Biomedical subjects

A Pedotti

Publications and source records attributed to A Pedotti.

At least 37 records · Page 2Linked to original sources

PubMed2004

Detection of expiratory flow limitation in COPD using the forced oscillation technique.

Expiratory flow limitation (EFL) during tidal breathing is a major determinant of dynamic hyperinflation and exercise limitation in chronic obstructive pulmonary disease (COPD). Current methods of detecting this are either invasive or unsuited to following changes breath-by-breath. It was hypothesised that tidal flow limitation would substantially reduce the total respiratory system reactance (Xrs) during expiration, and that this reduction could be used to reliably detect if EFL was present. To test this, 5-Hz forced oscillations were applied at the mouth in seven healthy subjects and 15 COPD patients (mean +/- sD forced expiratory volume in one second was 36.8 +/- 11.5% predicted) during quiet breathing. COPD breaths were analysed (n=206) and classified as flow-limited if flow decreased as alveolar pressure increased, indeterminate if flow decreased at constant alveolar pressure, or nonflow-limited. Of these, 85 breaths were flow-limited, 80 were not and 41 were indeterminate. Among other indices, mean inspiratory minus mean expiratory Xrs (deltaXrs) and minimum expiratory Xrs (Xexp,min) identified flow-limited breaths with 100% specificity and sensitivity using a threshold between 2.53-3.12 cmH2O x s x L(-1) (deltaXrs) and -7.38- -6.76 cmH2O x s x L(-1) (Xexp,min) representing 6.0% and 3.9% of the total range of values respectively. No flow-limited breaths were seen in the normal subjects by either method. Within-breath respiratory system reactance provides an accurate, reliable and noninvasive technique to detect expiratory flow limitation in patients with chronic obstructive pulmonary disease.

Aged↗

PubMed2003

Real-time human motion estimation using biomechanical models and non-linear state-space filters.

In the field of sports biomechanics and rehabilitation engineering, the possibility of computing, in real time, the angular displacements and derivatives of human joints, from a video of motion sequences, represents an appealing goal. In particular, applications of biofeedback protocols in rehabilitation can benefit from this capability. The focus of the investigation was concerned with the application of biomechanical models, comprising of a kinematic chain and surface envelopes, and state-space filters, to the computation, in real time and with high accuracy, of the angular data and derivatives. By minimising the distances, measured with TV cameras, between the 2D marker projections and the corresponding back-projected markers located on the mannequin, the configuration of the biomechanical model was automatically updated. The use of state-space estimation allowed the computation of smooth derivatives of the orientation data. Owing to the non-linearity of the functions involved, the derivatives of the observation model were obtained through a multidimensional extension of Stirling's interpolation formula. Proper algorithms were developed to cope with the model calibration, initialisation and data labelling. Extensive experiments on real and simulated motions proved the reliability (maximum angular error less than 1 degree, maximum point reconstruction less than 1 mm) of the developed system, which is robust to false matching caused by marker occlusions. Moreover, orientation artifacts due to skin motion can be reduced by a factor of 50%.

Algorithms↗

PubMed2003

Hierarchical radial basis function networks and local polynomial un-warping for X-ray image intensifier distortion correction: a comparison with global techniques.

Global polynomial (GP) methods have been widely used to correct geometric image distortion of small-size (up to 30 cm) X-ray image intensifiers (XRIIs). This work confirms that this kind of approach is suitable for 40 cm XRIIs (now increasingly used). Nonetheless, two local methods, namely 3rd-order local un-warping polynomials (LUPs) and hierarchical radial basis function (HRBF) networks are proposed as alternative solutions. Extensive experimental tests were carried out to compare these methods with classical low-order local polynomial and GP techniques, in terms of residual error (RMSE) measured at points not used for parameter estimation. Simulations showed that the LUP and HRBF methods had accuracies comparable with that attained using GP methods. In detail, the LUP method (0.353 microm) performed worse than HRBF (0.348 microm) only for small grid spacing (15 x 15 control points); the accuracy of both HRBF (0.157 microm) and LUP (0.160 microm) methods was little affected by local distortions (30 x 30 control points); weak local distortions made the GP method poorer (0.320 microm). Tests on real data showed that LUP and HRBF had accuracies comparable with that of GP for both 30 cm (GP: 0.238 microm; LUP: 0.240 microm; HRBF: 0.238 microm) and 40 cm (GP: 0.164 microm; LUP: 0.164 microm; HRBF: 0.164 microm) XRIIs. The LUP-based distortion correction was implemented in real time for image correction in digital tomography applications.

