Clinical Research Directory

Markerless Motion Capture for 3D Clinical Gait Analysis (IMAGine)

Many children have trouble with walking and frequently trip and fall. To understand the extent of the changes in their walking, but also to inform and evaluate possible interventions to improve their walking, a gait analysis is carried out. Gait analysis is the assessment of how someone walks. It requires the accurate placement of markers on the skin in anatomical locations. The positions of these markers are then measured using infrared cameras and the results are displayed as movement graphs. These graphs are used in clinical decision making. However, this assessment can be time-consuming and uncomfortable for the child, and it may trigger anxiety, leading to an unnatural walking pattern. This style of assessment may also not be suitable for some children who are either very young or have additional sensory needs. One potential solution to these problems is to use motion capture systems that do not require markers. Instead, these systems use high-resolution video cameras to capture human motion. Artificial intelligence is then used to identify human body features from the video footage and produces movement graphs. Known as markerless motion capture, this emerging approach has been developed over the last few years and has demonstrated promising results compared to the current marker-based method in adults and children. However, it is not known how well markerless motion capture works for children with gait abnormalities, which is what this study aims to find out. Therefore, fifty children with movement difficulties will walk barefoot over a walkway with and without markers attached, while markerless and marker-based cameras record all trials simultaneously. This study will then compare the movement graphs created by the markerless and marker-based motion capture systems. The results of this study will also enable Alder Hey to be the lead clinical gait lab user of markerless technology in the UK, helping other gait labs to adopt the technology.

Monitoring Neurocognitive Dysfunction and the Impact of Metabolism and Physical Capacity After Paediatric HSCT

Today the overall survival of childhood cancers has increased to above 85%. This increase is partially caused by treatment with bone marrow transplantation. A bone marrow transplantation is an efficient treatment against high-risk leukemia, as well as other life-threatening immunological and hematological diseases. However, it is unfortunately also related to the risk of developing a long series of late effects during early adulthood, such as reduced muscle mass, cardiovascular disease and diabetes. Some survivors of bone marrow transplantation in childhood also seem to experience changes in cognitive functions. These changes may be experienced as difficulties with concentration, forgetfulness, learning difficulties, and challenges in school or the labour market. Currently, the extent of cognitive changes following bone marrow transplantation in childhood is not fully understood, nor how it relates to other late effects, and what can be done to prevent cognitive impairment. This research project will examine cognitive function in a group of survivors of bone marrow transplantation in childhood and find out whether there is a correlation between reduced cognitive function and the occurrence of other late effects, including metabolic changes and reduced physical capacity. It will also explore associations between cognitive function at late follow up and blood-based biomarkers of neurological damage and systemic inflammation at the time of transplantation to identify predictors of reduced cognitive function. The goal of the study is to evaluate the level of cognitive functioning after bone marrow transplantation in childhood, see how it relates to other late effect and identify risk factors and biomarkers in the blood that can predict which patients are at risk of neurocognitive impairment. The results of this study will hopefully contribute to optimizing the prevention and treatment of cognitive impairments following bone marrow transplantation in childhood, thereby improving the quality of life for survivors of bone marrow transplantation in childhood.

A Fast, Quiet, Artificial Intelligence-based PET/MR Solution for Paediatric Diseases

To investigate the feasibility of deep learning-assisted rapid silent PET/MR in pediatric applications.