Search results for: auditory rehabilitation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 961

Search results for: auditory rehabilitation

661 Status of Sensory Profile Score among Children with Autism in Selected Centers of Dhaka City

Authors: Nupur A. D., Miah M. S., Moniruzzaman S. K.

Abstract:

Autism is a neurobiological disorder that affects physical, social, and language skills of a person. A child with autism feels difficulty for processing, integrating, and responding to sensory stimuli. Current estimates have shown that 45% to 96 % of children with Autism Spectrum Disorder demonstrate sensory difficulties. As autism is a worldwide burning issue, it has become a highly prioritized and important service provision in Bangladesh. The sensory deficit does not only hamper the normal development of a child, it also hampers the learning process and functional independency. The purpose of this study was to find out the prevalence of sensory dysfunction among children with autism and recognize common patterns of sensory dysfunction. A cross-sectional study design was chosen to carry out this research work. This study enrolled eighty children with autism and their parents by using the systematic sampling method. In this study, data were collected through the Short Sensory Profile (SSP) assessment tool, which consists of 38 items in the questionnaire, and qualified graduate Occupational Therapists were directly involved in interviewing parents as well as observing child responses to sensory related activities of the children with autism from four selected autism centers in Dhaka, Bangladesh. All item analyses were conducted to identify items yielding or resulting in the highest reported sensory processing dysfunction among those children through using SSP and Statistical Package for Social Sciences (SPSS) version 21.0 for data analysis. This study revealed that almost 78.25% of children with autism had significant sensory processing dysfunction based on their sensory response to relevant activities. Under-responsive sensory seeking and auditory filtering were the least common problems among them. On the other hand, most of them (95%) represented that they had definite to probable differences in sensory processing, including under-response or sensory seeking, auditory filtering, and tactile sensitivity. Besides, the result also shows that the definite difference in sensory processing among 64 children was within 100%; it means those children with autism suffered from sensory difficulties, and thus it drew a great impact on the children’s Daily Living Activities (ADLs) as well as social interaction with others. Almost 95% of children with autism require intervention to overcome or normalize the problem. The result gives insight regarding types of sensory processing dysfunction to consider during diagnosis and ascertaining the treatment. So, early sensory problem identification is very important and thus will help to provide appropriate sensory input to minimize the maladaptive behavior and enhance to reach the normal range of adaptive behavior.

Keywords: autism, sensory processing difficulties, sensory profile, occupational therapy

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660 Algorithm for Predicting Cognitive Exertion and Cognitive Fatigue Using a Portable EEG Headset for Concussion Rehabilitation

Authors: Lou J. Pino, Mark Campbell, Matthew J. Kennedy, Ashleigh C. Kennedy

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A concussion is complex and nuanced, with cognitive rest being a key component of recovery. Cognitive overexertion during rehabilitation from a concussion is associated with delayed recovery. However, daily living imposes cognitive demands that may be unavoidable and difficult to quantify. Therefore, a portable tool capable of alerting patients before cognitive overexertion occurs could allow patients to maintain their quality of life while preventing symptoms and recovery setbacks. EEG allows for a sensitive measure of cognitive exertion. Clinical 32-lead EEG headsets are not practical for day-to-day concussion rehabilitation management. However, there are now commercially available and affordable portable EEG headsets. Thus, these headsets can potentially be used to continuously monitor cognitive exertion during mental tasks to alert the wearer of overexertion, with the aim of preventing the occurrence of symptoms to speed recovery times. The objective of this study was to test an algorithm for predicting cognitive exertion from EEG data collected from a portable headset. EEG data were acquired from 10 participants (5 males, 5 females). Each participant wore a portable 4 channel EEG headband while completing 10 tasks: rest (eyes closed), rest (eyes open), three levels of the increasing difficulty of logic puzzles, three levels of increasing difficulty in multiplication questions, rest (eyes open), and rest (eyes closed). After each task, the participant was asked to report their perceived level of cognitive exertion using the NASA Task Load Index (TLX). Each participant then completed a second session on a different day. A customized machine learning model was created using data from the first session. The performance of each model was then tested using data from the second session. The mean correlation coefficient between TLX scores and predicted cognitive exertion was 0.75 ± 0.16. The results support the efficacy of the algorithm for predicting cognitive exertion. This demonstrates that the algorithms developed in this study used with portable EEG devices have the potential to aid in the concussion recovery process by monitoring and warning patients of cognitive overexertion. Preventing cognitive overexertion during recovery may reduce the number of symptoms a patient experiences and may help speed the recovery process.

Keywords: cognitive activity, EEG, machine learning, personalized recovery

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659 Cesium 137 Leaching from Soils of Territories, Polluted by Radionuclides

Authors: S. V. Vasilenkov, O. N. Demina

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Chernobyl NPP accident is the biggest in history of nuclear energetic. Bryansk region of Russia was exposed by the most intensive radiation pollution. For that, we made some researches in order to find the methods of soil rehabilitation on territories, polluted by radionuclides with the means of Cesium 137 leaching by watering. For experiments we took the soil from the upper more polluted 10 cm layer of different species. Cesium 137 leaching was made by different methods in washing columns. Washout of Cesium was made by periodical cycles in terms of 4-6 days. In experiments with easy argillaceous soil with start specific radioactivity 4158 bk/kg through 17 cycles the effective reducing was achieved and contained 1512 bk/kg. Besides, results of researches showed, that in the first 6-10 cycles we can see reducing of washing rate but after application of intensificators: ultrasound water processing, aerification, application of fertilizers (KCl), lime, freezing, we can see increasing of Cesium 137 leaching. The experimental investigations in washout of Cesium (Cs) – 137 from the soil were carried out in the field and laboratorial conditions during its freezing and melting. The experiments showed, that washout of Cesium (Cs) – 137 from the soil is rather high after freezing, than non-frozen soil is. And it conforms to washout of Cesium, made under the influence of the intensificaters. This fact allows to recommend chip and easy to construct technically arrangement for regulation of the snow-melt runoff for rehabilitation of the radioactive impoundment.