Algorithms↗

PubMed2003

Evaluation of methods for opto-electronic body surface sensing applied to patient position control in breast radiation therapy.

The accuracy gap between the high levels of accuracy in radiotherapy planning and the uncertain set-up of each therapy fraction represents a crucial factor in the optimisation of radiation treatment. This occurs because the conventional means of patient alignment and immobilisation do not guarantee accurate implementation of the therapy plan in the actual irradiation treatment. A patient repositioning technique is proposed, based on opto-electronic motion capture and on methods of registration of body surfaces described by a limited dataset. The validation of the method was related to breast cancer radiotherapy and was based on simulated and experimental repositioning procedures involving a phantom and two subjects. With respect to previous work, the surface registration procedure was, in this case, implemented as a constrained non-linear least-square problem (constraints were given by the position of a couple of passive markers placed on the sternum), and three different algorithms were compared in terms of accuracy in misalignment detection and of computational cost. The simulation and experimental activities identified the best performing algorithm, which systematically limited the repositioning errors to below clinically acceptable thresholds (5 mm), with residual surface mismatches lower than 2 mm.

Algorithms↗

PubMed2003

Robust recovery of human motion from video using Kalman filters and virtual humans.

In sport science, as in clinical gait analysis, optoelectronic motion capture systems based on passive markers are widely used to recover human movement. By processing the corresponding image points, as recorded by multiple cameras, the human kinematics is resolved through multistage processing involving spatial reconstruction, trajectory tracking, joint angle determination, and derivative computation. Key problems with this approach are that marker data can be indistinct, occluded or missing from certain cameras, that phantom markers may be present, and that both 3D reconstruction and tracking may fail. In this paper, we present a novel technique, based on state space filters, that directly estimates the kinematical variables of a virtual mannequin (biomechanical model) from 2D measurements, that is, without requiring 3D reconstruction and tracking. Using Kalman filters, the configuration of the model in terms of joint angles, first and second order derivatives is automatically updated in order to minimize the distances, as measured on TV-cameras, between the 2D measured markers placed on the subject and the corresponding back-projected virtual markers located on the model. The Jacobian and Hessian matrices of the nonlinear observation function are computed through a multidimensional extension of Stirling's interpolation formula. Extensive experiments on simulated and real data confirmed the reliability of the developed system that is robust against false matching and severe marker occlusions. In addition, we show how the proposed technique can be extended to account for skin artifacts and model inaccuracy.

Humans↗

PubMed2003

Optimised procedure for the calibration of the force platform location.

An innovative optimised method, including an experiment and a mathematical model, for the calibration of the force platform location in the optoelectronic reference frame is proposed. The calibration experiment adopts a bearing-marker testing object contacting the platform and does not directly measure the platform location. The experiment is designed in order to avoid the main drawbacks possibly occurring in commonly adopted methods. The mathematical model of the experiment estimates the expected ground reaction. An optimisation algorithm identifies the optimal platform location as the one that best matches the measured outcome of the calibration experiment with the corresponding model estimate. The innovative calibration procedure has been assessed in terms of inter-tester reliability and compared with commonly used calibration procedures of platform location. These results evidenced how the introduction of such optimised procedure could improve the reliability of the calibrated platform location and, consequently, of the kinetic variables considered in posture and gait analysis.

