A smartphone-based architecture to detect and quantify freezing of gait in Parkinson’s disease

Introduction The freezing of gait (FOG) is a common and highly distressing motor symptom in patients with Parkinson’s Disease (PD). Effective management of FOG is difficult given its episodic nature, heterogeneous manifestation and limited responsiveness to drug treatment. Methods In order to verify the acceptance of a smartphone-based architecture and its reliability at detecting FOG in real-time, we studied 20 patients suffering from PD-related FOG. They were asked to perform video-recorded Timed Up and Go (TUG) test with and without dual-tasks while wearing the smartphone. Video and accelerometer recordings were synchronized in order to assess the reliability of the FOG detection system as compared to the judgement of the clinicians assessing the videos. The architecture uses two different algorithms, one applying the Freezing and Energy Index (Moore-Bächlin Algorithm), and the other adding information about step cadence, to algorithm 1. Results A total 98 FOG events were recognized by clinicians based on video recordings, while only 7 FOG events were missed by the application. Sensitivity and specificity were 70.1% and 84.1%, respectively, for the Moore-Bächlin Algorithm, rising to 87.57% and 94.97%, respectively, for algorithm 2 (McNemar value = 28.42; p = 0.0073). Conclusion Results confirm previous data on the reliability of Moore-Bächlin Algorithm, while indicating that the evolution of this architecture can identify FOG episodes with higher sensitivity and specificity. An acceptable, reliable and easy-to-implement FOG detection system can support a better quantification of the phenomenon and hence provide data useful to ascertain the efficacy of therapeutic approaches

The KIMORE dataset: KInematic assessment of MOvement and clinical scores for remote monitoring of physical REhabilitation

The paper proposes a free dataset, available at the following link1, named KIMORE, regarding different rehabilitation exercises collected by a RGB-D sensor. Three data inputs including RGB, Depth videos and skeleton joint positions were recorded during five physical exercises, specific for low back pain and accurately selected by physicians. For each exercise, the dataset also provides a set of features, specifically defined by the physicians, and relevant to describe its scope. These features, validated with respect to a stereophotogrammetric system, can be analyzed to compute a score for the subject's performance. The dataset also contains an evaluation of the same performance provided by the clinicians, through a clinical questionnaire. The impact of KIMORE has been analyzed by comparing the output obtained by an example of rule and template-based approaches and the clinical score. The dataset presented is intended to be used as a benchmark for human movement assessment in a rehabilitation scenario in order to test the effectiveness and the reliability of different computational approaches. Unlike other existing datasets, the KIMORE merges a large heterogeneous population of 78 subjects, divided into 2 groups with 44 healthy subjects and 34 with motor dysfunctions. It provides the most clinically-relevant features and the clinical score for each exercise

An instrumental approach for monitoring physical exercises in a visual markerless scenario: A proof of concept

none8This work proposes a real-time monitoring tool aimed to support clinicians for remote assessing exercise performances during home-based rehabilitation. The study relies on clinician indications to define kinematic features, that describe five motor tasks (i.e., the lateral tilt of the trunk, lifting of the arms, trunk rotation, pelvis rotation, squatting) usually adopted in the rehabilitation program for axial disorders. These features are extracted by the Kinect v2 skeleton tracking system and elaborated to return disaggregated scores, representing a measure of subjects performance. A bell-shaped function is used to rank the patient performances and to provide the scores. The proposed rehabilitation tool has been tested on 28 healthy subjects and on 29 patients suffering from different neurological and orthopedic diseases. The reliability of the study has been performed through a cross-sectional controlled design methodology, comparing algorithm scores with respect to blinded judgment provided by clinicians through filling a specific questionnaire. The use of task-specific features and the comparison between the clinical evaluation and the score provided by the instrumental approach constitute the novelty of the study. The proposed methodology is reliable for measuring subject's performance and able to discriminate between the pathological and healthy condition.Capecci, Marianna; Ceravolo, Maria Gabriella; Ferracuti, Francesco; Grugnetti, Martina; Iarlori, Sabrina; Longhi, Sauro; Romeo, Luca; Verdini, FedericaCapecci, Marianna; Ceravolo, Maria Gabriella; Ferracuti, Francesco; Grugnetti, Martina; Iarlori, Sabrina; Longhi, Sauro; Romeo, Luca; Verdini, Federic

