El protocolo sigue las directrices del Comité Local humana Ética en Zurich (Zurich KEK). 1. Instalación del hardware (Figura 1) <ol><li> Utilice dos de 10 m conjuntos de barras basado piso-y los colocan paralelos entre sí (y con la línea de progresión) para crear un pasillo con una distancia entre conjunto de aproximadamente 1 m. NOTA: Esta distancia se puede aumentar hasta 8 m. Cada barra tiene una longitud de 1 m y se compone de 96 diodos. </li><li> Hacer una distinción entre transmisora ​​de luz (T) y receptores de luz (R) unidades para la instalación de las barras colocando el transmisor de la luz (T) unidades en el lado derecho y el receptor de luz (R) unidades a la izquierda lado con respecto a la dirección de caminar. NOTA: Los primeros compases metros (tanto T y R) tienen tambores de plata. Las barras de T y R dispuestas en el restante 9 m son todos iguales e intercambiables. </li><li> Conecte todos los barrotes de una fila con las tapas (inalámbrica). Utilice 2 powesuministros r: una para cada conjunto de barras (T y R). </li><li> Conecte el primer bar R a la computadora portátil mediante un cable USB. </li><li> Coloque la cámara al lado de la primera barra de verificaciones fuera de línea (por ejemplo, el pie de partida), y conectarlo a la computadora portátil mediante un cable USB. </li><li> Ponga una marca de 2 m antes y después de que el comienzo y el final de la pista. </li><li> Encienda el dispositivo fotoeléctrico utilizando el interruptor de encendido y apagado de la primera R y T bar. </li><li> Compruebe que los indicadores LED de control situados en todos los bares R son de color verde. NOTA: Si es así, el sistema está colocado correctamente y puede iniciar la prueba; Sin embargo, si uno o más de los LEDs de control son de color rojo el sistema no se coloca y / o conectada correctamente. Controla todas las tapas comprobando que están completamente hecho clic en su lugar y luego apague el sistema y vuelva a encenderlo. </li></ol><img alt="Figura 1" src="/files/ftp_upload/51878/51878fig1.jpg" /> Figura 1. El photoelectric sistema consiste en transmisora ​​de luz (T) y de recepción de luz (R) unidades que se colocan en paralelo entre sí con una distancia de aproximadamente 1 m. La cámara está instalada cerca de la zona de salida para fines de control. El portátil está conectado con cables USB a la primera barra y R a la cámara. <a href="https://www.jove.com/files/ftp_upload/51878/51878fig1highres.jpg" target="_blank">Por favor, haga clic aquí para ver una versión más grande de esta cifra.</a> 2. Software de instalación y preparación de una prueba <ol><li> Cargue el software que opera el sistema fotoeléctrico de www.optogait.com/Support/Downloads. Nota: Este protocolo se describe mediante el uso de la versión 1.8.1. </li><li> Si el software se utiliza por primera vez para el análisis de la marcha crear una nueva prueba de la siguiente manera (de lo contrario vaya al paso 2.3): <ol><li> Seleccione Prueba continuación, haga clic en Definir / Modificar pruebas. Ahora haga clic en la prueba de la marcha y luego seleccione la prueba Duplicar.Haga clic en Confirmar en la ventana emergente para que se duplica la prueba. </li><li> Doble click en la prueba duplicada para modificar el nombre (por ejemplo, la prueba de la marcha 10 bares) y seleccione 10 para el número de barras. Utilice los parámetros estándar para la prueba de la marcha, que se presenta en la Figura 2. Por último, seleccione Guardar para guardar todas las modificaciones. </li></ol></li><li> Añadir un nuevo paciente a la base de datos. Seleccione pacientes, haga clic en Insertar / Modificar paciente, y luego haga clic en Nuevo paciente para introducir los datos. A continuación, guarde los datos. </li></ol><img alt="Figura 2" src="/files/ftp_upload/51878/51878fig2.jpg" /> Figura 2. Configuración estándar para una prueba de la marcha con 10 barras, como se describe en el presente protocolo. Estos ajustes tienen que ser definido cuando se utiliza el sistema fotoeléctrico por primera vez. En este protocolo el pie de salida no está definido.El sistema comienza a medir cuando el paciente entra en el área de grabación y se detiene la medición cuando el paciente sale de las unidades de medida. <a href="https://www.jove.com/files/ftp_upload/51878/51878fig2highres.jpg" target="_blank">Por favor, haga clic aquí para ver una versión más grande de esta cifra.