Keywords: pollution, radiation, Cesium 137 leaching, agriculture

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658 Mikrophonie I (1964) by Karlheinz Stockhausen - Between Idea and Auditory Image

Authors: Justyna Humięcka-Jakubowska

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1. Background in music analysis. Traditionally, when we think about a composer’s sketches, the chances are that we are thinking in terms of the working out of detail, rather than the evolution of an overall concept. Since music is a “time art’, it follows that questions of a form cannot be entirely detached from considerations of time. One could say that composers tend to regard time either as a place gradually and partially intuitively filled, or they can look for a specific strategy to occupy it. In my opinion, one thing that sheds light on Stockhausen's compositional thinking is his frequent use of 'form schemas', that is often a single-page representation of the entire structure of a piece. 2. Background in music technology. Sonic Visualiser is a program used to study a musical recording. It is an open source application for viewing, analysing, and annotating music audio files. It contains a number of visualisation tools, which are designed with useful default parameters for musical analysis. Additionally, the Vamp plugin format of SV supports to provide analysis such as for example structural segmentation. 3. Aims. The aim of my paper is to show how SV may be used to obtain a better understanding of the specific musical work, and how the compositional strategy does impact on musical structures and musical surfaces. I want to show that ‘traditional” music analytic methods don’t allow to indicate interrelationships between musical surface (which is perceived) and underlying musical/acoustical structure. 4. Main Contribution. Stockhausen had dealt with the most diverse musical problems by the most varied methods. A characteristic which he had never ceased to be placed at the center of his thought and works, it was the quest for a new balance founded upon an acute connection between speculation and intuition. In the case with Mikrophonie I (1964) for tam-tam and 6 players Stockhausen makes a distinction between the "connection scheme", which indicates the ground rules underlying all versions, and the form scheme, which is associated with a particular version. The preface to the published score includes both the connection scheme, and a single instance of a "form scheme", which is what one can hear on the CD recording. In the current study, the insight into the compositional strategy chosen by Stockhausen was been compared with auditory image, that is, with the perceived musical surface. Stockhausen's musical work is analyzed both in terms of melodic/voice and timbre evolution. 5. Implications The current study shows how musical structures have determined of musical surface. My general assumption is this, that while listening to music we can extract basic kinds of musical information from musical surfaces. It is shown that an interactive strategies of musical structure analysis can offer a very fruitful way of looking directly into certain structural features of music.

Keywords: automated analysis, composer's strategy, mikrophonie I, musical surface, stockhausen

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657 Green Materials for Hot Mixed Asphalt Production

Authors: Salisu Dahiru, Jibrin M. Kaura, Abubakar I. Jumare, Sulaiman M. Mahmood

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Reclaimed asphalt, used automobile tires and rice husk, were regarded as waste. These materials could be used in construction of new roads and for roads rehabilitation. Investigation into the production of a Green Hot Mixed Asphalt (GHMA) pavement using Reclaimed Asphalt Pavement (RAP) as partial replacement for coarse aggregate, Crumb Rubber (CR) from waste automobile tires as modifier for bitumen binder and Rice Husk Ash (RHA) as partial replacement of ordinary portland cement (OPC) filler, for roads construction and rehabilitation was presented. 30% Reclaimed asphalt of total aggregate, 15% Crumb Rubber of total binder content, 5% Rice Husk Ash of total mix, and 5.2% Crumb Rubber Modified Bitumen content were recommended for optimum performance. Loss of marshal stability was investigated on mix with the recommended optimum CRMB. The mix revealed good performance with only about 13% loss of stability after 24 hours of immersion in hot water bath, as against about 24% marshal stability lost reported in previous studies for conventional Hot Mixed Asphalt (HMA).

Keywords: rice husk, reclaimed asphalt, filler, crumb rubber, bitumen content green hot mix asphalt

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656 Effect of Noise Reducing Headphones on the Short-Term Memory Recall of College Students

Authors: Gregory W. Smith, Paul J. Riccomini

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The goal of this empirical inquiry is to explore the effect of noise reducing headphones on the short-term memory recall of college students. Immediately following the presentation (via PowerPoint) of 12 unrelated and randomly selected one- and two-syllable words, students were asked to recall as many words as possible. Using a linear model with conditions marked with binary indicators, we examined the frequency and accuracy of words that were recalled. The findings indicate that for some students, a reduction of noise has a significant positive impact on their ability to recall information. As classrooms become more aurally distracting due to the implementation of cooperative learning activities, these findings highlight the need for a quiet learning environment for some learners.

Keywords: auditory distraction, education, instruction, noise, working memory

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655 Probabilistic Seismic Loss Assessment of Reinforced Concrete (RC) Frame Buildings Pre- and Post-Rehabilitation

Authors: A. Flora, A. Di Lascio, D. Cardone, G. Gesualdi, G. Perrone

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This paper considers the seismic assessment and retrofit of a pilotis-type RC frame building, which was designed for gravity loads only, prior to the introduction of seismic design provisions. Pilotis-type RC frame buildings, featuring an uniform infill throughout the height and an open ground floor, were, and still are, quite popular all over the world, as they offer large open areas very suitable for retail space at the ground floor. These architectural advantages, however, are of detriment to the building seismic behavior, as they can determine a soft-storey collapse mechanism. Extensive numerical analyses are carried out to quantify and benchmark the performance of the selected building, both in terms of overall collapse capacity and expected losses. Alternative retrofit strategies are then examined, including: (i) steel jacketing of RC columns and beam-column joints, (ii) steel bracing and (iv) seismic isolation. The Expected Annual Loss (EAL) of the selected case-study building, pre- and post-rehabilitation, is evaluated, following a probabilistic approach. The breakeven time of each solution is computed, comparing the initial cost of the retrofit intervention with expected benefit in terms of EAL reduction.

Keywords: expected annual loss, reinforced concrete buildings, seismic loss assessment, seismic retrofit

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654 Efficiency of Virtual Reality Exercises with Nintendo Wii System on Balance and Independence in Motor Functions in Hemiparetic Patients: A Randomized Controlled Study

Authors: Ayça Utkan Karasu, Elif Balevi Batur, Gülçin Kaymak Karataş

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The aim of this study was to examine the efficiency of virtual reality exercises with Nintendo Wii system on balance and independence in motor functions. This randomized controlled assessor-blinded study included 23 stroke inpatients with hemiparesis all within 12 months poststroke. Patients were randomly assigned to control group (n=11) or experimental group (n=12) via block randomization method. Control group participated in a conventional balance rehabilitation programme. Study group received a four-week balance training programme five times per week with a session duration of 20 minutes in addition to the conventional balance rehabilitation programme. Balance was assessed by the Berg’s balance scale, the functional reach test, the timed up and go test, the postural assessment scale for stroke, the static balance index. Also, displacement of centre of pressure sway and centre of pressure displacement during weight shifting was calculated by Emed-SX system. Independence in motor functions was assessed by The Functional Independence Measure (FIM) ambulation and FIM transfer subscales. The outcome measures were evaluated at baseline, 4th week (posttreatment), 8th week (follow-up). Repeated measures analysis of variance was performed for each of the outcome measure. Significant group time interaction was detected in the scores of the Berg’s balance scale, the functional reach test, eyes open anteroposterior and mediolateral center of pressure sway distance, eyes closed anteroposterior center of pressure sway distance, center of pressure displacement during weight shifting to effected side, unaffected side and total centre of pressure displacement during weight shifting (p < 0.05). Time effect was statistically significant in the scores of the Berg’s balance scale, the functional reach test, the timed up and go test, the postural assessment scale for stroke, the static balance index, eyes open anteroposterior and mediolateral center of pressure sway distance, eyes closed mediolateral center of pressure sway distance, the center of pressure displacement during weight shifting to effected side, the functional independence measure ambulation and transfer scores (p < 0.05). Virtual reality exercises with Nintendo Wii system combined with a conventional balance rehabilitation programme enhances balance performance and independence in motor functions in stroke patients.

