Search results for: modified Ashworth scale
8199 A Questionnaire-Based Survey: Therapists Response towards Upper Limb Disorder Learning Tool
Authors: Noor Ayuni Che Zakaria, Takashi Komeda, Cheng Yee Low, Kaoru Inoue, Fazah Akhtar Hanapiah
Abstract:
Previous studies have shown that there are arguments regarding the reliability and validity of the Ashworth and Modified Ashworth Scale towards evaluating patients diagnosed with upper limb disorders. These evaluations depended on the raters’ experiences. This initiated us to develop an upper limb disorder part-task trainer that is able to simulate consistent upper limb disorders, such as spasticity and rigidity signs, based on the Modified Ashworth Scale to improve the variability occurring between raters and intra-raters themselves. By providing consistent signs, novice therapists would be able to increase training frequency and exposure towards various levels of signs. A total of 22 physiotherapists and occupational therapists participated in the study. The majority of the therapists agreed that with current therapy education, they still face problems with inter-raters and intra-raters variability (strongly agree 54%; n = 12/22, agree 27%; n = 6/22) in evaluating patients’ conditions. The therapists strongly agreed (72%; n = 16/22) that therapy trainees needed to increase their frequency of training; therefore believe that our initiative to develop an upper limb disorder training tool will help in improving the clinical education field (strongly agree and agree 63%; n = 14/22).Keywords: upper limb disorder, clinical education tool, inter/intra-raters variability, spasticity, modified Ashworth scale
Procedia PDF Downloads 3108198 Efficacy of Botulinum Toxin in Alleviating Pain Syndrome in Stroke Patients with Upper Limb Spasticity
Authors: Akulov M. A., Zaharov V. O., Jurishhev P. E., Tomskij A. A.
Abstract:
Introduction: Spasticity is a severe consequence of stroke, leading to profound disability, decreased quality of life and decrease of rehabilitation efficacy [4]. Spasticity is often associated with pain syndrome, arising from joint damage of paretic limbs (postural arthropathy) or painful spasm of paretic limb muscles. It is generally accepted that injection of botulinum toxin into a cramped muscle leads to decrease of muscle tone and improves motion range in paretic limb, which is accompanied by pain alleviation. Study aim: To evaluate the change in pain syndrome intensity after incections of botulinum toxin A (Xeomin) in stroke patients with upper limb spasticity. Patients and methods. 21 patients aged 47-74 years were evaluated. Inclusion criteria were: acute stroke 4-7 months before the inclusion into the study, leading to spasticity of wrist and/or finger flexors, elbow flexor or forearm pronator, associated with severe pain syndrome. Patients received Xeomin as monotherapy 90-300 U, according to spasticity pattern. Efficacy evaluation was performed using Ashworth scale, disability assessment scale (DAS), caregiver burden scale and global treatment benefit assessment on weeks 2, 4, 8 and 12. Efficacy criterion was the decrease of pain syndrome by week 4 on PQLS and VAS. Results: The study revealed a significant improvement of measured indices after 4 weeks of treatment, which persisted until the 12 week of treatment. Xeomin is effective in reducing muscle tone of flexors of wrist, fingers and elbow, forearm pronators. By the 4th week of treatment we observed a significant improvement on DAS (р < 0,05), Ashworth scale (1-2 points) in all patients (р < 0,05), caregiver burden scale (р < 0,05). A significant decrease of pain syndrome by the 4th week of treatment on PQLS (р < 0,05) и VAS (р < 0,05) was observed. No adverse effect were registered. Conclusion: Xeomin is an effective treatment of pain syndrome in postural upper limb spasticity after stroke. Xeomin treatment leads to a significant improvement on PQLS and VAS.Keywords: botulinum toxin, pain syndrome, spasticity, stroke
Procedia PDF Downloads 3098197 Correlation of Spirometry with Six Minute Walk Test and Grading of Dyspnoea in COPD Patients
Authors: Anand K. Patel
Abstract:
Background: Patients with COPD have decreased pulmonary functions, which in turn reflect on their day-to-day activities. Objectives: To assess the correlation between functional vital capacity (FVC) and forced expiratory volume in one second (FEV1) with 6 minutes walk test (6MWT). To correlate the Borg rating for perceived exertion scale (Borg scale) and Modified medical research council (MMRC) dyspnea scale with the 6MWT, FVC and FEV1. Method: In this prospective study total 72 patients with COPD diagnosed by the GOLD guidelines were enrolled after taking written consent. They were first asked to rate physical exertion on the Borg scale as well as the modified medical research council dyspnea scale and then were subjected to perform pre and post bronchodilator spirometry followed by 6 minute walk test. The findings were correlated by calculating the Pearson coefficient for each set and obtaining the p-values, with a p < 0.05 being clinically significant. Result: There was a significant correlation between spirometry and 6MWT suggesting that patients with lower measurements were unable to walk for longer distances. However, FVC had the stronger correlation than FEV1. MMRC scale had a stronger correlation with 6MWT as compared to the Borg scale. Conclusion: The study suggests that 6MWT is a better test for monitoring the patients of COPD. In spirometry, FVC should be used in monitoring patients with COPD, instead of FEV1. MMRC scale shows a stronger correlation than the Borg scale, and we should use it more often.Keywords: spirometry, 6 minute walk test, MMRC, Borg scale
Procedia PDF Downloads 2028196 Effects of Preparation Conditions on the Properties of Crumb Rubber Modified Binder
Authors: Baha Vural Kök, Mehmet Yilmaz, Mustafa Akpolat, Cihat Sav
Abstract:
