BACKGROUND: Based on mainly vascular diseases and traumatic injuries, around 40,000 upper limb amputations are performed annually worldwide. The affected persons are strongly impaired in their physical abilities by such an intervention. Through myoelectric prostheses, affected persons are able to recover some of their abilities. METHODS: In order to control such prostheses, a system is to be developed by which electromyographic (EMG) measurements on the upper extremities can be carried out. The data obtained in this way should then be processed to recognize different gestures. These EMG measurements are to be performed by means of a suitable microcontroller and afterwards processed and classified by adequate software. Finally, a model or prototype of a hand is to be created, which is controlled by means of the acquired data. RESULTS: The signals from the upper extremities were picked up by four MyoWare sensors and transmitted to a computer via an Arduino Uno microcontroller. The Signals were processed in quantized time windows using Matlab. By means of a neural network, the gestures were recognized and displayed both graphically and by a prosthesis. The achieved recognition rate was up to 87% across all gestures. CONCLUSION: With an increasing number of gestures to be detected, the functionality of a neural network exceeds that of any fuzzy logic concerning classification accuracy. The recognition rates fluctuated between the individual gestures. This indicates that further fine tuning is needed to better train the classification software. However, it demonstrated that relatively cheap hardware can be used to create a control system for upper extremity prostheses.

Purpose: Several studies have examined intralimb coordination between the shoulder and elbow joints during target-oriented movements. These studies have observed consistent patterns in coordination despite changes in movement variables such as speed, direction, and inertia. Researchers used intersegmental dynamics to quantitatively analyze these patterns between shoulder and elbow joints while systematically changing values of these movement variables. Some studies have examined central nervous system adaptations to inertial changes at the elbow and entire arm during a movement, but none have examined inertial changes to the upper limb. Methods: Five male and five female participants aged 27 to 39 years (mean age = 33 ± 4.3 standard deviation) performed a maximal speed, point-to-point, reversal hand movement in the sagittal plane with and without a 2.2 kg. weight attached to their dominant, right upper arm. To determine the effects of the added mass, dependent t-tests were performed on elbow and shoulder peak muscular torques generated during the reversal region of the movement. Results: A significant increase in shoulder joint torque (p < 0.05), a significant increase in movement time (p < 0.05) and a non-significant decrease in elbow muscular torque (p = 0.1074) was shown to achieve the movement objective with the added weight. Conclusions: While future studies may result in more conclusive findings, this study showed a pattern of increased shoulder torque and decreased elbow torque due to the added inertia. Larger shoulder torque was needed to overcome the added inertia and move at high speed. As a result of the higher shoulder force, interaction torque at the elbow increased, and a reduction in elbow torque was needed to control the hand path and accurately hit the targets. This pattern supports Bernstein’s proposal that passively arising phenomena (i.e., interaction torque) is exploited during multi-segment movement.

This paper presents a novel approach to the design of a motorized rehabilitation device – active elbow orthosis (AEO) – inspired by the principles of robotic exoskeletons. The device is currently designed for the elbow joint, but can be easily modified for other joints as well. AEO determines the motion activity of the patient using a strain gauge and utilizes this measurement to control the actuator that drives the forearm part of the orthosis. Patient activity level is related to a free arm measurement obtained via a calibration procedure prior to the exercise. A high-level control module offers several types of exercises mimicking the physiotherapist. The device was successfully verified by tests on a number of patients, resulting in extended range of elbow-joint motion.

