Technology and Health Care - Volume 30, issue 1

Authors: Lee, SiA | Cha, HyunGyu

Article Type: Research Article

Abstract: BACKGROUND: The ability to manipulate the upper limbs and fingers of stroke patients is very important for independent daily life. Among the latest approaches for upper limb rehabilitation training, transcranial direct current stimulation (tDCS) is a non-invasive stimulation method that stimulates the cranial nerves by attaching electrodes to the scalp. In addition, virtual reality (VR) is an intervention method that provides an environment similar to reality and can help restore function by performing body movements as if playing a game. In addition, VR is an intervention method that provides an environment similar to reality and helps to recover functions …by performing body movements as if playing a game. OBJECTIVE: This study was conducted to investigate the effect of anodal tDCS applied to the ipsilateral primary motor cortex (M1) during VR training on the upper limb function, cognition, and executive function of stroke patients. METHODS: After 20 patients were randomly assigned to the experimental group and the control group, the experimental group received tDCS and VR, and the control group received sham tDCS and VR for 20 minutes a day, 5 days a week, for a total of 4 weeks. Participants were evaluated for upper limb function using Box and Block Test (BBT) and Jebsen-Taylor Hand Function Test (JTHFT), and cognitive and executive function using the Stroop Test (ST) and Trail Making Test (TMT). RESULTS: In the experimental group, significant differences were found in the pre- and post-test for the all variance (p < 0.05). Control group is significant differences were found in the pre- and post-test for BBT, ST, TMT (p < 0.05). There were significant differences between the two groups in the post test of BBT and ST (p < 0.05). CONCLUSION: The results of this study suggest that anodal tDCS applied to the ipsilateral M1 during VR training is effective for upper limb function, cognitive function, and executive function in stroke patients. Show more

Keywords: Stroke, transcranial direct current stimulation, virtual reality, cognition, executive function, upper limb function

DOI: 10.3233/THC-212991

Citation: Technology and Health Care, vol. 30, no. 1, pp. 117-127, 2022

Authors: Lu, Hongchun | Tian, Shengwei | Yu, Long | Xing, Yan | Cheng, Junlong | Liu, Lu

Article Type: Research Article

Abstract: BACKGROUND: The automatic segmentation of medical images is an important task in clinical applications. However, due to the complexity of the background of the organs, the unclear boundary, and the variable size of different organs, some of the features are lost during network learning, and the segmentation accuracy is low. OBJECTIVE: To address these issues, this prompted us to study whether it is possible to better preserve the deep feature information of the image and solve the problem of low segmentation caused by unclear image boundaries. METHODS: In this study, we (1) build …a reliable deep learning network framework, named BGRANet,to improve the segmentation performance for medical images; (2) propose a packet rotation convolutional fusion encoder network to extract features; (3) build a boundary enhanced guided packet rotation dual attention decoder network, which is used to enhance the boundary of the segmentation map and effectively fuse more prior information; and (4) propose a multi-resolution fusion module to generate high-resolution feature maps. We demonstrate the effffectiveness of the proposed method on two publicly available datasets. RESULTS: BGRANet has been trained and tested on the prepared dataset and the experimental results show that our proposed model has better segmentation performance. For 4 class classifification (CHAOS dataset), the average dice similarity coeffiffifficient reached 91.73%. For 2 class classifification (Herlev dataset), the prediction, sensitivity, specifificity, accuracy, and Dice reached 93.75%, 94.30%, 98.19%, 97.43%, and 98.08% respectively. The experimental results show that BGRANet can improve the segmentation effffect for medical images. CONCLUSION: We propose a boundary-enhanced guided packet rotation dual attention decoder network. It achieved high segmentation accuracy with a reduced parameter number. Show more

Keywords: Medical image segmentation, packet rotation convolution, dual attention mechanism, boundary enhancement, convolutional neural network

