Objectives This study reports on a secondary exploratory analysis of the early clinical outcomes of a randomised clinical trial comparing robotic arm-assisted unicompartmental knee arthroplasty (UKA) for medial compartment osteoarthritis of the knee with manual UKA performed using traditional surgical jigs. This follows reporting of the primary outcomes of implant accuracy and gait analysis that showed significant advantages in the robotic arm-assisted group. Methods A total of 139 patients were recruited from a single centre. Patients were randomised to receive either a manual UKA implanted with the aid of traditional surgical jigs, or a UKA implanted with the aid of a tactile guided robotic arm-assisted system. Outcome measures included the American Knee Society Score (AKSS), Oxford Knee Score (OKS), Forgotten Joint Score, Hospital Anxiety Depression Scale, University of California at Los Angeles (UCLA) activity scale, Short Form-12, Pain Catastrophising Scale, somatic disease (Primary Care Evaluation of Mental Disorders Score), Pain visual analogue scale, analgesic use, patient satisfaction, complications relating to surgery, 90-day pain diaries and the requirement for revision surgery. Results From the first post-operative day through to week 8 post-operatively, the median pain scores for the robotic arm-assisted group were 55.4% lower than those observed in the manual surgery group (p = 0.040). At three months post-operatively, the robotic arm-assisted group had better AKSS (robotic median 164, interquartile range (IQR) 131 to 178, manual median 143, IQR 132 to 166), although no difference was noted with the OKS. At one year post-operatively, the observed differences with the AKSS had narrowed from a median of 21 points to a median of seven points (p = 0.106) (robotic median 171, IQR 153 to 179; manual median 164, IQR 144 to 182). No difference was observed with the OKS, and almost half of each group reached the ceiling limit of the score (OKS > 43). A greater proportion of patients receiving robotic arm-assisted surgery improved their UCLA activity score. Binary logistic regression modelling for dichotomised outcome scores predicted the key factors associated with achieving excellent outcome on the AKSS: a pre-operative activity level > 5 on the UCLA activity score and use of robotic-arm surgery. For the same regression modelling, factors associated with a poor outcome were manual surgery and pre-operative depression. Conclusion Robotic arm-assisted surgery results in improved early pain scores and early function scores in some patient-reported outcomes measures, but no difference was observed at one year post-operatively. Although improved results favoured the robotic arm-assisted group in active patients (i.e. UCLA ⩾ 5), these do not withstand adjustment for multiple comparisons. Cite this article: M. J. G. Blyth, I. Anthony, P. Rowe, M. S. Banger, A. MacLean, B. Jones. Robotic arm-assisted versus conventional unicompartmental knee arthroplasty: Exploratory secondary analysis of a randomised controlled trial. Bone Joint Res 2017;6:631–639. DOI: 10.1302/2046-3758.611.BJR-2017-0060.R1.
This paper presents the development of a cluster based, motion capture enabled, rehabilitation game for intensive practice in stroke rehabilitation. The implementation uses a low cost 6 camera Vicon Origin system and their Evoke software. The data is streamed live to a Visualstudio2022 bespoke c++ program (SCM) which implements a biomechanical cluster based model of the upper arms utilizing a pointer and 12 key anatomical landmarks. The data is then lived streamed to Unreal Engine 5 where it is used as the input to a 3D bubble popping game designed for stroke rehabilitation in mild to moderately effected stroke survivors.
Human gait analysis for stroke rehabilitation therapy using video processing tools has become popular in recent years. This paper proposes a single-camera system for capturing gait patterns using a Kalman-Structural-Similarity-based algorithm which tracks multiple markers simultaneously. This algorithm is initialized by obtaining the user-selected blocks in the first frame of each video, and the tracker is implemented by using Structural-Similarity image quality assessment algorithm to detect each marker frame by frame within a search area determined by a discrete Kalman filter. Experimental results show the trajectories of the markers fixed on the joints of a human body. The obtained numerical results are used to generate gait information (e.g., knee joint angle) that is later used for diagnostics. The proposed method aims to explore an alternative and portable way to implement human gait analysis with significantly less cost compared to a state-of-the-art 3D motion capture system.
Abstract Jaswal & Akhtar's outstanding target article identifies the necessary social nature of the human mind, even in autism. We agree with the authors and present significant contributory origins of this autistic isolation in disruption of purposeful movement made social from infancy. Timing differences in expression can be misunderstood in embodied engagement, and social intention misread. Sensitive relations can repair this.
<p>Supplemental Figure 1. (A) Calu-1 cells were treated with VEGF (50 ng/ml) for 15 minutes and phospho-p38 levels were evaluated by Western blotting. VEGF treatment resulted in activation of p38, and this was blocked with the addition of VEGFR TKIs axitinib or sorafenib. (B) A549, H23, and Calu-1 cells express minimal levels of VEGFR1 as determined by ELISA assay. SKNAS neuroblastoma cells serve as a positive control.</p>
Falls in elderly are the leading cause of injury and therefore considered a major health problem in our ageing society [1]. A fall is the result of an inadequate restoration of balance when it is compromised. The use of external perturbations to evoke loss of balance in a standardized and safe manner is an increasingly popular approach to measur e dynamic stability, offering opp ortunities for fall prevention research [2]. Although a perturbation - paradigm is promising, little is known about the type of perturbation that is most informative to quantify dynamic stability. Therefore, the first aim of this feasibility study was to evaluate whether mechanical, visual and auditory perturbations can be used to affect dynamic stability. The second aim was to evaluate whether we can distinguish between younger and older adults using the response to external perturbations.
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