The aim of this thesis is to determine the use of surface electromyography for functional diagnostic of upper limb in spinal cord injury patients from an occupational therapy perspective. Functional diagnostic is focused on personal activities of daily living (pADL). So far, no one has commented this topic from an occupational therapy perspective in the Czech Republic. The thesis should offer another possibility of objective evaluation. The theoretical part deals with the description of upper limb, including kinesiology, the types of grasps of quadriplegic patients and the muscles involved in performing personal activities of daily living. There are problem areas of activities of daily living in spinal cord injury patients and their classification. At the end of the theoretical part is described electromyography, interconnection with occupational therapy and use of surface electromyography. There is also described interdisciplinary team. The practical part consists of six case reports, in which subjects were measured muscle activity during performing personal activities of daily living using surface electromyography. This section presents a diverse use of application of surface electromyography both in terms of graphical imaging and wide age dispersion of patients. Keywords: surface...

The purpose of this thesis was to examine coronary heart disease (CHD) risk factors and secondary complications in individuals with spinal cord injury (SCI). In particular, this thesis was organized around the central theme of adiposity, which is a prevalent complication following SCI. Study 1 focused on understanding the relationships between activities of daily living (ADL) and CHD risk factors including central adiposity, lipoproteins, and triglycerides. Using generalized linear models, while controlling for pertinent covariates such as sex, age, and leisure time physical activity (LTPA), it was found that Mobility ADL (wheeling and transferring) were negatively associated with total and LDL-cholesterol. Study 2 examined whether individuals who considered themselves to be overweight subsequently had less favourable subjective well-being, and were more likely to report specific secondary complications than individuals who did not consider themselves to be overweight. Logistic regression analysis and partial correlations controlling for pertinent covariates such as sex, age, and injury severity, revealed that individuals who considered themselves to be overweight reported greater pain, depression, overuse injuries, and fatigue, and less satisfaction with life than individuals who did not consider themselves to be overweight. In summary, the findings suggest that a) participation in specific types of ADL (i.e. Mobility ADL) are associated with a lower CHD risk and should be further explored and that b) elevated perceived adiposity is associated with specific secondary complications and lower subjective well-being. Overall thesis findings support the overwhelming evidence of the benefits of daily physical activity and maintaining a healthy bodyweight in the SCI population. / Thesis (Master, Kinesiology & Health Studies) -- Queen's University, 2009-05-28 11:40:32.574

Traumatic damage to the cervical spinal cord has a dramatic impact on determinants affecting cardiovascular fitness. In tetraplegia, in addition to diminished skeletal muscle function, impaired sympathetic cardiovascular innervation together with a dysfunction of catecholamine release is typically present. Individuals with tetraplegia are at a high risk of long-term inactivity, which increasingly contributes to the development of common civilization diseases. The aim of the current dissertation project is to investigate the cardiovascular fitness in males with cervical spinal cord injury (n=20) as compared to able- bodied males (n=27). Both groups completed exercise testing on an arm-crank ergometer. Arterial blood pressure response to exercise, peak oxygen consumption and peak heart rate were the primary outcome variables. In the first part of the study, a graded maximal arm- crank ergometer test to the subjective exhaustion was performed for the inter-group peak exercise comparison. The peak power dramatically differs between the groups and could be an important confounding factor limiting the evaluation of a physiologic response related to the equivalent physical loading. Therefore, in the second part of the study, individuals of the control group completed a second graded arm-crank ergometer...

Background: Functional electrical stimulation (FES) has been found to be effective in restoring voluntary functions after spinal cord injury (SCI) and stroke. However, the central nervous system (CNS) changes that occur in as a result of this therapy are largely unknown. Objective: To examine the effects of FES on the restoration of voluntary locomotor function of the CNS in a SCI rat model. Methods: SCI rats were instrumented with chronic FES electrodes in the hindlimb muscles and were divided into two groups: (a) FES therapy and (b) sedentary. At day 7 post-SCI, the animals were assessed for locomotion performance by using a Basso, Beattie and Bresnahan (BBB) scale. They were then anesthetized for a terminal in vivo experiment. The lumbar spinal cord and somatosensory cortex were exposed and the instrumented muscles were stimulated electrically. Associated neurovascular responses in the CNS were recorded with an intrinsic optical imaging system. Results: FES greatly improved locomotion recovery by day 7 post-SCI, as measured by BBB scores (P < 0.05): (a) FES 10 ± 2 and (b) controls 3 ± 1. Furthermore, the FES group showed a significant increase (P < 0.05) of neurovascular activation in the spinal cord and somatosensory cortex when the muscles were stimulated between 1 and 3 motor threshold (MT). Conclusion: Hind limb rehabilitation with FES is an effective strategy to improve locomotion during the acute phase post-SCI. The results of this study indicate that after FES, the CNS preserves/acquires the capacity to respond to peripheral electrical stimulation.

