The aim of this project is to provide a manual wheelchair simulator for advanced wheelchair research within Toronto Rehabilitation Institute‘s Challenging Environment Assessment Laboratory (CEAL). To achieve this, a comprehensive mathematical model of the wheelchair/user system and a fully adjustable physical interface (which mimics various wheelchair configurations) have been developed. The mathematical model is unique in its ability to predict complex motions such as wheelies, and is able to update the wheelchair‘s position in a virtual environment, and calculate the force-feedback required for simulating various slopes and surfaces. The physical interface is used to measure the inputs required by the mathematical model (hand-rim input torques, hand and torso positions, and user centre-of-mass position), and utilizes servo motors to provide force-feedback at the wheelchair‘s hand-rims. Preliminary results comparing real-world wheelchair motion data to the mathematical model‘s predictions are presented, along with the physical interface design and mathematical model development.

The aim of this project is to provide a manual wheelchair simulator for advanced wheelchair research within Toronto Rehabilitation Institute‘s Challenging Environment Assessment Laboratory (CEAL). To achieve this, a comprehensive mathematical model of the wheelchair/user system and a fully adjustable physical interface (which mimics various wheelchair configurations) have been developed. The mathematical model is unique in its ability to predict complex motions such as wheelies, and is able to update the wheelchair‘s position in a virtual environment, and calculate the force-feedback required for simulating various slopes and surfaces. The physical interface is used to measure the inputs required by the mathematical model (hand-rim input torques, hand and torso positions, and user centre-of-mass position), and utilizes servo motors to provide force-feedback at the wheelchair‘s hand-rims. Preliminary results comparing real-world wheelchair motion data to the mathematical model‘s predictions are presented, along with the physical interface design and mathematical model development.

No description available.

The purpose of this project was to create a business plan for a profitable, self-sustaining, program to build a bridge between physical therapists and fitness professionals. The Quick Fit Program was a new service for the existing business San Luis Sports Therapy. The program was designed to be implemented within each of the company’s physical therapy clinics in California using existing personnel and resources. The Quick Fit Program is one way in which physical therapy practices can diversify the services they offer to keep pace with the changing landscape of healthcare. Clients in the Quick Fit Program would receive an assessment of basic health and fitness during their initial visit. After the assessments, a licensed physical therapist debriefs each client and offers recommendations or referral to a physician or gym program as appropriate. Staff in the Quick Fit Program would also schedule a follow-up appointment three to six months from the date of the initial visit to assess any changes or improvements in health and fitness measures since the initial visit.

Introduktion: Missbruk och psykisk ohälsa är ett vanligt problem som kan ge kognitiva nedsättningar vilka försvårar en persons förmågor att klara sin vardag och en eventuell behandling. Många med missbruksproblematik saknar meningsfullhet och en känsla av sammanhang i vardagen då många vardagsaktiviteter fallit bort. Vissa personer med svårt missbruk behandlas på behandlingshem för sitt beroende, men både utbudet av aktiviteter på behandlingshemmen och resultatet av behandlingen kan variera.Syfte: Att belysa vad personer med erfarenhet av behandlingshemsvistelse för sitt substansberoende upplevt vara meningsfullt i sin behandling för att bättre klara sin vardag. Metod: Kvalitativa intervjuer har genomförts med 10 deltagare. De var fyra kvinnor och sex män mellan 24 - 58 år och hade haft missbruksproblematik mellan fyra till 40 år. Deltagarna hade varit på behandlingshem mellan totalt fem månader upp till två år. Intervjuerna genomfördes främst per telefon med en intervjuguide som stöd. Intervjuerna spelades in, transkriberades och analyserades med hjälp av kvalitativ innehållsanalys. Etiska riktlinjer har beaktats.Resultat: Analysen ledde till fem huvudkategorier som berör aktiviteter, miljö, relationer, rutiner och övergången från behandling till hemgång. Alltsammans utmynnade i ett tema som berör vikten av att behandlingen är individuellt utformad och personligt meningsfull.Slutsats: Det är viktigt att se till varje enskild individ när en behandling ska planeras. På så sätt kan alla få tillgång till aktiviteter och stöd som är meningsfulla för dem. Att uppmuntra klienter till att vara aktiva gör att de lättare klarar sin behandling och håller sig nyktra efter de avslutat tiden på behandlingshem. / Introduction: Substance abuse and mental illness is a common problem that may cause cognitive impairments that complicates a persons abilities to cope with their everyday life and eventual treatment. Lack of meaningfulness and sense of coherense is common when everyday activities are lost. Some people with heavy substance abuse are treated in drug rehab centers, but the variety of activities and results of treatment may vary. Aims: To illuminate what people with experience of drug rehab stays, experienced as meaningful in their treatment in order to better cope with every day life.Methods: Qualitative interviews have been made with ten participants. They were four women and six men aged 24-58 and had had substance abuse between four to 40 years. Participants had spent a total of five months to two years in drug rehab. Interviews were mostly carried through by phone using an interview guide. Interviews have been recorded, transcribed and analyzed with qualitative content analysis. Ethical considerations have been taken. Results: The analysis led to five main categories concerning activities, environment, relationships, routines and the transition from treatment to going home. A theme that touches the importance of an individually planned treatment with personal meaningfulness, was identified.Conclusion: It’s important to see to every individual when planning treatment. This way everyone can access activities and support meaningful to them. To encourage clients to be active makes it easier for them to cope with their treatment and stay sober after their stay at drug rehab.

