Il protocollo segue le linee guida del Comitato Etico locale umana a Zurigo (KEK Zurigo). 1. Installazione hardware (Figura 1) <ol><li> Utilizzare due 10-m gruppi di barre pavimento-based e posizionarli parallele tra loro (e alla linea di progressione) per creare un corridoio con interasse set di circa 1 m. NOTA: Questa distanza può essere aumentata fino a 8 m. Ogni barra ha una lunghezza di 1 m ed è costituito da 96 diodi. </li><li> Effettuare una distinzione tra luce-trasmissione (T) e luce di ricezione (R) per il montaggio delle barre posizionando luce-trasmissione (T) unità sul lato destro e la spia di ricezione (R) unità a sinistra lato rispetto alla direzione di marcia. NOTA: Le prime barre dell&#39;indicatore (sia T e R) hanno fusti d&#39;argento. Le barre T e R disposti sul restante 9 m sono tutte uguali e intercambiabili. </li><li> Collegare tutti i bar di una riga con i tappi (wireless). Utilizzare 2 Potenzar forniture: uno per ogni gruppo di barre (T e R). </li><li> Collegare il primo bar R al computer portatile con un cavo USB. </li><li> Posizionare la fotocamera accanto al primo bar per le verifiche in linea (ad esempio, piede di partenza), e collegarlo al portatile con un cavo USB. </li><li> Mettere un segno 2 m prima e dopo l&#39;inizio e la fine della traccia. </li><li> Accendere il dispositivo fotoelettrico utilizzando l&#39;interruttore on-off del primo R e T bar. </li><li> Verificare che i LED di controllo si trovano su tutte le barre R sono verdi. NOTA: Se è così, il sistema è posizionata correttamente e collaudo può iniziare; Tuttavia, se uno o più LED di controllo sono rossi il sistema non è posizionato e / o collegato correttamente. Controllare tutti i tappi controllando che siano completamente scattati in posizione e poi spegnere il sistema e riaccenderlo. </li></ol><img alt="Figura 1" src="/files/ftp_upload/51878/51878fig1.jpg" /> Figura 1. Il photSistema oelectric consiste trasmette la luce (T) e di ricezione luce (R) unità che sono posti paralleli tra loro ad una distanza di circa 1 m. La telecamera è installata vicino alla zona di inizio per scopi di controllo. Il portatile è collegato con i cavi USB per la prima barra R e alla fotocamera. <a href="https://www.jove.com/files/ftp_upload/51878/51878fig1highres.jpg" target="_blank">Clicca qui per vedere una versione più grande di questa figura.</a> 2. Installazione del software e la preparazione di un test <ol><li> Caricare il software operativo del sistema fotoelettrica da www.optogait.com/Support/Downloads. Nota: Questo protocollo è descritto utilizzando la versione 1.8.1. </li><li> Se il software viene utilizzato per la prima volta per l&#39;analisi del cammino creare un nuovo test come segue (altrimenti passare al punto 2.3): <ol><li> Selezionare Test quindi fare clic su Definisci / Modifica test. Ora cliccate sulla prova del cammino e quindi selezionare campioni in doppio.Fare clic su Conferma nella finestra pop-up in modo che il test è duplicato. </li><li> Fare doppio clic sul test duplicato per modificare il nome (ad esempio, Gait prova 10 bar) e selezionare 10 per il numero di barre. Utilizzare i parametri standard per il test del cammino, che sono presentati nella figura 2. Infine, selezionare Salva per salvare tutte le modifiche. </li></ol></li><li> Aggiungere un nuovo paziente al database. Selezionare i pazienti, clicca su Inserisci / Modifica paziente, e quindi fare clic su Nuovo paziente di inserire i dati. Quindi salvare i dati. </li></ol><img alt="Figura 2" src="/files/ftp_upload/51878/51878fig2.jpg" /> Figura 2. Impostazioni standard per un test del cammino con 10 bar, come descritto nel presente protocollo. Queste impostazioni devono essere definite quando il sistema fotoelettrico viene utilizzato per la prima volta. In questo protocollo il piede di partenza non è definito.Il sistema avvia la misurazione quando il paziente entra nell&#39;area di registrazione e si ferma la misurazione quando il paziente lascia le unità di misura. <a href="https://www.jove.com/files/ftp_upload/51878/51878fig2highres.jpg" target="_blank">Clicca qui per vedere una versione più grande di questa figura.