Person: Lecumberri Villamediana, Pablo
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Lecumberri Villamediana
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Pablo
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Matemática e Informática
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Publication Open Access An evaluation of the 30-s chair stand test in older adults: frailty detection based on kinematic parameters from a single inertial unit(BioMed Central, 2013) Millor Muruzábal, Nora; Lecumberri Villamediana, Pablo; Gómez Fernández, Marisol; Martínez Ramírez, Alicia; Izquierdo Redín, Mikel; Matemáticas; Ciencias de la Salud; Matematika; Osasun Zientziak; Gobierno de Navarra / Nafarroako GobernuaBackground: A growing interest in frailty syndrome exists because it is regarded as a major predictor of co-morbidities and mortality in older populations. Nevertheless, frailty assessment has been controversial, particularly when identifying this syndrome in a community setting. Performance tests such as the 30-second chair stand test (30-s CST) are a cornerstone for detecting early declines in functional independence. Additionally, recent advances in body-fixed sensors have enhanced the sensors’ ability to automatically and accurately evaluate kinematic parameters related to a specific movement performance. The purpose of this study is to use this new technology to obtain kinematic parameters that can identify frailty in an aged population through the performance the 30-s CST. Methods: Eighteen adults with a mean age of 54 years, as well as sixteen pre-frail and thirteen frail patients with mean ages of 78 and 85 years, respectively, performed the 30-s CST while threir trunk movements were measured by a sensor-unit at vertebra L3. Sit-stand-sit cycles were determined using both acceleration and orientation information to detect failed attempts. Movement-related phases (i.e. impulse, stand-up, and sit-down) were differentiated based on seat off and seat on events. Finally, the kinematic parameters of the impulse, stand-up and sit-down phases were obtained to identify potential differences across the three frailty groups. Results: For the stand-up and sit-down phases, velocity peaks and “modified impulse” parameters clearly differentiated subjects with different frailty levels (p < 0.001). The trunk orientation range during the impulse phase was also able to classify a subject according to his frail syndrome (p < 0.001). Furthermore, these parameters derived from the inertial units (IUs) are sensitive enough to detect frailty differences not registered by the number of completed cycles which is the standard test outcome. Conclusions: This study shows that IUs can enhance the information gained from tests currently used in clinical practice, such as the 30-s CST. Parameters such as velocity peaks, impulse, and orientation range are able to differentiate between adults and older populations with different frailty levels. This study indicates that early frailty detection could be possible in clinical environments, and the subsequent interventions to correct these disabilities could be prescribed before further degradation occurs.Publication Open Access Assessment of asymmetric leg loading before and after total hip arthroplasty using instrumented shoes(BioMed Central, 2014) Martínez Ramírez, Alicia; Weenk, Dirk; Lecumberri Villamediana, Pablo; Verdonschot, Nico; Pakvis, Dean; Veltink, Peter H.; Matemáticas; MatematikaBackground: Total hip arthroplasty is a successful surgical treatment in patients with osteoarthritis of the hip. Different questionnaires are used by the clinicians to assess functional capacity and the patient's pain, despite these questionnaires are known to be subjective. Furthermore, many studies agree that kinematic and kinetic parameters are crucial to evaluate and to provide useful information about the patient’s evolution for clinicians and rehabilitation specialists. However, these quantities can currently only be obtained in a fully equipped gait laboratory. Instrumented shoes can quantify gait velocity, kinetic, kinematic and symmetry parameters. The aim of this study was to investigate whether the instrumented shoes is a sufficiently sensitive instrument to show differences in mobility performance before and after total hip arthroplasty. Methods: In this study, patients undergoing total hip arthroplasty were measured before and 6–8 months after total hip arthroplasty. Both measurement sessions include 2 functional mobility tasks while the subject was wearing instrumented shoes. Before each measurement the Harris Hip Score and the Traditional Western Ontario and McMaster Universities osteoarthritis index were administered as well. Results: The stance time and the average vertical ground reaction force measured with the instrumented shoes during walking, and