Search results for: hip fracture rehabilitation
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1397

Search results for: hip fracture rehabilitation

1367 A Robotic Rehabilitation Arm Driven by Somatosensory Brain-Computer Interface

Authors: Jiewei Li, Hongyan Cui, Chunqi Chang, Yong Hu

Abstract:

It was expected to benefit patient with hemiparesis after stroke by extensive arm rehabilitation, to partially regain forearm and hand function. This paper propose a robotic rehabilitation arm in assisting the hemiparetic patient to learn new ways of using and moving their weak arms. In this study, the robotic arm was driven by a somatosensory stimulated brain computer interface (BCI), which is a new modality BCI. The use of somatosensory stimulation is not only an input for BCI, but also a electrical stimulation for treatment of hemiparesis to strengthen the arm and improve its range of motion. A trial of this robotic rehabilitation arm was performed in a stroke patient with pure motor hemiparesis. The initial trial showed a promising result from the patient with great motivation and function improvement. It suggests that robotic rehabilitation arm driven by somatosensory BCI can enhance the rehabilitation performance and progress for hemiparetic patients after stroke.

Keywords: robotic rehabilitation arm, brain computer interface (BCI), hemiparesis, stroke, somatosensory stimulation

Procedia PDF Downloads 385
1366 Limiting Fracture Stress of Composite Ceramics with Symmetric Triangle Eutectic

Authors: Jian Zheng, Jinfeng Yu, Xinhua Ni

Abstract:

The limiting fracture stress predicting model of composite ceramics with symmetric triangle eutectic was established based on its special microscopic structure. The symmetric triangle eutectic is consisted of matrix, the strong constraint inter-phase and reinforced fiber inclusions which are 120 degrees uniform symmetrical distribution. Considering the conditions of the rupture of the cohesive bond between matrix and fibers in eutectic and the stress concentration effect at the fiber end, the intrinsic fracture stress of eutectic was obtained. Based on the biggest micro-damage strain in eutectic, defining the load function, the macro-damage fracture stress of symmetric triangle eutectic was determined by boundary conditions. Introducing the conception of critical zone, the theoretical limiting fracture stress forecasting model of composite ceramics was got, and the stress was related to the fiber size and fiber volume fraction in eutectic. The calculated results agreed with the experimental results in the literature.

Keywords: symmetric triangle eutectic, composite ceramics, limiting stress, intrinsic fracture stress

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1365 Failure Analysis of Fuel Pressure Supply from an Aircraft Engine

Authors: M. Pilar Valles-gonzalez, Alejandro Gonzalez Meije, Ana Pastor Muro, Maria Garcia-Martinez, Beatriz Gonzalez Caballero

Abstract:

This paper studies a failure case of a fuel pressure supply tube from an aircraft engine. Multiple fracture cases of the fuel pressure control tube from aircraft engines have been reported. The studied set was composed of the mentioned tube, a welded connecting pipe, where the fracture has been produced, and a union nut. The fracture has been produced in one most critical zones of the tube, in a region next to the supporting body of the union nut to the connector. The tube material was X6CrNiTi18-10, an austenitic stainless steel. Chemical composition was determined using an X-Ray fluorescence spectrometer (XRF) and combustion equipment. Furthermore, the material has been mechanical, by hardness test, and microstructural characterized using a stereomicroscope and an optical microscope. The results confirmed that it is within specifications. To determine the macrofractographic features, a visual examination and a stereo microscope of the tube fracture surface have been carried out. The results revealed a tube plastic macrodeformation, surface damaged, and signs of a possible corrosion process. Fracture surface was also inspected by scanning electron microscopy (FE-SEM), equipped with a microanalysis system by X-ray dispersive energy (EDX), to determine the microfractographic features in order to find out the failure mechanism involved in the fracture. Fatigue striations, which are typical from a progressive fracture by a fatigue mechanism, have been observed. The origin of the fracture has been placed in defects located on the outer wall of the tube, leading to a final overload fracture.

Keywords: aircraft engine, fatigue, FE-SEM, fractography, fracture, fuel tube, microstructure, stainless steel

Procedia PDF Downloads 146
1364 Insufficiency Fracture of Femoral Head in Patients Treated With Intramedullary Nailing for Proximal Femur Fracture

Authors: Jai Hyung Park, Eugene Kim, Jin Hun Park, Min Joon Oh

Abstract:

Introduction: Subchondral insufficiency fracture of the femoral head (SIF) is a rare complication; however, it has been recognized to cause femoral head collapse. Subchondral insufficiency fracture (SIF) is caused by normal or physiological stress without any trauma. It has been reported in osteoporotic patients after the fixation of the proximal femur with an Intramedullary nail. Case presentation: We reported 5 cases with SIF of the femoral head after proximal femur fracture fixation with Intra-medullary nail. All patients had osteoporosis as an underlying disease. Good reduction was achieved in all 5 patients. SIF was found from about 3 months to 4 years after the initial operation, and all the fractures were solidly united at the final diagnosis. We investigated retrospectively the feature of those cases and several factors that affected the occurrence of SIF. Discussion: There are a few discussions regarding the SIF of the femoral head. These discussions may include the predisposing risk factors, how to diagnose the SIF in osteoporotic patients, and the peri-operative factors to prevent SIF. Conclusion: Subchondral insufficiency fracture of the femoral head is a considerable complication after the internal fixation of the proximal femur. There are several factors that can be modified. If they could be controlled in the peri-operative period, SIF could be prevented or handled in advance. Other options related to arthroplasty can be considered in old osteoporotic patients.

