Statistical validation for clinical measures: Repeatability and agreement of Kinect based software

Background. The rehabilitation process is a fundamental stage for recovery of people's capabilities. However, the evaluation of the process is performed by physiatrists and medical doctors, mostly based on their observations, that is, a subjective appreciation of the patient's evolution. This paper proposes a tracking platform of the movement made by an individual's upper limb using Kinect sensor(s) to be applied for the patient during the rehabilitation process. The main contribution is the development of quantifying software and the statistical validation of its performance, repeatability, and clinical use in the rehabilitation process. Methods. The software determines joint angles and upper limb trajectories for the construction of a specific rehabilitation protocol and quantifies the treatment evolution. In turn, the information is presented via a graphical interface that allows the recording, storage, and report of the patient's data. For clinical purposes, the software information is statistically validated with three different methodologies, comparing the measures with a goniometer in terms of agreement and repeatability. Results. The agreement of joint angles measured with the proposed software and goniometer is evaluated with Bland-Altman plots; all measurements fell well within the limits of agreement, meaning interchangeability of both techniques. Additionally, the results of Bland-Altman analysis of repeatability show 95% confidence. Finally, the physiotherapists' qualitative assessment shows encouraging results for the clinical use. Conclusion. The main conclusion is that the software is capable of offering a clinical history of the patient and is useful for quantification of the rehabilitation success. The simplicity, low cost, and visualization possibilities enhance the use of the software Kinect for rehabilitation and other applications, and the expert's opinion endorses the choice of our approach for clinical practice. Comparison of the new measurement technique with established goniometric methods determines that the proposed software agrees sufficiently to be used interchangeably.Fil: López Celani, Natalia Martina. Universidad Nacional de San Juan. Facultad de Ingeniería. Departamento de Electrónica y Automática. Gabinete de Tecnología Médica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; ArgentinaFil: Pérez Berenguer, María Elisa. Universidad Nacional de San Juan. Facultad de Ingeniería. Departamento de Electrónica y Automática. Gabinete de Tecnología Médica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; ArgentinaFil: Tello, Emanuel Bienvenido. Universidad Nacional de San Juan. Facultad de Ingeniería. Departamento de Electrónica y Automática. Gabinete de Tecnología Médica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; ArgentinaFil: Rodrigo, Alejandro. Universidad Nacional de San Juan. Facultad de Ingeniería. Departamento de Electrónica y Automática. Gabinete de Tecnología Médica; ArgentinaFil: Valentinuzzi, Maximo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet Noa Sur. Instituto Superior de Investigaciones Biológicas. Grupo de Investigación y Desarrollo del Noroeste Argentino | Universidad Nacional de Tucumán. Instituto Superior de Investigaciones Biológicas. Grupo de Investigación y Desarrollo del Noroeste Argentino; Argentin

Analysis of vectorcardiographic dynamic changes in patients with acute myocardial ischemia

This work evaluates the vectorcardiographic dynamic changes in ischemic patients before and during Percutaneous Transluminal Coronary Angioplasty (PTCA). Four vectorcardiographic parameters were computed in 51 ischemic and 52 healthy subjects with the objective of assessing the differences between both groups: ST Vector Magnitude Area (STVMa), T Vector Magnitude Area (TVMa), ST Vector Difference (STVD), and T Vector Difference (TVD). The conventional ST-Change Vector Magnitude (STCVM) and Spatial Ventricular Gradient (SVG) were also calculated. Results indicate that the most of them show significant differences between healthy and ischemic subjects. Since, the statistical minute-by-minute PTCA comparison against a healthy population shows that ischemic patients monitoring reached values of Sensitivity = 99.5% and Specificity = 99.4%, when STVD, TVD and SVG were used in the classification. In conclusion the sensitivity and specificity for acute ischemia monitoring could be increase with the used of only three vectorcardiographic parameters.Fil: Correa Prado, Raul Oscar. Universidad Nacional de San Juan. Facultad de Ingenieria. Departamento de Electronica y Automatica. Gabinete de Tecnologia Medica; ArgentinaFil: Arini, Pedro David. Universidad de Buenos Aires. Facultad de Ingenieria. Instituto de Ingeniería Biomédica; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Instituto Argentino de Matemática; ArgentinaFil: Correa Prado, Lorena Sabrina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Instituto Argentino de Matemática; ArgentinaFil: Valentinuzzi, Maximo. Universidad de Buenos Aires. Facultad de Ingenieria. Instituto de Ingeniería Biomédica; ArgentinaFil: Laciar Leber, Eric. Universidad Nacional de San Juan. Facultad de Ingenieria. Departamento de Electronica y Automatica. Gabinete de Tecnologia Medica; Argentin

