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ISSN 0928-7329 (P)
Impact Factor 2023: 1.6
Technology and Health Care is intended to serve as a forum for the presentation of original articles and technical notes, observing rigorous scientific standards. Furthermore, upon invitation, reviews, tutorials, discussion papers and minisymposia are featured.
The following types of contributions and areas are considered:
1. Original articles:
Technology development in medicine: New concepts, procedures and devices associated with the use of technology in medical research and clinical practice are presented to a readership with a widespread background in engineering and/or medicine.
Significance of medical technology and informatics for healthcare: The appropriateness, efficacy and usefulness deriving from the application of engineering methods, devices and informatics in medicine and with respect to public health are discussed.
2. Technical notes:
Short communications on novel technical developments with relevance for clinical medicine.
3. Reviews and tutorials (upon invitation only):
Tutorial and educational articles for persons with a primarily medical background on principles of engineering with particular significance for biomedical applications and vice versa are presented.
4. Minisymposia (upon invitation only):
Under the leadership of a Special Editor, controversial issues relating to healthcare are highlighted and discussed by various authors.
Abstract: BACKGROUND: The study aims to determine the effectiveness of robot-assisted training in the recovery of stroke-affected arms using an exoskeleton robot Armeo Spring. OBJECTIVE: To identify the effect of robot training on functional recovery of the arm. METHODS: A total of 34 stroke patients were divided into either an experimental group (EG; n = 17) or a control group (n = 17). EG was also trained to use the Armeo Spring during occupational therapy. Both groups were clinically assessed before and after treatment.…Statistical comparison methods (i.e. one-tailed t-tests for differences between two independent means and the simplest test) were conducted to compare motor recovery using robot-assisted training or conventional therapy. RESULTS: Patients assigned to the EG showed a statistically significant improvement in upper extremity motor function when compared to the CG by FIM (P < 0.05) and ACER (P < 0.05). The calculated treatment effect in the EG and CG was meaningful for shoulder and elbow kinematic parameters. CONCLUSIONS: The findings show the benefits of robot therapy in two areas of functional recovery. Task-oriented robotic training in rehabilitation setting facilitates recovery not only of the motor function of the paretic arm but also of the cognitive abilities in stroke patients.
Abstract: BACKGROUND: Assessment of the foot arch is an important element of posture examination. In clinical practice, different methods are used. Reliability and repeatability of the techniques raises many doubts. OBJECTIVE: Development and verification of our own, automated diagnostic algorithm for evaluation of the longitudinal arch of the foot with the use of the Zebris FDM-S dynamometric platform. METHODS: This paper presents selected footprints assessment methods and Zebris dynamometric platform to assess the longitudinal arch of the foot. RESULTS: The results were compared to standard plantography examination. The outcomes show high…correlation of the investigated parameters methods used. The ambiguity of classification criteria of foot arch was observed. CONCLUSIONS: 1/Examination confirmed strong linear correlation between the Arch Index results obtained during examinations on a stabilometric platform and plantography examination. 2/The proposed algorithm for AI evaluation using the Zebris FDM-S dynamometric platform enables simultaneous analysis of stabilometric and pedobarometric variables as well classifying the type of disorder arch longitudinal arch of the foot. 3/Qualitative analysis of the arch, based on plantography results and the Arch Index, shows inconsistency in results obtained with different methods. 4/The obtained results show further necessity to conduct more studies to develop methods of standardization of foot arch assessment.