</a> 3. Procedimientos de prueba <ol><li> Siempre dar las mismas instrucciones para el paciente 13. <ol><li> Instruir al paciente a caminar con zapatos de suela plana a lo largo de la pasarela de 10 metros en dos velocidades distintas: normal (&quot;caminar a un ritmo que sea cómodo para usted&quot;), y más rápido de lo normal (&quot;caminar a un ritmo que es más rápido que que normalmente caminar &quot;). </li><li> Pida al paciente que mire hacia el frente durante los ensayos para caminar. </li><li> Pida al paciente para iniciar el primer paso con el mismo pie de estandarizar mejor las condiciones de la prueba. </li><li> Pida al paciente que empezar a caminar 2 m antes de la primera barra fotoeléctrico y concluir cada trIAL 2 m después de la última barra con el fin de mantener la velocidad de la marcha constante 13. </li></ol></li><li> Demostrar un ensayo a velocidad normal a la paciente. </li><li> Solicitar el paciente para llevar a cabo tres ensayos de familiarización seguido de un ensayo experimental en cada velocidad. Siempre ensayos de velocidad normales completos primero. </li><li> Para prepararse con el software, haga clic en Test y luego en Ejecutar para iniciar las mediciones con la prueba creada. <ol><li> Seleccione el paciente haciendo clic en Seleccionar, elegir el paciente y luego hacer clic en Confirmar. </li><li> Seleccione la prueba, haga clic en Seleccionar y, a la elección de la prueba, por ejemplo, la prueba de la marcha de 10 bares. Compruebe que sólo se selecciona esta prueba para la medición. </li><li> Coloque la cámara para que pueda grabar todo el paseo. Cambie la posición de la cámara, mientras que el control de la imagen en vivo en la pantalla de su computadora portátil. </li><li> Por último, haga clic en Ejecutarde nuevo. NOTA: Ahora el software está listo para medir. Tan pronto como el paciente entra en los bares, el sistema comienza a medir y una ventana pop-up aparece preguntando por el pie de salida. </li></ol></li><li> Haga clic en el pie adecuado para que se calculan correctamente los parámetros de la marcha. NOTA: La cámara graba automáticamente una vez que se inicia la prueba. </li><li> Guarde la prueba. </li></ol> Análisis 4. Datos <ol><li> Haga clic en Resultados para ver los ensayos completos. Luego haga clic en la flecha situada junto a la prueba de interés para transferir la prueba de la lista de pruebas a la sección de análisis de prueba. Ahora haga clic en Ver para mostrar la prueba seleccionada. Consulte la sección Resultados de todas las pruebas realizadas en este estudio. NOTA: Una ventana con todos los datos de prueba (Figura 3). En el lado izquierdo de la ventana hay algunos botones de comando para activar diversas funciones. La otra parte de la ventana presenta 4 types de información con respecto a la prueba actual. Cada conjunto de información se puede mostrar / ocultar utilizando los comandos de configuración. De arriba a abajo los artículos son los siguientes: vídeo, gráficos que muestran los resultados, tabla con datos numéricos, y bares fotoeléctricos. </li><li> Haga clic en los datos de la marcha para mostrar un informe de la marcha (Figura 3). </li><li> Haga clic en Imprimir (aparece una ventana con el informe) para imprimir el informe. NOTA: El informe se puede imprimir, ya que es o puede ser modificado. Para los distintos parámetros espacio-temporales, los siguientes resultados se presentan en el informe: valores medios ± desviación estándar (SD) del lado izquierdo y derecho, coeficientes de variación (CV) que expresa la marcha Variabilidad 14,15, y diferencia porcentual entre la izquierda y el lado derecho (asimetría). <ol><li> Si es necesario, modifique el informe de la siguiente manera: abrir el informe como se describió anteriormente (paso 4.3). Haga clic en los botones Mostrar u ocultar en la sid izquierdacorreo de la pantalla para adaptar los datos y gráficos presentados en el informe. </li><li> Para cambiar el logotipo y / o el pie de página en el informe, haga clic en el botón correspondiente (Cambiar logo o cambiar el pie de página) para modificar estos parámetros. </li></ol></li><li> Para comparar dos o más pruebas realizadas en diferentes ocasiones, por ejemplo, antes y después de una intervención, seleccione las diferentes pruebas en la sección de resultados, haga clic en la flecha que aparece junto a las pruebas y, a continuación, haga clic en el botón Comparar. Se muestra un informe con la comparación directa de todos los parámetros de las diferentes pruebas: NOTA. </li></ol><img alt="Figura 3" src="/files/ftp_upload/51878/51878fig3.jpg" /> Figura 3. Captura de pantalla de todos los datos de prueba. Los botones de comando aparecen en la parte izquierda de la ventana (por ejemplo, haciendo clic en Imprimir se genera un informe, que puede ser modificado con el tiempo). El otroparte de la ventana presenta la siguiente información con respecto a la prueba actual, de arriba a abajo: vídeo, gráficos de la visualización de los resultados, tabla con datos numéricos, y bares fotoeléctricos. Estos datos se pueden mostrar / oculta usando el botón Configurar en la parte derecha. El punto de vista real de los datos se puede cambiar haciendo clic en los datos de la marcha o informe de la marcha, respectivamente. <a href="https://www.jove.com/files/ftp_upload/51878/51878fig3highres.jpg" target="_blank">Por favor, haga clic aquí para ver una versión más grande de esta cifra.</a>

