Enhancing Activity Recognition After Stroke: Generative Adversarial Networks for Kinematic Data Augmentation.

The generalizability of machine learning (ML) models for wearable monitoring in stroke rehabilitation is often constrained by the limited scale and heterogeneity of available data. Data augmentation addresses this challenge by adding computationally derived data to real data to enrich the variability represented in the training set. Traditional augmentation methods, such as rotation, permutation, and time-warping, have shown some benefits in improving classifier performance, but often fail to produce realistic training examples.

Performance of a multisensor smart ring to evaluate sleep: in-lab and home-based evaluation of generalized and personalized algorithms.

Study Objectives: Wearable sleep technology has rapidly expanded across the consumer market due to advances in technology and increased interest in personalized sleep assessment to improve health and mental performance. We tested the performance of a novel device, the Happy Ring, alongside other commercial wearables (Actiwatch 2, Fitbit Charge 4, Whoop 3.0, Oura Ring V2), against in-lab polysomnography (PSG) and at-home electroencephalography (EEG)-derived sleep monitoring device, the Dreem 2 Headband.

Real-World Evidence for a Smartwatch-Based Parkinson's Motor Assessment App for Patients Undergoing Therapy Changes.

Introduction: Parkinson's disease (PD) is poorly quantified by patients outside the clinic, and paper diaries have problems with subjective descriptions and bias. Wearable sensor platforms; however, can accurately quantify symptoms such as tremor, dyskinesia, and bradykinesia. Commercially available smartwatches are equipped with accelerometers and gyroscopes that can measure motion for objective evaluation.

Kinematic but not clinical measures predict falls in Parkinson-related orthostatic hypotension.

Objective: We sought to test the hypothesis that technology could predict the risk of falls in Parkinson's disease (PD) patients with orthostatic hypotension (OH) with greater accuracy than in-clinic assessment.

Methods: Twenty-six consecutive PD patients with OH underwent clinical (including home-like assessments of activities of daily living) and kinematic evaluations of balance and gait as well as beat-to-beat blood pressure (BP) monitoring to estimate their association with the risk of falls. Fall frequency was captured by a diary collected prospectively over 6 months.

Neural network pattern recognition of lingual-palatal pressure for automated detection of swallow.

We describe a novel device and method for real-time measurement of lingual-palatal pressure and automatic identification of the oral transfer phase of deglutition. Clinical measurement of the oral transport phase of swallowing is a complicated process requiring either placement of obstructive sensors or sitting within a fluoroscope or articulograph for recording. Existing detection algorithms distinguish oral events with EMG, sound, and pressure signals from the head and neck, but are imprecise and frequently result in false detection.

Targeted transtracheal stimulation for vocal fold closure.

Paralysis of the structures in the head and neck due to stroke or other neurological disorder often causes dysphagia (difficulty in swallowing). Patients with dysphagia have a significantly higher incidence of aspiration pneumonia and death. The recurrent laryngeal nerve (RLN), which innervates the intrinsic laryngeal muscles that control the vocal folds, travels superiorly in parallel to the trachea in the tracheoesophageal groove.

Laryngeal elevation by selective stimulation of the hypoglossal nerve.

Objective: Laryngeal elevation protects the airway and assists opening of the esophagus during swallowing. The GH, thyrohyoid, and MH muscles provide a majority of this elevatory motion. This study applied functional electrical stimulation to the XII/C1 nerve complex using a nerve cuff electrode to determine the capabilities of neural stimulation to induce laryngeal elevation.

Electrical stimulation for the management of aspiration during swallowing.

Protection of the airway during swallow is often compromised following stroke and other neurological diseases. If a patient fails to recover airway protection with standard therapy, they are often left with few if any options to avoid repeated pneumonia resulting from aspiration. For them, the only option is no food by mouth and a PEG-tube for nutrition.

Selective intraoperative stimulation of the human larynx.

Objectives/hypothesis: Laryngeal contraction normally entails activation of mutually cooperative intrinsic laryngeal muscles (ILMs). Unfortunately, standard stimulating methods do not completely mimic the normal ongoing synchrony between the muscles. We submit that this problem can be addressed by modifying the stimulating waveform.

Paced glottic closure for controlling aspiration pneumonia in patients with neurologic deficits of various causes.

Objectives: We undertook to determine whether paced vocal fold adduction can check aspiration in patients with various neurologic conditions.

Methods: Five patients with fluoroscopically documented aspiration and repeated pneumonias were enrolled. Two previously reported patients with hemispheric stroke were compared to 3 additional subjects with brain stem-basal ganglia and cerebellar stroke, cerebral palsy, and multiple sclerosis.

Improvement of respiratory compromise through abductor reinnervation and pacing in a patient with bilateral vocal fold impairment.

Objectives/hypothesis: To determine whether respiratory compromise from bilateral vocal fold impairment (paralysis) can be objectively alleviated by reinnervation and pacing.

Methods: A patient with paramedian vocal folds and synkinesis had a tracheotomy for stridor after bilateral laryngeal nerve injury and Miller Fisher syndrome. One posterior cricoarytenoideus (PCA) received a nerve-muscle pedicle fitted with a perineural electrode for pacemaker stimulation.