Technology and Health Care - Volume 25, issue 5

Authors: Ratnovsky, Anat | Gino, Omri | Naftali, Sara

Article Type: Research Article

Abstract: Different rehabilitation programs are used to relieve dyspnea for hyper-inflated lung patients. In this study, a new approach, based on integrated changes in respiratory rate and pattern, for inspiratory muscles rehabilitation and training was examined utilizing noninvasive measurements of the two inspiratory muscles (rib cage inspiratory and neck inspiratory muscles) activity during controlled breathing in healthy subjects. Muscles activity was measured using electromyography, while subjects, breathed at different combinations of respiratory rate (6, 10, 16 breath per minutes) and inspiratory duty cycles (TI/Ttot). The results clearly show that both muscles were most active at the lowest evaluated respiratory rate, and …that alteration of the duty cycle at the lowest rate significantly (p < 0.05) changes their electrical activity. Breathing at low respiratory rate RR is recommended for hyper-inflated lung patients in order to improve their gas exchange, therefore, it is recommended for these patients to find their most effective combination of RR and TI/Ttot and to use control breathing to practice their breath at optimum combination. Show more

Keywords: Electromyography, device guided breathing, respiratory muscles, signal processing, respiratory rate, inspiratory duty cycle

DOI: 10.3233/THC-170826

Citation: Technology and Health Care, vol. 25, no. 5, pp. 823-830, 2017

Authors: Matsuda, Tatsuya | Ito, Yasumasa | Masunaga, Kohei | Sakai, Yasuhiko | Irie, Keiko | Iwano, Koji | Nagata, Koji

Article Type: Research Article

Abstract: BACKGROUND: Stent placement can change the hemodynamics in basilar artery aneurysms. However, the effects of the stent placement can depend on the angle of vessel bifurcation. OBJECTIVE: The hemodynamics in and near the aneurysm are investigated for two angles of vessel bifurcation and two stent models. Some statistical indexes are calculated to evaluate the effects of the stent placements on the possibility of aneurysm rupture. METHODS: Computational fluid dynamics simulations and phantom model experiments are performed. The angle between the basilar and posterior cerebral arteries is set to 90 and 135 degrees. …The single stent and Y stent models are tested in addition to the case without stent placement. RESULTS: The velocity in the aneurysm in the Y stent case is smaller than that in the no stent and single stent cases when the angle is 135 degrees. High OSI and low AFI areas often appear at the same locations, and the area is larger in the single stent case than in the no stent and Y stent cases. CONCLUSIONS: The Y stent placement promotes hemostasis and thrombosis in the basilar artery aneurysm, whereas the single stent placement can enhance the growth and rupture. Show more

Keywords: Basilar artery aneurysm, hemodynamics, stent, computer simulation

DOI: 10.3233/THC-160487

Citation: Technology and Health Care, vol. 25, no. 5, pp. 831-842, 2017

Authors: Misaki, Kouichi | Takao, Hiroyuki | Suzuki, Takashi | Nishimura, Kengo | Kan, Issei | Yuki, Ichiro | Ishibashi, Toshihiro | Yamamoto, Makoto | Murayama, Yuichi

Article Type: Research Article

Abstract: BACKGROUND: Hemodynamic factors play important roles in aneurysm recurrence after endovascular treatment. OBJECTIVE: Predicting the risk of recurrence by hemodynamic analysis using an untreated aneurysm model is important because such prediction is required before treatment. METHODS: We retrospectively analyzed hemodynamic factors associated with aneurysm recurrence from pretreatment models of five recurrent and five stable posterior communicating artery (Pcom) aneurysms with no significant differences in aneurysm volume, coil packing density, or sizes of the dome, neck, or Pcom. Hemodynamic factors of velocity ratio, flow rate, pressure ratio, and wall shear stress were investigated. RESULTS: …Among the hemodynamic factors investigated, velocity ratio and flow rate of the Pcom showed significant differences between the recurrence group and stable group (0.630 ± 0.062 and 0.926 ± 0.051, P = 0.016; 56.4 ± 8.9 and 121.6 ± 6.7, P = 0.008, respectively). CONCLUSIONS: Our results suggest that hemodynamic factors may be associated with aneurysm recurrence among Pcom aneurysms. Velocity and flow rate in the Pcom may be a pretreatment prognostic factor for aneurysm recurrence after endovascular treatment. Show more

