Dexteria app. therapy versus conventional hand therapy in stroke

2020 ◽  
Vol 14 (4) ◽  
pp. 221-231
Author(s):  
Neha Sawant ◽  
Meruna Bose ◽  
Shrutika Parab
Keyword(s):  
Peer Review ◽  
Conventional Therapy ◽  
Therapy Group ◽  
Hand Function ◽  
Functional Independence ◽  
Wilcoxon Test ◽  
Fine Motor ◽  
Hand Therapy ◽  
Content Type ◽  
Advanced Therapy

Purpose Hand impairment post-stroke is a very common and important rehabilitation goal for functional independence. Advanced therapy options such as an app. therapy provides repetitive training, which may be beneficial for improving fine motor function. This study aims to evaluate the effect of app-based therapy compared to conventional hand therapy in improving dexterity in individuals with stroke. Methodology In total, 39 individuals within the first year of stroke with Brunnstrom stage of hand recovery IV to VI were randomly divided into three groups. All three groups received 60 min of therapy for 21 sessions over a period of 30 days. Group A received conventional hand therapy; Group B received app. therapy, while Group C received conventional therapy along with the app. therapy. All participants were assessed on the Nine-Hole Peg Test and Jebsen–Taylor Hand Function Test at the beginning and after completion of 21 sessions of intervention. Kruskal–Wallis (H) test and Wilcoxon test were used for statistical analysis. Results All three groups improved on hand function post-treatment. However, Group C demonstrated significant improvement with 16%–58% increase in hand function performance on outcome measures (p < 0.05). Findings Findings of the present study demonstrate improvement in dexterity with the app. therapy and combination therapy, in comparison to conventional therapy alone in individuals with stroke. Originality This experimental study focuses the first time on a structured protocol using an enabling technology adjunct to conventional physical therapy to improve hand function in individuals with stroke, which opens up the further scope in Neurorehabilitation. Peer review The peer review history for this article is available at: https://publons.com/publon/10.1108/ILT-04-2020-0144/

scholarly journals Neurocognitive robot-assisted rehabilitation of hand function: a randomized control trial on motor recovery in subacute stroke

2020 ◽  
Author(s):  
Raffaele Ranzani ◽  
Olivier Lambercy ◽  
Jean-Claude Metzger ◽  
Antonella Califfi ◽  
Stefania Regazzi ◽  
...  
Keyword(s):  
Upper Limb ◽  
Conventional Therapy ◽  
Therapy Group ◽  
Hand Function ◽  
Motor Recovery ◽  
Hand Therapy ◽  
Robot Assisted ◽  
Subacute Stage ◽  
Subacute Stroke ◽  
Conventional Therapy Group

Abstract Background: Hand function is often impaired after stroke, strongly affecting the ability to perform daily activities. Upper limb robotic devices have been developed to complement rehabilitation therapy offered to persons who suffered a stroke, but they rarely focus on the training of hand sensorimotor function. The primary goal of this study was to evaluate whether robot-assisted therapy of hand function following a neurocognitive approach (i.e., combining motor training with somatosensory and cognitive tasks) produces an equivalent decrease in upper limb motor impairment compared to dose-matched conventional neurocognitive therapy, when embedded in the rehabilitation program of inpatients in the subacute stage after stroke. Methods: A parallel-group, randomized controlled trial was conducted on subjects with subacute stroke receiving either conventional or robot-assisted neurocognitive hand therapy using a haptic device. Therapy was provided for 15, 45-minute sessions over four weeks, nested within the standard therapy program. Primary outcome was the change from baseline in the upper extremity part of the Fugl-Meyer Assessment (FMA-UE) after the intervention, which was compared between groups using equivalence testing. Secondary outcome measures included upper limb motor, sensory and cognitive assessments, delivered therapy dose, as well as questionnaires on user technology acceptance. Results: 33 participants with stroke were enrolled. 14 subjects in the robot-assisted and 13 subjects in the conventional therapy group completed the study. At the end of intervention, week 8 and week 32, the robot-assisted/conventional therapy group improved by 7.14/6.85, 7.79/7.31, and 8.64/8.08 points on the FMA-UE, respectively, establishing that motor recovery in the robot-assisted group is non-inferior to that in the control group. Conclusions: Neurocognitive robot-assisted therapy of hand function allows for a non-inferior motor recovery compared to conventional dose-matched neurocognitive therapy when performed during inpatient rehabilitation in the subacute stage. This allows the early familiarization of subjects with stroke to the use of such technologies, as a first step towards minimal therapist supervision in the clinic, or directly at home after hospital discharge, to help increase the dose of hand therapy for persons with stroke. Trial registration: EUDAMED database (CIV-13-02-009921), clinicaltrials.gov (NCT02096445). Registered 26 March 2014 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02096445

