Cervical range of motion (CROM) has been used in research and clinically for assessing cervical health. Gold-standard goniometers tend to be cumbersome. However, Inertial Measurement Units (IMUs) or vision-based alternatives demand frequent calibration and/or costly hardware; moreover, the subject is aware of being measured and there is a risk of breaching privacy. In response, we have developed a non-contact HPNet system for head pose estimation (HPE) that can use a rear-facing camera to quantify CROM accurately. A Re-parameterized Visual Geometry Group (RepVGG)-D2se model is employed as the backbone of the network, and a Spatial Feature Enhancement (SCFE) module is incorporated to improve feature extraction. HPNet was evaluated on the large-scale Carnegie Mellon University (CMU) Panoptic dataset, achieving a mean absolute error (MAE) of 3.48°, 3.22°and 3.34° for yaw, pitch and roll respectively. Inter-instrument reliability was excellent for all six cervical movements when compared with the research/clinical-grade CROM device, with intraclass correlation coefficients (ICCs) averaging 0.939. Bland–Altman plots confirmed close agreement between the two methods. Cervical movement trajectory curves further confirmed the concordance between the clinical device and our method. The system is fully automatic, requires only a rear-facing camera, effectively preserves patient privacy, and provides accurate cervical posture estimation. This technology may provide a basis for future applications in neck-disorder screening, remote health monitoring, and personalized musculoskeletal wellness management, although further task-specific clinical validation will be required. To date, HPNet has been validated primarily on a computer-based platform and has not yet been deployed on smartphones. Future work will focus on model lightweighting, mobile deployment, and cross-device adaptation to facilitate its practical implementation on mobile devices.

Patient-centred care (PCC) is considered an essential concept in twentyfirst-century healthcare; however, health care providers’ attitudes can be an important barrier or facilitator to its actual implementation. Chiropractic is frequently referred to as providing PCC. However, the attitudes of practising chiropractors towards patient-centred care have not previously been evaluated. To explore attitudes and orientation of chiropractors towards patient-centered care. We used a sequential explanatory mixed methods with quantitative priority study design. Data were collected from May 2018 to April 2019 from a convenience sample of Canadian chiropractors located across Canada. Quantitative data were collected by a survey consisting of demographic and clinical practice questions, and the Patient-Practitioner Orientation Scale (PPOS) to measure practitioner attitudes towards care delivered (range 1–6, scores < 4.57 = doctor-centred attitudes). Qualitative data were collected using semi-structured interviews. Quantitative data were analyzed with descriptive statistics and bivariate analysis; whilst qualitative data were analyzed using thematic analysis. We included 31 chiropractors in the study, with seven completing interviews. The mean for PPOS Overall score was 4.35 (95

Sleep posture detection is a potentially important component of sleep quality assessment and health monitoring. Accurate identification of sleep postures can offer valuable insights into an individual’s sleep patterns, comfort levels, and potential health risks. For example, improper sleep postures may lead to musculoskeletal issues, respiratory disturbances, and even worsen conditions like sleep apnea. Additionally, for long-term bedridden patients, continuous monitoring of sleep postures is essential to prevent pressure ulcers and other complications. Traditional methods for sleep posture detection have several limitations: wearable sensors can disrupt natural sleep and cause discomfort, camera-based systems raise privacy concerns and are sensitive to environmental conditions, and pressure-sensing mats are often complex and costly. To address these issues, we have developed a low-cost non-contact sleeping posture detection system. Our system features eight optimally distributed triaxial accelerometers, providing a comfortable and non-contact front-end data acquisition unit. For sleep posture classification, we employ an improved density peak clustering algorithm that incorporates the K-nearest neighbor mechanism. Additionally, we have constructed a Parallel Convolutional Spatiotemporal Network (PCSN) by integrating Convolutional Neural Network (CNN), Long Short-Term Memory (LSTM), and Bidirectional Long Short-Term Memory (Bi-LSTM) modules. Experimental results demonstrate that the PCSN can accurately distinguish six sleep postures: prone, supine, left log, left fetus, right log, and right fetus. The average accuracy is 98.42%, outperforming most state-of-the-art deep learning models. The PCSN achieves the highest scores across all metrics: 98.64% precision, 98.18% recall, and 98.10% F1 score. The proposed system shows considerable promise in various applications, including sleep studies and the prevention of diseases like pressure ulcers and sleep apnea.