Keywords: Computational fluid dynamics, intracranial aneurysm, recurrence; pressure, velocity, flow rate, endovascular treatment, coil

DOI: 10.3233/THC-160495

Citation: Technology and Health Care, vol. 25, no. 5, pp. 843-850, 2017

Authors: Mo, Jun-Cong | Huang, Jin | Gu, Wen-Dong | Gao, Min | Ning, Zhong-Hua | Mu, Jin-Ming | Li, Qi-Lin | Pei, Hong-Lei

Article Type: Research Article

Abstract: OBJECTIVE: To compare the dosimetric and efficiency differences for left-sided breast cancer radiotherapy after breast-conserving surgery among three different planning techniques: double-arc volumetric-modulate arc therapy (VMAT), step-shoot intensity-modulated radiotherapy (sIMRT) and three-dimensional conformal radiation therapy (3D-CRT). MATERIALS AND METHODS: A total of 17 female patients with left-sided breast cancer who underwent breast-conserving surgery were selected; the prescription doses were 50 Gy in 25 fractions. For every patient VMAT, sIMRT and 3D-CRT plans were generated within the Monaco treatment planning system for an Axesse™ accelerator equipped with the Agility MLC. The Conformity Index (CI), the Homogeneity Index (HI), …the dose volume histogram (DVH) parameters for the organs at risk and the delivery efficiency were evaluated. RESULTS: The VMAT plans showed on average higher CI of PTV (0.77 ± 0.03) than both sIMRT (0.68 ± 0.02) and 3D-CRT (0.55 ± 0.04) plans (P < 0.05). The HI values in the VMAT, sIMRT and 3D-CRT plans were 0.10 ± 0.01 0.09 ± 0.01 and 0.13 ± 0.01 (P > 0.05), respectively, and the differences among the three techniques were not statistically significant. In the ipsilateral lung, the VMAT plans showed lower D mean , V 30 , V 20 , and V 10 than the sIMRT and 3D-CRT (P < 0.05); however, there was no significant difference in V 5 . In the heart, the VMAT plans had lower V 30 and V 20 than the sIMRT and 3D-CRT plans (P < 0.05), but there was no significant difference in the D mean and V 5 . In the contralateral lung, the VMAT plans showed higher D mean and V 5 than sIMRT and 3D-CRT (P < 0.05). In the contralateral breast, the VMAT plans had a higher V 5 than the sIMRT and 3D-CRT plans (P < 0.05). The VMAT plans had higher MU’s than sIMRT and 3D-CRT, while the treatment times were lower than that of sIMRT. CONCLUSION: For left-sided breast cancer radiotherapy after breast-conserving surgery, the VMAT plans had a better CI than the sIMRT and 3D-CRT plans. The VMAT and the sIMRT plans had better HI than the 3D-CRT plans, but no significant difference was observed between VMAT and sIMRT. Show more

Keywords: Left-sided breast-conserving surgery, double-arc volumetric arc therapy, step-shoot intensity modulated radiotherapy, 3D-CRT, dosimetry

