Search results for: patient rehabilitation

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

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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

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Authors: Matjaž Divjak, Simon Zelič, Aleš Holobar

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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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Authors: Reem Alshiha, Tanzila Saba

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Physical rehabilitation is the process of helping people to recover and be able to go back to their former activities that have been delayed due to external factors such as car accidents, old age and victims of strokes (chronic diseases and accidents, and those related to sport activities).The cost of hiring a personal nurse or driving the patient to and from the hospital could be costly and time-consuming. Also, there are other factors to take into account such as forgetfulness, boredom and lack of motivation. In order to solve this dilemma, some experts came up with rehabilitation software to be used with Microsoft Kinect to help the patients and their families for in-home rehabilitation. In home rehabilitation software is becoming more and more popular, since it is more convenient for all parties affiliated with the patient. In contrast to the other costly market-based systems that have no portability, Microsoft’s Kinect is a portable motion sensor that reads body movements and interprets it. New software development has made rehabilitation games available to be used at home for the convenience of the patient. The game will benefit its users (rehabilitation patients) in saving time and money. There are many software's that are used with the Kinect for rehabilitation, but the software that is chosen in this research is Kinectotherapy. Kinectotherapy software is used for rehabilitation patients in Riyadh clinics to test its acceptance by patients and their physicians. In this study, we used Kinect because it was affordable, portable and easy to access in contrast to expensive market-based motion sensors. This paper explores the importance of in-home rehabilitation by using Kinect with Kinectotherapy software. The software targets both upper and lower limbs, but in this research, the main focus is on upper-limb functionality. However, the in-home rehabilitation is applicable to be used by all patients with motor disability, since the patient must have some self-reliance. The targeted subjects are patients with minor motor impairment that are somewhat independent in their mobility. The presented work is the first to consider the implementation of in-home rehabilitation with real-time feedback to the patient and physician. This research proposes the implementation of in-home rehabilitation in Riyadh, Saudi Arabia. The findings show that most of the patients are interested and motivated in using the in-home rehabilitation system in the future. The main value of the software application is due to these factors: improve patient engagement through stimulating rehabilitation, be a low cost rehabilitation tool and reduce the need for expensive one-to-one clinical contact. Rehabilitation is a crucial treatment that can improve the quality of life and confidence of the patient as well as their self-esteem.

Keywords: x-box, rehabilitation, physical therapy, rehabilitation software, kinect

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Authors: Joaquim de Almeida Dultra, Daiana Cristina Pereira Santana, Fátima Karoline Alves Araújo Dultra, Liliane Akemi Kawano Shibasaki, Mariana Machado Mendes de Carvalho, Ieda Margarida Crusoé Rocha Rebello

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Defects originating from mandibular resections can cause significant functional impairment and facial disharmony, and they have complex rehabilitation. The aim of this report is to demonstrate the authors' experience facing challenging rehabilitation after mandibular resection in a patient with ameloblastoma. Clinical and surgical steps are described simultaneously, highlighting the adaptation of the final fixed prosthesis, reported in an unprecedented way in the literature. A 37-year-old male patient was seen after a sports accident, where a pathological fracture in the symphysis and left mandibular body was identified, where a large radiolucent lesion was found. The patient underwent resection, bone graft, distraction osteogenesis, rehabilitation with dental implants, prosthesis, and finally, orofacial harmonization, in an interval of six years. Rehabilitation should consider the patient's needs individually and should have as the main objective to provide similar aesthetics and function to that present before the disease. We also emphasize the importance of interdisciplinary work during the course of rehabilitation.

Keywords: ameloblastoma, mandibular reconstruction, distraction osteogenesis, dental implants. dental prosthesis, implant-supported, treatment outcome

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Authors: Mamoun S. Ideis, Zein Salah

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Virtual Rehabilitation (VR) refers to using Virtual Reality’s hardware and simulations as means of exercising tools to rehabilitate patients in need. These patients will undergo their treatment exercises while playing different computer games, which helps achieve greater motivation for patients undergoing their therapeutic exercises. Virtual Rehabilitation systems adopt computer games as part of the treatment therapy. In this paper, we present a preliminary proposal to using adaptive computer games in Virtual Rehabilitation therapy. We also present some tips in designing those adaptive computer games by using different machine learning algorithms in order to create a personalized experience for each patient, which in turn, increases the potential benefits of the treatment that each patient receives. Furthermore, we propose a method of comparing the results of treatment using the adaptive computer games with the results of using static and classical computer games.