Various types of additives are used frequently in order to improve the rheological and mechanical properties of bituminous mixtures. Small devices instead of full scale machines are used for bitumen modification in the laboratory. These laboratory scale devices vary in terms of their properties such as mixing rate, mixing blade and the amount of binder. In this study, the effect of mixing rate and time during the bitumen modification processes on conventional and rheological properties of pure and crumb rubber modified binder were investigated. Penetration, softening point, rotational viscosity (RV) and dynamic shear rheometer (DSR) tests were applied to pure and CR modified bitumen. It was concluded that the penetration and softening point test did not show the efficiency of CR obtained by different mixing conditions. Besides, oxidation that occurred during the preparation processes plays a great part in the improvement effects of the modified binder.Keywords: bitumen, crumb rubber, modification, rheological properties
Procedia PDF Downloads 3168195 NFResNet: Multi-Scale and U-Shaped Networks for Deblurring
Authors: Tanish Mittal, Preyansh Agrawal, Esha Pahwa, Aarya Makwana
Abstract:
Multi-Scale and U-shaped Networks are widely used in various image restoration problems, including deblurring. Keeping in mind the wide range of applications, we present a comparison of these architectures and their effects on image deblurring. We also introduce a new block called as NFResblock. It consists of a Fast Fourier Transformation layer and a series of modified Non-Linear Activation Free Blocks. Based on these architectures and additions, we introduce NFResnet and NFResnet+, which are modified multi-scale and U-Net architectures, respectively. We also use three differ-ent loss functions to train these architectures: Charbonnier Loss, Edge Loss, and Frequency Reconstruction Loss. Extensive experiments on the Deep Video Deblurring dataset, along with ablation studies for each component, have been presented in this paper. The proposed architectures achieve a considerable increase in Peak Signal to Noise (PSNR) ratio and Structural Similarity Index (SSIM) value.Keywords: multi-scale, Unet, deblurring, FFT, resblock, NAF-block, nfresnet, charbonnier, edge, frequency reconstruction
Procedia PDF Downloads 1368194 The Effects of Mirror Therapy on Clinical Improvement in Hemiplegic Lower Extremity Rehabilitation in Subjects with Chronic Stroke
Authors: Hassan Abo-Salem, Huang Xiaolin
Abstract:
Background and Purpose: The effectiveness of mirror therapy (MT) has been investigated in acute hemiplegia. The present study examines whether MT, given during chronic stroke, was more effective in promoting motor recovery of the lower extremity and walking speed than standard rehabilitation alone. Methods: The study enrolled 30 patients with chronic stroke. Fifteen patients each were assigned to the treatment group and the control group. All patients received a conventional rehabilitation program for a 4-week period. In addition to this rehabilitation program, patients in the treatment group received mirror therapy for 4 weeks, 5 days a week. Main measures: Passive ankle joint dorsiflexion range of motion, gait speed, Brunnstrom stages of motor recovery, plantarflexor muscle tone by Modified Ashworth Scale. Results: Results: No significant difference was found in the outcome measures among groups before treatment. When compared with standard rehabilitation, mirror therapy improved Ankle ROM, Brunnstrom stages and waking speed (p < 0.05). However, there were no significant differences between two groups on MAS (P > 0.05). Conclusions: Mirror therapy combined with a conventional stroke rehabilitation program enhances lower-extremity motor recovery and walking speed in chronic stroke patients.Keywords: mirror therapy, stroke, MAS, walking speed
Procedia PDF Downloads 5078193 Effect of Nitrogen-Based Cryotherapy on the Calf Muscle Spasticity in Stroke Patients
Authors: Engi E. I. Sarhan, Usama M. Rashad, Ibrahim M. I. Hamoda, Mohammed K. Mohamed
Abstract:
Background: This study aimed to know the effect of nitrogen-based cryotherapy on the spasticity of calf muscle in stroke patients. Patients were selected from the outpatient clinic of Neurology, Al-Mansoura general hospital, Al-Mansoura University. Subjects and methods: Thirty Stroke Patients of both sexes ranged from 45 to 60 years old were divided randomly into two equal groups, a study group (A) received a nitrogen-based cryotherapy, a selective physical therapy program and ankle foot orthosis (AFO), while as patients in control group (B) received the same program and AFO only. The treatment duration was three times per week for four weeks for both groups. We assessed spasticity of calf muscle before and after treatment subjectively using modified Ashworth scale (MAS) and objectively via measuring H / M ratio on electromyography machine. We also assessed ankle dorsiflexion ROM objectively using two dimensions motion analysis (2D). Results: After treatment, there was a highly significant improvement in the study group compared to the control group regarding the score of MAS, no significant difference in the study group compared to the control group regarding the readings of H / M ratio, highly significant improvement in the study group compared to the control group regarding the 2D motion analysis findings. Conclusion: This modality considers effective in reducing spasticity in the calf muscle and improving ankle dorsiflexion of the affected limb.Keywords: ankle foot orthosis, nitrogen-based cryotherapy, stroke, spasticity
Procedia PDF Downloads 2028192 Identification of Ice Hockey World Championship International Sports Event through Brand Personality
Authors: Eva Čáslavová, Andrej Višněvský
Abstract:
This research focused on the dimensions of brand personality of the Ice Hockey World Championship sporting event. The authors compared the elements in relation to different demographic groups including gender, age, level of education and student status of the population of Prague. Moreover, the differences of opinions of respondents who had experience of visiting a sports event and those who had not were assessed. In the research, the modified brand personality scale was used. This modified scale consists of five dimensions: responsibility, activity, toughness, individuality and emotionality, none of which was previously tested. The authors had an intentional sample of 291 respondents from Prague available, ranging in age from 18 years to 75 years, with either a high school or university education. The respondents rated the characteristic features in a seven-point Likert Scale and the data was collected in November 2012. The results suggest that the Ice Hockey World Championship is most identified with these dimensions: responsibility, emotionality and activity. Men had higher mean scores (4.93) on the Likert Scale in the emotionality dimension, while women had higher mean scores (4.91) in the activity dimension. Those respondents with experience visiting an Ice Hockey World Championship match had the highest mean score (5.10) in the emotionality dimension. This research had expected to show more pronounced mean values (above six) on the Likert scale in the emotionality and activity dimensions that more strongly characterize the brand personality of the Ice Hockey World Championship, however this expectation was not confirmed.Keywords: dimensions, brand personality, ice hockey, international sports event, marketing
