Hand dominance is the preferential use of one hand over the other for motor tasks. 90% of people are right-hand dominant, and the majority of injuries (acute and cumulative trauma) occur to the dominant limb, creating a double-impact injury whereby a person is left in a functional state of single-handedness and must rely on the less-dexterous, non-dominant hand. When loss of dominant hand function is permanent, a forced shift of dominance is termed injury-induced hand dominance transfer (I-IHDT). Military service members injured in combat operation may face I-IHDT following mutilating injuries (crush, avulsion, burn and blast wounds) that result in dominant limb amputation or limb salvage. Military occupational therapy practitioners utilize an intervention called Handwriting For Heroes to facilitate hand dominance transfer. This intervention trains the injured military member how to write again using the previously non-dominant hand. Efficacy and clinical effectiveness studies were needed to validate the use of this intervention. This dissertation contains three studies related to I-IHDT. One study measured handwriting performance in adults who previously (greater than 2 years ago) lost function of their dominant hands. Results verified that handwriting performance, when measured on two separate occasions (six-weeks apart) was similar (stable). A second study examined the efficacy of Handwriting For Heroes in non-impaired participants. Results demonstrated a positive effect on the variables that measured the written product: legibility, writing speed (letters-per-minute); as well as a positive effect on the variables that measured the writing process: kinematic and kinetic parameters. The final study examined the clinical effectiveness of Handwriting For Heroes in an injured military population. Results did not show as positive results as the efficacy study, despite similar compliance with the intervention. Specifically, non-impaired participants started with faster writing speeds in their non-dominant hands (higher letters-per-minute) and made more gains (wider ranges). The non-impaired participants also started with faster dexterity (betters scores on the Grooved Pegboard) but they made fewer gains than the injured service members (smaller ranges). Nevertheless, injured participants clearly made gains in all dependent variables thereby demonstrating clinical effectiveness of the intervention

Clinical experience has shown that patients performing the Grooved Pegboard Test have difficulty maintaining the manualized right-to-left placement strategy with their left hand. This study sought to investigate possible differences in placement time on the Grooved Pegboard task between participants using the standardized left hand approach and a reversed manualized left hand placement strategy (i.e., left-to-right). The participants included 63 male and female undergraduate volunteers between the ages of 18 and 25 years. All participants had no history of neurologic disease/trauma, or conditions that would affect motor functioning of the right and left upper extremities. Data were analyzed using a 3-way mixed-design ANOVA. Results revealed a significant main effects for gender (F(1, 59) = 5.215, p = .026) and handedness (F(1, 59) = 6.362, p = .014). Of primary interest was the main effect for placement direction, which was not significant, F(1, 59) = .120, p = .731. No significant interaction was observed (all p > .40). Recommendations for the use of this test in applied neuropsychological settings are offered.

No description available.

Partial paralysis of the hand is one of the main impairments after stroke. Constraint Induced Movement Therapy (CIT) is a new treatment technique that appears to improve upper extremity function after stroke. CIT consists of 6 hours of training/day for the affected arm (mainly with shaping exercises) and of restraint (mitt) of the non affected arm for two weeks. There are concerns about the practicality and resource issues in carrying out CIT according to the original model. In this thesis the benefit of modifications of CIT, of an assessment tool and of two common types of hand training have been evaluated.   CIT (n=16) administered in groups for two weeks (paper I) seems to be a feasible alternative to improve upper limb motor function after chronic stroke. The arm/hand motor performance improved significantly on Motor Assessment Scale (MAS; p= 0.003) and on Sollerman hand function test (p= 0.037). The median self reported motor ability (MAL) also improved (p < 0.001). No additional effect was seen from wearing a mitt for an extended period of three months. The reliability of the Sollerman hand function test (paper II) was studied in patients with chronic stroke. Three examiners observed 24 patients at three experimental sessions. There was agreement (kappa ≥ 0.4) between the examiners for 15/20 subtests. Using total sum scores, the agreement within the examiners was higher than 0.96 (for Spearman’s rhos and ICCs) and agreement between the examiners was higher than 0.96 (Spearman’s rhos) and 0.92 (ICCs), respectively. In a cohort of 24 patients with subacute stroke (paper III) forced use therapy (FUT; mitt use and 3 hours of training/day for 2 weeks) improved arm/hand function, but not more than regular arm therapy given to the control group. Significant improvements in arm/hand motor performance were found in the FUT group (n=12) as well as in the control group (n=12) on the Sollerman hand function test (p= 0.001), on MAS (p< 0.05) and on MAL (p < 0.05). No significant differences were seen between the groups pre- or post training or at three months follow up, demonstrating that the mitt had limited importance. In a separate study on 30 healthy subjects (paper IV), employing transcranial magnetic brain stimulation (TMS), we found that shaping exercises but not general activity training increased dexterity (p<0.05; Purdue peg board test) of the trained non dominant hand. After shaping exercises the cortical motor map shifted forwardly into the premotor area but did not expand. After general activity training the cortical motor map expanded significantly (p=0.03) in the posterior (sensory) direction. Shift of location of active TMS positions rather than their numbers might therefore be a critical factor for the interpretation of cortical plasticity.   In conclusion, the studies in this thesis have shown that less resource consuming modifications of CIT may be feasible to improve upper limb motor function after stroke. The type and amount of training for the more affected arm seems to be an important factor rather than the mitt use in itself. Shaping exercises, at least in healthy people, are effective in improving dexterity and the Sollerman hand function test reliable to evaluate arm/hand function after stroke.