Keywords: insufficiency fracture of femoral head, intra-medullary nail, osteoporosis, proximal femur fracture

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1363 A Technique for Planning the Application of Buttress Plate in the Medial Tibial Plateau Using the Preoperative CT Scan

Authors: P. Panwalkar, K. Veravalli, R. Gwynn, M. Tofighi, R. Clement, A. Mofidi

Abstract:

When operating on tibial plateau fracture especially medial tibial plateau, it has regularly been said “where do I put my thumb to reduce the fracture”. This refers to the ideal placement of the buttress device to hold the fracture till union. The aim of this study was to see if one can identify this sweet spot using a CT scan. Methods: Forty-five tibial plateau fractures with medial plateau involvement were identified and included in the study. The preoperative CT scans were analysed and the medial plateau involvement pattern was classified based on modified radiological classification by Yukata et-al of stress fracture of medial tibial plateau. The involvement of part of plateau was compared with position of buttress plate position which was classified as medial posteromedial or both. Presence and position of the buttress was compared with ability to achieve and hold the reduction of the fracture till union. Results: Thirteen fractures were type-1 fracture, 19 fractures were type-2 fracture and 13 fractures were type-3 fracture. Sixteen fractures were buttressed correctly according to the potential deformity and twenty-six fractures were not buttressed and three fractures were partly buttressed correctly. No fracture was over butressed! When the fracture was buttressed correctly the rate of the malunion was 0%. When fracture was partly buttressed 33% were anatomically united and 66% were united in the plane of buttress. When buttress was not used, 14 were malunited, one malunited in one of the two planes of deformity and eleven anatomically healed (of which 9 were non displaced!). Buttressing resulted in statistically significant lower mal-union rate (x2=7.8, p=0.0052). Conclusion: The classification based on involvement of medial condyle can identify the placement of buttress plate in the tibial plateau. The correct placement of the buttress plate results in predictably satisfactory union. There may be a correlation between injury shape of the tibial plateau and the fracture type.

Keywords: knee, tibial plateau, trauma, CT scan, surgery

Procedia PDF Downloads 138
1362 Fracture Toughness Properties and FTIR Analysis of Corn Fiber Green Composites

Authors: Ahmed Hashim, Aseel Abdullah

Abstract:

In this work, the fracture toughness of new green composite based on bio-PMMA resin reinforced with randomly short corn natural fiber of constant weight fraction by 10% wt was investigated. The corn fiber surface was modified by mercerization treatment with two different concentrations of sodium hydroxide (3, and 5% NaOH) for 1.5 and 3 hours respectively. The effect of mercerization treatment on the fracture behavior of the green composites was analyzed by FTIR spectra. NaOH concentration of 3% for 1.5 hrs. That was used for corn fiber green composite should the highest improvement in terms of plane strain fracture toughness KIC which increased by 62 % compared to untreated fiber composite material. On the other hand, increased both concentrations of alkali solution to 5% NaOH and time of soaking to 3 hrs. reduced the values of KIC lower than the value of the unfilled material.

Keywords: green composites, fracture toughness, corn natural fiber, bio-PMMA

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1361 Multi-Plane Wrist Movement: Pathomechanics and Design of a 3D-Printed Splint

Authors: Sigal Portnoy, Yael Kaufman-Cohen, Yafa Levanon

Abstract:

