Effective Assessment Method Research Articles

Non-invasive imaging of pathological scars using a portable handheld two-photon microscope.

Pathological scars are a disorder that can lead to various cosmetic, psychological, and functional problems, and no effective assessment methods are currently available. Assessment and treatment of pathological scars are based on cutaneous manifestations. A two-photon microscope (TPM) with the potential for real-time non-invasive assessment may help determine the under-surface pathophysiological conditions in vivo . This study used a portable handheld TPM to image epidermal cells and dermal collagen structures in pathological scars and normal skin in vivo to evaluate the effectiveness of treatment in scar patients. Fifteen patients with pathological scars and three healthy controls were recruited. Imaging was performed using a portable handheld TPM. Five indexes were extracted from two dimensional (2D) and three dimensional (3D) perspectives, including collagen depth, dermo-epidermal junction (DEJ) contour ratio, thickness, orientation, and occupation (proportion of collagen fibers in the field of view) of collagen. Two depth-dependent indexes were computed through the 3D second harmonic generation image and three morphology-related indexes from the 2D images. We assessed index differences between scar and normal skin and changes before and after treatment. Pathological scars and normal skin differed markedly regarding the epidermal morphological structure and the spectral characteristics of collagen fibers. Five indexes were employed to distinguish between normal skin and scar tissue. Statistically significant differences were found in average depth ( t = 9.917, P <0.001), thickness ( t = 4.037, P <0.001), occupation ( t = 2.169, P <0.050), orientation of collagen ( t = 3.669, P <0.001), and the DEJ contour ratio ( t = 5.105, P <0.001). Use of portable handheld TPM can distinguish collagen from skin tissues; thus, it is more suitable for scar imaging than reflectance confocal microscopy. Thus, a TPM may be an auxiliary tool for scar treatment selection and assessing treatment efficacy.

Assessment of laparoscopic intracorporeal intestinal anastomosis training using simulation-based 3D printed models: exploring surgical performance and learning curves.

Intestinal anastomosis is a clinical procedure widely used to reconstruct the digestive tract, but authentic laparoscopic intracorporeal intestinal anastomosis（LIIA） models are lacking. However, three-dimensional (3D) printing can enable authentic and reusable models. In this paper, a novel cost-effective 3D-printing training model of LIIA is designed and the authenticity and validity of the model are tested. An FDM 3D printing and assembled lab model were built to test LIIA. Fifteen surgeons were required to perform LIIA, and their operation score and time were recorded and analyzed. Five experts were invited to assess the face and content validity of the models. A study was also performed to further evaluate and validate the learning curve of surgeons. The difference in Modified anastomosis objective structured assessment of technical skills (MAOSATS) scores between the expert, intermediate and novice groups were significant (64.1±1.8: 48.5±1.7: 29.5±3.1, P < 0.001). In addition, the operation time of the procedure was statistically different for all three groups (21.5±1.9: 30.6±2.8:70.7±4.0, P < 0.001). The five experts rated the face and content validity of the model very highly, with the median being four out of five. Surgeons who underwent repeated training program showed improved surgical performance. After eight training, the novices' performance was similar to that of the average level of untrained intermediates, while the operation scores of the intermediates were close to that of the average level of experts. In this study, it is found that the LIIA model exhibits excellent face, content and construct validity, repeated simulation training of the LIIA training program improved the surgeon's operative performance, so the model is considered one of the effective methods for LIIA training and assessment of surgical quality in the future and for reducing healthcare costs.