A pediatric robotic thumb exoskeleton for at-home rehabilitation

2014 ◽  
Vol 7 (3) ◽  
pp. 233-252 ◽  
Author(s):  
Patrick Aubin ◽  
Kelsey Petersen ◽  
Hani Sallum ◽  
Conor Walsh ◽  
Annette Correia ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Degrees Of Freedom ◽  
Hand Function ◽  
Maximum Efficiency ◽  
Fine Motor ◽  
Content Type ◽  
Flexion Extension ◽  
Linear Force ◽  
At Home

Purpose – Pediatric disorders, such as cerebral palsy and stroke, can result in thumb-in-palm deformity greatly limiting hand function. This not only limits children's ability to perform activities of daily living but also limits important motor skill development. Specifically, the isolated orthosis for thumb actuation (IOTA) is 2 degrees of freedom (DOF) thumb exoskeleton that can actuate the carpometacarpal (CMC) and metacarpophalangeal (MCP) joints through ranges of motion required for activities of daily living. The paper aims to discuss these issues. Design/methodology/approach – IOTA consists of a lightweight hand-mounted mechanism that can be secured and aligned to individual wearers. The mechanism is actuated via flexible cables that connect to a portable control box. Embedded encoders and bend sensors monitor the 2 DOF of the thumb and flexion/extension of the wrist. A linear force characterization was performed to test the mechanical efficiency of the cable-drive transmission and the output torque at the exoskeletal CMC and MCP joints was measured. Findings – Using this platform, a number of control modes can be implemented that will enable the device to be controlled by a patient to assist with opposition grasp and fine motor control. Linear force and torque studies showed a maximum efficiency of 44 percent, resulting in a torque of 2.39±1.06 in.-lbf and 0.69±0.31 in.-lbf at the CMC and MCP joints, respectively. Practical implications – The authors envision this at-home device augmenting the current in-clinic and at-home therapy, enabling telerehabilitation protocols. Originality/value – This paper presents the design and characterization of a novel device specifically designed for pediatric grasp telerehabilitation to facilitate improved functionality and somatosensory learning.

Study on high-temperature wear and mechanism of Al-Si/graphite composites prepared by the die-casting process

2020 ◽  
Vol 72 (10) ◽  
pp. 1153-1158 ◽  
Author(s):  
Yafei Deng ◽  
Xiaotao Pan ◽  
Guoxun Zeng ◽  
Jie Liu ◽  
Sinong Xiao ◽  
...  
Keyword(s):  
Friction Coefficient ◽  
Wear Rate ◽  
Peer Review ◽  
Die Casting ◽  
Casting Machine ◽  
Injection Pressure ◽  
Casting Process ◽  
Matrix Alloy ◽  
Content Type ◽  
The Matrix

Purpose This paper aims to improve the tribological properties of aluminum alloys and reduce their wear rate. Design/methodology/approach Carbon is placed in the model at room temperature, pour 680°C of molten aluminum into the pressure chamber, and then pressed it into the mold containing carbon felt through a die casting machine, and waited for it to cool, which used an injection pressure of 52.8 MPa and held the same pressure for 15 s. Findings The result indicated that the mechanical properties of matrix and composite are similar, and the compressive strength of the composite is only 95% of the matrix alloy. However, the composite showed a low friction coefficient, the friction coefficient of Gr/Al composite is only 0.15, which just is two-third than that of the matrix alloy. Similarly, the wear rate of the composite is less than 4% of the matrix. In addition, the composite can avoid severe wear before 200°C, but the matrix alloy only 100°C. Originality/value This material has excellent friction properties and is able to maintain this excellent performance at high temperatures. Peer review The peer review history for this article is available at: https://publons.com/publon/10.1108/ILT-10-2019-0454/

Socioeconomic effects of pension spending: evidence from Spain

2020 ◽  
Vol 47 (5) ◽  
pp. 599-617
Author(s):  
Fernando Bermejo ◽  
Eladio Febrero ◽  
Andre Fernandes Tomon Avelino
Keyword(s):  
Peer Review ◽  
Social Protection ◽  
Pension System ◽  
Decomposition Analysis ◽  
Value Added ◽  
Total Output ◽  
Alternative View ◽  
Input Output ◽  
Structural Decomposition Analysis ◽  
Content Type