DOI: 10.3233/THC-202789

Citation: Technology and Health Care, vol. 30, no. 1, pp. 129-143, 2022

Authors: Tripathi, Sumit | Sharma, Neeraj

Article Type: Research Article

Abstract: BACKGROUND: The noise in magnetic resonance (MR) images causes severe issues for medical diagnosis purposes. OBJECTIVE: In this paper, we propose a discriminative learning based convolutional neural network denoiser to denoise the MR image data contaminated with noise. METHODS: The proposed method incorporates the use of depthwise separable convolution along with local response normalization with modified hyperparameters and internal skip connections to denoise the contaminated MR images. Moreover, the addition of parametric RELU instead of normal conventional RELU in our proposed architecture gives more stable and fine results. The denoised images were further …segmented to test the appropriateness of the results. The network is trained on one dataset and tested on other dataset produces remarkably good results. RESULTS: Our proposed network was used to denoise the images of different noise levels, and it yields better performance as compared with various networks. The SSIM and PSNR showed an average improvement of (7.2 ± 0.002) % and (8.5 ± 0.25) % respectively when tested on different datasets without retaining the network. An improvement of 5% and 6% was achieved in the values of mean intersection over union (mIoU) and BF score when the denoised images were segmented for testing the relevancy in biomedical imaging applications. The statistical test suggests that the obtained results are statistically significant as p < 0.05. CONCLUSION: The denoised images obtained are more clinically suitable for medical image diagnosis purposes, as depicted by the evaluation parameters. Further, external clinical validation was performed by an experienced radiologist for testing the validation of the resulting images. Show more

Keywords: Deep learning, image denoising, depthwise separable convolution, local response normalization, skip connections, convolutional neural network

DOI: 10.3233/THC-212882

Citation: Technology and Health Care, vol. 30, no. 1, pp. 145-160, 2022

Authors: Alfouzan, Afnan F. | Alotiabi, Hadeel M. | Labban, Nawaf | Al-Otaibi, Hanan N. | Al Taweel, Sara Mohammad | AlShehri, Huda A.

Article Type: Research Article

Abstract: BACKGROUND: The use of 3D printed material in the dental field is gaining tremendous attention. However, studies related to 3D printed denture resins are scarce and need consideration before their inclusion in routine clinical practice. OBJECTIVE: This study aimed to assess the surface roughness (Ra) of 3D printed denture resins following aging and mechanical brushing. METHODS: Forty round samples (diameter, 10 mm and thickness, 3 mm) were fabricated from two 3D printed (DentaBASE and Denture 3D+) and one conventional polymethylmethacrylate (PMMA) denture materials. The samples were thermo-cycled, subjected to mechanical brushing, and later …immersed in either artificial saliva (AS), coffee, cola, or lemon juice (n = 10) to simulate one and two years of oral use. Surface roughness (Ra) was determined using a non-contact profilometer and scanning electron microscope was used for qualitative analysis. The data was analyzed using SPSS v.20 (α = 0.05). RESULTS: Denture 3D+ demonstrated highest mean Ra (1.15 ± 0.28 μ m), followed by PMMA (0.99 ± 0.50 μ m) and DentaBASE (0.81 ± 24). The difference in mean Ra between the materials was statistically non-significant (P = 0.08). Amongst the different beverages used, the highest Ra was observed for samples immersed in lemon juice (1.06 ± 0.40 μ m) followed by cola (1.04 ± 0.46 μ m) and coffee (0.98 ± 0.40 μ m), respectively. The lowest Ra was observed for samples immersed in AS (0.85 ± 0.24 μ m). CONCLUSION: The surface roughness of 3D printed denture resins was comparable with that of conventional PMMA resins. Denture 3D+ demonstrated the highest mean roughness, followed by PMMA and DentaBASE. Show more

Keywords: 3D printed dentures, bacterial adherence, mechanical brushing, staining, surface topography