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Los autores no tienen nada que revelar.

El protocolo que aquí se presenta se puede utilizar para evaluar los parámetros espaciales y temporales de la marcha de los pacientes (ortopédica, neurológica, cardiorrespiratorios, etc.) y los adultos mayores sanos con un sistema fotoeléctrico introducido recientemente. La longitud total y el ancho del sistema pueden ser moduladas en función del espacio y el presupuesto disponible. El costo estimado (en Europa) es de aproximadamente 2.800 dólares por metro para un sistema de 10 metros y la longitud mínima recom...

Caminar es una de las actividades físicas más importantes en la vida cotidiana, y es un determinante principal de la calidad de vida de las poblaciones de edad avanzada y los pacientes que pueden cursar con alteraciones de la marcha. Evaluación clínica de la función de la marcha tanto, es importante para revelar posibles alteraciones inducidas por el envejecimiento y / o patologías neurológicas / ortopédicas, sino también para demostrar los beneficios funcionales de un tratamiento. Diferentes instrumentos han sido desarrollados para la evaluación cuantitativa de los parámetros de la marcha, por ejemplo, placas de fuerza, análisis de movimiento en 3D basado en video, acelerómetros cuerpo montado en 10,11, y instrumentada esteras transportadoras o cintas de correr 12. Sin embargo, estos sistemas se utilizan principalmente para estudios de investigación y no para fines clínicos, ya que son complejos de manejar, tener una baja accesibilidad, y sensores frágiles. Un sistema fotoeléctrico basada piso ha sido recientemente introducido, que es capaz de proporcionar una cal válidaculación de características temporales y 1D coordenadas espaciales de pasos para caminar. Este instrumento de medición tiene varias ventajas en comparación con los sistemas pre-existentes: es fácil de manejar, se recogen datos muy rápidamente, es simple para crear un informe detallado y es un sistema modular que significa que la longitud del sistema se puede cambiar . Por lo tanto, se puede utilizar con confianza para medir dentro de los grupos los cambios en las evaluaciones longitudinales y diferencias entre los grupos en las comparaciones transversales. Los objetivos del protocolo descrito son para centrarse en el equipo y su instalación, y para describir de manera objetiva y sin rodeos a los procedimientos de evaluación para la evaluación de los parámetros espacio-temporales de la marcha en la población de edad avanzada y los pacientes.