DOI: 10.3233/THC-160746

Citation: Technology and Health Care, vol. 25, no. 5, pp. 851-858, 2017

Authors: Li, Yan-Qing | Geng, Jing | Tan, Cheng | Tang, Jun | Yang, Xin

Article Type: Research Article

Abstract: OBJECTIVE: This study was designed to evaluate the significance of transperineal two-dimensional ultrasound in the diagnosis and classification of female stress urinary incontinence (SUI). METHODS: A total of 87 preoperative SUI patients (group A) from the Department of Gynecology of Peking University People’s Hospital were included into this study. These patients were further divided into two groups (groups A1 and A2) according to the severity of their disease. In addition, during the same period, 72 age-matched women without SUI were enrolled into this study and assigned as the control group (group B). Through transperineal two-dimensional ultrasound …technique, detrusor wall thickness (DWT) was measured in the resting state, the bladder neck descent (BND) was measured under the maximal valsalva maneuver, the proximal urethral rotation angle (α angle) and posterior vesicourethral angle (β angle) were measured, and the formation of the funnel-shaped urethra was observed. RESULTS: Under the resting state, differences in DWT between groups A and B, as well as between groups A1 and A2, were not statistically significant (P > 0.05). The BND, α and β angles were significantly larger in group A than in group B under the maximal Valsalva maneuver; and the differences were statistically significant (P < 0.05). The formation rate of the funnel-shaped urethra was significantly higher in group A (94%) than in group B (3%), and the difference was statistically significant; while the difference between groups A1 and A2 was not statistically significant (P > 0.05). CONCLUSION: Transperineal two-dimensional ultrasound can play an assistant role in the diagnosis of female SUI. However, its role in the assessment of the severity of SUI remains to be studied. Show more

Keywords: Transperineal ultrasound, stress urinary incontinence, diagnosis, grading

DOI: 10.3233/THC-160786

Citation: Technology and Health Care, vol. 25, no. 5, pp. 859-866, 2017

Authors: Kim, Kyung Hun | Lee, Kyoung Bo | Bae, Young-Hyeon | Fong, Shirley S.M. | Lee, Suk Min

Article Type: Research Article

Abstract: BACKGROUND AND OBJETIVE: A stroke patient with hemiplegic gait is generally described as being slow and asymmetric. Body weight-supported treadmill training and backward gait training are recent additions to therapeutic gait trainings that may help improve gait in stroke patient with hemiplegic gait. Therefore, we examined the effect of progressive backward body weight-supported treadmill training on gait in chronic stroke patients with hemiplegic gait. METHODS: Thirty subjects were divided to the experimental and control groups. The experimental group consisted of 15 patients and underwent progressive backward body weight-supported treadmill training. The control group consisted of 15 …patients and underwent general treadmill gait training five times per week, for a total of four weeks. The OptoGait was used to analyze gait kinematics, and the dynamic gait index (DGI) and results of the 6-minute walk test were used as the clinical evaluation indicators. A follow-up test was carried out four weeks later to examine persistence of exercise effects. RESULTS: The experimental group showed statistically significant results in all dependent variables week four compared to the control group. However, until the eighth week, only the dependent variables, of affected step length (ASL), stride length (SL), and DGI differed significantly between the two groups. CONCLUSION: This study verified that progressive bodyweight-supported treadmill training had a positive influence on the temporospatial characteristics of gait and clinical gait evaluation index in chronic stroke patients. Show more

Keywords: Backward body weight supported treadmill training, chronic stroke, gait ability

DOI: 10.3233/THC-160720

Citation: Technology and Health Care, vol. 25, no. 5, pp. 867-876, 2017

Authors: Dehghanpour, Peyman | Einalou, Zahra

Article Type: Research Article

Abstract: BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD), as one of the most common neurological disorders in children and adolescents, is characterized by decentralization, slow learning, distraction and hyperactivity. Studies have shown that in addition to medication, neurofeedback training can also be used to partially control the brain activity of these patients. METHODS: In this study, using the brain signals processing before and after the treatment in 10 children treated by neurofeedback, the changes were evaluated by non-parametric statistical analysis and impact of neurofeedback on brain frequency bands was investigated. Finally, the results were compared with the protocols introduced in …this paper and before researches. RESULTS: The results of Kruskal-Wallis test showed an approximately significant increase in the relative power of gamma and an approximately significant reduction in the ratio of relative power of alpha/beta. CONCLUSIONS: It represents the emotional response, elicited by the successful learning and diminished ratio of slow learning to active learning respectively. Show more

Keywords: Attention-deficit/hyperactivity disorder, Electroencephalography, Kruskal-Wallis test, neurofeedback, power spectral density

DOI: 10.3233/THC-170845

Citation: Technology and Health Care, vol. 25, no. 5, pp. 877-885, 2017

Authors: Kan, Chung-Dann | Chen, Wei-Ling | Lin, Chia-Hung | Wu, Ming-Jui | Mai, Yi-Chen

