Limb accelerations during sleep are related to measures of strength, sensation, and spasticity among individuals with spinal cord injury.

Autor: Rigot SK; Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA.; Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA.; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.; Max Näder Center for Rehabilitation Technologies & Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA.; Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA., Boninger ML; Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA.; Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA.; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.; Departments of Rehabilitation Science and Technology, Pittsburgh, PA, USA.; Departments of Physical Medicine and Rehabilitation, University of Pittsburgh, 3520 Fifth Avenue, Suite 300, 15213, Pittsburgh, PA, USA., Ding D; Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA.; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.; Departments of Rehabilitation Science and Technology, Pittsburgh, PA, USA., Collinger JL; Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA.; Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA.; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.; Departments of Physical Medicine and Rehabilitation, University of Pittsburgh, 3520 Fifth Avenue, Suite 300, 15213, Pittsburgh, PA, USA., Dicianno BE; Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA.; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.; Departments of Rehabilitation Science and Technology, Pittsburgh, PA, USA.; Departments of Physical Medicine and Rehabilitation, University of Pittsburgh, 3520 Fifth Avenue, Suite 300, 15213, Pittsburgh, PA, USA., Worobey LA; Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA, USA. law93@pitt.edu.; Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA. law93@pitt.edu.; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA. law93@pitt.edu.; Departments of Physical Medicine and Rehabilitation, University of Pittsburgh, 3520 Fifth Avenue, Suite 300, 15213, Pittsburgh, PA, USA. law93@pitt.edu.; Departments of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA. law93@pitt.edu.
Jazyk: angličtina
Zdroj: Journal of neuroengineering and rehabilitation [J Neuroeng Rehabil] 2022 Nov 03; Vol. 19 (1), pp. 118. Date of Electronic Publication: 2022 Nov 03.
DOI: 10.1186/s12984-022-01090-8
Abstrakt: Background: To evaluate the relationship between measures of neuromuscular impairment and limb accelerations (LA) collected during sleep among individuals with chronic spinal cord injury (SCI) to provide evidence of construct and concurrent validity for LA as a clinically meaningful measure.
Methods: The strength (lower extremity motor score), sensation (summed lower limb light touch scores), and spasticity (categorized lower limb Modified Ashworth Scale) were measured from 40 adults with chronic (≥ 1 year) SCI. Demographics, pain, sleep quality, and other covariate or confounding factors were measured using self-report questionnaires. Each participant then wore ActiGraph GT9X Link accelerometers on their ankles and wrist continuously for 1-5 days to measure LA from movements during sleep. Regression models with built-in feature selection were used to determine the most relevant LA features and the association to each measure of impairment.
Results: LA features were related to measures of impairment with models explaining 69% and 73% of the variance (R²) in strength and sensation, respectively, and correctly classifying 81.6% (F1-score = 0.814) of the participants into spasticity categories. The most commonly selected LA features included measures of power and frequency (frequency domain), movement direction (correlation between axes), consistency between movements (relation to recent movements), and wavelet energy (signal characteristics). Rolling speed (change in angle of inclination) and movement smoothness (median crossings) were uniquely associated with strength. When LA features were included, an increase of 72% and 222% of the variance was explained for strength and sensation scores, respectively, and there was a 34% increase in spasticity classification accuracy compared to models containing only covariate features such as demographics, sleep quality, and pain.
Conclusion: LA features have shown evidence of having construct and concurrent validity, thus demonstrating that LA are a clinically-relevant measure related to lower limb strength, sensation, and spasticity after SCI. LA may be useful as a more detailed measure of impairment for applications such as clinical prediction models for ambulation.
(© 2022. The Author(s).)
Databáze: MEDLINE
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