Introduction: Rehabilitation following wrist fractures often includes exercising flexion-extension movements with a dynamic splint. However, during daily activities, we combine most of our wrist movements with radial and ulnar deviations. Also, the multi-plane wrist motion, named the ‘dart throw motion’ (DTM), was found to be a more stable motion in healthy individuals, in term of the motion of the proximal carpal bones, compared with sagittal wrist motion. The aim of this study was therefore to explore the pathomechanics of the wrist in a common multi-plane movement pattern (DTM) and design a novel splint for rehabilitation following distal radius fractures. Methods: First, a multi-axis electro-goniometer was used to quantify the plane angle of motion of the dominant and non-dominant wrists during various activities, e.g. drinking from a glass of water and answering a phone in 43 healthy individuals. The following protocols were then implemented with a population following distal radius fracture. Two dynamic scans were performed, one of the sagittal wrist motion and DTM, in a 3T magnetic resonance imaging (MRI) device, bilaterally. The scaphoid and lunate carpal bones, as well as the surface of the distal radius, were manually-segmented in SolidWorks and the angles of motion of the scaphoid and lunate bones were calculated. Subsequently, a patient-specific splint was designed using 3D scans of the hand. The brace design comprises of a proximal attachment to the arm and a distal envelope of the palm. An axle with two wheels is attached to the proximal part. Two wires attach the proximal part with the medial-palmar and lateral-ventral aspects of the distal part: when the wrist extends, the first wire is released and the second wire is strained towards the radius. The opposite occurs when the wrist flexes. The splint was attached to the wrist using Velcro and constrained the wrist movement to the desired calculated multi-plane of motion. Results: No significant differences were found between the multi-plane angles of the dominant and non-dominant wrists. The most common daily activities occurred at a plane angle of approximately 20° to 45° from the sagittal plane and the MRI studies show individual angles of the plane of motion. The printed splint fitted the wrist of the subjects and constricted movement to the desired multi-plane of motion. Hooks were inserted on each part to allow the addition of springs or rubber bands for resistance training towards muscle strengthening in the rehabilitation setting. Conclusions: It has been hypothesized that activation of the wrist in a multi-plane movement pattern following distal radius fractures will accelerate the recovery of the patient. Our results show that this motion can be determined from either the dominant or non-dominant wrists. The design of the patient-specific dynamic splint is the first step towards assessing whether splinting to induce combined movement is beneficial to the rehabilitation process, compared to conventional treatment. The evaluation of the clinical benefits of this method, compared to conventional rehabilitation methods following wrist fracture, are a part of a PhD work, currently conducted by an occupational therapist.

Keywords: distal radius fracture, rehabilitation, dynamic magnetic resonance imaging, dart throw motion

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1360 Nonlinear Flow Behavior and Validity of the Cubic Law in a Rough Fracture

Authors: Kunwar Mrityunjai Sharma, Trilok Nath Singh

Abstract:

The Navier-Stokes equation is used to study nonlinear fluid flow in rough 2D fractures. The major goal is to investigate the influence of inertial flow owing to fracture wall roughness on nonlinear flow behavior. Roughness profiles are developed using Barton's Joint Roughness Coefficient (JRC) and used as fracture walls to assess wall roughness. Four JRC profiles (5, 11, 15, and 19) are employed in the study, where a higher number indicates higher roughness. A parametric study has been performed using varying pressure gradients, and the corresponding Forchheimer number is calculated to observe the nonlinear behavior. The results indicate that the fracture roughness has a significant effect on the onset of nonlinearity. Additionally, the validity of the cubic law is evaluated and observed that it overestimates the flow in rough fractures and should be used with utmost care.

Keywords: fracture flow, nonlinear flow, cubic law, Navier-stokes equation

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1359 Crack Initiation Assessment during Fracture of Heat Treated Duplex Stainless Steels

Authors: Faraj Ahmed E. Alhegagi, Anagia M. Khamkam Mohamed, Bassam F. Alhajaji

Abstract:

Duplex stainless steels (DSS) are widely employed in industry for apparatus working with sea water in petroleum, refineries and in chemical plants. Fracture of DSS takes place by cleavage of the ferrite phase and the austenite phase ductile tear off. Pop-in is an important feature takes place during fracture of DSS. The procedure of Pop-ins assessment plays an important role in fracture toughness studies. In present work, Zeron100 DSS specimens were heat treated at different temperatures, cooled and pulled to failure to assess the pop-ins criterion in crack initiation prediction. The outcome results were compared to the British Standard (BS 7448) and the ASTEM standard (E1290) for Crack-Tip Opening Displacement (CTOD) fracture toughness measurement. Pop-in took place during specimens loading specially for those specimens heat treated at higher temperatures. The standard BS7448 was followed to check specimen validity for fractured toughness assessment by direct determination of KIC. In most cases, specimens were invalid for KIC measurement. The two procedures were equivalent only when single pop-ins were assessed. A considerable contrast in fracture toughness value between was observed where multiple pop-ins were assessed.

Keywords: fracture toughness, stainless steels, pop ins, crack assessment

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1358 An Unexpected Hand Injury with Pluridigital Fractures Due to Premature Explosion of a Ramadan Cannon

Authors: Hakan Akgul

Abstract:

Purpose: The use of firecrackers (i.e., Ramadan Cannon) during the month of Ramadan is a traditional way of indicating that the fasting period is over in Muslim countries. Here, we report the rehabilitation of a case of hand injury with pluridigital fractures due to premature explosion of a Ramadan cannon. Materials and Methods: A 48-year old man admitted to the Emergency Department due to left hand injury as a result of a premature explosion of a Ramadan cannon. The patient was immediately taken to operation room because of the multiple fractures, tendon loss, and soft tissue loss in the left hand. Range of motion (ROM) of joints was measured with goniometer, pain and oedema were measured and splinting was performed. Results: Rehabilitation team took over the patient at postoperative 9th week. During the 3 month rehabilitation, range of motion increased, oedema was taken under control, pain was reduced, the colour of the skin turned to the normal tone. According to the visual analog scale (VAS), pain decreased from 9 to 4. Oedema, around the metacarpofalangeal (MCP) joints, decreased from 27,5 cm to 23,5 cm. Total active range of motion of the wrist increased from 5 degrees to 50 degrees.Total active range of motion of supination and pronation increased from 55 degrees to 70 degrees. Discussion: The rehabilitation of multiple hand injury is quite difficult. Different aspects of trauma should be taken into consideration when rehabilitation is planned. Factors such as waiting for the bone union, wound healing, and use of external fixators may delay rehabilitation process. Joint mobilization, massage for reducing oedema and preventing scar tissue, exercise within the range of motion are efficient measures. Poor patient compliance to treatment may lead to poor outcome. First of all, oedema and scar formation must be taken under control. Removing fixators should not be delayed depending on the bone union, and exercise within the range of motion should be started.

