scholarly journals The utility of upper limb loading device in determining optimal walking ability in ambulatory individuals with spinal cord injury

2021 ◽  
pp. 1-9
Author(s):  
Makamas Kumprou ◽  
Pipatana Amatachaya ◽  
Thanat Sooknuan ◽  
Preeda Arayawichanon ◽  
Thiwabhorn Thaweewannakij ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Upper Limb ◽  
Lower Limb ◽  
Weight Bearing ◽  
Walking Ability ◽  
Limb Loading ◽  
Cord Injury ◽  
Loading Device ◽  
Walking Performance

Background: Walking devices are frequently prescribed for many individuals, including those with spinal cord injury (SCI), to promote their independence. However, without proper screening and follow-up care, the individuals may continue using the same device when their conditions have progressed, that may possibly worsen their walking ability. Objective: This study developed an upper limb loading device (ULLD), and assessed the possibility of using the tool to determine the optimal walking ability of ambulatory participants with SCI who used a walking device daily ([Formula: see text]). Methods: All participants were assessed for their optimal walking ability, i.e., the ability of walking with the least support device or no device as they could do safely and confidently. The participants were also assessed for their amount of weight-bearing on the upper limbs or upper limb loading while walking, amount of weight-bearing on the lower limbs or lower limb loading while stepping of the other leg, and walking performance. Results: The findings indicated that approximately one third of the participants (31%) could progress their walking ability from their current ability, whereby four participants could even walk without a walking device. The amount of upper limb loading while walking, lower limb loading ability, and walking performance were significantly different among the groups of optimal walking ability ([Formula: see text]). Furthermore, the amount of upper limb loading showed negative correlation to the amount of lower limb loading and walking performance ([Formula: see text] to [Formula: see text]0.493, [Formula: see text]). Conclusion: The findings suggest the potential benefit of using the upper limb loading device and the amount of upper limb loading for walking device prescription, and monitoring the change of walking ability among ambulatory individuals with SCI.

scholarly journals A comparison of passive hindlimb cycling and active upper-limb exercise provides new insights into systolic dysfunction after spinal cord injury

2017 ◽  
Vol 313 (5) ◽  
pp. H861-H870 ◽  
Author(s):  
Kathryn M. DeVeau ◽  
Kathryn A. Harman ◽  
Jordan W. Squair ◽  
Andrei V. Krassioukov ◽  
David S. K. Magnuson ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Upper Limb ◽  
Lower Limb ◽  
Contractile Function ◽  
Left Ventricular ◽  
Cardiac Contractile ◽  
Cord Injury ◽  
Lower Limb Exercise ◽  
Limb Exercise

Active upper-limb and passive lower-limb exercise are two interventions used in the spinal cord injury (SCI) population. Although the global cardiac responses have been previously studied, it is unclear how either exercise influences contractile cardiac function. Here, the cardiac contractile and volumetric responses to upper-limb (swim) and passive lower-limb exercise were investigated in rodents with a severe high-thoracic SCI. Animals were divided into control (CON), SCI no exercise (NO-EX), SCI passive hindlimb cycling (PHLC), or SCI swim (SWIM) groups. Severe contusion SCI was administered at the T2 level. PHLC and SWIM interventions began on day 8 postinjury and lasted 25 days. Echocardiography and dobutamine stress echocardiography were performed before and after injury. Cardiac contractile indexes were assessed in vivo at study termination via a left ventricular pressure-volume conductance catheter. Stroke volume was reduced after SCI (91 µl in the NO-EX group vs. 188 µl in the CON group, P < 0.05) and was reversed at study termination in the PHLC (167 µl) but not SWIM (90 µl) group. Rates of contraction were reduced in NO-EX versus CON groups (6,079 vs. 9,225 mmHg, respectively, P < 0.05) and were unchanged by PHLC and SWIM training. Similarly, end-systolic elastance was reduced in the NO-EX versus CON groups (0.67 vs. 1.37 mmHg/µl, respectively, P < 0.05) and was unchanged by PHLC or SWIM training. Dobutamine infusion normalized all pressure indexes in each SCI group (all P < 0.05). In conclusion, PHLC improves flow-derived cardiac indexes, whereas SWIM training displayed no cardiobeneficial effect. Pressure-derived deficits were corrected only with dobutamine, suggesting that reduced β-adrenergic stimulation is principally responsible for the impaired cardiac contractile function after SCI. NEW & NOTEWORTHY This is the first direct comparison between the cardiac changes elicited by active upper-limb or passive lower-limb exercise after spinal cord injury. Here, we demonstrate that lower-limb exercise positively influences flow-derived cardiac indexes, whereas upper-limb exercise does not. Furthermore, neither intervention corrects the cardiac contractile dysfunction associated with spinal cord injury.