</a> 3. Procedure di test <ol><li> Dare sempre le stesse istruzioni al paziente 13. <ol><li> Chiedere al paziente di camminare con le scarpe con la suola piatta lungo la passerella di 10 metri a due velocità diverse: normale (&quot;camminare a un ritmo che è comodo per voi&quot;), e più velocemente del normale (&quot;camminare a un ritmo che è più veloce di che normalmente camminare &quot;). </li><li> Chiedere al paziente di guardare dritto davanti a sé durante le prove a piedi. </li><li> Chiedi al paziente di avviare il primo passo con lo stesso piede standardizzare meglio le condizioni di prova. </li><li> Chiedere al paziente di iniziare a camminare 2 m prima della prima barra fotoelettrica e di concludere ogni trial 2 m dopo l&#39;ultima barra in modo da mantenere costante la velocità del cammino 13. </li></ol></li><li> Dimostrare una prova a velocità normale per il paziente. </li><li> Chiedere al paziente di effettuare tre prove di familiarizzazione seguiti da uno studio sperimentale ad ogni velocità. Sempre completi prove di velocità normali prime. </li><li> Per prepararsi con il software, fare clic su Test e quindi eseguire per avviare le misure con il test creato. <ol><li> Selezionare il paziente facendo clic su Seleziona, scegliere il paziente e poi cliccando su Conferma. </li><li> Selezionare il test facendo clic su Seleziona e scegliere il test ad esempio, Gait di prova 10 bar. Verificare che solo questo test è selezionato per la misurazione. </li><li> Posizionare la fotocamera in modo che possa registrare l&#39;intero cammino. Modificare la posizione della fotocamera controllando l&#39;immagine dal vivo sullo schermo del vostro computer portatile. </li><li> Infine, fare clic su Eseguinuovo. NOTA: Ora il software è pronto per misurare. Non appena il paziente entra bar, il sistema inizia a misurare e viene visualizzata una finestra pop-up chiedendo il piede di partenza. </li></ol></li><li> Istruzioni sul piede appropriata in modo che i parametri dell&#39;andatura saranno calcolati correttamente. NOTA: La fotocamera registra automaticamente una volta che il test viene avviato. </li><li> Salvare il test. </li></ol> Analisi 4. Dati <ol><li> Fare clic su Risultati per visualizzare i processi completati. Quindi fare clic sulla freccia accanto alla prova di interesse per trasferire il test dall&#39;elenco Test per la sezione di analisi del test. Ora fare clic su Visualizza per visualizzare il test selezionato. Fare riferimento alla sezione risultati di tutti i test eseguiti in questo studio. NOTA: una finestra con tutti i dati di test (Figura 3). Sul lato sinistro della finestra ci sono alcuni pulsanti di comando per l&#39;attivazione di varie funzioni. L&#39;altra parte della finestra presenta 4 types di informazioni per quanto riguarda il test in corso. Ogni set di dati può essere mostrato / nascosto utilizzando i comandi di configurazione. Dall&#39;alto verso il basso le voci sono le seguenti: video, grafici che mostrano i risultati, tabella con dati numerici, e bar fotoelettrici. </li><li> Clicca sui dati del cammino per visualizzare un rapporto di andatura (Figura 3). </li><li> Fare clic su Stampa (appare una finestra con la relazione) per stampare il report. NOTA: Il rapporto può essere stampato come è o può essere modificato. Per i differenti parametri spazio-temporali, i seguenti risultati sono presentati nella relazione: media dei valori ± deviazione standard (SD) del lato destro e sinistro, coefficienti di variazione (CV) che esprime la variabilità andatura 14,15, e la differenza percentuale tra la sinistra e il lato destro (asimmetria). <ol><li> Se necessario, modificare il report nel modo seguente: aprire il report come descritto in precedenza (punto 4.3). Fare clic sui pulsanti Mostra o Nascondi sulla sid sinistrae dello schermo per adattare i dati presentati e grafici del report. </li><li> Per cambiare il logo e / o il piè di pagina del report, fare clic sul relativo tasto (Change logo o Cambia piè di pagina) per modificare questi parametri. </li></ol></li><li> Per confrontare due o più test eseguiti in diverse occasioni, ad esempio, prima e dopo un intervento, selezionare i diversi test nella sezione risultati facendo clic sulla freccia accanto alle prove e poi clicca sul pulsante Confronta. Viene visualizzato un report con il confronto diretto di tutti i parametri dei vari test: NOTA. </li></ol><img alt="Figura 3" src="/files/ftp_upload/51878/51878fig3.jpg" /> Figura 3. schermo di tutti i dati di test. I pulsanti di comando compaiono sul lato sinistro della finestra (ad esempio, cliccando su stampa viene generato un rapporto, che può essere eventualmente modificato). L&#39;altraparte della finestra presenta le seguenti informazioni per quanto riguarda la prova di corrente, dall&#39;alto verso il basso: video, grafici visualizzazione dei risultati, tabella con dati numerici, e bar fotoelettrici. Questi dettagli possono essere visualizzati / nascosti utilizzando il pulsante Configura sul lato destro. Il punto di vista reale dei dati può essere modificata facendo clic su dati Gait o rapporto Gait, rispettivamente. <a href="https://www.jove.com/files/ftp_upload/51878/51878fig3highres.jpg" target="_blank">Clicca qui per vedere una versione più grande di questa figura.</a>