System Development and Evaluation of Human–Computer Interaction Approach for Assessing Functional Impairment for People with Mild Cognitive Impairment: A Pilot Study

Non-pharmacological treatments have gained significant attention in the field of cognitive impairment. Among them, human–computer interaction-based (HCI) methods have emerged as a promising approach due to their broad applicability and convenience in assessing symptoms associated with this progressively debilitating condition. However, existing rehabilitation training systems for cognitive impairment lack effective assessment methods to meet the diverse rehabilitation needs of users. In this article, we surveyed existing HCI-based cognitive rehabilitation training systems and analyzed their advantages and shortcomings. Drawing from the insights gained from these systems, we propose a novel Leap Motion-based building block training system that incorporates system software capable of generating highly realistic virtual scenes, with the added capability of user behavior detection using Kinect. We conducted user testing of this new system, comparing the performance of a representative cohort with mild cognitive impairment (MCI) (n = 9) to that of disease-free participants (n = 10). Additionally, we conducted ergonomic experiments to assess the system’s performance in elderly people. The experimental results revealed significant differences between the MCI cohort and the control cohort. Specifically, the MCI cohort exhibited a reduced range of motion and longer task completion times compared to the control cohort. These findings have the potential to contribute to the differentiation of cognitive levels. In conclusion, our analysis of existing cognitive rehabilitation training systems provides valuable insights for researchers working on the development of future innovative cognitive rehabilitation training systems and enriches the non-pharmacological treatment models for cognitive impairment. Furthermore, the observed relationship between behavioral data, task completion times, and cognitive levels in older adults offers useful insights for the design of HCI-based approaches for diagnosing and assessing the treatment of MCI.

P-202 Using artificial intelligence platform coupled to an existing time system; external validation of an automatic embryo score to assist in selection

Abstract Study question How does a novel artificial intelligence-based embryo evaluation system work in Geri® time-lapse systems? Summary answer Automatic score platform provided externally for embryos cultured in Geri® was associated with conventional morphology, euploidy, implantation and live birth. What is known already Artificial intelligence has been making headway in assisted reproduction in recent years. Many companies have developed different models for automated embryo evaluation and selection, such as CHLOETM software (Fairtility, Israel). According to the developers, it is an orchestration of cutting-edge morphological and morphokinetic AI algorithms, trained over 100,000 embryo videos and tens of millions of images. Different laboratories validated its use in specific time-lapse systems (Embryoscope, Vitrolife). However, this is the first time that an objective and independent review of CHLOETM has been performed on Geri® (Genea Biomedx, Australia) time-lapse system. Study design, size, duration This retrospective analysis included 3568 embryos from 417 patients that underwent IVF treatments in a single center. Embryos were cultured in Geri® (Genea Biomedx, Australia) time-lapse systems by single step media (Geri Medium, Genea Biomedx, Australia) and routinely evaluated by senior embryologists by using Connect and Assess software according to the ASEBIR criteria (from A-high quality to D-low quality and excluded embryos). Then, embryos were automatically scored by CHLOETM from 0 to 1. Participants/materials, setting, methods Automatic embryo score was compared with conventional morphology (n = 3568 embryos), ploidy (n = 467 embryos), and clinical outcomes for single blastocyst transfers (n = 461). Main results and the role of chance The comparison between the embryo score provided by CHLOETM and the category assigned by embryologists showed a direct association*. The means were 0.97 ± 0.10 for A (n = 123); 0.89 ± 0.21 for B (n = 842); 0.74 ± 0.30 for C (n = 607), 0.24 ± 0.31 for D (n = 997) and 0.15 ± 0.25 for excluded embryos (n = 403). The automatic embryo score for oocytes that failed to fertilize was 0.06 ± 0.19 (n = 596). Regarding the chromosomal status, embryos with normal content had significantly higher score than abnormal ones. Following results are presented per quartiles of similar sample size: the euploidy rates were 35.9% for score &amp;lt; 0.81 (n = 117), 40.8% for score 0.81-0.96 (n = 120), 48% for score 0.96-0.99 (n = 125) and 58.1% for score &amp;gt;0.99 (n = 105)*. Implanted embryos achieved significantly higher marks than non-implanted embryos: 0.93 ± 0.15 (n = 251) vs. 0.85 ± 0.25 (n = 210)*. Also, automatic embryo score was higher for embryos that led to a live birth than those that did not: 0.94 ± 0.15 (n = 188) vs. 0.86 ± 0.24 (n = 243)*. Focusing on top quality embryos (A+B), the score means were 0.94 ± 0.16 for implanted good quality embryos 0.88 ± 0.22 for non-implanted ones* (*p&amp;lt;0.05). Limitations, reasons for caution This project is limited by its retrospective and single-center nature. Multicenter validation would be necessary to ensure it is a safe and effective method of embryo assessment. Wider implications of the findings In addition to verifying that automatic scoring agrees with embryologists, this study demonstrated its ability to be applied in Geri Time-lapse incubator to distinguish between potential embryos with similar morphological characteristics helping embryologist to make decisions. Trial registration number NOT APPLICABLE