Keywords: explosion, fracture, hand, injury

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1357 Assessment of Rehabilitation Possibilities in Case of Budapest Jewish Quarter Building Stock

Authors: Viktória Sugár, Attila Talamon, András Horkai, Michihiro Kita

Abstract:

The dense urban fabric of the Budapest 7th district is known as the former Jewish Quarter. The majority of the historical building stock contains multi-story tenement houses with courtyards, built around the end of the 19th century. Various rehabilitation and urban planning attempt occurred until today, mostly left unfinished. Present paper collects the past rehabilitation plans, actions and their effect which took place in the former Jewish District of Budapest. The authors aim to assess the boundaries of a complex building stock rehabilitation, by taking into account the monument protection guidelines. As a main focus of the research, structural as well as energetic rehabilitation possibilities are analyzed in case of each building by using Geographic Information System (GIS) methods.

Keywords: geographic information system, Hungary, Jewish Quarter, monument, protection, rehabilitation

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1356 Tracking Trajectory of a Cable-Driven Robot for Lower Limb Rehabilitation

Authors: Hachmia Faqihi, Maarouf Saad, Khalid Benjelloun, Mohammed Benbrahim, M. Nabil Kabbaj

Abstract:

This paper investigates and presents a cable-driven robot to lower limb rehabilitation use in sagittal plane. The presented rehabilitation robot is used for a trajectory tracking in joint space. The paper covers kinematic and dynamic analysis, which reveals the tensionability of the used cables as being the actuating source to provide a rehabilitation exercises of the human leg. The desired trajectory is generated to be used in the control system design in joint space. The obtained simulation results is showed to be efficient in this kind of application.

Keywords: cable-driven multi-body system, computed-torque controller, lower limb rehabilitation, tracking trajectory

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1355 Vocational Rehabilitation for People with Disabilities: Employment Rates, Job Persistence and Wages

Authors: Hester Fass, Ofir Pinto

Abstract:

Research indicates gaps in education, employment rates and wages between people with disabilities and those without disabilities. One of the main tools available to reduce these gaps is vocational rehabilitation. In order to examine the effects of vocational rehabilitation, a follow-up study, based on comprehensive administrative data, was conducted. The study included 88,286 people with disabilities who participated in vocational rehabilitation of the National Insurance Institute of Israel (NII), and completed the process between 1999 and 2012. Research variables included: employment rates, job persistence and wage levels. This research, the first of its kind in Israel, has several unique aspects: a)a long-range follow-up study on people who completed vocational rehabilitation; b) examination of a broad population spectrum, including also people that are not eligible to disability pensions ; c) a comparison among those with work-related injuries, those injured in hostile acts and those injured in other circumstances; and finally d) the identification of the characteristics of those who are entitled to vocational rehabilitation but who do not participate in any vocational rehabilitation plan. The most notable results include: 1. Vocational rehabilitation contributed to employment, job persistence and wage levels. Participation in vocational rehabilitation resulted in an employment rate of 65% within two years after completing the program, and 73% eventually. Participation in a vocational rehabilitation plan also contributed to job persistence and wage levels. 2. Vocational rehabilitation plans aimed at integration in universal frameworks increased the chances of being employed, persisting at the job and receiving a higher wage than did the vocational rehabilitation aimed at selective frameworks (such as sheltered workshops). 3. The type of disability affected the chances of integration in a vocational rehabilitation plan and in the labor market. People with a disability from birth had greater chances of integration in a vocational rehabilitation plan, while the type of disability and its severity affected the chances of the person with disabilities to find employment.

Keywords: vocational rehabilitation, employment, job persistence, wages

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1354 Comparative Study of Impact Strength and Fracture Morphological of Nano-CaCO3 and Nanoclay Reinforced HDPE Nanocomposites

Authors: Harun Sepet, Necmettin Tarakcioglu

Abstract:

The present study investigated the impact strength and fracture mechanism of nano-CaCO3 and nanoclay reinforced HDPE nanocomposites by using Charpy impact test. The nano-CaCO3 and nanoclay reinforced HDPE granules were prepared by the melt blending method using a compounder system, which consists of industrial banbury mixer, single screw extruder and granule cutting in industrial-scale. The nano-CaCO3 and nanoclay reinforced HDPE granules were molded using an injection-molding machine as plates, and then impact samples were cut by using punching die from the nanocomposite plates. As a result of impact experiments, nano-CaCO3 and nanoclay reinforced HDPE nanocomposites were determined to have lower impact energy level than neat HDPE. Also, the impact strength of HDPE further decreased by addition nanoclay compared to nano-CaCO3. The occurred fracture areas with the impact were detected by SEM examination. It is understood that fracture surface morphology changes when nano-CaCO3 and nanoclay ratio increases. The fracture surface changes were examined to determine the fracture mechanism of nano-CaCO3 and nanoclay reinforced HDPE nanocomposites.

