The study is to propose a novel design for the lower limb rehabilitation system through the motion training of stepping upward or downward. A main goal of this design is to constrain the system dimension to a small value for home use purpose. It is also desired that the functioning of system is automatic that the direction of stepping upward or downward can be changed arbitrarily in the training process. The TRIZ theory, which offers a systematic thinking process for problem solving, is adopted in this study to construct the first step of conceptual design. From the theory, the problems of system design is mainly to deal with three issues, which are the spatial analysis and optimization, motion conversion design for ladder, and the motion control of ladder. The spatial analysis is to investigate the optimal trajectory of ladder motion that the total space of the system can be minimized. It is done by assuming a specific geometrical property of ladder trajectory and solving the optimization problem through the parameter optimization. The motion conversion design is to invent an approach to change the configuration of ladder from either open-to-close or close-to-open status. To do so, a small section of ladder trajectory is asked to be flexible and a mechanism to trigger the configuration change is proposed. The motion control is to maintain the user located in an almost same location while the training is preceded. In this study, the PID control scheme is adopted to examine whether the control goal can be properly achieved. This study reveals that a proper design can be obtained through the specific process of problem solving. The system is shown to function well when the above three issues are solved by the proposed schemes.

Magistrinio darbo tikslas yra įvertinti medicininės reabilitacijos sistemos reformos pagrindinius trūkumus ir privalumus, nustatyti pagrindinius tai įtakojančius veiksnius ir remiantis analizės duomenimis bei reabilitacijos sistemos kūrime dalyvaujančių ekspertų nuomone, pateikti pasiūlymus kaip gerinti reabilitacijos paslaugų teikimo kokybę ir prieinamumą Lietuvoje. Darbo teorinėje dalyje analizuojami reabilitacijos sistemos pokyčių teoriniai pagrindai. Nagrinėjami norminiai aktai, moksliniai darbai ir kiti literatūros šaltiniai , aprašantys reabilitacijos sistemos raidą, struktūrą, reabilitacijos etapus, paslaugų rūšis bei jų vietą Lietuvos Nacionalinėje sveikatos sistemoje. Praktinėje dalyje analizuojami reabilitacijos sistemos pokyčiai Lietuvoje nuo 1992 m. iki 2005 m. Analizę sudaro trys dalys. Pirmoje dalyje analizuojami teisės aktai turėję įtaką reabilitacijos sistemos pokyčiams, buvo įvertintas kiekvieno jų tiesioginis poveikis reabilitacijos paslaugų struktūrai bei sąsajos su Lietuvos reabilitacijos strategijoje įvardintais reabilitacijos sistemos kūrimo principais. Antroje dalyje buvo atlikta reabilitacijos efektyvumo statistinių rodiklių analizė. Analizuota reabilitacijos paslaugų struktūra jos rodiklių kitimai bei teisės aktų, įtaka šiems pokyčiams. Trečioje dalyje apibendrinami anketinės apklausos duomenys. Tam, kad įvertintume reabilitacijos sistemos paslaugų kitimą bei reabilitacijos sistemos reformos sėkmę Lietuvoje, atlikta ekspertų apklausa. Buvo... [to full text] / The purpose of the master paper is to evaluate the key advantages and drawbacks of the reform of the medical rehabilitation system, to establish its influencing factors and, based on the data of analysis and the opinion of the experts participating in the development of the rehabilitation system, to develop suggestions how to improve the quality and accessibility of the rehabilitation services in Lithuania. In the theory part of the paper the theoretical base of the changes in the rehabilitation system are analysed. Legal acts, scientific papers and other sources of literature dealing with the development, structure, steps of rehabilitation, types of services and their place in the National Health Care System in Lithuania. The practical part analysis the changes in the rehabilitation system in the period From 1992 to 2005. The analysis consists of three parts. The first part deals with the legal acts, which influenced the changes in the rehabilitation system, the direct impact of each of them on the structure of services and the correlation with the principles defined in the Lithuanian Rehabilitation System Development Strategy. The second part contains the analysis of the statistical data of the rehabilitation efficiency. The structure of the rehabilitation services, the changes in its indexes and the influence of the legal acts have been analysed. The third part summarise the data of the questionnaire. A survey among experts has been carried with the purpose to... [to full text]

Introduction: Multiple sclerosis is a chronic autoimmune neurodegenerative affection of the central nervous system with various neurological symptoms. Disability of upper extremities with other symptoms leads to impaired ability to work and ADL-activities of daily living. The purpose of the pilot study was to evaluate the effect of hand training with the Hand Tutor® rehabilitation system. Methods: The study involved 9 probands, completed 6 probands (2 females and 4 males) at an average age of 36 (SD 4), with a mean disease duration of 13 years (SD 4). Patients received a series of 10 Hand Tutor® therapies, 1-2 times a week. The effect of the therapy was evaluated using the Nine Hole Peg Test (9HPT), the Modified Frenchay Scale and the subjective evaluation of the probands. Results: Before the therapies, the average performance in the 9HPT test was 85 seconds and 83 points in the Modified Frenchay scale. After the therapies, the average 9HPT performance was 67 seconds and 86 points in the Modified Frenchay scale. According to the subjective evaluation of probands, the therapy had a positive effect on the tremor of the upper limb and on the use of the upper limb in the ADL. Conclusion: Therapy with a special rehabilitation system provides patients with MS with more intensive hand training using...