Browsing by Author "Konstantinovic, Ljubica (16207335300)"

We present a hand functions assessment system (BEAGLE) for kinematic tracking of hand and finger movements, envisioned as a technology-mediated rehabilitation tool. The system is custom-designed for fast and easy placement on an impaired hand (spastic or flaccid), featuring inertial sensors integrated into simple finger caps and a hand strap. An algorithm for a range of motion (ROM) estimation was implemented to provide an objective assessment of hand functions. The efficacy and feasibility of the BEAGLE system were examined in a pilot clinical study performed with ten stroke survivors in the subacute phase. Participants received therapy within two consecutive intensity-matched rehabilitation cycles. The first consisted of conventional therapy, while the second involved a combination of conventional therapy and advanced functional electrical stimulation. Assessments were performed before and after each phase. These included BEAGLE estimates of active voluntary ROM for wrist and various digits, as well as two referent clinical measures for hand functions assessment, Fugl-Meyer and Action Research Arm Test. The results indicate that the ROM assessments can detect change with sensitivity comparable to the standardized clinical scales. Statistically significant changes between the beginning and the end of the second cycle existed in all observed measures, whereas none of these measurements showed a statistically significant improvement in the first therapy cycle. The noted usability metrics indicate that the BEAGLE could be integrated into the rehabilitation workflow in a clinical environment. © 2001-2011 IEEE.

We present a hand functions assessment system (BEAGLE) for kinematic tracking of hand and finger movements, envisioned as a technology-mediated rehabilitation tool. The system is custom-designed for fast and easy placement on an impaired hand (spastic or flaccid), featuring inertial sensors integrated into simple finger caps and a hand strap. An algorithm for a range of motion (ROM) estimation was implemented to provide an objective assessment of hand functions. The efficacy and feasibility of the BEAGLE system were examined in a pilot clinical study performed with ten stroke survivors in the subacute phase. Participants received therapy within two consecutive intensity-matched rehabilitation cycles. The first consisted of conventional therapy, while the second involved a combination of conventional therapy and advanced functional electrical stimulation. Assessments were performed before and after each phase. These included BEAGLE estimates of active voluntary ROM for wrist and various digits, as well as two referent clinical measures for hand functions assessment, Fugl-Meyer and Action Research Arm Test. The results indicate that the ROM assessments can detect change with sensitivity comparable to the standardized clinical scales. Statistically significant changes between the beginning and the end of the second cycle existed in all observed measures, whereas none of these measurements showed a statistically significant improvement in the first therapy cycle. The noted usability metrics indicate that the BEAGLE could be integrated into the rehabilitation workflow in a clinical environment. © 2001-2011 IEEE.

Background: Recognition of pain in people with dementia is challenging. Observational scales have been developed, but there is a need to harmonize and improve the assessment process. In EU initiative COST-Action TD1005, 36 promising items were selected from existing scales to be tested further. We aimed to study the observer agreement of each item, and to analyse the factor structure of the complete set. Methods: One hundred and ninety older persons with dementia were recruited in four different countries (Italy, Serbia, Spain and The Netherlands) from different types of healthcare facilities. Patients represented a convenience sample, with no pre-selection on presence of (suspected) pain. The Pain Assessment in Impaired Cognition (PAIC, research version) item pool includes facial expressions of pain (15 items), body movements (10 items) and vocalizations (11 items). Participants were observed by health professionals in two situations, at rest and during movement. Intrarater and interrater reliability was analysed by percentage agreement. The factor structure was examined with principal component analysis with orthogonal rotation. Results: Health professionals performed observations in 40–57 patients in each country. Intrarater and interrater agreement was generally high (≥70%). However, for some facial expression items, agreement was sometimes below 70%. Factor analyses showed a six-component solution, which were named as follows: Vocal pain expression, Face anatomical descriptors, Protective body movements, Vocal defence, Tension and Lack of affect. Conclusions: Observation of PAIC items can be done reliably in healthcare settings. Observer agreement is quite promising already without extensive training. Significance: In this international project, promising items from existing observational pain scales were identified and evaluated regarding their reliability as an alternative to pain self-report in people with dementia. Analysis on factor structure helped to understand the character of the items. Health professionals from four countries using four different European languages were able to rate items reliably. The results contributed to an informed reduction of items for a clinical observer scale (Pain Assessment in Impaired Cognition scale with 15 items: PAIC15). © 2019 European Pain Federation - EFIC®