The Impact of Lifestyle Interventions in High-Risk Early Breast Cancer Patients: A Modeling Approach from a Single Institution Experience

none21noA healthy lifestyle plays a strategic role in the prevention of BC. The aim of our prospective study is to evaluate the effects of a lifestyle interventions program based on special exercise and nutrition education on weight, psycho-physical well-being, blood lipid and hormonal profile among BC patients who underwent primary surgery. From January 2014 to March 2017, a multidisciplinary group of oncologists, dieticians, physiatrists and an exercise specialist evaluated 98 adult BC female patients at baseline and at different time points. The patients had at least one of the following risk factors: BMI ≥ 25 Kg/m2, high testosterone levels, high serum insulin levels or diagnosis of MS. Statistically significant differences are shown in terms of BMI variation with the lifestyle interventions program, as well as in waist circumference and blood glucose, insulin and testosterone levels. Moreover, a statistically significant difference was reported in variations of total Hospital Anxiety and Depression Scale (HADS) score, in the anxiety HADS score and improvement in joint pain. Our results suggested that promoting a healthy lifestyle in clinical practice reduces risk factors involved in BC recurrence and ensures psycho-physical well-being.openMirco Pistelli, Valentina Natalucci, Laura Scortichini, Veronica Agostinelli, Edoardo Lenci, Sonia Crocetti, Filippo Merloni, Lucia Bastianelli, Marina Taus, Daniele Fumelli, Gloria Giulietti, Claudia Cola, Marianna Capecci, Roberta Serrani, Maria Gabriella Ceravolo, Maurizio Ricci, Albano Nicolai, Elena Barbieri, Giulia Nicolai, Zelmira Ballatore, Agnese Savini and Rossana BerardiPistelli, Mirco; Natalucci, Valentina; Scortichini, Laura; Agostinelli, Veronica; Lenci, Edoardo; Crocetti, Sonia; Merloni, Filippo; Bastianelli, Lucia; Taus, Marina; Fumelli, Daniele; Giulietti, Gloria; Cola, Claudia; Capecci, Marianna; Serrani, Roberta; Gabriella Ceravolo, Maria; Ricci, Maurizio; Nicolai, Albano; Barbieri, Elena; Nicolai, Giulia; Ballatore, Zelmira; Savini and Rossana Berardi, Agnes

Evoluzione della disabilità nei parkinsonismi atipici: indagine retrospettiva su comunità.

Disegno dello studio: retrospettivo su 7 anni di pazienti affetti da parkinsonismo atipico primario afferiti all’ambulatorio dedicato ai disordini del movimento presso la Clinica di Neuroriabilitazione dell'Az. Ospedaliero-Universitaria Osp. Riuniti di Ancona. Sono stati arruolati 47 pazienti: 16 erano affetti da Atrofia multisistemica (AMS), 11 da Demenza a Corpi di Lewy (DCL), 19 da Paralisi Sopranucleare Progressiva (PSP) e 1 con Degenerazione Cortico-Basale (DCB)). Le misure di outcome erano rappresentate dai punteggi alla parte I (cognitivo-comportamentale), II (ADL) e III (motoria) della UPDRS (Unified Parkinson Disease Rating Scale). L’analisi dei dati ha evidenziato che i sintomi non motori rispetto a quelli motori condizionano maggiormente la sopravvivenza dei soggetti unitamente all’età all’esordio e che i pazienti con PSP presentano un quadro motorio e funzionale precocemente compromesso rispetto alle altre patologie in particolare la AMS con speranza di vita sovrapponibile. La diagnosi differenziale nei primi anni è difficile a causa di una vasta sovrapposizione dei sintomi motori e non motori. La speranza di vita più breve appare correlata alla diagnosi di DCL. Considerando tutta la popolazione, risultava fattore predittivo di ridotta sopravvivenza il deterioramento cognitivo moderato-grave a tre anni dalla diagnosi. Infine correlati alla mortalità sono la presenza di catetere vescicale, ipotensione ortostatica sintomatica