Hybrid Human-Machine Interface to Mouse Control for Severely Disabled People

This paper describes a hybrid human-machine interface, based on electro-oculogram (EOG) and electromyogram (EMG), which allows the mouse control of a personal computer using eye movement and the voluntary contraction of any facial muscle. The bioelectrical signals are sensed through adhesives electrodes, and acquired by a custom designed portable and wireless system. The mouse can be moved in any direction, vertical, horizontal and diagonal, by two EOG channels and the EMG signal is used to perform the mouse click action. Blinks are avoided by a decision algorithm and the natural reading of the screen is possible with a specially designed software. A virtual keyboard was used for the experiments with healthy people and with a severely disabled patient. The results demonstrate an intuitive and accessible control, evaluated in terms of performance, time for task execution and user´s acceptance. Besides, a quantitative index to estimate the training impact was computed with good results.Fil: López Celani, Natalia Martina. Universidad Nacional de San Juan. Facultad de Ingeniería. Departamento de Electrónica y Automática. Gabinete de Tecnología Médica; ArgentinaFil: Orosco, Eugenio Conrado. Universidad Nacional de San Juan. Facultad de Ingeniería. Instituto de Automática; ArgentinaFil: Pérez Berenguer, María Elisa. Universidad Nacional de San Juan. Facultad de Ingeniería. Departamento de Electrónica y Automática. Gabinete de Tecnología Médica; ArgentinaFil: Bajinay, Sergio. Universidad Nacional de San Juan. Facultad de Ingeniería. Departamento de Electrónica y Automática. Gabinete de Tecnología Médica; ArgentinaFil: Zanetti, Roberto. Universidad Nacional de San Juan. Facultad de Ingeniería. Departamento de Electrónica y Automática. Gabinete de Tecnología Médica; ArgentinaFil: Valentinuzzi, Maximo. Universidad Nacional de San Juan. Facultad de Ingeniería. Departamento de Electrónica y Automática. Gabinete de Tecnología Médica; Argentin

Horses also deserve our respect and love

Animals, no doubt, trigger our emotions and have contributed to medical knowledge and human life.1, 2 In many respects, the horse is very peculiar. It never occurred to me the feelings and communication that can be established with it. It is extremely sensitive and clever, showing a tremendous learning capacity, especially when properly treated and taken care of...Fil: Valentinuzzi, Maximo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto Superior de Investigaciones Biológicas. Universidad Nacional de Tucumán. Instituto Superior de Investigaciones Biológicas; Argentin

Matemathical models in bioengineering

We intend here to offer an overview of how biology and medicine entered into a process of mathematization, starting with Leonardo until reaching our current days, pointing out some outstanding areas without forgetting essential concepts that remain as theoretical columns or pillars.Fil: Valentinuzzi, Maximo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Tucumán; ArgentinaFil: Arini, Pedro David. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Saavedra 15. Instituto Argentino de Matemática Alberto Calderón; Argentin

The brain willis circle and ring electric power systems analogies

Blood flowing to the brain keeps it alive, while electrons flowing to inhabited civilized places keep them active, leading to greater understanding of the world. What, however, of those many human beings still confined to distant hostile regions, unaware of the magic of electricity now over a century old. The word analogy is a synonym of likeness, resemblance, similitude, or affinity and involves two concepts being placed side by side, as in a comparison. The workings of nature and those of human societies are amenable to such analogous comparison?even though the evolution of the natural world obviously spans millions of years, while human societies are much younger, relatively puppies by comparison. This article considers two interesting examples from these two realms that show remarkable similarities (possibly a result of sheer chance), i.e., a circulatory brain anastomosis, the circle of Willis (CW), and modern power transmission-distribution systems in the ring arrangement. Remember that electric networks handle the flow of charges [say, in coulombs per second (C/s) or electric charge per unit time, which is current), whereas hydraulic systems deal with fluid flow [say, in liters per minutes (L/min) or volume/unit time or fluid mass/unit time]. Hence, these systems too are analogous, a well-known fact often mentioned by instructors of electrical engineering courses. Cerebral circulation refers to the movement of blood through the network of blood vessels supplying the brain, the primary governing organ that makes us human beings. The rate of cerebral blood flow in adults is typically 750 mm/min, representing about 15% of cardiac output. The brain is very vulnerable to compromises in its blood supply; consequently, its circulatory system has many safeguards, of which the CW is one. Brain circulatory failure results in cerebrovascular accidents, commonly known as strokes, a health situation of considerable concern.Fil: Valentinuzzi, Maximo. Universidad Nacional de Tucumán; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán. Instituto Superior de Investigaciones Biológicas. Universidad Nacional de Tucumán. Instituto Superior de Investigaciones Biológicas; ArgentinaFil: Diaz, Ricardo Ruben. Universidad Nacional de Tucumán; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán; Argentin