Algorithms↗

PubMed2003

Energy consumption of locomotion with orthosis versus Parastep-assisted gait: a single case study.

STUDY DESIGN: Single case study. OBJECTIVES: To evaluate the energy expenditure during ambulation with the Advanced Reciprocating Gait Orthosis (ARGO), with and without functional electrical stimulation (FES), and with the Parastep system in a single subject, in order to avoid the effect of inter-subject variability. SETTING: The Centre of Sport Medicine and Bioengineering Centre 'Don C Gnocchi' Foundation ONLUS IRCCS, Milano, Italy. METHODS: A single patient (lesion level T5-T6) was trained specifically for each walking system and was evaluated after each training period. The effects of FES on muscle conditioning, spasticity and bone density were also evaluated. The HR/VO2 relationship and the energy cost of locomotion were measured during wheelchair (WHCH) use, during locomotion with ARGO (with and without FES) and Parastep system at different speeds. RESULTS: The following was observed at the end of the whole training: (a) circumferences of both lower limbs and quadriceps forces were increased, whereas fatigue index was slightly decreased, spasticity and bone density were unchanged; (b) compared to WHCH locomotion, the slope of HR/VO2 curves with ARGO was higher (slope difference=51.1 b 1O2(-1)), with ARGO+FES was similar (slope difference=-5.3 b 1O2(-1)) and with Parastep was smaller (slope difference=-55.6 b 1O2(-1)); (c) HR increased linearly with all locomotion systems, but did not rise above 125 bpm with Parastep; (d) the cost of locomotion was higher with Parastep than with ARGO (with and without FES), tested at each velocity; (e) Parastep appears to be easier to use for the subject. CONCLUSIONS: (a) FES can improve ambulation with orthosis, but the cost of locomotion remains very high; (b) the Parastep assisted gait elicits a higher energy expenditure than other orthoses, probably due to the lower speed of locomotion and to the high isometric effort of the stimulated muscles. SPONSORSHIP: This work has been partially supported by the Italian Minister of Public Health (Ricerca Finalizzata IRCCS no ICS030.7/RF97.25).

Adaptation, Physiological↗

PubMed2003

Spatial distribution of human respiratory system transfer impedance.

Transfer impedance (Ztr) of the respiratory system provides specific information on airways and tissues, but little is known about its spatial distribution in the different thoracoabdominal regions. To study Ztr distribution on the chest wall surface we analyzed five healthy subjects in the supine position by applying a sinusoidal forcing pressure (4, 8, and 12 Hz) at the mouth and measuring airway opening pressure and flow. Three-dimensional positions of 68 reflective markers placed on the chest wall over selected reference points were simultaneously measured by an optoelectronic motion analyzer. A subset of ten points placed on the midline were used to measure chest wall movements in the craniocaudal direction. While the motion of rib cage markers was synchronous, the abdominal markers demonstrated surface waves propagating caudally. The amplitude and phase of these waves were strongly dependent on position and frequency. We used a new method to measure total and local chest wall volume variations to compute the distribution of Ztr over the chest wall. Above 4 Hz we found that Ztr was inhomogeneously distributed and strongly dependent on position and frequency, mainly in the abdomen where the phase was often more more than 180 degrees with high values of modulus. For this reason, we conclude that above 8 Hz Ztr represents rib cage mechanics almost exclusively.

Abdomen↗

PubMed2002

Chest wall kinematic determinants of diaphragm length by optoelectronic plethysmography and ultrasonography.

