Enhanced recovery after surgery (ERAS) for adolescent idiopathic scoliosis: Standardisation of care improves patient outcomes.

INTRODUCTION: Adolescent idiopathic scoliosis (AIS) surgeries are major paediatric procedures requiring multidisciplinary management. Enhanced recovery after surgery (ERAS) programs, with proven benefits in adults, remain poorly developed in paediatrics. The main objective of this Before/After study was to evaluate the impact of an ERAS program implementation for AIS on length of stay (LOS) and postoperative recovery. METHODS: The ERAS protocol included intrathecal morphine, standardised multimodal analgesia and multidisciplinary measures for early recovery. Retrospective data from adolescents operated between 2015 and 2017 ("Before ERAS" group) were compared with data from patients benefiting from the ERAS program ("After ERAS" group). Patients treated for neuromuscular scoliosis were not included. After a descriptive analysis, a propensity score matching defined two comparable populations. The main outcome was the LOS. The time to first solid food intake, first ambulation, first bowel movement and Foley removal were also analysed. RESULTS: During the "Before ERAS" period, 73 underwent PSF for AIS. Thereafter, 65 patients benefited from the ERAS protocol, including 35 for AIS. After propensity score application, 32 patients of the "After ERAS" group were matched with 32 patients of the "Before ERAS" group. The ERAS implementation was associated with 25% reduction in LOS (2.10 ± 1.60 days p < 0.001). All other enhanced recovery criteria were significantly reduced after ERAS implementation. CONCLUSION: These results confirm the expected benefits of ERAS program in AIS with a significant impact on postoperative recovery and LOS. Patient adherence and the involvement of all caregivers are essential to the success of such a program.

LIPSHOK: LIARA Portable Smart Home Kit.

Several smart home architecture implementations have been proposed in the last decade. These architectures are mostly deployed in laboratories or inside real habitations built for research purposes to enable the use of ambient intelligence using a wide variety of sensors, actuators and machine learning algorithms. However, the major issues for most related smart home architectures are their price, proprietary hardware requirements and the need for highly specialized personnel to deploy such systems. To tackle these challenges, lighter forms of smart home architectures known as smart homes in a box (SHiB) have been proposed. While SHiB remain an encouraging first step towards lightweight yet affordable solutions, they still suffer from few drawbacks. Indeed, some of these kits lack hardware support for some technologies, and others do not include enough sensors and actuators to cover most smart homes' requirements. Thus, this paper introduces the LIARA Portable Smart Home Kit (LIPSHOK). It has been designed to provide an affordable SHiB solution that anyone is able to install in an existing home. Moreover, LIPSHOK is a generic kit that includes a total of four specialized sensor modules that were introduced independently, as our laboratory has been working on their development over the last few years. This paper first provides a summary of each of these modules and their respective benefits within a smart home context. Then, it mainly focus on the introduction of the LIPSHOK architecture that provides a framework to unify the use of the proposed sensors thanks to a common modular infrastructure capable of managing heterogeneous technologies. Finally, we compare our work to the existing SHiB kit solutions and outline that it offers a more affordable, extensible and scalable solution whose resources are distributed under an open-source license.

Effects and Acceptability of an Individualized Home-Based 10-Week Training Program in Adults with Myotonic Dystrophy Type 1.

BACKGROUND: Muscle weakness is a cardinal sign of myotonic dystrophy type 1, causing important functional mobility limitations and increasing the risk of falling. As a non-pharmacological, accessible and safe treatment for this population, strength training is an intervention of choice. OBJECTIVE: To document the effects and acceptability of an individualized semi-supervised home-based exercise program on functional mobility, balance and lower limb strength, and to determine if an assistive training device has a significant impact on outcomes. METHODS: This study used a pre-post test design and men with the adult form of DM1 were randomly assigned to the control or device group. The training program was performed three times a week for 10 weeks and included three exercises (sit-to-stand, squat, and alternated lunges). Outcome measures included maximal isometric muscle strength, 10-Meter Walk Test, Mini-BESTest, 30-Second Chair Stand Test and 6-minute walk test. RESULTS: No outcome measures showed a significant difference, except for the strength of the knee flexors muscle group between the two assessments. All participants improved beyond the standard error of measurement in at least two outcome measures. The program and the device were well accepted and all participants reported many perceived improvements at the end of the program. CONCLUSIONS: Our results provide encouraging data on the effects and acceptability of a home-based training program for men with the adult form of DM1. These programs would reduce the financial burden on the health system while improving the clinical services offered to this population.

Highly Accurate Bathroom Activity Recognition Using Infrared Proximity Sensors.

Among elderly populations over the world, a high percentage of individuals are affected by physical or mental diseases, greatly influencing their quality of life. As it is a known fact that they wish to remain in their own home for as long as possible, solutions must be designed to detect these diseases automatically, limiting the reliance on human resources. To this end, our team developed a sensors platform based on infrared proximity sensors to accurately recognize basic bathroom activities such as going to the toilet and showering. This article is based on the body of scientific literature which establish evidences that activities relative to corporal hygiene are strongly correlated to health status and can be important signs of the development of eventual disorders. The system is built to be simple, affordable and highly reliable. Our experiments have shown that it can yield an F-Score of 96.94%. Also, the durations collected by our kit are approximately 6 seconds apart from the real ones; those results confirm the reliability of our kit.

A More Efficient Transportable and Scalable System for Real-Time Activities and Exercises Recognition.

Many people in the world are affected by muscle wasting, especially the population hits by myotonic dystrophy type 1 (DM1). Those people are usually given a program of multiple physical exercises to do. While DM1 and many other people have difficulties attending commercial centers to realize their program, a solution is to develop such a program completable at home. To this end, we developed a portable system that patients could bring home. This prototype is an improved version of the previous one using Wi-Fi, as this new prototype runs on BLE technology. This new prototype conceptualized induces great results.