Introduction: Obesity is a complex condition with multifactorial origin. Assuming that such a state is genetically controlled, the aim of our study was to evaluate the degree of genetic homozygosity among overweight and obese individuals by the homozygously recessive characteristics (HRC) test. Material and methods: We analysed the presence, distribution and individual combination of 15 selected genetically controlled recessive phenotype traits in a sample of 140 individuals with increased body mass index (overweight individuals n = 100 and obese individuals n = 40) and a control group of normal weight individuals (n = 300). Results: Obese individuals have significantly higher mean values for genetic homozygosity than those with normal weight (normal weight:3.61 ±1.48; obese:4.13 ±1.47, p <0.05) and difference in the presence of certain individual combinations of evaluated phenotype traits (Σχ2 = 76.9; p <0.01). There was no difference in average homozygosity of such genetic markers between groups of normal weight and overweight individuals (normal weight:3.61 ±1.48; overweight:3.93 ±1.51, p >0.05) and between groups of overweight and obese individuals (overweight:3.93 ±1.51; obese:4.13 ±1.47, p >0.05). There is no difference in the presence of certain individual combinations of evaluated phenotype traits between overweight and obese individuals (Σχ 2 = 20.6; p >0.05). Conclusions: There is a populational genetic difference in the degree of genetic homozygosity and variability between the group of normal weight and group of obese individuals, indicating a possible genetic component. Overweight and obese individuals have a genetic predisposition, but different expression of genetic loads could be one of the possible explanations for different susceptibility to increase of fat mass and body mass index. Copyright © 2012 Termedia & Banach.

Purpose: To evaluate short- and long-term effects of structured exercise program in euthyroid patients with Graves' disease. Methods: The study employed a retrospective case-control design. The exercise group (n62) underwent 3 weeks of structured exercise program consisting of daily walking, strengthening, and stretching exercises while the control group (n62) participated in leisure activities. Thyroid profile, aerobic capacity, and perceived fatigue were evaluated on in-patient admission and discharge. Time to discontinuation of anti-thyroid medication after discharge and time to relapse of symptoms were determined. Results: The exercise group increased estimated peak oxygen consumption (significant group-by-time ANOVA interaction, P < 0.001), decreased serum thyroxin (P0.038), increased serum thyrotropin (P0.071), and reported less fatigue (Fisher's exact test, p < 0.001) from admission to discharge. The anti-thyroid medication was withdrawn within 6 months of discharge in significantly greater proportion of subjects in the exercise than control group (84% vs. 18%). Conversely, the rate of relapse within 12 months of medication withdrawal was smaller in the exercise (29%) than control group (72%). Conclusions: The results suggest that structured exercise program may normalize thyroid profile, improve aerobic capacity, and reduce fatigue on the short-term basis as well as reduce the need for anti-thyroid medication on the long-term basis. Implications for Rehabilitation This retrospective study suggests that the structured exercise program is safe and beneficial for euthyroid Graves' disease patients. The main benefits include short-term improvements in aerobic capacity and fatigue and long-term reduction in anti-thyroid medication. The prospective randomized control study is warranted to define optimal exercise protocol and validate these preliminary results. © 2012 Informa UK, Ltd.

Background: Over the last decades, a considerable number of observational scales have been developed to assess pain in persons with dementia. The time seems ripe now to build on the knowledge and expertize implemented in these scales to form an improved, “best-of” meta-tool. The EU-COST initiative “Pain in impaired cognition, especially dementia” aimed to do this by selecting items out of existing observational scales and critically re-assessing their suitability to detect pain in dementia. This paper reports on the final phase of this collaborative task. Methods: Items from existing observational pain scales were tested for “frequency of occurrence (item difficulty),” “reliability” and “validity.” This psychometric testing was carried out in eight countries, in different healthcare settings, and included clinical as well as experimental pain conditions. Results: Across all studies, 587 persons with dementia, 27 individuals with intellectual disability, 12 Huntington's disease patients and 59 cognitively healthy controls were observed during rest and movement situations or while receiving experimental pressure pain, respectively. The psychometric outcomes for each item across the different studies were evaluated within an international and multidisciplinary team of experts and led a final selection of 15 items (5x facial expressions, 5x body movements, 5x vocalizations). Conclusions: The final list of 15 observational items have demonstrated psychometric quality and clinical usefulness both in their former scales and in the present international evaluation; accordingly, they qualified twice to form a new internationally agreed-on meta-tool for Pain Assessment in Impaired Cognition, the PAIC-15 scale. Significance: Using a meta-tool approach by building on previous observational pain assessment scales and putting the items of these scales through rigorous empirical testing (using experimental as well as clinical pain studies in several European countries), we were able to identify the best items for pain assessment in individuals with impaired cognition. These selected items form the novel PAIC15 scale (pain assessment in impaired cognition, 15 items). © 2019 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC®

The ArmAssist is a low-cost robotic system for post-stroke upper-limb telerehabilitation based on serious games. The system incorporates a set of games for the assessment of arm function, the ArmAssist Assessment (AAA), which allows a remote monitoring of the progress of the patient and an automatic adaptation of the therapy. In this study, different components of the AAA are compared against three widely-used clinical tests, the Fugl-Meyer Assessment (FMA) [1], the Action Research Arm Test (ARAT) [2] and the Wolf Motor Function Test (WMFT) [3] in order to select the most clinically meaningful ones for the final score provided to patients and therapist, and evaluate their capability to predict or even improve some aspects of these standard scales. All four tests were performed in 38 separate sessions in 19 post-stroke individuals in their sub-acute phase, as part of a broader study. Statistically significant correlation could be shown with the three clinical tests. These preliminary results are promising for the validation of AAA as a fast, automatic and clinically meaningful tool for remote progress assessment and therapy adaptation; however, more data and further analysis is needed to confirm this. © 2015 IEEE.