<table border="0" cellpadding="0" cellspacing="0" width="846">
	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:325px;">Name of Equipment</td>
			<td style="width:169px;">Company</td>
			<td style="width:119px;">Catalog Number</td>
			<td style="width:233px;">Comments/Description</td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:325px;">-Optogait system (10 meters)</td>
			<td style="width:169px;">Microgate, Bolzano, Italy</td>
			<td style="width:119px;"></td>
			<td><a href="http://www.optogait.com/">www.optogait.com</a></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:325px;">-Optogait software</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td>www.optogait.com/Support/Downloads</td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:325px;">-Laptop</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:325px;"></td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:325px;">The Optogait system contains the following equipment:</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:325px;">-10 light-transmitting (T) bars (1 as a first meter)</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:325px;">-10 light-receiving (R) bars (1 as a first meter)</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="63">
			<td height="63" style="height:63px;width:325px;">-18 caps to connect the bars within a set (9 for T and 9 for R bars) and 2 special caps for the last T and R bar</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:325px;">-1 camera with its tripod</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:22px;width:325px;">-1 cable for connecting the Optogait to the laptop</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="42">
			<td height="42" style="height:42px;width:325px;">-1 cable for connecting the camera to the laptop</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:325px;">-2 power supplies (one for each set of bars)</td>
			<td style="width:169px;"></td>
			<td style="width:119px;"></td>
			<td></td>
		</tr>
	</tbody>
</table>

clinical assessment of spatiotemporal gait parameters in patients and older adults

Las características espaciales y temporales de la marcha humana son evaluados con frecuencia para identificar las posibles deficiencias de la marcha, principalmente en pacientes ortopédicos y neurológicos 1-4, sino también en los adultos sanos mayores de 5,6. El análisis de la marcha cuantitativo descrito en este protocolo se realiza con un sistema fotoeléctrico introducido recientemente (ver tabla Materiales), que tiene el potencial para ser utilizado en la clínica, ya que es portátil, fácil de configurar (no se requiere preparación sujeto antes de una prueba ), y no requiere mantenimiento y calibración del sensor. El sistema fotoeléctrico consiste en una serie de células fotoeléctricas basadas suelo de alta densidad con diodos emisores de luz y receptores de luz que se colocan en paralelo entre sí para crear un pasillo, y se orientan perpendicular a la línea de progresión 7. El sistema simplemente detecta las interrupciones en la señal de la luz, por ejemplo debido a la presencia de los pies dentro del área de grabación. Temporalparámetros de la marcha y 1D coordenadas espaciales de pasos consecutivos se calculan posteriormente para proporcionar parámetros de la marcha comunes tales como la longitud del paso, ayuda sola extremidad y la velocidad de caminar 8, cuya validez contra un instrumento criterio ha sido demostrado recientemente 7,9. Los procedimientos de medición son muy sencillas; un solo paciente puede ser probado en menos de 5 min y un informe completo se puede generar en menos de 1 min.

Un estudio reciente demostró la validez del sistema fotoeléctrico contra un instrumento criterio (una pasarela electrónica validado) para la evaluación de los parámetros espacio-temporales de la marcha en pacientes ortopédicos y controles sanos de edad avanzada 7. Las mismas diferencias entre los grupos en las variables de la marcha fueron detectados por los dos sistemas. A pesar de la validez concurrente fue excelente, con coeficientes de correlación intraclase que oscilan entre los 0,933 y 0,999 (p &...

Watch this Scientific Journal Video about Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults at JoVE.com

Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults

This protocol is used to evaluate spatial and temporal gait variables of neurological/orthopedic patients and older persons by means of a recently-introduced floor-based photocell system.

Evaluación clínica de los parámetros de la marcha en pacientes Spatiotemporal y Adultos Mayores

Spatial and temporal characteristics of human walking are frequently evaluated to identify possible gait impairments, mainly in orthopedic and ...

clinical-assessment-spatiotemporal-gait-parameters-patients-older

Research

JoVE Journal

Medicine

13.7K vistas.  Schulthess Clinic. This protocol is used to evaluate spatial and temporal gait variables of neurological/orthopedic patients and older persons by means of a recently-introduced floor-based photocell system.