Keywords: virtual rehabilitation, physiotherapy, adaptive computer games, post-stroke, game design

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Authors: David Maman, David E. Rothem, Merav Ben Natan, Yaron Berkovich

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Introduction: Hip fractures are a major health concern due to their impact on disability, independence, and mortality. Timely rehabilitation is crucial for improving patient outcomes and reducing healthcare costs, yet delays in rehabilitation, often due to challenges in discharge processes, can lead to adverse events and increased healthcare burdens. Aim: The study aimed to investigate two primary aspects related to hip fracture older adults patients: firstly, identifying subgroups more prone to delayed discharge for further rehabilitation; and secondly, exploring the consequences of this delay on short-term outcomes and the incidence of adverse events. Methods: Conducting a retrospective analysis, we examined the medical records of 474 patients aged 65 and older, hospitalized for hip fractures between 2018 and 2022 in a major hospital in the north-central region of Israel. All patients were eligible for further rehabilitation, including options for in-patient or home-based care. Results: Of the studied patients, 61.4% experienced delayed discharge, with an average waiting period of 3.5 days. Factors such as older age, prolonged hospital stay, and the need for in-patient rehabilitation were associated with a higher likelihood of delayed discharge. Those promptly discharged demonstrated lower rates of infections, falls, and mortality. Furthermore, delayed discharge to further rehabilitation correlated with elevated hospitalization costs. Notably, no significant differences were observed in re-hospitalization or repeat surgery rates. Conclusion: This study underscores the pressing need for efficient strategies to ensure timely rehabilitation, particularly for older adults. Implementing such strategies can optimize outcomes, mitigate adverse events, and contribute to a reduction in healthcare costs.

Keywords: hip fracture rehabilitation, delayed discharge, older adults, healthcare coordination, adverse events

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Authors: Pim Terachinda, Witaya Wannasuphoprasit, Wasuwat Kitisomprayoonkul, Anan Srikiatkhachorn

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Restoration of hand function and dexterity remain challenges in rehabilitation after stroke. We have developed soft exoskeleton hand robot in which using tendon-driven mechanism. Finger flexion and extension can be triggered by a foot switch and force can be adjusted manually depending on patient’s grip strength. The objective of this study is to investigate feasibility and safety of this device. The study was done in 2 stroke patients with the strength of the finger flexors/extensors grade 1/0 and 3/1 on Medical Research Council scale, respectively. Grasp and release training was performed for 30 minutes. No complication was observed. Results demonstrated that the device is safe, and therapy can be tailored to individual patient’s need. However, further study is required to determine recovery and rehabilitation outcomes after training in patients after nervous system injury.

Keywords: hand, rehabilitation, robot, stroke

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Authors: Boxiang Zhuang

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This study analyzes the clinical manifestations, hearing rehabilitation methods and outcomes of a complex case of neurofibromatosis type II (NF2). Methods: The clinical manifestations, medical history, clinical data, surgical methods and postoperative hearing rehabilitation outcomes of an NF2 patient were analyzed to determine the hearing reconstruction method and postoperative effect for a special type of NF2 acoustic neuroma. Results: The patient had bilateral acoustic neuromas with profound sensorineural hearing loss in both ears. Peripheral blood genetic testing did not reveal pathogenic gene mutations, suggesting mosaicism. The patient had an intracochlear schwannoma in the right ear and severely impaired vision in both eyes. Cochlear implantation with tumor retention was performed in the right ear. After 2 months of family-based auditory and speech rehabilitation, the Categories of Auditory Performance (CAP) score improved from 0 to 5. Conclusion: NF2 has complex clinical manifestations and poor prognosis. For NF2 patients with intracochlear tumors, cochlear implantation with tumor retention can be used to reconstruct hearing.