Keywords: balance, hemiplegia, stroke rehabilitation, virtual reality

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653 Research Progress on the Correlation between Tinnitus and Sleep Behaviors

Authors: Jiajia Peng

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Tinnitus is one of the common symptoms of ear diseases and is characterized by an abnormal perception of sound without external stimulation. Tinnitus is agony and seriously affects the life of the general population by approximately 1%. Sleep disturbance is a common problem in patients with tinnitus. Lack of sleep will lead to the accumulation of metabolites in the brain and cannot be cleared in time. These substances enhance sympathetic nerve reactivity in the auditory system, resulting in tinnitus occurrence or aggravation. Then, tinnitus may aggravate sleep disturbance, thus forming a vicious circle. Through a systematic review of the relevant literature, we summarize the research on tinnitus and sleep. Although the results suggest that tinnitus is often accompanied by sleep disturbance, the impact of unfavorable sleep habits on tinnitus is not clear. In particular, the relationships between sleep behaviors and other chronic diseases have been revealed. To reduce the incidence rate of tinnitus, clinicians should pay attention to the relevance between different sleep behaviors and tinnitus.

Keywords: tinnitus, sleep, sleep factor, sleep behavior

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652 The Effects on Hand Function with Robot-Assisted Rehabilitation for Children with Cerebral Palsy: A Pilot Study

Authors: Fen-Ling Kuo, Hsin-Chieh Lee, Han-Yun Hsiao, Jui-Chi Lin

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Background: Children with cerebral palsy (CP) usually suffered from mild to maximum upper limb dysfunction such as having difficulty in reaching and picking up objects, which profoundly affects their participation in activities of daily living (ADLs). Robot-assisted rehabilitation provides intensive physical training in improving sensorimotor function of the hand. Many researchers have extensively studied the effects of robot-assisted therapy (RT) for the paretic upper limb in patients with stroke in recent years. However, few studies have examined the effect of RT on hand function in children with CP. The purpose of this study is to investigate the effectiveness of Gloreha Sinfonia, a robotic device with a dynamic arm support system mainly focus on distal upper-limb training, on improvements of hand function and ADLs in children with CP. Methods: Seven children with moderate CP were recruited in this case series study. RT using Gloreha Sinfonia was performed 2 sessions per week, 60 min per session for 6 consecutive weeks, with 12 times in total. Outcome measures included the Fugl-Meyer Assessment-upper extremity (FMA-UE), the Box and Block Test, the electromyography activity of the extensor digitorum communis muscle (EDC) and brachioradialis (BR), a grip dynamometer for motor evaluation, and the ABILHAND-Kids for measuring manual ability to manage daily activities, were performed at baseline, after 12 sessions (end of treatment) and at the 1-month follow-up. Results: After 6 weeks of robot-assisted treatment of hand function, there were significant increases in FMA-UE shoulder/elbow scores (p=0.002), FMA-UE wrist/hand scores (p=0.002), and FMA-UE total scores (p=0.002). There were also significant improvements in the BR mean value (p = 0.015) and electrical agonist-antagonist muscle ratio (p=0.041) in grasping a 1-inch cube task. These gains were maintained for a month after the end of the intervention. Conclusion: RT using Gloreha Sinfonia for hand function training may contribute toward the improvement of upper extremity function and efficacy in recruiting BR muscle in children with CP. The results were maintained at one month after intervention.

Keywords: activities of daily living, cerebral palsy, hand function, robotic rehabilitation

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651 The Quality of Life of Transtibial Amputees: The Prosthetists Role

Authors: Riyona Chetty, Raisuyah Bhagwan, Nalini Govender

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Background: During rehabilitation, the prosthetist establishes prosthetic and/or orthotic realistic goals and programmes as well as clinical outcome measures. They are well-positioned to improve the amputee’s physical and psychosocial well-being. Objective: This study aims to explore the ways in which the prosthetist may be able to improve the holistic well-being of the amputee. Methods: Data was collected using a focus group discussion with 16 prosthetists at a medical facility in KwaZulu-Natal, South Africa. Results: The findings indicate that amputees are encouraged to consider physical activities to improve their health. However, a major challenge experienced by the prosthetists was their lack of adequate psychosocial expertise, which affected their ability to offer emotional support. Additional factors such as language barriers, rotational systems, and unrealistic expectations further obstructed optimal service delivery. Conclusion: The prosthetists are adequately skilled in manufacturing the ideal prosthesis and encouraging physical exercise to promote the amputee’s physical health. However, their lack of psychosocial training limits them in providing emotional support during rehabilitation. It is recommended that prosthetists are provided with professional training to provide emotional support as part of holistic healthcare. Clinical relevance: The intention of this study was to provide pertinent recommendations for prosthetists, enabling them to provide holistic quality care to their patients.

Keywords: psychological, social, well-being, amputee, prosthetist

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650 Perceptual Organization within Temporal Displacement

Authors: Michele Sinico

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The psychological present has an actual extension. When a sequence of instantaneous stimuli falls in this short interval of time, observers perceive a compresence of events in succession and the temporal order depends on the qualitative relationships between the perceptual properties of the events. Two experiments were carried out to study the influence of perceptual grouping, with and without temporal displacement, on the duration of auditory sequences. The psychophysical method of adjustment was adopted. The first experiment investigated the effect of temporal displacement of a white noise on sequence duration. The second experiment investigated the effect of temporal displacement, along the pitch dimension, on temporal shortening of sequence. The results suggest that the temporal order of sounds, in the case of temporal displacement, is organized along the pitch dimension.

Keywords: time perception, perceptual present, temporal displacement, Gestalt laws of perceptual organization

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649 Predictors of Motor and Cognitive Domains of Functional Performance after Rehabilitation of Individuals with Acute Stroke