PurposeThe purpose of this study is to provide broader understanding of the significant role that the pension system has in the Spanish economy by estimating the sectoral production, employment and income sustained by pensioners' consumption.Design/methodology/approachBased on input–output tables by the World Input–Output Database and consumption data from the Household Budget Survey by the Spanish Statistical Office, a demoeconomic model is applied to quantify the direct impacts, indirect impacts from interindustry links and induced impacts from income–consumption connections over a nine-year period (2006–2014). Then, the factors driving the evolution of total output, employment and value added during such period have been examined by using structural decomposition analysis.FindingsThe growing participation of consumption by pensioner households in final demand had proven crucial during the 2008 crisis to alleviate the negative trend in production and employment derived from the collapse in consumption suffered by the rest of households.Practical implicationsDetermining the underlying factors driving changes in both employment and income during the 2008 crisis can be of interest in political decision-making on the sustainability of the Spanish pension system.Social implicationsThe results of estimating both the employment and income supported by pensioners' consumption reveal the significant stabilizing effect of the public spending on pensions, particularly during the 2008 crisis.Originality/valueThe current Spanish approach of attaining the pension system sustainability by merely reducing social protection costs ignores the adverse consequences of a lower pensioners' demand. This paper addresses an alternative view in which pension spending is not considered a burden on economic growth but rather a means of improving the level of production and employment.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-01-2019-0047

scholarly journals Sitagliptin on carotid intima-media thickness in type 2 diabetes and hyperuricemia patients: a subgroup analysis of the PROLOGUE study

2021 ◽  
Vol 12 ◽  
pp. 204062232110269
Author(s):  
Yipin Zhao ◽  
Huawei Wang ◽  
Dazhi Ke ◽  
Wei Deng ◽  
Yingying Ji ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Carotid Artery ◽  
Conventional Therapy ◽  
Therapy Group ◽  
Controlled Trial ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Media Thickness ◽  
Significant Difference

Background and Aims: Studies have shown that dipeptidyl peptidase-4 (DDP-4) inhibitors have anti-atherosclerotic effects. However, in the PROLOGUE study, sitagliptin failed to slow the progression of carotid intima-media thickness (CIMT) relative to conventional therapy. We conducted a post hoc analysis of the PROLOGUE study and compared the effects of sitagliptin and conventional therapy on changes in CIMT in subgroups with or without hyperuricemia. Methods: The PROLOGUE study was a randomized controlled trial of 442 patients with type 2 diabetes mellitus (T2DM). Patients were randomized to receive sitagliptin added therapy or conventional therapy. Based on the serum uric acid levels of all study populations in the PROLOGUE study, we divided them into hyperuricemia subgroup ( n = 104) and non-hyperuricemia subgroup ( n = 331). The primary outcome was changed in carotid intima-media thickness (CIMT) parameters compared with baseline during the 24 months treatment period. Results: In the hyperuricemia subgroup, compared with the conventional therapy group, the changes in the mean internal carotid artery (ICA)-IMT and max ICA-IMT at 24 months were significantly lower in the sitagliptin group [−0.233 mm, 95% confidence interval (CI) (−0.419 to 0.046), p = 0.015 and −0.325 mm, 95% CI (−0.583 to −0.068), p = 0.014], although there was no significant difference in the common carotid artery CIMT. Conclusion: The results of our analysis indicated that sitagliptin attenuated the progression of CIMT than conventional therapy in T2DM and hyperuricemia patients.

scholarly journals SME credit constraints and access to informal credit markets in Vietnam

2020 ◽  
Vol 47 (6) ◽  
pp. 787-807 ◽  
Author(s):  
Lan Archer ◽  
Parmendra Sharma ◽  
Jen-Je Su
Keyword(s):  
Peer Review ◽  
Credit Markets ◽  
Credit Constraints ◽  
Policy Implications ◽  
Informal Credit ◽  
Banking Services ◽  
Content Type ◽  
Credit Access ◽  
Access Policy ◽  
Correlated Random Effects

