5.8 RESULTS, INTERPRETATION AND DISCUSSION
5.8.18 TREND ON CORRELATION OF TTH DURATION WITH OCCURRENCE
This analysis was performed to establish the correlation between the frequencies of occurrence of TTH pain with its duration of stay (Fig. 5.25).
Representation
1. - - dotted line Median.
2. –Average (continuous line).
3. Bubbles (O)—Average of all subjects.
4. + individual subject plot.
The baseline data for the GSRav was more toward the average of frequency and duration with a few exceptions for subjects where the data lay in the high duration and high frequency zone.
The baseline data for EMGav mostly belonged to the high duration and high frequency zone, show- ing that the subject group consisted of individuals suffering from the most frequently occurring severe pain.
After applying the different trend models such as linear, logarithmic, exponential, polynomial, and power model, we found the best fitted trend in the logarithmic model. Hence, the logarithmic model trend was analyzed. The mathematical modeling of the logarithmic model is given as follows:
(Tables 5.17–5.19).
Period
20
10
Avg. duration
0
0 5 10 15
Avg. frequency
0 5 10 15
Avg. frequency
0 5 10 15
Avg. frequency
0 5 10 15
Avg. frequency
0 5 10 15
Avg. frequency
BaseLine 1 month 3 months 6 months 12 months
Median
Median
Median
Median
Median
Median
Median
Median
Median
Median
Median Average
Techniques EMGav GSRav
FIG. 5.25
Correlation of TTH: duration with occurrence.
132 CHAPTER 5 CHRONIC TTH ANALYSIS BY EMG AND GSR BIOFEEDBACK
Trend Lines Model
A linear trend model is computed for average of duration given natural log of average of frequency.
The model may be significant atP.05. The factor period may be significant atP.05.
GSRav:After applying the therapies, the data started moving toward the quartile of low duration and low frequency. This trend continued and at the end of the year, the majority of the data came under the zone of low frequency and low duration with the exceptions of four subjects.
EMGav:There was high rate of convergence of data toward the lower quartile of low duration and low frequency in the initial months and this continued until the end of the year. The data came under the average values for most of the subjects.
In conclusion, EMGav converged most of the diverged data more effectively than the GSRav.
Trend of TTH Duration per frequency with time:
All of the analysis that was undertaken was either from external resources or by solving the data from big data and this is where the proper analysis of patient data using the IoT comes into effect (Fig. 5.26).
The subjects underwent different therapies for the chronic type of TTH headache for 12 months and their observations were recorded. The Duration per Frequency graph was plotted where the average TTH duration per cycle (frequency) was recorded and presented in minutes per cycle.
GSRav:The GSRav therapy showed a continuous improvement in the reduction of occurrence of chronic TTH duration per frequency. The overall improvement in reduction in duration of 12 months was recorded as 136.17–72.63 min/week with an improvement of 63.54 min/week. The ther- apy also recorded a total dropout of 5. The rate of reduction for TTH duration per frequency was continuous.
Table 5.17 Trend Line Models
Model formula PeriodTechniques(ln(Avg. Frequency) + intercept)
Number of modeled observations 232
Number of filtered observations 43
Model degrees of freedom 20
Residual degrees of freedom (DF) 212
SSE (sum squared error) 2966.96
MSE (mean squared error) 13.9951
R-Squared 0.464517
Standard error 3.741
P-Value (significance) <.0001
Table 5.18 Analysis of Variance
Field DF SSE MSE F P-Value
Period 16 1186.1289 74.1331 5.29707 <.0001
Techniques 10 200.28787 20.0288 1.43113 .16814
133 5.8 RESULTS, INTERPRETATION AND DISCUSSION
Table 5.19 Individual Trend Lines
Panes Color Line Coefficients
Row Column Techniques P-Value DF Term Value StdErr t-Value P-Value
Duration BaseLine GSRav .234358 26 ln(Avg.
Frequency)
2.50658 2.05883 1.21748 .234358
intercept 6.87875 3.58937 1.91642 .0663662
Duration BaseLine EMGav .0011665 25 ln(Avg.
Frequency)
6.40729 1.74851 3.66444 .0011665
intercept 1.01322 3.45925 0.292901 .772015
Duration 1 month GSRav .394332 26 ln(Avg.
