Purpose Conventional arm-prosthesis are expensive to make and therefore limit the availability for users on the geographical locations there the user pays for it. This study compares the hand function of a 3D-printed prosthesis with lower production cost with a traditional prosthesis. Method A test person performed two different tests of hand function (Box and Block test and Nine-hole peg test) with a myoelectric trans radial prosthetic arm and a body powered 3D printed trans radial prosthetic arm. The test person also answered two parts of the orthotics and prosthetics users’ survey (OPUS) considering both prosthetic arms. Result The 3D-printed prosthesis performed worse than the traditional prosthesis in the two tests of hand function and generally worse in the questionnaire about the function of the prosthesis. Though it got higher values in comfort and affordability. Conclusion There was a significant difference in function between the 3D-printed prosthesis and the myoelectric prosthesis but the printed prosthesis could perform many activities in daily living. Whether the 3D-printed prosthetic device is priceworthy or not is hard to measure because of different criteria, therefore a conclusion is hard to reach.

Made available in DSpace on 2016-03-15T19:40:39Z (GMT). No. of bitstreams: 1 Renata Guimaraes Germano.pdf: 354197 bytes, checksum: c7eb459873d6433370f92edd68a9ed00 (MD5) Previous issue date: 2009-02-17 / Fundo Mackenzie de Pesquisa / Children with Down syndrome (DS) show slower development when compared to normal population of same age, and also reveal handicap in oral expression, cognition and psychomotricity. The quantitative assessment of the motor performance on upper limbs in children with DS is important to design strategies of early stimulation and adequate therapeutic approaches to this population. The scarceness of quantitative information and instruments to evaluate hand dexterity has motivated this study, which aims to evaluate manual dexterity of children and adolescents (7, 8, 9, 14 and 15 years) with DS, using the Box and Block Test (BBT). Although not originally developed to evaluate this particular population, the BBT was chosen for providing a quantitative evaluation, centered on the motor dexterity without complex cognitive requirements. It is a cheap and easy-to-apply test that needs no training and is of easy comprehension even for mentally handicapped persons. The result of manual dexterity is given in blocks per minute (BPM) transferred inside a two-division standardized box. Fifty children and adolescents of both genders with Down syndrome (DS group DSG) and 50 normal participants (control group CG) took part in the study. The BBT was applied individually to each participant in his/hers own school or institution, in towns of São Paulo state, after approval of the Ethics Committee. The results showed a drawback in the manual dexterity in the DSG when compared to CG. There was no statistically significant variation on the manual dexterity of DSG between ages 7 to 9 years compared to 14 and 15 years (7y = 30 BPM, 8y = 29 BPM, 9y = 29 BPM); (14y = 32 BPM, 15y = 34 BPM), revealing that there is almost no improvement in manual dexterity related to age in this group. Conversely, in CG an age-dependent improvement was observed (7y = 63 BPM, 8y = 66 BPM, 9y = 68 BPM, 14y = 80 BPM, 15y = 81 BPM). Moreover, we observed differences in the way participants of DSG grip the blocks, using thumb and middle finger (36%) versus 4% in CG. We conclude that the Box and Block Test is an objective and efficient solution to quantify manual dexterity of intellectually drawback population for its fast and qualified information, and for the easiness of application and comprehension by the participants. / O desenvolvimento da criança com síndrome de Down (SD) ocorre de forma mais lenta que a criança normal e apresenta prejuízo nas áreas de linguagem, cognição e psicomotricidade. A avaliação quantitativa do desempenho motor de membros superiores em crianças com SD é importante para estabelecer estratégias de estimulação precoce e condutas terapêuticas adequadas para esta população. A carência de resultados e instrumentos para avaliação quantitativa da destreza manual foi a motivação deste estudo, que tem por objetivo avaliar a destreza manual de crianças e adolescentes com SD nas idades de 7, 8, 9, 14 e 15 anos, utilizando para isso o Teste de Caixa e Blocos (TCB). Embora não tendo sido desenvolvido originalmente para esta população, o TCB foi escolhido por possibilitar uma avaliação quantitativa centrada na atividade motora, sem exigências cognitivas mais complexas. É um teste de fácil aplicação, barato, exige pouco treinamento para sua aplicação e é de fácil compreensão mesmo por populações com déficits intelectuais. O resultado da destreza é dado pelo número de blocos transferidos por minuto (BPM) dentro de uma caixa padronizada com duas