Article Type: Research Article

Abstract: An arteriovenous graft (AVG) has a higher patency rate in stenosis progression at the venous anastomosis site, which causes coexisting inflow and outflow stenoses. This leads to increases in blood pressure, flow velocity, and flow resistance, resulting in hemodialysis (HD) vascular access dysfunction from early clots and thrombosis to the progression of coexisting stenoses. To prevent vascular access complications such as inflow or outflow stenoses, this study proposes a novel examination method in an experimental AVG system using a substitution-rate based screening model. In our practical measurements, we found that inflow and outflow channeled through a narrowed access indicated both …pressure and resistance differences as the degree of stenosis (DOS) gradually increased. A substitution-rate matrix was conducted to replace bilateral pressure variations, while a transition probability matrix was calculated. Differences in transition probabilities were then used to distinguish between normal conditions and flow instabilities using the distance estimation method. The joint probability decayed from < 0.81 to 0.00 could be specified to identify the progression in stenosis levels from a DOS% = 50.0–95.0%. Average joint probabilities were found to be inversely related with the DOS using a non-linear regression (R> 2 0.90). Hence, the joint probability could be specified as a critical threshold, < 0.81, to identify the severity stenosis level, DOS% ⩾ 70%, in the assessment of coexisting inflow and outflow stenoses. Experimental results suggest that the proposed model is superior to hemodynamic analysis and traditional intelligent method, and can be used for dysfunction screening during HD treatment. Show more

Keywords: Arteriovenous graft, patency rate, substitution rate, transition probability matrix

DOI: 10.3233/THC-160474

Citation: Technology and Health Care, vol. 25, no. 5, pp. 887-902, 2017

Authors: Alzahrani, Ahmed | Qureshi, Muhammad Shuaib | Thayananthan, Vijey

Article Type: Research Article

Abstract: This paper aims to analyze possible next generation of networked radio frequency identification (NGN-RFID) system for customer relationship management (CRM) in healthcare industries. Customer relationship and its management techniques in a specific healthcare industry are considered in this development. The key objective of using NGN-RFID scheme is to enhance the handling of patients’ data to improve the CRM efficiency in healthcare industries. The proposed NGN-RFID system is one of the valid points to improve the ability of CRM by analyzing different prior and current traditional approaches. The legacy of customer relationship management will be improved by using this modern NGN-RFID …technology without affecting the novelty. Show more

Keywords: Next generation network, RFID, sensors, customer relationship management, e-Health

DOI: 10.3233/THC-170934

Citation: Technology and Health Care, vol. 25, no. 5, pp. 903-916, 2017

Authors: Lee, Tso-Ying | Sun, Gi-Tseng | Kou, Li-Tseng | Yeh, Mei-Ling

Article Type: Research Article

Abstract: BACKGROUND: Issues in patient safety and nursing efficiency have long been of concern. Advancing the role of nursing informatics is seen as the best way to address this. OBJECTIVES: The aim of this study was to determine if the use, outcomes and satisfaction with a nursing information system (NIS) improved patient safety and the quality of nursing care in a hospital in Taiwan. METHOD: This study adopts a quasi-experimental design. Nurses and patients were surveyed by questionnaire and data retrieval before and after the implementation of NIS in terms of blood drawing, nursing process, drug administration, …bar code scanning, shift handover, and information and communication integration. RESULTS: Physiologic values were easier to read and interpret; it took less time to complete electronic records (3.7 vs. 9.1 min); the number of errors in drug administration was reduced (0.08% vs. 0.39%); bar codes reduced the number of errors in blood drawing (0 vs. 10) and transportation of specimens (0 vs. 0.42%); satisfaction with electronic shift handover increased significantly; there was a reduction in nursing turnover (14.9% vs. 16%); patient satisfaction increased significantly (3.46 vs. 3.34). CONCLUSIONS: Introduction of NIS improved patient safety and nursing efficiency and increased nurse and patient satisfaction. Medical organizations must continually improve the nursing information system if they are to provide patients with high quality service in a competitive environment. Show more