DOI: 10.3233/THC-212974

Citation: Technology and Health Care, vol. 30, no. 1, pp. 161-173, 2022

Authors: Griškevičius, Julius

Article Type: Editorial

DOI: 10.3233/THC-219000

Citation: Technology and Health Care, vol. 30, no. 1, pp. 175-176, 2022

Authors: Saffert, Anne-Sophie | Melzner, Maximilian | Dendorfer, Sebastian

Article Type: Research Article

Abstract: BACKGROUND: Many statistics reveal that violin players suffer most often from musculoskeletal disorders compared to musicians of other instrument groups. A common phenomenon, especially observed in violin beginners, is the tendency to elevate the right shoulder during playing the violin. This can probably lead to serious disorders in long-term practice with repetitive movements. OBJECTIVE: For this reason, this study investigated the relationship between the right shoulder elevation and the force in the right glenohumeral joint during violin playing. It was hypothesized that the forces in the right glenohumeral joint are higher during playing with the right …shoulder raised compared to playing in normal posture. METHODS: Motion capture data from four experienced violinists was recorded and processed by means of musculoskeletal simulation to get the force and elevation angle while playing with raised shoulder and in normal position. RESULTS: The results indicate that the absolute values of the resulting force, as well as the forces in the mediolateral, inferosuperior, and anteroposterior directions, are higher in playing the violin with the shoulder raised than in a normal posture. CONCLUSIONS: Elevating the right shoulder while playing the violin may pose a potential problem. Show more

Keywords: Biomechanics, violin, shoulder elevation, shoulder joint force, musculoskeletal disease

DOI: 10.3233/THC-219001

Citation: Technology and Health Care, vol. 30, no. 1, pp. 177-186, 2022

Authors: Petuchova, Aleksandra | Maknickas, Algirdas

Article Type: Research Article

Abstract: BACKGROUND: The usefulness of numerical modelling of a patient’s cardiovascular system is growing in clinical treatment. Understanding blood flow mechanics can be crucial in identifying connections between haemodynamic factors and aortic wall pathologies. OBJECTIVE: This work investigates the haemodynamic parameters of an ascending aorta and ascending aortic aneurysm in humans. METHODS: Two aortic models were constructed from medical images using the SimVascular software. FEM blood flow modelling of cardiac cycle was performed using CFD and CMM-FSI at different vascular wall parameters. RESULTS: The results showed that highest blood velocity was …1.18 m/s in aorta with the aneurysm and 1.9 m/s in healthy aorta model. The largest displacements ware in the aorta with the aneurysm (0.73 mm). In the aorta with the aneurysm, time averaged WSS values throughout the artery range from 0 Pa to 1 Pa. In the healthy aorta, distribution of WSS values changes from 0.3 Pa to 0.6 Pa. CONCLUSIONS: In the case of an ascending aortic aneurysm, the maximum blood velocity was found to be 1.6 times lower than in the healthy aorta. The aneurysm-based model demonstrates a 45% greater wall displacement, while the oscillatory shear index decreased by 30% compared to healthy aortic results. Show more

Keywords: Ascending aortic aneurysm, blood flow, computational fluid dynamics (CFD), finite element method (FEM), SimVascular

DOI: 10.3233/THC-219002

Citation: Technology and Health Care, vol. 30, no. 1, pp. 187-200, 2022

Authors: Lukšys, Donatas | Griškevičius, Julius

Article Type: Research Article

Abstract: BACKGROUND: Gait can be affected by diseases such as Parkinson’s disease (PD), which lead to alterations like shuffle gait or loss of balance. PD diagnosis is based on subjective measures to generate a score using the Unified Parkinson’s Disease Rating Scale (UPDRS). To improve clinical assessment accuracy, gait analysis can utilise linear and nonlinear methods. A nonlinear method called the Lyapunov exponent (LE) is being used to identify chaos in dynamic systems. This article presents an application of LE for diagnosing PD. OBJECTIVE: The objectives were to use the largest Lyapunov exponents (LaLyEx), sample entropy (SampEn) …and root mean square (RMS) to assess the gait of subjects diagnosed with PD; to verify the applicability of these parameters to distinguish between people with PD and healthy controls (CO); and to differentiate subjects within the PD group according to the UPDRS assessment. METHODS: The subjects were divided into the CO group (n = 12) and the PD group (n = 14). The PD group was also divided according to the UPDRS score: UPDRS 0 (n = 7) and UPDRS 1 (n = 7). Kinematic data of lower limbs were measured using inertial measurement units (IMU) and nonlinear parameters (LaLyEx, SampEn and RMS) were calculated. RESULTS: There were significant differences between the CO and PD groups for RMS, SampEn and the LaLyEx. After dividing the PD group according to the UPDRS score, there were significant differences in LaLyEx and RMS. CONCLUSIONS: The selected parameters can be used to distinguish people with PD from CO subjects, and separate people with PD according to the UPDRS score. Show more