divisões. Participaram do estudo 50 crianças e jovens com SD, de ambos os sexos, que compuseram o grupo estudado (GSD), e 50 sem a síndrome, que constituíram o grupo controle (GC). O teste foi aplicado individualmente para cada participante nas dependências das instituições colaboradoras no interior do Estado de São Paulo após aprovação do Comitê de Ética em Pesquisa. Os resultados indicaram que há desvantagem na destreza manual dos participantes com SD quando comparados ao GC. Observou-se também que não houve alteração estatisticamente significativa na destreza manual para o GSD entre as idades de 7 a 9 anos em comparação com as idades de 14 e 15 anos (7a = 30 BPM, 8a = 29 BPM, 9a = 29 BPM), (14a = 32 BPM, 15a = 34 BPM), evidenciando que quase não há evolução na destreza manual com a idade neste grupo. Já para o GC essa evolução foi observada, com os resultados de destreza manual linearmente dependentes da idade dos participantes (7a = 63 BPM, 8a = 66 BPM, 9a = 68 BPM, 14a = 80 BPM, 15a = 81 BPM). Adicionalmente, foram observadas diferenças na forma de preensão dos blocos nos participantes do GSD, com a utilização da pinça entre os dedos polegar e médio em 36% dos casos contra 4% no GC. Conclui-se que o Teste de Caixa e Blocos é uma solução eficiente e objetiva para a quantificação da destreza manual em populações com déficits intelectuais, pela qualidade e rapidez da informação, e por ser de fácil aplicação e compreensão pelos avaliados.

Objectif : La perception de l’effort (PE) est utilisée dans la prescription et la supervision d’exercice lors de tâches locomotrices et de résistance. Néanmoins, son utilisation pour prescrire et superviser l’exercice lors de tâches motrices des membres supérieurs reste incertaine. Cette étude vise à tester ces possibilités. Méthodes : Quarante participants se sont portés volontaires. Dans l’expérience 1, quatre intensités de PE ont été utilisées pour prescrire l’exercice dans une version modifiée du Test du Box and Block (TBB) et d’une tâche de pointage. La possibilité de superviser l’exercice a été étudiée en imposant trois niveaux de difficultés via un tempo ou un poids et en mesurant les changements de PE associés. L’expérience 2 réplique la possibilité de prescrire l’exercice avec l’intensité de la PE et étudie les effets de l’ajout d’un poids sur l’avant-bras dominant sur la performance et la PE au cours de la version standardisée du TBB. L’activité musculaire, les fréquences cardiaque et respiratoire ont été mesurées. Résultats : Dans l’expérience 1, l’augmentation de l’intensité de la PE pour prescrire l’exercice a induit une augmentation de la performance et l’augmentation de la difficulté des tâches a augmenté la PE du participant. Dans l’expérience 2, la possibilité d’utiliser la PE pour prescrire l’intensité de l’exercice a été répliquée. La réalisation du TBB avec un poids additionnel révèle un maintien de la performance au prix d’une PE plus élevée. Dans les deux expériences, l’activité musculaire constitue le meilleur corrélat physiologique de la PE. Conclusion : Nos résultats suggèrent que la PE est un outil efficace pour prescrire et superviser l’exercice au cours de tâches motrices des membres supérieurs. / Purpose: While the perception of effort (PE) is widely used to prescribe and monitor exercise during locomotor and resistance tasks, its use to prescribe and monitor exercise during upper-limb motor tasks remains unclear. This study aimed to test these possibilities. Methods: Forty participants volunteered in two experiments. In experiment 1, by using a modified version of the box and block test (BBT) and a pointing task, four PE intensities were used to prescribe the exercise. The possibility of monitoring the exercise was investigated during these tests by monitoring changes in the rating of PE in response to three task difficulties manipulated with different movement tempo and weights added on the exercising forearm. Experiment 2 replicated the possibility of prescribing the exercise with the PE intensity during the BBT and explored the impact of adding weight on the exercising forearm on performance and PE during the standardized version of the BBT. Muscle activation, heart rate and respiratory frequencies were recorded. Results: In experiment 1, increasing the PE intensity to prescribe the exercise induced an increased performance between each intensity. Increasing task difficulty with higher movement tempo and adding weight on the forearm increased the rating of PE. Experiment 2 replicated the possibility to use PE intensity for exercise prescription during the BBT. When completing the BBT with an additional weight on the forearm, performance was maintained at a cost of a higher PE. In both experiments, muscle activation was the best physiological marker of PE. Conclusion: Our results suggest that PE is an efficient tool to prescribe and monitor exercise during upper-limb motor tasks.