To estimate diaphragm fiber length from thoracoabdominal configuration, we measured axial motion of the right-sided area of apposition by ultrasonography and volumes displaced by chest wall compartments [pulmonary, abdominal rib cage, and abdomen (Vab)] by optoelectronic plethysmography in four normal men during quiet breathing and incremental exercise without and with expiratory flow limitation. Points at the cephalic area of apposition border were digitized from echo images and mapped into three-dimensional space, and the axial distance from the xyphoidal transverse plane (D(ap)) was measured simultaneously with the volumes. Linear regression analysis between changes (Delta) in D(ap) and the measured volume changes under all conditions showed that 1) DeltaD(ap) was linearly related more to DeltaVab than to changes in pulmonary and abdominal rib cage volumes; and 2) this was highly repeatable between measures. Multiple stepwise regression analysis showed that DeltaVab accounted for 89-96% of the variability of DeltaD(ap), whereas the rib cage compartments added <1%. We conclude that, under conditions of quiet breathing and exercise, with and without expiratory flow limitation, instantaneous DeltaD(ap) can be estimated from DeltaVab.

Adult↗

PubMed2002

Touch-screen system for assessing visuo-motor exploratory skills in neuropsychological disorders of spatial cognition.

A new computerised test adopting touch-screen technology has been developed to assess the visuo-motor exploration of extra-personal space. The test was derived from well-known paper-and-pencil cancellation tasks used widely in the diagnosis and quantitative assessment of unilateral spatial neglect (USN), a neuropsychological syndrome that is more frequent and severe after damage to the right cerebral hemisphere. A main component deficit of USN is the defective visuo-motor exploration of the side of space contralateral to the side of the lesion (contralesional), namely, in right-sided brain-damaged patients it occurs on the left side and vice versa. The computer-based paradigm consisted of a visuo-motor spatial exploratory task: the subjects were instructed to touch, in any order they wished, all the targets they detected on a computer touch-screen. This measured the time of occurrence and the spatial co-ordinates of each touch event and forwarded the data to the computer for storage; the computer provided feedback to the subject by 'tagging' the touched target. The paradigm allowed the calculation of accuracy and latency indexes and recorded the exploratory pathway taken by each subject. A pilot study was performed in ten normal subjects and 15 brain-damaged patients, with and without psychometric evidence of USN; the results showed that the equipment was able to provide quantitative indexes related to the spatial-temporal aspects of exploratory ability, which are useful for diagnostic purposes, and revealed significant differences between the controls and patients with USN: the overall average values of latency and crossing indexes increased in patients with USN, compared with the controls (latency from 0.77 to 1.90s; path crossing index from 7.0% to 59.5%), and the significantly negative USN patient latency gradient (-2.79 against a null control value) evidenced a worsening of performance towards the left side.

Aged↗

PubMed2002

High-frequency electrical stimulation of the subthalamic nucleus in Parkinson's disease: kinetic and kinematic gait analysis.

In the advanced phase of Parkinson's disease (PD), gait disturbances represent one of the main causes of disability. Several studies demonstrated that high-frequency electrical stimulation (HFS) of the subthalamic nucleus (STN) significantly improves the motor symptoms of PD. This study was finalised to quantitatively analyze the effect of STN HFS on gait of PD patients, through a three-dimensional gait analysis system. Ten PD patients were studied, with and without STN HFS. The results demonstrated that STN HFS significantly improves all the main gait parameters in PD patients.

Biomechanical Phenomena↗

PubMed2002

Self-marking of anatomical landmarks for on-orbit experimental motion analysis compared to expert direct-marking.

The on-orbit application of movement analysis methodology, on-board space stations, for studying the gravity role in motor functions, requires a careful adaptation of the currently adopted techniques in order to obtain reliable data. In those operative conditions, differently from common on-ground experimental activities, a non-specialist operator, an astronaut of the space station crew, is expected to self-administer the experimental protocol, particularly self-marking specific anatomical landmarks. The present paper proposes a movement analysis methodology, which fits the specific constraints of space activity and matches the objective of maximising reliability and minimising on-orbit time, and reports normative data about accuracy and precision of the self-marking of an extended set of anatomical landmarks. The same set of landmarks has been considered also for direct-marking performed by experts in motion analysis and their results have been compared to self-marking ones. The paper contents will support the design of future space experimental campaigns and is, in general, applicable to any on-ground scientific investigation, possibly increasing data reliability.