their symmetry index, showed significant differences before and after total hip arthroplasty. However, the data obtained with the sit to stand test did not reveal this improvement after surgery. Conclusions: Our results show that inter-limb asymmetry during a walking activity can be evaluated with the instrumented shoes before and after total hip arthroplasty in an outpatient clinical setting.Publication Open Access Pre-operative ambulatory measurement of asymmetric lower limb loading during walking in total hip arthroplasty patients(BioMed Central, 2013) Martínez Ramírez, Alicia; Weenk, Dirk; Lecumberri Villamediana, Pablo; Verdonschot, Nico; Pakvis, Dean; Veltink, Peter H.; Matemáticas; Matematika; Universidad Pública de Navarra / Nafarroako Unibertsitate PublikoaBackground: Total hip arthroplasty is a successful surgical procedure to treat hip osteoarthritis. Clinicians use different questionnaires to assess the patient’s pain and functional capacity. Furthermore, they assess the quality of gait in a very global way. This clinical evaluation usually shows significant improvement after total hip arthroplasty, however, does not provide objective, quantifiable information about the movement patterns underlying the functional capacity, which can currently only be obtained in a gait laboratory. Instrumented force shoes can quantify gait velocity, ground reaction forces and the gait pattern easily in an outpatient setting. The main goal of this study was to investigate how mobility characteristics during walking, relate to gait velocity and questionnaire outcomes of patients with hip osteoarthritis in an outpatient setting. Methods: 22 patients with primary osteoarthritis of the hip selected for a total hip arthroplasty participated in this study. For each patient the Harris Hip Score, the Traditional Western Ontario and the McMaster Universities osteoarthritis index were administered. Subsequently, the patients were instructed to walk through the corridor while wearing instrumented shoes. The gait velocity estimated with the instrumented force shoes was validated measuring the time required to walk a distance of 10 m using a stopwatch and a measuring tape as a reference system. A regression analysis between spatial, temporal, ground reaction force parameters, including asymmetry, and the gait velocity and the questionnaires outcomes was performed. Results: The velocity estimated with the instrumented shoes did not differ significantly from the velocity measured independently. Although gait parameters correlated significantly with velocity, symmetry index parameters were not correlated with velocity. These symmetry index parameters show significant inter-limb asymmetry during walking. No correlation was found between any of the variables studied and questionnaires outcomes. Conclusion: Inter-limb asymmetry can be evaluated with the instrumented shoes supplying important additional information about the individual gait pattern, which is not represented by gait velocity and questionnaires usually used. Therefore, this new ambulatory measurement system is able to provide complementary information to gait velocity and questionnaires outcomes to assess the functional capacity of patients with hip osteoarthritis.Publication Open Access Motor abnormalities and cognitive impairment in first-episode psychosis patients, their unaffected siblings and healthy controls(Elsevier, 2018) Cuesta, Manuel J.; Moreno-Izco, Lucía; Ribeiro Fernández, María; López-Ilundain, José M.; Lecumberri Villamediana, Pablo; Cabada Giadás, Teresa; Lorente Omeñaca, Ruth; Sánchez Torres, Ana María; Gómez Fernández, Marisol; Peralta Martín, Víctor; Ciencias de la Salud; Osasun Zientziak; Matemáticas; MatematikaMotor abnormalities (MAs) may be already evidenced long before the beginning of illness and are highly prevalent in psychosis. However, the extent to which the whole range of MAs are related to cognitive impairment in psychosis remains understudied. This study aimed to examine comparatively the relationships between the whole range of motor abnormalities and cognitive impairments in the first-episode of psychosis (FEP), their unaffected siblings and healthy control subjects. Fifty FEP patients, 21 of their healthy siblings and 24 age- and sex matched healthy controls were included. Motor assessment included catatonic, extrapyramidal and neurological soft signs (NSS) by means of standardized instruments. An exhaustive neuropsychological battery was also performed to extract the 7 cognitive dimensions of MATRICS initiative. Higher scores on NSS but not on extrapyramidal and catatonic signs showed significant associations with worse cognitive performance in the three study groups. However, the pattern of associations regarding specific cognitive functions was different among the three groups. Moreover, extrapyramidal signs