Keywords: charpy, HDPE, industrial scale nano-CaCO3, nanoclay, nanocomposite

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1353 The Effect of Heating-Liquid Nitrogen Cooling on Fracture Toughness of Anisotropic Rock

Authors: A. Kavandi, K. Goshtasbi, M. R. Hadei, H. Nejati

Abstract:

In geothermal energy production, the method of liquid nitrogen (LN₂) fracturing in hot, dry rock is one of the most effective methods to increase the permeability of the reservoir. The geothermal reservoirs mainly consist of hard rocks such as granites and metamorphic rocks like gneiss with high temperatures. Gneiss, as a metamorphic rock, experiences a high level of inherent anisotropy. This type of anisotropy is considered as the nature of rocks, which affects the mechanical behavior of rocks. The aim of this study is to investigate the effects of heating-liquid nitrogen (LN₂) cooling treatment and rock anisotropy on the fracture toughness of gneiss. For this aim, a series of semi-circular bend (SCB) tests were carried out on specimens of gneiss with different anisotropy plane angles (0°, 30°, 60°, and 90°). In this study, gneiss specimens were exposed to heating–cooling treatment through gradual heating to 100°C followed by LN₂ cooling. Results indicate that the fracture toughness of treated samples is lower than that of untreated samples, and with increasing the anisotropy plane angle, the fracture toughness increases. The scanning electron microscope (SEM) technique is also implemented to evaluate the fracture process zone (FPZ) ahead of the crack tip.

Keywords: heating-cooling, anisotropic rock, fracture toughness, liquid nitrogen

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1352 The Important of Nutritional Status in Rehabilitation of Children with CP: Saudi Perspective

Authors: Reem Al-Garni

Abstract:

Malnutrition is a global epidemic, but the under-weight or Failure-To-Thrive risk is increasing in rehabilitation setting and considered one of the contribution factor for developmental delay. Beside the consequences of malnutrition on children growth and development, there are other side-effects that might delay or hold the progress of rehabilitation. The awareness for malnutrition must be raised and discussed by the rehabilitation team, to promote the treatment and to optimize the client care. The solution can start from food supplements intake and / or Enteral Nutrition plan, depending on the malnutrition level and to reach the goal, the medical team should to work together in order to provide comprehensive treatment and to help the family to be able to manage their child condition. We have explore the outcomes of rehabilitation between the children with CP whose diagnosed with malnutrition and children with normal body Wight Over a period of 4 months who received 4-6 weeks of rehabilitation two hours daily by using WeeFIM score to measure rehabilitation outcomes. WeeFIM measures and covers various domains, such as: self-care, mobility, locomotion, communication and other psycho-social aspects. Our findings reported that children with normal body Wight has better outcomes and improvement comparing with children with malnutrition for the entire study sample.

Keywords: Cerebral Palsy (CP), pediatric Functional Independent Measure (WeeFIM), rehabilitation, malnutrition

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1351 The Role of Secondary Filler on the Fracture Toughness of HDPE/Clay Nanocomposites

Authors: R. Kamarudzaman, A. Kalam, N. A. Mohd Fadzil

Abstract:

Oil Palm Fruit Bunch Fiber (OPEFB) was used as secondary filler in HDPE/clay nanocomposites. The composites were prepared by melt compounding which contains High Density Polyethylene (HDPE), OPEFB fibers, Maleic Anhydride Graft Polyethylene (MAPE) and four different clay loading (3, 5, 7 and 10 PE nanoclay pellets per hundred of HDPE pellets). Four OPEFB sizes (180 µm, 250 µm, 300 µm and 355 µm) were added in the composites to investigate their effects on fracture toughness. Fracture toughness of the composites were determined according to ASTM D5045 and Single Edge Notch Bending (SENB) been employed during the test. The effects of alkali treatment were also investigated in this study. The results indicate that the fracture toughness slightly increased as clay loading increased. The highest value of fracture toughness was 0.47 and 1.06 MPa.m1/2 at 5 phr for both types of clay loading. The presence of filler as reinforcement with the matrix indicates the enhancement of composites compared to those without the filler.