Adult↗

PubMed2002

Quantitative analysis of gait in Parkinson's disease: a pilot study on the effects of bilateral sub-thalamic stimulation.

Four patients with Parkinson's disease who had a Subthalamic Nucleus (STN) stimulator implanted and four age-matched controls underwent gait analysis using a three-dimensional system. STN stimulation substantially improved most of the key variables in the patients, without producing inefficient compensatory movements of the trunk. A reduction of ankle power production during push off was the most persistent abnormality seen when the patients were stimulated. We also found a reduction of trunk lateral bending and torsion when the patients were not stimulated when compared with controls.

Biomechanical Phenomena↗

PubMed2002

Euromir 95 T4 experiment 'Human Posture in microgravity': global results and future perspectives.

After 7 years of studies on Euromir 95 T4 experiment 'Human Posture in microgravity' dataset, some important remarks can be proposed for best exploiting future experimental campaigns as well as for neurophysiological investigations on-ground. The main focus of such experiments was to monitor the process of learning and adapting to the new environment in performing complex voluntary movements. Euromir 95 was the first quantitative investigation with high technology instrumentation (ELITE-S) involving two subjects starting from 15 days after the launch until 5 months of mission. Results confirm the excellent capability of mutation of motor planning by the central nervous system (CNS) in order to best exploit environmental constraints and advantages. Under this view, the results offer a unique cue for improving the design of rehabilitation processes in motor pathologies.

Journal Article↗

PubMed2001

Optimisation of shape kernel and threshold in image-processing motion analysers.

The aim of the work is to optimise the image processing of a motion analyser. This is to improve accuracy, which is crucial for neurophysiological and rehabilitation applications. A new motion analyser, ELITE-S2, for installation on the International Space Station is described, with the focus on image processing. Important improvements are expected in the hardware of ELITE-S2 compared with ELITE and previous versions (ELITE-S and Kinelite). The core algorithm for marker recognition was based on the current ELITE version, using the cross-correlation technique. This technique was based on the matching of the expected marker shape, the so-called kernel, with image features. Optimisation of the kernel parameters was achieved using a genetic algorithm, taking into account noise rejection and accuracy. Optimisation was achieved by performing tests on six highly precise grids (with marker diameters ranging from 1.5 to 4 mm), representing all allowed marker image sizes, and on a noise image. The results of comparing the optimised kernels and the current ELITE version showed a great improvement in marker recognition accuracy, while noise rejection characteristics were preserved. An average increase in marker co-ordinate accuracy of +22% was achieved, corresponding to a mean accuracy of 0.11 pixel in comparison with 0.14 pixel, measured over all grids. An improvement of +37%, corresponding to an improvement from 0.22 pixel to 0.14 pixel, was observed over the grid with the biggest markers.

Algorithms↗

PubMed2001

Voluntary head stabilisation in space during oscillatory trunk movements in the frontal plane performed before, during and after a prolonged period of weightlessness.

The ability to voluntarily stabilise the head in space exhibited by two subjects during lateral rhythmic oscillations of the trunk has been investigated before, during and after a prolonged period of microgravity (microG) exposure. In flight acquisitions were performed onboard the Core Module of the Russian Space Station MIR as part of the T4 "Human Posture in Microgravity" experiment of the 179-days ESA-RKA mission EUROMIR-95. Data collection and kinematic analysis were performed by means of a space-qualified version of the automatic motion analyser ELITE. Head stabilisation in space strategy was estimated by means of the head anchoring index and cross-correlation analysis. Results show that head orientation may be well stabilised about the roll axis both with and without the presence of visual information. This was true despite the expected reduction in vestibular efficiency and muscular proprioception occurring in-flight. In one subject, however, vision was found to improve head stabilisation in space post-flight, presumably to recover from the postural deficiency induced by the long-term microG exposure. Head stability during trunk movements was achieved with either over-compensatory (out-of-phase), under-compensatory (in-phase) or mixed movement strategies, as was attested by the analysis of cross-correlation functions between head and shoulder movements. In weightlessness, vision occlusion seemed to influence the choice of the strategies to be used as well as the reduction of movement variability. The feedforward nature of compensatory head movements suggests that head stabilisation could be based in weightlessness on the internal postural body scheme, supposed to be adapted to the weightless environment within 5 months of microG exposure.