Keywords: NF2, intracochlear schwannoma, hearing reconstruction, cochlear implantation

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Authors: Chung-Yuan Wang, Kai-Chun Lee, Min-Hung Wang, Yu-Ren Chen, Hung-Sheng Lin, Sen-Shan Fan

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Taiwan National Health Insurance (NHI) was launched in 1995. It is an important social welfare policy in Taiwan. Regardless of the diversified social and economic status, universal coverage of NHI was assured. In order to regain better self-care performance, stroke people received in-patient and out-patient rehabilitation. Though NHI limited the rehabilitation frequency to one per day, the cost of rehabilitation still increased rapidly. Through the intensive rehabilitation during the post-stroke rehabilitation golden period, stroke patients might decrease their disability and shorten the rehabilitation period. Therefore, the aim of this study was to investigate the effect of intensive post-acute stroke rehabilitation in hospital under per diem payment. This study was started from 2014/03/01. The stroke patients who were admitted to our hospital or medical center were indicated to the study. The neurologists would check his modified Rankin Scale (mRS). Only patients with their mRS score between 2 and 4 were included to the study. Patients with unclear consciousness, unstable medical condition, unclear stroke onset date and no willing for 3 weeks in-patient intensive rehabilitation were excluded. After the physiatrist’s systemic evaluation, the subjects received intensive rehabilitation programs. The frequency of rehabilitation was thrice per day. Physical therapy, occupational therapy and speech/swallowing therapy were included in the programs for the needs of the stroke patients. Activity daily life performance (Barthel Index) and functional balance ability (Berg Balance Scale) were used to measure the training effect. During 3/1 to 5/31, thirteen subjects (five male and eight female) were included. Seven subjects were aged below 60. Three subjects were aged over 70. Most of the subjects (seven subjects) received intensive post-stroke rehabilitation for three weeks. Three subjects drop out from the programs and went back home respectively after receiving only 7, 10, and 13 days rehabilitation. Among these 13 subjects, nine of them got improvement in activity daily life performance (Barthel Index score). Ten of them got improvement in functional balance ability (Berg Balance Scale). The intensive post-acute stroke rehabilitation did help stroke patients promote their health in our study. Not only their functional performance improved, but also their self-confidence improved. Furthermore, their family also got better health status. Stroke rehabilitation under per diem payment was noted in long-term care institution in developed countries. Over 95% populations in Taiwan were supported under the Taiwan's National Health Insurance system, but there was no national long-term care insurance system. Most of the stroke patients in Taiwan live with his family and continue their rehabilitation programs from out-patient department. This pilot study revealed the effect of intensive post-acute stroke rehabilitation in hospital under per diem payment. The number of the subjects and the study period were limited. Thus, further study will be needed.

Keywords: rehabilitation, post-acute stroke, per diem payment, NHI

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Authors: Marketa Kotova, Jana Kolarova, Ludek Zalud, Petr Dobsak

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A game for training of breath (TRABR) for continuous monitoring of pulmonary ventilation during the patients’ therapy focuses especially on monitoring of their ventilation processes. It is necessary to detect, monitor and differentiate abdominal and thoracic breathing during the therapy. It is a fun form of rehabilitation where the patient plays and also practicing isolated breathing. Finally the game to practice breath was designed to evaluate whether the patient uses two types of breathing or not.

Keywords: pulmonary ventilation, thoracic breathing, abdominal breathing, breath monitoring using pressure sensors, game TRABR TRAining of BReath)

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Authors: Young Ae Song, So Yun Kim, Nan Ji Kim, So Young Jang, Yun Mee Park, Mi Jin Lee, Ji Yeon Lee

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Background & Purpose: Many patients have psychological problems such as depression and anxiety during the rehabilitation period. Such psychological instability affects the prognosis of the patient in the long term. We develop a nursing intervention program for rehabilitation inpatients using a rehabilitation self –management note and evaluate the effects of the program on depression, motivation, and self-efficacy. Methods: The study was conducted using a nonequivalent control group non-synchronized design. Participants were rehabilitation inpatients, 27 patients in the control group and 20 in the experimental group. Questionnaires were completed three times (pretest, 5 days, 10 days) Final data for 40 patients were analyzed, 23 patients in the control group and 17 in the experimental group. Data were analyzed using x2-test, t-test, and repeated measure ANOVA. Results: Depression in the experimental group decreased compared to the control group, but it was not significant. The motivation for the experimental group changed significantly (F=3.90, p=.029) and self-efficacy increased, but not significantly (F=0.59, p=.559) Conclusion: Results of this study indicate that nursing intervention programs for rehabilitation inpatients could be useful to decrease depression and to improve motivation and self-efficacy.