Keywords: oil palm empty fruit bunch, fiber, polyethylene, polymer nanocomposite, impact strength

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1350 Effect of Rehabilitation on Outcomes for Persons with Traumatic Brain Injury: Results from a Single Center

Authors: Savaş Karpuz, Sami Küçükşen

Abstract:

The aim of this study is to investigate the effectiveness of neurological rehabilitation in patients with traumatic brain injury. Participants were 45 consecutive adults with traumatic brain injury who were received the neurologic rehabilitation. Sociodemographic characteristics of the patients, the cause of the injury, the duration of the coma and posttraumatic amnesia, the length of stay in the other inpatient clinics before rehabilitation, the time between injury and admission to the rehabilitation clinic, and the length of stay in the rehabilitation clinic were recorded. The differences in functional status between admission and discharge were determined with Disability Rating Scale (DRS), Functional Independence Measure (FIM), and Functional Ambulation Scale (FAS) and levels of cognitive functioning determined with Ranchos Los Amigos Scale (RLAS). According to admission time, there was a significant improvement identified in functional status of patients who had been given the intensive in-hospital cognitive rehabilitation program. At discharge time, the statistically significant differences were obtained in DRS, FIM, FAS and RLAS scores according to admission time. Better improvement in functional status was detected in patients with lower scores in DRS, and higher scores FIM and RLAS scores at the entry time. The neurologic rehabilitation significantly affects the recovery of functional status after traumatic brain injury.

Keywords: traumatic brain injury, rehabilitation, functional status, neurological

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1349 Evaluation of Rehabilitation in Ischemic Stroke

Authors: Amirmohammad Dahouri

Abstract:

Each year, more than 795,000 individuals in the United States grieve a stroke, and by 2030, it is predictable that 4% of the U.S. people will have had a stroke. Ischemic stroke, accounting for about 80% of all strokes, is one of the main causes of disability. The goal of stroke rehabilitation is to help patients return to physical and mental functions and relearn the required aids to living everyday life. This flagging has an adverse effect on patients’ quality of life and affects their daily living activities. In recent years, the rehabilitation of ischemic stroke attractions more attention in the world. A review of the rudimentary perceptions of stroke rehabilitation that are price stressing to all specialists who delicacy patients with stroke. Ideas are made for patients on how to functionally manage daily activities after they have qualified for a stroke. It is vital for home healthcare clinicians to understand the process from acute events to medical equilibrium and rehabilitation to adaptation. Different sources such as Pub Med Google Scholar and science direct have been used and various contemporary articles in this era have been analyzed. The care plan must also foundation actual actions to protect against recurrent stroke, as stroke patients are generally at significant risk for further ischemic or hemorrhagic attacks. Here, we review evidence of rehabilitation in treating post-stroke impairment.

Keywords: rehabilitation, stroke, ischemic, hemorrhagic, brain

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1348 Numerical and Experimental Investigation of Mixed-Mode Fracture of Cement Paste and Interface Under Three-Point Bending Test

Authors: S. Al Dandachli, F. Perales, Y. Monerie, F. Jamin, M. S. El Youssoufi, C. Pelissou

Abstract:

The goal of this research is to study the fracture process and mechanical behavior of concrete under I–II mixed-mode stress, which is essential for ensuring the safety of concrete structures. For this purpose, two-dimensional simulations of three-point bending tests under variable load and geometry on notched cement paste samples of composite samples (cement paste/siliceous aggregate) are modeled by employing Cohesive Zone Models (CZMs). As a result of experimental validation of these tests, the CZM model demonstrates its capacity to predict fracture propagation at the local scale.

Keywords: cement paste, interface, cohesive zone model, fracture, three-point flexural test bending

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1347 Video-Based System for Support of Robot-Enhanced Gait Rehabilitation of Stroke Patients

Authors: Matjaž Divjak, Simon Zelič, Aleš Holobar

Abstract:

We present a dedicated video-based monitoring system for quantification of patient’s attention to visual feedback during robot assisted gait rehabilitation. Two different approaches for eye gaze and head pose tracking are tested and compared. Several metrics for assessment of patient’s attention are also presented. Experimental results with healthy volunteers demonstrate that unobtrusive video-based gaze tracking during the robot-assisted gait rehabilitation is possible and is sufficiently robust for quantification of patient’s attention and assessment of compliance with the rehabilitation therapy.

Keywords: video-based attention monitoring, gaze estimation, stroke rehabilitation, user compliance

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1346 General Principles of Accident Prevention in Built Environment Rehabilitation

Authors: Alfredo Soeiro

Abstract:

Rehabilitation in construction or built environment is a particular type of operations when concerning prevention of accidents. In fact, it is also a different type of task in construction itself. Therefore, due to the complex characteristics of construction rehabilitation tasks and due to the intrinsic difficulty of preventing accidents in construction, a major challenge faces the responsibility for implementing adequate safety levels in this type of safety management. This paper addresses a set of proposed generic measures to face the unknown characteristics of built environment in terms of stability, materials and actual performance of buildings or other constructions. It is also addressed the necessary adaptation of preventive guidelines to this type of delicate refurbishing and renovating of existing facilities. Training, observation and reflective approaches are necessary to perform this safety management in the rehabilitation of built environment.

