MUAP rate and MUAP shape properties in subjects with work-related muscle pain

The objective of this study was to investigate differences in motor control of the trapezius muscle in cases with work-related chronic pain, compared to healthy controls. Ten cases with chronic pain and 13 controls participated in the study. Electromyographic (EMG) signals were recorded from the upper trapezius during five computer work-related tasks. Motor control was assessed using global root-mean-square value (RMSG), motor unit action potential (MUAP) rate (number of MUAPs per second, MR) and two MUAP shape parameters, i.e. root-mean-square (RMSMUAP) and median frequency (FMEDMUAP). MR and FMEDMUAP were higher for the cases than for the controls (P<0.05). RMSMUAP showed a trend for higher values in the chronic pain group (P<0.13), whereas RMSG did not show a significant difference between the groups. The higher MR, FMEDMUAP and the trend for higher RMSMUAP suggest that more high-threshold MUs contribute to low-level computer work-related tasks in chronic pain cases. Additionally, the results suggest that the input of the central nervous system to the muscle is higher in the cases with chronic pain

Telemedicine provides new treatment possibilities in COPD care

Chronic Obstructive Pulmonary Disease (COPD) is a chronic, progressive lung disease. COPD has a high impact on quality of life, large social consequences, a progressive course and it cannot be cured. Physiotherapy, increasing physical participation in daily activities, and early detection and treatment of exacerbations are important elements in current COPD disease management. Home-exercise programmes and self-management of exacerbations are effective new treatment methods. When these programmes are offered as a telemedicine application, they could contribute to a reduction in labour and costs. This paper describes a number of telemedicine applications designed for implementation in COPD care: 1) remote monitoring of physical activity and symptoms; 2) coaching and feedback in daily life to gain an active lifestyle; 3) a web portal for online exercising, self-management of exacerbations and communication between professionals and patient and; 4) serious gaming. For each application we share the motivation, design, and (future) evaluations with the target group: COPD patients. The designed applications are in general positively received by patients and professionals and seem to be able to improve the patient’s well-being. Further development and further scaling of these technologies in everyday care would be an important next step

Neurophysiological methods for the assessment of spasticity: the Hoffmann reflex, the tendon reflex, and the stretch reflex

Purpose: To review the literature concerning neurophysiological methods to assess spasticity with respect to mechanisms and methodology, and to describe the three most commonly used methods: the Hoffmann reflex (H-reflex), the Tendon reflex (T-reflex), and the Stretch Reflex (SR).\ud Method: A systematic internet database search was performed to identify neurophysiological measurement methods of spasticity. A systematic exclusion procedure resulted in 185 included references, completed by additional informal search. For this paper, information about the H-, T- and stretch reflexes was extracted from these references. \ud Results: Although the reflexes are basically monosynaptic, there are many supraspinal pathways which modulate the responses in terms of their amplitude and latency. As a consequence the methods are sensitive to a considerable number of experimental conditions and are characterized by a moderate reliability and sensitivity. Correlations with other (i.e. biomechanical, neurophysiological or clinical) spasticity assessment parameters are moderate to poor. Standardised and broadly accepted protocols are still largely lacking preventing an effective exchange of knowledge. \ud Conclusions: The clinical and experimental use of the three methods is restricted due to moderate reliability and sensitivity. It is recommended to perform combined neurophysiological – biomechanical assessment of spasticity during active, functional movement

Time-related feedback messages for changing activity behaviour of patients with COPD

Background: The promotion of physical activity in daily life is an important aspect in the treatment of COPD patients [1]. We developed a telemedicine application – the Activity Coach – that aims to increase activity levels and to balance activities over the day. Activity levels are measured using a triaxial accelerometer, and time-related feedback text messages are provided on a smartphone. The objective of this study was to investigate how COPD patients responded to the feedback messages on a short-term notice. Conclusions: COPD patients significantly change their activity level on a short-term notice in response to time-related feedback messages provided on a smartphone. Ambulant feedback messages might therefore be a valuable component of telemedicine interventions that aim to improve activity behaviour of COPD patients