Keywords: depression, motivation, self-efficacy, rehabilitation inpatient, self-management workbook

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Authors: Winncy Du, Jeremy Nguyen, Harpinder Dhillon, Reinardus Justin Halim, Clayton Haske, Trent Hughes, Marissa Ortiz, Rozy Saini

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Stroke often causes death or cerebro-vascular (CV) brain damage. Most patients with CV brain damage lost their motor control on their limbs. This paper focuses on developing a reliable, safe, and non-invasive EEG-based robot-assistant stroke rehabilitation system to help stroke survivors to rapidly restore their motor control functions for their limbs. An electroencephalogram (EEG) recording device (EPOC Headset) and was used to detect a patient’s brain activities. The EEG signals were then processed, classified, and interpreted to the motion intentions, and then converted to a series of robot motion commands. A six-axis articulated robot (AdeptSix 300) was employed to provide the intended motions based on these commends. To ensure the EEG device, the computer, and the robot can communicate to each other, an Arduino microcontroller is used to physically execute the programming codes to a series output pins’ status (HIGH or LOW). Then these “hardware” commends were sent to a 24 V relay to trigger the robot’s motion. A lookup table for various motion intensions and the associated EEG signal patterns were created (through training) and installed in the microcontroller. Thus, the motion intention can be direct determined by comparing the EEG patterns obtaibed from the patient with the look-up table’s EEG patterns; and the corresponding motion commends are sent to the robot to provide the intended motion without going through feature extraction and interpretation each time (a time-consuming process). For safety sake, an extender was designed and attached to the robot’s end effector to ensure the patient is beyond the robot’s workspace. The gripper is also designed to hold the patient’s limb. The test results of this rehabilitation system show that it can accurately interpret the patient’s motion intension and move the patient’s arm to the intended position.

Keywords: brain waves, EEG sensor, motion control, robot-assistant stroke rehabilitation

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Authors: Ana-Katarina Nikich

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Background: The kinesiotaping method is often used in physiotherapy and rehabilitation. The purpose of this study was to evaluate the effectiveness of taping in the rehabilitation process of patients. Materials and methods: The study involved 90 male and female patients (the average age was 40-50 years) with various conditions requiring rehabilitation, such as injuries of the musculoskeletal system, sports injuries and other ailments. All patients were divided into two groups: experimental (n=40) and control (n=50). Both groups received 20 days of standard rehabilitation. In the experimental group, kinesiotaping methods were used, taking into account the individual characteristics of each patient. The control group performed regular exercises and physical therapy, but without using kinesiotape. During the study, physical parameters were monitored, interviews were conducted and the conditions of patients from both groups were compared. Results and discussion: The use of the kinesiotaping method in the rehabilitation process led to a significant improvement in physical parameters and pain reduction in patients. Significant improvement (p <0.005) was observed in all evaluated parameters among the patients of the experimental group. The control group also showed sufficient improvement (p <0.005), but the percentage of the experimental group was higher. As a result of the observation, the patients of the experimental group showed faster and more complete rehabilitation compared to the control group. The use of the kinesiotaping method allows to reduce the load on the damaged areas, improve blood circulation and lymphatic drainage, as well as increase stability and coordination of movements. Conclusions: Kinesiotaping as one of the modern therapeutic methods has shown its effectiveness in the rehabilitation process, contributing to the optimal recovery of patients with various conditions requiring rehabilitation. The use of tapes should be included in a comprehensive rehabilitation program to achieve the best results and reduce recovery time.

Keywords: kinesiotaping, rehabilitation, therapy, pain

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Authors: Hakan Akgul

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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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Authors: Rania E. Ramadan

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Dental esthetics is subjective, can be reported by the dentist and not noticed by the patient. However, if there is any imperfection seen by both the dentist and the patient, it is considered as an unesthetic like white and/or brown spot lesions. Many patients nowadays have been concerned about dental esthetics. Esthetic rehabilitation of anterior teeth and even maxillary premolars aid a lot in patients’ satisfaction of their smile consequently, gaining positive psychological impact for the patients. Many cases need esthetic rehabilitation such as diastema closure, spaced teeth and masking discolored teeth. Dental fluorosis and enamel hypo calcification can be presented as white and/or brown spot lesions. There are many treatment options for the management of these spotted teeth. Treatment options range from bleaching, microabrasion, direct composite restorations, porcelain veneers, and complete coverage crowns. The selection of certain options depends on many factors: the patient’s age, socioeconomic status and the severity of the lesion. In this clinical report, a 22-year-old male patient has been presented to the Department of Prosthodontics in Alexandria University, Egypt. His chief complaint was, “I was unpleased by white and brown spots in my teeth and I want to close the space between the two maxillary central.” Upon medical history, clinical examination, diagnostic photographs, and digital smile design by Exocad software, lithium disilicate veneers were chosen as the treatment of choice in maxillary anterior and first premolars.

