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Data-driven modelling of pelvic floor muscles dynamics
Steffi Knorn Damiano Varagnolo & Ernesto Oliver-ChivaUppsala University Luleå University of Technology
Reinhilde Melles & Marieke DewitteMaastricht Universitair Medisch Centrum
June 19, 2018Reglermöte
1
Motivations
can we help improving the treatments related to dyspareunia?
2
Etiology
causes:
physiological
psychological
3
Etiology
causes:
physiological
psychological
infections
3
Etiology
causes:
physiological
psychological
infections
vaginal narrowing / shortening(side effects of cancer treatments, surgeries, genetic defects)
3
Etiology
causes:
physiological
psychological
infections
vaginal narrowing / shortening(side effects of cancer treatments, surgeries, genetic defects)
injuries (childbirth, accidents)
3
Etiology
causes:
physiological
psychological
infections
vaginal narrowing / shortening(side effects of cancer treatments, surgeries, genetic defects)
injuries (childbirth, accidents)
auto-immune conditions (Graph vs. host diseases)
3
Etiology
causes:
physiological
psychological
infections
vaginal narrowing / shortening(side effects of cancer treatments, surgeries, genetic defects)
injuries (childbirth, accidents)
auto-immune conditions (Graph vs. host diseases)
male to female gender confirmation surgeries
3
Etiology
causes:
physiological
psychological
infections
vaginal narrowing / shortening(side effects of cancer treatments, surgeries, genetic defects)
injuries (childbirth, accidents)
auto-immune conditions (Graph vs. host diseases)
male to female gender confirmation surgeries
unconscious tightening of the pelvic floor muscles(a.k.a. vaginismus, often caused by sexual traumas)
3
Relevance of dyspareunia
approximately 15% of women1 in a variety of age groups
Indirect effects:self-shamingself-blamingisolationnegative effects on patients’ families and friends
1Hayes, Bennett, Dennerstein, Taffe & Fairley, “Are aspects of study design associated with thereported prevalence of female sexual difficulties?”, Fertility and Sterility, 2008.
4
Relevance of dyspareunia
approximately 15% of women1 in a variety of age groups
Indirect effects:self-shamingself-blamingisolationnegative effects on patients’ families and friends
1Hayes, Bennett, Dennerstein, Taffe & Fairley, “Are aspects of study design associated with thereported prevalence of female sexual difficulties?”, Fertility and Sterility, 2008.
4
How is it treated today?
infections
vaginal shortening / narrowing
injuries
auto-immune conditions
gender confirmation surgeries
vaginismus
5
How is it treated today?
infections
vaginal shortening / narrowing
injuries
auto-immune conditions
gender confirmation surgeries
vaginismus
antibiotics & antifungals
5
How is it treated today?
infections
vaginal shortening / narrowing
injuries
auto-immune conditions
gender confirmation surgeries
vaginismus
antibiotics & antifungals
5
How is it treated today?
infections
vaginal shortening / narrowing
injuries
auto-immune conditions
gender confirmation surgeries
vaginismus
antibiotics & antifungals
+ counterconditioning
5
Side effects
“uncomfortable”, “shameful”
leads often to dropouts
needs better treatments
needs better understandings
6
Side effects
“uncomfortable”, “shameful”
leads often to dropouts
needs better treatments
needs better understandings
6
Side effects
“uncomfortable”, “shameful”
leads often to dropouts
needs better treatments
needs better understandings
6
Side effects
“uncomfortable”, “shameful”
leads often to dropouts
needs better treatments
needs better understandings
6
Our contributions, in this talk
help understanding the physiological responseto vaginal dilation stimuli
7
Our contributions, in a broader perspectivehelp developing novel dilators and dilation strategies
treatedperson
phys. & psych.responses
sensors& HCI tools
phys. & psych.status observers
dilationcontrol
smartdilator
.
8
Our contributions, in a broader perspectivehelp developing novel dilators and dilation strategies
treatedperson
phys. & psych.responses
sensors& HCI tools
phys. & psych.status observers
dilationcontrol
smartdilator
.