Medical Information Representation Framework for Mobile Healthcare

In mobile healthcare, medical information are often expressed in different formats due to the local policies and regulations and the heterogeneity of the applications, systems, and the adopted Information and communication technology. This chapter describes a framework which enables medical information, in particular clinical vital signs and professional annotations, be processed, exchanged, stored and managed modularly and flexibly in a mobile, distributed and heterogeneous environment despite the diversity of the formats used to represent the information. To deal with medical information represented in multiple formats the authors adopt techniques and constructs similar to the ones used on the Internet, in particular, the authors are inspired by the constructs used in multi-media e-mail and audio-visual data streaming standards. They additionally make a distinction of the syntax for data transfer and store from the syntax for expressing medical domain concepts. In this way, they separate the concerns of what to process, exchange and store from how the information can be encoded or transcoded for transfer over the internet. The authors use an object oriented information model to express the domain concepts and their relations while briefly illustrate how framework tools can be used to encode vital sign data for exchange and store in a distributed and heterogeneous environment

Економічний менеджмент підприємства і суспільний інноваційний розвиток в умовах ризиків

The knowledge of surface electromyography (SEMG) and the number of applications have increased considerably during the past ten years. However, most methodological developments have taken place locally, resulting in different methodologies among the different groups of users. A specific objective of the European concerted action SENIAM (surface EMG for a non-invasive assessment of muscles) was, besides creating more collaboration among the various European groups, to develop recommendations on sensors, sensor placement, signal processing and modeling. This paper will present the process and the results of the development of the recommendations for the SEMG sensors and sensor placement procedures. Execution of the SENIAM sensor tasks, in the period 1996–1999, has been handled in a number of partly parallel and partly sequential activities. A literature scan was carried out on the use of sensors and sensor placement procedures in European laboratories. In total, 144 peer-reviewed papers were scanned on the applied SEMG sensor properties and sensor placement procedures. This showed a large variability of methodology as well as a rather insufficient description. A special workshop provided an overview on the scientific and clinical knowledge of the effects of sensor properties and sensor placement procedures on the SEMG characteristics. Based on the inventory, the results of the topical workshop and generally accepted state-of-the-art knowledge, a first proposal for sensors and sensor placement procedures was defined. Besides containing a general procedure and recommendations for sensor placement, this was worked out in detail for 27 different muscles. This proposal was evaluated in several European laboratories with respect to technical and practical aspects and also sent to all members of the SENIAM club (>100 members) together with a questionnaire to obtain their comments. Based on this evaluation the final recommendations of SENIAM were made and published (SENIAM 8: European recommendations for surface electromyography, 1999), both as a booklet and as a CD-ROM. In this way a common body of knowledge has been created on SEMG sensors and sensor placement properties as well as practical guidelines for the proper use of SEMG

Using combined accelerometer and heart rate data to estimate physical fitness

Description of the results of an experiment performed on a treadmill, in which heart rate and accelerometer parameters were combined to estimate physical fitness. This to ultimately develop a method to estimate physical fitness (VO2max) in the home environment of a patient

A Context-Aware Adaptive Feedback System for Activity Monitoring

An active lifestyle is an important factor in the prevention of deconditioning and many negative secondary effects in chronic diseases (e.g. COPD). A number of studies have been conducted with the aim of gaining insight into the daily activity patterns of these patients. Current research is focussing on motivating patients to stay physically active and balancing their activity patterns by using an activity sensor combined with remote monitoring and smart, personalised feedback

The influence of the reciprocal cable linkage in the advanced reciprocating gait orthosis on paraplegic gait performance

A wide variety of mechanical orthoses is available to provide ambulation to paraplegic patients. Evaluation of energy cost during walking in each of these devices has been acknowledged as an important topic in this field of research. In order to investigate the benefits of a ballistic swing on gait performance in the Advanced Reciprocating Gait Orthosis (ARGO) a study was conducted in which the ARGO was compared with an orthosis with freely swinging legs. This Non Reciprocally linked Orthosis (NRO) was obtained by removing the reciprocal linkage in the subjects' own ARGOs. Subsequently, flexion/extension limits were mounted to permit adjustment of stride length. Six male paraplegic subjects with lesions ranging from T4 to T12 were included in the study. A single case experimental design (B-A-B-A) was conducted in order to improve internal validity. Biomechanical and physiological parameters were assessed and the subjects' preference for either ARGO or NRO was determined.\ud \ud It was found that large inter-individual differences produced insufficient evidence in this study to draw general conclusions about difference in energy expenditure between both orthoses. However, individual analysis of the results showed a reduction of oxygen cost (range: 4%-14%) in the NRO in T9 and T12 lesions, while oxygen cost in subjects with T4 lesions increased markedly (22% and 40%). It is concluded that patients with low level lesions could benefit in terms of oxygen lost from removing the reciprocal cable linkage in the ARGO. However, only one subject preferred the NRO for walking, whereas none of the subject chose the NRO for use in daily living activities. Removal of the reciprocal cable linkage in the ARGO may not be desirable for these patients