Keywords: flourosis, ceramic veneers, case report, diastema closure

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Authors: Mauricio Plaza, Willian Aperador

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Hip disarticulation is an amputation through the hip joint capsule, removing the entire lower extremity, with a closure of the remaining musculature over the exposed acetabulum. Tumors of the distal and proximal femur were treated by total femur resection; a hip disarticulation sometimes is a performance for massive trauma with crush injuries to the lower extremity. This article discusses the design a system for rehabilitation of a patient with bilateral hip disarticulations. The prosthetics designed allowed the patient to do natural gait suspended between parallel articulate crutches with the body weight support between the crutches. The care of this patient was a challenge due to bilateral amputations at such a high level and the special needs of a patient mobility.

Keywords: amputation, prosthesis, mobility, hemipelvectomy

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Authors: Olga Maksakova

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A work with unconscious patients after acute brain damages besides special knowledge and practical skills of all the participants requires a very specific organization. A lot of said about team approach in neurorehabilitation, usually as for outpatient mode. Rehabilitologists deal with fixed patient problems or deficits (motion, speech, cognitive or emotional disorder). Team-building means superficial paradigm of management psychology. Linear mode of teamwork fits casual relationships there. Cases with deep altered states of consciousness (vegetative states, coma, and confusion) require non-linear mode of teamwork: recovery of consciousness might not be the goal due to phenomenon uncertainty. Rehabilitation team as Semi-open Complex System includes the patient as a part. Patient's response pattern becomes formed not only with brain deficits but questions-stimuli, context, and inquiring person. Teamwork is sourcing of phenomenology knowledge of patient's processes as Third-person approach is replaced with Second- and after First-person approaches. Here is a chance for real-time change. Patient’s contacts with his own body and outward things create a basement for restoration of consciousness. The most important condition is systematic feedbacks to any minimal movement or vegetative signal of the patient. Up to now, recovery work with the most severe contingent is carried out in the mode of passive physical interventions, while an effective rehabilitation team should include specially trained psychologists and psychotherapists. It is they who are able to create a network of feedbacks with the patient and inter-professional ones building up the team. Characteristics of ‘Team-Patient’ system (TPS) are energy, entropy, and complexity. Impairment of consciousness as the absence of linear contact appears together with a loss of essential functions (low energy), vegetative-visceral fits (excessive energy and low order), motor agitation (excessive energy and excessive order), etc. Techniques of teamwork are different in these cases for resulting optimization of the system condition. Directed regulation of the system complexity is one of the recovery tools. Different signs of awareness appear as a result of system self-organization. Joint meetings are an important part of teamwork. Regular or event-related discussions form the language of inter-professional communication, as well as the patient's shared mental model. Analysis of complex communication process in TPS may be useful for creation of the general theory of consciousness.

Keywords: rehabilitation team, urgent rehabilitation, severe brain damage, consciousness disorders, complex system theory

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Authors: Nancy N. Sharmila, Aparna Mishra

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Hemiparesis affects almost 80% of stroke patients each year. It is marked by paralysis or weakness on one half of the body. Our model provides both assistance and physical therapy for hemiparesis patients for swift recovery. In order to accomplish our goal a force is provided that pulls the forearm up (as in flexing the arm), and pushes the forearm down (as in extending the arm), which will also assist the user during ADL (Activities of Daily Living). The model consists of a mechanical component which is placed around the patient’s bicep and an EMG control circuit to assist patients in daily activities, which makes it affordable and easy to use. In order to enhance the neuromuscular system’s effectiveness in synchronize the movement, proprioceptive neuromuscular facilitation (PNF) concept is used. The EMG signals are acquired from the unaffected arm as an input to drive the orthosis. This way the patient is invigorated to use the orthosis for regular exercise.