PurposeA review of literature has documented that accessing formal credit and other banking services has always been a crucial challenge for small and medium-sized enterprises (SMEs). The alternative, therefore, tends to be informal channels. However, the credit constraint vis-à-vis informal channel link does not appear to be well documented in the literature. This study aims to investigate whether credit constraints significantly affect the probability of accessing informal credit, as well as the credit values of Vietnamese SMEs.Design/methodology/approachThis study uses a trinary approach and correlated random-effects Probit and Tobit techniques to avoid the incidental coefficients problem.FindingsThe results suggest that relative to unconstrained and partially constrained firms, fully constrained firms tend to be more active in the informal credit markets, shown by their higher probability of informal credit access and larger credit values.Originality/valueTo the best of authors’ knowledge, this is the first study on Vietnam that takes a different approach to credit constraints and examines their impact on informal credit access. Policy implications arise and are discussed.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-11-2017-0543

scholarly journals On the way home: a BCI-FES hand therapy self-managed by sub-acute SCI participants and their caregivers: a usability study

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Anna Zulauf-Czaja ◽  
Manaf K. H. Al-Taleb ◽  
Mariel Purcell ◽  
Nina Petric-Gray ◽  
Jennifer Cloughley ◽  
...  
Keyword(s):  
Computer Literacy ◽  
Hand Function ◽  
Training Session ◽  
Transfer Of Knowledge ◽  
Wrist Flexion ◽  
Hand Therapy ◽  
The People ◽  
Custom Made ◽  
Cord Injury ◽  
Set Up

Abstract Background Regaining hand function is the top priority for people with tetraplegia, however access to specialised therapy outwith clinics is limited. Here we present a system for hand therapy based on brain-computer interface (BCI) which uses a consumer grade electroencephalography (EEG) device combined with functional electrical stimulation (FES), and evaluate its usability among occupational therapists (OTs) and people with spinal cord injury (SCI) and their family members. Methods Users: Eight people with sub-acute SCI (6 M, 2F, age 55.4 ± 15.6) and their caregivers (3 M, 5F, age 45.3 ± 14.3); four OTs (4F, age 42.3 ± 9.8). User Activity: Researchers trained OTs; OTs subsequently taught caregivers to set up the system for the people with SCI to perform hand therapy. Hand therapy consisted of attempted movement (AM) of one hand to lower the power of EEG sensory-motor rhythm in the 8-12 Hz band and thereby activate FES which induced wrist flexion and extension. Technology: Consumer grade wearable EEG, multichannel FES, custom made BCI application. Location: Research space within hospital. Evaluation: donning times, BCI accuracy, BCI and FES parameter repeatability, questionnaires, focus groups and interviews. Results Effectiveness: The BCI accuracy was 70–90%. Efficiency: Median donning times decreased from 40.5 min for initial session to 27 min during last training session (N = 7), dropping to 14 min on the last self-managed session (N = 3). BCI and FES parameters were stable from session to session. Satisfaction: Mean satisfaction with the system among SCI users and caregivers was 3.68 ± 0.81 (max 5) as measured by QUEST questionnaire. Main facilitators for implementing BCI-FES technology were “seeing hand moving”, “doing something useful for the loved ones”, good level of computer literacy (people with SCI and caregivers), “active engagement in therapy” (OT), while main barriers were technical complexity of setup (all groups) and “lack of clinical evidence” (OT). Conclusion BCI-FES has potential to be used as at home hand therapy by people with SCI or stroke, provided it is easy to use and support is provided. Transfer of knowledge of operating BCI is possible from researchers to therapists to users and caregivers. Trial registration Registered with NHS GG&C on December 6th 2017; clinicaltrials.gov reference number NCT03257982, url: https://clinicaltrials.gov/ct2/show/NCT03257982.

scholarly journals Early Administration of Tolvaptan Can Improve Survival in Patients with Cirrhotic Ascites

2021 ◽  
Vol 10 (2) ◽  
pp. 294
Author(s):  
Atsushi Hosui ◽  
Takafumi Tanimoto ◽  
Toru Okahara ◽  
Munehiro Ashida ◽  
Kohsaku Ohnishi ◽  
...  
Keyword(s):  
Conventional Therapy ◽  
Low Dose ◽  
Therapy Group ◽  
Survival Rates ◽  
Refractory Ascites ◽  
High Dose ◽  
Term Survival ◽  
Conventional Therapy Group ◽  
One Year ◽  
The One

