Free-living monitoring of ambulatory activity after treatments for lower extremity musculoskeletal cancers using an accelerometer-based wearable – a new paradigm to outcome assessment in musculoskeletal oncology?

Furtado, Sherron; Godfrey, Alan; Din, Silvia Del; Rochester, Lynn; Gerrand, Craig

doi:10.1080/09638288.2022.2083701

Cited by 4 publications

(4 citation statements)

References 48 publications

(74 reference statements)

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“…The next steps would be to conduct a larger study with sufficient power using purposive sampling strategy to validate the MMC approach. In future, other methods such as stopwatch, wearables like accelerometery in the clinic [ 10 ] and community [ 32 ] or fitbits, IMUs, mobile apps or Xsens could be utilised to collect outcomes alongside MMC. Xsens will be a useful comparison to MMC, if joint range of motion is the area of focus.…”

Section: Discussionmentioning

confidence: 99%

“…writing-up reports, presenting at conferences and submitting to journals. After successfully publishing two key papers from this large project, on the topics of the use of triaxial accelerometer-based body worn monitor technology in the clinic [ 10 ] and in the community [ 32 ] respectively; this current paper which investigated a different dataset of MMC outcomes to answer questions about the feasibility and clinical applicability of the use of depth sensors for MMC was compiled. The current paper is different from the previous two publications, as it investigates the MMC approach which has never been done before for this cancer group.…”

Section: Methodsmentioning

confidence: 99%

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Feasibility of using low-cost markerless motion capture for assessing functional outcomes after lower extremity musculoskeletal cancer surgery

Furtado,

Galna,

Godfrey

et al. 2024

PLoS ONE

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Background Physical limitations are frequent and debilitating after sarcoma treatment. Markerless motion capture (MMC) could measure these limitations. Historically expensive cumbersome systems have posed barriers to clinical translation. Research question Can inexpensive MMC [using Microsoft KinectTM] assess functional outcomes after sarcoma surgery, discriminate between tumour sub-groups and agree with existing assessments? Methods Walking, unilateral stance and kneeling were measured in a cross-sectional study of patients with lower extremity sarcomas using MMC and standard video. Summary measures of temporal, balance, gait and movement velocity were derived. Feasibility and early indicators of validity of MMC were explored by comparing MMC measures i) between tumour sub-groups; ii) against video and iii) with established sarcoma tools [Toronto Extremity Salvage Score (TESS)), Musculoskeletal Tumour Rating System (MSTS), Quality of life-cancer survivors (QoL-CS)]. Statistical analysis was conducted using SPSS v19. Tumour sub-groups were compared using Mann-Whitney U tests, MMC was compared to existing sarcoma measures using correlations and with video using Intraclass correlation coefficient agreement. Results Thirty-four adults of mean age 43 (minimum value—maximum value 19–89) years with musculoskeletal tumours in the femur (19), pelvis/hip (3), tibia (9), or ankle/foot (3) participated; 27 had limb sparing surgery and 7 amputation. MMC was well-tolerated and feasible to deliver. MMC discriminated between surgery groups for balance (p<0.05*), agreed with video for kneeling times [ICC = 0.742; p = 0.001*] and showed moderate relationships between MSTS and gait (p = 0.022*, r = -0.416); TESS and temporal outcomes (p = 0.016* and r = -0.0557*), movement velocity (p = 0.021*, r = -0.541); QoL-CS and balance (p = 0.027*, r = 0.441) [* = statistical significance]. As MMC uncovered important relationships between outcomes, it gave an insight into how functional impairments, balance, gait, disabilities and quality of life (QoL) are associated with each other. This gives an insight into mechanisms of poor outcomes, producing clinically useful data i.e. data which can inform clinical practice and guide the delivery of targeted rehabilitation. For example, patients presenting with poor balance in various activities can be prescribed with balance rehabilitation and those with difficulty in movements or activity transitions can be managed with exercises and training to improve the quality and efficiency of the movement. Significance In this first study world-wide, investigating the use of MMC after sarcoma surgery, MMC was found to be acceptable and feasible to assess functional outcomes in this cancer population. MMC demonstrated early indicators of validity and also provided new knowledge that functional impairments are related to balance during unilateral stance and kneeling, gait and movement velocity during kneeling and these outcomes in turn are related to disabilities and QoL. This highlighted important relationships between different functional outcomes and QoL, providing valuable information for delivering personalised rehabilitation. After completing future validation work in a larger study, this approach can offer promise in clinical settings. Low-cost MMC shows promise in assessing patient’s impairments in the hospitals or their homes and guiding clinical management and targeted rehabilitation based on novel MMC outcomes affected, therefore providing an opportunity for delivering personalised exercise programmes and physiotherapy care delivery for this rare cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Feasibility of using low-cost markerless motion capture for assessing functional outcomes after lower extremity musculoskeletal cancer surgery