Snoring, a common sleep-disordered breathing phenomenon, impairs sleep quality for both the sufferer and any bed partner. While mild snoring primarily disrupts sleep continuity, severe cases often indicate obstructive sleep apnea (OSA), a disorder affecting 9–17% of the global population, linked to significant comorbidities and socioeconomic burden (see Introduction for supporting data). Here, we propose a low-cost, real-time snoring detection and intervention system that integrates a multiple-spectrum deep learning framework with an Internet of Things (IoT)-enabled smart pillow. The modified Parallel Convolutional Spatiotemporal Network (PCSN) combines three parallel convolutional neural network (CNN) branches processing Constant-Q Transform (CQT), Synchrosqueezing Wavelet Transform (SWT), and Hilbert–Huang Transform (HHT) features with a Long Short-Term Memory (LSTM) network to capture spatial and temporal characteristics of sounds associated with snoring. The smart pillow prototype incorporates two Micro-Electro-Mechanical System (MEMS) microphones, an ESP8266 off-shelf board, a speaker, and two vibration motors for real-time audio acquisition, cloud-based processing via Arduino cloud, and closed-loop haptic/audio feedback that encourages positional changes without fully awakening the snorers. Experiments demonstrated that the modified PCSN model achieves 98.33% accuracy, 99.29% sensitivity, 98.34% specificity, 98.3% recall, and 98.32% F1-score, outperforming existing systems. Hardware costs are under USD 8 and a smartphone app provides authorized users with real-time visualization and secure data access. This solution offers a cost-effective and accurate approach for home-based OSA screening and intervention.

Sedentary behaviors, including poor postures, are significantly detrimental to health, particularly for individuals losing motion ability. This study presents a posture detection system utilizing four force-sensitive resistors (FSRs) and two triaxial accelerometers selected after rigorous assessment for consistency and linearity. We compared various machine learning algorithms based on classification accuracy and computational efficiency. The k-nearest neighbor (KNN) algorithm demonstrated superior performance over Decision Tree, Discriminant Analysis, Naive Bayes, and Support Vector Machine (SVM). Further analysis of KNN hyperparameters revealed that the city block metric with K = 3 yielded optimal classification results. Triaxial accelerometers exhibited higher accuracy in both training (99.4%) and testing (99.0%) phases compared to FSRs (96.6% and 95.4%, respectively), with slightly reduced processing times (0.83 s vs. 0.85 s for training; 0.51 s vs. 0.54 s for testing). These findings suggest that, apart from being cost-effective and compact, triaxial accelerometers are more effective than FSRs for posture detection.

The primary goal of mirror therapy is to alleviate symptoms and improve motor function and perception. It involves using a mirror to create a visual illusion that the affected limb is moving regularly and painlessly. Mirror therapy is often used in conjunction with traditional physical and occupational therapy methods and has been studied for post-stroke rehabilitation. However, mirror therapy effectiveness can vary among individuals. Virtual reality mirror therapy (VRMT) is an advanced application of mirror therapy that utilises virtual reality technology to enhance rehabilitation. While traditional mirror therapy uses a physical mirror to create the illusion of movement in the affected limb, VR mirror therapy takes advantage of immersive digital environments to provide a more engaging and customizable experience. This approach is particularly beneficial for stroke rehabilitation. The paper summarises four key design factors: e dosage, motivation, task difficulty and sensory feedback. In addition, it indicates the potential role of mirror neurons in both mirror therapy and VRMT and highlights three areas for future VRMT studies.

