A narrative analysis was used to explore the question, What does it mean to be an Aboriginal man with quadriplegia? Six in-depth semi-structured interviews and follow-up reviews were conducted with Dennis Sapp, a 52-year old Plains Cree man with quadriplegia who requested that his full name be used in the thesis document. <p>The results of the study appear in the form of a life story written in the first person derived through a process of narrative analysis of the interview transcripts. The narrative details Dennis early beginnings on the Little Pine Reserve near North Battleford, Saskatchewan, Canada and his memories of his maternal grandfather, Cree elder and WWII Veteran, Tom Sapp, who raised Dennis in the traditional way until he was forced to go to the St. Anthonys Residential School at Onion Lake at six years of age. The narrative includes an account of Dennis life before being taken to residential school, his experiences at residential school, and his life after leaving the school. In the narrative Dennis recounts the experience of losing his traditional culture and spirituality at residential school and the difficulties he encountered in his life as a result of the trauma of the residential school experience. He gives an account of sustaining a spinal cord injury and his experience post-injury and in rehabilitation. After reconnecting with his grandfather and returning to school to complete his education, Dennis rediscovered his traditional culture and spirituality and gained a renewed sense of meaning and purpose as a counsellor, disabilities advocate, and storyteller. Through regaining his culture and spirituality and sharing his story Dennis found balance and healing.

A narrative analysis was used to explore the question, What does it mean to be an Aboriginal man with quadriplegia? Six in-depth semi-structured interviews and follow-up reviews were conducted with Dennis Sapp, a 52-year old Plains Cree man with quadriplegia who requested that his full name be used in the thesis document. <p>The results of the study appear in the form of a life story written in the first person derived through a process of narrative analysis of the interview transcripts. The narrative details Dennis early beginnings on the Little Pine Reserve near North Battleford, Saskatchewan, Canada and his memories of his maternal grandfather, Cree elder and WWII Veteran, Tom Sapp, who raised Dennis in the traditional way until he was forced to go to the St. Anthonys Residential School at Onion Lake at six years of age. The narrative includes an account of Dennis life before being taken to residential school, his experiences at residential school, and his life after leaving the school. In the narrative Dennis recounts the experience of losing his traditional culture and spirituality at residential school and the difficulties he encountered in his life as a result of the trauma of the residential school experience. He gives an account of sustaining a spinal cord injury and his experience post-injury and in rehabilitation. After reconnecting with his grandfather and returning to school to complete his education, Dennis rediscovered his traditional culture and spirituality and gained a renewed sense of meaning and purpose as a counsellor, disabilities advocate, and storyteller. Through regaining his culture and spirituality and sharing his story Dennis found balance and healing.

Thesis (Ph.D.)--University of Wollongong, 2007. / Typescript. Includes bibliographical references.

