Subacromial Space Reduction in Wheelchair Users: the Role of Loading and Subject Characteristics.

Aim: The goals of this study were 1) to identify the relationship between adipose (subcutaneous and intramuscular) characteristics and pressure injury (PrI) history in wheelchair users and 2) to identify subject characteristics, including biomechanical risk, that are related to adipose characteristics.Materials and Methods: The buttocks of 43 full-time wheelchair users with and without a history of pelvic PrIs were scanned in a seated posture in a FONAR UPRIGHT® MRI. Intramuscular adipose (the relative difference in intensity between adipose and gluteus maximus) and the subcutaneous adipose characteristics (the relative difference in intensity between subcutaneous adipose under and surrounding the ischium) were compared to PrI history and subject characteristics.Results: Participants with a history of PrIs had different subcutaneous fat (subQF) characteristics than participants without a history of PrIs. Specifically, they had significantly darker adipose under the ischium than surrounding the ischium (subQF effect size = 0.21) than participants without a history of PrIs (subQF effect size = 0.58). On the other hand, only when individuals with complete fat infiltration (n = 7) were excluded did individuals with PrI history have more fat infiltration than those without a PrI history. The presence of spasms (μ intramuscular adipose, 95% CI with spasms 0.642 [0.430, 0.855], without spasms 0.168 [−0.116, 0.452], p = 0.01) and fewer years using a wheelchair were associated with leaner muscle (Pearson Corr = −0.442, p = 0.003).Conclusion: The results of the study suggest the hypothesis that changes in adipose tissue under the ischial tuberosity (presenting as darker SubQF) are associated with increased biomechanical risk for pressure injury. Further investigation of this hypothesis, and the role of intramuscular fat infiltration in PrI development, may help our understanding of PrI etiology. It may also lead to clinically useful diagnostic techniques that can identify changes in adipose and biomechanical risk to inform early preventative interventions.

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Effects of Repetitive Shoulder Activity on the Subacromial Space in Manual Wheelchair Users

BioMed Research International ◽

10.1155/2014/583951 ◽

2014 ◽

Vol 2014 ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Yen-Sheng Lin ◽

Michael Boninger ◽

Lynn Worobey ◽

Shawn Farrokhi ◽

Alicia Koontz

Keyword(s):

Shoulder Pain ◽

External Rotation ◽

Shoulder Function ◽

Subacromial Space ◽

Wheelchair Users ◽

Manual Wheelchair ◽

Before And After ◽

Acromiohumeral Distance ◽

The Relationship ◽

Subject Characteristics

This study investigated (1) the effect of repetitive weight-relief raises (WR) and shoulder external rotation (ER) on the acromiohumeral distance (AHD) among manual wheelchair users (MWUs) and (2) the relationship between shoulder pain, subject characteristics, and AHD changes. Twenty-three MWUs underwent ultrasound imaging of the nondominant shoulder in an unloaded baseline position and while holding a WR position before and after the WR/ER tasks. Pairedt-tests and Spearman correlational analysis were used to assess differences in the AHD before and after each task and the relationships between pain, subject characteristics, and the AHD measures. A significant reduction in the subacromial space (P<0.01) occurred when subjects performed a WR position compared to baseline. Individuals with increased years of disability had greater AHD percentage narrowing after WR (P=0.008). Increased shoulder pain was associated with AHD percentage narrowing after ER (P≤0.007). The results support clinical practice guidelines that recommend MWUs limit WR to preserve shoulder function. The isolated repetitive shoulder activity did not contribute to the changes of subacromial space in MWUs. The ultrasonographic measurement of the AHD may be a target for identifying future interventions that prevent pain.

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Videogames as Therapy

Handbook of Research on ICTs and Management Systems for Improving Efficiency in Healthcare and Social Care ◽

10.4018/978-1-4666-3990-4.ch003 ◽

2013 ◽

pp. 43-68 ◽

Cited By ~ 12

Author(s):

Mark Griffiths ◽

Daria J. Kuss ◽

Angelica B. Ortiz de Gortari

Keyword(s):

Communication Skills ◽

Cognitive Rehabilitation ◽

Brain Injuries ◽

The Elderly ◽

Learning Disabled ◽

Stroke Patients ◽

Wheelchair Users ◽

Therapeutic Benefits ◽

History Of

There is a long history of using videogames in a therapeutic capacity, including rehabilitation for stroke patients, people with traumatic brain injuries, burns victims, wheelchair users, Erb’s palsy sufferers, children undergoing chemotherapy, children with muscular dystrophy, and autistic children. This chapter briefly examines a number of areas including: (1) videogames as physiotherapy and occupational therapy, (2) videogames as distractors in the role of pain management, (3) videogames and cognitive rehabilitation, (4) videogames and the development of social and communication skills among the learning disabled, (5) videogames and impulsivity/attention deficit disorders, (6) videogames and therapeutic benefits in the elderly, (7) videogames in psychotherapeutic settings, (8) videogames and health care, and (9) videogames and anxiety disorders. It is concluded that there has been considerable success when games are designed to address a specific problem or to teach a certain skill. However, generalizability outside the game-playing situation remains an important consideration.

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Obstacle Avoidance of Omnidirectional Intelligent Wheelchair Based on Multi-Sensors

Applied Mechanics and Materials ◽

10.4028/www.scientific.net/amm.742.590 ◽

2015 ◽

Vol 742 ◽

pp. 590-593 ◽

Cited By ~ 1

Author(s):

Xiu Zhi Li ◽

Zhao Liu ◽

Song Min Jia

Keyword(s):

Obstacle Avoidance ◽

Information Fusion ◽

Visual Information ◽

Distance Information ◽

Wheelchair Users ◽

Optical Flow Method ◽

Intelligent Wheelchair ◽

Handicapped People ◽

Relevant Community

As the number of handicapped people increases worldwidely, the role of electric wheelchair becomes important to enhance their mobility. In the relevant community, attention is mainly directed to how to solve the problems in motion control for the wheelchair users, and scarce reports have appeared concerning obstacle avoidance of wheelchair. In this paper, we present a new method of obstacle avoidance for omnidirectional intelligent wheelchair bases on multi-sensors information fusion. Distance information acquired from ultrasonic sensors and visual information acquired from monocular camera are combined together, in which optical flow method is employed to distinguish obstacles. Extensive experiments have been conducted in the laboratory. As shown in experimental results that, the developed omnidirectional intelligent wheelchair works correctly and effectively in obstacle avoidance.

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