Browsing by Author "Sumanasena, S. P."

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Applicability of adaptive machine learning algorithm for improving reading and comprehension capabilities of dyslexic patients.
(International Research Symposium on Pure and Applied Sciences, 2017 Faculty of Science, University of Kelaniya, Sri Lanka., 2017) Sathsara, G. W. C.; Rupasinghe, T. D.; Sumanasena, S. P.
Dyslexia is a well-known reading disorder that involves difficulty in fluent reading, decoding, and processing of words despite adequate intelligence. This causes the reading speed of such patients to be lower than the healthy counterparts, because of slow processing of letters and words. Despite this disorder, a dyslexic person can be trained to read at normal speed. The literature has mainly described manual methods and some technical improvements can be reported such as the Live scribe smart pen, Dragon Naturally Speaking, Word processors, and Video Games. From literature, it is evident that minimal efforts have been mobilized into the aforementioned focus and there is no way other than the manual method to identify the actual reading speeds, and to improve the speed according to the ability of a particular person. Thus, this study produces a novel Machine Learning-based (ML) algorithmic application, which allows customization on the reading speed based on the capabilities of patients, using experiment-based approach with real patients. The study is conducted via three phases. In the first phase of the study, reading rate improvement and detection methodologies are reviewed systematically in order to identify important characteristics of dyslexic improvements. Second phase is focused on developing an ML-based algorithm to identify the improvement rate of the dyslexic patients and training them using Tensorflow and Python. In the third phase, the outcome of the ML based algorithm is tested with samples from different clusters (using iterative experiments with real dyslexic patients). This approach improves the reading speed per minute of the dyslexic patients and lays the foundation for future research in the areas of ML, healthcare applications and ML-based training tools.
Developmental profile at initial presentation in children with infantile spasms.
(Mac Keith Press, 2019) Sumanasena, S. P.; Wanigasinghe, J.; Arambepola, C.; Sri Ranganathan, S.; Muhandiram, E.
AIM: To describe the baseline developmental profile and influence of clinical and demographic factors on the developmental skills of infants diagnosed with infantile spasms. METHOD: Ninety-five infants (55 males, 40 females) newly diagnosed with infantile spasms were recruited for a cross-sectional, longitudinal study. All infants underwent Bayley Scales of Infant and Toddler Development assessments in the cognitive, receptive communication, expressive communication, and fine and gross motor developmental domains; they also underwent visual, auditory, and social behaviour assessments. Infants were categorized as 'early' (<6mo) or 'late' (≥6mo) presenters; if presented within 28 days, this was considered as 'early presentation', whereas a delay greater than 28 days was considered as a 'delay in presentation'. Antenatal, perinatal, and postnatal risk factors were identified. RESULTS: Over 90% of infants showed impairment in all domains, with the majority having severe delay; 99% showed cognitive impairment. Delayed presentation was significantly associated with receptive communication delay (odds ratio [OR]=5.35; 95% confidence interval [CI]=1.05-27.32). Onset at 6 months or less influenced auditory (OR=2.8; 95% CI=1.16-6.8) and visual (OR=3.03; 95% CI=1.22-7.57) behaviours. Neonatal infections impacted both receptive (OR=1.12; 95% CI=1.04-1.2) and expressive communication (OR=1.08; 95% CI=1.02-1.14) delay. Neonatal seizures significantly influenced visual, auditory, and social impairments. Expressive communication and gross motor development shared common perinatal risk factors. INTERPRETATION: Adverse developmental status at presentation, associated with delayed presentation and neonatal risk factors should alert clinicians to the surveillance of at-risk infants and seek out timely interventions. WHAT THIS PAPER ADDS: Ninety per cent of infants showed impaired cognitive, communication, and motor skills at presentation. Visual, auditory, and social behaviour impairments were significantly associated with perinatal risks. Visual, auditory, and social behaviour impairments were significantly associated with neonatal seizures.
The physical and functional outcomes after ultrasound guided intramuscular botulinum toxin injections in ambulatory children with cerebral palsy attending to a multidisciplinary tertiary care center
(Faculty of Graduate Studies, University of Kelaniya Sri Lanka, 2022) Fernando, W. P. N.; Safinaz, Z. M. F. Z.; Wijayasinghe, W. A. P. N.; Siriwardana, S. A. S. R.; Vipulaguna, D. V.; Sumanasena, S. P.
Hypertonia is one of the major manifestations and affects the movement and posture of children with cerebral palsy (CP). Evidence-based interventions for hypertonia include the administration of botulinum toxin (BoNT-A) with adjunctive therapy. Administration of BoNT-A, an adjunctive to physiotherapy interventions has demonstrated a significant improvement in gait pattern, range of motion of muscles as well as functional abilities. This study aimed to investigate the physical and functional outcomes of ultrasound-guided BoNT-A injections for lower limb hypertonia in ambulatory children with CP, Gross Motor and Functional Classification System (GMFCS) level I, II, and III. This retrospective study was conducted using the medical records at Ayati center, of the children with CP who received lower limb BoNT-A injections. Besides, these children have received evidence-based interdisciplinary interventions such as physiotherapy, and occupational therapy and have been referred to devices such as Ankle Foot Orthoses along with serial casting, and tone-managing medications. The Modified Tardieu Scale (MTS) and the Edinburg Visual Gait analysis (EVG) were done to assess the physical outcome and the Gross Motor Function Measure (GMFM-66) and the GMFCS level were assessed for the functional outcome before and after BoNT-A treatment. Seven children (4 males and 3 females) with CP were included. The age range was 23 to 118 months (mean 62 ± 31.37 months). Most of the children had bilateral involvement (85.7%) and had diplegic topographical distribution (42.9%). Twenty-eight percent had quadriplegic CP. Distal injections for foot deformity were given on 3 occasions (42.9%), while multilevel injections targeting the muscles of the three joints, hip, ankle, and/or knee were given on 4 occasions (57.1%). Participants with good functioning according to their GMFCS level were more likely to receive a distal, rather than proximal injection. The most common injected site was the plantar flexor muscles for dynamic foot deformity (28.6%). The second most commonly injected site was the hip adductor muscles and the knee flexor muscles. The Modified Tardieu Scale of hip adductors, hamstrings, and plantar flexors has improved after BoNT-A treatment, but these changes were not statistically significant. The mean EVG scores on the right leg were 12.86 (± 5.367) before treatment and 10.43 ± 4.894 after treatment. The mean ± SD of EVG scores on the left leg was 14.57 ± 6.37 before treatment, and 12.0 ± 4.08 after treatment. There was a statistically significant mean reduction in the EVG score on both sides (p<0.05). There was a significant improvement in mean GMFM-66 scores from 54.72 (± 10.44) before the BoNT-A treatment, to 61.61 (± 13.27) after treatment (p<0.01). GMFCS level following treatment improved in 28.6% of the participants and has not changed in five participants. There is a significant improvement in the functional outcomes of children with ambulatory CP who received BoNT-A adjunctive to physiotherapy interventions.