Keywords: Nursing information system, patient safety, nurse efficiency, bar codes, shift handover

DOI: 10.3233/THC-170848

Citation: Technology and Health Care, vol. 25, no. 5, pp. 917-928, 2017

Authors: Zahar, Akos | Kocsis, György | Citak, Mustafa | Puskás, Gábor | Domahidy, Mónika | Hajdú, Mária | Antal, István | Szendrői, Miklós

Article Type: Research Article

Abstract: BACKGROUND: Both osteomyelitis and prosthetic joint infection can be treated surgically with the use of antibiotic loaded bone grafts, as part of local antimicrobial therapy. OBJECTIVE: The purpose of the study was to evaluate and to report on a novel, biodegradable, long-acting (4–6 weeks) antibiotic-impregnated bone graft (AIBG). A novel drug delivery system, containing vancomycin, was utilized in a rabbit osteomyelitis model in order to evaluate the antimicrobial efficacy of the antibiotic bone graft. METHODS: Forty adult New Zealand rabbits were used. The animals were randomized into three Groups: healthy animals without osteomyelitis, …where AIBG was used to fill a defect (Group I); osteomyelitis caused with a methicillin-resistant S.aureus strain (MRSA) treated with AIBG (Group II); osteomyelitis caused with MRSA and treated with bone grafts without local antibiotics (Group III). At six weeks post-operation, the animals were sacrificed and histological, laboratory and radiologic evaluations were performed. RESULTS: Of the 24 operated rabbits, osteomyelitis was confirmed in 18 animals. In groups with osteomyelitis, only minor radiological changes were observed on day 21 post-op. Radiographs taken on day 42 post-op showed radiological signs of chronic osteomyelitis in Group III, whereas in Group II, bone healing was observed. Bacterial cultures taken on day 42 post-op revealed the original MRSA strain in Group III, whereas no bacteria were detected in Group II. Histological examinations showed the presence of macrophage cells which slowly break down the DDS matrix. The presence of DDS did not inhibit re-ossification. CONCLUSIONS: The drug delivery system was effective against MRSA-induced osteomyelitis without negative effect on osteointegration. This biodegradable technology has the potential to be a powerful tool in fighting bone infections. Show more

Keywords: Local antibiotic therapy, drug delivery system, biodegradable, bone infection, experimental osteomyelitis

DOI: 10.3233/THC-170869

Citation: Technology and Health Care, vol. 25, no. 5, pp. 929-938, 2017

Authors: Linkel, Artūras | Raudonytė, Inga | Shippen, James | May, Barbara | Daunoravičienė, Kristina | Sawicki, Aleksander | Griškevičius, Julius

Article Type: Research Article

Abstract: BACKGROUND: The quality of upper extremity (UE) function can be evaluated by measuring the kinematic parameters of patient movements. OBJECTIVE: This investigation focused on finding the angles and angular velocity amplitudes of UE motions in healthy participants to compare with the experimental results of patients with a UE disability who are trying to recover previous movement conditions. METHODS: The UE motions of 23 healthy adult volunteers were tested using a three-dimensional motion capture system and measuring hand segment motions. A simplified 7 degrees of freedom (DOF) human arm kinematic model created within MATLAB and …used to process the experimental data. RESULTS: The interpersonal CV (coefficients of variability) of left-side motions showed that the lowest CV of linear velocity amplitudes was at elbow flexion (4.2%), but the highest was at wrist extension (48.3%). The lowest and highest CV of angular velocity amplitudes were 19.6% and 55.7%, during shoulder adduction and wrist extension, respectively. CONCLUSIONS: High interpersonal CV may restrict the direct comparison of kinematic parameters of UE in different healthy and disabled persons. Show more

Keywords: Upper extremity, objective evaluation, motion capture system, biomechanics, kinematic human hand model

DOI: 10.3233/THC-170927

Citation: Technology and Health Care, vol. 25, no. 5, pp. 939-948, 2017

Authors: Struwe, Charlotte | Hermann, Pia C. | Bornemann, Rahel | Plöger, Milena | Roessler, Philip P. | Strauss, Andreas C. | Rommelspacher, Yorck | Koch, Ernst M.W. | Pflugmacher, Robert