Bakgrund: Att drabbas av en ryggmärgsskada till följd av trauma innebär ofta en stor livsomställning. Det är vanligt med både fysiska och psykiska sekundära hälsoeffekter hos personer med ryggmärgsskada och dessa patienter är ofta mer sårbara för flera olika ohälsotillstånd. Personer med funktionsnedsättning möter ofta omfattande barriärer i samhället, trots deras rättighet att bli inkluderade och kunna delta i samhället i samma utsträckning som den generella befolkningen. Syfte: Att belysa patienters upplevelser av att leva med tetra- eller paraplegi till följd av trauma. Metod: Litteraturstudien bygger på 11 vetenskapliga artiklar med kvalitativ ansats. Datainsamlingen skedde i databaserna PubMed och Cinahl med hjälp av PEO-modellen för att finna sökblock. Artiklarna kvalitetsgranskades med hjälp av SBUs granskningsmall och analyserades med tematisk analys för att identifiera subkategorier och kategorier. Resultat: Analysen resulterade i att deltagarnas upplevelser kunde kategoriseras i åtta subkategorier som mynnade ut i två övergripande kategorier. Kategorin En förändrad vardag innehöll subkategorierna; olika känslor som väcktes, begränsade fysiska förutsättningar, påverkad självständighet och varierande bemötande i samhället. Kategorien Hantering av tillvaron innehöll subkategorierna; behov av socialt och professionellt stöd, nya perspektiv på tillvaron, vikten av meningsfulla aktiviteter och strävan efter delaktighet i samhället. Konklusion: Sjuksköterskan har en viktig roll i bemötandet och behandlingen av personer med tetra- och paraplegi. Det är viktigt att arbeta personcentrerat och holistiskt för att tillgodose såväl fysiska som psykosociala behov. / Background: Suffering a spinal cord injury as a result of trauma often entails a significant life adjustment. Both physical and psychological secondary health effects are common among individuals with spinal cord injury, and these patients are often more vulnerable to various health conditions. People with disabilities often encounter extensive barriers in society, despite their right to inclusion and participation in society to the same extent as the general population. Objective: To illuminate patients' experiences of living with tetraplegia or paraplegia resulting from trauma. Method: The literature review is based on 11 scientific articles with a qualitative approach. Data collection was conducted in the PubMed and CINAHL databases using the PEO model to guide the search blocks. The articles were quality-assessed using the SBU review guide and analyzed using thematic analysis to identify subcategories and categories. Results: The analysis resulted in categorizing participants' experiences into eight subcategories, which converged into two overarching categories. The subcategories of different emotions evoked, limited physical capabilities, impacted independence, and varying societal encounters resulted in the category "Altered everyday life." The subcategories of the need for social and professional support, new perspectives on existence, the importance of meaningful activities, and the pursuit of societal participation resulted in the category "Managing life." Conclusion: The nurse plays a crucial role in the care and treatment of individuals with tetra- and paraplegia. It is important to work in a person-centered and holistic manner to address both physical and psychosocial needs.

Traumatic damage to the cervical spinal cord has a dramatic impact on determinants affecting cardiovascular fitness. In tetraplegia, in addition to diminished skeletal muscle function, impaired sympathetic cardiovascular innervation together with a dysfunction of catecholamine release is typically present. Individuals with tetraplegia are at a high risk of long-term inactivity, which increasingly contributes to the development of common civilization diseases. The aim of the current dissertation project is to investigate the cardiovascular fitness in males with cervical spinal cord injury (n=20) as compared to able- bodied males (n=27). Both groups completed exercise testing on an arm-crank ergometer. Arterial blood pressure response to exercise, peak oxygen consumption and peak heart rate were the primary outcome variables. In the first part of the study, a graded maximal arm- crank ergometer test to the subjective exhaustion was performed for the inter-group peak exercise comparison. The peak power dramatically differs between the groups and could be an important confounding factor limiting the evaluation of a physiologic response related to the equivalent physical loading. Therefore, in the second part of the study, individuals of the control group completed a second graded arm-crank ergometer...