Orientador: Alberto Cliquet Junior / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T11:25:08Z (GMT). No. of bitstreams: 1 Medina_GiovannaIgnacioSubira_M.pdf: 4494302 bytes, checksum: 6f25ed31ea0d7dac8ce1a714d5be6094 (MD5) Previous issue date: 2011 / Resumo: A lesão da medula espinhal é uma afecção incapacitante e que é acompanhada de inúmeras complicações diretas e indiretas. No Brasil, ocorrem cerca de 6 a 8 mil novos casos por ano de LME e, desde o momento do trauma, os pacientes lesados medulares necessitam de cuidados direcionados que devem persistir mesmo após passados anos da lesão. A dor no ombro é o processo doloroso mais comum entre os pacientes com lesão medular que se queixam de dor nos membros superiores perfazendo 71% do total. Este é um estudo clínico e radiográfico que avaliou o ombro de pacientes tetraplégicos e paraplégicos que estavam em programa de reabilitação no Laboratório de Biomecânica e Reabilitação do Aparelho locomotor do Hospital das Clínicas da Faculdade de Ciências Médicas da Universidade Estadual de Campinas (UNICAMP). Os objetivos foram estabelecer a utilidade da radiografia como exame de triagem para dor no ombro de pacientes lesados medulares. Trinta e dois ombros de 16 pacientes foram avaliados clinica e radiograficamente. Os pacientes foram divididos em 2 grupos: paraplégicos e tetraplégicos. Um grupo controle de 16 indivíduos normais, voluntários, foi selecionado. Dor no ombro foi encontrada em 89% dos tetraplégicos e em 43% dos paraplégicos. O tempo desde a lesão variou de 1.5-22 anos (média 7.88 anos); a média de idade dos pacientes foi de 35 anos (variou de 21-57 anos). A medida da articulação acromioclavicular variou de 0.03-0.7cm para o lado direito e 0.15-0.7cm para o lado esquerdo, com média de 0.37cm e 0.41cm respectivamente. Não foi encontrada correlação alguma entre dor no ombro e sexo, idade ou tempo da lesão. Houve uma tendência a correlação entre dor no ombro e tipo de lesão, com tendência dos tetraplégicos em apresentar sintomas dolorosos. Na média, os tetraplégicos apresentaram menores medidas da articulação acromioclavicular. Com os dados deste estudo, não houve confirmação da hipótese de que achados radiográficos pudessem indicar risco de desenvolver dor no ombro em pacientes lesados medulares / Abstract: Spinal Cord injury is a very disabling condition that has many direct and indirect complications. In Brazil, there are around 6 to 8 thousand new cases each year and the patients need specific care from the moment of the lesion even through years after the SCI. Shoulder pain is the most common painful process among SCI patients that complaint of pain in the upper extremities, representing 71% of the total. This was a clinical and radiographic study which evaluated the shoulders of tetraplegic and paraplegic patients who attend the rehabilitation program of the Biomechanics and Locomotor-System Rehabilitation Laboratory of the University Hospital of the Faculty of Medical Sciences of the State University of Campinas (UNICAMP). The objective was to establish the usefulness of radiography as a screening exam for shoulder pain in spinal cord injured patients. Thirty two shoulders of sixteen patients were evaluated by clinical exam and radiography. Patients were divided into two groups: paraplegic and tetraplegic. A control group of 16 normal volunteer subjects was selected. Shoulder pain was reported in 89% of tetraplegic and 43% of paraplegic. The time of injury ranged from 1.5 - 22 years (mean 7.88 years); patients had a mean age of 35 years (range, 21-57 years). The acromioclavicular joint space ranged from 0.03-0.7cm on the right side and 0.15-0.7cm on the left side, with a mean of 0.37 and 0.41cm respectively. No correlation was found between shoulder pain and gender, age or time since injury. There was a trend to correlation between shoulder pain and type of injury with tetraplegic having a tendency to pain symptoms. On average, tetraplegic had smaller acromioclavicular joint. With this study we were not able to confirm the hypothesis that radiography could be used to predict risk factor for developing shoulder pain among SCI patients / Mestrado / Fisiopatologia Cirúrgica / Mestre em Ciências

"Ghost of a Life Long Past" is a memoir about the necessity of movement and physicality. It chronicles the author's life, both before and after a skiing accident that left him with quadriplegia. The memoir is split into two alternating narratives. One follows the author's post-accident journey to regain physicality and the ability to move through the world and function in his environment. The other is a series of flashbacks, looking[at] the author's pre-accident childhood in Juneau, Alaska. Themes include independence, travel, sports, disability, and the need to test the limits of ones body.

