Current one-handed manual wheelchairs are difficult to propel because one arm can only provide half the power that is ascertained in a two-handed manual wheelchair. A power-assisted hemiplegic (one-sided paralysis) wheelchair was developed that can effectively be propelled with one arm while remaining maneuverable, lightweight, and foldable. An existing manual wheelchair was minimally modified and fitted with powerassisted components that could alternatively be attached to a wide range of manual wheelchairs. The design implements a motor and gear train to power the wheel on the user’s affected side, encoders on both rear wheels to track wheel position, and a heel interface on the footrest to control steering. A controls program was developed that analyzes wheel position and steering to respond to the motion of the hand-driven wheel. Extensive testing was performed to ensure design integrity. Testing results showed that the prototype successfully met and exceeded predetermined design specifications based on industry standard testing procedures. The design has the potential to deliver increased freedom to a considerable consumer base.

No description available.

Thesis (M.S.)--University of Delaware, 2007. / Principal faculty advisor: Nancy Getchell, Dept. of Health, Nutrition, and Exercise Sciences. Includes bibliographical references.

Orientador: José Angelo Barela / Banca: Rosana Mattioli / Banca: Lilian Teresa Bucken Gobbi / Resumo: O objetivo deste estudo foi avaliar e comparar o padrão de andar hemiplégico no solo e na esteira com suporte parcial e total de peso. Participaram deste estudo dez pacientes hemiplégicos crônicos, com média de idade de 55,2 l 8,72 anos, com tempo de evolução de 2,8 l 2,69 anos após o AVC. Os participantes realizaram a tarefa experimental do andar em duas superfícies: no solo e em uma esteira motorizada e em quatro condições diferentes de suporte de peso: sem colete e com colete com apoio de 100% do peso corporal, suspensão de 15% e de 30% do peso corporal. Marcadores foram afixados nos centros articulares dos membros inferiores: quadril, joelho, tornozelo e quinto metatarso e o andar foi filmado no plano sagital, de forma alternada para ambos os lados. Inicialmente, andaram numa passarela na condição sem colete, depois com colete e, posteriormente, foi definida por sorteio a ordem das condições de suspensão de peso. Após um curto período de adaptação, os participantes realizaram o andar na esteira, com uma velocidade fixa de 0,33 m/s, primeiro com colete, depois na seqüência previamente definida para a suspensão de peso no solo e finalmente sem colete. Para cada condição de peso e para cada superfície foram digitalizadas três tentativas para a perna parética e três para a perna não parética utilizando o sistema APAS. O comportamento das passadas foi analisado por meio das variáveis descritivas: comprimento, duração, freqüência e velocidade. A organização temporal foi analisada por meio da duração das fases de suporte e de balanço e das subfases de suporte simples, primeiro e segundo duplo suporte. Adicionalmente foram obtidos os índices de simetria para as variáveis descritivas e temporais. A movimentação articular foi analisada utilizando os ângulos de flexão de quadril no TC, a extensão de quadril... (Resumo completo, clicar acesso eletrônico abaixo). / Abstract: The purpose of this study was to evaluate and compare the gait pattern of hemiparetic subjects walking in the overground and the treadmill with partial body weight support (BWS) and full weight bearing. Ten hemiparetic chronic patients, nine men and one woman, mean age 55,2 l 8,72 years and 2,8 l 2,69 years poststroke participated on the study. The task consisted of walking in two surfaces: overground and motor-driven treadmill and four conditions of weight support: without harness, with harness, with 15% and 30% BWS. Markers were placed on the joint centers in both lower extremities: hip, knee, ankle and five metatarsal. The walking performances were videotaped in the sagittal plane for both sides, alternately. First, hemiparetic subjects walking in a runway without harness, soon after with harness and subsequently the trial order with BWS were randomly defined. At the start of task in the treadmill, all subjects were habituated for the short time. The treadmill speed was kept constant during all trials in 0,33 m/s and sequence of BWS was 1) with harness, 2) order with BWS previously defined at the floor, 3) without harness. For each condition and surface, 3 trials of paretic limb and 3 trials non-paretic limb were collected and were digitized using the APAS system. The step walking organization was examined through the variables stride length, duration, cadence and velocity. In addition, the symmetry indexes for espacial and temporal variables were measured. The temporal walking organization was calculated through the variables duration of support and swing phases, single support, first and second double support period. The joint excursions was evaluated through hip flexion angle at heel strike, hip extension at single support, knee flexion at middle-swing, knee extension at single support, ankle dorsiflexion at heel strike and ankle... (Complete abstract, click electronic address below). / Mestre