Background: Parkinson's disease (PD) is a debilitating progressive neurological disorder. The main clinical features of PD are: rigidity, bradykinesia, akinesia, and resting tremor. People living with PD often present with impaired gross- and fine upper-limb motor control and ocular tracking. The impaired motor control associated with PD results in difficulty performing basic- and instrumental activities of daily living (BADLs and IADLs). Virtual reality (VR) therapy is an emerging treatment strategy used to address movement impairment in people with neurological diseases, but has not been extensively researched in the rehabilitation of people with PD. This study aimed to determine the effectiveness of VR therapy as a treatment modality for the rehabilitation of upper-limb function during BADLs and IADLs and ocular tracking for people with PD, when compared to conventional physiotherapy. Methods: A single blind randomised control trial was done. Participants were randomly allocated to either the conventional therapy (control) or VR therapy (experimental) groups using the concealed opaque envelope method. Twenty-two participants who gave informed consent were included, if they met the following criteria: Confirmed PD diagnoses; scored above 24/30 for the Mini Mental State Examination; and did not suffer from uncontrolled co-morbid diseases. The control- and experimental groups underwent twelve intervention session of 45 minutes. The control group participated in conventional physiotherapy sessions and the experimental group used the X-box Kinect© VR apparatus during treatment. Participants were assessed at baseline and post-intervention (directly following the 12 session) with the: 9 Hole Peg Test (9HPT), Test d'Evaluation des Membres Superieurs De Personnes Agees (TEMPA) and the King Devick Test. Results: The TEMPA was used to determine unilateral- and bilateral upper-limb function during IADLs and BADLs. Three of the four items of the TEMPA that assessed bilateral upper-limb function indicated statistically significant improvement when the difference between the control and experimental groups were compared post-intervention (Task1 p=0.611; Task 2 p=0.0043; Task 3 p=0.0078; Task 4 p=0.0002). Similarly, three of the four items of the TEMPA that assessed unilateral upper-limb function indicated statistically significant improvement for the experimental group, when compared to the control- group post-intervention (Task 5 p=0.0151; Task 6 p=0.4118; Task 7 p=0.0064; Task 8 p=0.0009). The 9HPT assessed in-hand manipulation and fine upper-limb function. Results from the 9HPT for the left- and right hands of both groups showed clinically significant improvements from baseline to post-intervention, but there was no statistically significant difference between the two groups. The King Devick test was used to assess ocular tracking. The comparison of change between the two groups from baseline to post-intervention on the King Devick did not indicate clinically- or statistically significant change. Discussion and Conclusion: The findings from the bilateral IADL and BADL tasks as measured with the TEMPA are similar to findings in the literature. The results show that VR therapy improve motor control of the upper-limb significantly when both hands work together and when the upper-limbs are moving unilaterally. VR therapy might be more effective than conventional physiotherapy because it allowed for repetitive practice of functional activities, which aided the development of limb control and functional muscle strength. The VR therapy also allowed task-oriented training to occur repetitively. Task-oriented training is known to aid neural plasticity and facilitate functional rehabilitation. The insignificant differences between the groups on the 9HPT is an indication that the task performed for this outcome measure is not specific enough to detect hand function and grip strength. The King Devick test did not indicate change for the control- or experimental groups, which indicates that specific ocular tracking exercises should be included in therapy to address this impairment. / Dissertation (MPhysiotherapy)--University of Pretoria, 2016. / Physiotherapy / MPhysiotherapy / Unrestricted

The diploma thesis explores the use biofeedback balls called SunBall® as a possible alternative in hand diagnostics and grip therapy in occupational therapy practice. This thesis includes theoretical knowledge about stroke with emphasis on upper limb from the point of view of occupational therapist. It describes the types of grips and discusses the use of a robotic biofeedback in occupational therapy practice. It includes basic information about SunBall® machine, which is used in the practical part of the thesis. The practical part of the thesis evaluates the benefit of the machine in interventions with patients after stroke in subacute and chronic phase. It also presents its possibilities of use in hand diagnostics. Performing these results objectively was achieved by the use of specific occupational therapy examination and also by standardized method, such as modified Ashworth scale, Jamar dynamometer or goninometric measurement. As the results of this thesis show, there is an apparent positive influence on the upper limb and grip therapy according to the disability of probands. There was no success in finding an appropriate application of the measured modalities of the machine in the area of upper limb and grip diagnostics.

The diploma thesis explores the use biofeedback balls called SunBall® as a possible alternative in hand diagnostics and grip therapy in occupational therapy practice. This thesis includes theoretical knowledge about stroke with emphasis on upper limb from the point of view of occupational therapist. It describes the types of grips and discusses the use of a robotic biofeedback in occupational therapy practice. It includes basic information about SunBall® machine, which is used in the practical part of the thesis. The practical part of the thesis evaluates the benefit of the machine in interventions with patients after stroke in subacute and chronic phase. It also presents its possibilities of use in hand diagnostics. Performing these results objectively was achieved by the use of specific occupational therapy examination and also by standardized method, such as modified Ashworth scale, Jamar dynamometer or goninometric measurement. As the results of this thesis show, there is an apparent positive influence on the upper limb and grip therapy according to the disability of probands. There was no success in finding an appropriate application of the measured modalities of the machine in the area of upper limb and grip diagnostics. Key words: stroke, biofeedback, upper limb robotic therapy, SunBall

Title: The effect of exercise with blood flow restriction on the development of muscle strength Objectives: The aim of this work was to assess the magnitude of the effect of exercise with blood flow restriction on the development of muscle strength on the basis of a systematic research and to determine the main factors that moderate this increase. Methods: Primary sources were searched in the scientific databases Academic Search Ultimate, Web of Science and Taylor and Francis. Individual training interventions were found in the included studies. Based on the training interventions, possible moderating factors of the magnitude of the effect on the development of muscular strength of the upper or lower limbs were defined. From the results of the studies, the effect size values of Cohen's d and Hedge's g were calculated. The influence of concrete parameters of application of the vascular occlusion and blood flow restriction exercise on the magnitude of the effect was evaluated on the basis of correlation analysis. Results: A total of 27 studies were included in this diploma thesis, in which 39 different trainings using blood flow restriction exercises were found and included. Based on the correlation analysis, no direct relationship was found between the exercise parameters and the magnitude of the...