Abstract: BACKGROUND: Simulation divergence due to the backflow through the outlet boundary is a common, but not fully addressed challenge in patient-specific simulations of the aortic valve flows. OBJECTIVE: The purpose of this study is to develop the outlet boundary conditions aiming to improve convergence of the patient-specific aortic valve computations and to control the backflow in the case of partial reversal of the flow through the outlet. METHODS: Haemodynamic analysis of the aortic valve flows governed by the Navier-Stokes equations is performed by using the finite volume method. The pressure distribution, obtained from…the convergent computations driven by the outflow boundary condition, is approximated by the parabolic surface of revolution and prescribed on the outlet as the novel pressure boundary condition. RESULTS: Various types of outlet boundary conditions are investigated to evaluate their influence on the resulting backflows. The outflow boundary condition produces a smaller backflow than other investigated boundary conditions, but it causes the solution divergence. The proposed outlet boundary condition allows for continuing the solution and preserving the expected backflow. CONCLUSIONS: The proposed outlet boundary condition helps to achieve a convergent solution and to conserve the observed backflow by varying the convexity of the specified pressure surface.
Abstract: BACKGROUND: This paper reports on the torques developed in the shoulder joint experienced by occupants of moving vehicles during manual handling tasks. Handling heavy weights can cause musculoskeletal injuries, especially if handling is done with arms extended or at high levels. OBJECTIVE: The aim of the study was to measure the longitudinal and lateral accelerations in a variety of passenger vehicles together with the postures of subjects lifting luggage onto storage shelves. This data enabled the application of inverse dynamics methods in a non-inertial reference frame to calculate the shoulder joint torques. METHODS:…The subjects lifted 3 pieces of luggage of masses of 5 kg, 10 kg and 14 kg onto shelving which were at heights of 1.2 m, 1.6 m and 1.8 m. The movement of subjects was measured using a 12 camera, 3-dimensional optical tracking system. The subjects stood on force plates to measure the ground reaction forces. RESULTS: Sixty-three trials were completed, although 9 trials were aborted because subjects felt unable to complete the task. It was found that the shoulder torques exceeded the levels recommend by the UK Health and Safety Executive for manual handling. A lift assistance device is suggested to reduce the shoulder torques required for luggage handling.
Abstract: BACKGROUND: In this paper a method is proposed to evaluate the heart’s coronary vessels’ status based on the elimination of large coronary branches from IR-thermal image. This method makes it possible to determine nutrient cardiac blood circulation by calculation of the rate of heat spreading in small coronary vessels in the myocardium at hypothermia and hyperthermia under the conditions of artificial blood circulation. OBJECTIVE: The objective of the paper includes a theoretical substantiation of the proposed method for evaluation of the heart’s coronary vessels’ status and an experimental investigation of the efficiency of the method. METHODS:…In the experiment, the dynamics of temperature distribution in the myocardium were registered by using thermal imaging cameras Flir i7 and Thermo Cam E300. RESULTS: Processing of the myocardium’s thermographic images and the results of heat spreading modeling make it possible to single out the temperature profiles of the visible myocardium zones and to establish the presence of coronary arteries in them. CONCLUSIONS: The method makes it possible to monitor the heart temperature at hypothermia and hyperthermia; additionally, it makes it possible to evaluate the efficiency of the coronary artery bypass graft surgery performed during open heart operation.
Abstract: BACKGROUND: Support systems designed for human lower limbs are usually characterized by a serial kinematic structure taking into account only one lower limb. To overcome the mobility range limitations, a new structure of the exoskeleton is proposed in this paper. OBJECTIVE: The design process of the dynamic model for the support structure characterized by a parallel-serial mechanism is presented in the paper. The structure works as an exoskeleton and is designed to assist motion of the human lower limb in the process of rehabilitation. METHODS: The structure of the support model was divided into linear (executive…system) and nonlinear (the mechanical skeleton of the system) parts. The model of the executive system was designed and its parameters were estimated in the course of tests on a laboratory stand, as well as identification procedures. The nonlinear model was expressed by mathematical equations. The characteristic coefficients in the equation were determined based on a 3d CAD model. RESULTS: To analyze the behavior of the mechanism, a simulation of dynamic responses was compared with experimental results for a real system consisting of a mechatronic device, actuator drivers, a controller, and programmed software. CONCLUSIONS: The proposed new structure enables an increase of the range of rotation angles and can be fitted to an individual person. The derived model is in the analytical form and can also be easily adopted to the different versions of the exoskeleton and used in the design of control systems.