Detta arbete syftar till att undersöka vilka attityder fyra engelsklärare samt en lärare i samhällsorienterande ämnen i årskurs 7-9 har till digitalisering i skolan i allmänhet och ett specifikt digitalt läromedel i synnerhet i samma kommun. Arbetet syftar även till att översiktligt redogöra för de olika roller som krävs för förändring. Semistrukturerade intervjuer med fem lärare i samma kommun, samt med försteläraren i it har genomförts för att undersöka fördelar och nackdelar som kan finnas med ett digitalt läromedel med fokus på engelska. Forskningen som presenteras samt resultaten antyder att en förändring, som digitalisering i undervisningen innebär, kräver engagerade och positiva lärare som ser fördelar med förändringen tydligt. För att lärarna ska bli positivt inställda krävs en engagerad och positiv skolledning. I den aktuella kommunen ser inte lärarna vinsten med förändringen tydligt vilket kan vara en av orsakerna till att förändringsarbetet går tungt. I slutet av arbetet ges några förslag på hur en skolledning skulle kunna arbeta för att underlätta införandet av ett digitalt läromedel.

In this thesis, a strategy to accomplish pick-and-place operations using a six degree-of-freedom (DOF) robotic arm attached to a wheeled mobile robot is presented. This research work is part of a bigger project in developing a robotic-assisted nursing to be used in medical settings. The significance of this project relies on the increasing demand for elderly and disabled skilled care assistance which nowadays has become insufficient. Strong efforts have been made to incorporate technology to fulfill these needs. Several methods were implemented to make a 6-DOF manipulator capable of performing pick-and-place operations. Some of these methods were used to achieve specific tasks such as: solving the inverse kinematics problem, or planning a collision-free path. Other methods, such as forward kinematics description, workspace evaluation, and dexterity analysis, were used to describe the manipulator and its capabilities. The manipulator was accurately described by obtaining the link transformation matrices from each joint using the Denavit-Hartenberg (DH) notations. An Iterative Inverse Kinematics method (IIK) was used to find multiple configurations for the manipulator along a given path. The IIK method was based on the specific geometric characteristic of the manipulator, in which several joints share a common plane. To find admissible solutions along the path, the workspace of the manipulator was considered. Algebraic formulations to obtain the specific workspace of the 6-DOF manipulator on the Cartesian coordinate space were derived from the singular configurations of the manipulator. Local dexterity analysis was also required to identify possible orientations of the end-effector for specific Cartesian coordinate positions. The closed-form expressions for the range of such orientations were derived by adapting an existing dexterity method. Two methods were implemented to plan the free-collision path needed to move an object from one place to another without colliding with an obstacle. Via-points were added to avoid the robot mobile platform and the zones in which the manipulator presented motion difficulties. Finally, the segments located between initial, final, and via-points positions, were connected using straight lines forming a global path. To form the collision-free path, the straight-line were modified to avoid the obstacles that intersected the path. The effectiveness of the proposed analysis was verified by comparing simulation and experimental results. Three predefined paths were used to evaluate the IIK method. Ten different scenarios with different number and pattern of obstacles were used to verify the efficiency of the entire path planning algorithm. Overall results confirmed the efficiency of the implemented methods for performing pick-and-place operations with a 6-DOF manipulator.

Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-04-12T13:20:23Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação_Paula_Lins.pdf: 3016371 bytes, checksum: 08c66d69326a38e3820667fdada12e43 (MD5) / Made available in DSpace on 2016-04-12T13:20:24Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Dissertação_Paula_Lins.pdf: 3016371 bytes, checksum: 08c66d69326a38e3820667fdada12e43 (MD5) Previous issue date: 2015-07-29 / CAPEs / O presente estudo tem como objetivo analisar de forma empírica a possibilidade de jogos digitais do tipo casual para tablets Android, serem utilizados para reabilitação da destreza fina das mãos, com enfoque nas atividades da vida diária, em pacientes que sofreram lesões nos membros superiores. Observando-se o atual mercado brasileiro de dispositivos digitais, o tablet ocupa posição de destaque, tornando-se líder em inclusão digital no país. Em contrapartida, uma realidade que assombra a população nacional, o alto índice de acidentes de motocicleta, produzindo vítimas que carregam sequelas pelo resto de suas vidas. Profissionais da área de fisioterapia e terapia ocupacional têm feito uso de vídeo games com sensores de movimento, para auxiliar na reabilitação de pacientes, por meio de exergames. Contudo estes aparelhos são pouco acessíveis às classes populares, além de focarem em movimentos de ombro, enquanto o tablet, utiliza extensa gama de movimentos dos dedos e pulso. Logo, representando um recurso relevante na relação entre pacientes e profissionais da saúde, promovendo motivação e beneficiando ambos. Portanto, foram selecionados e instalados quatro jogos da loja de apps Android no dispositivo Samsung galaxy tab pro 10.1 (SM-T520), em seguida, foram observadas suas mecânicas, comparando com exercícios para reabilitação das mãos. Os resultados apontam para uma viável reprodução dos exercícios, onde o movimento de toque, mais comum aos jogos, envolve flexão e extensão, dos dedos e pulso, entre outros estímulos aos músculos, ligamentos e tendões. Mimetizando os exercícios planejados por profissionais para serem realizados pelo paciente em sua casa. Demonstrando real possibilidade de utilizar tablets como instrumento para a prática de exercício, por meio de jogos casuais, em pacientes que necessitam reabilitar suas funções por meio exercícios efetuados no ambiente doméstico. / This study aims to examine empirically the possibility of causal digital games for Android tablets, be used for rehabilitation of the hand’s fine dexterity, focusing on activities of daily living in patients who have suffered injuries in the upper limbs. Observing the current Brazilian market of digital devices, the tablet has an outstanding position, becoming a leader in digital inclusion in the country. In contrast, a reality that haunts the national population, the high rate of motorcycle accidents, producing victims that carry consequences for the rest of their lives. Physiotherapy and occupational therapy professionals have been making use of video games with motion sensors, to assist in the rehabilitation of patients through exergames. However, these devices are not easily accessible to the working classes, and focus mainly on shoulder movements, while the tablet, uses extensive range of finger and wrist movements. Therefore, representing an important feature in the relationship between patients and health professionals, promoting motivation and benefiting both. Thus, four games were selected and installed from Android apps store the device Samsung galaxy tab 10.1 pro (SM-T520), then its mechanics were observed, compared to exercises for rehabilitation of the hands. The results point to a viable reproduction of exercises where the movement of touch, the most common between the games, involves flexion and extension of the fingers and wrist, among other stimuli to muscles, ligaments and tendons. Mimicking the exercises planned by professionals to be performed by the patient in their home. Demonstrating real possibility to use tablets as a tool to practice exercise, through casual games, in patients who need to rehabilitate their functions through exercises fulfilled in their home.

京都大学 / 新制・課程博士 / 博士(理学) / 甲第23461号 / 理博第4755号 / 新制||理||1682(附属図書館) / 京都大学大学院理学研究科生物科学専攻 / (主査)教授 高田 昌彦, 准教授 宮地 重弘, 教授 古市 剛史 / 学位規則第4条第1項該当 / Doctor of Science / Kyoto University / DGAM

BACKGROUND: Almost all fields of dentistry are very reliant on dentists’ well-developed dexterity and psychomotor skills. Simulation preclinical dental training is important for dental students to acquire preliminary manual dexterity before interacting with real patients. In the recent years, virtual reality specifically haptic simulations have drawn a lot of attention due to their multiple advantages including lack of the threat of spreading air-borne diseases. PURPOSE: The overall purpose of this study was to provide a review of the available dental haptic simulators in the market, and specific aim was to report the available evidence from the current scientific literature about the use and benefit of them during early preclinical pediatric dentistry training. METHODS: Information about Haptic VR simulators was obtained through manufacturers’ websites and current scientific literature. For the specific aim, the review is reported using the PRISMA-Scoping Review (ScR) guidelines and bibliographic databases such as PubMed, Cochrane library, Embase, and Dentistry and Oral Sciences Source. RESULTS: The systematic search identified 79 titles of which 14 full-text articles were selected for detailed review. Based on inclusion and exclusion criteria 4 studies were included in this review. CONCLUSION: Evaluation evidence from reviewed studies indicates the usefulness of the haptic simulators in preclinical pediatric dental training. The haptic simulators complement the existing phantom head simulators by offering different beneficial features. Further studies are necessary to evaluate the effectiveness of the simulators in pediatric dental training and to support the current availability of evidence.

No description available.