Video: Clinical Assessment of Spatiotemporal Gait Parameters in Patients and Older Adults

Collecting Saliva and Measuring Salivary Cortisol and Alpha-amylase in Frail Community Residing Older Adults via Family Caregivers

Salivary measures have emerged in bio-behavioral research that are easy-to-collect, minimally invasive, and relatively inexpensive biologic markers of stress. This article we present the steps for collection and analysis of two salivary assays in research with frail, community residing older adults-salivary cortisol and salivary alpha amylase. The field of salivary bioscience is rapidly advancing and the purpose of this presentation is to provide an update on the developments for investigators interested in integrating these measures into research on aging. Strategies are presented for instructing family caregivers in collecting saliva in the home, and for conducting laboratory analyses of salivary analytes that have demonstrated feasibility, high compliance, and yield quality specimens. The protocol for sample collection includes: (1) consistent use of collection materials; (2) standardized methods that promote adherence and minimize subject burden; and (3) procedures for controlling certain confounding agents. We also provide strategies for laboratory analyses include: (1) saliva handling and processing; (2) salivary cortisol and salivary alpha amylase assay procedures; and (3) analytic considerations.

We demonstrate: (1) procedures for collection of salivary samples in cognitive impaired older adults by family caregivers in the home setting, (2) procedures for measuring stress activity via salivary cortisol and alpha amylase, and (3) representative profiles. Protocols that allow researchers to study stress-linked processes advance our understanding of biological sensitivity and susceptibility.

Recopilación de la saliva y la medición de cortisol salival y alfa-amilasa en Frail comunitarios residentes adultos mayores a través de Cuidadores de Familia

Salivary measures have emerged in bio-behavioral research  that are easy-to-collect, minimally invasive, and relatively inexpensive  biologic markers of ...

Investigación

Medicina

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Patients with chronic kidney disease (CKD) have significantly increased risk of cardiovascular disease (CVD) compared to the general population, and this is only partially explained by traditional CVD risk factors. Vascular dysfunction is an important non-traditional risk factor, characterized by vascular endothelial dysfunction (most commonly assessed as impaired endothelium-dependent dilation [EDD]) and stiffening of the large elastic arteries. While various techniques exist to assess EDD and large elastic artery stiffness, the most commonly used are brachial artery flow-mediated dilation (FMDBA) and aortic pulse-wave velocity (aPWV), respectively. Both of these noninvasive measures of vascular dysfunction are independent predictors of future cardiovascular events in patients with and without kidney disease. Patients with CKD demonstrate both impaired FMDBA, and increased aPWV. While the exact mechanisms by which vascular dysfunction develops in CKD are incompletely understood, increased oxidative stress and a subsequent reduction in nitric oxide (NO) bioavailability are important contributors. Cellular changes in oxidative stress can be assessed by collecting vascular endothelial cells from the antecubital vein and measuring protein expression of markers of oxidative stress using immunofluorescence. We provide here a discussion of these methods to measure FMDBA, aPWV, and vascular endothelial cell protein expression.

The degree of vascular dysfunction and contributing physiological mechanisms can be assessed in patients with chronic kidney disease by measuring brachial artery flow-mediated dilation, aortic pulse-wave velocity, and vascular endothelial cell protein expression.

Evaluación de la función vascular en pacientes con enfermedad renal crónica

Patients with chronic kidney disease (CKD) have significantly increased risk of cardiovascular disease (CVD) compared to the general population, and this ...

A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients

Intracranial pressure (ICP) monitoring is now widely used in neurosurgical critical patients. Besides mean ICP value, the ICP derived parameters such as ICP waveform, amplitude of pulse (AMP), the correlation of ICP amplitude and ICP mean (RAP), pressure reactivity index (PRx), ICP and arterial blood pressure (ABP) wave amplitude correlation (IAAC), and so on, can reflect intracranial status, predict prognosis, and can also be used as guidance of proper treatment. However, most of the clinicians focus only on the mean ICP value while ignoring these parameters because of the limitations of the current devices. We have recently developed a multimodality monitoring system to address these drawbacks. This portable, user-friendly system will use a data collecting and storing device to continuously acquire patients&#39; physiological parameters first, i.e., ABP, ICP, and oxygen saturation, and then analyze these physiological parameters. We hope that the multimodality monitoring system will be accepted as a key measure to monitor physiological parameters, to analyze the current clinical status, and to predict the prognosis of the neurosurgical critical patients.