Authors: A. F. Jaber, E. Dean, M. Liu, J. He, D. Sabata, J. Radel

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Background: Stroke is a serious health care concern and a major cause of disability in the United States. This condition impacts the individual’s functional ability to perform daily activities. Predicting functional performance of people with stroke assists health care professionals in optimizing the delivery of health services to the affected individuals. The purpose of this study was to identify significant predictors of Motor FIM and of Cognitive FIM subscores among individuals with stroke after discharge from inpatient rehabilitation (typically 4-6 weeks after stroke onset). A second purpose is to explore the relation among personal characteristics, health status, and functional performance of daily activities within 2 weeks of stroke onset. Methods: This study used a retrospective chart review to conduct a secondary analysis of data obtained from the Healthcare Enterprise Repository for Ontological Narration (HERON) database. The HERON database integrates de-identified clinical data from seven different regional sources including hospital electronic medical record systems of the University of Kansas Health System. The initial HERON data extract encompassed 1192 records and the final sample consisted of 207 participants who were mostly white (74%) males (55%) with a diagnosis of ischemic stroke (77%). The outcome measures collected from HERON included performance scores on the National Institute of Health Stroke Scale (NIHSS), the Glasgow Coma Scale (GCS), and the Functional Independence Measure (FIM). The data analysis plan included descriptive statistics, Pearson correlation analysis, and Stepwise regression analysis. Results: significant predictors of discharge Motor FIM subscores included age, baseline Motor FIM subscores, discharge NIHSS scores, and comorbid electrolyte disorder (R2 = 0.57, p <0.026). Significant predictors of discharge Cognitive FIM subscores were age, baseline cognitive FIM subscores, client cooperative behavior, comorbid obesity, and the total number of comorbidities (R2 = 0.67, p <0.020). Functional performance on admission was significantly associated with age (p < 0.01), stroke severity (p < 0.01), and length of hospital stay (p < 0.05). Conclusions: our findings show that younger age, good motor and cognitive abilities on admission, mild stroke severity, fewer comorbidities, and positive client attitude all predict favorable functional outcomes after inpatient stroke rehabilitation. This study provides health care professionals with evidence to evaluate predictors of favorable functional outcomes early at stroke rehabilitation, to tailor individualized interventions based on their client’s anticipated prognosis, and to educate clients about the benefits of making lifestyle changes to improve their anticipated rate of functional recovery.

Keywords: functional performance, predictors, stroke, recovery

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648 A Top-down vs a Bottom-up Approach on Lower Extremity Motor Recovery and Balance Following Acute Stroke: A Randomized Clinical Trial

Authors: Vijaya Kumar, Vidayasagar Pagilla, Abraham Joshua, Rakshith Kedambadi, Prasanna Mithra

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Background: Post stroke rehabilitation are aimed to accelerate for optimal sensorimotor recovery, functional gain and to reduce long-term dependency. Intensive physical therapy interventions can enhance this recovery as experience-dependent neural plastic changes either directly act at cortical neural networks or at distal peripheral level (muscular components). Neuromuscular Electrical Stimulation (NMES), a traditional bottom-up approach, mirror therapy (MT), a relatively new top down approach have found to be an effective adjuvant treatment methods for lower extremity motor and functional recovery in stroke rehabilitation. However there is a scarcity of evidence to compare their therapeutic gain in stroke recovery.Aim: To compare the efficacy of neuromuscular electrical stimulation (NMES) and mirror therapy (MT) in very early phase of post stroke rehabilitation addressed to lower extremity motor recovery and balance. Design: observer blinded Randomized Clinical Trial. Setting: Neurorehabilitation Unit, Department of Physical Therapy, Tertiary Care Hospitals. Subjects: 32 acute stroke subjects with first episode of unilateral stroke with hemiparesis, referred for rehabilitation (onset < 3 weeks), Brunnstorm lower extremity recovery stages ≥3 and MMSE score more than 24 were randomized into two group [Group A-NMES and Group B-MT]. Interventions: Both the groups received eclectic approach to remediate lower extremity recovery which includes treatment components of Roods, Bobath and Motor learning approaches for 30 minutes a day for 6 days. Following which Group A (N=16) received 30 minutes of surface NMES training for six major paretic muscle groups (gluteus maximus and medius,quadriceps, hamstrings, tibialis anterior and gastrocnemius). Group B (N=16) was administered with 30 minutes of mirror therapy sessions to facilitate lower extremity motor recovery. Outcome measures: Lower extremity motor recovery, balance and activities of daily life (ADLs) were measured by Fugyl Meyer Assessment (FMA-LE), Berg Balance Scale (BBS), Barthel Index (BI) before and after intervention. Results: Pre Post analysis of either group across the time revealed statistically significant improvement (p < 0.001) for all the outcome variables for the either group. All parameters of NMES had greater change scores compared to MT group as follows: FMA-LE (25.12±3.01 vs. 23.31±2.38), BBS (35.12±4.61 vs. 34.68±5.42) and BI (40.00±10.32 vs. 37.18±7.73). Between the groups comparison of pre post values showed no significance with FMA-LE (p=0.09), BBS (p=0.80) and BI (p=0.39) respectively. Conclusion: Though either groups had significant improvement (pre to post intervention), none of them were superior to other in lower extremity motor recovery and balance among acute stroke subjects. We conclude that eclectic approach is an effective treatment irrespective of NMES or MT as an adjunct.

Keywords: balance, motor recovery, mirror therapy, neuromuscular electrical stimulation, stroke

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647 Iterative Estimator-Based Nonlinear Backstepping Control of a Robotic Exoskeleton

Authors: Brahmi Brahim, Mohammad Habibur Rahman, Maarouf Saad, Cristóbal Ochoa Luna

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A repetitive training movement is an efficient method to improve the ability and movement performance of stroke survivors and help them to recover their lost motor function and acquire new skills. The ETS-MARSE is seven degrees of freedom (DOF) exoskeleton robot developed to be worn on the lateral side of the right upper-extremity to assist and rehabilitate the patients with upper-extremity dysfunction resulting from stroke. Practically, rehabilitation activities are repetitive tasks, which make the assistive/robotic systems to suffer from repetitive/periodic uncertainties and external perturbations induced by the high-order dynamic model (seven DOF) and interaction with human muscle which impact on the tracking performance and even on the stability of the exoskeleton. To ensure the robustness and the stability of the robot, a new nonlinear backstepping control was implemented with designed tests performed by healthy subjects. In order to limit and to reject the periodic/repetitive disturbances, an iterative estimator was integrated into the control of the system. The estimator does not need the precise dynamic model of the exoskeleton. Experimental results confirm the robustness and accuracy of the controller performance to deal with the external perturbation, and the effectiveness of the iterative estimator to reject the repetitive/periodic disturbances.

Keywords: backstepping control, iterative control, Rehabilitation, ETS-MARSE

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646 Nigeria’s Terrorists RehabIlitation And Reintegration Policy: A Victimological Perspective