Article Type: Research Article

Abstract: BACKGROUND: Spinal fusion surgery has become one of the most common spinal procedures during the recent years. Searching for an optimum structural stability of the vertebral interspace, surgical implants which can be inserted via a posterior lumbar interbody fusion (PLIF) approach have been enhanced recently. OBJECTIVE: Evaluation of safety and efficacy of a novel PLIF polyetheretherketone (PEEK) interbody cage (TWIST) with an impactionless insertion technique. METHODS: Surgical outcome in 15 patients treated with the new system were observed preoperatively, one and three years after surgery using the Oswestry Disability Index (ODI), a Visual …Analogue Scale (VAS) for pain and radiological outcome analysis of fusion success. RESULTS: Fifteen patients (7 female, 8 male) were included in the test series. After three years ODI and VAS were significantly improved. The pain intensity was reduced by more than 75% after one year and after 3 years, pain intensity was about 60% below the initial situation. The Oswestry values (ODI) improved significantly in all patients after 3 years. The fusion evaluation showed a fusion success in 87% of the patients. CONCLUSION: The clinical and radiological results of this first series give a positive standing and important information on the efficacy and safety over 3 years. The follow-up checks with imaging techniques showed that the fusions were very successful and functional outcome as well as pain reduction were increased. Show more

Keywords: Spine, chronic low back pain, posterior lumbar interbody fusion (PLIF), interbody cage

DOI: 10.3233/THC-160721

Citation: Technology and Health Care, vol. 25, no. 5, pp. 949-957, 2017

Authors: Panzica, M. | Brandes, J. | Schmiddem, U. | Karch, A. | Hawi, N. | Krettek, C. | Meller, R.

Article Type: Research Article

Abstract: INTRODUCTION: The use of reverse shoulder arthroplasty (RSA) has increased dramatically over the last two decades, with many surgeons now indicating RSA for the acute management of displaced proximal humerus fractures (PHF) in the elderly. RSA relies on adequate deltoid muscle function to obtain a good outcome, yet no literature to date exists which discusses preoperative assessment of deltoid structure prior to RSA. The purpose of this study was to assess for preoperative fatty deltoid-degeneration in patients with displaced PHF. MATERIALS AND METHODS: We reviewed the axial CT scans of 100 consecutive patients with a displaced …PHF. Fatty degeneration within each of the three deltoid-heads was graded at three levels, according to Goutallier and colleagues. Fractures were classified according to Neer. RESULTS: Seventy-nine percent of the patients were female, 75% showed 3 or 4 parts fractures. The average cross-sectional area of the posterior deltoid was greatest-representing 37%, 40% and 42% of total area at each level, respectively. Severe fatty degeneration (Stages 3 and 4) was observed in the posterior deltoid only (26%). Absence of fatty degeneration (Stage 0) was observed in < 25% of cases. The Inter-Observer-Reliability for the continuous variables proved to be high. CONCLUSION: Preoperative deltoid fatty degeneration is common in displaced PHF in the elderly. Because CT is commonly obtained to assess fracture morphology and for preoperative planning purposes, it is an ideal tool to assess the deltoid additionally. Future studies are warranted to determine whether preoperative fatty infiltration of the deltoid correlates with mid and long term functional outcomes when RSA is used acutely to manage a PHF. LEVEL OF EVIDENCE: Level IV-consecutive case series. Show more

Keywords: Proximal humeral fracture, Goutallier, fatty degeneration, deltoid, computed tomography

DOI: 10.3233/THC-170834

Citation: Technology and Health Care, vol. 25, no. 5, pp. 959-967, 2017

Authors: Nayak, Chitresh | Singh, Amit | Chaudhary, Himanshu | Unune, Deepak Rajendra

