PowerPoint Presentation
Patient Centric ResearchEkta Grewal, M.Sc.interdisciplinary
Consortium on Advanced Motion Performance (iCAMP)University of
Arizona, Tucson, AZ
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OverviewPhantom pain and sensationPhantom limb SyndromePhantom
Bladder SyndromeObjective outcome evaluation Quality of life
Postural balanceGait Physical activity 2
Phantom Pain & SensationsContinued sensations following
amputation of a body part
Common phantom pain/sensations Phantom limb syndromePhantom
bladder syndrome 3
Management of Phantom PainMirror TherapyVirtual training
Not ideal for PBS What alternatives do we have ? 4
Alternative MedicineGuided imagery a therapeutic and stress
relaxation techniqueEndorphinsChronic pain conditions, anxiety,
cancer pain, interstitial cystitis5
https://www.youtube.com/watch?v=W0i0KvHoSiM
Study DesignA randomized, double blind, parallel group
controlled trialSample size= 30Control- relaxation CD,
Intervention- Guided Imagery twice a day for 8 weeksPrimary
outcomePain (VAS)
Secondary outcomeQuality of life (SF-36)
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Skills AcquiredConducting comprehensive literature reviewHES
database/ICD-10 and OPCS-4 codingResearch DesignIRB protocolPatient
recruitment
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Objective Outcome EvaluationOutcome evaluation of an
intervention Outcomes related to quality of life and day to day
mobility are most evaluated through subjective measures Standard
questionnairesSelf-reports No objective measures under most
scenarios 8
Why Go ObjectiveExampleOrthopedic surgeryKnee/Hip joint
replacement
What impact does these interventions have on everyday living and
quality of lifePostural balance, walking, everyday living
activitiesHas the above been improved or at least regained9
Postural BalanceBody swayPreviously assessed
subjectivelyImproved technology led to objective measures However,
still not feasible for busy clinicsAdvent of Body-worn
sensors10
ML Sway, cmAP Sway, cmCenter of massSway, cm2
Walking PatternsMotion Capture/ Mat SystemsTedious Confined to
in lab measurements
Body-worn sensors Out of labIn clinic/homeEasy
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Daily Spontaneous ActivitiesGenerally Pedometers Very basic
measures (steps, calories, distance)
Body worn sensorsAccurateEasyValuable measures (steps, speed,
postural transitions, standing time, walking time)
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Stress Assessment 20 Diabetic patients with active foot ulcers
(57 12 years)Stress assessed during clinical visit for wound
dressing Body worn sensor (Zephyr BioHarness) Stress quantified by
HRV
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18%35%47%Typical example of patient with low stress (a) and high
stress (b) during would dressingabDuration of different levels of
stress experienced by patients during wound dressing
Skills AcquiredIRB Protocols: CITI, HIPPAResearch Design and
coordinationSCM/All scriptsPatient recruitmentData collectionBody
worn sensorsGrants writingSPSS
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Patient population
Diabetes/Peripheral neuropathy
Chronic pancreatitis
Phantom urinary bladder syndrome
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AccomplishmentsGrants ContributionsUrostomy Association: Grant
awarded during research at Bournemouth, EnglandNIH R21: A Tailored
Stress-Management intervention to accelerate wound healing in
diabetes(Submitted)Diabetes Research and Wellness Foundation Grant:
Multifaceted Patient Centric Approach to ImproveManagementof
Diabetic Foot Wounds (Submitted)American Diabetes Association: An
Innovative Game-Based Exercise to Accelerate Diabetic Foot Wound
Healing (Submitted)PublicationsParvaneh S, Grewal GS, Grewal E,
Menzies RA. Talal TK, Armstrong DG, Sternberg E, and Najafi B. 2014
Stressing the Dressing: Assessing Stress during Wound Care in
Real-Time Using Wearable Sensors. Wound Medicine, 4: 21-26.Parvaneh
S, Grewal GS, Grewal E, Talal TK, Armstrong DG and Najafi B. 2014
Heart Rate Variability for assessment of physiological stress
response: validation of a personalized algorithm.
(Submitted).Grewal E et al. Phantom Urinary Bladder Syndrome: A
Systematic Review (Drafting)
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