Authors: Ujene Ikem Godspower

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Acts of terror perpetrated either by state or non-state actors are considered a social ill and impugn on the collective well-being of the society. As such, there is the need for social reparations, which is meant to ensure the healing of the social wounds resulting from the atrocities committed by errant individuals under different guises. In order to ensure social closure and effectively repair the damages done by anomic behaviors, society must ensure that justice is served and those whose rights and privileges have been denied and battered are given the necessary succour they deserve. With regards to the ongoing terrorism in the Northeast, the moves to rehabilitate and reintegrate Boko Haram members have commenced with the establishment of Operation Safe Corridor,1 and a proposed bill for the establishment of “National Agency for the Education, Rehabilitation, De-radicalisation and Integration of Repentant Insurgents in Nigeria”2. All of which Nigerians have expressed mixed feelings about. Some argue that the endeavor is lacking in ethical decency and justice and totally insults human reasoning. Terrorism and counterterrorism in Nigeria have been enmeshed in gross human rights violations both by the military and the terrorists, and this raises the concern of Nigeria’s ability to fairly and justiciably implement the deradicalization and reintegration efforts. On the other hand, there is the challenge of the community dwellers that are victims of terrorism and counterterrorism and their ability to forgive and welcome back their immediate-past tormentors even with the slightest sense of injustice in the process of terrorists reintegration and rehabilitation. With such efforts implemented in other climes, the Nigeria’s case poses a unique challenge and commands keen interests by stakeholders and the international community due to the aforementioned reasons. It is therefore pertinent to assess the communities’ level of involvement in the cycle of reintegration- hence, the objective of this paper. Methodologically as a part of my larger PhD thesis, this study intends to explore the three different local governments (Michika in Adamawa, Chibok in Borno, and Yunusari in Yobe), all based on the intensity of terrorists attacks. Twenty five in-depth interview will be conducted in the study locations above featuring religious leaders, Community (traditional) leaders, Internally displaced persons, CSOs management officials, and ex-Boko Haram insurgents who have been reintegrated. The data that will be generated from field work will be analyzed using the Nvivo-12 software package, which will help to code and create themes based on the study objectives. Furthermore, the data will be content-analyzed, employing verbatim quotations where necessary. Ethically, the study will take into consideration the basic ethical principles for research of this nature. It will strictly adhere to the principle of voluntary participation, anonymity, and confidentiality.

Keywords: boko haram, reintegration, rehabilitation, terrorism, victimology

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645 An Automated Sensor System for Cochlear Implants Electrode Array Insertion

Authors: Lei Hou, Xinli Du, Nikolaos Boulgouris

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A cochlear implant, referred to as a CI, is a small electronic device that can provide direct electrical stimulation to the auditory nerve. During cochlear implant surgery, atraumatic electrode array insertion is considered to be a crucial step. However, during implantation, the mechanical behaviour of an electrode array inside the cochlea is not known. The behaviour of an electrode array inside of the cochlea is hardly identified by regular methods. In this study, a CI electrode array capacitive sensor system is proposed. It is able to automatically determine the array state as a result of the capacitance variations. Instead of applying sensors to the electrode array, the capacitance information from the electrodes will be gathered and analysed. Results reveal that this sensing method is capable of recognising different states when fed into a pre-shaped model.

Keywords: cochlear implant, electrode, hearing preservation, insertion force, capacitive sensing

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644 Future Considerations for Wounded Service Members and Veterans of the Global War on Terror

Authors: Selina Doncevic, Lisa Perla, Angela Kindvall

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The Global War on Terror which began after September 11, 2011, increased survivability of severe injuries requiring varying trajectories of rehabilitation and recovery. The costs encompass physiologic, functional, social, emotional, psychological, vocational and scholastic domains of life. The purpose of this poster is to inform private sector health care practitioners and clinicians at various levels of the unique and long term dynamics of healthcare recovery for polytrauma, and traumatic brain injured service members and veterans in the United States of America. Challenges include care delivery between the private sector, the department of defense, and veterans affairs healthcare systems while simultaneously supporting the dynamics of acute as well as latent complications associated with severe injury and illness. Clinical relevance, subtleties of protracted recovery, and overwhelmed systems of care are discussed in the context of lessons learned and in reflection on previous wars. Additional concerns for consideration and discussion include: the cost of protracted healthcare, various U.S. healthcare payer systems, lingering community reintegration challenges, ongoing care giver support, the rise of veterans support groups and the development of private sector clinical partnerships.

Keywords: brain injury, future, polytrauma, rehabilitation

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643 Investigating the English Speech Processing System of EFL Japanese Older Children

Authors: Hiromi Kawai

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This study investigates the nature of EFL older children’s L2 perceptive and productive abilities using classroom data, in order to find a pedagogical solution to the teaching of L2 sounds at an early stage of learning in a formal school setting. It is still inconclusive whether older children with only EFL formal school instruction at the initial stage of L2 learning are able to attain native-like perception and production in English within the very limited amount of exposure to the target language available. Based on the notion of the lack of study of EFL Japanese children’s acquisition of English segments, the researcher uses a model of L1 speech processing which was developed for investigating L1 English children’s speech and literacy difficulties using a psycholinguistic framework. The model is composed of input channel, output channel, and lexical representation, and examines how a child receives information from spoken or written language, remembers and stores it within the lexical representations and how the child selects and produces spoken or written words. Concerning language universality and language specificity in the language acquisitional process, the aim of finding any sound errors in L1 English children seemed to conform to the author’s intention to find abilities of English sounds in older Japanese children at the novice level of English in an EFL setting. 104 students in Grade 5 (between the ages of 10 and 11 years old) of an elementary school in Tokyo participated in this study. Four tests to measure their perceptive ability and three oral repetition tests to measure their productive ability were conducted with/without reference to lexical representation. All the test items were analyzed to calculate item facility (IF) indices, and correlational analyses and Structural Equation Modeling (SEM) were conducted to examine the relationship between the receptive ability and the productive ability. IF analysis showed that (1) the participants were better at perceiving a segment than producing a segment, (2) they had difficulty in auditory discrimination of paired consonants when one of them does not exist in the Japanese inventory, (3) they had difficulty in both perceiving and producing English vowels, and (4) their L1 loan word knowledge had an influence on their ability to perceive and produce L2 sounds. The result of the Multiple Regression Modeling showed that the two production tests could predict the participants’ auditory ability of real words in English. The result of SEM showed that the hypothesis that perceptive ability affects productive ability was supported. Based on these findings, the author discusses the possible explicit method of teaching English segments to EFL older children in a formal school setting.

Keywords: EFL older children, english segments, perception, production, speech processing system

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642 Concussion: Clinical and Vocational Outcomes from Sport Related Mild Traumatic Brain Injury