Keywords: Gait, IMU, Parkinson disease, nonlinear analysis

DOI: 10.3233/THC-219003

Citation: Technology and Health Care, vol. 30, no. 1, pp. 201-208, 2022

Authors: Pauk, Jolanta | Trinkunas, Justas | Puronaite, Roma | Ihnatouski, Mikhail | Wasilewska, Agnieszka

Article Type: Research Article

Abstract: BACKGROUND: The traditional rheumatoid arthritis (RA) diagnosis is very complicated because it uses many clinical and image data. Therefore, there is a need to develop a new method for diagnosing RA using a consolidated set of blood analysis and thermography data. OBJECTIVE: The following issues related to RA are discussed: 1) Which clinical data are significant in the primary diagnosis of RA? 2) What parameters from thermograms should be used to differentiate patients with RA from the healthy? 3) Can artificial neural networks (ANN) differentiate patients with RA from the healthy? METHODS: The …dataset was composed of clinical and thermal data from 65 randomly selected patients with RA and 104 healthy subjects. Firstly, the univariate logistic regression model was proposed in order to find significant predictors. Next, the feedforward neural network model was used. The dataset was divided into the training set (75% of data) and the test set (25% of data). The Broyden-Fletcher-Goldfarb-Shanno (BFGS) and non-linear logistic function to transformation nodes in the output layer were used for training. Finally, the 10 fold Cross-Validation was used to assess the predictive performance of the ANN model and to judge how it performs. RESULT: The training set consisted of the temperature of all fingers, patient age, BMI, erythrocyte sedimentation rate, C-reactive protein and White Blood Cells (10 parameters in total). High level of sensitivity and specificity was obtained at 81.25% and 100%, respectively. The accuracy was 92.86%. CONCLUSIONS: This methodology suggests that the thermography data can be considered in addition to the currently available tools for screening, diagnosis, monitoring of disease progression. Show more

Keywords: Rheumatoid arthritis, inflammation, neural networks thermography

DOI: 10.3233/THC-219004

Citation: Technology and Health Care, vol. 30, no. 1, pp. 209-216, 2022

Authors: Vevere, Adelina | Oks, Alexander | Katashev, Alexei | Terlecka, Galina | Saiva, Laima | Jansons, Mareks | Dyachenko, Natalya | Seglina, Patricija

Article Type: Research Article

Abstract: BACKGROUND: The manner in which shooters pull the trigger may significantly affect the shooter’s results. Shooting coaches are often not able to detect incorrect pull because of gun movement during the shot and recoil. OBJECTIVE: Development of the smart-textile based trigger pull monitoring system and demonstration of its ability to distinguish correct and wrong triggering techniques. METHODS: Two separated knitted resistive pressure sensors were integrated over III and II phalanges in the index finger fingerstall; single sensor was integrated over both III and II phalanges of the middle finger fingerstall. Resistance of the …sensors was measured in a course of shots, performed by expert shooter, which simulated typical novice’s trigger pull errors. RESULTS: Sensors’ resistance recordings were made for following erroneous trigger pull motions: pulling of the trigger with index finger’s II phalanx instead of III; fast and jerky trigger pull (trigger tear-off); too fast release of the trigger after shot; and excessive grip force, applied by middle finger. For each type of erroneous movement, recordings waveforms included distinguishable features that characterised a particular type of error. CONCLUSIONS: The developed trigger pull monitoring system provides signals that could be used for recognition of the incorrect trigger pull motions during gun shots. Show more

Keywords: Motion capture, smart textile, shooting, shot triggering, finger pressure

DOI: 10.3233/THC-219005

Citation: Technology and Health Care, vol. 30, no. 1, pp. 217-229, 2022

Authors: Bliudzius, Antanas | Puronaite, Roma | Trinkunas, Justas | Jakaitiene, Audrone | Kasiulevicius, Vytautas

