Technology to enhance locomotor function

2020 ◽  
pp. 461-476
Author(s):  
Rüdiger Rupp ◽  
Daniel Schließmann ◽  
Christian Schuld ◽  
Norbert Weidner
Keyword(s):  
Central Nervous System ◽  
Gait Training ◽  
Gait Rehabilitation ◽  
Compensatory Strategies ◽  
Life Conditions ◽  
Walking Aids ◽  
Training Quality ◽  
The Central Nervous System ◽  
Task Oriented ◽  
Time Movement

Technology plays an important role in the rehabilitation of patients with impairments of the lower extremity due to disease or trauma of the central nervous system (CNS). In gait rehabilitation, compensatory or restorative strategies are applied depending on the time after trauma and the severity of impairment. Advances in the understanding of CNS plasticity led to the establishment of task-oriented restorative therapies, first of all body weight supported treadmill training, either manually or robotically assisted. Although robotic therapies have not been shown to be superior, they relieve therapists from the exhaustive work of assisting the stepping movements. At this point, locomotion robots provide advanced therapeutic options like intensive gait training also at home and improvement of training quality through the integration of real-time movement feedback. For enhancement of mobility in individuals with severe sensorimotor impairments and the associated limited potential for recovery, compensatory strategies including wheelchairs and more recently active exoskeletons need to be considered. It will be exciting to see whether technological progress in mechatronics, energy storage, and intuitive control will result in exoskeletons capable of replacing traditional walking aids in everyday life conditions.

Technology to enhance locomotor function

2015 ◽  
pp. 385-398 ◽  
Author(s):  
Rüdiger Rupp ◽  
Daniel Schließmann ◽  
Christian Schuld ◽  
Norbert Weidner
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Gait Rehabilitation ◽  
Compensatory Strategies ◽  
Robotic Locomotion ◽  
The Central Nervous System ◽  
Intrinsic Capacity ◽  
Sensorimotor Impairment ◽  
Robotic Devices ◽  
Task Oriented

Technology plays an important role in the rehabilitation of patients with impairments of the lower extremity due to disease or trauma of the central nervous system. In gait rehabilitation compensatory or restorative strategies are applied depending on the time after trauma and the level of impairment. Over the last 20 years advances in the understanding of the intrinsic capacity of the central nervous system for plasticity and recovery led to the establishment of task-oriented restorative therapies: body weight supported treadmill training, either manually assisted or with robotic devices. The effectiveness of robotic locomotion systems will only improve by consequent implementation of principles of motor learning. For enhancement of mobility in individuals with severe sensorimotor impairment of the lower extremities compensatory strategies including the implementation of wheelchairs and more recently active exoskeletons need to be considered.

scholarly journals Systematic review on wearable lower-limb exoskeletons for gait training in neuromuscular impairments

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Antonio Rodríguez-Fernández ◽  
Joan Lobo-Prat ◽  
Josep M. Font-Llagunes
Keyword(s):  
Systematic Review ◽  
Clinical Efficacy ◽  
Lower Limb ◽  
Gait Training ◽  
Health Conditions ◽  
Current Evidence ◽  
Clinical Aspects ◽  
Gait Rehabilitation ◽  
Comprehensive Overview ◽  
Walking Aids

AbstractGait disorders can reduce the quality of life for people with neuromuscular impairments. Therefore, walking recovery is one of the main priorities for counteracting sedentary lifestyle, reducing secondary health conditions and restoring legged mobility. At present, wearable powered lower-limb exoskeletons are emerging as a revolutionary technology for robotic gait rehabilitation. This systematic review provides a comprehensive overview on wearable lower-limb exoskeletons for people with neuromuscular impairments, addressing the following three questions: (1) what is the current technological status of wearable lower-limb exoskeletons for gait rehabilitation?, (2) what is the methodology used in the clinical validations of wearable lower-limb exoskeletons?, and (3) what are the benefits and current evidence on clinical efficacy of wearable lower-limb exoskeletons? We analyzed 87 clinical studies focusing on both device technology (e.g., actuators, sensors, structure) and clinical aspects (e.g., training protocol, outcome measures, patient impairments), and make available the database with all the compiled information. The results of the literature survey reveal that wearable exoskeletons have potential for a number of applications including early rehabilitation, promoting physical exercise, and carrying out daily living activities both at home and the community. Likewise, wearable exoskeletons may improve mobility and independence in non-ambulatory people, and may reduce secondary health conditions related to sedentariness, with all the advantages that this entails. However, the use of this technology is still limited by heavy and bulky devices, which require supervision and the use of walking aids. In addition, evidence supporting their benefits is still limited to short-intervention trials with few participants and diversity among their clinical protocols. Wearable lower-limb exoskeletons for gait rehabilitation are still in their early stages of development and randomized control trials are needed to demonstrate their clinical efficacy.