Authors: Jack Nash, Chris Simpson, Holly Hurn, Ronel Terblanche, Alan Mistlin

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There is an increasing incidence of mild traumatic brain injury (mTBI) cases throughout sport and with this, a growing interest from governing bodies to ensure these are managed appropriately and player welfare is prioritised. The Berlin consensus statement on concussion in sport recommends a multidisciplinary approach when managing those patients who do not have full resolution of mTBI symptoms. There are as of yet no standardised guideline to follow in the treatment of complex cases mTBI in athletes. The aim of this project was to analyse the outcomes, both clinical and vocational, of all patients admitted to the mild Traumatic Brain Injury (mTBI) service at the UK’s Defence Military Rehabilitation Centre Headley Court between 1st June 2008 and 1st February 2017, as a result of a sport induced injury, and evaluate potential predictive indicators of outcome. Patients were identified from a database maintained by the mTBI service. Clinical and occupational outcomes were ascertained from medical and occupational employment records, recorded prospectively, at time of discharge from the mTBI service. Outcomes were graded based on the vocational independence scale (VIS) and clinical documentation at discharge. Predictive indicators including referral time, age at time of injury, previous mental health diagnosis and a financial claim in place at time of entry to service were assessed using logistic regression. 45 Patients were treated for sport-related mTBI during this time frame. Clinically 96% of patients had full resolution of their mTBI symptoms after input from the mTBI service. 51% of patients returned to work at their previous vocational level, 4% had ongoing mTBI symptoms, 22% had ongoing physical rehabilitation needs, 11% required mental health input and 11% required further vestibular rehabilitation. Neither age, time to referral, pre-existing mental health condition nor compensation seeking had a significant impact on either vocational or clinical outcome in this population. The vast majority of patients reviewed in the mTBI clinic had persistent symptoms which could not be managed in primary care. A consultant-led, multidisciplinary approach to the diagnosis and management of mTBI has resulted in excellent clinical outcomes in these complex cases. High levels of symptom resolution suggest that this referral and treatment pathway is successful and is a model which could be replicated in other organisations with consultant led input. Further understanding of both predictive and individual factors would allow clinicians to focus treatments on those who are most likely to develop long-term complications following mTBI. A consultant-led, multidisciplinary service ensures a large number of patients will have complete resolution of mTBI symptoms after sport-related mTBI. Further research is now required to ascertain the key predictive indicators of outcome following sport-related mTBI.

Keywords: brain injury, concussion, neurology, rehabilitation, sports injury

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641 Management of Dysphagia after Supra Glottic Laryngectomy

Authors: Premalatha B. S., Shenoy A. M.

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Background: Rehabilitation of swallowing is as vital as speech in surgically treated head and neck cancer patients to maintain nutritional support, enhance wound healing and improve quality of life. Aspiration following supraglottic laryngectomy is very common, and rehabilitation of the same is crucial which requires involvement of speech therapist in close contact with head and neck surgeon. Objectives: To examine the functions of swallowing outcomes after intensive therapy in supraglottic laryngectomy. Materials: Thirty-nine supra glottic laryngectomees were participated in the study. Of them, 36 subjects were males and 3 were females, in the age range of 32-68 years. Eighteen subjects had undergone standard supra glottis laryngectomy (Group1) for supraglottic lesions where as 21 of them for extended supraglottic laryngectomy (Group 2) for base tongue and lateral pharyngeal wall lesion. Prior to surgery visit by speech pathologist was mandatory to assess the sutability for surgery and rehabilitation. Dysphagia rehabilitation started after decannulation of tracheostoma by focusing on orientation about anatomy, physiological variation before and after surgery, which was tailor made for each individual based on their type and extent of surgery. Supraglottic diet - Soft solid with supraglottic swallow method was advocated to prevent aspiration. The success of intervention was documented as number of sessions taken to swallow different food consistency and also percentage of subjects who achieved satisfactory swallow in terms of number of weeks in both the groups. Results: Statistical data was computed in two ways in both the groups 1) to calculate percentage (%) of subjects who swallowed satisfactorily in the time frame of less than 3 weeks to more than 6 weeks, 2) number of sessions taken to swallow without aspiration as far as food consistency was concerned. The study indicated that in group 1 subjects of standard supraglottic laryngectomy, 61% (n=11) of them were successfully rehabilitated but their swallowing normalcy was delayed by an average 29th post operative day (3-6 weeks). Thirty three percentages (33%) (n=6) of the subjects could swallow satisfactorily without aspiration even before 3 weeks and only 5 % (n=1) of the needed more than 6 weeks to achieve normal swallowing ability. Group 2 subjects of extended SGL only 47 %( n=10) of them could achieved satisfactory swallow by 3-6 weeks and 24% (n=5) of them of them achieved normal swallowing ability before 3 weeks. Around 4% (n=1) needed more than 6 weeks and as high as 24 % (n=5) of them continued to be supplemented with naso gastric feeding even after 8-10 months post operative as they exhibited severe aspiration. As far as type of food consistencies were concerned group 1 subject could able to swallow all types without aspiration much earlier than group 2 subjects. Group 1 needed only 8 swallowing therapy sessions for thickened soft solid and 15 sessions for liquids whereas group 2 required 14 sessions for soft solid and 17 sessions for liquids to achieve swallowing normalcy without aspiration. Conclusion: The study highlights the importance of dysphagia intervention in supraglottic laryngectomees by speech pathologist.

Keywords: dysphagia management, supraglotic diet, supraglottic laryngectomy, supraglottic swallow

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640 Using Rainfall Simulators to Design and Assess the Post-Mining Erosional Stability

Authors: Ashraf M. Khalifa, Hwat Bing So, Greg Maddocks

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Changes to the mining environmental approvals process in Queensland have been rolled out under the MERFP Act (2018). This includes requirements for a Progressive Rehabilitation and Closure Plan (PRC Plan). Key considerations of the landform design report within the PRC Plan must include: (i) identification of materials available for landform rehabilitation, including their ability to achieve the required landform design outcomes, (ii) erosion assessments to determine landform heights, gradients, profiles, and material placement, (iii) slope profile design considering the interactions between soil erodibility, rainfall erosivity, landform height, gradient, and vegetation cover to identify acceptable erosion rates over a long-term average, (iv) an analysis of future stability based on the factors described above e.g., erosion and /or landform evolution modelling. ACARP funded an extensive and thorough erosion assessment program using rainfall simulators from 1998 to 2010. The ACARP program included laboratory assessment of 35 soil and spoil samples from 16 coal mines and samples from a gold mine in Queensland using 3 x 0.8 m laboratory rainfall simulator. The reliability of the laboratory rainfall simulator was verified through field measurements using larger flumes 20 x 5 meters and catchment scale measurements at three sites (3 different catchments, average area of 2.5 ha each). Soil cover systems are a primary component of a constructed mine landform. The primary functions of a soil cover system are to sustain vegetation and limit the infiltration of water and oxygen into underlying reactive mine waste. If the external surface of the landform erodes, the functions of the cover system cannot be maintained, and the cover system will most likely fail. Assessing a constructed landform’s potential ‘long-term’ erosion stability requires defensible erosion rate thresholds below which rehabilitation landform designs are considered acceptably erosion-resistant or ‘stable’. The process used to quantify erosion rates using rainfall simulators (flumes) to measure rill and inter-rill erosion on bulk samples under laboratory conditions or on in-situ material under field conditions will be explained.

