach for different research fields. This study is aimed at evaluating the robustness of EMG reconstruction via muscle synergies and the repeatability of muscle synergy parameters as potential neurophysiological indices. Eight healthy subjects performed walking, stepping, running, and ascending and descending stairs' trials for five repetitions in three sessions. Twelve muscles of the dominant leg were analyzed. The ânonnegative matrix factorizationâ and âvariability account forâ were used to extract muscle synergies and to assess EMG goodness reconstruction, respectively. Intraclass correlation was used to quantify methodology reliability. Cosine similarity and coefficient of determination assessed the repeatability of the muscle synergy vectors and the temporal activity patterns, respectively. A 4-synergy model was selected for EMG signal factorization. Intraclass correlation was excellent for the overall reconstruction, while it ranged from fair to excellent for single muscles. The EMG reconstruction was found repeatable across sessions and subjects. Considering the selection of neurophysiological indices, the number of synergies was not repeatable neither within nor between subjects. Conversely, the cosine similarity and coefficient of determination values allow considering the muscle synergy vectors and the temporal activity patterns as potential neurophysiological indices due to their similarity both within and between subjects. More specifically, some synergies in the 4-synergy model reveal themselves as more repeatable than others, suggesting focusing on them when seeking at the neurophysiological index identification
The Effect of ACTIVE Training on Clinical and Physiological Outcomes in Healthy and Concussed College-Aged Participants
Concussions are a pathophysiological injury resulting in symptom, clinical, and physiological deficits. Current guidelines dictate complete physical rest until asymptomatic but a shift towards more active recovery is being advised. Exercise as rehabilitation has been successful in patients with chronic concussion dysfunction, but has not been thoroughly studied acutely following injury. The expected changes of brief aerobic training on clinical and physiological outcomes remain unknown. The acute concussion therapy intervention (ACTIVE) training is an aerobic exercise program designed to expedite clinical and physiological healing following concussion, but first must be vetted in healthy populations. The primary purpose of this study was to evaluate the feasibility and effectiveness of ACTIVE training in healthy college-aged participants. Participants were randomly assigned to ACTIVE training or control groups. All participants received clinical and physiological assessments at two test sessions approximately 14 days apart. ACTIVE training participants completed six training bouts between test sessions. ACTIVE training was feasible, with no adverse events reported and high adherence to the progressively increasing training protocol. Heart rate (P=0.01), percentage of predicted maximal heart rate (P=0.01), and test duration (P=0.03) significantly increased in the intervention group between test sessions. The intervention group had significantly increased central alpha power between sessions and higher central theta compared to the control group (p=0.02) during eyes closed (p=0.006) conditions. Clinical outcomes were stable in response to ACTIVE training, with no mean differences exceeding reliable change scores. These cardiopulmonary improvements provide an important proof of concept in translating ACTIVE training to concussed patients, suggesting that aerobic training may target the physiological domains affected following concussion and help athletes maintain fitness during recovery. EEG outcomes may represent the neural underpinning of psychological and cognitive domains, which may have additional relevance to concussed populations and should be studied further in the future. The stability of clinical variables following ACTIVE training highlights their utility as diagnostic and management tools, as any changes seen in these assessments following injury represents subsequent healing and are not a byproduct of exercise alone.Doctor of Philosoph