Orientador: Alberto Cliquet Junior / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-20T15:29:18Z (GMT). No. of bitstreams: 1 Ferreira_VanessaMariadeVargas_M.pdf: 2494774 bytes, checksum: 74419f732c2e800ecd68ccd1416acbcf (MD5) Previous issue date: 2012 / Resumo: Pacientes com lesão medular cervical apresentam disfunção dos membros superiores com grande perda de funcionalidade. A eletroestimulação neuromuscular (EENM) é considerada uma ferramenta importante para a reabilitação desses pacientes. O presente estudo tem como objetivo avaliar a função de pacientes tetraplégicos na tarefa mimética de beber e comparar com a utilização de EENM e um sistema híbrido (órtese dinâmica e EENM) para membros superiores, por meio de análise clínica e cinemática. Participaram desta pesquisa 14 pacientes com tetraplegia com nível motor entre C4 a C7 e 5 voluntários saudáveis. Foram aplicadas escalas clínicas para definir o nível de acometimento neurológico e funcional do paciente (AIS e MIF) e foi realizada avaliação cinemática da tarefa mimética de beber, sendo que os pacientes realizaram a atividade em 3 situações: movimento livre, com EENM e com o sistema híbrido. As variáveis cinemáticas utilizadas foram: tempo do movimento, razão do pico de velocidade máxima, índice de curvatura, trajetória do esterno, distância punho-esterno e abertura da mão. Também foi computado o número de acertos para a realização da tarefa. Os resultados indicam que pacientes que realizam a preensão por tenodese possuem maior independência funcional pela MIF (p=0,0008). Na tarefa mimética de beber houve 60% de acertos no movimento livre, 72,8% com EENM e apenas 47,6% com o sistema híbrido. Pela análise cinemática o uso da EENM não foi diferente do movimento livre, no entanto, os pacientes apresentaram maior tempo e menor suavidade no movimento e realizaram maior trajetória do punho e esterno durante a atividade quando comparado com o controle. O uso do sistema híbrido alterou o padrão de movimento dos pacientes, apresentando um aumento na trajetória do esterno e diminuição da suavidade do movimento. Em suma, a EENM promoveu uma melhor atividade funcional para os pacientes com nível C5, no entanto, o uso do sistema híbrido não parece facilitar a manipulação de objetos por pessoas com tetraplegia / Abstract: Patients with cervical spinal cord injury have dysfunction of the upper limbs with great loss of motor function. Neuromuscular electrical stimulation (NMES) is considered an important tool in rehabilitation. The aim of the present study is to evaluate the function of patients with tetraplegia in the mimetic task of drinking and compare with the use of NMES and a hybrid system (NMES and dynamic orthosis) through clinical evaluation and kinematic analysis. Fourteen patients with tetraplegia level C4 to C7 and 5 able-bodied volunteers participated in the study. Clinical tests were applied to verify the neurological and functional impairment (AIS and FIM) and the mimetic task of drinking was assessed with kinematic during three situations: free movement, with NMES and with the hybrid system. The kinematic variables used were: movement time, peak velocity ratio, index of curvature, sternum trajectory, wrist-sternum distance and hand opening. We also computed the number of successes to perform the task. The results indicate that patients that are able to perform tenodesis grip have greater functional independence through FIM (p=0.0008). The rate of success of the free movement was 60%, 72.8% with NMES and only 47.6% with the hybrid system. In the kinematic analysis the NMES was not different from the free movement, however, patients performed the task in a longer time, the movement was less smooth and the sternum and wrist trajectories were greater than the control group. The use of the hybrid system modified the pattern of movement of the patients, with an increase of the sternum trajectory and decrease of the smoothness. In conclusion, NMES improved the functional activity of patients with C5 level; on the other hand, the use of the hybrid system does not appear to facilitate the prehension of persons with tetraplegia / Mestrado / Fisiopatologia Cirúrgica / Mestre em Ciências

This report is the result of the master thesis project in Industrial Design engineering (IDE), performed at Luleå University of Technology, by Erik Vesterlund. The task was to produce a conceptual belly boat design that enables individuals paralyzed in the lower extremities to use, propel, maneuver, assemble and use a belly boat. The initial stage included a pre-study of identifying and clarifying what the most common causes of paralyzation of the lower extremities originates from as well as finding the correct terms and what challenges they may include. It was discovered that there are many different causes and effects. Paraplegic are individuals who are unable to move, control or feel their legs depending on the severity of the injury. Quadriplegic individuals are unable to move, control or feel the entire of their body below their shoulders, depending on the severity of the injury. After the causes and effects were mapped, the challenges had to be identified. This was done through tests, interviews, literature studies and participant observations with individuals that are living with these types of injuries. Different problems and needs were mapped, and the most crucial to the usage of a belly boat was identified as the propelling and maneuvering of the craft. Safety aspects were also looked into and documented in order to ensure that the concept was safe for the users. Thereafter, a variety of methods were used in order to generate multiple ideas of how the identified problems and needs could be solved. The generated ideas were formulated and composed into complete solutions in the concept generating phase. The less good solutions were filtered out with the help of an evaluation matrix, and the good solutions were framed into different over-all concepts. Those were graded in a concept scoring matrix and composed into the final concept. The final concept fulfills the overall objectives and aims of the project, and also exceeds some of them, like allowing fully functional individuals to share the craft with Para- and quadriplegics, and without looking as equipment for individuals with disabilities. This broadens the market potential and increases the realization possibilities of a production, hence making the dream of assistance free wilderness adventures for Para- and quadriplegics all over the world, a reality. / Denna rapport är resultatet av ett examensarbete i Teknisk design, utfört vid Luleå tekniska universitet av Erik Vesterlund. Uppgiften var att ta fram en konceptuell båt design, som gör det möjligt för individer som är förlamade i de nedre extremiteterna att använda, driva, manöverera och använda en båt. I inledningsskedet genomfördes en förstudie för att identifiera och tydliggöra vad de vanligaste orsakerna till förlamning i de nedre extremiteterna, samt att ta reda på vilka utmaningar det omfattar. Det upptäcktes att det finns många olika orsaker och effekter. Paraplegi är individer som inte kan röra sig, kontrollera eller känna sina ben, beroende på hur allvarlig skadan är. Tetraplegi är individer som inte kan röra sig, styra eller känna hela sin kropp under sina axlar, beroende på hur allvarlig skadan är. Efter det att orsaker och effekter kartlagts, hade utmaningarna identifierats. Detta gjordes även genom tester, intervjuer, litteraturstudier och deltagande observationer med personer som lever med dessa typer av skador. Olika problem och behov kartlades, och den mest avgörande för användningen av en båt identifierades som framdrivning och manövrering av båten. Säkerhetsaspekter undersöktes och dokumenteras i syfte att säkerställa att konceptet var säkert för användarna. Därefter användes en mängd olika metoder för att generera flera idéer om hur de identifierade problemen och behoven skulle kunna lösas. De genererade idéer gestaltades i form av olika lösningar. De mindre bra lösningarna filtrerades bort, med hjälp av en utvärderingsmatris, och de goda lösningarna gestaltades i olika helhetskoncept. De graderades sedan i en konceptmatris och resulterade i det slutliga konceptet. Det slutgiltiga konceptet uppfyller det övergripande syftet och målen för projektet, och överträffar också några av dem, som att tillåta att fungerande individer delar båten med para- och quadriplegics, samt att konceptet inte ser ut som utrustning för personer med funktionshinder. Detta vidgar den potentiella marknaden och ökar realiseringsmöjligheterna, och bidrar därför till att drömmen om ett vildmarksäventyr för Para- och quadriplegics över hela världen, kan bli verklighet.