Continuous monitoring of health status has the potential to enhance the quality of life and life expectancy of people suffering from chronic illness and of the elderly. However, such systems can only come into widespread use if the cost of manufacturing is low. Advancements in material science and engineering technology have led to a significant decrease in the expense of developing healthcare monitoring devices. This review aims to investigate the progress of the use of low-cost sensors in healthcare monitoring and discusses the challenges faced when accomplishing continuous and real-time monitoring tasks. The major findings include (1) only a small number of publications (N = 50) have addressed the issue of healthcare monitoring applications using low-cost sensors over the past two decades; (2) the top three algorithms used to process sensor data include SA (Statistical Analysis, 30%), SVM (Support Vector Machine, 18%), and KNN (K-Nearest Neighbour, 12%); and (3) wireless communication techniques (Zigbee, Bluetooth, Wi-Fi, and RF) serve as the major data transmission tools (77%) followed by cable connection (13%) and SD card data storage (10%). Due to the small fraction (N = 50) of low-cost sensor-based studies among thousands of published articles about healthcare monitoring, this review not only summarises the progress of related research but calls for researchers to devote more effort to the consideration of cost reduction as well as the size of these components.

There are 1.2 million stroke survivors living in the UK, of which approximately 77% have lost some upper limb function. Traditional mirror therapy (MT) uses repetition, motor priming, and action observation to promote motor recovery in stroke patients. Although a range of intense repetitive exposure to therapeutic interventions, such as exercises and mirror therapy, appear key in motor recovery, it can be difficult to keep patients motivated as change can be slow and therapy appears monotonous. Virtual reality (VR) systems offer the ability of tracking hand function, which could benefit MT as it may provide realistic feedback, in a game like environment to increase motivation. In addition, VR may increase the variety of therapeutic exercises needed for patients as it is not restricted by the physical barrier of the mirror box. This study aimed to develop and evaluate the feasibility and effectiveness of a Virtual Reality Mirror Therapy (VRMT) system, intended to improve finger dexterity in post-stroke patients. Ten post stroke participants with upper limb hemiparesis were recruited for this study, which was run virtually at the participants' home. Participants were randomly allocated into three groups: Group 1 used the VRMT intervention; Group 2 used the Nine-hole peg (9HPT) test and Group 3 received no intervention (Control group). The results show that Groups 1 and 2 increased their 9HPT scores more than Group 3. Feedback from participants highlighted functional issues with the VR controller, which may have impacted on usability and motivation. The results of this study indicate that VRMT has the potential to improve finger function, can be used by post-stroke individuals and could increase engagement with therapeutic exercises post-conventional treatment.

Measuring temperature changes at the body-seat interface has been drawing increased attention from both industrial and scientific fields, due to the increasingly sedentary nature from daily leisure activity to routine work. Although contact measurement is considered the gold standard, it can affect the local micro-environment and the perception of sitting comfort. A non-contact temperature measurement system was developed to determine the interface temperature using data gathered unobtrusively and continuously from an infrared sensor (IRs). System performance was evaluated regarding linearity, hysteresis, reliability and accuracy. Then a healthy participant sat for an hour on low/intermediate density foams with thickness varying from 0.5–8 cm while body-seat interface temperature was measured simultaneously using a temperature sensor (contact) and an IRs (non-contact). IRs data were filtered with empirical mode decomposition and fractal scaling indices before a data-driven artificial neural network was utilized to estimate the contact surface temperature. A strong correlation existed between non-contact and contact temperature measurement (ρ > 0.85) and the estimation results showed a low root mean square error (RMSE) (<0.07 for low density foam and <0.16 for intermediate density foam) and high Nash-Sutcliff efficiency (NSE) values (≈1 for both types of foam materials).

