NSF CAREER Awardee developed a 1 minute weakness testing platform

Ordinary people might think of “weak” as just a synonym for “weak” or “fragile”. But in the medical field, frailty is a special term, meaning – due to factors including inflammation and shifting hormones – the patient has a deficient physiological reserve, or a reduced ability to tolerate stress.

“Stress can be anything from the simple incident of falling to contracting COVID or another infectious disease,” says Nima Toosizadeh, assistant professor of biomedical engineering and medicine. “Or, it could be a treatment that might be invasive for the patient. Knowing who can tolerate stress is important.”

This is important because frailty influences treatment decisions. For example, a doctor may be less likely to recommend a risky procedure such as open heart surgery to a frail patient, choosing instead a different option that does not cause high levels of stress. Weak patients with COVID-19 will receive special care, compared to patients who are not debilitated. Weak patients are also at increased risk for depression, as loss of muscle mass can lead to reduced mobility which sometimes results in isolation.

With a $580,000 CAREER Award from the National Science Foundation, Toosizadeh is developing and perfecting a new method for diagnosing weakness: attaching wearable sensors to measure motor, cardiac, and brain function, and asking older adult patients to bend and straighten their arms in less than a minute. .

“It’s just bending the elbow,” said Toosizadeh, who joined the university as a postdoctoral researcher in 2013 and became a faculty member in 2017. “The point is to make it easy for doctors and patients to do it.”

Little Elbow Oil

Current methods for diagnosing weakness can be impractical in clinical settings. One method is a 72-point questionnaire that asks about symptoms of cognitive and physical weakness. The other main method involves a task of about 45 minutes for the patient to complete, and this is partly subjective.

The Toosizadeh Laboratory is centered on the mission of assessing weakness and how it affects motor function, cognitive abilities, and autonomic control of the heart. Not only is his group the first to measure flaws using wearable sensors, it’s also the first to use these measurements to look specifically at the interactions of the various systems involved in the flaw, rather than examining each one individually.

After years of collecting data from more than 1,000 patients, Toosizadeh and his team previously developed a physical weakness test in which patients bend and straighten their arms as quickly as possible in just 20 seconds. That’s long enough to produce accurate results, while as short as possible to reduce discomfort for the sake of patience. Sensors on the patient’s arm use this small source of physical stress to predict how the patient will respond to much greater stress.

With NSF funding, the team is developing tests for two other components of weakness: cardiac autonomic control and cognitive impairment. To measure cognitive weakness, they would apply a “multiple task concept,” which involves simultaneously moving and counting the arms, over a period of one minute. Patients also wear sensors on their heads to measure brain function.

“What you’re trying to do is put a cognitive load on the patient while we measure their brain function and motor tasks,” Tooszadeh said. “And, based on that, we can also determine the cognitive status of the patient.”

The team is also working on an app that could one day monitor for symptoms of weakness with everyday sensors such as smartwatches. While the app itself won’t be a diagnostic or preventive tool, doctors can use this information about a patient’s health to make more informed decisions.

Training the Next Generation of Doctors and Engineers

Toosizadeh collaborates with Focusing Research on the Border Area, (FRONTERA), and Border Latino and American Indian Summer Exposure to Research (BLAISER), two initiatives at the University of Arizona designed to provide research experiences for undergraduate students. The CAREER award will also help systematize and streamline this partnership to benefit the maximum number of students.

Toosizadeh says he aims to help students go beyond summer research experiences and start developing a roadmap for future careers.

“Many students are in biomedical engineering and are unsure whether to go on to medical school, enter industry, or pursue research,” he says. “It gives them an idea of ​​what it’s like to be on both sides – collecting data as a researcher and being in the hospital as a medical provider to patients, as well as doing the programming, developing code, and doing post-processing on the engineering side.”