Adaptation, Biological↗

PubMed2001

Estimation of end-expiratory lung volume variations by optoelectronic plethysmography.

OBJECTIVE: To test the capability of optoelectronic plethysmography (OEP) to monitor positive end-expiratory pressure (PEEP)-induced changes of end-expiratory lung volume (EELV) changes in mechanically ventilated paralyzed patients. DESIGN: Laboratory and clinical investigation. SETTING: Intensive care unit of the Ospedale Maggiore Policlinico di Milano. PATIENTS: A total of eight patients with respiratory failure of various degrees, sedated and paralyzed. INTERVENTIONS: PEEP variations (+/-5 cm H2O) relative to the baseline PEEP of 10 cm H2O. MEASUREMENTS AND MAIN RESULTS: In the model protocol, we tested the reproducibility of the OEP by repeating volume measurements of a plastic torso model over a 21-hr period, every 30 mins. The variations of OEP measurements of the torso model (9337 mL value) were encountered in a range of 16 mL (sd = 4 mL). In the patient protocol, we measured the end-expiratory volume of the chest wall (EEVCW) breath-by-breath by OEP before, during, and after the PEEP increase/decrease and we compared its variations with the corresponding variations of EELV measured by helium dilution technique. The regression line between EELV changes measured by helium and EEVCW changes measured by OEP resulted very close to the identity line (slope 1.06, intercept -0.02 L, r(2) = 0.89) and their difference was not related to their absolute magnitude. After PEEP increase, the new steady state of EEVCW was reached approximately in 15 breaths; and, after PEEP decrease, in 3-4 breaths. The slow increase in EEVCW was mainly because of the abdominal compartment. CONCLUSION: OEP measurements of EEVCW accurately reflect the changes of EELV. Furthermore, OEP allows a continuous compartmental analysis, even during unsteady conditions.

Adult↗

PubMed2001

Transfer impedance of the respiratory system by forced oscillation technique and optoelectronic plethysmography.

To estimate the transfer impedance of the respiratory system (Ztr), we applied pressure forcing at the mouth from 1 to 24 Hz in eight healthy subjects and used optoelectronic plethysmography (OEP) to measure volume changes of the chest wall and its different compartments: pulmonary rib cage (RCp), abdominal rib cage (RCa) and abdomen (AB). Spectral analysis allowed assessment of input impedance (Zin) and total (Ztr) and compartmental (ZRCP, ZRCa, and ZAB) transfer impedances. As expected, averaged values of Zin and Ztr were similar at low frequencies (< 8 Hz) while they progressively differed at high frequencies. The percentage contributions of ZRCp, ZRCa , and ZAB to Ztr were, respectively, 35.3 +/- 1.4SD, 13.8 +/- 1.4, and 50.8 +/- 2.8 at low frequencies (< 8 Hz) and 63.1 +/- 5.5, 20.7 +/- 5.2, and 16.2 +/- 2.3 at higher frequencies (> 10 Hz). The validation of our approach was based on the comparison with a physical model comprised of a rubber membrane stretched over and attached to the lip of a bowl. We conclude that the combination of forced oscillations with OEP provides the simultaneous assessment of Zin and Ztr, it does not require the use of a plethysmographic chamber and it allows the separation between the different rib cage-abdominal pathways.

Abdomen↗