Execution Of Daily Living Activities Research Articles

Age Group Discrimination via Free Handwriting Indicators.

Ageing is a physiological phenomenon associated with cognitive and functional decline which, in the long term, could hamper the execution of daily life activities and threaten both social and independent life. The onset of chronic diseases can intensify this process, increasing the risk of hospitalisation and admission to long term care. This represents a significant burden on public health and reduces the quality of life of those affected. Early detection of unhealthy decline is therefore key, but the similarity to normal ageing hinders its prompt screening. This study presents a first step towards the early screening of unhealthy ageing, based on an innovative instrumented ink pen to ecologically assess handwriting performance in different age groups: 40-59 (Group 1), 60-69 (Group 2) and 70+ (Group 3) years old. Raw handwriting data were collected from 60 healthy subjects and used to extract fourteen indicators related to gesture and tremor. The indicators were then used to discriminate between subjects of different age groups in three binary classification tasks, using a selection of machine learning algorithms. This approach produced remarkable results, particularly in the task of greatest interest, identifying subjects at the very beginning of the ageing process (Group 2) from elderly subjects (Group 3), achieving an accuracy of 97.5%, an F1 score of 97.44% and a ROC-AUC of 95%. Explainability of the model, facilitated by the analysis of the Shapley values of the learned indicators, revealed age-dependent sensitivity of handwriting and tremor-related indicators. The proposed method represents a promising solution for the early detection of abnormal signs of ageing, and is designed for the remote, non-invasive, unsupervised home monitoring, to improve the care of older adults.

Three-Dimensional Assessment of Upper Limb Proprioception via a Wearable Exoskeleton

Proprioception—the sense of body segment’s position and movement—plays a crucial role in human motor control, integrating the sensory information necessary for the correct execution of daily life activities. Despite scientific evidence recognizes that several neurological diseases hamper proprioceptive encoding with consequent inability to correctly perform movements, proprioceptive assessment in clinical settings is still limited to standard scales. Literature on physiology of upper limb’s proprioception is mainly focused on experimental approaches involving planar setups, while the present work provides a novel paradigm for assessing proprioception during single—and multi-joint matching tasks in a three-dimensional workspace. To such extent, a six-degrees of freedom exoskeleton, ALEx-RS (Arm Light Exoskeleton Rehab Station), was used to evaluate 18 healthy subjects’ abilities in matching proprioceptive targets during combined single and multi-joint arm’s movements: shoulder abduction/adduction, shoulder flexion/extension, and elbow flexion/extension. Results provided evidence that proprioceptive abilities depend on the number of joints simultaneously involved in the task and on their anatomical location, since muscle spindles work along their preferred direction, modulating the streaming of sensory information accordingly. These findings suggest solutions for clinical sensorimotor evaluation after neurological disease, where assessing proprioceptive deficits can improve the recovery path and complement the rehabilitation outcomes.

Diretrizes da prática do cuidado de indivíduos pós-ave em contexto hospitalar na perspectiva de profissionais de saúde e cuidadores

Esta pesquisa foi fruto de uma dissertação e buscou sugerir diretrizes para a elaboração de um manual de cuidados direcionados a pacientes pós-AVE, em contexto hospitalar, com base na perspectiva dos profissionais de saúde e cuidadores. Trata-se de um estudo qualitativo com quarenta entrevistas individuais. A transcrição das entrevistas foi realizada através da Técnica de Análise de Conteúdo e apontou: necessidade de suporte para a execução das AVD e suporte psicológico para o cuidador; habilidades relacionadas aos aspectos práticos e afetivos do cuidado; conhecimento sobre o AVE e AVD para a capacitação. Recomenda-se a criação e utilização de manuais de orientação para cuidadores de pacientes pós-AVE.

Self-regulated learning with approximate reasoning and situation awareness

We present a decision support system for seamless and self-regulating learning. The decision support system presents a degree of novelty in supporting learners since it allows to: (1) understand the concepts that a learner may have acquired during her/his daily life activities, and (2) make the learner aware of these concepts and enforcing learning paths. Two key ideas are behind our results. The first idea relates to the identification of classes of indiscernible competences, and comes from the intuition that some real-world activities can lead to the acquisition of sets of competences (not always easy to discriminate) which can be considered as good approximations of competences related to a specific concept. Classes of indiscernible competences are building blocks that our decision support system uses to understand, with a certain degree of approximation, the concepts that a learner may have acquired, and this is an added value with regard to the self-awareness of a learner. The second idea is to allow our decision support system to identify incremental learning situations, which are situations in which a learning path is enforced or modified by the recognition that some concepts may have been learned, also during the execution of daily life activities. The decision support system grounds on three-way decisions and situation awareness. An evaluation of the system following the SAGAT approach has been done and reported in the paper.