Keywords: built environment, rehabilitation, construction safety, accident prevention, safety plan

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1345 Maxillofacial Trauma: A Case of Diacapitular Condylar Fracture

Authors: Krishna Prasad Regmi, Jun-Bo Tu, Cheng-Qun Hou, Li-Feng Li

Abstract:

Maxillofacial trauma in a pediatric group of patients is particularly challenging, as these patients have significant differences from adults as far as the facial skeleton is concerned. Mandibular condylar fractures are common presentations to hospitals across the globe and remain the most important cause of temporomandibular joint (TMJ) ankylosis. The etiology and epidemiology of pediatric trauma involving the diacapitular condylar fractures (DFs) have been reported in a large series of patients. Nevertheless, little is known about treatment protocols for DFs in children. Accordingly, the treatment modalities for the management of pediatric fractures also differ. We suggest following the PDA and intracapsular ABC classification of condylar fracture to increase the overall postoperative satisfaction level that bypasses the change of subjective feelings of patients’ from preoperative to the postoperative condition. At the same time, use of 3-D technology and surgical navigation may also increase treatment accuracy.

Keywords: maxillofacial trauma, diacapitular fracture, condylar fracture, PDA classification

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1344 Prediction of Crack Propagation in Bonded Joints Using Fracture Mechanics

Authors: Reza Hedayati, Meysam Jahanbakhshi

Abstract:

In this work, Fracture Mechanics is used to predict crack propagation in the adhesive jointing aluminum and composite plates. Three types of loadings and two types of glass-epoxy composite sequences: [0/90]2s and [0/45/-45/90]s are considered for the composite plate. Therefore 2*3=6 cases are considered and their results are compared. The debonding initiation load, complete debonding load, crack face profile and load-displacement diagram have been compared for the six cases.

Keywords: fracture, adhesive joint, debonding, APDL, LEFM

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1343 A Study on Effect of Dynamic Loading Speed on the Fracture Toughness of Equivalent Stress Gradient (ESG) Specimen

Authors: Moon Byung Woo, Seok Chang-Sung, Koo Jae-Mean, Kim Sang-Young, Choi Jae Gu, Huh Nam-Su

Abstract:

Recently, the occurrence of the earthquake has increased sharply and many of the casualties have occurred worldwide, due to the influence of earthquakes. Especially, the Fukushima nuclear power plant accident which was caused by the earthquake in 2011 has significantly increased the fear of people and the demand for the safety of the nuclear power plant. Thus, in order to prevent the earthquake accident at nuclear power plant, it is important to evaluate the fracture toughness considering the seismic loading rate. To obtain fracture toughness for the safety evaluation of nuclear power plant, it is desirable to perform experiments with a real scale pipe which is expensive and hard to perform. Therefore, many researchers have proposed various test specimens to replicate the fracture toughness of a real scale pipe. Since such specimens have several problems, the equivalent stress gradient (ESG) specimen has been recently suggested. In this study, in order to consider the effects of the dynamic loading speed on fracture toughness, the experiment was conducted by applying five different kinds of test speeds using an ESG specimen. In addition, after we performed the fracture toughness test under dynamic loading with different speeds using an ESG specimen and a standard specimen, we compared them with the test results under static loading.

Keywords: dynamic loading speed, fracture toughness, load-ratio-method, equivalent stress gradient (ESG) specimen

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1342 Impact of Pulmonary Rehabilitation on Respiratory Parameters in Interstitial Lung Disease Patients: A Tertiary Care Hospital Study

Authors: Vivek Ku, A. K. Janmeja, D. Aggarwal, R. Gupta

Abstract:

Purpose: Pulmonary rehabilitation plays a key role in management of chronic lung diseases. However, pulmonary rehabilitation is an underused modality in the management of interstitial lung disease (ILD). This is because limited information is available in literature and no data is available from India on this issue so far. The study was carried out to evaluate the role of pulmonary rehabilitation on respiratory parameters in ILD patients. Methods: The present study was a prospective randomized non-blind case control study. Total of 40 ILD patients were randomized into 2 groups of 20 patients each viz ‘pulmonary rehabilitation group’ and ‘control group’. Pulmonary rehabilitation group underwent 8 weeks pulmonary rehabilitation (PR) along with medical management as per guidelines and the control group was advised only medical management. Results: Mean age in case group was 59.15 ± 10.39 years and in control group was 62.10 ± 14.54 years. The case and the control groups were matched for age and sex. Mean MRC grading at the end of 8 weeks showed significant improvement in the case group as compared to control group (p= 0.011 vs p = 0.655). Similarly, mean St. George Respiratory Questionnaire (SGRQ) score also showed significant improvement in pulmonary rehabilitation group at the end of the study (p= 0.001 vs p= 0.492). However, FEV1 and FVC had no significant change in the case and control group. Similarly, blood gases also did not show any significant difference in the group. Conclusion: Pulmonary rehabilitation improves breathlessness and thereby improves quality of life in the patients suffering from ILD. However, the pulmonary function values and blood gases are unaffected by pulmonary rehabilitation. Clinical Implications: Further large scale multicentre study is needed to ascertain the association.

