A Co-creation Centre for Accessible Rehabilitation Technology

Background: The prevalence of disabling conditions is increasing globally. Rehabilitation improves function and quality of life across many conditions, particularly when applied intensively. The limited workforce, however, cannot deliver evidence-based intensive rehabilitation. By providing individuals with the tools for self- rehabilitation, technology helps bridge the gap between evidence and practise. Few people, however, can access rehabilitation technology. Barriers such as cost, training, education, portability and poor design stand in the way of equitable access. Our group of engineers and researchers have established a centre dedicated to developing accessible technology through close, frequent engagement with users and industry.Methods: The centre employs a co-creation model, coupling engineering and science with user experience and industrial partnerships to develop accessible technology and associated processes. Due to the complexity and size of the challenge the initial focus is stroke. Recruited through a medical charity, participants, with a wide range of disabilities, use prototype and commercial technology during an 8-week rehabilitation programme with supervision from health professionals. The centre includes de-weighting systems, neurostimulation, virtual reality, treadmills, bespoke rehab games, communication apps, powered exercise equipment and gamified resistance equipment. Standard outcome measures (International Classification of Functioning, Disability and Health) are recorded before, during, immediately after, and 3 months after the intervention and used in combination with an interview to design the initial rehabilitation programme, which is reviewed fortnightly. Qualitative methods (surveys and interviews) are used to capture personal experiences of the programme and individual technology and an advisory group of stroke survivors help interpret outcomes to feed into the technology design process. Ethical approval has been granted for a pilot cohort study with stroke survivors, which is currently underway (01/09/2021–31/12/2021) investigating acceptability and feasibility, due to report findings in 2022.Discussion: Through partnerships, research collaborations and a co-creation model a new centre dedicated to the development of accessible rehabilitation technology has been launched and currently undergoing acceptability and feasibility testing with stroke survivors. The centre, through its close engagement with users and industry, has the potential to transform the way rehabilitation technology is developed and help revolutionise the way rehabilitation is delivered.

Reduction of Energy Consumption for Water Wells Rehabilitation. Technology Optimization

Groundwater wells are widely used in the energy sector, including for drinking water supplies and as water source wells in the oil and gas industry to increase production of natural gas and petroleum. Water well clogging, which can happen to any well for various reasons, is a serious problem that can lead to increased power costs due to a higher head to the pump, a reduction in the flow rate and various drawdown issues. If rehabilitation procedures do not take place in time, this can result in permanent loss of the well, and a new well must be drilled, which is not a sustainable approach. Rehabilitation methods for water wells usually include mechanical and chemical treatments, and even though these methods are well established and have been used for many years we can still observe many abandoned wells which could be rehabilitated. In this study, sets of cavitation generators are developed and used in combination with common conic hydrodynamic nozzles. This combination reduces the pressure in the system and makes the cleaning setup much lighter and more mobile. The designed nozzles were successfully used in hydrodynamic cleaning of four water wells.

Current trends in the rehabilitation of patients with spastic paresis with focal brain damage

Spasticity is one of the most frequent movement disorders and its development is associated with such CNS lesions as stroke, multiple sclerosis, cerebral palsy, craniocerebral and spinal injuries, CNS tumors, neurodegenerative diseases. Post-stroke spasticity develops in about 40% of patients, and about 15% of patients have severe and disabling spasticity. According to statistics, after TBI, about 75% of patients develop spasticity, and half of them require treatment.Spasticity worsens walking, complicates hygiene, dressing, complicates rehabilitation measures, and reduces the quality of life of patients and his family members. In recent years, this movement disorder has been actively studied, new data have appeared on the pathophysiology of spastic paresis and encouraging data on improving function in patients receiving botulinum toxin injections as part of multidisciplinary rehabilitation.The article presents data from the latest systematic reviews on the effectiveness of various rehabilitation technologies for the treatment of spasticity.The use of botulinum neurotoxin for the treatment of spastic paresis of the upper and lower extremities is the preferred method of complex multidisciplinary rehabilitation of patients with spasticity and has the highest level of evidence.Currently, there is no doubt that botulinum toxin should be used as early as possible in patients with an emerging pathological movement pattern, which can contribute to pattern change and muscle length maintenance. But the question remains: which rehabilitation technology is most effective for enhancing and prolonging the action of botulinum neurotoxin. To date, there is no clear answer to this question.

Correction: Homes of Stroke Survivors Are a Challenging Environment for Rehabilitation Technologies (Preprint)

UNSTRUCTURED The design of digital technologies that support poststroke rehabilitation at home has been a topic of research for some time. If technology is to have a large-scale impact on rehabilitation practice, then we need to understand how to create technologies that are appropriate for the domestic environment and for the needs and motivations of those living there. This paper reflects on the research conducted in the Motivating Mobility project (UK Engineering and Physical Science Research Council: EP/F00382X/1). We conducted sensitizing studies to develop a foundational understanding of the homes of stroke survivors, participatory design sessions situated in the home, and experimental deployments of prototype rehabilitation technologies. We identified four challenges specific to the homes of stroke survivors and relevant to the deployment of rehabilitation technologies: identifying a location for rehabilitation technology, negotiating social relationships present in the home, avoiding additional stress in households at risk of existential stress, and providing for patient safety. We conclude that skilled workers may be needed to enable successful technology deployment, systematizing the mapping of the home may be beneficial, and education is a viable focus for rehabilitation technologies.

Sedimentary Organic Matter Load Influences the Ecological Effects and Potential Risks of Submerged Macrophyte Restoration Through Rhizosphere Metabolites

Aims Rehabilitation of submerged vegetation is one of the commonly used techniques for the ecological restoration of shallow lakes. The changes of pollution structure in sediments caused by plant recovery and the rhizosphere chemical process under different sediment organic matter (SOM) levels are theoretical basis for the rational application of plant rehabilitation technology in lake management.Methods A circulating extraction system was designed for in situ collection of rhizospheric metabolites especially for the submerged plants. We explored how Vallisneria natans (V. natans) mediate the changes in sediment N and P through rhizospheric metabolites under low (4.94%) and high (17.35%) SOM levels. Results By analysing 63 rhizospheric metabolites from V. natans, glucitol was found to be 146.82% lower in the low SOM than in the high SOM treatment. NH4-N and NO2-N increased by 57% and 68.39%, respectively, in the high SOM treatment, while approximately one-seventh Inorg-P was transferred from Fe/Al-P to Ca-P in the low SOM treatment. The metabolites lactic acid, 3-hydroxybutyric acid, and phosphoric acid mediated NH4-N accumulation. Additionally, 3-hydroxy-decanoic acid and adipic acid mediated the transformation of Fe/Al-P to Ca-P.Conclusions The growth of V. natans significantly changed Inorg-N or Inorg-P fractions. The changes were SOM level-dependent and rhizosphere metabolites related. This study emphasised the benefit of V. natans rehabilitation at low SOM level. When restoring submerged macrophytes from high SOM sediment, care should be taken due to the release potential of labile N and P forms.