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Il protocollo qui presentato può essere utilizzato per valutare i parametri dell&#39;andatura spaziali e temporali dei pazienti (ortopedica, neurologica, cardio, ecc) e sani adulti più anziani con un sistema fotoelettrico di recente introduzione. La lunghezza e la larghezza totale del sistema può essere modulata a seconda dello spazio disponibile budget. Il costo stimato (in Europa) è di circa 2.800 dollari al metro per un sistema di 10 metri e la lunghezza minima consigliata è di 3 metri per l&#39;analisi del camm...

Camminare è una delle più importanti attività fisica nella vita di tutti i giorni, ed è un fattore determinante principale della qualità della vita delle popolazioni anziane e pazienti, che possono presentarsi con alterazioni dell&#39;andatura. La valutazione clinica della funzione andatura è quindi importante per rivelare potenziali alterazioni indotte dall&#39;invecchiamento e / o patologie neurologiche / ortopediche, ma anche per dimostrare i vantaggi funzionali di un trattamento. Diversi strumenti sono stati sviluppati per la valutazione quantitativa dei parametri di andatura, ad esempio, piattaforme di forza, di analisi del movimento 3D video-based, accelerometri montati sul telaio 10,11, e strumentato stuoie passerella o tapis roulant 12. Tuttavia, questi sistemi sono utilizzati principalmente per studi di ricerca piuttosto che per scopi clinici, perché sono complessi da usare, avere una bassa accessibilità e sensori fragili. Un sistema basato fotoelettrica piano è stato recentemente introdotto, che è in grado di fornire una valida calcal- delle caratteristiche temporali e 1D coordinate spaziali di passi a piedi. Questo strumento di misura ha diversi vantaggi rispetto ai sistemi preesistenti: è facile da maneggiare, i dati sono raccolti molto velocemente, è semplice da creare una relazione dettagliata ed è un sistema modulare che significa che la lunghezza del sistema può essere cambiato . Quindi, può essere usato con sicurezza per misurare all&#39;interno del gruppo i cambiamenti nelle valutazioni longitudinali e differenze tra i gruppi nei confronti trasversali. Gli obiettivi del protocollo descritto sono di concentrarsi sulle attrezzature e la sua installazione, e di obiettività e semplicemente descrivere le procedure di valutazione per la valutazione dei parametri spazio-temporali del cammino in popolazioni di anziani e di pazienti.

<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

Caratteristiche spaziali e temporali del cammino umano sono spesso valutati per identificare eventuali perdite di valore deambulazione, principalmente in pazienti ortopedici e neurologici 1-4, ma anche in soggetti sani adulti più anziani 5,6. L&#39;analisi quantitativa del cammino descritto in questo protocollo è eseguita con un sistema fotoelettrica recentemente introdotta (vedi tabella Materials) che ha il potenziale per essere usato in clinica perché è portatile, facile da installare (nessuna preparazione soggetto richiesto prima un test ), e non richiede manutenzione e calibrazione del sensore. Il sistema fotoelettrica consiste serie di fotocellule basati pavimento ad alta densità con diodi emettitori di luce e la luce di ricezione che sono posti paralleli tra loro per creare un corridoio, e sono orientati perpendicolarmente alla linea di progressione 7. Il sistema rileva semplicemente interruzioni nel segnale luminoso, ad esempio a causa della presenza dei piedi all&#39;interno dell&#39;area di registrazione. Temporaleparametri dell&#39;andatura e 1D coordinate spaziali di fasi consecutive sono successivamente calcolate per fornire parametri dell&#39;andatura comuni come la lunghezza del passo, il supporto singolo arto e la velocità a piedi 8, la cui validità nei confronti di un strumento di criterio è stato recentemente dimostrato 7,9. Le procedure di misurazione sono molto semplici; un singolo paziente può essere testato in meno di 5 minuti e un rapporto completo può essere generato in meno di 1 minuto.

Uno studio recente ha dimostrato la validità del sistema fotoelettrico contro uno strumento criterio (un tappeto elettronico convalidato) per la valutazione dei parametri spazio-temporali del cammino in pazienti ortopedici e controlli sani anziani 7. Le stesse differenze tra i gruppi nelle variabili andatura sono stati rilevati dai due sistemi. Anche se validità concorrente era eccellente, con coefficienti di correlazione intraclasse compresi tra 0,933 e 0,999 (p &lt;0,001), un errore sistematico (p &lt;0,0...

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.

La valutazione clinica di spazio-temporali del cammino parametri in pazienti adulti e anziani

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 Views.  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.

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

Ricerca

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.

Valutazione della funzione vascolare nei pazienti con malattia renale cronica

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 protocollo dettagliato per i parametri fisiologici di acquisizione e analisi nei pazienti neurochirurgici critici

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.

Lesione grave ustione in un modello di suina per valutazione clinica Dressing

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.

Misure della funzione motoria e altri parametri di risultato clinico in fase postoperatoria bambini con la distrofia muscolare di 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.

Sonno di multi-modale Home monitoraggio in adulti più anziani

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.

Valutazione della postura e del profilo di andatura dopo chirurgia di fusione lombare da Rasterstereography Video e tapis roulant Gait Analysis dei pazienti

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.

Valutazione emodinamica invasiva per il sistema ventricolare destro e l'ipertensione arteriosa polmonare indotta dall'ipossia nei topi

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 programma di formazione con una scala di agilità per gli adulti anziani che vivono nella comunità

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.

Valutazione della salute orale da parte del personale laico per gli adulti più anziani

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