Recently, we have developed a portable multimodality monitoring system for the monitoring of various physiological parameters in neurosurgical critical patients. Detailed protocols on how to use this multimodality monitoring system are presented here.

Un protocolo detallado de parámetros fisiológicos de adquisición y análisis en pacientes críticos neuroquirúrgicos

Intracranial pressure (ICP) monitoring is now widely used in neurosurgical critical patients. Besides mean ICP value, the ICP derived parameters such as ...

Severe Burn Injury in a Swine Model for Clinical Dressing Assessment

Wound healing is a dynamic repair process and is the most complex biological process in human life. In response to burn injury, alterations in biological pathways impair the inflammation response, resulting in delayed wound healing. Impaired wound healing frequently occurs in patients with diabetes leading to unfavorable outcomes such as amputation. Hence, dressings having beneficial effect in promoting burn wound repair are needed. However, studies on burn wound treatment are limited due to lack of proper animal models. Our previous study demonstrated wound-healing performance in rat and swine models using a minimally invasive surgical technique. This study aimed to demonstrate a swine model of severe burn injury that eliminates wound contraction and more closely approximates the human processes of re-epithelialization and new tissue formation. This protocol provides a detailed procedure for creating consistent burn wounds and examining the wound-healing performance under the treatment of an experimental dressing in a swine model. Six burn wounds were created symmetrically on the dorsum, which were covered with a clinical dressing composed of four layers: an inner contact layer of experimental materials, an inner intermediate layer of waterproof film, an outer intermediate layer of gauze, and an outer layer of adhesive plaster. Upon the completion of experiments, wound closure, wound area, and Vancouver Scar Scale score were examined. The samples of skin resected from each animal post-sacrifice were histologically prepared and stained using hematoxylin and eosin staining. Antibacterial activity of each dressing in the context of wound healing was also examined. The application of the clinical dressing to the wounds in swine model mimics the biological processes of human wound healing with respect to the processes of epithelialization, cellular proliferation, and angiogenesis. Therefore, this swine model provides an easy-to-learn, cost-effective, and robust method to assess the effect of clinical dressings in severe burn injury.

To closely mimic the mode of burn injuries requires the interplay between clinical observation and studies in animal models. In this study, a swine model of severe burn injury was established to assess an experimental dressing in physiological and pathophysiological settings.

Quemaduras severas en un modelo porcino para la preparación clínica evaluación

Wound healing is a dynamic repair process and is the most complex biological process in human life. In response to burn injury, alterations in biological ...

Measurements of Motor Function and Other Clinical Outcome Parameters in Ambulant Children with Duchenne Muscular Dystrophy

While the number of new treatment options tested in patients with Duchenne muscular dystrophy (DMD) is increasing, there is still no defining of the most reliable assessments regarding therapeutic efficacy. We present clinical and radiological outcome measures used in ambulatory patients participating in our trial &#34;Treatment with L-citrulline and metformin in Duchenne muscular dystrophy&#34;. The motor function measure is a validated test in patients with neuromuscular disorders that consists of 32 items and assesses all three dimensions of motor performance including standing and transfer (D1 subscore), axial and proximal motor function (D2 subscore), and distal motor function (D3 subscore). The test shows high intra- and inter-rater variability but only when strictly following guidelines of the materials, examination steps, and calculation of scores. The 6-minute walk test, timed 10-meter walk/run test, and supine-up time are commonly used timed functional tests that also sufficiently monitor changes in muscle function; however, they strongly depend on patient collaboration. Quantitative MRI is an objective and sensitive biomarker to detect subclinical changes, though the examination costs may be a reason for its limited use. In this study, a high correlation between all clinical assessments and quantitative MRI scans was found. The combinational use of these methods provides a better understanding about disease progression; however, longitudinal studies are needed to validate their reliability.

The aim of this study is to present the most reliable clinical outcome measures and their correlations with quantitative muscle MRI in ambulant patients with Duchenne muscular dystrophy.

