Efficacy of a Forearm Rotation Orthosis for People With a Hemiparetic Arm

Importance: Insufficient voluntary forearm movements are associated with ineffective and inefficient functional performance among people poststroke. Although evidence supports the application of the occupational therapy task-oriented (OTTO) approach for this population, the training protocol does not explicitly address the role of forearm rotation movements. In addition, a need exists for theoretical support for orthotic interventions for people poststroke. Objective: To examine the efficacy of (1) a forearm rotation orthosis, (2) the OTTO approach, and (3) the combination of the two with people poststroke with a hemiparetic arm. Design: Stratified, randomized, two-group, single-blinded, repeated-measures design. Setting: Rehabilitation clinic. Participants: Participants (N = 14) with a diagnosis of stroke and at least 10° of voluntary shoulder and elbow movement. Intervention: Participants were stratified into three groups by motor function (mild, moderate, severe) and randomly assigned either to 6 wk of no treatment followed by 6 wk of OTTO or to 6 wk of orthotic intervention followed by 6 wk of orthosis plus OTTO. Outcomes and Measures: Primary outcome measures were the Canadian Occupational Performance Measure (COPM), Wolf Motor Function Test (WMFT), and Motor Activity Log (MAL), administered at baseline (Week 1), at the end of Phase 1 (Week 7), and at the end of Phase 2 (Week 15) by blinded evaluators. Results: Both groups showed clinically important improvements on the COPM. No significant differences were found on the WMFT or MAL. Conclusions and Relevance: The OTTO intervention provides clinically important benefits in self-perceived functional performance to people poststroke. What This Article Adds: The OTTO approach is an occupation-focused intervention that aims at functional performance and emphasizes clients' active engagement throughout the process. The findings suggest that the protocol of the OTTO intervention and its efficacy are appropriate for clinical practice.

Rancang bangun alat monitoring fisioterapi pasien pasca stroke menggunakan sensor MPU6050 melalui media transmisi bluetooth

Stroke Transient Ischemic Attack (TIA ) adalah kondisi stroke ringan. Stroke ringan diakibatkan oleh berkurangnya suplai darah menuju otak. Kelumpuhan disebabkan oleh kurangnya aliran darah ke otak, sehingga sisi tubuh akan mengalami kelumpuhan terutama pada siku dan lutut. Fisioterapi pada pasien pasca stroke ringan dilakukan dengan metode terapi gerakan antara lain seperti penggunaan alat bantu fisioterapi pasien pasca stroke menggunakan sensor MPU6050 melalui media transmisi Bluetooth. Sistem rancangan ini membantu latihan pada pasien berbentuk sensor MPU6050 yang digunakan untuk mendeteksi sudut serta banyaknya gerakan rehabilitasi pasien pasca stroke. Sensor gyroscope menghasilkan deteksi sudut pada siku sebesar 150 dan sudut pada lutut sebesar 135 . Data yang didapatkan diproses oleh arduino nano menggunakan metode I2C. Penelitian ini bertujuan untuk merancang alat bantu fisioterapi pasien pasca stroke berbasis mikrokontroler guna memperoleh hasil yang maksimal karena bentuk alat ini yang portable. Stroke Transient Ischemic Attack (TIA) is a mild stroke condition that can be caused by reduced blood supply to the brain due to blocked blood vessels. Lack of blood flow to the brain can cause paralysis, usually only on one side of the body such as the elbows and knees. Physiotherapy in post-stroke patients is carried out using movement therapy methods, including elbow and knee flexion. Currently, patients come to the therapist or vice versa to perform therapeutic movements, so a telemonitoring system for post-stroke patient physiotherapy tools is made using the MPU6050 sensor which is connected to ESP 232 and the internet network and can be monitored by therapists and clinic admins where the therapy is done. This system helps monitor elbow and knew flexion exercises using the MPU6050 sensor which is used to detect the angle and number of rehabilitation movements of post-stroke patients. . From the results of testing the accuracy of this sensor is able to detect the angle of elbow movement from 00-1500 and knee flexion angle of 00-1350 by 99%.The telemonitoring application for physiotherapy tools for post-stroke patients based on Android is equipped with a therapist menu so that the number of movements and the average angle of movement of the knees and elbows can be monitored by the therapist, this tool can also be used anywhere and anytime due to the portable form of this tool.

The Classification of Elbow Extension and Flexion: A feature selection investigation

Nowadays, the worldwide primary reasons of long-term disability is stroke. When the blood supply to your brain is interupted and reduced, stroke occurs as it depriving brain tissue of nutrients and oxygen. In the modern world, advanced technology are revolutionizing the rehabilitation process. This research uses mechanomyography (MMG) and machine learning models to classify the elbow movement, extension and flexion of the elbow joint. The study will aid in the control of an exoskeleton for stroke patient's rehabilitation process in future studies. Five volunteers (21 to 23 years old) were recruited in Universiti Malaysia Pahang (UMP) to execute the right elbow movement of extension and flexion. The movements are repeated five times each for two active muscles for the extension and flexion motion, namely triceps and biceps. From the time domain based MMG signals, twenty-four features were extracted from the MMG before being classified by the machine learning model, namely k-Nearest Neighbors (k-NN). The k-NN has achieved the classification accuracy (CA) with 88.6% as the significant features are identified through the information gain approach. It may well be stated that the suggested process was able to classify the elbow movement well