scholarly journals Gait Rehabilitation Device in Central Nervous System Disease: A Review

2011 ◽  
Vol 2011 ◽  
pp. 1-14 ◽  
Author(s):  
Kazuya Kubo ◽  
Takanori Miyoshi ◽  
Akira Kanai ◽  
Kazuhiko Terashima
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Central Nervous System Disease ◽  
Gait Training ◽  
Lower Limbs ◽  
Nervous System Disease ◽  
Gait Rehabilitation ◽  
System Disease ◽  
Physical Burden ◽  
Rehabilitation Devices

Central nervous system diseases cause the gait disorder. Early rehabilitation of a patient with central nervous system disease is shown to be benefit. However, early gait training is difficult because of muscular weakness and those elderly patients who lose of leg muscular power. In the patient's walking training, therapists assist the movement of patient's lower limbs and control the movement of patient's lower limbs. However the assistance for the movement of the lower limbs is a serious hard labor for therapists. Therefore, research into and development of various gait rehabilitation devices is currently underway to identify methods to alleviate the physical burden on therapists. In this paper, we introduced the about gait rehabilitation devices in central nervous system disease.

scholarly journals Systematic Review on Wearable Lower-Limb Exoskeletons for Gait Training in Neuromuscular Impairments

2020 ◽  
Author(s):  
Antonio Rodríguez-Fernández ◽  
Joan Lobo-Prat ◽  
Josep M. Font-Llagunes
Keyword(s):  
Systematic Review ◽  
Clinical Efficacy ◽  
Lower Limb ◽  
Gait Training ◽  
Health Conditions ◽  
Current Evidence ◽  
Clinical Aspects ◽  
Gait Rehabilitation ◽  
Comprehensive Overview ◽  
Walking Aids

Abstract Gait disorders can reduce the quality of life for people with neuromuscular impairments. Therefore, walking recovery is one of the main priorities for counteracting sedentary lifestyle, reducing secondary health conditions and restoring legged mobility. At present, wearable powered lower-limb exoskeletons are emerging as a revolutionary technology for robotic gait rehabilitation. This systematic review provides a comprehensive overview on wearable lower-limb exoskeletons for people with neuromuscular impairments, addressing the following three questions: (1) what is the current technological status of wearable lower-limb exoskeletons for gait rehabilitation?, (2) what is the methodology used in the clinical validations of wearable lower-limb exoskeletons?, and (3) what are the benefits and current evidence on clinical efficacy of wearable lower-limb exoskeletons? We analyzed 87 clinical studies focusing on both device technology (e.g., actuators, sensors, structure) and clinical aspects (e.g., training protocol, outcome measures, patient impairments), and make available the database with all the compiled information. The results of the literature survey reveal that wearable exoskeletons have potential for a number of applications including early rehabilitation, promoting physical exercise, and carrying out daily living activities both at home and the community. Likewise, wearable exoskeletons may improve mobility and independence in non-ambulatory people, and may reduce secondary health conditions related to sedentariness, with all the advantages that this entails. However, the use of this technology is still limited by heavy and bulky devices, which require supervision and the use of walking aids. In addition, evidence supporting their benefits is still limited to short-intervention trials with few participants and diversity among their clinical protocols. Wearable lower-limb exoskeletons for gait rehabilitation are still in their early stages of development and randomized control trials are needed to demonstrate their clinical efficacy.

scholarly journals Systematic Review on Wearable Lower-Limb Exoskeletons for Gait Training in Neuromuscular Impairments

2020 ◽  
Author(s):  
Antonio Rodríguez-Fernández ◽  
Joan Lobo-Prat ◽  
Josep M. Font-Llagunes
Keyword(s):  
Systematic Review ◽  
Clinical Efficacy ◽  
Lower Limb ◽  
Gait Training ◽  
Health Conditions ◽  
Current Evidence ◽  
Clinical Aspects ◽  
Gait Rehabilitation ◽  
Comprehensive Overview ◽  
Walking Aids