Ventricular Fibrillation detection

In automatic defibrillation, early detection of the arrhythmia constitutes an essential and extremely sensitive task. Its failure means no shock delivery and, hence, no possible reversal leading to the patient’s death. Besides, as Golden Rule, a shock should not be delivered to a collapsed patient not in cardiac arrest and a successfully defibrillated patient should not be defibrillated again. After defining basic evaluating parameters (sensitivity, specificity, receiver operating curve, positive predictivity and accuracy), several algorithms are reviewed comparing them at the end of the chapter in an attempt to help the designer engineer is his/her selection. Acronyms are used along the text for the sake of space knowing the risk of confusion, although frequently their full identification is repeated and realizing that occasionally the same algorithm shares two abbreviations. To make navigation in this chapter easier, find here listed the seven algorithms treated plus other nine mentioned in the discussion, including also two algorithms for QRS complex detection, and calling attention to some overlapping between the two sets, that is: Probability Density Function (PDF), Threshold Crossing Intervals (TCI), Cardiac Frequency (CF), Signal Morphology (SM) or Correlation Waveform Analysis (CWA), Time-Frequency Analysis (TFA), Wavelet Transform (WT), Phase Space Analysis (PSA), in the first group, followed by Threshold Crossing Intervals (TCI), described in section 4.2.2, AutoCorrelation Fischer (ACF95) algorithm, based on Correlation Waveform Analysis (CWA), explained in section 4.2.4, VF Filter algorithm, after Kuo and Dillman (1978); Spectral (SPEC) algorithm based on Fourier Transform analysis, described in section 4.2.5, Complexity (CPLX) algorithm, the Standard Exponential (STE) algorithm, the Modified Exponential Algorithm (MEA), an STE akin, the Signal Comparison Algorithm (SCA), the Wavelet (WVL) Algorithm, also explained in section 4.2.6. Likewise, two QRS complexes detection algorithms are considered: Tompkins (TOMP, see section 4.2.3), and LI algorithm, (see section 4.2.6).Fil: Laciar Leber, Eric. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; ArgentinaFil: Valentinuzzi, Maximo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires; Argentina. Universidad Nacional de Tucumán; Argentin

Physical Rehabilitation: A Historical Look

Medicine aims toward restoring, maintaining, and improving human health, and engineering aims toward restoring, maintaining and improving human wellness. Both disciplines apply knowledge from science and technology at large to accomplish such objectives. Bioengineering, also called biomedical engineering, is defined as the application of engineering principles and techniques to problems in medicine and biology (always with restoration, maintenance, and improvement in mind), which now also includes veterinary medicine, and the environment in general.Fil: Valentinuzzi, Maximo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Tucumán; Argentina. Universidad Nacional de Tucumán; ArgentinaFil: López Celani, Natalia Martina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; Argentina. Universidad Nacional de San Juan. Facultad de Ingeniería. Departamento de Electrónica y Automática. Gabinete de Tecnología Médica; Argentin

Ludwig: The Bioengineer

On the basis of the strict exclusion of the vis vitalis, the demand was raised by Carl Ludwig, Helmholtz, Du Bois-Reymond, and Brucke for a physiology which was causal-analytical and physically and chemically experimental. If, out of these four investigators, we pick Ludwig as the actual founder of modern physiology, the grounds for this must be justified specifically. That modern physiology is not to be contemplated without the works of the three great students of Johannes Muller is explicitly emphasized. However, Carl Ludwig occupies a special position for physiology [1]. © 2012, IEEE. All rights reserved.Fil: Valentinuzzi, Maximo. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Bioquímica y Medicina Molecular. Universidad de Buenos Aires. Facultad Medicina. Instituto de Bioquímica y Medicina Molecular; ArgentinaFil: Beneke, Klaus. Universitat Erlangen-nurmberg. Institute Of Inorganic Chemistry; AlemaniaFil: González, Germán Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Bioquímica y Medicina Molecular. Universidad de Buenos Aires. Facultad Medicina. Instituto de Bioquímica y Medicina Molecular; Argentin

Ludwig: The physiologist

The thought reproduced in the above epigraph is taken from an article by Thurau et al. [1], who attribute it to Arthur Schopenhauer (17881860), an outstanding philosopher and author of the far-reaching piece Die Welt als Wille und Vorstellung (The World as Will and Representation). In German, it would perhaps read as etwas denken, das niemand vorher gedacht hat, während etwas sehen, was jeder sieht. We could not assert whether Schopenhauer really said that, but it should not be at all surprising if it were, because it sounds simple, perhaps even naïve, and very deep, indeed. It fits perfectly to Carl Friedrich Wilhelm Ludwigs personality (18161895), whom we will look at as physiologist in this second note. Yes, second notebecause in the first one [2], we looked at him as bioengineer. A third and last Retrospectroscope column completing this series will deal with his wonderful and always humble and generous activities as teacher. © 2012 IEEE.Fil: Valentinuzzi, Maximo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires; ArgentinaFil: Beneke, Klaus. Christin-Albrechts-University; AlemaniaFil: González, Germán Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Bioquímica y Medicina Molecular. Universidad de Buenos Aires. Facultad Medicina. Instituto de Bioquímica y Medicina Molecular; Argentin