THE ROLE OF KINETOTHERAPY IN THE RECOVERY OF ELBOW TRAUMA - EPICONDYLITIS IN PERFORMANCE SPORT

This paper presents the most effective ways of early and systematic application of kinetotherapy means and procedures to re-educate the functionality of the elbow. Movement therapy comes into action simultaneously with the other recovery means, within the general therapeutic plan, without excluding other therapies. The treatment of medial epicondylitis caused by overuse of the forearm muscles is a concern for the functional recovery of the elbow. The treatment of functional recovery of the elbow through physiotherapy is based on the functional re-education for the fastest return to the daily activities and sports of the patient. In addition to its curative role, physiotherapy, influencing a series of pathophysiological links, also has a preventive action, by improving the muscle tone of the arm, toning both the muscles of the forearm and the arm and stretching the epicondylis elbow tendons.

The Impact of CPR Position (Kneeling, Footstool and Standing Beside Bed) on Cardiopulmonary Resuscitation Quality: A Literature Review

Background: Cardiopulmonary Resuscitation (CPR) is one of the measures to deal with emergency cardiac arrest (cardiac arrest) where the heart organ loses its function suddenly. Hence it is unable to pump blood throughout the body. CPR consists of aid in circulation (compression) and breathing (ventilation). AHA has determined guidelines for implementing CPR, especially an essential point in CPR, namely chest compression. The standing position is fundamental in the implementation of CPR, but kneeling and footstool positions can be carried out during CPR implementation. This paper aims to show the impact of standing, kneeling, and footstool positions on CPR quality.Method: The method used is by searching journals in Science Direct, PubMed, and Google Scholar. The keywords used are CPR, Kneeling Position, Footstool, standing beside the bed Obtained eight selected journals according to the topic, then analyzed.Results: Based on the search result, eight articles meet the criteria. The literature review results showed three positions that can be chosen when conducting CPR: standing, kneeling, and footstool. Those positions could give impact toward helper: pain level and exhaustion degree, and quality of CPR: compression strength, depth of compression, amount of compression, chest recoil, elbow movement, and movement in the lower back.Conclusion: Three CPR positions can be done, including standing beside the bed, kneeling, and standing on stepstool footing. Each position gives impacts both to helper condition and CPR quality. Researchers recommend standing on stepstool footing due to it provides the best effect on CPR quality.

Explicit feedback and instruction do not change shoulder muscle activity reduction after shoulder fixation

Generating pure elbow rotation requires contracting muscles at both the shoulder and elbow joints to counter torques that arise at the shoulder when the forearm rotates (i.e., intersegmental dynamics). Previous work has shown that human participants learn to reduce their shoulder muscle activity if the same elbow movement is performed after the shoulder joint is mechanically locked, which is appropriate because locking the shoulder joint eliminates the torques that arise at the shoulder when the forearm rotates. However, this learning is slow (i.e., it unfolds over hundreds of trials) and incomplete (i.e., shoulder activity is not fully eliminated). Here we investigated whether and how the addition of explicit strategies and biofeedback modulate this type of learning. Three groups of human participants (N = 55) performed voluntary pure elbow rotations using a robotic exoskeleton that permits shoulder and elbow rotation in a horizontal plane. Participants did the task with the shoulder free to move (baseline), then with the shoulder joint locked by the robotic manipulandum (adaptation), and then with the shoulder free to move again (post-adaptation). The first group of participants performed this protocol and received no instructions about what to do after their shoulder was locked. The second group of participants received visual feedback about their shoulder muscle activity after each movement and was instructed to reduce their shoulder activity to zero. The third group of participants also received visual biofeedback, but it was removed part way through the experiment. We found that, although all groups learned, the rate and magnitude of learning was not reliably different across the groups. Taken together, our results suggest that learning new arm dynamics, unlike other motor learning paradigms, unfolds independent of explicit instructions, biofeedback and task instructions.

Compensatory Trunk Movements in Naturalistic Reaching and Manipulation Tasks in Chronic Stroke Survivors

Impairment of arm movements poststroke often results in the use of compensatory trunk movements to complete motor tasks. These compensatory movements have been mostly observed in tightly controlled conditions, with very few studies examining them in more naturalistic settings. In this study, the authors quantified the presence of compensatory movements during a set of continuous reaching and manipulation tasks performed with both the paretic and nonparetic arm (in 9 chronic stroke survivors) or the dominant arm (in 20 neurologically unimpaired control participants). Kinematic data were collected using motion capture to assess trunk and elbow movement. The authors found that trunk displacement and rotation were significantly higher when using the paretic versus nonparetic arm (P = .03). In contrast, elbow angular displacement was significantly lower in the paretic versus nonparetic arm (P = .01). The reaching tasks required significantly higher trunk compensation and elbow movement than the manipulation tasks. These results reflect increased reliance on compensatory trunk movements poststroke, even in everyday functional tasks, which may be a target for home rehabilitation programs. This study provides a novel contribution to the rehabilitation literature by examining the presence of compensatory movements in naturalistic reaching and manipulation tasks.