Furtado,

Galna,

Godfrey

et al. 2024

PLoS ONE

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“…Te Axivity AX3 accelerometer (Axivity Ltd., Newcastle upon Tyne, UK), a small waterproof device (23 × 32.5 × 7.6 mm; 11 g), was used to measure sleep quantity and quality. Te Axivity AX3 was used in the UK Biobank study [29] and has been previously used in cancer survivors [30][31][32]. Te participants were instructed to wear the device on their nondominant wrist for seven consecutive days, except while swimming.…”

Section: Sleep Monitoringmentioning

confidence: 99%

A Comparative Study of Sleep Parameters in Adult Survivors of Childhood Acute Lymphoblastic Leukemia and Healthy Peers: Insights from Accelerometer Data

Vyhlídal,

Dygrýn,

Chmelík

2023

European Journal of Cancer Care

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Background. Sleep problems are among the common late side effects of treatment that can occur in survivors of childhood acute lymphoblastic leukemia. At present, the objective evaluation of sleep in the natural environment using actigraphy rather than self-assessment of research participants or the more demanding polysomnography is increasingly coming to the forefront in population epidemiological studies. The main objective of this cross-sectional study is to objectively characterize selected sleep parameters with respect to gender in adult survivors of childhood acute lymphoblastic leukemia (ALS) in their natural environment and to compare them with a control group (CG) sampled from a healthy population. Another partial aim of the study is to determine the fulfillment of recommendations in the areas of sleep (SL) and sleep efficiency (SE). Methods. 20 ALS and 20 CGs aged 18–30 years participated in the survey. The ALS were diagnosed on average 15.5 years ago. Selected sleep parameters were measured instrumentally by means of an Axivity AX3 accelerometer worn on the wrist for seven days in a natural environment. Results. No significant differences were found between the ALS and CG groups for the selected sleep parameters. The total time in bed for the ALS was 405.5 min/day compared to 428.2 min/day for the CG ( p = 0.37 ), sleep for the ALS was 372.7 min/day compared to 382.9 min/day for the CG ( p = 0.34 ), and SE for the ALS was 88.0% compared to 88.5% for the CG ( p = 0.99 ). No significant gender differences were found. The sleep recommendation of >420 min/day was met by 15% for the ALS and 19% for the CG; SE > 85% was achieved by 80% for the ALS and 80% for the CG. Conclusion. The results of our study suggest that ALS may achieve the same values as the healthy population in selected sleep parameters.

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“…This could for instance allow us to evaluate rehabilitation procedures or treatment choices for specific diseases and to assess the impact of treatments on pathologies such as musculoskeletal tumors of the lower limbs or neurological disorders (Parkinson's disease for instance). The current monitoring of the effects of these FLE treatments is only carried out via calculations of general metrics (steps/day, ambulatory bouts/day) [19] when our graphical tool will enable a refined follow-up displaying an enhanced macro analysis of gait phases.…”

Section: Introductionmentioning

confidence: 99%

A Machine Learning Pipeline for Gait Analysis in a Semi Free-Living Environment

Jung

l’Escalopier

Oudre

et al. 2023

Sensors

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This paper presents a novel approach to creating a graphical summary of a subject’s activity during a protocol in a Semi Free-Living Environment. Thanks to this new visualization, human behavior, in particular locomotion, can now be condensed into an easy-to-read and user-friendly output. As time series collected while monitoring patients in Semi Free-Living Environments are often long and complex, our contribution relies on an innovative pipeline of signal processing methods and machine learning algorithms. Once learned, the graphical representation is able to sum up all activities present in the data and can quickly be applied to newly acquired time series. In a nutshell, raw data from inertial measurement units are first segmented into homogeneous regimes with an adaptive change-point detection procedure, then each segment is automatically labeled. Then, features are extracted from each regime, and lastly, a score is computed using these features. The final visual summary is constructed from the scores of the activities and their comparisons to healthy models. This graphical output is a detailed, adaptive, and structured visualization that helps better understand the salient events in a complex gait protocol.

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Free-living monitoring of ambulatory activity after treatments for lower extremity musculoskeletal cancers using an accelerometer-based wearable – a new paradigm to outcome assessment in musculoskeletal oncology?

Cited by 4 publications

References 48 publications

Feasibility of using low-cost markerless motion capture for assessing functional outcomes after lower extremity musculoskeletal cancer surgery

Feasibility of using low-cost markerless motion capture for assessing functional outcomes after lower extremity musculoskeletal cancer surgery

A Comparative Study of Sleep Parameters in Adult Survivors of Childhood Acute Lymphoblastic Leukemia and Healthy Peers: Insights from Accelerometer Data

A Machine Learning Pipeline for Gait Analysis in a Semi Free-Living Environment

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