Article Type: Research Article

Abstract: BACKGROUND: Monitoring physical activity with consumers wearables is one of the possibilities to control a patient’s self-care and adherence to recommendations. However, clinically approved methods, software, and data analysis technologies to collect data and make it suitable for practical use for patient care are still lacking. OBJECTIVE: This study aimed to analyze the potential of patient physical activity monitoring using Fitbit physical activity trackers and find solutions for possible implementation in the health care routine. METHODS: Thirty patients with impaired fasting glycemia were randomly selected and participated for 6 months. Physical activity variability …was evaluated and parameters were calculated using data from Fitbit Inspire devices. RESULTS: Changes in parameters were found and correlation between clinical data (HbA1c, lipids) and physical activity variability were assessed. Better correlation with variability than with body composition changes shows the potential to include nonlinear variability parameters analysing physical activity using mobile devices. Less expressed variability shows better relationship with control of prediabetic and lipid parameters. CONCLUSIONS: Evaluation of physical activity variability is essential for patient health, and these methods used to calculate it is an effective way to analyze big data from wearable devices in future trials. Show more

Keywords: Fitbit, Poincaré plot, variability, physical activity monitoring, pre-diabetes

DOI: 10.3233/THC-219006

Citation: Technology and Health Care, vol. 30, no. 1, pp. 231-242, 2022

Authors: Aleknaite-Dambrauskiene, Ieva | Domeika, Aurelijus | Zvironas, Arunas

Article Type: Research Article

Abstract: BACKGROUND: Balance control is a leading component of human motor activities and its impairment is associated with an increased risk of falling, lower back pain due to impaired motor control mechanism. Prolonged sitting position at workplace is one of the risk factors of reduced postural control and lower back pain. OBJECTIVE: To evaluate theta and alpha waves cortical activity, trunk muscles activity and kinematics in static sitting, dynamic sitting on different platforms: simple wobble board (WB) and wobble board on bearing surface (WBB). METHODS: The kinematics of body segments, electromyography of five trunk …muscles, electroencephalography of 32 scalp electrodes were measured during balance tasks in sitting position for 17 subjects with continuous seated position at workplace. RESULTS: Cortical power on WBB1 increase in fronto – central (p < 0.05) region while on WBB2 increase in centro – parietal region (p < 0.05). WBB2 increase more muscles compared with WB2. The amplitude of movement of ASIS, Th10 can be seen lower on WBB compared with WB (p < 0.05). CONCLUSIONS: The study shows that WBB can increase personalized sitting and improve trunk motor control during hours of prolonged sitting. Show more

Keywords: Electromyography, electroencephalography, occupational sitting, trunk control, wobble board

DOI: 10.3233/THC-219007

Citation: Technology and Health Care, vol. 30, no. 1, pp. 243-255, 2022

Authors: Zdrodowska, Małgorzata | Dardzińska-Głȩbocka, Agnieszka

Article Type: Research Article

Abstract: BACKGROUND: Disability, especially in children, is a very important and current problem. Lack of proper diagnosis and care increases the difficulty for children to adapt to disabilities. Disabled children have many problems with basic activities of daily living. Therefore, it is very important to support diagnosticians and physiotherapists in recognizing self-care problems in children. OBJECTIVE: The aim of this paper is to extract classification and action rules, useful for those who work with children with disabilities. METHODS: First, features and their impact on the accuracy of classification are determined. Then, two models are …built: one with all features and one with selected ones. For these models the classification rules are extracted. Finally, action rules are mined and the next step in treatment process is predicted. RESULTS: Seventeen features with the greatest impact on classifying a child into a particular group of self-care problems were identified. Based on the implemented algorithms, decision and action rules were obtained. CONCLUSIONS: The obtained model, selected attributes and extracted classification and action rules can support the work of therapists and direct their work to those areas of disability where even a minimal reduction of features would be of great benefit to the children. Show more

Keywords: Disability, ICF-CY, self-care problem, classification rules, action rules, feature selection, classification, data mining

DOI: 10.3233/THC-219008

Citation: Technology and Health Care, vol. 30, no. 1, pp. 257-269, 2022

Authors: Ziziene, Jurgita | Daunoraviciene, Kristina | Juskeniene, Giedre | Pauk, Jolanta

