Ergonomics and Workflow Evaluation of Automatic Doppler Angle Technology Implemented in a Diagnostic Ultrasound System

AbstractCommonly available Pulsed Wave Doppler (PW) flow velocity measurements for Ultrasound (US) investigation require the operator to manually set the direction of the flow velocity vector along the blood vessel axis on the US image, in order to determine the Doppler angle and then to estimate the real flow velocity. The present work investigates the possibility to implement on a commercially available US system an innovative Automatic Doppler Angle (ADA) Technology by analyzing the best workflow in terms of higher execution speed, lower keystrokes/adjustments helping in the prevention of Work-related Musculoskeletal Disorders (WRMSD) and a Doppler angle correction precision, comparable to the one obtained manually by expert sonographer. Ergonomics and workflow tests, then accuracy and repeatability evaluations of the Doppler velocity measurement, were performed on a portable US system (MyLabAlpha, Esaote S.p.A., Florence, Italy) by an expert sonographer. Ergonomics and workflow Tests were performed to analyze the potential of ADA in terms of reduction of muscular activation applied (by SEMG), number of activations (by cameras optoelectronic system) and time needed using ADA, in comparison to manual procedure. Accuracy and intra-operator repeatability tests of the velocity measurement were performed to evaluate the precision of the obtained PW trace velocity measurements with ADA technology, compared to manual ones. Results provided evidence that ADA tool allowed: a reduction of muscular activation (from 12% for trapezius descendens, to 25% for deltoideus anterior) a lower total number of keystrokes and a reduction of the US scan time of about 56%. The maximal variation between PW Doppler trace velocity measurement set automatically by ADA and set manually by sonographer was 11%. ADA technology can provide a Doppler angle correction precision comparable to the manual one, while decreasing the risk of WRMSD

Effects in short and long term of global postural reeducation (GPR) on chronic low back pain: A controlled study with one-year follow-up

Objective. Comparing global postural reeducation (GPR) to a standard physiotherapy treatment (PT) based on active exercises, stretching, and massaging for improving pain and function in chronic low back pain (CLBP) patients. Design. Prospective controlled study. Setting. Outpatient rehabilitation facility. Participants. Adult patients with diagnosis of nonspecific, chronic (>6 months) low back pain. Interventions. Both treatments consisted of 15 sessions of one hour each, twice a week including patient education. Measures. Roland Morris Disability Questionnaire to evaluate disability, and Numeric Analog Scale for pain. A score change >30% was considered clinically significant. Past treatments, use of medications, smoking habits, height, weight, profession, and physical activity were also recorded on baseline, on discharge, and 1 year after discharge (resp., T0, T1, and T2). Results. At T0 103 patients with cLBP (51 cases and 52 controls) were recruited. The treatment (T1) has been completed by 79 (T1) of which 60 then carried out the 1-year follow-up (T2). Both GPR and PT at T1 were associated with a significant statistical and clinical improvement in pain and function, compared to T0. At T2, only pain in GPR still registered a statistically significant improvement

CLOCK gene polymorphisms and quality of aging in a cohort of nonagenarians – The MUGELLO Study

Abstract A total of 356 elderly subjects [257F; 88–106 years] were genotyped for three polymorphisms of the CLOCK gene by TaqMan real-time PCR approach, in order to find associations with quality of aging. Subjects homozygous for the minor allele of rs1801260 were less frequently overweight (p = 0.046), had higher fasting glucose levels (p = 0.037), better scores at the Clock Drawing Test (CDT) (p = 0.047) and worse scores at the Geriatric Depression Scale (p = 0.032). Subjects homozygous for the minor allele of rs11932595 showed higher fasting glucose levels (p = 0.044) and better scores at CDT (p = 0.030). Conversely, subjects homozygous for the minor allele of rs4580704 showed higher triglyceride (p = 0.012), and LDL-cholesterol levels (p = 0.44), and a greater adherence to the Mediterranean diet (MD) (p = 0.044). In addition, AAC, AAG, GGC and AGC (rs1801260–rs11932595–rs4580704) haplotypes were analyzed: AAG was associated with higher risk of overweight (p = 0.008), hypertriglyceridemia (p = 0.040) and hypercholesterolemia (p = 0.036); GGC with lower risk of hyperglycemia (p = 0.022), better sleep pattern (p = 0.001) and with better score at mini-mental state examination (p = 0.010); AGC with lower risk of depression (p = 0.026) and AAC with lower adherence to the MD (p = 0.028). Therefore, CLOCK gene polymorphisms let us hypothesize an involvement in the quality of aging in a cohort of nonagenarians