Although rare, distal biceps tears are common in middle-aged men in their 4th and 5th decades of life. The evidence surrounding prognosis, complications and rehabilitation interventions for distal biceps ruptures are of poor quality and therefore, many questions remain to be answered. This thesis includes four manuscripts describing studies that aim to improve our understanding of the rehabilitation of surgical and non-surgical management of distal biceps tendon rupture, prognostic factors associated with surgical repair and the outcomes for non-surgical management. The first manuscript is a scoping review of rehabilitation procedures described in the literature for the management of distal biceps ruptures. Overall, rehabilitation descriptions for distal biceps ruptures are poor for both post-surgical and non-surgical management. The findings suggest heterogeneity, both on the reporting and the content of rehabilitation delivered as a stand-alone intervention or post-operatively. The second manuscript is a cross-sectional study evaluating potential factors associated with reduced function post double incision surgical repair. The findings suggest that having a smoking history and weaker biceps flexion strength are associated with a poor prognosis and accounted for 50.4% of the variability in functional scores. These findings support existing studies that indicate a smoking history is associated with less favourable pain, function and disability outcomes follow distal biceps repair. The third manuscript is a prospective study evaluating prognostic factors associated with reduced function for those undergoing double incision surgical repair. These findings suggest that the majority of persons undergoing a distal biceps repair using a two-incision approach have minimal complications and good functional outcomes. In addition, having surgery on the non-dominant hand and having a weaker grip strength at baseline accounted for 43.4% of the variability of functional scores. The fourth manuscript describes two cases of non-surgical management of a complete distal biceps rupture. Despite the common belief that surgical repair for biceps rupture results in superior elbow flexion and supination strength, these cases demonstrated that full recover of strength and function is possible through rehabilitation alone. This study contributes to the evidence-base by questioning the need for surgical repair for all cases of distal biceps ruptures. / Dissertation / Doctor of Philosophy (PhD) / The biceps tendon is prone to rupture where it inserts into the elbow. While not a common injury, it does occur more often in middle aged men following a forceful movement. Most of the research regarding the prognosis and management of distal biceps ruptures is of poor quality and imprecise due to small sample sizes. This thesis examined management in a set of studies. A scoping review indicated that rehabilitation descriptions for distal bicep ruptures were of very poor quality for both surgical and non-surgical management for this condition. A cross-sectional analysis of 60 patients revealed that having a smoking history and weaker flexion strength was associated with poor outcomes after distal biceps repairs. A prospective cohort study of 34 patients found that having surgery on the non-dominant arm and weaker grip strength was associated with poor outcomes 6-12 months after surgical repair. Given the excellent outcomes after surgery and presumption of the need for surgery as standard practice, there has been little attention to the role of conservative management. We evaluated two cases where patients refused surgery and were able to recover full strength and functional abilities using a comprehensive rehabilitation program. This thesis confirms that excellent outcomes occur after this injury and raises the need for future trials comparing surgery and rehabilitation as treatment options. The fact that this injury often occurs in healthy men may partially explain the excellent outcomes with surgery or rehabilitation.

When adults with neurological conditions can access occupational therapy (OT) services, they have better outcomes. Unfortunately, many people who are living in the community with these conditions do not participate in OT services. This can compound deficits, lead to re-hospitalization, and negatively impact independence and quality of life. The issues with access for this population, specifically adults aged 18-65, can largely be attributed to lack of awareness of the role and scope of OT, lack of availability of specialized services, and issues with affordability. Evolve Occupational Therapy (Evolve OT) is a program designed specifically for this group, adults with neurological conditions aged 18-65 who have difficulty accessing OT services. This innovative approach to service delivery provides an alternative access pathway, treatment, and payment models that are intentionally designed to increase participation in and utilization of OT services. With this program, it is expected that patients will report increased satisfaction with participation, increased quality of life, and outcomes will hopefully effect change amongst policymakers.

No description available.