Quantitative Evaluation Method for the Structural Safety Status of Traditional Courtyard-Style Timber Buildings

ABSTRACT Traditional courtyard-style timber building is a type of typical architectural timber heritage with special structures, which is different from traditional timber building unit. This paper proposes a scientific and effective assessment method for the structural safety status of traditional courtyard-style timber buildings. Firstly, based on the Improved Analytic Hierarchy Process (IAHP) which introduces the calculation method of component importance, the quantitative weights of components in traditional courtyard-style timber buildings are obtained. Secondly, the structural safety status evaluation system, the evaluation indexes and the evaluation weights are established based on the consideration of the structural characteristics of courtyard-style timber buildings. Finally, through on-site investigation and structural analysis, the structural safety status of a typical traditional courtyard-style timber-frame building — the Chu Hsi’s Public Granary, is studied to provide a basis for the subsequent conservation of the building. In addition, a quantitative automated security assessment software for courtyard-style timber buildings is developed. The study results can provide a reference for the safety assessment and preventive conservation of traditional courtyard-style timber building.

Hourly based methods to assess carbon footprint flexibility and primary energy use in decarbonized buildings

Constant emission factors to assess the carbon footprint of buildings energy use, as usually included in national Building Technical Codes, show their limitations since the electrical grid mix changes constantly. For this reason, hourly-based methods using time-varying penalty signals to calculate carbon emissions and primary energy use in buildings constitute more effective assessment methods, especially with the aim to activate energy flexibility in buildings based on those inputs. Such signals have been developed and tested in the present work. The robustness and effectiveness of the methods is tested throughout two study cases. The first case compares the impact of using hourly signals over constant factors from the standards. For that purpose, a measured aggregated consumption profile corresponding to 226 real households is analyzed. In the second study case, demand response is implemented through control strategies reacting to the hourly penalty signals, aiming to decrease the emissions, primary energy use and cost. Results for the first case reveal that hourly rates better capture the variability of the electric grid compared to constant yearly factors from national standards, with a 50% difference in carbon emissions and a 20% overestimation with primary energy. Results from the second study case show how the implemented modulation strategies offer benefits in the flexible scenarios compared to the base scenarios, in terms of accumulated emissions or primary energy. Improvements are especially perceived when splitting data seasonally and considering periods with higher demand. Furthermore, this study provides insights for developing energy flexibility inputs when assessing the building performance during critical events such as the COVID19 pandemic or extreme weather conditions, where hourly and seasonal variation might have greater impact. Demand response mechanisms as energy flexibility strategies studied through this work might help in the reduction of total emissions and primary energy. Depending if the goal is to shift the demand due to environmental or economical reasons, different modulation strategies can be implemented to reach greater benefits.

Mass Spectrometry-Based Omics and Imaging Technique: A Novel Tool for Molecular Toxicology and Health Impacts

Mass spectrometry (MS)-based omics and MS imaging (MSI) technique have been adopted as a powerful analytical strategy to investigate the toxicological effect on human health and molecular mechanism of environmental pollutants. In contrast to conventional toxicological methodologies, MS-based omics and MSI technique provides the possibility to analysis a plenty of molecules in qualitative, quantitative and spatial distribution variation including parent compounds and their metabolites as well as related endogenous metabolome, lipidome and proteome. In this perspective, we showcase the progress in MS-based omics analysis and MSI, and highlight sample preparation, high-throughput screening, data mining and more which are critical to the success of acquiring the exogenous exposure-induced molecule profiling variation and effective risk assessment method at the cellular and organ scale. The aim of this review is to contribute to a better understanding of potential molecule toxicity, pathological findings and action mechanisms caused by pollutant exposure, avoiding the environmental damage on human health if possible.

