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      Tensiomyography and Statistical Analysis Based Muscle Change Detection in Multiple Sclerosis for Smart Healthcare

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          Abstract

          The impact of demyelinization on muscle fiber changes and the type of changes in multiple sclerosis (MS) is very hard to estimate. One of the major problems of MS patients is muscle fatigue and decrease of muscle force in the range of 16–57%. The objective of this research work is to estimate various aspects of muscle changes at tibial muscle (mTA) level using a noninvasive method named as tensiomyography (TMG). TMG provides information about muscle functions in MS. This study includes 40 MS patients among which 18 are males (45%) and 22 are females (55%). They are divided in two subgroups: subgroup A and subgroup B. Subgroup A includes 20 MS patients without clinical decelable gait disorders and subgroup B includes 20 MS patients with clinical decelable gait disorders. Also, we have a control group that includes 20 healthy people with the same average age. Average age is 38.15 ± 11.19 y for MS patients and 39.34 ± 10.57 for healthy people. Evaluation measures include ADL score and EDSS scale. The ADL score is 0 for patients from subgroup A and 1 for patients from subgroup B. The EDSS score is 1 for subgroup A and 2.5 for subgroup B. This study confirms the importance of TMG based evaluation of muscle changes in MS patients. This smart healthcare system is also used for prediction of the muscle changes and muscle imbalance. Contraction time (Tc) recordings are used to detect the muscle fatigue which is a specific symptom of MS. The value of Tc for subgroup A is 45.8 ms and subgroup B is 61.37 ms for right side. Analysis of these two parameters such as Dm and Tc could define the muscle behaviour and help provide early information about the possibility of developing gait disorders. This smart TMG system analyses the muscle tone in the best possible way to predict the onset of any diseases which is an integral part of the smart healthcare system.

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          Most cited references19

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          Multiple Sclerosis

          New England Journal of Medicine, 343(13), 938-952
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            Multiple sclerosis and physical exercise: recommendations for the application of resistance-, endurance- and combined training.

            This review summarizes the existing knowledge regarding the effects of physical exercise in patients suffering from multiple sclerosis (MS). Furthermore, recommendations are given regarding exercise prescription for MS patients and for future study directions. Previously, MS patients were advised not to participate in physical exercise. During recent years, it has been increasingly acknowledged that exercise benefits MS patients. The requirement for exercise in MS patients is emphasized by their physiological profile, which probably reflects both the effects of the disease per se and the reversible effects of an inactive lifestyle. To date the effects of exercise have only been studied in moderately impaired MS patients with an EDSS score of less than 7. Evidence exists for recommending participation in endurance training at low to moderate intensity, as the existing literature demonstrates that MS patients can both tolerate and benefit from this training modality. Also, resistance training of moderate intensity seems to be well tolerated and to have beneficial effects on MS patients, but the methodological quality of the existing evidence is in general low and the number of studies is limited. Only two studies have evaluated the effects of combined resistance- and endurance training, making solid conclusions regarding this training modality impossible.
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              Motor determinants of gait in 100 ambulatory patients with multiple sclerosis.

              A prospective analysis of gait and strength parameters was performed in 100 patients diagnosed with MS and pyramidal involvement admitted in a rehabilitation unit The patients were divided into two groups based on their ability to walk in daily life (nonassisted or cane-assisted gait) and into four clinical subgroups depending on associated involvements such as sensory loss or cerebellar ataxia. Twenty healthy subjects were studied as a control group. Gait parameters were evaluated with a Locometre and muscle strength with an isokinetic dynamometer. The results showed that the average velocity and strength of the hamstring and quadriceps were strongly correlated and reduced in the MS group in comparison with the control, and in the cane-assisted group compared with the nonassisted group. Gait velocity tended to be more correlated to hamstring strength in the nonassisted group with a determination coefficient (r2) reaching a value of 0.44 in the sensory subgroup. These findings provide evidence that a correlation between strength reduction and gait impairment is obvious whatever the clinical form in patients with MS. This correlation is higher with hamstrings but may change depending on the disability level and the clinical form. This could be taken into account in the individual assessment of further rehabilitation programmes.
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                Author and article information

                Contributors
                Journal
                J Healthc Eng
                J Healthc Eng
                JHE
                Journal of Healthcare Engineering
                Hindawi
                2040-2295
                2040-2309
                2022
                2 December 2022
                : 2022
                : 5225851
                Affiliations
                1Sport Medicine and Physical Therapy Department, University of Craiova, Craiova 200585, Romania
                2Physiology Department, University of Medicine and Pharmacy Craiova, Craiova 200349, Romania
                3Applied Mechanic Department, University of Craiova, Craiova 200585, Romania
                4Department of ECE, Karunya Institute of Technology and Sciences, Coimbatore, India
                Author notes

                Academic Editor: Ayush Dogra

                Author information
                https://orcid.org/0000-0002-4366-6895
                https://orcid.org/0000-0001-6615-4940
                https://orcid.org/0000-0002-5228-3351
                https://orcid.org/0000-0003-3630-5044
                https://orcid.org/0000-0002-4042-6829
                https://orcid.org/0000-0001-6944-8127
                https://orcid.org/0000-0002-6091-1880
                Article
                10.1155/2022/5225851
                9733985
                36504637
                eba5fdca-857a-49e4-9e6a-a18133614b4a
                Copyright © 2022 Ligia Rusu et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 21 January 2022
                : 15 February 2022
                : 9 May 2022
                Categories
                Research Article

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