Feedback rehabilitation system for children with problems of Spastic Hemiparesis in the upper extremities

Author(s):  
Jose Luis Gonzalez-Vidal ◽  
Daniel Hernandez Moedano ◽  
Carmen Betsabet Rodriguez Cisneros ◽  
Jose Juan Raygoza Panduro ◽  
Luz Noe Oliva Moreno ◽  
...  
2021 ◽  
Author(s):  
Grigore Burdea ◽  
Nam H. Kim ◽  
Kevin Polistico ◽  
Ashwin Kadaru ◽  
Namrata Grampurohit ◽  
...  

BACKGROUND BrightArm Compact is a new rehabilitation system for upper extremities. It provides bimanual training with gradated gravity loading and mediates interactions with serious games. OBJECTIVE To design and test a robotic rehabilitation table-based virtual rehabilitation system for training upper extremities early post-stroke. METHODS A new robotic rehabilitation table, controllers and adaptive games were developed. Participants underwent 12 experimental sessions in addition to the standard of care. Standardized measures of upper extremity motor impairment and function, depression severity, and cognitive function were administered pre- and post-intervention. Non-standardized measures included game variables and subjective evaluations. RESULTS Two case study participants attained high total arm repetitions per session (504 and 957, respectively), and achieved high grasp and finger extension counts. Training intensity contributed to marked improvements in affected arm shoulder strength (225% and 100%, respectively), grasp strength (27% and 16% increase), 3-finger pinch strength (31% and 15% increase). Shoulder active flexion range increased 17% and 18%, respectively, and elbow active supination was larger by 75% and 58%, respectively. Improvements in motor function were at/above Minimal Clinically Important Difference for Fugl-Meyer Assessment (11 and 10 points), Chedoke Inventory (11 and 14 points) and Upper Extremity Functional Index (19 and 23 points). Cognitive/emotive outcomes were mixed. CONCLUSIONS The design of the robotic rehabilitation table was successfully tested on two participants early post-stroke. Results are encouraging. CLINICALTRIAL ClinicalTrials.gov NCT04252170


Author(s):  
Z. Andrea Sánchez ◽  
T. Santiago Alvarez ◽  
F. Roberto Segura ◽  
C. Tomás Núñez ◽  
P. Urrutia-Urrutia ◽  
...  

2006 ◽  
Vol 2006.81 (0) ◽  
pp. _6-27_
Author(s):  
Masashi OHNISHI ◽  
Hiroyuki HONDA ◽  
Tomio KOYAMA ◽  
Weining ZHANG ◽  
Toshimitsu SUGA

2009 ◽  
Vol 14 (4) ◽  
pp. 1-6
Author(s):  
Christopher R. Brigham

Abstract The AMAGuides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, does not provide a separate mechanism for rating spinal nerve injuries as extremity impairment; radiculopathy was reflected in the spinal rating process in Chapter 17, The Spine and Pelvis. Certain jurisdictions, such as the Federal Employee Compensation Act (FECA), rate nerve root injury as impairment involving the extremities rather than as part of the spine. This article presents an approach to rate spinal nerve impairments consistent with the AMA Guides, Sixth Edition, methodology. This approach should be used only when a jurisdiction requires ratings for extremities and precludes rating for the spine. A table in this article compares sensory and motor deficits according to the AMA Guides, Sixth and Fifth Editions; evaluators should be aware of changes between editions in methodology used to assign the final impairment. The authors present two tables regarding spinal nerve impairment: one for the upper extremities and one for the lower extremities. Both tables were developed using the methodology defined in the sixth edition. Using these tables and the process defined in the AMA Guides, Sixth Edition, evaluators can rate spinal nerve impairments for jurisdictions that do not permit rating for the spine and require rating for radiculopathy as an extremity impairment.


2017 ◽  
Vol 22 (2) ◽  
pp. 3-5
Author(s):  
James B. Talmage ◽  
Jay Blaisdell

Abstract Physicians use a variety of methodologies within the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Sixth Edition, to rate nerve injuries depending on the type of injury and location of the nerve. Traumatic injuries that cause impairment to the peripheral or brachial plexus nerves are rated using Section 15.4e, Peripheral Nerve and Brachial Plexus Impairment, for upper extremities and Section 16.4c, Peripheral Nerve Rating Process, for lower extremities. Verifiable nerve lesions that incite the symptoms of complex regional pain syndrome, type II (similar to the former concept of causalgia), also are rated in these sections. Nerve entrapments, which are not isolated traumatic events, are rated using the methodology in Section 15.4f, Entrapment Neuropathy. Type I complex regional pain syndrome is rated using Section 15.5, Complex Regional Pain Syndrome for upper extremities or Section 16.5, Complex Regional Pain Syndrome for lower extremities. The method for grading the sensory and motor deficits is analogous to the method described in previous editions of AMA Guides. Rating the permanent impairment of the peripheral nerves or brachial plexus is similar to the methodology used in the diagnosis-based impairment scheme with the exceptions that the physical examination grade modifier is never used to adjust the default rating and the names of individual nerves or plexus trunks, as opposed to the names of diagnoses, appear in the far left column of the rating grids.


1986 ◽  
Vol 13 (1) ◽  
pp. 107-118 ◽  
Author(s):  
Norman S. Levine ◽  
Robert T. Buchanan
Keyword(s):  

2020 ◽  
Vol 46 (3) ◽  
pp. 175-181
Author(s):  
Marcelo Bighetti Toniollo ◽  
Mikaelly dos Santos Sá ◽  
Fernanda Pereira Silva ◽  
Giselle Rodrigues Reis ◽  
Ana Paula Macedo ◽  
...  

Rehabilitation with implant prostheses in posterior areas requires the maximum number of possible implants due to the greater masticatory load of the region. However, the necessary minimum requirements are not always present in full. This project analyzed the minimum principal stresses (TMiP, representative of the compressive stress) to the friable structures, specifically the vestibular face of the cortical bone and the vestibular and internal/lingual face of the medullary bone. The experimental groups were as follows: the regular splinted group (GR), with a conventional infrastructure on 3 regular-length Morse taper implants (4 × 11 mm); and the regular pontic group (GP), with a pontic infrastructure on 2 regular-length Morse taper implants (4 × 11 mm). The results showed that the TMiP of the cortical and medullary bones were greater for the GP in regions surrounding the implants (especially in the cervical and apical areas of the same region) but they did not reach bone damage levels, at least under the loads applied in this study. It was concluded that greater stress observed in the GP demonstrates greater fragility with this modality of rehabilitation; this should draw the professional's attention to possible biomechanical implications. Whenever possible, professionals should give preference to use of a greater number of implants in the rehabilitation system, with a focus on preserving the supporting tissue with the generation of less intense stresses.


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