New approach to junction efficiency analysis of hexagonal geogrid using digital image correlation method

Geosynthetics are commonly used in many civil engineering applications. At the same time, intensive development of these materials is being carried out. Therefore, it becomes more and more important to correctly determine the mechanical parameters of geosynthetics in laboratory tests. This is especially important for more complicated hexagonal geogrids. This article presents the results of the laboratory research carried out to evaluate the junction efficiency of hexagonal geogrid under static load by analyzing deformations of geogrid junctions and ribs. A new approach to determination the efficiency is given by the newly defined strain junction efficiency coefficient based on the true principal strains. In the laboratory tests the digital image correlation (DIC) method was used. This method allowed for the determination of displacements and strains of geogrid specimens in any direction and at any point. The results of the conducted research and analysis indicate that the proposed innovative junction effectiveness assessment method enables a better presentation of the geogrid performance at different levels of tensile load. In addition to the parameters given in the technical approval for this material, the proposed new strain junction efficiency coefficient can be an effective parameter for evaluating hexagonal geogrid performance at different strain levels.

Material recognition for fault diagnosis in machine tools using improved Mel Frequency Cepstral Coefficients

Identification of material type in structural cracks is crucial for fault diagnosis and structural integrity assessment in multi-component operation systems. In the current literature, acoustic emission (AE) signal analysis has been extensively explored as an effective method for crack monitoring and fatigue damage assessment. Most existing research on crack diagnosis is primarily focused on determining the crack formation in structures using the AE signals corresponding to known materials. However, the material recognition at any given cracking conditions using AE signals has lagged behind, hindering fault detection and damage repair in complex and multi-material structures. This research investigates the feasibility of the synergistic use of Mel Frequency Cepstral Coefficients (MFCC) and K-nearest neighbor (KNN) algorithms for identifying the material type in any arbitrary cracking processes. In the proposed method, MFCC and first-order differential MFCC parameters are extracted from the real-time AE signals. Material-specific cracking characteristics are identified and tuned for material recognition using a KNN classifier. The proposed method is validated using the AE signals of different types of materials acquired under uniaxial tension, and its effectiveness in identifying tool breakage is evaluated through case studies in the milling process. The result indicates that the recognition accuracy of up to 96.21 % can be achieved in tool breakage detection in milling operations by extracting material-specific fracture characteristics.

Leiter-3 Scale as Instrument for Assessment of Children with Emotional-Volitional Disorders

Background : assistance to children with emotional and volitional disorders requires effective methods of psychological assessment. However, using standard diagnostic methods in this regard is often considered problematic. Successful application of a standard Leiter-3 test in the described sample provides a valuable insight into the prospects for standardized diagnostics in this area. Aim : to evaluate the possibilities of using the Leiter-3 battery for examining a group of children with severe emotional and volitional disorders. Patients and methods : the study involved preschoolers and adolescents with emotional and volitional disorders (41 people in total) attending group remedial classes at the Center of Curative Pedagogics (Moscow). A pilot study of non-verbal intelligence was carried out using the Leiter-3 test. Results : we have identified a number of problems that make it difficult to use the technique in this group. They are associated with certain traits of the children involved — difficulties in contact, interaction, communication (both verbal and non-verbal), acceptance of the examination situation, focusing on the task, etc. Many of these problems could be solved by slightly modifying the methodology and maintaining certain conditions during testing. Conclusions: the Leiter-3 method can be successfully used to assess the level of intellectual development of children with severe emotional and volitional disorders. However, in some cases it is advisable to apply an individual approach and modify the examination procedure taking into account the characteristics of the child. Further research is needed to verify results obtained that way.