Mediciones de la función motora y otros parámetros de resultado clínico en niños ambulatorios con Distrofia Muscular de Duchenne

While the number of new treatment options tested in patients with Duchenne muscular dystrophy (DMD) is increasing, there is still no defining of the most ...

Multi-Modal Home Sleep Monitoring in Older Adults

The gold standard for sleep monitoring is attended in-lab polysomnography; however, this method may be cost-prohibitive and inconvenient for patients and research participants. Home sleep testing has gained momentum in the field of sleep medicine due to its convenience and lower cost, as well as being more naturalistic. The accuracy and quality of home sleep testing, however, may be variable because studies are not monitored by sleep technologists. There has been some success in improving the accuracy of home sleep studies by having trained sleep technicians assist participants inside their homes with putting on the devices, but this can be intrusive and time-consuming for those involved. In this protocol, participants undergo at-home sleep monitoring with multiple devices: 1) a single-channel EEG device; 2) a home sleep test for sleep-disordered breathing and periodic limb movements; 3) actigraphy; and 4) sleep logs. A major challenge of this study is obtaining high-quality sleep monitoring data on the first attempt in order to minimize participant burden. This protocol describes the implementation of educational manuals with step-by-step instructions and photos. The goal is to improve the quality of home sleep testing.

Here, we present a protocol to improve the quality of data from home sleep testing by providing a method to enhance instructions through a structured participant visit. This protocol includes the implementation of a step-by-step educational manual with photos to ensure proper placement of equipment.

Sueño hogar multimodal en adultos mayores

The gold standard for sleep monitoring is attended in-lab polysomnography; however, this method may be cost-prohibitive and inconvenient for patients and ...

Evaluation of Patients' Posture and Gait Profile After Lumbar Fusion Surgery by Video Rasterstereography and Treadmill Gait Analysis

This protocol provides guidance on how to perform high resolution video rasterstereography and treadmill gait analysis on patients after lumbar fusion surgery to obtain results about altered variables of gait and posture. These observed changes can then be correlated with the patient-reported outcome measure of pain relief. The rasterstereographic device projects lines of parallel light onto the surface of the tested subject&#39;s back. The deformation of these lines is recognized by the device. From these data, a special software then generates a 3-D profile based on the principle of triangulation. With an inaccuracy of only 0.2 mm it can measure changes in posture at very high precision. Gait and stance parameters are recorded using a treadmill equipped with an electric sensor mat that contains 10,200 miniature force sensors in the registering zone under the belt. Initial walking speed on the treadmill is 0.5 km/h. Speed is then gradually increased by increments of 0.1 km/h until each subject reaches his or her individual maximum well tolerable walking speed. At this speed, parameters are recorded during a 20 s measurement interval. Subjects are tested barefoot and without holding a handrail. Among various other parameters, stride width, step length, stance phase and foot rotation are measured. Both methods used reportedly have a high intra- and inter-observer reliability. The advantage of these highly accurate techniques is that they offer an objective and very detailed perspective on changes in the patient&#39;s posture and gait. Due to the amount of data generated, these techniques are, however, not so much suitable for everyday routine use, but rather interesting to scientifically evaluate long term alterations in posture and gait in patients like for example after lumbar fusion surgery.

Evaluation of Patients&#039; Posture and Gait Profile After Lumbar Fusion Surgery by Video Rasterstereography and Treadmill Gait Analysis

Here, we present a protocol to analyze the posture and the gait of patients after lumbar fusion surgery by means of high-resolution video rasterstereography and a treadmill equipped with an integrated sensor mat. Allowing critical functional postoperative evaluation on a less subjective level may enhance accuracy and reliability of indication for surgery.

Evaluación de postura y Perfil de la marcha después de la cirugía de fusión Lumbar por Rasterstereography Video y análisis de la marcha de caminadora pacientes

This protocol provides guidance on how to perform high resolution video rasterstereography and treadmill gait analysis on patients after lumbar fusion ...