Det finns ett behov av billiga löpband som reglerar hastighet automatiskt efter användarens steg. Behovet finns främst inom vården för rehabilitering av patienter med olika rörelse- eller balansproblem där nuvarande lösningar ofta är mycket dyra. Fördelar är att kunna förbättra behandling, öka tillgänglighet och öka säkerhet utan att kräva utrustning på användaren. För att lösa detta skapades ett system med löpband och sensorer som kan följa användarens position och kroppshållning och reglera löpbandets hastighet efter detta. Kroppshållning följs av en algoritm som identifierar risker som tecken på tappad balans eller fall och bandet bör saktas ner eller stoppas. En prototyp skapades under ett tidigare projekt men denna hade problem och svagheter. Problem med lasersensorn för avståndsmätning undersöktes och tröghet i löpbandets styrning testades. För att undvika trögheten gjordes försök att ta reda på löpbandets kommunikationsprotokoll för att uppnå närmare motorstyrning. Nya algoritmer för hastighetsreglering och riskdetektering skapades. Det ursprungliga systemet gjordes om för att lägga till nya funktioner och tester. Resultat visar att sensorproblemen berodde på elektromagnetisk interferens från löpbandet som störde sensorns I2C-protokoll. Jämförelse mellan laser och Kinect visar att lasern inte behövs och att Kinect-sensorn ger stabilare mätningar. Det nya systemets mjukvara ger en mer modulär testmiljö för algoritmer. Det kan vara svårt att anpassa löpband beroende på konstruktion utan att bygga om för att uppnå en mjuk hastighetsreglering. Systemet och algoritmerna kan med lämplig styrmetod uppnå reglering av hastighet efter användarens rörelse och ge ökad säkerhet. / Needs exist for cheap treadmills that control speed automatically according to the user's step. Needs are primarily in healthcare for rehab involving patients with different mobility and balance issues for which current solutions are very expensive. Pros are the ability to improve treatment, increase availability and safety without the need for equipment worn by the user. To solve this a system consisting of treadmill and sensors was created. The system can track the user's position and posture and control the treadmill's speed accordingly. Posture is tracked by an algorithm that identifies risks as signs of lost balance and fall indicating that the treadmill should slow down or stop. A prototype was created during an earlier project but it had problems and weaknesses. Issues with the laser sensor used for measuring distance were investigated and delay in the control of the treadmill's motor was tested. To avoid the delay attempts were made to identify the communication protocol used by the treadmill to achieve better speed control. New algorithms for speed control and risk detection were created. The original system was modified to add new functionality and tools for testing. Results show that the sensor issues were caused by electromagnetic interference from the treadmill interfering with the I2C-protocol used with the sensor. A comparison of the laser and kinect show that the laser is not needed and that the Kinect is more stable. The new system's software creates a more modular environment for testing algorithms. It can be difficult to adjust treadmills depending on their construction without rebuilding them to reach a smoother speed control. The system and algorithms can given an appropriate motor control scheme achieve the purpose.