Real-time comprehensive health status assessment of hydropower units based on multi-source heterogeneous uncertainty information

An effective health status assessment (HSA) method of hydropower unit (HU) is the key to obtaining the real status of HU and providing technical support for safety operation decisions. Thus, a real-time comprehensive HSA method for HUs is proposed. Firstly, a multi-scale data cleaning method based on Gaussian mixture model and density-based spatial clustering of applications with noise (GMM-DBSCAN) is proposed to eliminate outliers and dense anomalies while considering for the variation of operating conditions. Secondly, the correlation analysis method is used to select important measurement points reflecting HU operation status to create multi-source evaluation indices. Then, a novel health indicator (HI) based on Gaussian cloud model (GCM) is proposed to analyze HU condition changes, considering the uncertainty of monitoring signal changes. Further, a hybrid weighting calculation method is proposed to establish a real-time comprehensive health index (RCHI) for assessing HU status. Finally, the proposed approach is verified by a case study using data from a hydropower station in China. The results show that the method improved the stability and smoothness of the state assessment curve compared to other studies.

Assessing the Implementation of Critical Thinking Skills in the University: A Focus on Technology Education

There is a great demand for universities to foster critical thinking skills and this requires universities to develop effective assessment methods. Critical thinking skills enable students to interpret and integrate new information and the manner in which it is applied in unfamiliar settings. The purpose of this article is to determine the extent to which technology lecturers set summative questions that stimulate students to apply critical thinking skills. Facione’s framework for critical thinking skills was used to assess how technology lecturers stimulate critical thinking during the summative assessment. A qualitative approach was applied using a case study design. The sample constituted four technology lecturers who taught four technology modules at the undergraduate level. The findings indicated that technology lecturers in the selected university, to some extent, elicited critical thinking skills, which is important as modern education requires students to develop critical thinking skills to find technological solutions to everyday problems. Keywords: Analysis; Assessment; Bloom’s Taxonomy; Critical Thinking Skills; Deduction; Evaluation

Quantitative study on the propagation characteristics of MFL signals of outer surface defects in long-distance oil and gas pipelines

The magnetic flux leakage (MFL) internal detection is one of the most effective methods for assessment of long-distance oil and gas pipelines. To quantify the outer surface defect through MFL signals, which are affected by pipe wall and its shielding effect, propagation compensation factor (PCF) was proposed to apply to a classical magnetic charge model. Using the established model for outer surface defects in long-distance oil and gas pipelines, characteristics of MFL signals with different wall thicknesses and defect sizes along with their propagation patterns were analyzed. To verify the analytical model, X70 pipes with different wall thicknesses were used for systematic experiments. The results showed that the pipe wall thickness had a significant attenuation effect on the MFL signals of external defects. As the wall thickness increased from 7 to 17 mm, the MFL signals exhibited a first-order exponential decay, with a maximum error of 25.8% and a minimum error of 2.5%. When the defect depth increased from 0.6 to 7.2 mm, the MFL signals showed a first-order exponential upward trend, with a maximum error of 18.8% and a minimum error of 2.0%. This study effectively described the propagation characteristics of MFL signals of outer surface defects, and facilitated identification and quantitative evaluation of outer surface defects.

Applications of Terrestrial Laser Scanner in Detecting Pavement Surface Defects

An entire roadway system represents a crucial element in the sustainable urban transportation planning process. Pavement surfaces are at continual risk of accumulating serious deteriorations and defects throughout their service life due to traffic loading and environmental impact. Since roadway networks are growing rapidly, relying on visual pavement inspection is not always feasible. Therefore, this paper proposes an effective assessment method for evaluating flexible pavement surface distresses using a terrestrial laser scanner (TLS) and calculating the pavement condition index (PCI). The proposed terrestrial laser scanner method results in road condition assessments becoming faster, safer, and more systematic. It also aims to determine the geometric characteristics of the investigated roads. A major road in Egypt was selected to test the proposed technique and compare it with the traditional visual inspection method. The evaluation was carried out to assess different types of pavement distress, such as cracking, rutting, potholes, and raveling distresses. Every pavement distress was defined in terms of surface area, the width of the crack, and intensity, and the data from TLS were then processed by MAGNET COLLAGE software. A MATLAB program was developed to match the TLS observational data to plane equations. PAVER software was also used to determine the PCI values for each TLS position. The revealed distresses for the investigated road using TLS observations reveal a significant improvement in determining flexible pavement distresses and geometric characteristics.