The purpose of this project was to analyze the coordination between gaze and the upper limb movement while performing a predefined task. We implemented a method to simultaneously compute and visualize recorded gaze data from a head mounted eye tracker and motion data from a motion capture system in the same coordinate system.  A python script was implemented to temporarily synchronize the two systems and then proceed with the spatial/coordinate transformation which was validated with the data acquired while the subject was asked to perform specific tasks. Task 1 was to fixate his gaze on a block placed in the center of a table and the Task 2 was to stack the blocks by picking it up and placing it on top of each other. Wrist and elbow flexion-extension angles were tracked simultaneously based on reflective markers trajectories while performing the task. This was visualized and discussed on how the results of our study suggest that the eye movements play a vital role in planning, estimating, coordinating and providing feedback for the body to perform a motor task.

Essential Tremor (ET), a condition characterized by postural and kinetic tremor in the upper limbs, is one of the most prevalent movement disorders. While pharmaceutical and surgical treatment options exist, they are not ideal. Assistive devices have the potential to provide relief to patients but are largely unexplored for ET. Furthermore, prior characterizations of essential tremor have focused on endpoint tremor and provide insufficient detail for designing such a device. We propose and demonstrate a novel method for characterizing essential tremor in the 7 proximal degrees of freedom (DOF) of the upper limb in various postures. In addition, we provide a preliminary characterization in a small number of patients with mild ET. We collected data from 10 patients with ET. Subjects were instrumented with four electromagnetic sensors that recorded orientation of upper limb segments. After a calibration, each subject positioned his/her upper limb in 16 different postures for 15 seconds each. This procedure was repeated 4 times for each subject, with each repetition being considered a run. Sensor data were converted to angular kinematic data for each DOF using inverse kinematics, a practice unique to this study. These data were then analyzed in the frequency domain to calculate the power associated with the tremor in each DOF and posture. More specifically, we computed the area of the periodogram over the 4-12 Hz frequency band typically associated with ET [narrow-band area (NBA)] and over the wider frequency band from 2 Hz to the Nyquist frequency [wide-band area (WBA)]. If significant peaks were found in the 4-12 Hz band, their frequency and amplitude were reported. Mixed-model ANOVA tests were used to investigate effects of DOF, posture, run, gravity, and patient characteristics on reported measures. NBA and WBA varied significantly between DOF, being lowest in the wrist, intermediate in the shoulder, and greatest in the elbow and forearm (pronation-supination). NBA and WBA also varied significantly with posture. Only 5% of observations had significant peaks, with 49% of peaks occurring in wrist flexion-extension and 39% occurring in wrist radial-ulnar deviation. Peak frequency was quite stereotyped (5.7 Hz ± 1.3Hz). Run had no significant effects, indicating that tremor measures were consistent over the duration of the experiment. Effects of gravity and demographic factors on measures were mixed and did not present a discernible pattern. This preliminary characterization suggests that tremor may be focused in a subset of upper limb DOF, being greatest (in terms of power) in elbow flexion-extension and forearm pronation-supination, and most concentrated (with peaks at a stereotyped frequency) in wrist flexion-extension and radial-ulnar deviation. Our method of 7 DOF characterization through inverse kinematics, in conjunction with future research (isolation studies, EMG, and finger DOF) may allow for optimal tremor suppression by an orthosis.

The purpose of this study is to examine the position and use of an upper extremity prosthetic simulator on non-amputees. To see how a 3D printed prosthetic simulator can be optimized to serve the user correctly and accurately. In addition, this study examines the improvement of the Hosmer 5X Prosthetic Hook with the addition of newly designed trusses on to the prosthetic, as well as utilizing a new manufacturing method known as 3D printing. These topics are important because there is no standardized prosthetic simulator for schools and research facilities to use. Off the shelf prosthetic simulator cost upwards of $2000, often too expensive for early stage research. By optimizing the Hosmer 5X Prosthetic Hook with 3D printing, this new opportunity could allow amputees, from a range of income classes, to have access to a wide variety of prosthetics that are strong enough to support everyday living activities. A low-cost prosthetic that is easily distributable and accessible can give people a chance to regain their independence by giving them different options of efficient prosthetic devices, without having to spend so much. The devices in this project were design and analyzed on SOLIDWORKS, 3D scanned on the Artec Space Spider, and surfaced on Geomagic Wrap. Key results include developing a low-cost, robust prosthetic simulator capable of operating a Hosmer 5X Prosthetic hook, as well as developing a lighter version of the Hosmer 5X Prosthetic Hook that is more cost efficient and easily obtainable to the population around the world.