Keywords: EMG, hemiparesis, orthosis, rehabilitation

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Authors: Nathalia Andrea Calderon Lesmes, Eduardo Barragan Parada, Diego Fernando Villegas Bermudez

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Spasticity in the plantiflexor muscles as a product of stroke (CVA-Cerebrovascular accident) restricts the mobility and independence of the affected people. Commonly, physiotherapists are in charge of manually performing the rehabilitation therapy known as Sustained Mechanical Stretching, rotating the affected foot of the patient in the sagittal plane. However, this causes a physical wear on the professional because it is a fatiguing movement. In this article, a mechanical device is developed to implement this rehabilitation therapy more efficiently. The device consists of a worm-crown mechanism that is driven by a crank to gradually rotate a platform in the sagittal plane of the affected foot, in order to achieve dorsiflexion. The device has a range of sagittal rotation up to 150° and has velcro located on the footplate that secures the foot. The design of this device was modeled by using CAD software and was checked structurally with a general purpose finite element software to be sure that the device is safe for human use. As a measurement system, a goniometer is used in the lateral part of the device and load cells are used to measure the force in order to determine the opposing torque exerted by the muscle. Load cells sensitivity is 1.8 ± 0.002 and has a repeatability of 0.03. Validation of the effectiveness of the device is measured by reducing the opposition torque and increasing mobility for a given patient. In this way, with a more efficient therapy, an improvement in the recovery of the patient's mobility and therefore in their quality of life can be achieved.

Keywords: biomechanics, mechanical device, plantiflexor muscles, rehabilitation, spastic hemiplegia, sustained mechanical stretching

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Authors: Mariana Volpini, Volker Bartenbach, Marcos Pinotti, Robert Riener

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Restoration of gait ability is an important task in the rehabilitation of people with neurological disorders presenting a great impact in the quality of life of an individual. Based on the motor learning concept, robotic assisted treadmill training has been introduced and found to be a feasible and promising therapeutic option in neurological rehabilitation but unfortunately it is not available for most patients in developing countries due to the high cost. This paper presents the concept of a low cost rehabilitation robot to help consolidate the robotic-assisted gait training as a reality in clinical practice in most countries. This work indicates that it is possible to build a simpler rehabilitation device respecting the physiological trajectory of the ankle.

Keywords: bioengineering, gait therapy, low cost rehabilitation robot, rehabilitation robotics

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Authors: Yirui Wang

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In the past few decades, patient safety has been the focus of much attention in the global medical and health field. As medical standards continue to improve and develop, the demand for patient safety is also growing. As one of the important dimensions in assessing patient safety, the Patient Perception Patient Safety Assessment Tool provides unique and valuable information from the patient's own perspective and plays an important role in promoting patient safety. This article aims to summarize and analyze the assessment content, assessment methods and applications of currently commonly used patient-perceived patient safety assessment tools at home and abroad, with a view to providing a reference for medical staff to select appropriate patient-perceived patient safety assessment tools.

Keywords: patients, patient safety, perception, assessment tools, review

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Authors: Ya-Hui Wang

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Lower speech therapy rate of tracheostomized patient was noted in comparison with previous researches. This study is aim to shed light on the referral status of speech therapy in those patients in Taiwan. This study developed an analysis for the size and key characteristics of the population of tracheostomized in-patient in the Taiwan. Method: We analyzed National Healthcare Insurance data (The Collaboration Center of Health Information Application, CCHIA) from Jan 1 2010 to Dec 31 2010. Result: over ages 3, number of tracheostomized in-patient is directly proportional to age. A high service loading was observed in North region in comparison with other regions. Only 4.87% of the tracheostomized in-patients were referred for speech therapy, and 1.9% for swallow examination, 2.5% for communication evaluation.

Keywords: refer, speech therapy, training, rehabilitation

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Authors: Juliani Rianto, Emma Lumby, Tracey Smith

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Cancer patients’ survival are growing with the new approach and therapy in oncology medicine. Cancer is now a new chronic disease, and rehabilitation program has become an ongoing program as part of cancer care. The focus of Cancer rehabilitation is maximising person’s physical and emotional function, stabilising general health and reducing unnecessary hospital admission. In Australia there are 150000 newly diagnosed cancer every year, and the most common Cancer are prostate, Breast, Colorectal, Melanoma and Lung Cancer. Through referral from the oncology team, we recruited cancer patient into our cancer rehabilitation program. Patients are assessed by our multi-disciplinary team including rehabilitation specialist, physiotherapist, occupational therapist, dietician, exercise physiologist, and psychologist. Specific issues are identified, including pain, side effect of chemo and radiation therapy and mental well-being. The goals were identified and reassessed every fortnight. Common goals including nutritional status, improve endurance and exercise performance, working on balance and mobility, improving emotional and vocational state, educational program for insomnia and tiredness, and reducing hospitalisation are identified and assessed. Patients are given 2 hours exercise program twice a week for 6 weeks with focus on aerobic and weight exercises and education sessions. Patients are generally benefited from the program. The quality of life is improved, support and interaction from the therapist has played an important factor in directing patient for their goals.