Keywords: Parallel-serial mechanism, dynamic model, electric linear drive, exoskeleton
Abstract: BACKGROUND: The main position of the working population is becoming sitting. Immobile prolonged sedentary time may cause negative effects including reduced intervertebral discs nutrition. Main ways of mitigating them are regular position changes and exercising. OBJECTIVE: To evaluate influence of the short term training on unstable training machine on balance control and trunk muscles activity in patients with lower back pain. METHODS: Participants (n = 16) experiencing lower back pain were trained on an unstable sculling machine “Rehabili”. Their balance tested by (Biodex Balance System) and rectus abdominis, externus…oblique, transverse abdominis, multifidus and erector spine muscles activity (measured by surface electromyography) while sitting and standing with usual and aligned body postures both before and after six weeks of training (three 15 minutes sessions per week) were compared in between. RESULTS: Balance control improved after the training program. Besides, more symmetrical activation of both sides rectus and transversus abdominis muscles, as well as increased transversus abdominis muscle activation of 19% (p < 0.05), were observed. CONCLUSIONS: Six weeks short sessions training on unstable training machine improved balance control and increased trunk muscles activity especially in aligned body posture when standing or sitting on unstable surface.
Keywords: Prolonged sitting, balance, trunk muscles activity, unstable training
Abstract: BACKGROUND: Gait analysis is a useful tool medical staff use to support clinical decision making. There is still an urgent need to develop low-cost and unobtrusive mobile health monitoring systems. OBJECTIVE: The goal of this study was twofold. Firstly, a wearable sensor system composed of plantar pressure insoles and wearable sensors for joint angle measurement was developed. Secondly, the accuracy of the system in the measurement of ground reaction forces and joint moments was examined. METHODS: The measurements included joint angles and plantar pressure distribution. To validate the wearable sensor system and examine the effectiveness…of the proposed method for gait analysis, an experimental study on ten volunteer subjects was conducted. The accuracy of measurement of ground reaction forces and joint moments was validated against the results obtained from a reference motion capture system. RESULTS: Ground reaction forces and joint moments measured by the wearable sensor system showed a root mean square error of 1% for min. GRF and 27.3% for knee extension moment. The correlation coefficient was over 0.9, in comparison with the stationary motion capture system. CONCLUSIONS: The study suggests that the wearable sensor system could be recommended both for research and clinical applications outside a typical gait laboratory.
Abstract: BACKGROUND: Integration of the verticalization robot, Erigo, with functional electric stimulation and passive leg movements in the postacute rehabilitation of neurological patients could reduce the risk of secondary complications and improve functional outcomes (i.e. orthostatic hypotension, postural control and walking ability). OBJECTIVE: The aim of this study was to estimate and quantify changes in the postacute stage, mainly related to heart rate and blood pressure in functional recovery, postural parameters, walking ability and psychoemotional reactions, during training using the verticalization robot Erigo. METHODS: Six patients [three suffering from a stroke (ST) and three…with spinal cord injuries (SCI)] participated in 10 sessions of physical therapy with the verticalization robot during primary inpatient rehabilitation. Functional state changes were assessed using clinical tests before and after the treatment, and the loading tolerance during Erigo training was noted. RESULTS: In early rehabilitation, Erigo training was safe and effective at improving orthostatic tolerance, posture and positive emotional reactions in both the ST and SCI patients (P < 0.05). In addition, advanced technologies were more effective at boosting the orthostatic tolerance in SCI patients, while they were more effective at increasing the dynamic balance and walking ability in ST patients (P < 0.05).