The use of lower limb loading ability as an indicator for independence and safety in ambulatory individuals with spinal cord injury

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Teerawat NITHIATTHAWANON ◽  
Pipatana AMATACHAYA ◽  
Thiwabhorn THAWEEWANNAKIJ ◽  
Nuttaset MANIMMANAKORN ◽  
Lugkana MATO ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Lower Limb ◽  
Limb Loading ◽  
Cord Injury

scholarly journals Design and simulation of a new powered gait orthosis for paraplegic patients

2012 ◽  
Vol 36 (1) ◽  
pp. 125-130 ◽  
Author(s):  
Mokhtar Arazpour ◽  
Ahmad Chitsazan ◽  
Stephen W Hutchins ◽  
Farhad Tabatabai Ghomshe ◽  
Mohammad Ebrahim Mousavi ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Lower Limb ◽  
Healthy Subjects ◽  
Weight Bearing ◽  
Knee Motion ◽  
Powered Gait Orthosis ◽  
Cord Injury ◽  
Good Range ◽  
Flexion And Extension

Background and Aim: This article describes the development and testing of a new powered gait orthosis to potentially assist spinal cord injury patients to walk by producing synchronized hip and knee joint movements.Technique: The first evaluation of the orthosis was performed without users, and was followed by evaluation of the orthosis performance using three healthy subjects to test the structure under weight-bearing conditions. The orthosis was primarily evaluated to ascertain its ability to generate appropriate hip and knee motion during walking. The walking experiments replicated the flexion and extension of both the hip and knee produced by the actuators which had previously been demonstrated during the initial computer simulations.Discussion: The results suggest that this new orthosis could be used to assist paraplegic subjects who have adequate ranges of motion and also with weakness or reduced tone to ambulate, and may also be suitable for other subjects with impaired lower limb function (e.g. stroke, poliomyelitis, myelomeningocele and traumatic brain injury provided they do not have increased tone or movement disorders.Clinical relevanceThe new powered gait orthosis can provide walking assistance for patients with a spinal cord injury who have a good range of motion at the hip and knee and who also have weakness or reduced tone.

Regional musculoskeletal injuries

2020 ◽  
pp. 397-456
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Chest Wall ◽  
Upper Limb ◽  
Lower Limb ◽  
Spinal Fractures ◽  
Musculoskeletal Injuries ◽  
Cord Injury ◽  
Specific Care

Following on from Chapter 9, this chapter describes the specific care and management of regional musculoskeletal injuries. The chapter starts by considering spinal fractures and the care and management of the patient with a spinal cord injury. It then moves on to consider in detail injuries of the upper limb, the chest wall, the pelvis, and the lower limb.

scholarly journals Increased Lower Limb Loading During Sit-to-Stand is Important for the Potential for Walking Progression in Ambulatory Individuals with Spinal Cord Injury

2019 ◽  
Vol 26 (1) ◽  
pp. 99-106
Author(s):  
Lalita Khuna ◽  
◽  
Lugkana Mato ◽  
Pipatana Amatachaya ◽  
Thiwabhorn Thaweewannakij ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Lower Limb ◽  
Sit To Stand ◽  
Limb Loading ◽  
Cord Injury