The ArmAssist is a low-cost robotic system for post-stroke upper-limb telerehabilitation based on serious games. The system incorporates a set of games for the assessment of arm function, the ArmAssist Assessment (AAA), which allows a remote monitoring of the progress of the patient and an automatic adaptation of the therapy. In this study, different components of the AAA are compared against three widely-used clinical tests, the Fugl-Meyer Assessment (FMA) [1], the Action Research Arm Test (ARAT) [2] and the Wolf Motor Function Test (WMFT) [3] in order to select the most clinically meaningful ones for the final score provided to patients and therapist, and evaluate their capability to predict or even improve some aspects of these standard scales. All four tests were performed in 38 separate sessions in 19 post-stroke individuals in their sub-acute phase, as part of a broader study. Statistically significant correlation could be shown with the three clinical tests. These preliminary results are promising for the validation of AAA as a fast, automatic and clinically meaningful tool for remote progress assessment and therapy adaptation; however, more data and further analysis is needed to confirm this. © 2015 IEEE.

The Patient-Reported Impact of Spasticity Measure (PRISM) has been developed recently to assess the impact of spasticity on quality of life after spinal cord injury. Although PRISM may also be useful in patients with multiple sclerosis (MS), its psychometric properties in MS have not been established and PRISM is currently available only in English. The aims of this cross-sectional study were to translate PRISM into the Serbian language (PRISM SR) and examine its validity (construct, convergent, divergent) and reliability (internal consistency, test-retest reliability) in 48 patients with spasticity because of MS diagnosed at least 1 year earlier and in remission at least 3 months. PRISM SR was administered twice 3 days apart. The validity of seven PRISM SR subscales was examined against the Modified Ashworth Scale (MAS), the Numerical Rating Scale (NRS) for spasticity, sex, and education. Internal consistency was assessed with Cronbach α and test-retest reliability with intraclass correlation coefficient for agreement (ICC 2,1). During the forward-backward translation, only one PRISM item required minor cultural adaption. Almost all PRISM SR scores correlated significantly with MAS and NRS scores (r=0.29-0.51, 0.001≤P≤0.043). They were all significantly higher for MAS≥2 group versus the MAS<2 group (0.003≤P≤0.035) and for the NRS≥7 group versus the NRS<7 group (0.001≤P≤0.042), except for the Social Embarrassment subscale (P=0.083). The PRISM SR scores were not significantly different between sexes (P≥0.104) or those with high school versus college degree (P≥0.139). Both Cronbach α (0.78-0.93) and test-retest ICC 2,1 (0.82-0.90) were high. The original PRISM may be translated successfully into other languages. PRISM SR shows adequate validity and reliability for assessing the impact of spasticity on quality of life in patients with MS. © 2015 Wolters Kluwer Health, Inc.

The Patient-Reported Impact of Spasticity Measure (PRISM) has been developed recently to assess the impact of spasticity on quality of life after spinal cord injury. Although PRISM may also be useful in patients with multiple sclerosis (MS), its psychometric properties in MS have not been established and PRISM is currently available only in English. The aims of this cross-sectional study were to translate PRISM into the Serbian language (PRISM SR) and examine its validity (construct, convergent, divergent) and reliability (internal consistency, test-retest reliability) in 48 patients with spasticity because of MS diagnosed at least 1 year earlier and in remission at least 3 months. PRISM SR was administered twice 3 days apart. The validity of seven PRISM SR subscales was examined against the Modified Ashworth Scale (MAS), the Numerical Rating Scale (NRS) for spasticity, sex, and education. Internal consistency was assessed with Cronbach α and test-retest reliability with intraclass correlation coefficient for agreement (ICC 2,1). During the forward-backward translation, only one PRISM item required minor cultural adaption. Almost all PRISM SR scores correlated significantly with MAS and NRS scores (r=0.29-0.51, 0.001≤P≤0.043). They were all significantly higher for MAS≥2 group versus the MAS<2 group (0.003≤P≤0.035) and for the NRS≥7 group versus the NRS<7 group (0.001≤P≤0.042), except for the Social Embarrassment subscale (P=0.083). The PRISM SR scores were not significantly different between sexes (P≥0.104) or those with high school versus college degree (P≥0.139). Both Cronbach α (0.78-0.93) and test-retest ICC 2,1 (0.82-0.90) were high. The original PRISM may be translated successfully into other languages. PRISM SR shows adequate validity and reliability for assessing the impact of spasticity on quality of life in patients with MS. © 2015 Wolters Kluwer Health, Inc.