Keywords: cancer, exercises, benefit, mental health

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Authors: Zahra Hassani

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Background and Purpose: Poststroke depression (PSD) is one of the complications of a stroke that reduces the patient's chance of recovery, becomes irritable, and changes personality. Cognitive rehabilitation is one of the non-pharmacological methods that improve deficits such as attention, memory, and symptoms of depression. Therefore, the purpose of the present study is to evaluate the Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of stroke. Method: In this study, a systematic review of the databases Google Scholar, PubMed, Science Direct, Elsevier between the years 2015 and 2019 with the keywords cognitive rehabilitation therapy, post-stroke, depression Search is done. In this process, studies that examined the Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of stroke were included in the study. Results: Inclusion criteria were full-text availability, interventional study, and non-review articles. There was a significant difference between the articles in terms of the indices studied, sample number, method of implementation, and so on. A review of studies have shown that cognitive rehabilitation therapy has a significant role in reducing the symptoms of post-stroke depression. The use of these interventions is also effective in improving problem-solving skills, improving memory, and improving attention and concentration. Conclusion: This study emphasizes on the development of efficient and flexible adaptive skills through cognitive processes and its effect on reducing depression in patients after stroke.

Keywords: cognitive therapy, depression, stroke, rehabilitation

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Authors: Taisuke Sakaki, Toshihiko Shimokawa, Nobuhiro Ushimi, Koji Murakami, Yong-Kwun Lee, Kazuhiro Tsuruta, Kanta Aoki, Kaoru Fujiie, Ryuji Katamoto, Atsushi Sugyo

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Recently attention has been focused on incomplete spinal cord injuries (SCI) to the central spine caused by pressure on parts of the white matter conduction pathway, such as the pyramidal tract. In this paper, we focus on a training robot designed to assist with primary walking-pattern training. The target patient for this training robot is relearning the basic functions of the usual walking pattern; it is meant especially for those with incomplete-type SCI to the central spine, who are capable of standing by themselves but not of performing walking motions. From the perspective of human engineering, we monitored the operator’s actions to the robot and investigated the movement of joints of the lower extremities, the circumference of the lower extremities, and exercise intensity with the machine. The concept of the device was to provide mild training without any sudden changes in heart rate or blood pressure, which will be particularly useful for the elderly and disabled. The mechanism of the robot is modified to be simple and lightweight with the expectation that it will be used at home.

Keywords: training, rehabilitation, SCI patient, welfare, robot

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Authors: Sasibhushan Yengala, Nelson Muthu, Subramani Kanagaraj

Abstract:

The abstract reports on the design related to a modular and affordable standing cum sitting device to meet the requirements of paraplegic patients of the different physiques. Paraplegic patients need the assistance of an external arrangement to the lower limbs and trunk to help patients adopt the correct posture while standing abreast gravity. This support can be from a tilt table or a standing frame which the patient can use to stay in a vertical posture. Standing frames are devices fitting to support a person in a weight-bearing posture. Commonly, these devices support and lift the end-user in shifting from a sitting position to a standing position. The merits of standing for a paraplegic patient with a spinal injury are numerous. Even when there is limited control on muscles that ordinarily support the user using the standing frame in a vertical position, the standing stance improves the blood pressure, increases bone density, improves resilience and scope of motion, and improves the user's feelings of well-being by letting the patient stand. One limitation with standing frames is that these devices are typically function definitely; cannot be used for different purposes. Therefore, users are often compelled to purchase more than one of these devices, each being purposefully built for definite activities. Another concern frequent in standing frames is manoeuvrability; it is crucial to provide a convenient adjustment scope for all users. Thus, there is a need to provide a standing frame with multiple uses that can be economical for a larger population. There is also a need to equip added readjustment means in a standing frame to lessen the shear and to accommodate a broad range of users. The proposed Versatile Standing cum Sitting Device (VSD) is designed to change from standing to a comfortable sitting position using a series of mechanisms. First, a locking mechanism is provided to lock the VSD in a standing stance. Second, a dampening mechanism is provided to make sure that the VSD shifts from a standing to a sitting position gradually when the lock mechanism gets disengaged. An adjustment option is offered for the height of the headrest via the use of lock knobs. This device can be used in clinics for rehabilitation purposes irrespective of patient's anthropometric data due to its modular adjustments. It can facilitate the patient's daily life routine while in therapy and giving the patient the comfort to sit when tired. The device also provides the availability of rehabilitation to a common person.

