Gait & posture
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Controlled Clinical Trial
A classification system for delirium subtyping with the use of a commercial mobility monitor.
The usefulness of motor subtypes of delirium is unclear due to inconsistency in subtyping methods and a lack of validation with objective measures of activity. The activity of 40 patients was measured over 24h with a commercial accelerometer-based activity monitor. Accelerometry data from patients with DSM-IV delirium that were readily divided into hyperactive, hypoactive and mixed motor subtypes, were used to create classification trees that were subsequently applied to the remaining cohort to define motoric subtypes. ⋯ The use of a classification system shows how delirium subtypes can be categorised in relation to overall activity and postural changes, which was one of the most discriminating measures examined. The classification system was also implemented to successfully define other patient motoric subtypes. Motor subtypes of delirium defined by observed ward behaviour differ in electronically measured activity levels.
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The purpose of this study was to assess the use of a multivariate statistical method to rank clinical and gait variables, thus describing a ranking of patient dysfunction prior to and following total knee replacement (TKR) surgery. Twenty end-stage knee osteoarthritis (KOA) subjects scheduled for TKR and 20 healthy controls performed level walking and stair ascent twice: pre- (P1) and 6 months post-surgery (P2). Clinical and gait measures were entered into a principle component analysis (PCA) to determine orthogonal principle components (PCs). ⋯ For P2, the "stair ascent dysfunction" dimension best discriminated between 6 months post-TKR patients and controls. The results of this study suggest that a multivariate statistical method provides a clinically relevant ranking of patient dysfunction prior to and following TKR. This ranking of dysfunction could serve to identify rehabilitation priorities.