showed significant associations with cognitive impairment only in FEP patients but not in their unaffected siblings and healthy controls. Catatonic signs did not show any significant association with cognitive functioning in the three study groups. These findings add evidence to the associations between motor abnormalities, particularly NSS and extrapyramidal signs, and cognitive impairment in first-episode psychosis patients. In addition, our results suggest that the specific pattern of associations between MAs and cognitive functioning is different in FEP patients from those of the unaffected siblings and healthy subjects.Publication Open Access Sprint mechanics evaluation using inertial sensor-based technology: a laboratory validation study(Wiley, 2018) Setuain Chourraut, Igor; Lecumberri Villamediana, Pablo; Ahtiainen, J. P.; Mero, A. A.; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun ZientziakAdvances in micro‐electromechanical systems have turned magnetic inertial measurement units (MIMUs) into a suitable tool for vertical jumping biomechanical evaluation. Thus, this study aimed to determine whether appropriate reliability and agreement reports could also be obtained when analyzing 20‐m sprint mechanics. Four bouts of 20‐m sprints were evaluated to determine whether the data provided by a MIMU placed at the lumbar spine could reliably assess sprint mechanics and to examine the validity of the MIMU sensor compared to force plate recordings. Maximal power (P0), force (F0), and velocity (V0), as well as other mechanical determinants of sprint performance associated with the force‐velocity, power‐velocity, and ratio of forces‐velocity, such as applied horizontal force loss (Sfv) and decrease in ratio of forces (Drf), were calculated and compared between instrumentations. Extremely large‐to‐very large correlation levels between MIMU sensor‐based sprint mechanics variables and force plate recordings were obtained (mean±SD, force plate vs MIMU; V0, 8.61±0.85 vs 8.42±0.69; F0, 383±110 vs 391±103; P0, 873±246 vs 799±241; Sfv, −44.6±12.7 vs −46.2±10.7), ranging from 0.88 to 0.94, except for Drf, which showed weak‐to‐moderate correlation level (r=.45; −6.32±1.08 vs −5.76±0.68). Step‐averaged force values measured with both systems were highly correlated (r=.88), with a regression slope close to the identity (1.01). Bland and Altman graphical representation showed a no random distribution of measured force values. Finally, very large‐to‐extremely large retest correlation coefficients were found for the intertrial reliability of MIMU measurements of sprint performance variables (r value ranging from .72 to .96). Therefore, MIMUs showed appropriate validity and reliability values for 20‐m sprint performance variables.Publication Open Access Frailty assessment based on trunk kinematic parameters during walking(BioMed Central, 2015) Martínez Ramírez, Alicia; Martinikorena Aranburu, Ion; Gómez Fernández, Marisol; Lecumberri Villamediana, Pablo; Millor Muruzábal, Nora; Rodríguez Mañas, Leocadio; García García, Francisco José; Izquierdo Redín, Mikel; Matemáticas; MatematikaBackground: Physical frailty has become the center of attention of basic, clinical and demographic research due to its incidence level and gravity of adverse outcomes with age. Frailty syndrome is estimated to affect 20 % of the population older than 75 years. Thus, one of the greatest current challenges in this field is to identify parameters that can discriminate between vulnerable and robust subjects. Gait analysis has been widely used to predict frailty. The aim of the present study was to investigate whether a collection of parameters extracted from the trunk acceleration signals could provide additional accurate information about frailty syndrome. Methods: A total of 718 subjects from an elderly population (319 males, 399 females; age: 75.4 ± 6.1 years, mass: 71.8 ± 12.4 kg, height: 158 ± 6 cm) volunteered to participate in this study. The subjects completed a 3-m walk test at their own gait velocity. Kinematic data were acquired from a tri-axial inertial orientation tracker. Findings: The spatio-temporal and frequency parameters measured in this study with an inertial sensor are related to gait disorders and showed significant differences among groups (frail, pre-frail and robust). A selection of those parameters improves frailty classification obtained to gait velocity, compared to classification model based on gait velocity solely. Interpretation: Gait parameters simultaneously used with gait velocity are able to provide useful information for a more accurate frailty classification. Moreover, this technique could improve the early detection of pre-frail status, allowing clinicians to perform measurements outside of a laboratory environment with the potential to prescribe a treatment for reversing their physical decline.