Abstract: BACKGROUND: Majority of limb amputations are caused by circulatory disturbances such as vascular occlusions and strictures. Discovery of modern and more advanced ultrasonic interventional vascular debulking methodology would likely save limbs of CVD patients and their lives in an economical way. However, there is a lack of researches regarding the ultrasound’s effect on physiological functions of human blood cells. The tube-shaped ultrasound waveguide wire with orifices at its operational end was offered as the alternative to some currently patented interventional thrombosis treatment solutions. OBJECTIVE: To establish the safe operating regime of the proposed device.…METHODS: The temperature rise induced by the cavitation process and friction between the waveguide and surrounding fluids was measured and microscopic pictures of human blood were made. RESULTS: Blood insonation lasting 15 seconds, leads to blood clot formation. If insonation continues for 30 seconds some cells are totally destroyed. In addition, the safe operating regime was established. To avoid heating of the environment to the temperature harmful for the medium (blood) and surrounding tissues, is achieved when the system should be on for 40%, and of for 60% of the period of 1 second. CONCLUSIONS: The safe operating regime of the proposed device was established.
Abstract: BACKGROUND: Transapical off-pump mitral valve (MV) repair is a novel minimally-invasive surgical technique, allowing to correct mitral regurgitation (MR) caused by chordae tendineae rupture. While numerical simulation of the MV structure has proven to be useful to evaluate the effects of the MV surgical repair techniques, no numerical simulation studies on the outcomes of transapical MV repair have been done up to now. OBJECTIVE: The purpose of this study is to evaluate the transapical MV repair using finite element modeling and to determine the effect of the neochordal length on the function of the prolapsing MV.…METHODS: The reconstruction of the MV geometry based on the patient-specific data was performed. In order to simulate prolapse, chordae inserted into the middle segment of the posterior leaflet (P2) were ruptured. A total of four virtual transapical repairs using neochordae of different length were performed. The function of the MV before and after virtual repairs was simulated. RESULTS: The evaluation of the effect of the neochordal length on post-repair MV function showed that the length of the implanted neochordae has a significant impact on the correction of MR caused by chordae tendineae rupture. CONCLUSIONS: The presented results can improve the understanding of the effects of transapical MV repair.
Keywords: Mitral valve, prolapse, transapical, neochordae, finite element model
Abstract: BACKGROUND: Upper extremity (UE) motor function deficits are commonly noted in multiple sclerosis (MS) patients and assessing it is challenging because of the lack of consensus regarding its definition. Instrumented biomechanical analysis of upper extremity movements can quantify coordination with different spatiotemporal measures and facilitate disability rating in MS patients. OBJECTIVE: To identify objective quantitative parameters for more accurate evaluation of UE disability and relate it to existing clinical scores. METHODS: Thirty-four MS patients and 24 healthy controls (CG) performed a finger-to-nose test as fast as possible and, in addition, clinical evaluation kinematic…parameters of UE were measured by using inertial sensors. RESULTS: Generally, a higher disability score was associated with an increase of several temporal parameters, like slower task performance. The time taken to touch their nose was longer when the task was fulfilled with eyes closed. Time to peak angular velocity significantly changed in MS patients (EDSS > 5.0). The inter-joint coordination significantly decreases in MS patients (EDSS 3.0–5.5). Spatial parameters indicated that maximal ROM changes were in elbow flexion. CONCLUSIONS: Our findings have revealed that spatiotemporal parameters are related to the UE motor function and MS disability level. Moreover, they facilitate clinical rating by supporting clinical decisions with quantitative data.
Abstract: BACKGROUND: Long sitting causes many health problems for people. Healthy sitting monitoring systems, like real-time pressure distribution measuring, is in high demand and many methods of posture recognition were developed. Such systems are usually expensive and hardly available for the regular user. OBJECTIVE: The aim of study is to develop low cost but sensitive enough pressure sensors and posture monitoring system. METHODS: New self-made pressure sensors have been developed and tested, and prototype of pressure distribution measuring system was designed. RESULTS: Sensors measured at average noise amplitude of a =…56 mV (1.12%), average variation in sequential measurements of the same sensor s = 17 mV (0.34%). Signal variability between sensors averaged at 100 mV (2.0%). Weight to signal dependency graph was measured and hysteresis calculated. Results suggested the use of total sixteen sensors for posture monitoring system with accuracy of < 1.5% after relaxation and repeatability of around 2%. CONCLUSION: Results demonstrate that hand-made sensor sensitivity and repeatability are acceptable for posture monitoring, and it is possible to build low cost pressure distribution measurement system with graphical visualization without expensive equipment or complicated software.