Tese (doutorado)—Universidade de Brasília, Faculdade de Ciências da Saúde, 2007. / Submitted by Fernanda Weschenfelder (nandaweschenfelder@gmail.com) on 2009-11-26T18:02:06Z No. of bitstreams: 1 2007_ClaudiaMoraisTrevisan.PDF: 1668334 bytes, checksum: 4df440a447ef58fdbb11b08605214364 (MD5) / Approved for entry into archive by Carolina Campos(carolinacamposmaia@gmail.com) on 2009-11-30T18:39:06Z (GMT) No. of bitstreams: 1 2007_ClaudiaMoraisTrevisan.PDF: 1668334 bytes, checksum: 4df440a447ef58fdbb11b08605214364 (MD5) / Made available in DSpace on 2009-11-30T18:39:06Z (GMT). No. of bitstreams: 1 2007_ClaudiaMoraisTrevisan.PDF: 1668334 bytes, checksum: 4df440a447ef58fdbb11b08605214364 (MD5) Previous issue date: 2007-11-29 / O objetivo deste estudo foi investigar os efeitos da imagem mental em resposta ao estímulo visual em espelho na reabilitação da função motora do membro superior na hemiplegia, em fase crônica, por seqüela de acidente vascular encefálico. Foram selecionados, vinte voluntários, de maneira randômica simples, na faixa etária entre 40 e 60 anos, de ambos os sexos, que freqüentavam serviços de reabilitação comunitários da cidade de Santa Maria/RS. Os critérios de inclusão foram um único AVC, isquêmico ou hemorrágico, mínimo de seis meses entre o ictus e sua inclusão no estudo, comprovado por tomografia computadorizada ou ressonância magnética, com comprometimento dimidiado, predominante em um dos membros superiores, sem história de lesões prévias; sem déficits cognitivos, idades entre 40 e 60 anos; grau de espasticidade no máximo “2” e limiar de dor no máximo 04 no membro afetado. Foi realizada avaliação cinemática dos movimentos de membro superior, antes e após quatro semanas de terapia com o uso de espelho, quantificando ângulos de movimentação articular e tempos, em tarefas de alcance e preensão, utilizando-se o sistema automatizado de vídeo Peak PerformanceTM . Não foram observadas diferenças significativas pelo teste de Kruskal-Wallis, na avaliação das variáveis angulares e temporais, entre o grupo experimental, após uso de terapia por estímulo visual do espelho e o grupo controle. A comparação entre a extremidade hemiplégica e não-hemiplégica, em resposta ao estímulo visual do espelho, evidenciou diferença significativa, (p > 0,05) pelo teste de Wilcoxon na variável temporal em todas as tarefas, com manutenção de resultados estáveis pelo período de um mês. Na variável angular, foi encontrada diferença significativa (p > 0,05) pelo teste de Wilcoxon, em partes do movimento da extremidade hemiplégica, na execução da tarefa de menor complexidade. Concluímos que a resposta ao estimulo visual do espelho foi capaz de modificar a resposta funcional do membro superior na hemiplegia crônica. ______________________________________________________________________________________ ABSTRACT / The goal of this study was to investigate the effects of mental imagery in response to mirror therapy in rehabilitation of the motor function in the upper extremity in hemiplegia by stroke. Twenty volunteers both sexes were selected, by simple random, from communitary services via advertisements and physician referral of the city of Santa Maria/RS. The inclusion criteria were a single stroke, ischemic or hemorrhagic, at least 06 months post-stroke proved by evidenced by computed tomography or magnetic resonance, an obvious motor deficit of one upper limb, without cognitive deficits, ages between 40 and 60 years; maximum degree of spasticity 2 (Ashworth scale) and pain at most 04 in the hemiplegic upper extremity. All patients signed a term. A kinematic evaluation of the movements of the hemiplegic and nonhemiplegic upper extremity, 04 weeks before and after the application of the mirror therapy, quantifying articular movement angles and times, in reaching and grasping tasks, using the automatic Peak PerformanceTM video system. No significant differences were found in assessment of temporal and angular variables between the experimental group, after use mirror therapy and the control group (p < 0,05) by Kruskal-Wallis test. The comparison between the hemiplegic and nonhemiplegic upper extremity in response to the mirror therapy, showed significant differences in the variable time in all tasks (p> 0,05) by Wilcoxon test. The improvements over remained stable over one month period. Statically significant was found in angular variable but not all movements only in small complexity task. The present study suggests that rehabilitation with mirror visual feedback is an effective method for the recovery of the paretic limb post-stroke accident, even in a chronic phase.

No description available.