Keywords: open-cut, mining, erosion, rainfall simulator

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639 Pedestrian Areas, Development Stimulus in Urban Old Fabrics; Analyzing Stroget, Pedestrian Street in Copenhagen

Authors: Kiomars Habibi, Mostafa Behzadfar, Airin Jaberi

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Designing appropriate places for the comfort of pedestrians is one of the most important aspects of modern urbanization and renovation and rehabilitation stimulus of urban old fabrics. So, that special cities designed for pedestrians with a complete network of streets without cars, can be considered as one of the best habitations in the world. The number of these cities with a network of streets and squares in which beauty, enjoyment and comfort are mostly concerned for the pedestrians designed regions is increasing around the world, such as Stockholm, Copenhagen, Munich, Frankfurt, Venice, Rome, etc. In this paper, we are going to explain the influential factors regarding the efficiency of these cities by identifying one of the most important pedestrian ways of the world; Strøget is a car free zone in Copenhagen, Denmark. This popular tourist attraction in the center of town is the longest pedestrian shopping area in Europe. Analyses indicate that world-wide experience concerning the renovation and rehabilitation of old fabrics has many advantages in exploiting the idea of pedestrian way for regeneration of old fabrics. Transforming the streets to appropriate places for the comfort of pedestrians, expanding the public spaces such as city squares, and decreasing the masses of building alongside the brought comfort and peace is the main reason in the success of Strøget pedestrian street in urban old fabrics of Copenhagen. Hypothesis: The Strøget pedestrian street has been the development stimulus in Copenhagen and the urban old fabrics development as a result

Keywords: development, stimulus, pedestrian street, urban landscape, Stroget

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638 Functional Performance Needs of Individuals with Intellectual and Developmental Disabilities

Authors: Noor Taleb Ismael, Areej Abd Al Kareem Al Titi, Ala'a Fayez Jaber

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Objectives: To investigate self-perceived functional performance among adults with IDD who are Jordanian residential care and rehabilitation centers residents. Also, to investigate their functional abilities (i.e., motor, and cognitive). In addition, to determine the motor and cognitive predictors of their functional performance. Methods: The study utilized a cross-sectional descriptive design; the sample included 180 individuals with IDD (90 males and 90 females) aged 18 to 75 years. The inclusion criteria encompassed: 1) Adults with a confirmed IDD by their physician’s professional and 2) residents in Jordanian Residential Care and Rehabilitation Centers affiliated with the Jordanian Ministry of Social Development. The exclusion criteria were: 1) bedridden or totally dependent on their care providers; 2) who had an accident or acquired neurological conditions. Researchers conducted semi-structured interviews to complete the outcome measures that include the Canadian Occupational Performance Measure (COPM), the Functional Independence Measure (FIM), the Montreal Cognitive Assessment (MoCA), the Mini-Mental Status Examination (MMSE), and the sociodemographic questionnaire. Data analyses consisted of descriptive statistics, analysis of frequencies, correlation, and regression analyses. Result: Individuals with IDD showed low functional performance in all daily life areas, including self-care, productivity, and leisure; there was severe cognitive impairment and poor independence and functional performance. (COPM Performance M= 1.433, SD±.57021, COPM Satisfaction M= 1.31, SD±.54, FIM M= 3.673, SD± 1.7918). Two predictive models were validated for the COPM performance and FIM total scores. First, significant predictors of high self-perceived functional performance on COPM were high scores on FIM Motor sub scores, FIM cognitive sub scores, young age, and having a high school educational level (R2=0.603, p=0.012). Second, significant predictors of high functional capacity on FIM were a high score on the COPM performance subscale, a high MMSE score, and having a cerebral palsy (CP) diagnosis (R2=0.671, p<0.001). Conclusions: Evaluating functional performance and associated factors is important in rehabilitation to provide better services and improve health and QoL for individuals with IDD. This study suggested conducting future studies targeting integrated individuals with IDD who live with their families in the communities.

Keywords: functional performance, intellectual and developmental disabilty, cognitive abilities, motor abilities

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637 The Effect of Blood Flow Restriction on the Knee Rehabilitation

Authors: O. Casasayas, M. Vigo, R. Navarro, P. Ragazzi, P. Alvarez, A. Perez-Bellmunt

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Introduction: The blood flow restriction training (BFR) is a method of muscle training that allows increasing the stress of muscle tissue to enhance the muscle cross-section and strength. This type of training has clear benefits in the rehabilitation field since it can improve muscle strength using low mechanical loads. The aim of this study is to know in which knee pathologies BFR has been used, what methodology was used and what were the obtained results. Study design: We performed a systematic literature search using strategies for the concepts of “blood flow restriction OR blood flow restriction training AND knee” in Medline. Articles were screened by authors and included if they used the blood flow restriction training in pathology of the knee. Results: The pathology more frequently treated by BFR was knee osteoarthritis and the variables most analyzed were strength and pain. The vascular occlusion used was 80% in the major part of studies. The groups of BFR obtained an increase of strength with less pain but not always the results are statistically significant. The evidence levels are poor in the high number of studies because in some cases there is not a control group or the evaluators were not blinded. Conclusion: The use of BFR is useful to improve muscle strength in knee pathology since it does not increase the pain, but more studies are needed to see (comprehend) if this type of treatment obtains better results than a conventional therapy. No studies have been found that compare the different occlusion effects in both the strength improvement and the pain reduction. Neither studies that analyse the effects of BFR on the muscle contractile parameters have been found.

Keywords: blood flow restriction training, knee, arthroscopy knee, physical therapy

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636 UV Functionalised Short Implants as an Alternative to Avoid Crestal Sinus Lift Procedure: Controlled Case Series

Authors: Naira Ghambaryan, Gagik Hakobyan

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Purpose:The study was to evaluate the survival rate of short implants (5-6 mm) functionalized with UV radiation placed in the posterior segments of the atrophied maxilla. Materials and Methods:The study included 47 patients with unilateral/bilateral missing teeth and vertical atrophy of the posterior maxillary area. A total of 64 short UV-functionalized implants and 62 standard implants over 10 mm in length were placed in patients. The clinical indices included the following parameters: ISQБ MBL, OHIP-G scale. Results: For short implants, the median ISQ at placement was 62.2 for primary stability, and the median ISQ at 5 months was 69.6 ISQ. For standart implant, the mean ISQ at placement was 64.3 ISQ, and ISQ after 5 months was 71.6 ISQ. Аfter 6 months mean MBL short implants 0.87 mm, after 1 year, 1.13 mm, after 5 year was 1.48 mm. Аfter 6 months, mean MBL standard implants 0.84 mm, after 1 year, 1.24 mm, after 5 year was 1.58 mm. Mean OHIP-G scores -patients satisfaction with the implant at 4.8 ± 0.3, satisfaction with the operation 4.6 ± 0.4; satisfaction with prosthetics 4.7 ± 0.5. Cumulative 5-year short implants rates was 96.7%, standard implants was 97.4%, and prosthesis cumulative survival rate was 97.2%. Conclusions: Short implants with ultraviolet functionalization for prosthetic rehabilitation of the posterior resorbed maxilla region is a reliable, reasonable alternative to sinus lift, demonstrating fewer complications, satisfactory survival of a 5-year follow-up period, and reducing the number of additional surgical interventions and postoperative complications.