Nondestructive characterization of periodically poled lithium niobate crystals by measuring noise in diffraction pattern

Domain randomness is inherent in the fabrication of periodically poled lithium niobate (PPLN). The main cause of such domain randomness in fabrication of PPLN is due to electric poling process. This domain randomness not only impacts the effectiveness of frequency conversion, but also enhances the effectiveness of nonphase matched parasitic processes, which in many cases limits the performance of the device. In this paper, we experimentally demonstrate a nondestructive characterization of domain randomness in PPLN by diffraction-noise pattern with uniform illumination. We measure the domain randomness of PPLN and provide an effective method for poling quality assessment either as good or poor quality of PPLN through this paper.

Application of Remote Sensing Technology in Different Natural Disasters

Flood, typhoon and heat wave are common natural disasters in the world. Satellite remote sensing technology has become an effective method for geological hazard assessment due to its wide coverage, large imaging area and high time resolution. Based on introducing the research progress of flood disaster remote sensing monitoring, this paper compares and summarizes the research progress of principle and method of multi-source remote sensing flood monitoring, and analyses the advantages and disadvantages of various data. We also analyze the comprehensive application of remote sensing technology in typhoon monitoring from the perspectives of conventional observation data, satellite remote sensing data and unmanned aerial vehicle remote sensing data. In this paper, remote sensing technology is also used to monitor urban heat island and other climatic problems through machine learning, starting from solving heat wave problems in the climatic field by remote sensing. At the same time, the existing problems of various data resources in the analysis of various disasters are summarized, and the remote sensing technology which needs to make comprehensive use of multi-source data, the construction of climate monitoring system and other aspects are summarized to study the remote sensing information system in the field of natural climate disasters. The development trend of this technology is also summarized and prospected.

Non-intrusive speech quality assessment with attention-based ResNet-BiLSTM.

Speech quality is frequently affected by a variety factors in online conferencing applications, such as background noise, reverberation, packet loss and network jitter. In real scenarios, it is impossible to obtain a clean reference signal for evaluating the quality of the conferencing speech. Therefore, an effective non-intrusive speech quality assessment (NISQA) method is necessary. In this paper, we propose a new network framework for NISQA based on ResNet and BiLSTM. ResNet is utilized to extract local features, while BiLSTM is used to integrate representative features with long-term time dependencies and sequential characteristics. Considering that ResNet may result in the loss of context information when applied to the NISQA task, we propose a variant of ResNet which can preserve the time series information of the conferencing speech. The experimental results demonstrate that the proposed method has a high correlation with the mean opinion score of clean, noisy and processed speech.

Which field test should be used to compare the functional exercise capacities of patients with type 2 diabetes mellitus with and without diabetic peripheral neuropathy? Cross-sectional study