Orientadores: Antonio Augusto Fasolo Quevedo, Stella Maris Michaelsen / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia Eletrica e de Computação / Made available in DSpace on 2018-08-14T19:42:14Z (GMT). No. of bitstreams: 1 Magdalon_ElianeCristina_D.pdf: 6903170 bytes, checksum: ebb584674ca7c75d60201f5bd37e533c (MD5) Previous issue date: 2009 / Resumo: Introdução A tecnologia de Realidade Virtual (RV) vem sendo usada cada vez mais para criar ambientes visando à reabilitação motora. No entanto, há poucas evidências de que os movimentos realizados em ambientes virtuais (AV) se assemelhem aos realizados em ambientes físicos (AF). Objetivos: Comparar a cinemática dos movimentos de alcance e preensão realizados em um AV imersivo tridimensional (3D) e em um AF, e investigar o efeito do uso da luva de RV no desempenho do movimento. Participantes: Dez indivíduos saudáveis (62,1 ± 8,8 anos) e 12 com hemiparesia pós-AVE (66,6 ± 10.1anos). Metodologia: O AV foi apresentado em 3D via um capacete de RV, o qual forneceu visão estereoscópica. A representação virtual da mão e o feedback de força de preensão foram fornecidos pelo uso das luvas Cyberglove e Cybergrasp, respectivamente. A cinemática do tronco e membro superior (MS) foi registrada pelo sistema Optotrak Certus® (cinco corpos rígidos e sete marcadores adicionais). Os participantes eram instruídos para alcançar, pegar e transportar 3 objetos (lata - preensão cilíndrica; chave de fenda - preensão de força e caneta - preensão de precisão, respectivamente com 65.6, 31.6 e 7.5 milímetros de diâmetro) no AF, e no AV pegaram objetos virtuais visualmente semelhantes. Os parâmetros espaciais (alinhamento e suavidade da trajetória, ângulos rotacionais planos e axiais) e temporais (tempo, velocidade e tempo de desaceleração) do movimento de alcance e preensão do MS foram analisados. Resultados: Padrões similares de orientação da mão foram usados para pegar os objetos físicos e virtuais, exceto para a supinação, que foi menor no AV, para ambos os grupos, durante a preensão da lata. Ambos os grupos fizeram movimentos mais lentos, com um prolongamento na fase de desaceleração, e as trajetórias foram mais curvas no AV comparado com AF, especialmente nos indivíduos com hemiparesia. Ambos os grupos dimensionaram a abertura da preensão de acordo com o tamanho do objeto nos dois ambientes para a preensão cilíndrica, porém a abertura foi maior durante a preensão da chave de fenda e a caneta no AV. Para ambos os grupos, o uso da luva não interferiu nos parâmetros espaciais do alcance, entretanto os movimentos foram mais lentos, com pico de velocidade menor e prolongamento da fase de desaceleração. Para os indivíduos com hemiparesia, o uso da luva não influenciou nos parâmetros temporais da fase de preensão. Conclusão: Apesar de algumas diferenças nos parâmetros temporais do alcance e preensão e ângulos articulares, as estratégias motoras empregadas foram similares entre os ambientes. Tendo em vista estas diferenças, o AV pode ser considerado um ambiente adequado para intervenções clínicas e estudos em controle motor. Uma melhor representação visual dos objetos, dada pela melhoria da percepção de profundidade e pela qualidade da visualização dos objetos no ambiente virtual, poderia promover um movimento de alcance mais direto, aumentar a velocidade e diminuir o tempo de desaceleração, tornando estes parâmetros idênticos aos realizados em um ambiente real e eliminando completamente as diferenças observadas. / Abstract: Introduction Virtual Reality (VR) technology is increasingly being used to create environments for motor rehabilitation. However, there is little evidence that movements made in virtual environments (VE) are similar to those made in real world physical environments (PE). Objectives: To compare the kinematics of reaching and grasping movements, performed in a PE and a similarly designed immersive three-dimensional (3D) VE, and investigate the effect of using the VR glove in the performance of the movement. Participants: Ten healthy subjects (62.1±8.8 years) and twelve subjects with chronic post-stroke hemiparesis (66.6±10.1yrs). Methodology: The VE was displayed in 3D via a head-mounted display (helmet), with stereoscopic vision. The virtual representation of the subject's hand and prehension force feedback was obtained using Cyberglove¿ and Cybergrasp¿, respectively. Arm and trunk kinematics were recorded with the Optotrak Certus® System (five rigid bodies plus seven markers). Subjects were instructed to reach, grasp and transport three objects (can-cylindrical grasp; screwdriver-power grasp; and pen-precision grasp; with diameter 65.6, 31.6 and 7.5mm respectively) in a PE and visually similar virtual objects were grasped in the VE. Spatial (trajectory straightness and smoothness, axial and planar rotational angles) and temporal parameters (movement time, velocity and duration of deceleration phase) of arm and hand movements during reaching and grasping were analyzed. Results: Similar hand orientation patterns were used when grasping both physical and virtual objects, except for supination that was lower in VE while grasping the can for both groups. Both groups made slower movements, with an increase in the relative deceleration times and the trajectories were more curved in VE compared to PE, especially in the stroke subjects. Both groups scaled hand aperture to object size in both environments for cylindrical grasp, but it was wider when grasping the screwdriver and pen in VE. In both groups, use of glove did not affect spatial parameters of the reach task. However, movements were slower, with smaller peak velocities and longer deceleration phases. For stroke subjects, temporal parameters of grasp phase were not affected by glove use. Conclusion: Despite a few differences in temporal parameters of reach and grasp and joint ranges, similar motor strategies were employed in both environments. If these differences are taken into account, VE can be considered as a suitable environment for clinical interventions and motor control studies. A better visual representation of objects, provided by an improvement in depth perception and the quality of the viewing VE, may promote straighter reach movements, increased velocity and decreased deceleration time, making these parameters identical to those made in a physical environment, and eliminating the observed differences. / Doutorado / Engenharia Biomedica / Doutor em Engenharia Elétrica