Article Type: Research Article

Abstract: Technological advances in prosthetics have attracted the curiosity of researchers in monitoring design and developments of the sockets to sustain maximum pressure without any soft tissue damage, skin breakdown, and painful sores. Numerous studies have been reported in the area of pressure measurement at the limb/socket interface, though, the relation between amputee’s physiological parameters and the pressure developed at the limb/socket interface is still not studied. Therefore, the purpose of this work is to investigate the effects of patient-specific physiological parameters viz. height, weight, and stump length on the pressure development at the transtibial prosthetic limb/socket interface. Initially, the pressure …values at the limb/socket interface were clinically measured during stance and walking conditions for different patients using strain gauges placed at critical locations of the stump. The measured maximum pressure data related to patient’s physiological parameters was used to develop an artificial neural network (ANN) model. The effects of physiological parameters on the pressure development at the limb/socket interface were examined using the ANN model. The analyzed results indicated that the weight and stump length significantly affects the maximum pressure values. The outcomes of this work could be an important platform for the design and development of patient-specific prosthetic socket which can endure the maximum pressure conditions at stance and ambulation conditions. Show more

Keywords: Transtibial prosthetic socket, strain gauges, pressure, physiological parameters, artificial neural network

DOI: 10.3233/THC-160683

Citation: Technology and Health Care, vol. 25, no. 5, pp. 969-979, 2017

Authors: Cha, Young Joo | Lee, Jae Jin | Kim, Do Hyun | You, Joshua (Sung) H.

Article Type: Research Article

Abstract: BACKGROUND: Core stabilization plays an important role in the regulation of postural stability. To overcome shortcomings associated with pain and severe core instability during conventional core stabilization tests, we recently developed the dynamic neuromuscular stabilization-based heel sliding (DNS-HS) test. OBJECTIVE: The purpose of this study was to establish the criterion validity and test-retest reliability of the novel DNS-HS test. METHOD: Twenty young adults with core instability completed both the bilateral straight leg lowering test (BSLLT) and DNS-HS test for the criterion validity study and repeated the DNS-HS test for the test-retest reliability study. …Criterion validity was determined by comparing hip joint angle data that were obtained from BSLLT and DNS-HS measures. The test-retest reliability was determined by comparing hip joint angle data. RESULTS: Criterion validity was (ICC 2 , 3 ) = 0.700 (p < 0.05), suggesting a good relationship between the two core stability measures. Test-retest reliability was (ICC 3 , 3 ) = 0.953 (p < 0.05), indicating excellent consistency between the repeated DNS-HS measurements. CONCLUSIONS: Criterion validity data demonstrated a good relationship between the gold standard BSLLT and DNS-HS core stability measures. Test-retest reliability data suggests that DNS-HS core stability was a reliable test for core stability. Clinically, the DNS-HS test is useful to objectively quantify core instability and allow early detection and evaluation. Show more

Keywords: Core instability, criterion validity, test-retest reliability, dynamic neuromuscular stabilization-heel sliding test, rehabilitation

DOI: 10.3233/THC-170929

Citation: Technology and Health Care, vol. 25, no. 5, pp. 981-988, 2017

Authors: Wenzl, Marcus P. | Heller, Markus | Janz, Viktor | Perka, Carsten | Wassilew, Georgi I.

Article Type: Research Article

Abstract: BACKGROUND: Plain radiography, 2-dimensional (2D) magnetic resonance imaging (MRI), and computed tomography (CT) do not precisely display morphology and acetabular coverage in developmental dysplasia of the hip or pincer-type femoroacetabular impingement. Pelvic position and pelvic tilt affect assessment of the acetabular parameters, leading to misinterpretation. OBJECTIVE: We tested a 3-dimensional (3D) CT evaluation script to calculate the crossover sign (COS), acetabular coverage and morphology. METHODS: To test the method, we constructed a phantom pelvic model, in which the acetabulum was mounted at different coverages of the femoral head, and simulated a COS and …the acetabular morphology. Additionally we examined the reliability and objectivity of this method in ten patients with CT scans of the pelvis for conditions unrelated to hip disorders. RESULTS: We obtained an average accuracy of the 3D CT evaluation script of - 0.37 ∘ (range - 3.84 to 3.88; SD ± 1.43) for morphology, and 0.002% (range - 7.28% to 6.90%; SD ± 1.60%) for coverage of the femoral head. Significant correlation between the expected and calculated COS (p = 0.01) was found. CONCLUSIONS: Our 3D CT evaluation script permits precise evaluation of the acetabular coverage profile, the presence or absence of a COS and acetabular morphology, independent of patient positioning or pelvic tilt. Show more

Keywords: Acetabular coverage profile, crossover sign, 3D computed tomography

DOI: 10.3233/THC-170932

Citation: Technology and Health Care, vol. 25, no. 5, pp. 989-1004, 2017

Authors: Huttin, Christine C.