Abstract: BACKGROUND: Weight gain is the most significant change during pregnancy. The lack of consensus among scientists as far as significant spine alterations are concerned requires basic knowledge to be increased. OBJECTIVE: The aim of the paper is to determine changes in spine parameters occurring during pregnancy accompanying the increasing body gain. METHODS: Twelve pregnant women were included in this study. Winspine Pointer, a three-dimensional motion analysis system, was applied for the tests. The output measurements were: pelvic torsion, pelvic obliquity, pelvic/shoulder obliquity, thoracic kyphosis angle, lumbar lordosis angle, and sacral angle. The correlation…between the BMI index and the spine parameters was investigated using Spearman’s correlation coefficient. RESULTS: Differences between women in the 2nd and 3rd trimester of pregnancy were found for thoracic kyphosis angle and lumbar lordosis angle (P < 0.05). A statistically significant relationship was revealed between the BMI and the thoracic kyphosis in the 3rd trimester of pregnancy (R = 0.50, p = 0.005). With the increase of the BMI, the measured parameter also increased. CONCLUSIONS: Understanding the changes in spine parameters during pregnancy is important as far as prevention and treatment are concerned.
Abstract: BACKGROUND: Due to the problem of aging societies, there is a need for smart buildings to monitor and support people with various disabilities, including rheumatoid arthritis. OBJECTIVE: The aim of this paper is to elaborate on novel techniques for wireless motion capture systems for the monitoring and rehabilitation of disabled people for application in smart buildings. METHODS: The proposed techniques are based on cross-verification of distance measurements between markers and transponders in an environment with highly variable parameters. To their verification, algorithms that enable comprehensive investigation of a system with different numbers of…transponders and varying ambient parameters (temperature and noise) were developed. In the estimation of the real positions of markers, various linear and nonlinear filters were used. Several thousand tests were carried out for various system parameters and different marker locations. RESULTS: The results show that localization error may be reduced by as much as 90%. It was observed that repetition of measurements reduces localization error by as much as one order of magnitude. CONCLUSIONS: The proposed system, based on wireless techniques, offers a high commercial potential. However, it requires extensive cooperation between teams, including hardware and software design, system modelling, and architectural design.
Abstract: BACKGROUND: Polydimethylsiloxane (PDMS) is widely used in biomedical research and technology, but its mechanical properties should be tuned according to the desired product specifications. Mixing ratio of base polymer to curing agent or additives enables its mechanical properties to be manipulated and fit to mechanical properties of biological tissues. OBJECTIVE: In this paper, we analysed the effect of mechanical load on silk-reinforced PDMS depending on silk concentration. METHODS: We prepared cylinder-type PDMS samples with different silk concentrations and performed cyclic uniaxial compression tests with a fixed magnitude of applied strain. Next, we analysed…the mechanical charascteristics of PDMS using computational modelling. RESULTS: The stress-strain data within the large-strain region of different PDMS cylinders without silk and with 1%, 5% and 10% silk concentrations was fitted to non-linear second order Mooney-Rivlin, and third-order Ogden models. The results show the equivalence of both models for investigated strain region of PDMS. On the other hand, PDMS cylinders with 10% silk concentration allowed the successful fitting of experimental data just for the second-order Mooney-Rivlin model, while all numerical probes to find an appropriate fitting parameters for third-order Ogden models were unsuccessful. CONCLUSIONS: The second-order Mooney-Rivlin model is preferable for analysing the properties of silk-reinforced PDMS over the entire measurement range.