People who have a diagnosis of cancer may develop, or already have musculoskeletal conditions, just like any other person. However, discussion about potential benefits of chiropractic treatment to this group has generally been avoided related to the fear of misrepresentation. We aimed to derive a consensus from a group of experienced chiropractors regarding their perception of what chiropractic care offered to patients with cancer. An anonymous, two stage, online, Delphi process was performed using experienced chiropractors (n=23: >10 yrs practice experience, who had treated patients with cancer) purposively selected and recruited independently. One opted out of the study, 13 actively engaged in two rounds of questions and verification; agreeing such patients gained benefit from chiropractic care but use of spinal manipulation was not essential. There was no clear consensus regarding a protocol for interaction within any multidisciplinary team treating the patient. Concerns were raised about misinterpretation of advertising any benefits for cancer patients from chiropractic care. Lack of evidence in this area was acknowledged.

We present the results of a study investigating whether there is an effect of Anodal-Transcranial Direct Current Stimulation (A-tDCS) on working memory (WM) performance. The relative effectiveness of A-tDCS on WM is investigated using a 2-back test protocol using two commonly used memory visual stimuli (shapes and letters). In a double-blinded, randomised, crossover, sham-controlled experiment, real A-tDCS and sham A-tDCS were applied separately to the left dorsolateral prefrontal cortex (L-DLPFC) of twenty healthy subjects. There was a minimal interval of one week between sham and real A-tDCS sessions. For the letters based stimulus experiment, 2-back test recall accuracy was measured for a set of English letters (A-L) which were presented individually in a randomised order where each was separated by a blank interval. A similar 2-back protocol was used for the shapes based stimuli experiment where instead of letters, a set of 12 geometric shapes were used. The working memory accuracy scores measured appeared to be significantly affected by memory stimulus type used and by the application of A-tDCS (repeated measures ANOVA p<0.05). A large effect size (d = 0.98) and statistical significance between sham and real A-tDCS WM scores (p = 0.01) was found when shapes were used as a visual testing stimulus, while low (d = 0.38) effect size and insignificant difference (p = 0.15) was found when letters were used. This results are important as they show that recollection different stimuli used in working memory can be affected differently by A-tDCS application. This highlights the importance of considering using multiple methods of WM testing when assessing the effectiveness of A-tDCS.

Being seated has increasingly pervaded both working and leisure lifestyles, with development of more comfortable seating surfaces dependent on feedback from subjective questionnaires and design aesthetics. As a consequence, research has become focused on how to objectively resolve factors that might underpin comfort and discomfort. This review summarizes objective methods of measuring the microenvironmental changes at the body–seat interface and examines the relationship between objective measurement and subjective sensation. From the perspective of physical parameters, pressure detection accounted for nearly two thirds (37/54) of the publications, followed by microclimatic information (temperature and relative humidity: 18/54): it is to be noted that one article included both microclimate and pressure measurements and was placed into both categories. In fact, accumulated temperature and relative humidity at the body–seat interface have similarly negative effects on prolonged sitting to that of unrelieved pressure. Another interesting finding was the correlation between objective measurement and subjective evaluation; however, the validity of this may be called into question because of the differences in experiment design between studies.

Abstract Background Patient-centred care is internationally recognized as a foundation of quality patient care. Attitudes of students towards patient-centred care have been assessed in various health professions. However, little is known how chiropractic students’ attitudes towards patient-centred care compare to those of other health professions or whether they vary internationally, and between academic programs. Objective To assess the association of select variables on student attitude towards patient-centred care among select chiropractic programs worldwide. Methods We conducted a cross-sectional study using the Patient-Practitioner Orientation Scale (PPOS) to assess students’ patient-centred attitudes towards the doctor-patient relationship. Eighteen items were scored on a 1 to 6 Likert scale; higher scores indicating more patient-centredness. All students from seven chiropractic educational programs worldwide were invited to complete an online survey. Results were analyzed descriptively and inferentially for overall, sharing and caring subscales. General linear regression models were used to assess the association of various factors with PPOS scores. Results There were 1858 respondents (48.9% response rate). Student average age was 24.7 (range = 17–58) years and 56.2% were female. The average overall PPOS score was 4.18 (SD = 0.48) and average sharing and caring subscale scores were 3.89 (SD = 0.64) and 4.48 (SD = 0.52), respectively. There were small but significant differences in all PPOS scores by gender, age, and program. Year/semester of study within a program typically was not associated with scores, neither was history of previous chiropractic care nor having family members who are health professionals. Conclusion This is the first international study assessing students’ attitudes of patient-centred care in chiropractic educational programs. We found small but significantly different PPOS scores between chiropractic programs worldwide that did not change across year/semester of study. Scores tended to be lower than those reported among medical students. Observed differences may be related to curricular content, extent of patient exposure and/or regional cultural realities.