Immediate effects of lower limb loading exercise during stepping with and without augmented loading feedback on mobility of ambulatory individuals with spinal cord injury: a single-blinded, randomized, cross-over trial

Spinal Cord ◽  
2020 ◽  
Vol 58 (12) ◽  
pp. 1301-1309
Author(s):  
Teerawat Nithiatthawanon ◽  
Pipatana Amatachaya ◽  
Thiwabhorn Thaweewannakij ◽  
Nuttaset Manimmanakorn ◽  
Thanat Sooknuan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Lower Limb ◽  
Limb Loading ◽  
Cord Injury

Using a saddle-assistive device equipped with mechanical orthosis for walking of the person with incomplete spinal cord injury

2021 ◽  
pp. 095441192110201
Author(s):  
Akbar Hojjati Najafabadi ◽  
Saeid Amini ◽  
Farzam Farahmand
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Reaction Force ◽  
Assistive Devices ◽  
Assistive Device ◽  
Walking Ability ◽  
Vertical Force ◽  
Incomplete Spinal Cord Injury ◽  
Combined Application ◽  
Cord Injury

The majority of the people with incomplete spinal cord injury lose their walking ability, due to the weakness of their muscle motors in providing torque. As a result, developing assistive devices to improve their conditionis of great importance. In this study, a combined application of the saddle-assistive device (S-AD) and mechanical medial linkage or thosis was evaluated to improve the walking ability in patients with spinal cord injury in the gait laboratory. This mobile assistive device is called the saddle-assistive device equipped with medial linkage or thosis (S-ADEM). In this device, a mechanical orthosis was used in a wheeled walker as previously done in the literature. Initially, for evaluation of the proposed assistive device, the experimental results related to the forces and torques exerted on the feet and upper limbs of a person with the incomplete Spinal Cord Injury (SCI) during walking usingthe standard walker were compared with an those obtained from using the S-ADEM on an able-bodied subject. It was found that using this combination of assistive devices decreases the vertical force and torque on the foot at the time of walking by 53% and 48%, respectively compared to a standard walker. Moreover, the hand-reaction force on the upper limb was negligible instanding and walking positions usingthe introduced device. The findings of this study revealed that the walking ability of the patients with incomplete SCI was improved using the proposed device, which is due to the bodyweight support and the motion technology used in it.

scholarly journals Brain-Computer-Spinal Interface Restores Upper Limb Function after Spinal Cord Injury

2021 ◽  
pp. 1-1
Author(s):  
Soshi Samejima ◽  
Abed Khorasani ◽  
Vaishnavi Ranganathan ◽  
Jared Nakahara ◽  
Nick M. Tolley ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Upper Limb ◽  
Limb Function ◽  
Upper Limb Function ◽  
Cord Injury

Improving sit-to-stand transition by the saddle-assistive device in the spinal cord injury: A case study

2021 ◽  
pp. 095441192110033
Author(s):  
Akbar Hojjati Najafabadi ◽  
Saeid Amini ◽  
Farzam Farahmand
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Lower Limb ◽  
Reaction Force ◽  
Assistive Device ◽  
Limb Weakness ◽  
Sit To Stand ◽  
Lower Limb Weakness ◽  
Wide Range ◽  
Cord Injury

Physical problems caused by fractures, aging, stroke, and accidents can reduce foot power; these, in the long term, can dwindle the muscles of the waist, thighs, and legs. These conditions provide the basis for the invalidism of the harmed people. In this study, a saddle-walker was designed and evaluated to help people suffering from spinal cord injury and patients with lower limb weakness. This S-AD works based on body weight support against the previously report designs. This saddle-walker consisted of a non-powered four-wheel walker helping to walk and a powered mechanism for the sit-to-stand (STS) transfer. A set of experiments were done on the STS in the use of the standard walker and the saddle-assistive device(S-AD). A comparison of the results showed that this device could reduce the vertical ground reaction force (GRF) of the legs up to 70%. Using this device could help a wide range of patients with lower limb weakness and SCI patients in changing from sitting to standing.

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