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Master's thesis topic: Effects of the training with the krankcycle on wheelchair users Author: Bc. Ondřej Doubrava Branch of study: Physiotherapy Disertation Tutor: Mgr. Rostislav Čichoň, Ph.D. Year of Defense: 2014 This work was focused on training and strengthening of wheelchair users as a prevention of their health problems, a regulation of wrong physical and physiological mechanisms and an increase their fitness and motional skills. In this training the new instrument designed to strengthen the upper extremity and to improve the function of the cardiorespiratory system was used. This device is called krankcycle and its popularity has increased dramatically especially in the recent years. Therefore it became the main purpose of this work to determine whether completing a 12-week continuous training with krankcycle will lead to changes in monitored parameters evaluating physiological, physical and motional skills of subjects and thus identify the true value of its use. At the same time, we wanted to verify previously confirmed advantages and effectiveness of this exercise especifically for wheelchair users and reveal the krankcycle to them and the wider public as well. Values of body composition were measured in the biomedical laboratory of the UK FTVS by caliperation of four skinfolds method on...

Os objetivos deste trabalho foram desenvolver um dispositivo apontador, com as mesmas funções de um mouse, controlado pelo movimento da cabeça, e comparar a eficiência do dispositivo proposto, utilizando o controle do cursor do computador no modo absoluto e relativo (joystick), operado por dez indivíduos tetraplégicos e por dez indivíduos sem acometimento neuromuscular. A maioria dos parâmetros estudados apresentou diferença significativa, entre as situações de controle absoluto e relativo, para os indivíduos de ambos os grupos, evidenciando que os parâmetros medidos no modo absoluto foram melhores que os medidos no modo relativo. O dispositivo apontador emula adequadamente as funções de deslocamento do cursor, mostrando que o modo de controle absoluto é mais eficiente que o modo de controle relativo / The objectives of this study were to develop a head controlled pointer device with mouse functions and compare its performance when operated in absolute versus relative (joystick like) modes by ten quadriplegic subjects and ten people without neuromuscular impairment. The device was composed of a video camera, a computer program and a reflective paper target attached to a cap which was then placed on the user´s head. Most of the measured parameters revealed a significant difference between the control modes, favouring the absolute one, for both studied groups. The developed head pointer adequately emulates the computer cursor displacement, with the absolute control mode being functionally more efficient than the relative control mode in this study.

Em geral, indivíduos com disfunções motoras nos membros superiores apresentam dificuldades para executar a movimentação de objetos, a qual é essencial para a execução das atividades de vida diária. Dessa forma, esses indivíduos não a executam ou a fazem de maneira ineficiente. Para que essa manipulação seja realizada de maneira satisfatória, fazem-se necessários os movimentos de alcance e preensão de objetos controlados voluntariamente pelo indivíduo, e também a aquisição sensorial da força empregada durante a preensão. Portanto, este trabalho apresenta o desenvolvimento, a aplicação e a avaliação de um protótipo de sistema híbrido visando à reabilitação parcial da capacidade sensório-motora do membro superior direito de tetraplégicos. Tal sistema engloba uma órtese dinâmica para cotovelo utilizada em conjunto com a estimulação elétrica neuromuscular, e uma luva instrumentada que possibilita a realimentação qualitativa da força de preensão. Os resultados das avaliações clínicas mostraram que o sistema auxilia os tetraplégicos em tarefas que envolvem o alcance e a preensão de objetos, bem como trazê-los para próximo do corpo. O aumento da faixa de alcance, a geração de preensão e a restauração artificial da habilidade de movimentar um objeto para próximo do corpo representam esse auxílio proporcionado pelo sistema. Assim o protótipo de sistema híbrido representa uma estratégia alternativa para a reabilitação de lesados medulares (níveis C5-C6). / Generally, individuals with motor impairments in the upper limbs have difficulties performing the movement of objects, which is essential for the execution of activities of daily living. Thus, these individuals do not perform these activities or perform them inefficiently. Toward satisfactory manipulation, reach and grasp movements of objects performed with voluntary control, and grasp force feedback are necessary. Therefore, this work presents the development, application and evaluation of a hybrid system prototype aiming at partial rehabilitation of sensory-motor ability of quadriplegic\'s right upper limb. Such system includes an elbow dynamic orthosis combined with neuromuscular electrical stimulation, and an instrumented glove that allows the qualitative grasp force feedback. The results of clinical assessment showed that the system aids quadriplegic in tasks that involve reaching and grasping of objects, as well as bringing them close to the body. The improvement of reaching range, grasping generation and artificial restoration of the ability to move an object close to the body represent this aid provided by the system. Thus, the hybrid system prototype represents an alternative strategy for the rehabilitation of individuals with spinal cord injury (C5-C6 level).