Keywords: paraplegic, rehabilitation, spinal cord injury, standing frame

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Authors: Noorjehan Joosub-Vawda

Abstract:

Objectives: The aim of this poster presentation is to examine cultural contextual understandings of ABI that could aid conceptualisation and the development of a model for neuropsychological rehabilitation in this context. Characteristics of the South African context that make the implementation of international NR practices difficult include socioeconomic disparities, sociocultural influences, lack of accessibility to healthcare services, and poverty and unemployment levels. NR services in the developed world have characteristics such as low staff-to-patient ratios and interdisciplinary teams that make them unsuitable for the resource-constrained South African context. Methods: An exploratory, descriptive research design based on programme theory is being followed in the development of a South African model of neuropsychological rehabilitation. Results: The incorporation of African traditional understandings and practices, such as beliefs about ancestral spirits in the etiology of Acquired Brain Injury are relevant to the planning of rehabilitation interventions. Community-Based Rehabilitation workers, psychoeducation, and cooperation among the different systemic levels especially in rural settings is also needed to improve services offered to patients living with ABI. Conclusions. The preliminary model demonstrated in this poster will attempt to build on the strengths of South African communities, incorporating valuable evidence from international models to serve those affected with brain injury in this context.

Keywords: neuropsychological rehabilitation, South Africa, acquired brain injury, developing context

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Authors: Vinesh Janarthanan, Mohammad H. Rahman

Abstract:

There are numerous neurological conditions that may result in a loss of motor function. Such conditions may include cerebral palsy, Parkinson’s disease, stroke or multiple sclerosis. Due to impaired motor function, specifically in the hand and arm, living independently becomes tremendously more difficult. Rehabilitation programs are the main method to treat these kinds of disabled individuals. However, these programs require longtime commitment from the clinicians/therapists, demand person to person caring, and typically the treatment duration is usually very long. Aside from the treatment received from the therapist, the continuation of neuroplasticity at home is essential to maximizing development and restoring the biological function. To contribute in this area, we have researched and developed a portable and comfortable hand glove for fine motor skills rehabilitation. The glove provides interactive home-based therapy to engage the patient with simple games. The key to this treatment is the repetition of moving the hand and being capable of positioning the hand in various ways.

Keywords: home based, wearable sensors, glove, rehabilitation, motor function, video games

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Authors: Nina Robson, Kenneth John Faller II, Vishalkumar Ahir, Arthur Ricardo Deps Miguel Ferreira, John Buchanan, Amarnath Banerjee

Abstract:

This paper describes the development of a virtual-reality system ARWED, which will be used in physical rehabilitation of patients with reduced upper extremity mobility to increase limb Active Range of Motion (AROM). The ARWED system performs a symmetric reflection and real-time mapping of the patient’s healthy limb on to their most affected limb, tapping into the mirror neuron system and facilitating the initial learning phase. Using the ARWED, future experiments will test the extension of the action-observation priming effect linked to the mirror-neuron system on healthy subjects and then stroke patients.

Keywords: physical rehabilitation, mirror neuron, virtual reality, stroke therapy

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Authors: Bilal Ahmed

Abstract:

Rehabilitation of congenital and acquired maxillofacial defects is always a challenging clinical scenario. These defects pose major physiological and psychological threat not only to the patient but to the entire family. There has been an enormous scientific development in maxillofacial rehabilitation with the advent of CAD CAM, 3-D scanning, Osseo-integrated implants and improved restorative materials. There are also specialized centers with latest diagnostic and treatment facilities in the developed countries. However, in certain clinical case scenarios, conventional prosthodontic principles are still the gold standards. Similarly in a less developed world, financial and technical constraints are factors affecting treatment planning and final outcomes. However, we can do a lot of benefits to the affected human beings, even with use of simple and cost-effective conventional prosthodontic techniques and materials. These treatment strategies may sometimes be considered as intermediate or temporary options, but with regular follow-up maintenance these can be used on a definitive basis.

Keywords: maxillofacial defects, obturators, prosthodontics, medical and health sciences

Procedia PDF Downloads 345