Keywords: short implant, ultraviolet functionalization, atrophic posterior maxilla, prosthodontic rehabilitation

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635 Activation of Mirror Neuron System Response to Drumming Training: A Functional Magnetic Resonance Imaging Study

Authors: Manal Alosaimi

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Many rehabilitation strategies exist to aid persons with neurological disorders relearn motor skills through intensive training. Evidence supporting the theory that cortical areas involved in motor execution can be triggered by observing actions performed by others is attributed to the function of the mirror neuron system (MNS) indicates that activation of the MNS is associated with improvements in physical action and motor learning. Therefore, it is important to investigate the relationship between motor training (in this case, playing the drums) and the activation of the MNS. To achieve this, 15 healthy right-handed participants received drum-kit training for 21 weeks, during which time blood oxygen level-dependent (BOLD) signals were monitored in the brain using functional magnetic resonance imaging (fMRI). Participants were required to perform action–observation and action–execution fMRI tasks. The main results are that BOLD signals in classical regions of the MNS such as supramarginal gyri, inferior parietal lobule, and supplementary motor area increase significantly over the training period. Activation of these areas indicates that passive-observation of others performing these same skills may facilitate recovery of persons suffering from neurological disorders, and complement conventional rehabilitation programs that focus on action execution or intense training.

Keywords: fMRI, mirror neuron system, magnetic resonance imaging, neuroplasticity, drumming, learning, music, action observation, action execution

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634 Value Generation of Construction and Demolition Waste Originated in the Building Rehabilitation to Improve Energy Efficiency; From Waste to Resources

Authors: Mercedes Del Rio Merino, Jaime Santacruz Astorqui, Paola Villoria Saez, Carmen Viñas Arrebola

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The lack of treatment of the waste from construction and demolition waste (CDW) is a problem that must be solved immediately. It is estimated that in the world not to use CDW generates an increase in the use of new materials close to 20% of the total value of the materials used. The problem is even greater in case these wastes are considered hazardous because the final deposition of them may also generate significant contamination. Therefore, the possibility of including CDW in the manufacturing of building materials, represents an interesting alternative to ensure their use and to reduce their possible risk. In this context and in the last years, many researches are being carried out in order to analyze the viability of using CDW as a substitute for the traditional raw material of high environmental impact. Even though it is true, much remains to be done, because these works generally characterize materials but not specific applications that allow the agents of the construction to have the guarantees required by the projects. Therefore, it is necessary the involvement of all the actors included in the life cycle of these new construction materials, and also to promote its use for, for example, definition of standards, tax advantages or market intervention is necessary. This paper presents the main findings reached in "Waste to resources (W2R)" project since it began in October 2014. The main goal of the project is to develop new materials, elements and construction systems, manufactured from CDW, to be used in improving the energy efficiency of buildings. Other objectives of the project are: to quantify the CDW generated in the energy rehabilitation works, specifically wastes from the building envelope; and to study the traceability of CDW generated and promote CDW reuse and recycle in order to get close to the life cycle of buildings, generating zero waste and reducing the ecological footprint of the construction sector. This paper determines the most important aspects to consider during the design of new constructive solutions, which improve the energy efficiency of buildings and what materials made with CDW would be the most suitable for that. Also, a survey to select best practices for reducing "close to zero waste" in refurbishment was done. Finally, several pilot rehabilitation works conform the parameters analyzed in the project were selected, in order to apply the results and thus compare the theoretical with reality. Acknowledgements: This research was supported by the Spanish State Secretariat for Research, Development and Innovation of the Ministry of Economy and Competitiveness under "Waste 2 Resources" Project (BIA2013-43061-R).

Keywords: building waste, construction and demolition waste, recycling, resources

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633 Spino-Pelvic Alignment with SpineCor Brace Use in Adolescent Idiopathic Scoliosis

Authors: Reham H. Diab, Amira A. A. Abdallah, Eman A. Embaby

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Background: The effectiveness of bracing on preventing spino-pelvic alignment deterioration in idiopathic scoliosis has been extensively studied especially in the frontal plane. Yet, there is lack of knowledge regarding the effect of soft braces on spino-pelvic alignment in the sagittal plane. Achieving harmonious sagittal plane spino-pelvic balance is critical for the preservation of physiologic posture and spinal health. Purpose: This study examined the kyphotic angle, lordotic angle and pelvic inclination in the sagittal plane and trunk imbalance in the frontal plane before and after a six-month rehabilitation period. Methods: Nineteen patients with idiopathic scoliosis participated in the study. They were divided into two groups; experimental and control. The experimental group (group I) used the SpineCor brace in addition to a rehabilitation exercise program while the control group (group II) had the exercise program only. The mean ±SD age, weight and height were 16.89±2.15 vs. 15.3±2.5 years; 59.78±6.85 vs. 62.5±8.33 Kg and 162.78±5.76 vs. 159±5.72 cm for group I vs. group II. Data were collected using for metric Π system. Results: Mixed design MANOVA showed that there were significant (p < 0.05) decreases in all the tested variables after the six-month period compared with “before” in both groups. Moreover, there was a significant decrease in the kyphotic angle in group I compared with group II after the six-month period. Interpretation and conclusion: SpineCor brace is beneficial in reducing spino-pelvic alignment deterioration in both sagittal and frontal planes.

Keywords: adolescent idiopathic scoliosis, SpineCor, spino-pelvic alignment, biomechanics

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632 EEG Neurofeedback Training – Healing the Wounded Brain

Authors: Jamuna Rajeswaran

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In the past two decades, with a population of more than a billion. India is passing through a major socio-demographic and epidemiological transition with consequent changes in health scenario. TBI constitute significant burden on health care resources in India The impact on a person and family can be devastating. Patients with TBI experience persistent cognitive deficits, emotional changes, which contribute to the disruption of life activities. The recovery of TBI would be maximized by appropriate rehabilitation. Neurofeedback is an emerging neuroscience-based clinical application. Sixty patients were recruited for this study after obtaining informed consent. Rivermead Head Injury Follow-up Questionnaire, Rivermead Post Concussion Symptoms Questionnaire and Visual Analog Scale were used to assess the behavioral and symptomotolgy associated with post TBI. Neuropsychological assessment was carried out using NIMHANS neuropsychological battery 2004. The Intervention group received neurofeedback training and the waitlist group did not receive any treatment during this phase. Patients were allocated to intervention and waitlist group at random. There were 30 patients in each group. Patients were given 20 sessions of NFT Patients were trained on the O1 and O2 channels for alpha theta training. Each session was of 40 minutes duration with 5-6 sessions per week. The post-training assessment was carried out for the intervention group after 20 sessions of NFT. The waitlist group underwent assessment after one month. Results showed neurofeedback training is effective in ameliorating deficits in cognitive functions and quality of life in patients with TBI. Improvements were corroborated by the clinical interview with patients and significant others post NFT.

Keywords: assessment, rehabilitation, cognition, EEG neurofeedback

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