(1) Backgrounds and aim: Tolvaptan, a selective vasopressin type 2 receptor antagonist, was approved for ascites, and its short-term efficacy and safety have been confirmed. However, it is still unclear whether this novel drug may improve long-term survival rates in cirrhotic patients with ascites. (2) Patients and methods: A total of 206 patients who responded insufficiently to conventional diuretics and were hospitalized for refractory ascites for the first time were retrospectively enrolled in this study. Among them, the first 57 consecutive patients were treated with conventional diuretics (the conventional therapy group); the latter 149 consecutive patients were treated with tolvaptan in addition to the conventional therapy (the tolvaptan group). (3) Results: The exacerbation of renal function was significantly milder in the tolvaptan group than in the conventional therapy group. The prognostic factors for survival in the tolvaptan group were being male, having hyperbilirubinemia, having a high blood urea nitrogen (BUN), and receiving high-dose furosemide at the start of tolvaptan treatment. The one-year and three-year cumulative survival rates were 67.8 and 45.3%, respectively, in patients with low-dose furosemide (<40 mg/day) at the start of tolvaptan treatment. The prognosis was significantly better in the tolvaptan group with low-dose furosemide than in the conventional therapy group (p < 0.001). (4) Conclusion: Tolvaptan can improve survival in patients with cirrhotic ascites, especially when tolvaptan is started before high-dose furosemide administration.

Artificial intelligence research in agriculture: a review

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Amit Sood ◽  
Rajendra Kumar Sharma ◽  
Amit Kumar Bhardwaj
Keyword(s):  
Artificial Intelligence ◽  
Peer Review ◽  
Diffusion Of Innovation ◽  
Comprehensive Review ◽  
Content Type ◽  
Design Elements ◽  
Extant Literature ◽  
Use Of Technology ◽  
Challenges And Opportunities ◽  
Market Factors

PurposeThe purpose of this paper is to provide a comprehensive review on the academic journey of artificial intelligence (AI) in agriculture and to highlight the challenges and opportunities in adopting AI-based advancement in agricultural systems and processes.Design/methodology/approachThe authors conducted a bibliometric analysis of the extant literature on AI in agriculture to understand the status of development in this domain. Further, the authors proposed a framework based on two popular theories, namely, diffusion of innovation (DOI) and the unified theory of acceptance and use of technology (UTAUT), to identify the factors influencing the adoption of AI in agriculture.FindingsFour factors were identified, i.e. institutional factors, market factors, technology factors and stakeholder perception, which influence adopting AI in agriculture. Further, the authors indicated challenges under environmental, operational, technological, economical and social categories with opportunities in this area of research and business.Research limitations/implicationsThe proposed conceptual model needs empirical validation across countries or states to understand the effectiveness and relevance.Practical implicationsPractitioners and researchers can use these inputs to develop technology and business solutions with specific design elements to gain benefit of this technology at larger scale for increasing agriculture production.Social implicationsThis paper brings new developed methods and practices in agriculture for betterment of society.Originality/valueThis paper provides a comprehensive review of extant literature and presents a theoretical framework for researchers to further examine the interaction of independent variables responsible for adoption of AI in agriculture.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/OIR-10-2020-0448

Introduction of a new AAC symbol classification system: the multidimensional quaternary symbol continuum (MQSC)

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Eliada Pampoulou ◽  
Donald R. Fuller
Keyword(s):  
Peer Review ◽  
Classification System ◽  
Augmentative And Alternative Communication ◽  
Social Issues ◽  
Content Type ◽  
Design Attributes ◽  
Wide Range ◽  
Current Classification ◽  
Symbol Classification

PurposeWhen the augmentative and alternative communication (ACC) model (Lloyd et al., 1990) was proposed, these components of symbols were not considered, nor were they contemplated when superordinate (Lloyd and Fuller, 1986) and subordinate levels (Fuller et al., 1992) of AAC symbol taxonomy were developed. The purpose of this paper is to revisit the ACC model and propose a new symbol classification system called multidimensional quaternary symbol continuum (MQSC)Design/methodology/approachThe field of AAC is evolving at a rapid rate in terms of its clinical, social, research and theoretical underpinnings. Advances in assessment and intervention methods, technology and social issues are all responsible to some degree for the significant changes that have occurred in the field of AAC over the last 30 years. For example, the number of aided symbol collections has increased almost exponentially over the past couple of decades. The proliferation of such a large variety of symbol collections represents a wide range of design attributes, physical attributes and linguistic characteristics for aided symbols and design attributes and linguistic characteristics for unaided symbols.FindingsTherefore, it may be time to revisit the AAC model and more specifically, one of its transmission processes referred to as the means to represent.Originality/valueThe focus of this theoretical paper then, is on the current classification of symbols, issues with respect to the current classification of symbols in terms of ambiguity of terminology and the evolution of symbols, and a proposal for a new means of classifying the means to represent.Peer reviewThe peer review history for this article is available at: https://publons.com/publon10.1108/JET-04-2021-0024

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