Article Type: Case Report

Abstract: BACKGROUND: In children with spastic cerebral palsy (CP), the most common motor dysfunction is pathological gait. OBJECTIVE: To evaluate the effectiveness of measures for an individual CP case. METHODS: The case of one spastic diplegia child has been analyzed. Both lower extremities and spine were examined under three gait conditions: 1) barefoot, 2) with ankle-foot orthoses (AFOs) and thoracolumbosacral spinal orthosis (TLSO), and 3) with TLSO only. Spatiotemporal gait and kinematic parameters of the pelvic, hip, knee, ankle joints, and spine were obtained using Vicon Plug-in-Gait model. The difference (Δ ) between …the measured values and normative ranges was calculated to determine the efficiency of the orthoses. RESULTS: Significant differences were found in kinematic and spatiotemporal parameters comparing results between conditions and body sides. The effectiveness of the measures was confirmed by the smallest Δ values in the double and single support time with the AFOs/TLSO and in the stride and stance time with TLSO. CONCLUSIONS: Based on the study results, the best stability of the spine, ankle plantarflexion, and knee hyperextension is achieved with the AFOs/TLSO; therefore, this combination of measures was considered the most effective. However, not only quantitative parameters should be taken into account, but also the child’s willingness and comfort. Show more

Keywords: Cerebral palsy, spastic diplegia, children’s gait, kinematics, ankle-foot orthosis, thoracolumbar spinal orthosis, effectiveness

DOI: 10.3233/THC-219009

Citation: Technology and Health Care, vol. 30, no. 1, pp. 271-281, 2022

Authors: Stelzer, Vera | Krenkel, Lars

Article Type: Research Article

Abstract: BACKGROUND: Due to their corrugated profile, dragonfly wings have special aerodynamic characteristics during flying and gliding. OBJECTIVE: The aim of this study was to create a realistic 3D model of a dragonfly wing captured with a high-resolution micro-CT. To represent geometry changes in span and chord length and their aerodynamic effects, numerical investigations are carried out at different wing positions. METHODS: The forewing of a Camacinia gigantea was captured using a micro-CT. After the wing was adapted an error-free 3D model resulted. The wing was cut every 5 mm and 2D numerical analyses …were conducted in Fluent ® 2020 R2 (ANSYS, Inc., Canonsburg, PA, USA). RESULTS: The highest lift coefficient, as well as the highest lift-to-drag ratio, resulted at 0 mm and an angle of attack (AOA) of 5 ∘ . At AOAs of 10 ∘ or 15 ∘ , the flow around the wing stalled and a Kármán vortex street behind the wing becomes visible. CONCLUSIONS: The velocity is higher on the upper side of the wing compared to the lower side. The pressure acts vice versa. Due to the recirculation zones that are formed in valleys of the corrugation pattern the wing resembles the form of an airfoil. Show more

Keywords: Dragonfly wing, gliding flight, insect flight, computational fluid dynamics, aerodynamics

DOI: 10.3233/THC-219010

Citation: Technology and Health Care, vol. 30, no. 1, pp. 283-289, 2022

Authors: Gudziunas, Vaidotas | Domeika, Aurelijus | Puodžiukynas, Linas | Gustiene, Renata

Article Type: Research Article

Abstract: BACKGROUND: Balance training on unstable surfaces is widely used in medicine and sports. The main disadvantage of balance platforms is weakly definable assessment of the level of instability (IL) they create. OBJECTIVE: To evaluate the mechanical characteristics of a suspended single-plane instability balance platform which determines quantitative instability characteristics. METHODS: Three criteria influencing the IL were evaluated: 1. The displacement of the platform board by changing the position of the object on the board; 2. Amount of force required for board displacement; 3. The vibration damping of the platform. RESULTS: …1. 1IL the displacement of the object on the board affected 0.66 cm. the displacement of the board relative to the platform frame; 2IL – 0.79 cm; 3IL – 0.91 cm.; 2. A force of 2.64 is required for a board displacement of 1IL compared to 2IL and 5.76 times that of 3IL. 3. Damping factor 1IL – 0.015, 2IL – 0.006, 3IL – 0.003. CONCLUSIONS: 1. The longer the suspension, the change in the position of the object on the board affects the greater movement of the board relative to the platform. 2. Different IL can be compared with each other depending on how different the force required to cause the board to move. 3. The platform dampens vibrations weakly, but the damping between 1 and 3 IL differs about 5 times. Show more

Keywords: Balance assessment, suspended single-plane instability balance platform, level of instability

DOI: 10.3233/THC-219011

Citation: Technology and Health Care, vol. 30, no. 1, pp. 291-307, 2022