Exo-Glove: A Wearable Robot for the Hand with a Soft Tendon Routing System

Soft wearable robots are good alternatives to rigid-frame exoskeletons because they are compact and lightweight. This article describes a soft wearable hand robot called the Exo-Glove that uses a soft tendon routing system and an underactuation adaptive mechanism. The proposed system can be used to develop other types of soft wearable robots. The glove part of the system is compact and weighs 194 g. The results conducted using a healthy subject showed sufficient performance for the execution of daily life activities, namely a pinch force of 20 N, a wrap grasp force of 40 N, and a maximum grasped object size of 76 mm. The use of an underactuation mechanism enabled the grasping of objects of various shapes without active control. A subject suffering from paralysis of the hands due to a spinal cord injury was able to use the glove to grasp objects of various shapes.

Facilitação neuromuscular proprioceptiva na doença de Parkinson: relato de eficácia terapêutica

INTRODUÇÃO: A Facilitação Neuromuscular Proprioceptiva (FNP) está entre as várias opções de tratamento fisioterapêutico para que o paciente com doença de Parkinson (DP) possa atingir uma função motora eficiente, porém poucos estudos exploram os efeitos dessa abordagem nessa população. OBJETIVOS: Com base no exposto, o presente estudo teve como objetivo explorar os efeitos de uma intervenção fisioterapêutica baseada na FNP em sujeitos DP. MATERIAIS E MÉTODOS: Foram estudados quatro sujeitos com DP, com idade média de 65,25 ± 10,11 anos, nos quais foram aplicadas as avaliações antes do início do tratamento baseado na FNP e após dois meses de sua aplicação. Foram utilizadas a Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF), a Escala Unificada de Avaliação da Doença de Parkinson (Unified Parkinson's Disease Rating Scale - UPDRS), o questionário de qualidade de vida SF36 e o software de avaliação postural (SAPO). RESULTADOS: Os resultados revelam que o tratamento baseado na FNP proporcionou melhora nos quatro sujeitos investigados, especialmente nos aspectos cinéticos funcionais e na execução das atividades de vida diária. CONCLUSÃO: Todos os ganhos observados podem ser relacionados à terapia baseada na FNP, que englobou atividades corporais totais facilmente incorporadas às atividades cotidianas.

Age-related difference on weight transfer during unconstrained standing

The ability to transfer weight from one lower limb to the other is essential for the execution of daily life activities and little is known about how weight transfer during unconstrained natural standing is affected by age. This study examined the weight transfer ability of elderly individuals during unconstrained standing (for 30min) in comparison to young adults. The subjects (19 healthy elderly adults, range 65–80 years, and 19 healthy young adults, range 18–30 years) stood with each foot on a separate force plate and were allowed to change their posture freely at any time. The limits of stability and base of support width during standing, measures of mobility (using the timed up and go and the preferred walking speed tests), and fear of falling were also measured. In comparison to the young adults, during unconstrained standing the elderly adults produced four times fewer weight transfers of large amplitude (greater than half of their body weight). The limits of stability and base of support width were significantly smaller for the elderly adults but there were no significant differences in the measures of mobility and in the fear of falling score compared to young adults. The observed significant age-related decrease in the use of weight transfer during unconstrained standing, despite any difference in the measured mobility of the subjects, suggests that this task reveals unnoticed and subtle differences in postural control, which may help to better understand age related impairments in balance that the elderly population experiences.

Visuospatial cognitive tests for the evaluation of patients with Parkinson's disease.

Parkinson's disease (PD) is a neurological disorder characterized by motor disturbances, neuropsychological symptoms and cognitive changes, including cases of dementia. The most frequently described cognitive changes in these patients involve executive and visuospatial functions, which are very important for the execution of daily life activities.ObjectiveTo compare different tests used to examine visuospatial functions in patients with PD.MethodsThirty-five patients (21 women) with PD symptoms (medicated and “on”) and mean schooling of 5.5±4.2 years were examined using the following tests: Mini-Mental State Examination (MMSE), Dementia Rating Scale (DRS), Scales of Outcomes of Parkinson's Disease (SCOPA-COG), Hooper Visual Organization Test (HVOT), Judgment of Line Orientation, Form V (JLO), and Clock drawing task – CLOX (1 and 2).ResultsThe mean MMSE score was 24.8±3.03and 54.8% of the patients performed correctly in the copy of a pentagon drawing, with a medium-level performance in most tests. Good correlations were detected between JLO versus SCOPA Assembling patterns (0.67), JLO versus HVOT (0.56), JLO versus CLOX2 (0.64), SCOPA Figure Composition versus HVOT (0.54), CLOX1 versus CLOX2 (0.43), and DRS Construction versus CLOX2 (0.42).DiscussionAlthough correlations were detected, not all were strong, probably because the tests employed do not measure solely visuospatial functions, but also other skills such as attention, motor ability and executive functions. A limitation of the present study was the lack of a control group for the establishment of adequate standards for this population.