O objetivo deste trabalho foi estudar o efeito da radioterapia na profilaxia da ossificação heterotópica (OH) em pacientes com lesão medular traumática. Foram estudados 19 pacientes (15 homens e quatro mulheres), média de idade de 30,4 ± 10,8 anos (19 a 58 anos), com lesão medular traumática. A causa mais freqüente da lesão medular foi acidente de trânsito (42,1%), seguida por queda (26,3%), ferimento por projétil de arma de fogo (21%), mergulho (5,3%) e queda de objeto sobre as costas (5,3%). Dez pacientes eram tetraplégicos (52,6%) e nove (47,4%) eram paraplégicos. Apresentavam lesão medular completa (Frankel A) 14 pacientes (73,7%) e cinco pacientes (25,3%) tinham lesão incompleta (Frankel B). Todos os pacientes incluídos no estudo realizaram cintilografia óssea inicial até um mês após o traumatismo raquimedular e apresentaram diagnóstico negativo para OH. Os pacientes foram divididos em dois grupos: nove pacientes receberam radioterapia em dose única de 8 Gy nos quadris (Grupo Estudo) e 10 pacientes compuseram o Grupo Controle. Após seis meses de seguimento clínico e radiológico, um paciente do Grupo Estudo (11%) e cinco pacientes do Grupo Controle (50%) apresentaram OH. A distribuição da freqüência do desenvolvimento da OH nos dois grupos não mostrou diferença estatística significante, apesar da menor incidência de OH no grupo submetido à radioterapia (Grupo Estudo). Concluiu-se que, com o número de pacientes estudados, não foi possível comprovar a eficácia da radioterapia na prevenção da ossificação heterotópica, ainda que haja uma forte tendência para a correlação estatística / The goal of this study was to evaluate the effect of radiotherapy on the prophylaxis of heterotopic ossification (HO) after spinal cord injury (SCI). Nineteen SCI patients were studied (15 men and four women). The mean age was 30.4 ± 10.8 years (range 19 to 58 years). The most frequent causes of lesion were traffic accident (42.1%), fall (26.3%), shot gun (21%), diving (5.3%) and objects falling on the vertebral column (5.3%). Ten patients were tetraplegics (52.6%) and nine were paraplegics. Fourteen patients (73.7%) had complete lesion (Frankel A) and five had incomplete lesion (Frankel B). All patients realized initial scintigraphy until one month after SCI and showed negative results for HO. The patients were randomized in two groups: nine patients received single dose irradiation with 8 Gy on the hips (Study Group) and 10 patients were the Control Group. After six months of clinical and radiological follow up, one patient of the Study Group (11%) and five patients of Control Group (50%) showed HO. The frequency distribution of the development of HO in both groups showed no significant statistical difference, although there was lower incidence of HO in the radiotherapy group. We concluded that, with the number of patients studied, it was no possible to prove the efficacy of radiotherapy to prevent HO, although had a strong tendency for the statistical correlation

