scholarly journals Recovery of Distal Arm Movements in Spinal Cord Injured Patients with a Body-Machine Interface: A Proof-of-Concept Study

Sensors ◽  
2021 ◽  
Vol 21 (6) ◽  
pp. 2243 ◽  
Author(s):  
Camilla Pierella ◽  
Elisa Galofaro ◽  
Alice De Luca ◽  
Luca Losio ◽  
Simona Gamba ◽  
...  

Background: The recovery of upper limb mobility and functions is essential for people with cervical spinal cord injuries (cSCI) to maximize independence in daily activities and ensure a successful return to normality. The rehabilitative path should include a thorough neuromotor evaluation and personalized treatments aimed at recovering motor functions. Body-machine interfaces (BoMI) have been proven to be capable of harnessing residual joint motions to control objects like computer cursors and virtual or physical wheelchairs and to promote motor recovery. However, their therapeutic application has still been limited to shoulder movements. Here, we expanded the use of BoMI to promote the whole arm’s mobility, with a special focus on elbow movements. We also developed an instrumented evaluation test and a set of kinematic indicators for assessing residual abilities and recovery. Methods: Five inpatient cSCI subjects (four acute, one chronic) participated in a BoMI treatment complementary to their standard rehabilitative routine. The subjects wore a BoMI with sensors placed on both proximal and distal arm districts and practiced for 5 weeks. The BoMI was programmed to promote symmetry between right and left arms use and the forearms’ mobility while playing games. To evaluate the effectiveness of the treatment, the subjects’ kinematics were recorded while performing an evaluation test that involved functional bilateral arms movements, before, at the end, and three months after training. Results: At the end of the training, all subjects learned to efficiently use the interface despite being compelled by it to engage their most impaired movements. The subjects completed the training with bilateral symmetry in body recruitment, already present at the end of the familiarization, and they increased the forearm activity. The instrumental evaluation confirmed this. The elbow motion’s angular amplitude improved for all subjects, and other kinematic parameters showed a trend towards the normality range. Conclusion: The outcomes are preliminary evidence supporting the efficacy of the proposed BoMI as a rehabilitation tool to be considered for clinical practice. It also suggests an instrumental evaluation protocol and a set of indicators to assess and evaluate motor impairment and recovery in cSCI.

2006 ◽  
Vol 72 (6) ◽  
pp. 525-529 ◽  
Author(s):  
D.L. Franga ◽  
M.L. Hawkins ◽  
R.S. Medeiros ◽  
D. Adewumi

Cervical spinal cord injury is a highly morbid condition frequently associated with cardiovascular instability. This instability may include bradyarrhythmias, as well as hypotension, and usually resolves in a relatively short time. However, over a 3-year period (January 2003–December, 2005), 5 of 30 patients with complete cervical spinal cord injuries seen at our Level I trauma center required placement of permanent cardiac pacemakers for recurrent bradycardia/asystolic events. Strong consideration for pacemaker placement should be given for those spinal cord-injured patients with symptomatic bradyarrhythmic events still occurring 2 weeks after injury.


Radiology ◽  
1978 ◽  
Vol 129 (3) ◽  
pp. 707-711 ◽  
Author(s):  
Jin S. Leo ◽  
R. Thomas Bergeron ◽  
Irvin I. Kricheff ◽  
M. Vallo Benjamin

Author(s):  
Han Ting Wang ◽  
David Williamson ◽  
Mary Francispillai ◽  
Andréanne Richard-Denis ◽  
Martin Albert

2017 ◽  
Vol 13 (8) ◽  
pp. 724-730
Author(s):  
Bethany Hooper ◽  
Michele Verdonck ◽  
Delena Amsters ◽  
Michelle Myburg ◽  
Emily Allan

1985 ◽  
Vol 34 (1) ◽  
pp. 284-288
Author(s):  
Motofumi Komori ◽  
Kunio Sasaki ◽  
Keiichiro Shiba ◽  
Koichiro Yamano ◽  
Takayoshi Ueta ◽  
...  

Neurosurgery ◽  
2011 ◽  
Vol 69 (4) ◽  
pp. 930-941 ◽  
Author(s):  
Yiyan Zheng ◽  
Yi Ping Zhang ◽  
Lisa B E Shields ◽  
Yongjie Zhang ◽  
Marcus W Siu ◽  
...  

2008 ◽  
Vol 13 (2) ◽  
pp. 82-87 ◽  
Author(s):  
Donna Loupus ◽  
Susan Schuetrumpf ◽  
Laura F. Vazquez

Abstract Introduction: Peripherally Inserted Central Catheters (PICCs) are a proven and cost effective alternative to traditional short term central venous catheters inserted via subclavian or jugular vein routes. It has been theorized that persons with cervical spinal cord injury (SCI) are more prone to upper extremity deep venous thrombosis (DVT) post PICC insertion. Purpose: This study was conducted to determine if there is a statistically significant increase in the incidence of PICC-related upper extremity thrombosis in persons with quadriplegia as compared to other patient populations. Methods: A retrospective chart review of 56 PICC insertions, performed on 44 patients, was conducted to identify risk factors associated with symptomatic upper extremity DVTs. Results: The overall incidence of symptomatic DVTs was 7.1% per PICC line insertion (95% CI 2.8% - 17.0%) and 9.1% per patient (95% CI 3.6% - 21.2%) and the number of DVTs per 1,000 catheter days was 3.14. DVT diagnosis was not significantly associated with any of the patient or PICC-related characteristics examined. The incidence of symptomatic DVTs per PICC line insertion was not significantly different than the lowest incidence of thrombosis reported in the scientific literature among all patients receiving PICCs. Conclusions: Results from this study do not suggest that persons with cervical spinal cord injuries are at increased risk for developing upper-extremity DVTs related to PICC insertion. Due to the retrospective nature of the present study and small sample size, prospective studies are recommended to further examine DVTs in patients' with spinal cord injuries. Estimates from the present study can be used in planning prospective studies.


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