Keywords: ILD, pulmonary rehabilitation, quality of life, pulmonary functions

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1341 Sustainable Rehabilitation of Concrete Buildings in Iran: Harnessing Sunlight and Navigating Limited Water Resources

Authors: Amin Khamoosh, Hamed Faramarzifar

Abstract:

In the capital of Iran, Tehran, numerous buildings constructed when extreme climates were not prevalent now face the need for rehabilitation, typically within their first decade. Our data delves into the performance metrics and economic advantages of sustainable rehabilitation practices compared to traditional methods. With a focus on the scarcity of water resources, we specifically scrutinize water-efficient techniques throughout construction, rehabilitation, and usage. Examining design elements that optimize natural light while efficiently managing heat transmission is crucial, given the reliance on water for cooling devices in this region. The data aims to present a comprehensive strategy, addressing immediate structural concerns while harmonizing with Iran's unique environmental conditions.

Keywords: sustainable rehabilitation, concrete buildings, iran, solar energy, water-efficient techniques

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1340 Numerical Prediction of Effects of Location of Across-the-Width Laminations on Tensile Properties of Rectangular Wires

Authors: Kazeem K. Adewole

Abstract:

This paper presents the finite element analysis numerical investigation of the effects of the location of across-the-width lamination on the tensile properties of rectangular wires for civil engineering applications. FE analysis revealed that the presence of the mid-thickness across-the-width lamination changes the cup and cone fracture shape exhibited by the lamination-free wire to a V-shaped fracture shape with an opening at the bottom/pointed end of the V-shape at the location of the mid-thickness across-the-width lamination. FE analysis also revealed that the presence of the mid-width across-the-thickness lamination changes the cup and cone fracture shape of the lamination-free wire without an opening to a cup and cone fracture shape with an opening at the location of the mid-width across-the-thickness lamination. The FE fracture behaviour prediction approach presented in this work serves as a tool for failure analysis of wires with lamination at different orientations which cannot be conducted experimentally.

Keywords: across-the-width lamination, tensile properties, lamination location, wire

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1339 Mode II Fracture Toughness of Hybrid Fiber Reinforced Concrete

Authors: H. S. S Abou El-Mal, A. S. Sherbini, H. E. M. Sallam

Abstract:

Mode II fracture toughness (KIIc) of fiber reinforced concrete has been widely investigated under various patterns of testing geometries. The effect of fiber type, concrete matrix properties, and testing mechanisms were extensively studied. The area of hybrid fiber addition shows a lake of reported research data. In this paper an experimental investigation of hybrid fiber embedded in high strength concrete matrix is reported. Three different types of fibers; namely steel (S), glass (G), and polypropylene (PP) fibers were mixed together in four hybridization patterns, (S/G), (S/PP), (G/PP), (S/G/PP) with constant cumulative volume fraction (Vf) of 1.5%. The concrete matrix properties were kept the same for all hybrid fiber reinforced concrete patterns. In an attempt to estimate a fairly accepted value of fracture toughness KIIc, four testing geometries and loading types are employed in this investigation. Four point shear, Brazilian notched disc, double notched cube, and double edge notched specimens are investigated in a trial to avoid the limitations and sensitivity of each test regarding geometry, size effect, constraint condition, and the crack length to specimen width ratio a/w. The addition of all hybridization patterns of fiber reduced the compressive strength and increased mode II fracture toughness in pure mode II tests. Mode II fracture toughness of concrete KIIc decreased with the increment of a/w ratio for all concretes and test geometries. Mode II fracture toughness KIIc is found to be sensitive to the hybridization patterns of fiber. The (S/PP) hybridization pattern showed higher values than all other patterns, while the (S/G/PP) showed insignificant enhancement on mode II fracture toughness (KIIc). Four point shear (4PS) test set up reflects the most reliable values of mode II fracture toughness KIIc of concrete. Mode II fracture toughness KIIc of concrete couldn’t be assumed as a real material property.

Keywords: fiber reinforced concrete, Hybrid fiber, Mode II fracture toughness, testing geometry

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1338 Experimental and Numerical Analysis on Enhancing Mechanical Properties of CFRP Adhesive Joints Using Hybrid Nanofillers

Authors: Qiong Rao, Xiongqi Peng

Abstract:

In this work, multi-walled carbon nanotubes (MWCNTs) and graphene nanoplates (GNPs) were dispersed into epoxy adhesive to investigate their synergy effects on the shear properties, mode I and mode II fracture toughness of unidirectional composite bonded joints. Testing results showed that the incorporation of MWCNTs and GNPs significantly improved the shear strength, the mode I and mode II fracture toughness by 36.6%, 45% and 286%, respectively. In addition, the fracture surfaces of the bonding area as well as the toughening mechanism of nanofillers were analyzed. Finally, a nonlinear cohesive/friction coupled model for delamination analysis of adhesive layer under shear and normal compression loadings was proposed and implemented in ABAQUS/Explicit via user subroutine VUMAT.

Keywords: nanofillers, adhesive joints, fracture toughness, cohesive zone model

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