Perspectives of clinical video-analysis of movements in pediatric patients receiving HSCT
Nikolay N. Mitrakov1, Artem V. Shcherbuha1, Polina A. Shafran1, Alexey V. Korochkin1,2, Olga A. Laysheva1,2
1 Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
2 Russian Children’s Clinical Hospital Federal State Budgetary Educational Institution of Higher Professional Training, Moscow, Russia
3 N. I. Pirogov Russian National Research Medical University, Moscow, Russia
Contact: Dr. Nikolay N. Mitrakov
The problem of use of physical therapy methods in pediatric patients receiving hemopoietic stem cell transplantation (HSCT) for the correction of complications occurring in the process of treatment is becoming more and more pressing due to expansion of indications for HSCT and increasing survival rate of such patients. There are currently no publications dedicated to the analysis of movement disorders’ spectrum in patients who underwent HSCT, as well as methods of physical therapy efficiency control for up to 6 weeks following the beginning of treatment. We are offering a brand-new approach to the diagnostics of movement disorders by video analysis of reflex locomotion of the process of patient verticalisation from back-lying position into standing position with support on both legs. The purpose of this study was development of diagnostics, prevention and control of efficiency of physical therapy carried out for pediatric patients receiving HSCT using clinical video analysis method in order to make the results more objective.
Patients and methods
Our tasks were as follows: 1. Formalization of video criteria of movement test for acyclic locomotor stereotype of verticalization; 2. Research of inter-research variability upon determination of video criteria; 3. Determination of specific signs of typical movement disorders in pediatric patients following HSCT. A total of 230 patients took part in the study: 1. Study group: 64 pediatric patients following HSCT (median age is 10.4) who underwent treatment in Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology in 2017-2018. 2. Control group No. 1: 58 patients with oncological diseases receiving HDCT without HSCT (acute lymphocytic leukemia, n=42 (median age 7.4 years); acute myeloid leukemia: 18 patients (median age, 8.7 years); idiopathic immune deficiency: 21 patients (median age 10 years); neurogliocytomas in posterior cranial fossa: 8 patients (median age, 4.6 years); osteosarcoma of lower extremities’ bones: 11 patients (median age is14); 3. Control group, 87 conditionally healthy children with median age of 10.8 recruited in children’s groups for the first year of education of Russian Aikido Federation; 4. A group of researchers (n=65) formed out of the employees of medical rehabilitation center of Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology. Video materials were recorded using cell phone or tablet PC cameras. Video analysis was carried out using Dartfish software.
The criteria of video representation of invariant characteristics of acyclic locomotive verticalisation stereotype’s video material from back-lying position into standing position on a horizontal surface with support on both legs were determined, formally described and split into stages. Objectification of the analysis of video criteria concerning invariant characteristics of acyclic locomotive verticalisation stereotype was achieved by registering temporary characteristics of locomotive stereotype stages’ video material. Inter-research variability reached 1.2%. Invariant characteristics spectrum of acyclic locomotive verticalisation stereotype’s video material in patients following HSCT in the study group had statistically significant difference (p<0.01) from the similar spectrum of control groups.
1. Determined criteria of locomotive verticalisation stereotype’s video analysis allowed to set the patients who underwent HSCT from both conditionally healthy children and patients with distinct diseases receiving high dose chemotherapy.
2. The results of control of inter-research variability make it possible to hope for automation of the process of video registration of temporary invariant characteristics of the stages of locomotive verticalisation stereotype.
Due to lack of selection homogeneity, small spectrum of conditions included in the study, as well as insufficient number of observations, it is impossible to make firm conclusions on the formation of full criteria for movement disorders’ diagnostics in patients following HSCT based on video images of acyclic locomotive verticalisation stereotype. Further research in this area are currently being conducted.
Oncological diseases, treatment, motor rehabilitation, physical therapy, video analysis of movements.