A Novel Approach to Overcome Movement Artifact When Using a Laser Speckle Contrast Imaging System for Alternating Speeds of Blood Microcirculation

The laser speckle contrast imager (LSCI) provides a powerful yet simple technique for measuring microcirculatory blood flow. Ideal for blood dynamic responses, the LSCI is used in the same way as a conventional Laser Doppler Imager (LDI). However, with a maximum skin depth of approximately 1 mm, the LSCI is designed to focus on mainly superficial blood flow. It is used to measure skin surface areas of up to 15 cm x 20 cm. The new technique introduced in this paper accounts for alternating speeds of microcirculations; i.e. both slow and fast flow flux measurement using the LSCI. The novel technique also overcomes LSCI's biggest shortcoming, which is high sensitivity to artifact movement. An adhesive opaque patch (AOP) is introduced for satisfactory recording of microcirculatory blood flow, by subtracting the LSCI signal from the AOP from the laser speckle skin signal. The optimal setting is also defined because the LSCI is most powerful when flux changes are measured relative to a reference baseline, with blood microcirculatory flux expressed as a percentage change from the baseline. These changes may be used for analyzing the status of the blood flow syste

Validation of joint angle measurements: comparison of a novel low cost marker-less system with an industry standard marker-based system

Human motion tracking is widely used for assessment of movement dysfunction in orthopaedic patients. Currently, most clinical motion analysis centres use marker based three-dimensional (3D) systems as they are deemed to be the most accurate method. However, due to space, costs and logistics they are not available in many clinical settings. This study compared joint angles measured in functional tests using the novel low-cost Microsoft Kinect Perfect Phorm system with the established marker based Nexus VICON system. When measuring right and left knee flexion, the average difference between the VICON and Kinect Perfect Phorm measurement was 13.2%, with a SD of 19.6. Both overestimation and underestimation of the joint angle was recorded in different participants. Although the average percentage difference during hip abduction tests was lower at -3.9%, the range of error was far greater (SD=75). From this, it can be concluded that the level of accuracy presented in the new low cost Kinect Perfect Phorm system is not yet suitable for clinical assessments. However, for general tests of performance, and for tracking cases where absolute accuracy is less critical, future versions of this software may have a place

Why Do People Undergo THR and What Do They Expect to Gain—A Comparison of the Views of Patients and Health Care Professionals

Little concerted effort has been made to understand why individuals undergo total hip replacement (THR) surgery and their rehabilitation goals. Similarly, insight of views and perspective of health care professionals’ (HCPs) regarding surgery and what objective measures help them with decision-making is lacking. This patient and public involvement report aimed to explore both patients’ and HCPs’ perspectives of THR surgery. Twenty patients, 10 pre-THR, 10 post-THR, 9 physiotherapists, and 6 surgeons took part. Results suggest a consensus among patients and HCPs on pain reduction being the main reason for undergoing THR. The inability to carry out simple daily activities such as dog walking and sleep deprivation had a significant effect on patients’ mental and physical well-being. This article is the first to explore the views of THR patients and HCPs on reasons behind THR surgery amalgamated into a single report. As walking is important, wearable activity monitors are suggested as a possible motivator to enhance patient compliance to self-care rehabilitation and increase quality of life. A future research project on the use of such wearable activity monitors in enhancing mobility post-THR is therefore planned

Reliability of gait parameters in male and female healthy adults during self-paced treadmill-based walking

Background/Aims: The purpose of this study was to examine the intra-rater reliability of the Gait Real-time Analysis Interactive Laboratory (GRAIL) system during self-paced mode, in repeated gait analysis of healthy individuals. Methods: Ten healthy male (age: 35.4 ± 13.3 yr; BMI: 25.2 ± 4.3) and 10 healthy female (age: 41.1 ± 16.4 yr; BMI: 24.5 ± 2.6) participants walked on a split-belt, self-paced treadmill. Each participant completed two gait assessments separated by an average of 7±3 days. Key gait kinematic, kinetic and spatial-temporal parameters were analysed. The interclass correlation Coefficient (ICC), Standard Error of Measurement (SEM) and Minimum Detectable Change (MDC) were calculated to evaluate the reliability of these gait parameters. Findings: Results showed high repeatability of spatial temporal and excellent repeatability of kinematic and kinetic parameters in male and female groups. This is the first paper to evaluate the reliability of the GRAIL gait parameters for healthy females. Conclusion: The findings suggest that the GRAIL system in self-paced mode is a good instrument to evaluate gait parameters for females as well as males

Readability of Information on Smartphone apps for Total Hip Replacement and Total Knee Replacement surgery patients

Background: Readability is a vital component of health information and providing this material at an appropriate literacy level may positively influence patient experience. Objective: To assess the readability of the information provided within total hip replacement and total knee replacement apps to understand more about the impact this could have on patients. Method: A systematic search was conducted across the five most popular smartphone app stores: iTunes; Google Play; Windows Mobile; Blackberry App World; and Nokia Ovi. Apps were identified for screening if they: targeted total hip replacement or total knee replacement patients; were free of charge; and were in English. App readability assessment was conducted independently by three reviewers using the Gunning Fog Index (GFI), the Flesch Reading Ease Score (FRES) and the Flesch Kinacaid Grade Level (FKGL). Results: 15 apps met the inclusion criteria. Only one app was found “easy to read” (My THR). Conclusion: Findings suggest that the overall readability of information provided is written at a level which is difficult for patients to comprehend. App developers should engage patients in the design process of their apps, in order to enhance patient experience and for the potential impact of these innovative health technologies to be truly realised

Volumetric assessment of lower limb oedema using 3D laser scanning technique: a systematic review

Clinically, oedema is described as an abnormal build-up of interstitial fluid in the body that is enough to produce palpable swelling. Its assessment offers valuable information to clinicians as this can inform management interventions; and help monitor adherence to home therapy programmes and activity levels. The aim of this systematic review is to establish the utility of 3D scanning technologies in the assessment of lower limb oedema. A computer-based search was completed in October 2020. Four studies were identified which utilised a 3D scanner to measure lower limb oedema. A review of the studies found very little evidence to support the efficacy of 3D laser scanning technology, although they show that the use of the technology is feasible. Current methods of lower leg oedema measurement have issues with reliability, practicability and time taken. There is a need for future studies to validate new methods of oedema assessment using technologies such as 3D laser scanning

Using Gait Analysis to Evaluate Hip Replacement Outcomes—Its Current Use, and Proposed Future Importance: A Narrative Review

Total hip replacement (THR) is one of the most common elective orthopaedic operations. However, evidence suggests that despite postoperative pain improvements, aspects of longer-term physical performance, such as walking ability, do not reach the levels expected when compared to the general population. Walking is best assessed by using gait analysis. This review aims to explain the concept of gait analysis, its use to evaluate THR outcomes, and its proposed future importance when evaluating new technologies proposed to improve functional recovery in individuals undergoing THR surgery. Furthermore, this review discusses the advantages and challenges of gait analysis in THR patients and provides recommendations for future work