A dynamic neuro-fuzzy model providing bio-state estimation and prognosis prediction for wearable intelligent assistants.
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BACKGROUND: Intelligent management of wearable applications in rehabilitation requires an understanding of the current context, which is constantly changing over the rehabilitation process because of changes in the person's status and environment. This paper presents a dynamic recurrent neuro-fuzzy system that implements expert-and evidence-based reasoning. It is intended to provide context-awareness for wearable intelligent agents/assistants (WIAs). METHODS: The model structure includes the following types of signals: inputs, states, outputs and outcomes. Inputs are facts or events which have effects on patients' physiological and rehabilitative states; different classes of inputs (e.g., facts, context, medication, therapy) have different nonlinear mappings to a fuzzy "effect." States are dimensionless linguistic fuzzy variables that change based on causal rules, as implemented by a fuzzy inference system (FIS). The FIS, with rules based on expertise and evidence, essentially defines the nonlinear state equations that are implemented by nuclei of dynamic neurons. Outputs, a function of weighing of states and effective inputs using conventional or fuzzy mapping, can perform actions, predict performance, or assist with decision-making. Outcomes are scalars to be extremized that are a function of outputs and states. RESULTS: The first example demonstrates setup and use for a large-scale stroke neurorehabilitation application (with 16 inputs, 12 states, 5 outputs and 3 outcomes), showing how this modelling tool can successfully capture causal dynamic change in context-relevant states (e.g., impairments, pain) as a function of input event patterns (e.g., medications). The second example demonstrates use of scientific evidence to develop rule-based dynamic models, here for predicting changes in muscle strength with short-term fatigue and long-term strength-training. CONCLUSION: A neuro-fuzzy modelling framework is developed for estimating rehabilitative change that can be applied in any field of rehabilitation if sufficient evidence and/or expert knowledge are available. It is intended to provide context-awareness of changing status through state estimation, which is critical information for WIA's to be effective. (+info)
Exercise during childhood and adolescence: a prophylaxis against cystic fibrosis-related low bone mineral density? Exercise for bone health in children with cystic fibrosis.
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Endurance and strength training outcomes on cognitively impaired and cognitively intact older adults: a meta-analysis.
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BACKGROUND: Dementia is a common syndrome in the geriatric population. Subsequent impairment of cognitive functioning impacts the patient's mobility, ADLs, and IADLs. It is suggested that older persons with lower levels of cognition are less likely to achieve independence in ADLs and ambulation (1-2). Frequently, nursing home residents are viewed as too frail or cognitively impaired to benefit from exercise rehabilitation. Often, persons with Mini Mental State Score (MMSE) score below 25 are excluded from physical rehabilitation programs. However, Diamond (3) and Goldstein (4) concluded that geriatric patients with mild to moderate cognitive impairment were just as likely as cognitively intact patients to improve in functional abilities as a result of participation in exercise rehabilitation programs. PURPOSE: The objective of this study is to compare, through a meta-analysis endurance and strength outcomes of Cognitively Impaired (MMSE < 23) and Cognitively Intact (MMSE superior 24) older adults who participate in similar exercise programs. METHODS: Published articles were identified by using electronic and manual searches. Key search words included exercise, training, strength, endurance, rehabilitation, cognitive impairment, cognition, MMSE, older adult, aged, and geriatrics. Articles were included if the were from RCTs or well-designed control studies. RESULTS: A total of 41 manuscripts met the inclusion criteria. We examined 21 exercise trials with cognitively impaired individuals (CI=1411) and 20 exercise trials with cognitively intact individuals (IN=1510). Degree of cognitive impairment is based on the reported MMSE score. Moderate to large effect sizes (ES = dwi, Hedges gi) were found for strength and endurance outcomes for the CI groups (dwi = .51, 95% CI= .42- .60), and for the IN groups (dwi = .49, 95% CI= .40- .58). No statistically significant difference in ES was found between the CI and IN studies on strength (t=1.675, DF= 8, P= .132), endurance (t=1.904, DF= 14, P=.078), and combined strength and endurance effects (t=1.434, DF= 56, P= .263). CONCLUSIONS: These results suggest that cognitively impaired older adults who participate in exercise rehabilitation programs have similar strength and endurance training outcomes as age and gender matched cognitively intact older participants and therefore impaired individuals should not be excluded from exercise rehabilitation programs. (+info)
Initiating and maintaining resistance training in older adults: a social cognitive theory-based approach.
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Relationship between resistance training and lipoprotein profiles in sedentary male smokers.
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Epidemiological studies have found plasma lipid and lipoprotein levels to be predictive of cardiovascular disease in adults. To date, regular aerobic modes of exercise have been associated with favourable alterations in lipid and lipoprotein levels. However, the effect of resistance training on lipid and lipoprotein levels is inconclusive and conflicting. Therefore, the aim of this study was to provide some clarity on whether resistance training could be used to improve sedentary male smokers' lipoprotein profiles. The study made use of a pre-test, a treatment period and a post-test. Subjects were placed into one of two groups, namely, a resistance-training (RES) group (n = 13) or a control (CON) group (n = 12). Throughout the 16-week experimental period the CON group received no treatment whatsoever. After resistance training, serum triglyceride levels were significantly decreased by 18.42% from 1.162 mmol/l (+/- 0.476) to 0.831 mmol/l (+/- 0.058) (p = 0.038) in the RES group. However, resistance training was found to have no impact on any of the other measured lipid and lipoprotein measures. In conclusion, these findings indicate that resistance training appears to have no significant effect on lipid and lipoprotein profiles in sedentary male smokers and therefore cannot prevent the advance of CAD. (+info)
Changes in muscle size and MHC composition in response to resistance exercise with heavy and light loading intensity.
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