Submitted by Irene Nascimento (irene.kessia@ufpe.br) on 2016-07-20T18:42:56Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) _TESE REVISADA - BIBLIOTECA - 23.02.2015.pdf: 2738982 bytes, checksum: 725ce222cb83bbd8a2e2dc64a6b70f77 (MD5) / Made available in DSpace on 2016-07-20T18:42:56Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) _TESE REVISADA - BIBLIOTECA - 23.02.2015.pdf: 2738982 bytes, checksum: 725ce222cb83bbd8a2e2dc64a6b70f77 (MD5) Previous issue date: 2015-11-30 / Introdução: Atualmente profissionais da saúde tem buscado estratégias para ensinar seus pacientes a reaprender movimentos após lesões neurológicas. A Prática Mental tem sido um delas. Através de uma vasta revisão da literatura e presente pesquisa, foi observado que esse tipo de treinamento consiste na simulação mental de movimentos, com a intenção de promover a reaprendizagem de uma habilidade motora. Sabendo-se que os pacientes com a doença de Parkinson apresentam limitações no reaprendizado das tarefas motoras, pela diminuição da dopamina nos núcleos da base reduzir a atividade motora do córtex cerebral, reduzindo os movimentos voluntários, tornou-se assim importante a busca por recursos para o reaprendizado de tarefas motoras de seu cotidiano. Objetivo: Verificar a possibilidade de efeitos da Prática Mental na melhora da habilidade e imaginação motora em pacientes com a doença de Parkinson na atividade de alimentação. Métodos: A pesquisa de intervenção, foi realizada com 7 pacientes do sexo masculino com a Doença de Parkinson. Foram utilizados para a pesquisa a classificação de Hoehn & Yahr (HY), o Mini exame do Estado Mental (MEEM), a escala unificada de avaliação para a doença de Parkinson (UPDRS), o Questionário da Doença de Parkinson 39 (PDQ – 39), o Questionário de Imaginação Motora revisado (MIQ-RS). Todos os pacientes passaram por uma triagem para certificação de atenderem os critérios de inclusão desta pesquisa. Ocorreram como protocolo a realização de uma triagem, avaliação antes do início do treinamento da Prática Mental, um dia imediatamente após as 12 sessões determinadas, outra avaliação após 1 mês e última após 6 meses da realização da intervenção. A triagem foi baseada pela utilização de Ficha de registro de dados e o Miniexame do Estado Mental (MEEM) para análise das funções cognitivas, onde já foi iniciado os critérios de elegibilidade. A avaliação antes do início do treinamento utilizando do MIQ-RS, teve como principal objetivo analisar a habilidade de realizar a imaginação motora, com imagens visuais e imagens cinestésicas. O treino da Prática Mental foi subdividido em cada sessão em cinco fases. Sendo elas Ação sem intervenção, Determinação de Componentes Cinemáticos, Ação mencionando componentes, Realizando a Alimentação e apenas imaginando o movimento proposto de alimentação. Resultados: Observamos em nosso estudo de avaliação da qualidade de vida, que os pacientes com a doença de Parkinson obtiveram resultados significantes quando avaliados pós Prática Mental em relação à mobilidade, suporte social e cognição. Quando avaliados em relação à mobilidade, foram observadas melhoras significantes, de acordo com a escala de avaliação de mobilidade, que os membros superiores obtiveram bom desempenho até o primeiro mês após a primeira avaliação realizada. Ao buscarmos respostas aos resultados relacionados à imaginação motora foi observado que a Prática Mental pode estimular o desempenho desta imaginação e melhor execução das atividades de vida diária. Conclusão: Em sua maior parte os resultados apresentaram-se estáveis nas reavaliações pós tratamento realizado, levando a considerarmos a ocorrência de retenção do aprendizado motor relacionado à Prática Mental. Assim o presente estudo pode considerar que para indivíduos com a doença de Parkinson a efetividade da aplicação da Prática Mental é confirmada, contudo, ainda precisa ser investigada em vários aspectos para que sua aplicação seja direcionada para protocolos específicos e especificada às tarefas de habilidades motoras do paciente / Introduction: Currently health professionals has sought strategies to teach their patients to relearn movements after neurological injury. Mental practice has been one of them. Through an extensive literature review and this study, we observed that this type of training is the mental simulation of movements, with the intent to promote the relearning of motor skills. Knowing that patients with Parkinson's disease have limitations in the relearning of motor tasks, the decrease in dopamine in the basal ganglia reduce the motor activity of the cerebral cortex, reducing voluntary movements, it has become so important to search for resources to the relearning of motor tasks of their daily lives. Objective: To investigate the possibility of effects of mental practice on improving motor skills and imagination in patients with Parkinson's disease in feeding activity. Methods: The intervention research was conducted with seven male patients with Parkinson's disease. They were used to search the classification of Hoehn & Yahr (HY), the Mini Mental State Examination (MMSE), the unified rating scale for Parkinson's disease (UPDRS), the Questionnaire of Parkinson's Disease 39 (PDQ - 39 ), the Imagination Motor revised Questionnaire (MIQ-RS). All patients underwent a screening for certification meet the inclusion criteria of this research. Occurred as a protocol to conduct a screening assessment before the start of training of Mental Practice, the day immediately after the 12 specific sessions, further evaluation after 1 month and 6 months after the last performing surgery. The screening was based on the use of data recording sheet and the Mini Mental State Examination (MMSE) for analysis of cognitive functions, which has started the eligibility criteria. The evaluation before the start of training using the MIQ-RS, aimed to analyze the ability to perform motor imagination, with visual images and kinesthetic images. Training of Mental Practice was divided into five phases in each session. As they action without intervention, Determination of Kinematic Components, Action mentioning components, Realizing the Power and just imagining the proposed movement of food. Results: In our study evaluating the quality of life, patients with Parkinson's disease show significant results when evaluated post Mental Practice in relation to mobility, social support and cognition. When evaluated for mobility, significant improvements were observed, according to the mobility of rating scale, the upper limbs obtained a good performance until the first month after the first evaluation performed. As we seek answers to the results related to motor imagination it was observed that mental practice can stimulate the performance of this imagination and best performance of activities of daily living. Conclusion: For the most part the results were stable in the post treatment performed revaluations, leading to consider the motor learning retention occurrence related to Mental Practice. So this study may consider that for individuals with Parkinson's disease the effectiveness of the implementation of the Mental practice is confirmed, however, still needs to be investigated in various aspects so that your application is directed to specific protocols and specified the tasks of motor skills patient.