O objetivo deste trabalho foi estudar o efeito da radioterapia na profilaxia da ossificação heterotópica (OH) em pacientes com lesão medular traumática. Foram estudados 19 pacientes (15 homens e quatro mulheres), média de idade de 30,4 ± 10,8 anos (19 a 58 anos), com lesão medular traumática. A causa mais freqüente da lesão medular foi acidente de trânsito (42,1%), seguida por queda (26,3%), ferimento por projétil de arma de fogo (21%), mergulho (5,3%) e queda de objeto sobre as costas (5,3%). Dez pacientes eram tetraplégicos (52,6%) e nove (47,4%) eram paraplégicos. Apresentavam lesão medular completa (Frankel A) 14 pacientes (73,7%) e cinco pacientes (25,3%) tinham lesão incompleta (Frankel B). Todos os pacientes incluídos no estudo realizaram cintilografia óssea inicial até um mês após o traumatismo raquimedular e apresentaram diagnóstico negativo para OH. Os pacientes foram divididos em dois grupos: nove pacientes receberam radioterapia em dose única de 8 Gy nos quadris (Grupo Estudo) e 10 pacientes compuseram o Grupo Controle. Após seis meses de seguimento clínico e radiológico, um paciente do Grupo Estudo (11%) e cinco pacientes do Grupo Controle (50%) apresentaram OH. A distribuição da freqüência do desenvolvimento da OH nos dois grupos não mostrou diferença estatística significante, apesar da menor incidência de OH no grupo submetido à radioterapia (Grupo Estudo). Concluiu-se que, com o número de pacientes estudados, não foi possível comprovar a eficácia da radioterapia na prevenção da ossificação heterotópica, ainda que haja uma forte tendência para a correlação estatística / The goal of this study was to evaluate the effect of radiotherapy on the prophylaxis of heterotopic ossification (HO) after spinal cord injury (SCI). Nineteen SCI patients were studied (15 men and four women). The mean age was 30.4 ± 10.8 years (range 19 to 58 years). The most frequent causes of lesion were traffic accident (42.1%), fall (26.3%), shot gun (21%), diving (5.3%) and objects falling on the vertebral column (5.3%). Ten patients were tetraplegics (52.6%) and nine were paraplegics. Fourteen patients (73.7%) had complete lesion (Frankel A) and five had incomplete lesion (Frankel B). All patients realized initial scintigraphy until one month after SCI and showed negative results for HO. The patients were randomized in two groups: nine patients received single dose irradiation with 8 Gy on the hips (Study Group) and 10 patients were the Control Group. After six months of clinical and radiological follow up, one patient of the Study Group (11%) and five patients of Control Group (50%) showed HO. The frequency distribution of the development of HO in both groups showed no significant statistical difference, although there was lower incidence of HO in the radiotherapy group. We concluded that, with the number of patients studied, it was no possible to prove the efficacy of radiotherapy to prevent HO, although had a strong tendency for the statistical correlation

People with severe motor-impairments due to Spinal Cord Injury (SCI) or Spinal Cord Dysfunction (SCD), often experience difficulty with accurate and efficient control of pointing devices (Keates et al., 02). Usually this leads to their limited integration to society as well as limited unassisted control over the environment. The questions “How can someone with severe motor-impairments perform mouse pointer control as accurately and efficiently as an able-bodied person?” and “How can these interactions be advanced through use of Computational Intelligence (CI)?” are the driving forces behind the research described in this paper. Through this research, a novel fuzzy mouse cursor control system (FMCCS) is developed. The goal of this system is to simplify and improve efficiency of cursor control and its interactions on the computer screen by applying fuzzy logic in its decision-making to make disabled Internet users use the networked computer conveniently and easily. The FMCCS core consists of several fuzzy control functions, which define different user interactions with the system. The development of novel cursor control system is based on utilization of motor functions that are still available to most complete paraplegics, having capability of limited vision and breathing control. One of the biggest obstacles of developing human computer interfaces for disabled people focusing primarily on eyesight and breath control is user’s limited strength, stamina, and reaction time. Within the FMCCS developed in this research, these limitations are minimized through the use of a novel pneumatic input device and intelligent control algorithms for soft data analysis, fuzzy logic and user feedback assistance during operation. The new system is developed using a reliable and cheap sensory system and available computing techniques. Initial experiments with healthy and SCI subjects have clearly demonstrated benefits and promising performance of the new system: the FMCCS is accessible for people with severe SCI; it is adaptable to user specific capabilities and wishes; it is easy to learn and operate; point-to-point movement is responsive, precise and fast. The integrated sophisticated interaction features, good movement control without strain and clinical risks, as well the fact that quadriplegics, whose breathing is assisted by a respirator machine, still possess enough control to use the new system with ease, provide a promising framework for future FMCCS applications. The most motivating leverage for further FMCCS development is however, the positive feedback from persons who tested the first system prototype.