Abstract
This paper uses human movement analyses to assess the susceptibility of brain stroke, one of the most important causes of disability in elders. To that end, a computerized battery of nine neuromuscular tests has been designed and evaluated with a sample of 120 subjects with or without stoke risk factors. The kinematics of the movements produced was analyzed using a computational neuromuscular model and predictive characteristics were extracted. Logistic regression and linear discriminant analysis with leave-one-out cross-validation was used to infer the probability of presence of brain stroke risk factors. The clinical potential value of movement information for stroke prevention was assessed by computing area under the receiver operating characteristic curve (AUC) for the diagnostic of risk factors based on motion analysis. AUC mostly varying between 0.6 and 0.9 were obtained, depending on the neuromuscular test and the risk factor investigated (obesity, diabetes, hypertension, hypercholesterolemia, cigarette smoking, and cardiac disease). Our results support the feasibility of the proposed methodology and its potential application for the development of brain stroke prevention tools. Although further research is needed to improve this methodology and its outcome, results are promising and the proposed approach should be of great interest for many experimenters open to novel approaches in preventive medicine and in gerontology. It should also be valuable for engineers, psychologists, and researchers using human movements for the development of diagnostic and neuromuscular assessment tools.
Highlights
A brain stroke, or cerebrovascular accident, is characterized by the sudden loss of brain functions caused by an interruption of the blood supply to the brain or by the rupture of blood vessels in the brain
We present a summary of the outcome of our research program in terms of area under the receiver operating characteristic curve (AUC) for the classification of brain stroke risk factors as a demonstration of the level of clinical potential of human movement information for the development of brain stroke prevention tools
Such a qualitative assessment depends on the problem at hand, this rule of thumb can be used as a starting point when no previous data are available to compare the AUC reached in a study with previously established results
Summary
A brain stroke, or cerebrovascular accident, is characterized by the sudden loss of brain functions caused by an interruption of the blood supply to the brain or by the rupture of blood vessels in the brain. 50,000 Canadians and 795,000 Americans are victims of this disease. In Canada and United-States, it is the third cause of mortality, causing direct and indirect costs of Can$ 3.6 billion (evaluated in 2000) and US$ 68.9 billion (evaluated in 2009) (Lloyd-Jones et al, 2009; Fondation des maladies du coeur, 2012). Among subjects of 65 years old or more of the Framingham Study cohort, 6 month post-stroke, 50% were suffering from hemiparesis, 30% were unable to walk without assistance, 26% needed assistance for their daily activities and 26% were institutionalized. Aphasia, depression, incontinence, sensitive deficits, social integration difficulties, and hemianopsis were frequent symptoms (between 15 and 40%) (Kelly-Hayes et al, 2003)
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