Procedia PDF Downloads 2368191 Comparison of Two Transcranial Magnetic Stimulation Protocols on Spasticity in Multiple Sclerosis - Pilot Study of a Randomized and Blind Cross-over Clinical Trial
Authors: Amanda Cristina da Silva Reis, Bruno Paulino Venâncio, Cristina Theada Ferreira, Andrea Fialho do Prado, Lucimara Guedes dos Santos, Aline de Souza Gravatá, Larissa Lima Gonçalves, Isabella Aparecida Ferreira Moretto, João Carlos Ferrari Corrêa, Fernanda Ishida Corrêa
Abstract:
Objective: To compare two protocols of Transcranial Magnetic Stimulation (TMS) on quadriceps muscle spasticity in individuals diagnosed with Multiple Sclerosis (MS). Method: Clinical, crossover study, in which six adult individuals diagnosed with MS and spasticity in the lower limbs were randomized to receive one session of high-frequency (≥5Hz) and low-frequency (≤ 1Hz) TMS on motor cortex (M1) hotspot for quadriceps muscle, with a one-week interval between the sessions. To assess the spasticity was applied the Ashworth scale and were analyzed the latency time (ms) of the motor evoked potential (MEP) and the central motor conduction time (CMCT) of the bilateral quadriceps muscle. Assessments were performed before and after each intervention. The difference between groups was analyzed using the Friedman test, with a significance level of 0.05 adopted. Results: All statistical analyzes were performed using the SPSS Statistic version 26 programs, with a significance level established for the analyzes at p<0.05. Shapiro Wilk normality test. Parametric data were represented as mean and standard deviation for non-parametric variables, median and interquartile range, and frequency and percentage for categorical variables. There was no clinical change in quadriceps spasticity assessed using the Ashworth scale for the 1 Hz (p=0.813) and 5 Hz (p= 0.232) protocols for both limbs. Motor Evoked Potential latency time: in the 5hz protocol, there was no significant change for the contralateral side from pre to post-treatment (p>0.05), and for the ipsilateral side, there was a decrease in latency time of 0.07 seconds (p<0.05 ); for the 1Hz protocol there was an increase of 0.04 seconds in the latency time (p<0.05) for the contralateral side to the stimulus, and for the ipsilateral side there was a decrease in the latency time of 0.04 seconds (p=<0.05), with a significant difference between the contralateral (p=0.007) and ipsilateral (p=0.014) groups. Central motor conduction time in the 1Hz protocol, there was no change for the contralateral side (p>0.05) and for the ipsilateral side (p>0.05). In the 5Hz protocol for the contralateral side, there was a small decrease in latency time (p<0.05) and for the ipsilateral side, there was a decrease of 0.6 seconds in the latency time (p<0.05) with a significant difference between groups (p=0.019). Conclusion: A high or low-frequency session does not change spasticity, but it is observed that when the low-frequency protocol was performed, there was an increase in latency time on the stimulated side, and a decrease in latency time on the non-stimulated side, considering then that inhibiting the motor cortex increases cortical excitability on the opposite side.Keywords: multiple sclerosis, spasticity, motor evoked potential, transcranial magnetic stimulation
Procedia PDF Downloads 898190 Soil Rehabilitation Using Modified Diatomite: Assessing Chemical Properties, Enzymatic Reactions and Heavy Metal Immobilization
Authors: Maryam Samani. Ahmad Golchin. Hosseinali Alikkani. Ahmad Baybordi
Abstract:
Natural diatomite was modified by grinding and acid treatment to increase surface area and to decrease the impurities. Surface area and pore volume of the modified diatomite were 67.45 m² g-1 and 0.105 cm³ g-¹ respectively, and used to immobilize Pb, Zn and Cu in an urban soil. The modified diatomite was added to soil samples at the rates of 2.5, 5, 7.5 and 10% and the samples incubated for 60 days. The addition of modified diatomite increased SSA of the soil. The SSAs of soils with 2.5, 5.0, 7.5 and 10% modified diatomite were 20.82, 22.02, 23.21 and 24.41 m² g-¹ respectively. Increasing the SSAs of the soils by the application of modified diatomite reduced the DTPA extractable concentrations of heavy metals compared with un-amendment control. The concentration of Pb, Zn and Cu were reduced by 91.1%, 82% and 91.1% respectively. Modified diatomite reduced the concentration of Exchangeable and Carbonate bounded species of Pb, Zn and Cu, compared with the control. Also significantly increased the concentration of Fe Mn- OX (Fe-Mn Oxides) and OM (Organic Matter) bound and Res (Residual) fraction. Modified diatomite increased the urease, dehydrogenase and alkaline phosphatase activity by 52%, 57% and 56.6% respectively.Keywords: modified diatomite, chemical specifications, specific surface area, enzyme activity, immobilization, heavy metal, soil remediation
Procedia PDF Downloads 638189 Identification of the Main Transition Velocities in a Bubble Column Based on a Modified Shannon Entropy
Authors: Stoyan Nedeltchev, Markus Schubert
Abstract:
The gas holdup fluctuations in a bubble column (0.15 m in ID) have been recorded by means of a conductivity wire-mesh sensor in order to extract information about the main transition velocities. These parameters are very important for bubble column design, operation and scale-up. For this purpose, the classical definition of the Shannon entropy was modified and used to identify both the onset (at UG=0.034 m/s) of the transition flow regime and the beginning (at UG=0.089 m/s) of the churn-turbulent flow regime. The results were compared with the Kolmogorov entropy (KE) results. A slight discrepancy was found, namely the transition velocities identified by means of the KE were shifted to somewhat higher (0.045 and 0.101 m/s) superficial gas velocities UG.Keywords: bubble column, gas holdup fluctuations, modified Shannon entropy, Kolmogorov entropy
Procedia PDF Downloads 3288188 Exact Vibration Analysis of a Rectangular Nano-Plate Using Nonlocal Modified Sinusoidal Shear Deformation Theory
Authors: Korosh Khorshidi, Mohammad Khodadadi
Abstract:
In this paper, exact close form solution for out of plate free flexural vibration of moderately thick rectangular nanoplates are presented based on nonlocal modified trigonometric shear deformation theory, with assumptions of the Levy's type boundary conditions, for the first time. The aim of this study is to evaluate the effect of small-scale parameters on the frequency parameters of the moderately thick rectangular nano-plates. To describe the effects of small-scale parameters on vibrations of rectangular nanoplates, the Eringen theory is used. The Levy's type boundary conditions are combination of six different boundary conditions; specifically, two opposite edges are simply supported and any of the other two edges can be simply supported, clamped or free. Governing equations of motion and boundary conditions of the plate are derived by using the Hamilton’s principle. The present analytical solution can be obtained with any required accuracy and can be used as benchmark. Numerical results are presented to illustrate the effectiveness of the proposed method compared to other methods reported in the literature. Finally, the effect of boundary conditions, aspect ratios, small scale parameter and thickness ratios on nondimensional natural frequency parameters and frequency ratios are examined and discussed in detail.Keywords: exact solution, nonlocal modified sinusoidal shear deformation theory, out of plane vibration, moderately thick rectangular plate
Procedia PDF Downloads 3878187 A Modified Nonlinear Conjugate Gradient Algorithm for Large Scale Unconstrained Optimization Problems
Authors: Tsegay Giday Woldu, Haibin Zhang, Xin Zhang, Yemane Hailu Fissuh
Abstract:
It is well known that nonlinear conjugate gradient method is one of the widely used first order methods to solve large scale unconstrained smooth optimization problems. Because of the low memory requirement, attractive theoretical features, practical computational efficiency and nice convergence properties, nonlinear conjugate gradient methods have a special role for solving large scale unconstrained optimization problems. Large scale optimization problems are with important applications in practical and scientific world. However, nonlinear conjugate gradient methods have restricted information about the curvature of the objective function and they are likely less efficient and robust compared to some second order algorithms. To overcome these drawbacks, the new modified nonlinear conjugate gradient method is presented. The noticeable features of our work are that the new search direction possesses the sufficient descent property independent of any line search and it belongs to a trust region. Under mild assumptions and standard Wolfe line search technique, the global convergence property of the proposed algorithm is established. Furthermore, to test the practical computational performance of our new algorithm, numerical experiments are provided and implemented on the set of some large dimensional unconstrained problems. The numerical results show that the proposed algorithm is an efficient and robust compared with other similar algorithms.Keywords: conjugate gradient method, global convergence, large scale optimization, sufficient descent property
Procedia PDF Downloads 2058186 Effects of Virtual Reality on the Upper Extremity Spasticity and Motor Function in Patients with Stroke: A Single Blinded Randomized Controlled Trial
Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini, Omid Seyed Esmaeili, Rouzbeh Kezemi, Noushin Mehrbod, Nazanin Vahed, Tahereh Hajiahmad, Noureddin Nakhostin Ansari
Abstract:
Background: Stroke is a disabling neurological disease. Rehabilitative therapies are important treatment methods. This clinical trial was done to compare the effects of VR beside conventional rehabilitation versus conventional rehabilitation alone on spasticity and motor function in stroke patients. Materials and Methods: In this open-label randomized controlled clinical trial, 40 consecutive patients with stable first-ever ischemic stroke in the past three to 12 months that were referred to a rehabilitation clinic in Tehran, Iran, in 2020 were enrolled. After signing the informed written consent form, subjects were randomly assigned by block randomization of five in each block as cases with 1:1 into two groups of 20 cases; conventional plus VR therapy group: 45-minute conventional therapy session plus 15-minute VR therapy, and conventional group: 60-minute conventional therapy session. VR rehabilitation is designed and developed with different stages. Outcomes were modified Ashworth scale, recovery stage score for motor function, range of motion (ROM) of shoulder abduction/wrist extension, and patients’ satisfaction rate. Data were compared after study termination. Results: The satisfaction rate among the patients was significantly better in the combination group (P=0.003). Only wrist extension was varied between groups and was better in the combination group. The variables generally had a statistically significant difference (P < 0.05). Conclusion: Virtual reality plus conventional rehabilitation therapy is superior versus conventional rehabilitation alone on the wrist and elbow spasticity and motor function in patients with stroke.Keywords: stroke, virtual therapy, rehabilitation, treatment
Procedia PDF Downloads 2278185 Extracorporeal Shock Wave Therapy versus Functional Electrical Stimulation on Spasticity, Function and Gait Parameters in Hemiplegic Cerebral Palsy
Authors: Mohamed A. Eid, Sobhy M. Aly
Abstract:
Background: About 75% of children with spastic hemiplegic cerebral palsy walk independently, but most still show abnormal gait patterns because of contractures across the joints and muscle spasticity. Objective: The purpose of this study was to investigate and compare the effects of extracorporeal shock wave therapy (ESWT) versus functional electrical stimulation (FES) on spasticity, function, and gait parameters in children with hemiplegic cerebral palsy (CP). Methods: A randomized controlled trail was conducted for 45 children with hemiplegic CP ranging in age from 6 to 9 years. They were assigned randomly using opaque envelopes into three groups. Physical Therapy (PT) group consisted of 15 children and received the conventional physical therapy program (CPTP) in addition to ankle foot orthosis (AFO). ESWT group consisted of 15 children and received the CPTP, AFO in addition to ESWT. FES group also consisted of 15 children and received the CPTP, AFO in addition to FES. All groups received the program of treatment 3 days/week for 12 weeks. Evaluation of spasticity by using the Modified Ashworth Scale (MAS), function by using the Pediatric Evaluation Disability Inventory (PEDI) and gait parameters by using the 3-D gait analysis was conducted at baseline and after 12 weeks of the treatment program. Results: Within groups, significant improvements in spasticity, function, and gait (P = 0.05) were observed in both ESWT and FES groups after treatment. While between groups, ESWT group showed significant improvements in all measured variables compared with FES and PT groups (P ˂ 0.05) after treatment. Conclusion: ESWT induced significant improvement than FES in decreasing spasticity and improving function and gait in children with hemiplegic CP. Therefore, ESWT should be included as an adjunctive therapy in the rehabilitation program of these children.Keywords: cerebral palsy, extracorporeal shock wave therapy, functional electrical stimulation, function, gait, spasticity
Procedia PDF Downloads 1308184 Efficient Moment Frame Structure
Authors: Mircea I. Pastrav, Cornelia Baera, Florea Dinu
Abstract:
A different concept for designing and detailing of reinforced concrete precast frame structures is analyzed in this paper. The new detailing of the joints derives from the special hybrid moment frame joints. The special reinforcements of this alternative detailing, named modified special hybrid joint, are bondless with respect to both column and beams. Full scale tests were performed on a plan model, which represents a part of 5 story structure, cropped in the middle of the beams and columns spans. Theoretical approach was developed, based on testing results on twice repaired model, subjected to lateral seismic type loading. Discussion regarding the modified special hybrid joint behavior and further on widening research needed concludes the presentation.Keywords: modified hybrid joint, repair, seismic loading type, acceptance criteria
Procedia PDF Downloads 5238183 The Predictors of Head and Neck Cancer-Head and Neck Cancer-Related Lymphedema in Patients with Resected Advanced Head and Neck Cancer
Authors: Shu-Ching Chen, Li-Yun Lee
Abstract:
The purpose of the study was to identify the factors associated with head and neck cancer-related lymphoedema (HNCRL)-related symptoms, body image, and HNCRL-related functional outcomes among patients with resected advanced head and neck cancer. A cross-sectional correlational design was conducted to examine the predictors of HNCRL-related functional outcomes in patients with resected advanced head and neck cancer. Eligible patients were recruited from a single medical center in northern Taiwan. Consecutive patients were approached and recruited from the Radiation Head and Neck Outpatient Department of this medical center. Eligible subjects were assessed for the Symptom Distress Scale–Modified for Head and Neck Cancer (SDS-mhnc), Brief International Classification of Functioning, Disability and Health (ICF) Core Set for Head and Neck Cancer (BCSQ-H&N), Body Image Scale–Modified (BIS-m), The MD Anderson Head and Neck Lymphedema Rating Scale (MDAHNLRS), The Foldi’s Stages of Lymphedema (Foldi’s Scale), Patterson’s Scale, UCLA Shoulder Rating Scale (UCLA SRS), and Karnofsky’s Performance Status Index (KPS). The results showed that the worst problems with body HNCRL functional outcomes. Patients’ HNCRL symptom distress and performance status are robust predictors across over for overall HNCRL functional outcomes, problems with body HNCRL functional outcomes, and activity and social functioning HNCRL functional outcomes. Based on the results of this period research program, we will develop a Cancer Rehabilitation and Lymphedema Care Program (CRLCP) to use in the care of patients with resected advanced head and neck cancer.Keywords: head and neck cancer, resected, lymphedema, symptom, body image, functional outcome
Procedia PDF Downloads 2568182 Global Convergence of a Modified Three-Term Conjugate Gradient Algorithms
Authors: Belloufi Mohammed, Sellami Badreddine
Abstract:
This paper deals with a new nonlinear modified three-term conjugate gradient algorithm for solving large-scale unstrained optimization problems. The search direction of the algorithms from this class has three terms and is computed as modifications of the classical conjugate gradient algorithms to satisfy both the descent and the conjugacy conditions. An example of three-term conjugate gradient algorithm from this class, as modifications of the classical and well known Hestenes and Stiefel or of the CG_DESCENT by Hager and Zhang conjugate gradient algorithms, satisfying both the descent and the conjugacy conditions is presented. Under mild conditions, we prove that the modified three-term conjugate gradient algorithm with Wolfe type line search is globally convergent. Preliminary numerical results show the proposed method is very promising.Keywords: unconstrained optimization, three-term conjugate gradient, sufficient descent property, line search
Procedia PDF Downloads 3758181 Comparison of Silica-Filled Rubber Compound Prepared from Unmodified and Modified Silica
Authors: Thirawudh Pongprayoon, Watcharin Rassamee
Abstract:
Silica-filled natural rubber compounds were prepared from unmodified and surface-modified silica. The modified silica was coated by ultrathin film of polyisoprene by admicellar polymerization. FTIR and SEM were applied to characterize the modified silica. The cure, mechanic, and dynamics properties were investigated with the comparison of the compounds. Cure characterization of modified silica rubber compound was shorter than that of unmodified silica compound. Strength and abrasion resistance of modified silica compound were better than those of unmodified silica rubber compound. Wet grip and rolling resistance analyzed by DMA from tanδ at 0°C and 60°C using 5 Hz were also better than those of unmodified silica rubber compound.Keywords: silica, admicellar polymerization, rubber compounds, mechanical properties, dynamic properties
Procedia PDF Downloads 3508180 Investigating the Dynamic Plantar Pressure Distribution in Individuals with Multiple Sclerosis
Authors: Hilal Keklicek, Baris Cetin, Yeliz Salci, Ayla Fil, Umut Altinkaynak, Kadriye Armutlu
Abstract:
Objectives and Goals: Spasticity is a common symptom characterized with a velocity dependent increase in tonic stretch reflexes (muscle tone) in patient with multiple sclerosis (MS). Hypertonic muscles affect the normal plantigrade contact by disturbing accommodation of foot to the ground while walking. It is important to know the differences between healthy and neurologic foot features for management of spasticity related deformities and/or determination of rehabilitation purposes and contents. This study was planned with the aim of investigating the dynamic plantar pressure distribution in individuals with MS and determining the differences between healthy individuals (HI). Methods: Fifty-five individuals with MS (108 foot with spasticity according to Modified Ashworth Scale) and 20 HI (40 foot) were the participants of the study. The dynamic pedobarograph was utilized for evaluation of dynamic loading parameters. Participants were informed to walk at their self-selected speed for seven times to eliminate learning effect. The parameters were divided into 2 categories including; maximum loading pressure (N/cm2) and time of maximum pressure (ms) were collected from heal medial, heal lateral, mid foot, heads of first, second, third, fourth and fifth metatarsal bones. Results: There were differences between the groups in maximum loading pressure of heal medial (p < .001), heal lateral (p < .001), midfoot (p=.041) and 5th metatarsal areas (p=.036). Also, there were differences between the groups the time of maximum pressure of all metatarsal areas, midfoot, heal medial and heal lateral (p < .001) in favor of HI. Conclusions: The study provided basic data about foot pressure distribution in individuals with MS. Results of the study primarily showed that spasticity of lower extremity muscle disrupted the posteromedial foot loading. Secondarily, according to the study result, spasticity lead to inappropriate timing during load transfer from hind foot to forefoot.Keywords: multiple sclerosis, plantar pressure distribution, gait, norm values
Procedia PDF Downloads 3208179 Microstructure and Oxidation Behaviors of Al, Y Modified Silicide Coatings Prepared on an Nb-Si Based Ultrahigh Temperature Alloy
Authors: Xiping Guo, Jing Li
Abstract:
The microstructure of an Si-Al-Y co-deposition coating prepared on an Nb-Si based ultra high temperature alloy by pack cementation process at 1250°C for eight hours was studied. The results showed that the coating was composed of a (Nb,X)Si₂ (X represents Ti, Cr and Hf elements) outer layer, a (Ti,Nb)₅Si₄ middle layer and an Al, Cr-rich inner layer. For comparison, the oxidation behaviors of the coating at 800, 1050 and 1350°C were investigated respectively. Linear oxidation kinetics was found with the parabolic rate constants of 5.29×10⁻², 9×10⁻²and 5.81 mg² cm⁻⁴ h⁻¹, respectively. Catastrophic pesting oxidation has not been found at 800°C even for 100 h. The surface of the scale was covered by compact glassy SiO₂ film. The coating was able to effectively protect the Nb-Si based alloy from oxidation at 1350°C for at least 100 h. The formation process of the scale was testified following an epitaxial growth mechanism. The mechanism responsible for the oxidation behavior of the Si-Al-Y co-deposition coating at 800, 1050 and 1350°C was proposed.Keywords: Nb-Si based ultra high temperature alloy, oxidation resistance, pack cementation, silicide coating, Al and Y modified
Procedia PDF Downloads 4048178 Modified Preputial Urethrostomy as a Salvage Procedure in Four Dogs
Authors: Thomas Giansetto, Olivier Broux, Géraldine Bolen, Stéphanie Claeys
Abstract:
Objective: To describe a modified preputial urethrostomy in four dogs. Study design: Short case series. Animals: Four male dogs were treated by the modified preputial urethrostomy, three because of urethral stenosis, and one because of severe complications following perineal urethrostomy. Methods: Four dogs were presented for dysuria and urinary obstruction. secondary to urethral stenosis or tear. Obstruction was treated with a modified preputial urethrostomy. Results: Four dogs had resolution of dysuria with a modified preputial urethrostomy without penile amputation. None of the dogs presented signs of dysuria, urinary tract infection, or dermatitis postoperatively. Two dogs showed signs of urinary incontinence 15 days and one month postoperatively. Conclusion: The modified preputial urethrostomy resulted in a favorable prognosis and may be an alternative to prepubic urethrostomy in male dogs.Keywords: urethrostomy, preputial, technique, urogenital
Procedia PDF Downloads 1668177 Modeling of Nitrogen Solubility in Stainless Steel
Authors: Saeed Ghali, Hoda El-Faramawy, Mamdouh Eissa, Michael Mishreky
Abstract:
Scale-resistant austenitic stainless steel, X45CrNiW 18-9, has been developed, and modified steels produced through partial and total nickel replacement by nitrogen. These modified steels were produced in a 10 kg induction furnace under different nitrogen pressures and were cast into ingots. The produced modified stainless steels were forged, followed by air cooling. The phases of modified stainless steels have been investigated using the Schaeffler diagram, dilatometer, and microstructure observations. Both partial and total replacement of nickel using 0.33-0.50% nitrogen are effective in producing fully austenitic stainless steels. The nitrogen contents were determined and compared with those calculated using the Institute of Metal Science (IMS) equation. The results showed great deviations between the actual nitrogen contents and predicted values through IMS equation. So, an equation has been derived based on chemical composition, pressure, and temperature at 1600oC. [N%] = 0.0078 + 0.0406*X, where X is a function of chemical composition and nitrogen pressure. The derived equation has been used to calculate the nitrogen content of different steels using published data. The results reveal the difficulty of deriving a general equation for the prediction of nitrogen content covering different steel compositions. So, it is necessary to use a narrow composition range.Keywords: solubility, nitrogen, stainless steel, Schaeffler
Procedia PDF Downloads 2388176 Effects of Asphalt Modification with Nanomaterials on Fresh and Stored Bitumen
Authors: Ahmed W. Oda, Ahmed El-Desouky, Hassan Mahdy, Osama M. Moussa
Abstract:
Nanomaterials have many applications in the field of asphalt paving. Two locally produced nanomaterials were used in the asphalt binder modification. The nanomaterials used are Nanosilica (NS), and Nanoclay (NC). The virgin asphalt binder was characterized by the conventional tests. The bitumen was modified by 3%, 5% and 7% of NS and NC. The penetration index(PI), and the retaining penetration (RP) was calculated based on the results of the penetration and the softening point tests. The results show that the RP becomes 95.35% at 5%NS modified bitumen and reaches 97.56% when bitumen is modified with 3% NC. The results show significant improvement in the bitumen stiffness when modified by the two types of nanomaterials, either fresh or aged (stored).Keywords: bitumen, modified bitumen, aged, stored, nanomaterials
Procedia PDF Downloads 1938175 Exploring Error-Minimization Protocols for Upper-Limb Function During Activities of Daily Life in Chronic Stroke Patients
Authors: M. A. Riurean, S. Heijnen, C. A. Knott, J. Makinde, D. Gotti, J. VD. Kamp
Abstract:
Objectives: The current study is done in preparation for a randomized controlled study investigating the effects of an implicit motor learning protocol implemented using an extension-supporting glove. It will explore different protocols to find out which is preferred when studying motor learn-ing in the chronic stroke population that struggles with hand spasticity. Design: This exploratory study will follow 24 individuals who have a chronic stroke (> 6 months) during their usual care journey. We will record the results of two 9-Hole Peg Tests (9HPT) done during their therapy ses-sions with a physiotherapist or in their home before and after 4 weeks of them wearing an exten-sion-supporting glove used to employ the to-be-studied protocols. The participants will wear the glove 3 times/week for one hour while performing their activities of daily living and record the times they wore it in a diary. Their experience will be monitored through telecommunication once every week. Subjects: Individuals that have had a stroke at least 6 months prior to participation, hand spasticity measured on the modified Ashworth Scale of maximum 3, and finger flexion motor control measured on the Motricity Index of at least 19/33. Exclusion criteria: extreme hemi-neglect. Methods: The participants will be randomly divided into 3 groups: one group using the glove in a pre-set way of decreasing support (implicit motor learning), one group using the glove in a self-controlled way of decreasing support (autonomous motor learning), and the third using the glove with constant support (as control). Before and after the 4-week period, there will be an intake session and a post-assessment session. Analysis: We will compare the results of the two 9HPTs to check whether the protocols were effective. Furthermore, we will compare the results between the three groups to find the preferred one. A qualitative analysis will be run of the experience of participants throughout the 4-week period. Expected results: We expect that the group using the implicit learning protocol will show superior results.Keywords: implicit learning, hand spasticity, stroke, error minimization, motor task
Procedia PDF Downloads 598174 Deformation Behavior of Virgin and Polypropylene Modified Bituminous Mixture
Authors: Noor Zainab Habib, Ibrahim Kamaruddin, Madzlan Napiah
Abstract:
This paper present a part of research conducted to investigate the creep behavior of bituminous concrete mixture prepared with well graded using the dynamic creep test. The samples were prepared from unmodified control mix and Polypropylene modified bituminous mix. Unmodified or control mix was prepared with 80/100 grade bitumen while polypropylene modified mix was prepared using polypropylene PP polymer as modifier, blended with 80/100 Pen bitumen. The concentration of polymer in the blend was kept at 1%, 2%, and 3% by weight of bitumen content. For Dynamic Creep Test, Marshall Specimen were prepared at optimum bitumen content and then tested using IPC Global Universal Testing Machine (UTM), in order to investigate the creep stiffness of both modified and control mix. From the results obtained it was found that 1% and 2% PP modified bituminous mix offer better results in comparison to control and 3% PP modified mix samples. The results verify all the findings of empirical and viscosity test results which indicates that polymer modification induces stiffening effect in the binder. Enhanced viscous component of the binder was considered responsible for this change which eventually enhances the mechanical strength of the modified bituminous mixes.Keywords: polymer modified bitumen, stiffness, creep, viscosity
Procedia PDF Downloads 4198173 The Application of Transcranial Direct Current Stimulation (tDCS) Combined with Traditional Physical Therapy to Address Upper Limb Function in Chronic Stroke: A Case Study
Authors: Najmeh Hoseini
Abstract:
Strokerecovery happens through neuroplasticity, which is highly influenced by the environment, including neuro-rehabilitation. Transcranial direct current stimulation (tDCS) may enhance recovery by modulating neuroplasticity. With tDCS, weak direct currents are applied noninvasively to modify excitability in the cortical areas under its electrodes. Combined with functional activities, this may facilitate motor recovery in neurologic disorders such as stroke. The purpose of this case study was to examine the effect of tDCS combined with 30 minutes of traditional physical therapy (PT)on arm function following a stroke. A 29-year-old male with chronic stroke involving the left middle cerebral artery territory went through the treatment protocol. Design The design included 5 weeks of treatment: 1 week of traditional PT, 2 weeks of sham tDCS combined with traditional PT, and 2 weeks of tDCS combined with traditional PT. PT included functional electrical stimulation (FES) of wrist extensors followed by task-specific functional training. Dual hemispheric tDCS with 1 mA intensity was applied on the sensorimotor cortices for the first 20 min of the treatment combined with FES. Assessments before and after each treatment block included Modified Ashworth Scale, ChedokeMcmaster Arm and Hand inventory, Action Research Arm Test (ARAT), and the Box and Blocks Test. Results showed reduced spasticity in elbow and wrist flexors only after tDCS combination weeks (+1 to 0). The patient demonstrated clinically meaningful improvements in gross motor and fine motor control over the duration of the study; however, components of the ARAT that require fine motor control improved the greatest during the experimental block. Average time improvement compared to baseline was26.29 s for tDCS combination weeks, 18.48 s for sham tDCS, and 6.83 for PT standard of care weeks. Combining dual hemispheric tDCS with the standard of care PT demonstrated improvements in hand dexterity greater than PT alone in this patient case.Keywords: tDCS, stroke, case study, physical therapy
Procedia PDF Downloads 958172 Assessing an Instrument Usability: Response Interpolation and Scale Sensitivity
Authors: Betsy Ng, Seng Chee Tan, Choon Lang Quek, Peter Looker, Jaime Koh
Abstract:
The purpose of the present study was to determine the particular scale rating that stands out for an instrument. The instrument was designed to assess student perceptions of various learning environments, namely face-to-face, online and blended. The original instrument had a 5-point Likert items (1 = strongly disagree and 5 = strongly agree). Alternate versions were modified with a 6-point Likert scale and a bar scale rating. Participants consisted of undergraduates in a local university were involved in the usability testing of the instrument in an electronic setting. They were presented with the 5-point, 6-point and percentage-bar (100-point) scale ratings, in response to their perceptions of learning environments. The 5-point and 6-point Likert scales were presented in the form of radio button controls for each number, while the percentage-bar scale was presented with a sliding selection. Among these responses, 6-point Likert scale emerged to be the best overall. When participants were confronted with the 5-point items, they either chose 3 or 4, suggesting that data loss could occur due to the insensitivity of instrument. The insensitivity of instrument could be due to the discreet options, as evidenced by response interpolation. To avoid the constraint of discreet options, the percentage-bar scale rating was tested, but the participant responses were not well-interpolated. The bar scale might have provided a variety of responses without a constraint of a set of categorical options, but it seemed to reflect a lack of perceived and objective accuracy. The 6-point Likert scale was more likely to reflect a respondent’s perceived and objective accuracy as well as higher sensitivity. This finding supported the conclusion that 6-point Likert items provided a more accurate measure of the participant’s evaluation. The 5-point and bar scale ratings might not be accurately measuring the participants’ responses. This study highlighted the importance of the respondent’s perception of accuracy, respondent’s true evaluation, and the scale’s ease of use. Implications and limitations of this study were also discussed.Keywords: usability, interpolation, sensitivity, Likert scales, accuracy
Procedia PDF Downloads 4068171 Gravitational Wave Solutions in Modified Gravity Theories
Authors: Hafiza Rizwana Kausar
Abstract:
In this paper, we formulate the wave equation in modified theories, particularly in f(R) theory, scalar-tensor theory, and metric palatine f(X) theory. We solve the wave equation in each case and try to find maximum possible solutions in the form polarization modes. It is found that modified theories present at most six modes however the mentioned metric theories allow four polarization modes, two of which are tensor in nature and other two are scalars.Keywords: gravitational waves, modified theories, polariozation modes, scalar tensor theories
Procedia PDF Downloads 3628170 Multiscale Computational Approach to Enhance the Understanding, Design and Development of CO₂ Catalytic Conversion Technologies
Authors: Agnieszka S. Dzielendziak, Lindsay-Marie Armstrong, Matthew E. Potter, Robert Raja, Pier J. A. Sazio
Abstract:
Reducing carbon dioxide, CO₂, is one of the greatest global challenges. Conversion of CO₂ for utilisation across synthetic fuel, pharmaceutical, and agrochemical industries offers a promising option, yet requires significant research to understanding the complex multiscale processes involved. To experimentally understand and optimize such processes at that catalytic sites and exploring the impact of the process at reactor scale, is too expensive. Computational methods offer significant insight and flexibility but require a more detailed multi-scale approach which is a significant challenge in itself. This work introduces a computational approach which incorporates detailed catalytic models, taken from experimental investigations, into a larger-scale computational flow dynamics framework. The reactor-scale species transport approach is modified near the catalytic walls to determine the influence of catalytic clustering regions. This coupling approach enables more accurate modelling of velocity, pressures, temperatures, species concentrations and near-wall surface characteristics which will ultimately enable the impact of overall reactor design on chemical conversion performance.Keywords: catalysis, CCU, CO₂, multi-scale model
Procedia PDF Downloads 253