8
Our contributions, in a broader perspectivehelp developing novel dilators and dilation strategies
treatedperson
phys. & psych.responses
sensors& HCI tools
phys. & psych.status observers
dilationcontrol
smartdilator
.
8
Our contributions, in a broader perspectivehelp developing novel dilators and dilation strategies
treatedperson
phys. & psych.responses
sensors& HCI tools
phys. & psych.status observers
dilationcontrol
smartdilator
.
8
Our contributions, in a broader perspectivehelp developing novel dilators and dilation strategies
treatedperson
phys. & psych.responses
sensors& HCI tools
phys. & psych.status observers
dilationcontrol
smartdilator
.
8
Our contributions, in a broader perspectivehelp developing novel dilators and dilation strategies
treatedperson
phys. & psych.responses
sensors& HCI tools
phys. & psych.status observers
dilationcontrol
smartdilator
.
8
Our contributions, in a broader perspectivehelp developing novel dilators and dilation strategies
treatedperson
phys. & psych.responses
sensors& HCI tools
phys. & psych.status observers
dilationcontrol
smartdilator
.
8
Our contributions, in a broader perspectivehelp developing novel dilators and dilation strategies
treatedperson
phys. & psych.responses
sensors& HCI tools
phys. & psych.status observers
dilationcontrol
smartdilator
.
8
Our aims, in an even broader perspectivehelp accounting for psychological effects in medical treatments
treatedperson
phys. & psych.responses
sensors& HCI tools
phys. & psych.status observers
whatevercontrol
smartwhatever
.
9
towards psycho-physiological systems
10
This talk. . .
data-driven modelling of pelvic floor muscles dynamics
11
Brief description of the medical trial
12
Brief description of the medical trial
13
A typical dataset
0 5 10 15 20 25 30 35 40 45 50 55 60 65 700
100
200
300
400
time [minutes]
movievolumepressurepleasure
14
Our modelling approach
staticnon-linearity
dilationstimuli
q−kB (q−1)A (q−1)
rational model
+
disturbances
muscularforce
muscle
15
The results of our sysid efforts, in a nutshell
HW-pwlin
ear-pw
linear
HW-pwlin
ear-sa
turati
on
HW-poly1
d-poly
1d
sigmoid
netlin
ear
HW-pwlin
ear-de
adzon
e
wavenet
treepa
rtition
0102030405060708090
100
64.69 64.49 63.3556.26
49.56 43.328.78
3.59
model type
aver
age
fitin
test
set
16
Conclusions and future directions
1 control engineers can contribute to this area
2 it is definitely a non-trivial socio-psycho-physiological system
3 this is just a first step
right now:starting “PAIGE -Pelvic floor activation through gamified exercising”
17
Conclusions and future directions
1 control engineers can contribute to this area
2 it is definitely a non-trivial socio-psycho-physiological system
3 this is just a first step
right now:starting “PAIGE -Pelvic floor activation through gamified exercising”
17
Conclusions and future directions
1 control engineers can contribute to this area
2 it is definitely a non-trivial socio-psycho-physiological system
3 this is just a first step
right now:starting “PAIGE -Pelvic floor activation through gamified exercising”
17
Conclusions and future directions
1 control engineers can contribute to this area
2 it is definitely a non-trivial socio-psycho-physiological system
3 this is just a first step
right now:starting “PAIGE -Pelvic floor activation through gamified exercising”
17
Conclusions and future directions
1 control engineers can contribute to this area
2 it is definitely a non-trivial socio-psycho-physiological system
3 this is just a first step
right now:starting “PAIGE -Pelvic floor activation through gamified exercising”
17
Data-driven modelling of pelvic floor muscles dynamics
Steffi Knorn Damiano Varagnolo & Ernesto Oliver-ChivaUppsala University Luleå University of Technology
Reinhilde Melles & Marieke DewitteMaastricht Universitair Medisch Centrum
June 19, 2018Reglermöte
18