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Wearable Sensor-Based Digital Biomarker to Estimate Chest Expansion During Sit-to-Stand Transitions-A Practical Tool to Improve Sternal Precautions in Patients Undergoing Median Sternotomy.
IEEE Transactions on Neural Systems and Rehabilitation Engineering ( IF 4.9 ) Pub Date : 2019-11-06 , DOI: 10.1109/tnsre.2019.2952076
Changhong Wang , Rahul Goel , Maria Noun , Ravi K Ghanta , Bijan Najafi

Sternal precautions are a universal part of the discharge education for post-sternotomy patients to reduce the risk of sternal complications. However, they are always designed based on physical therapists' or surgeons' subjective judgment without any objective evidence. Thus, they could be overly restrictive to hinder the patients' recovery, physically and psychologically. To fill this gap, this paper proposes a digital biomarker to estimate chest expansion during sit-to-stand transitions based on wearable inertial sensing and data fusion technologies. First, we carried out bench tests to evaluate the reliability of the digital biomarker to represent relative sensor rotation. We also verified effectiveness of this digital biomarker to detect subtle skin extension in proactive chest expansion trials by 11 healthy volunteers. Then, we measured the digital biomarker during sit-to-stand transitions with different strategies and some daily routine activities (walking, sitting, and standing) performed by the healthy volunteers and 22 post-sternotomy patients. The comparison between these measurements evaluated the effectiveness of several known guidelines of sternal precautions for sit-to-stand transitions. The results showed that first, pushing up from a chair by taking support from armrests induced larger chest expansion ( p = 0.009 ) compared with sit-to-stand transition while keeping the arms relaxed; second, crossing the arms or hugging a pillow can help reduce chest expansion ( ) compared with keeping the arms relaxed during sit-to-stand transitions; third, pushing up while taking support from a frontal support (e.g., table or walker) induced the same level of chest expansion ( ) as that during sit-to-stand transition while keeping the arms relaxed.

中文翻译:

基于可穿戴传感器的数字生物标记,用于估计从坐到站的转换过程中胸部扩张情况 - 一种改善接受正中胸骨切开术患者胸骨预防措施的实用工具。

胸骨预防措施是胸骨切开术后患者出院教育的普遍组成部分,以降低胸骨并发症的风险。然而,它们总是基于物理治疗师或外科医生的主观判断而设计,没有任何客观证据。因此,它们可能会过度限制,从而阻碍患者身体和心理的康复。为了填补这一空白,本文提出了一种数字生物标记,基于可穿戴惯性传感和数据融合技术来估计从坐到站转变过程中的胸部扩张。首先,我们进行了台架测试,以评估数字生物标记代表相对传感器旋转的可靠性。我们还在 11 名健康志愿者进行的主动扩胸试验中验证了这种数字生物标记物检测细微皮肤延伸的有效性。然后,我们测量了健康志愿者和 22 名胸骨切开术后患者采用不同策略和一些日常活动(行走、坐着和站立)从坐到站转换过程中的数字生物标记。这些测量值之间的比较评估了几种已知的坐站转换胸骨预防措施指南的有效性。结果表明,首先,在保持手臂放松的情况下,与从坐到站的过渡相比,通过扶手的支撑从椅子上推起来会引起更大的胸部扩张(p = 0.009);其次,与在坐站转换过程中保持手臂放松相比,交叉双臂或抱枕头有助于减少胸部扩张();第三,在保持手臂放松的情况下,在获得正面支撑(例如桌子或助行器)支撑的同时向上推,会引起与从坐到站的过渡期间相同水平的胸部扩张()。
更新日期:2019-11-01
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