Article Type: Research Article

Abstract: This paper is the last of a series of five methodological contributions in the field of stated preference studies for disease econometric models. It proposes several advances to integrate in the predictive model new variables on effects of computerization of medical records in clinical practice, adoption of new drug therapies and effect of different types of variables to control physicians’ attributes such as the type of visit disposition (with a variable on the referral process). Different stages of propagation of IT in clinical practice are analyzed for the type of information computerized in the medical records. Results of a clustering …analysis on medical practices and the statistical results on the predictive disease models are presented on a diabetes type II analytical data set from the US National Medical Ambulatory Care Survey. The three new independent variables on ebilling, clusters of medical practices with different level of IT confirms previous results with a reduction of drug utilization with e billing and higher drug utilization for the more computerized group of practices. Drug utilization is also much lower when a physician requests a referral. Patient economics and its effects at the point of visit are clearly modified with the diffusion of IT. Show more

Keywords: Innovativeness, patient economics, clinical choices sets, IT in medical practice, clustering

DOI: 10.3233/THC-160769

Citation: Technology and Health Care, vol. 25, no. 5, pp. 1005-1020, 2017

Authors: Sun, Da-Hui | Zhao, Yi | Zhang, Ji-Ting | Qi, Bao-Chang

Article Type: Research Article

Abstract: Anatomical reduction and rigid fixation of acetabular posterior wall fractures extending to the acetabular roof proves challenging because of the big bony fragment and muscular obstruction to accessing this region. This report describes a novel reconstructive technique in a patient with an acetabular posterior wall fracture involving the acetabular roof. Both the standard Kocher-Langenbeck approach and a greater trochanter osteotomy technique were used. Following anatomical reduction, a dual arc-shaped reconstruction plate technique was employed to achieve rigid fixation. The patient recovered with satisfactory function at the injured hip. We recommend this dual arc-shaped reconstruction plate technique for the treatment of …acetabular posterior wall fractures extending to the acetabular roof in clinical practice. Show more

Keywords: Acetabular fractures, posterior wall, two arc-shaped plates

DOI: 10.3233/THC-170830

Citation: Technology and Health Care, vol. 25, no. 5, pp. 1021-1024, 2017

Authors: Wang, Yao-Chin | Chou, Willy | Lin, Bor-Shing | Wang, Jhi-Joung | Lin, Bor-Shyh

Article Type: Research Article

Abstract: Dysphagic patients usually have a variety of clinical problems such as malnutrition, significant weight loss, and aspiration pneumonia. Dysphagia is a complication commonly caused by strokes, and surface electromyography (sEMG) provides a simple, non-radioactive, and non-invasive method to measure the patterns of muscle activity during swallowing, allowing clinicians to describe the physiology of swallowing behavior. Most previous studies have described swallowing behavior in terms of amplitude and duration. However, there is no objective and precise approach available for the evaluation of swallowing coordination. In order to evaluate swallowing coordination more precisely, a wireless and wearable monitoring device for dysphagia evaluation …was designed for the present study in order to measure four muscle groups simultaneously during swallowing. In this context, the variations of the cross-correlation coefficients were defined as the discoordination index, a metric which can effectively reflect the differences between the surface EMG patterns of the bilateral muscle groups. The experimental results of this study show that the discoordination indices for dysphagic patients are significantly larger than those for healthy subjects and that these discoordination indices can be used as an effective means of evaluating the coordination between bilateral swallowing muscles. Show more

Keywords: Surface electromyography, dysphasia evaluation, medical device, swallowing

DOI: 10.3233/THC-170892

Citation: Technology and Health Care, vol. 25, no. 5, pp. 1025-1028, 2017