Invasive Hemodynamic Assessment for the Right Ventricular System and Hypoxia-Induced Pulmonary Arterial Hypertension in Mice

Pulmonary arterial hypertension (PAH) is a chronic and severe cardiopulmonary disorder. Mice are a popular animal model used to mimic this disease. However, the evaluation of right ventricular pressure (RVP) and pulmonary artery pressure (PAP) remains technically challenging in mice. RVP and PAP are more difficult to measure than left ventricular pressure because of the anatomical differences between the left and right heart systems. In this paper, we describe a stable right heart hemodynamic measurement method and its validation using healthy and PAH mice. This method is based on open-chest surgery and mechanical ventilation support. It is a complicated procedure compared to closed chest procedures. While a well-trained surgeon is required for this surgery, the advantage of this procedure is that it can generate both RVP and PAP parameters at the same time, so it is a preferable procedure for the evaluation of PAH models.

Here, we present a protocol to perform an invasive hemodynamic assessment of the right ventricle and pulmonary artery in mice using an open-chest surgery approach.

Evaluación hemodinámica invasiva para el sistema ventricular derecho y hipertensión arterial pulmonar inducida por hipoxia en ratones

Pulmonary arterial hypertension (PAH) is a chronic and severe cardiopulmonary disorder. Mice are a popular animal model used to mimic this disease. ...

A Training Program Using an Agility Ladder for Community-Dwelling Older Adults

Aging impairs physical and cognitive functions and limits daily activities. Agility training can improve or maintain physical functioning in older people. The purpose of this study is to report the physical fitness benefits of a training program for independent community-dwelling older adults using an agility ladder. Each training session lasted approximately 30 minutes, and the benefits were achieved with two sessions per week for 14 weeks. Training was timed and involved four different drills and varying levels of difficulty through time. The exercises were performed at the School of Physical Education of the University of Campinas, S&#227;o Paulo state, Brazil. The study participants (n = 16; mean age of 66.9 &#177; 5.0 years) were instructed to perform the exercises as quickly as possible without making mistakes and were assisted by a physical trainer when they made mistakes. Assessments were performed both before and after training using five functional tests (i.e., Illinois agility, five times sit-to-stand, timed up-and-go, walking usual speed, and one-leg stand). Although the study sample was not compared with a control group, the results indicate that training protocols using an agility ladder are easy and practical and improve physical function performance in older adults.

The aim of this study is to present an agility training program for older people. The feasibility of this program is described, and the training protocol demonstrated by video imaging.

Un programa de capacitación que utiliza una escalera de agilidad para adultos mayores que viven en la comunidad

Aging impairs physical and cognitive functions and limits daily activities. Agility training can improve or maintain physical functioning in older people. ...

Oral Health Assessment by Lay Personnel for Older Adults

Oral health is an often-undervalued contributor to overall health. The literature, however, underscores the myriad of systemic diseases influenced by oral health, including type II diabetes, heart disease, and atherosclerosis. Thus, assessments of oral health, called oral screenings, have a significant role in assessing risk of disease, managing disease, and even improving disease by oral care. Here we present a method to assess oral health quickly and consistently across time. The protocol is simple enough for non-oral health professionals such as students, family, and caregivers. Useful for any age of patient, the method is particularly key for older individuals who are often at risk of inflammation and chronic disease. Components of the method include existing oral health assessment scales and inventories, which are combined to produce a comprehensive assessment of oral health. Thus, oral characteristics assessed include intraoral and extraoral structures, soft and hard tissues, natural and artificial teeth, plaque, oral functions such as swallowing, and the impact this oral health status has on the patient&#39;s quality of life. Advantages of this method include its inclusion of measures and perceptions of both the observer and patient, and its ability to track changes in oral health over time. Results acquired are quantitative totals of questionnaire and oral screening items, which can be summed for an oral health status score. The scores of successive oral screenings can be used to track the progression of oral health across time and guide recommendations for both oral and overall health care.

The goal of this protocol is to enable non-dental professionals to assess oral health status for research or health-screening purposes. Aspects assessed include lips, tongue, soft and hard tissues, natural and artificial teeth, oral cleanliness, plaque, swallowing, and impact of oral health on quality of life.

Evaluación de salud oral por personal laicos para adultos mayores

Oral health is an often-undervalued contributor to overall health. The literature, however, underscores the myriad of systemic diseases influenced by oral ...