Student Number : 0414012 - MSc dissertation - School of Therapeutic Sciences - Faculty of Health Sciences / Aim: The aim of this study was to quantify the level of ability and in particular walking ability of a group of stroke survivors resident in Soweto, between 3-6 months post incident. Design: Descriptive study in which comfortable walking speed over ten metres is correlated with the distance covered in six minutes and two minutes. Subjects: Forty one subjects after stroke divided into two groups. Twenty six with a Barthel Index initial score of ≤60 and fifteen with a score >60. Main Outcome Measures: Walking speed and two and six minute distance were compared between groups. In addition actual distance walked in six minutes was compared with the distance predicted by the ten-metre walking speed test and the distance predicted by normative reference equations. Heart rate was measured during the six minute walking test. Functional ability was compared using the Barthel Index within ten days post stroke and three to six months. Results: Of those who survived 90% of subjects were able to walk independently after stroke. The mean walking speed of 0.55 m/s demonstrated a strong correlation with the distance walked in six minutes (R2=0.816). However it underestimated the distance walked in six minutes by 7.4%. There were no significant differences between groups for the walking tests. The two minute walking test distance accurately predicted the results of the six minute walking test distance (R2=0.97). The average distance walked in six minutes by subjects after stroke was 40% of the distance predicted for healthy adults. For the functional walk test 95.5% of subjects had a heart rate within normal recommended limits. The functional walk test together with a measure of exertion (heart rate) may indicate an individual's ability to sustain submaximal activity. Subjects had minimal rehabilitation training. Lower limb pain did not significantly lower the walking speed (p=0.18) or distance walked in six minutes (p=0.17). Mean Barthel Index score at three to six months was 85.78 indicative of independence with minimal assistance. Although the mortality rate for the Barthel Index group with a score less than 60 is 30.7%, the prognosis of survivors was not uniformly poor. Conclusion: This study demonstrates that though a high percentage of subjects recovered independent walking after stroke in the Soweto community with minimal rehabilitation, their walking speed and distance walked are indicative of limited walking capacity. Walking speed and the two minute walking test could be used to predict functional walk test performance. Pain in the paretic lower limb though commonly reported did not appear to affect walking speed or distance walked. The use of the Barthel Index to predict activities and/or survival merits further investigation.

This thesis investigated planned nursing intervention based on a detailed assessment to determine whether this would result in stroke patients and their families having a better understanding of pathology, a shorter hospitalization, and the ability to cope with minor problems and activities of daily living when discharged. An experimental group supervised by the author was compared with a control group. In addition, the patient's initial and discharge level of independent function was compared with the control group.The investigation revealed that there was a positive relationship between planned nursing intervention and the increase in knowledge of pathology, ability to cope with minor problems and the activities of daily living. The hypothesis that a shorter hospitalization would result for the experimental group was not proven. All patients increased their level of independent function. The experimental group had a higher level of independent function at discharge than the control group.Ball State UniversityMuncie, IN 47306

Recorded by Eugene Barsky, Physiotherapy Outreach Librarian, UBC / This is a Systematic Review Presentation titled - "Effectiveness of Constraint Therapy in Children with Hemiplegia:A Systematic Review", created by Master of Physical Therapy Graduating Students, University of British Columbia - 2006, Presented on September 14-15, 2006 , Vancouver, BC, Canada