The effects on biomechanics of walking and balance recovery in a novel pelvis exoskeleton during zero-torque control

Fall-related accidents are among the most serious concerns in elderly people, amputees and subjects with neurological disorders. The aim of this paper was to investigate the behaviour of healthy subjects wearing a novel light-weight pelvis exoskeleton controlled in zero-torque mode while carrying out unperturbed locomotion and managing unexpected perturbations. Results showed that the proposed exoskeleton was unobtrusive and had a minimum loading effect on the human biomechanics during unperturbed locomotion. Conversely, it affected the movement of the trailing leg while subjects managed unexpected slipping-like perturbations. These findings support further investigations on the potential use of powered exoskeletons to assist locomotion and, possibly prevent incipient fall

The Games for Older Adults Active Life (GOAL) Project for People With Mild Cognitive Impairment and Vascular Cognitive Impairment: A Study Protocol for a Randomized Controlled Trial

Background: People living with Mild Cognitive Impairment (MCI) and Vascular Cognitive Impairment (VCI) are persons who do not fulfill a diagnosis of dementia, but who have a high risk of progressing to a dementia disorder. The most recent guidelines to counteract cognitive decline in MCI/VCI subjects suggest a multidimensional and multi-domain interventions combining cognitive, physical, and social activities. The purpose of this study is to test an innovative service that provides a multi-dimensional tele-rehabilitation program through a user-friendly web application. The latter has been developed through a participatory design involving MCI specialists, patients, and their caregivers. Particularly, the proposed tele-rehabilitation program includes cognitive, physical, and caregiver-supported social activities. The goal is to promote and preserve an active life style and counteract cognitive decline in people living with MCI/VCI.Methods:The study is a randomized controlled trial. Sixty subjects will be randomly assigned to the experimental group, who will receive the tele-rehabilitation program, or the control group, who will not receive any treatment. The trial protocol comprises three steps of assessment for the experimental group: at the baseline (T_0), after tele-rehabilitation program (T_1) and at follow-up after 12-months (T_2). Differently, the control group will be assessed twice: at the baseline and at 12-months follow-up. Both the experimental and the control group will be assessed with a multidimensional evaluation battery, including cognitive functioning, behavioral, functional, and quality of life measures. The tele-rehabilitation program lasts 8 weeks and includes cognitive exercises 3 days a week, physical activities 2 days a week, and social activities once a week. In addition, group will be given an actigraph (GENEActiv, Activisinghts Ltd., Cambridgshire, UK) to track physical and sleep activity.Discussion:Results of this study will inform on the efficacy of the proposed tele-rehabilitation to prevent or delay further cognitive decline in MCI/VCI subjects. The expected outcome is to counteract cognitive decline and improve both physical functioning and quality of life.Ethics and Dissemination:The study is approved by the Local Ethics Committee and registered in https://clinicaltrials.gov (NCT03383549). Dissemination will include submission to a peer-reviewed journal, patients, and healthcare magazines and congress presentations.Trial Registration: ClinicalTrials.gov ID: NCT03383549 (registration date: 26/dec/2017)Trial Funding: Bando FAS Salute 2014 Regione ToscanaVersion Identifier: ver 5—16/11/201