Abstract Gait disorders can reduce the quality of life for people with neuromuscular impairments. Therefore, walking recovery is one of the main priorities for counteracting sedentary lifestyle, reducing secondary health conditions and restoring legged mobility. At present, wearable powered lower-limb exoskeletons are emerging as a revolutionary technology for robotic gait rehabilitation. This systematic review provides a comprehensive overview on wearable lower-limb exoskeletons for people with neuromuscular impairments, addressing the following three questions: (1) what is the current technological status of wearable lower-limb exoskeletons for gait rehabilitation?, (2) what are the benefits and risks for exoskeleton users?, and (3) what is the current evidence on clinical efficacy for wearable exoskeletons?. We analyzed 87 clinical studies focusing on both device technology (e.g., actuators, sensors, structure) and clinical aspects (e.g., training protocol, outcome measures, patient impairments), and make available the database with all the compiled information. The results of the literature survey reveal that wearable exoskeletons have potential for a number of applications including early rehabilitation, promoting physical exercise, and carrying out daily living activities both at home and the community. Likewise, wearable exoskeletons may improve mobility and independence in non-ambulatory people, and may reduce secondary health conditions related to sedentariness, with all the advantages that this entails. However, the use of this technology is still limited by heavy and bulky devices, which require supervision and the use of walking aids. In addition, evidence supporting their benefits is still limited to short-intervention trials with few participants and diversity among their clinical protocols. Wearable lower-limb exoskeletons for gait rehabilitation are still in their early stages of development and randomized control trials are needed to demonstrate their clinical efficacy.

Effects of Hyperoxia on Lung Utrastructure

1970 ◽  
Vol 28 ◽  
pp. 26-27
Author(s):  
Gladys Harrison
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Light Microscopy ◽  
Oxygen Effects ◽  
Age Dependent ◽  
The Central Nervous System ◽  
The Subject ◽  
Space Age ◽  
Alveolar Septa ◽  
Extensive Damage

With the advent of the space age and the need to determine the requirements for a space cabin atmosphere, oxygen effects came into increased importance, even though these effects have been the subject of continuous research for many years. In fact, Priestly initiated oxygen research when in 1775 he published his results of isolating oxygen and described the effects of breathing it on himself and two mice, the only creatures to have had the “privilege” of breathing this “pure air”.Early studies had demonstrated the central nervous system effects at pressures above one atmosphere. Light microscopy revealed extensive damage to the lungs at one atmosphere. These changes which included perivascular and peribronchial edema, focal hemorrhage, rupture of the alveolar septa, and widespread edema, resulted in death of the animal in less than one week. The severity of the symptoms differed between species and was age dependent, with young animals being more resistant.

Emigration of neutrophils in the central nervous system

1983 ◽  
Vol 41 ◽  
pp. 788-789
Author(s):  
John L.Beggs ◽  
John D. Waggener ◽  
Wanda Miller ◽  
Jane Watkins
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Osmium Tetroxide ◽  
White Blood Cells ◽  
Arterial Perfusion ◽  
E Coli ◽  
Intracisternal Injection ◽  
The Central Nervous System ◽  
Brain And Spinal Cord ◽  
Interendothelial Junctions

Studies using mesenteric and ear chamber preparations have shown that interendothelial junctions provide the route for neutrophil emigration during inflammation. The term emigration refers to the passage of white blood cells across the endothelium from the vascular lumen. Although the precise pathway of transendo- thelial emigration in the central nervous system (CNS) has not been resolved, the presence of different physiological and morphological (tight junctions) properties of CNS endothelium may dictate alternate emigration pathways.To study neutrophil emigration in the CNS, we induced meningitis in guinea pigs by intracisternal injection of E. coli bacteria.In this model, leptomeningeal inflammation is well developed by 3 hr. After 3 1/2 hr, animals were sacrificed by arterial perfusion with 3% phosphate buffered glutaraldehyde. Tissues from brain and spinal cord were post-fixed in 1% osmium tetroxide, dehydrated in alcohols and propylene oxide, and embedded in Epon. Thin serial sections were cut with diamond knives and examined in a Philips 300 electron microscope.

Mammalian Bone Marrow Acetylcholinesterase

1982 ◽  
Vol 40 ◽  
pp. 44-45
Author(s):  
Ezzatollah Keyhani
Keyword(s):  
Central Nervous System ◽  
Bone Marrow ◽  
Nervous System ◽  
Common Property ◽  
Extracellular Medium ◽  
The Central Nervous System ◽  
The Common ◽  
Mammalian Bone

Acetylcholinesterase (EC 3.1.1.7) (ACHE) has been localized at cholinergic junctions both in the central nervous system and at the periphery and it functions in neurotransmission. ACHE was also found in other tissues without involvement in neurotransmission, but exhibiting the common property of transporting water and ions. This communication describes intracellular ACHE in mammalian bone marrow and its secretion into the extracellular medium.

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