BackgroundThe 6-minute step test (6MST) has begun to be used as a simple and effective alternative for assessing functional exercise capacity. There is no study using 6MSTs to evaluate the exercise capacities of patients with type 2 diabetes mellitus (DM) with and without diabetic peripheral neuropathy (DPN). ObjectiveTo compare the cardiorespiratory responses of the 6-minute walk test (MWT) and the 6MST exercise tests and to analyze the usability of the 6MST in Type 2 DM patients with and without neuropathy. Methods32 non-neuropathic Type 2 DM, 32 neuropathic Type 2 DM patients, and 30 healthy volunteers were included in this cross-sectional study. Functional exercise capacity was evaluated with the 6MWT and the 6MST. The 30-second sit-stand test (30s STS) was used to evaluate general lower extremity muscle strength and function. ResultsThere was a significant difference in the results of 6MWT (m), 6MST (number of steps), and 30s STS of the three groups (p<0.05). The 6MST results of patients with neuropathic Type 2 DM were significantly lower than those of non-neuropathic diabetics and those who were healthy (number of steps; 114.07±25.57 vs. 133.48±33.57 vs. 160.35±28.52, respectively) (p=0.001). The change in cardiorespiratory response in systolic blood pressure, heart rate, perceived dyspnea, and leg fatigue severity was significantly higher at 6MST than 6MWT in the three groups (p<0.05). 6MST was correlated with 6MWT (r=0.679, p=0.001), and 30s STS (r=0.589, p=0.001) in patients with Type 2 DM. ConclusionsCardiorespiratory responses increased more in 6MST compared to 6MWT. In patients with Type 2DM, 6MWT and 6MST were moderately correlated with each other. 6MST is an effective and safe assessment method that may better reveal the differences in functional exercise capacity between neuropathic and non-neuropathic individuals in clinics.

Point-of-care ultrasound training in low-income countries: a need of time.

Point of care ultrasound (POCUS) is "an ultrasonography performed at the bedside in real-time by the treating physician." It is a powerful imaging modality used as an adjunct to physical examination and has gained momentum to become the future stethoscope. By using POCUS, the treating physician performs all image acquisition and interpretation and uses the information immediately to address specific hypotheses and guide the ongoing therapy. There is a shred of solid evidence that POCUS improves the diagnosis and management of acutely unwell patients is expanding rapidly. Due to the rise in the practice of POCUS in clinical medicine, the use of consultative ultrasonographic services has been reduced. The widespread availability of portable ultrasound machines and training an adequate number of clinicians to become competent in performing POCUS is a great challenge. The development of effective competency levels, curriculum, and assessment methods is imperative for the training of POCUS.

Which field test should be used to compare the functional exercise capacities of patients with type 2 diabetes mellitus with and without diabetic peripheral neuropathy? Cross-sectional study

BackgroundThe 6-minute step test (6MST) has begun to be used as a simple and effective alternative for assessing functional exercise capacity. There is no study using 6MSTs to evaluate the exercise capacities of patients with type 2 diabetes mellitus (DM) with and without diabetic peripheral neuropathy (DPN). ObjectiveTo compare the cardiorespiratory responses of the 6-minute walk test (MWT) and the 6MST exercise tests and to analyze the usability of the 6MST in Type 2 DM patients with and without neuropathy. Methods32 non-neuropathic Type 2 DM, 32 neuropathic Type 2 DM patients, and 30 healthy volunteers were included in this cross-sectional study. Functional exercise capacity was evaluated with the 6MWT and the 6MST. The 30-second sit-stand test (30s STS) was used to evaluate general lower extremity muscle strength and function. ResultsThere was a significant difference in the results of 6MWT (m), 6MST (number of steps), and 30s STS of the three groups (p<0.05). The 6MST results of patients with neuropathic Type 2 DM were significantly lower than those of non-neuropathic diabetics and those who were healthy (number of steps; 114.07±25.57 vs. 133.48±33.57 vs. 160.35±28.52, respectively) (p=0.001). The change in cardiorespiratory response in systolic blood pressure, heart rate, perceived dyspnea, and leg fatigue severity was significantly higher at 6MST than 6MWT in the three groups (p<0.05). 6MST was correlated with 6MWT (r=0.679, p=0.001), and 30s STS (r=0.589, p=0.001) in patients with Type 2 DM. ConclusionsCardiorespiratory responses increased more in 6MST compared to 6MWT. In patients with Type 2DM, 6MWT and 6MST were moderately correlated with each other. 6MST is an effective and safe assessment method that may better reveal the differences in functional exercise capacity between neuropathic and non-neuropathic individuals in clinics.