Relative humidity (RH) at the body-seat interface is considered an important factor in both sitting comfort and generation of health concerns such as skin lesions. Technical difficulties appear to have limited research aimed at the detailed and simultaneous exploration of RH and temperature changes at the body-seat interface; using RH sensors without the capability to record temperature where RH is recorded. To explore the causes of a spike in RH consistently produced on first contact between body and seat surface, we report data from the first use of dual temperature and RH (HTU21D) sensors in this interface. Following evaluation of sensor performance, the effect of local thermal changes on RH was investigated. The expected strong negative correlation between temperature and RH (R2 = −0.94) supported the importance of considering both parameters when studying impact of sitting on skin health. The influence of sensor movement speed (higher velocity approach: 0.32 cm/s ± 0.01 cm/s; lower velocity approach: 0.17 cm/s ± 0.01 cm/s) into a static RH region associated with a higher local temperature were compared with data gathered by altering the rate of a person sitting. In all cases, the faster sitting down (or equivalent) generated larger RH outcomes: e.g., in human sitting 53.7% ± 3.3% RH (left mid-thigh), 56.4% ± 5.1% RH (right mid-thigh) and 53.2% ± 2.7% RH (Coccyx). Differences in size of RH change were seen across the measurement locations used to study the body-seat interface. The initial sitting contact induces a transient RH response (duration ≤ 40 s) that does not accurately reflect the microenvironment at the body-seat interface. It is likely that any movement during sitting would result in similar artefact formation. As a result, caution should be taken when investigating RH performance at any enclosed interface when the surfaces may have different temperatures and movement may occur.

In this workshop paper, we present two of our team’s findings on the effect of brain electrical stimulation on BCI performance, reflecting a trend in neuro-engineering research. In many applications, BCI technology targets users with impaired neural activity and as such enhancement of such activity can be of great importance. We show that the application of transcranial direct current stimulation (tDCS) can significantly enhance an EEG potential (P300) which is used in BCI spellers. In addition, tDCS application also appears to improve working memory performance particularly relating to the recall of shapes.

IntroductionResearch has suggested baby wearing results in happier healthier babies [1]. Various designs of carrier are available, is there one which has less impact on the biomechanics of the cervical spine?Methods18 volunteers (9 male and female) performed a warm up procedure on the neck (movement through each range of motion), repeated thrice. Measurement of the active cervical range of motion (ACROM) in flexion and extension using a Cervical Range of Motion device, described in previous studies [2]. Volunteers were then allocated a baby carrier to wear including a specially designed “baby” mannequin (dimensions based on population average statistics for a 1yro). Volunteers continued with ADLs, returning after 2 hours. With the carrier removed, measurements were repeated (without warm-up). Volunteers were assessed at the same time of day, thrice (control, single carrier, double carrier) with at least 1 day between carrying.ResultsACROM measurements following the use of either single or double shoulder ...

Purpose and BackgroundBack pain impinges upon all aspects of life, has a reported UK lifetime prevalence as high as 84% and considering approximately a third of our lives are spent asleep the paucity of research into the effect a mattress has on back pain and sleep is surprising. Mood changes, effecting an increase in pain perception, due to sleep loss may also lead to a downward spiral of increasing back pain and greater sleep loss. A controllable factor in this spiral, affecting both aspects, is the mattress but to the authors' knowledge none currently available on the market have any robust, published research to objectively support any claims made and at best being ‘endorsed’ by experts. This may lead to possible misinterpretation of efficacy and leave professionals at a loss with what to advise when questioned.Methods and Data collectionMethod:A three month, randomised, controlled, double blind crossover field study is proposed to take place in the participants own homes, ensuring the most natural sl...

