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