Frequency)
1.5874 1.83271 0.866147 .394332
intercept 5.27343 2.67837 1.9689 .0597101
Duration 1 month EMGav .0031575 21 ln(Avg.
Frequency)
6.75871 2.02788 3.3329 .0031575
intercept 2.70307 3.99063 0.677354 .505576
Duration 3 months GSRav .136071 23 ln(Avg.
Frequency)
1.35293 0.875857 1.54469 .136071
intercept 3.68422 1.23566 2.98158 .0066725
Duration 3 months EMGav .0191972 21 ln(Avg.
Frequency)
2.95765 1.16602 2.53654 .0191972
intercept 2.9906 2.11083 1.41679 .171209
Duration 6 months GSRav .843898 23 ln(Avg.
Frequency)
0.195891 0.983651 0.199147 .843898
intercept 5.1114 1.30591 3.91405 .0006962
Duration 6 months EMGav .245477 19 ln(Avg.
Frequency)
0.939537 0.783959 1.19845 .245477
intercept 4.11587 1.22265 3.36635 .0032419
Duration 12 months GSRav .0380985 14 ln(Avg.
Frequency)
1.20562 0.526579 2.28953 .0380985
intercept 2.81357 0.667819 4.21307 .0008682
Duration 12 months EMGav .271597 14 ln(Avg.
Frequency)
1.77122 1.54756 1.14452 .271597
intercept 3.4277 2.12247 1.61496 .128625
EMGav:The EMGav therapy also recorded a continuous reduction and improvement. In the first month, a steep reduction was observed from 128.17 to 100.6 min/week with an improvement result of 27.57 min/week.
The overall improvement was 72.33 min/week with a total improvement of 55.84 min/week.
The dropout was 4.
The overall trend analysis showed that GSRav therapy was better than EMGav with 12.56% im- provement but it was a slow performer in terms of subject dropouts, which showed that the subjects had more trust, confidence, and interest in EMGav. Also, the rate of reduction and steepness for TTH duration per frequency was better with a continuous improvement in the subjects.
The tableau plot for the EMGav and GSRav groups showed the analysis of variation of frequency along with duration in the 12 months time period (Fig. 5.27).
GSRav:The graph showed that the therapy worked well from the start to 3 months and continuous improvement in the reduction of frequency per duration in chronic TTH on the subjects was reflected.
But between 3 and 6 months, the improvement was deeply hampered and the rate of reduction reversed toward an increase in frequency per duration. It showed the fluctuation in the therapy process. After 6– 12 months, again the therapy exhibited a steep reduction. The overall improvement in the 12 months period was recorded as 5.423 to 2.714 as 2.709 with a total dropout of 5. The fluctuation for 3 months showed the disinterest and distrust of the therapy among the subjects, which caused the dropouts.
EMGav: The EMGav therapy exhibited a continuous improvement in the reduction of chronic TTH headaches in the experiment period. A steep reduction was recorded between 3 and 6 months and a continuous but gradual improvement in frequency per duration was the result over the experiment duration. A complete improvement was recorded as 7.074 to 2.913 total as 4.161, which is almost dou- ble that of GSRav with 4 dropouts due to various human reasons in the experiment period. This showed an almost 180% improvement by the EMGav therapy over the GSRav therapy.
0 BaseLine 1 month 3 months 6 months 12 months
GSRa, 12 months GSRa, 6 months GSRa, 3 months GSRa, 1 month GSRa, BaseLine EMGa, 12 months EMGa, 6 months EMGa, 3 months EMGa, 1 month EMGa, BaseLine Techniques, period 136.17 min
Subject: 26 128.17 min Subject: 27
100.60 min Subject: 26
115.93 min Subject: 27
91.13 min Subject: 25 89.01 min Subject: 24
73.40 min Subject: 23
85.81 min Subject: 25
74.33 min Subject: 23 72.63 min Subject: 21 Period
Duration/frequency
20 40 60 80 100 120 140
FIG. 5.26
Analysis of TTH duration per frequency with time.
135 5.8 RESULTS, INTERPRETATION AND DISCUSSION
EMGa versus EMGv versus EMGav: Trend/Pattern Analysis of Groups undergoing EMGa EMGv and EMGav therapies over the experiment period of 12 months on the subjects for chronic TTH type headache for frequency, intensity and duration parameters is presented below.