The phenomenon of inattentional blindness has been discussed for years, in relation to everyday life and clinical practice. Inattentional blindness refers to the common failure to notice plainly visible items when attention is otherwise preoccupied. The purpose of this study was to assess any potential difference in inattentional blindness between chiropractic students on assessing plain film radiograph, and any difference compared to expert radiologist.

Study ObjectivesBack and neck pain are persistent and associated with disability and loss of independence in older adults.Spinal manipulative therapy (SMT) and supervised rehabilitative exercise (SRE) are both recommended treatments for spine pain in adults, often in combination with one another.It is unknown whether long-term management with these therapies is superior to shorter-term treatment.This study compares the effectiveness of short-term treatment (12 weeks) versus long-term management (36 weeks) of back and neck related disability in older adults using SMT combined with SRE. Methods and MaterialThis randomized clinical trial was approved by an Institutional Review Board and conducted at a private healthcare university.Participants were 65 years of age and older, community dwelling, and selfreported both back and neck disability >12 weeks in duration.Individuals were randomly assigned to receive either 12 or 36 weeks of SMT + SRE.Co-primary outcomes were changes in Oswestry and Neck Disability Index after 36 weeks.Secondary outcomes included self-reported pain, improvement, medication use, self-efficacy, and quality of life at weeks 4, 12, 24, 36, 52 and 78.Change in objective functional measures from baseline were measured post-intervention.Linear mixed models were used to compare between group differences in an intention to treat analysis Results 182 individuals participated (91 to each group).Both the short-term and long-term groups demonstrated significant improvements in back (-3.9, 95% confidence interval (CI) -5.8 to -2.0 versus -6.3, 95% CI -8.2 to -4.4) and neck disability (-7.3, 95% CI -9.1 to -5.5 versus -9.0, 95% CI = -10.8 to -7.2) after 36 weeks, with no difference between groups (back 2.4, 95% CI -0.3 to 5.1; neck 1.7, 95% CI -0.8 to 4.2).The long-term management group experienced greater improvement in neck pain at week 36, self-efficacy at week 36 and 52, functional ability and balance.On average, the short-term group attended 10 SMT and 4 SRE sessions; the long-term group attended 19 SMT and 9 SRE sessions. ConclusionFor older adults with chronic back and neck disability, extending management with SMT + SRE from 12 to 36 weeks did not result in

Objectives: The primary aim of this pilot study was to determine the feasibility of conducting a mixed-methods study assessing the extent patients with chronic health conditions perceive chiropractic care to be patient centred. Design: A sequential mixed methods feasibility study with a quantitative priority. Setting: Two private chiropractic clinics in Calgary, Alberta, Canada. Main outcome measures: Feasibility outcomes included pilot study participation, consent and completion rates. Demographic and health information and a modified version of the Patient Assessment of Chronic Illness Care (PACIC). Results: Over three weeks, 90 participants were recruited, 86 enrolled, and 78 provided complete data, with only one who commented on the clarity of paperwork. Included participants were on average 47.1 years of age and 60.3% were female. They had an average of 1.8 chronic conditions with 60% having chronic spinal pain. They reported seeing an average of 2.9 other health professionals for their chronic health condition and averaged 12.9 chiropractic visits in the past year. The average overall modified PACIC score was 3.29 on a 5-point scale. Higher scores were seen on the 'patient activation', 'delivery system design/decision support', and 'problem solving/contextual' subscales, with lower scores seen on the 'goal-setting/tailoring' and 'follow-up/coordination' sub scales. Interview data generally supported those findings. Conclusions: The pilot study results support the feasibility of the methods for a subsequent large-scale study. These preliminary results suggest that the degree of patient-centredness compares favourably to similar studies in primary medical care.