Automatic Segmentation of Monofilament Testing Sites in Plantar Images for Diabetic Foot Management

Costa, Tatiana; Coelho, Luís; Silva, Manuel F.

doi:10.3390/bioengineering9030086

Cited by 9 publications

(5 citation statements)

References 29 publications

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“…This pressure was maintained for 1 second, and the instrument was then removed and the patients' possible response was awaited. This procedure was carried out on both feet 18,57,59 . Application of the monofilament directly on ulcers, scars, callus and necrotic tissue was avoided 60 .…”

Section: Methodsmentioning

confidence: 99%

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Relationship between deep and superficial sensitivity assessments and gait analysis in diabetic foot patients

Sempere-Bigorra

Brognara

Julián-Rochina

et al. 2023

International Wound Journal

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Peripheral neuropathy is a prevalent complication of diabetes that can lead to gait impairment and its adverse consequences. This study explored the potential utility of different parameters of gait analysis using a single sensor unit as a simple tool to detect peripheral neuropathy in 85 diabetic patients (DP) with diabetic foot in whom different somato‐sensitivity tests in the feet were performed. Gait spatiotemporal parameters were examined by sensor inertial measurement placed in the lumbar area, while the superficial sensitivity pathway was assessed by nociception tests and deep sensitivity was examined by light touch‐pressure and vibration sensitivity tests. Correlations between each sensory test and gait parameters were analysed in a logistic regression model in order to assess if gait parameters are associated with two different sensory pathways. Impaired deep sensory pathways were significantly (P < .05) correlated with lower gait speed, reduced cadence, smaller stride length, longer stance periods, and a higher risk of falling on the Tinetti Scale, while all gait parameters were significantly (P < .01) correlated with the superficial sensory pathway. Type 2 diabetics have significantly (P < .05) higher impairment in vibratory sensitivity than type 1 diabetics, and the years with diabetes mellitus (DM) diagnosis have a significant (P < .05) association with reduced vibration sensitivity. These findings indicate relationships between the deep sensory pathway and gait impairments in DP measured by inertial sensors, which could be a useful tool to diagnose gait alterations in DP and to evaluate the effect of treatments to improve gait and thus the risk of falls in diabetic patients.

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Section: Methodsmentioning

confidence: 99%

“…This procedure was carried out on both feet. 18,57,59 Application of the monofilament directly on ulcers, scars, callus and necrotic tissue was avoided. 60 The test was classified as abnormal when the patients did not detect the pressure at 4 of 10 locations, following the evidence.…”

Section: Deep Sensitivitymentioning

confidence: 99%

Relationship between deep and superficial sensitivity assessments and gait analysis in diabetic foot patients

Sempere-Bigorra

Brognara

Julián-Rochina

et al. 2023

International Wound Journal

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“…The monofilament was applied perpendicular to the skin and pressed until it folded. After maintaining the pressure for a second, the monofilament was removed, and the next area was evaluated [ 66 , 72 , 73 ]. The application of the instrument was avoided on ulcers, necrotic areas, or calluses [ 74 ].…”

Section: Methodsmentioning

confidence: 99%

Relationship between Cognitive Impairment and Depressive Symptoms with Somatosensory Functions in Diabetic and Non-Diabetic Older Adults and Its Impact on Quality of Life

Sempere-Bigorra,

Julián-Rochina,

Pérez-Ros

et al. 2023

Life

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Aging is an inevitable process that impacts the peripheral and central nervous systems and is considered one of the strongest risk factors for neurodegenerative diseases. In addition, when it also presents with diabetes mellitus, the risk of neurological damage may be further increased. This current study aimed to explore the relationships between peripheral sensory system decline and cognitive functions, the symptoms of depression, and quality of life (QoL) as metrics of central nervous system impairment in institutionalized older adults. A total of 95 individuals participated in this case-control study, which included diabetics and non-diabetics. The superficial sensory pathway was assessed in terms of thermal sensation, nociception, and non-discriminative touch, and the deep sensory pathway was evaluated by assessing vibration and light touch-pressure sensations. To assess function at the intellectual level, the Mini-Mental State Examination (MMSE) and Trail Making Test (TMT) cognitive functional tests were used, while the symptoms of depression and QoL were explored by employing the Yesavage Geriatric Depression Scale and EuroQol 5D questionnaire (EQ-5D), respectively. In the overall population analyses, altered thermal sensation was significantly associated with cognitive impairment (CI; p < 0.05). In turn, bivariate analyses and a binary logistic regression showed that the symptoms of depression and QoL were significantly related to altered vibratory sensation when assessed using a medical tuning fork (p < 0.05). In the group of diabetic patients, those with CI also had significantly lower thermal sensation (p < 0.05) and non-discriminative touch sensation, although this was only a trend (p = 0.055). Diabetics with depression had a significantly worse non-discriminative touch (p < 0.05) and vibratory sensation when tested with a tuning fork (p < 0.05). In addition, poorer QoL was associated with reduced sensitivity to heat (p < 0.05), light touch pressure (p < 0.05), and vibrations when assessed either with a tuning fork (p < 0.05) or a biothesiometer (p < 0.05). In contrast, no relationships were found between sensory functions and cognitive assessments in non-diabetic patients. These findings indicate that superficial sensitivity damage was related to CI, while deep sensation alterations were related to depression and poor QoL, with diabetes apparently further strengthening these relationships.

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“…MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions, or products referred to in the content. This assessment is most often performed manually, by an experienced health professional, but it can also be performed automatically, using a collaborative robot [5,6]. The SWM only provides a binary qualitative assessment, as the health professional cannot obtain a numerical value as a result of the test.…”

Section: Introductionmentioning

confidence: 99%

Calibration and Modelling of the Semmes-Weinstein Monofilament for Diabetic Foot Management

Castro-Martins,

Coelho,

Campilho

2024

Preprint

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Diabetic foot is a serious complication that poses significant risks for diabetic people. The resulting reduction in protective sensitivity in the plantar region requires early detection to prevent the imminent ulceration and amputation. The primary method employed for evaluating this sensitivity loss is the 10 g f Semmes-Weinstein monofilament test, commonly used as a first-line procedure. However, the lack of calibration in existing devices often introduces decision errors due to unreliable feedback. In this paper, a new equipment designed to address these limitations and enhance the assessment of the sensitivity loss using the 10 g f monofilament is introduced. The proposed system automates metrological verification and evaluation processes, ensuring accurate and reliable results. Furthermore, it simulates the practitioner’s procedure, serving both as a valuable training tool and a means to provide force-feedback information. An analytical model of the monofilament buckling and deflection is also presented. The obtained results showed that the tested monofilaments had a very high error compared to the 10 g f declared by the manufacturers. It is aimed, by introducing this advanced equipment, to improve the precision and reliability of assessing the sensitivity loss. The integration of automated verification, simulation capabilities, and precise measurements shows great promise for diabetic patients, reducing the likelihood of adverse outcomes such as ulceration and amputation.

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Automatic Segmentation of Monofilament Testing Sites in Plantar Images for Diabetic Foot Management

Cited by 9 publications

References 29 publications

Relationship between deep and superficial sensitivity assessments and gait analysis in diabetic foot patients

Relationship between deep and superficial sensitivity assessments and gait analysis in diabetic foot patients

Relationship between Cognitive Impairment and Depressive Symptoms with Somatosensory Functions in Diabetic and Non-Diabetic Older Adults and Its Impact on Quality of Life

Calibration and Modelling of the Semmes-Weinstein Monofilament for Diabetic Foot Management

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