Search results for: stroke therapy.
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 255

Search results for: stroke therapy.

255 The Effects of Mirror Therapy on Clinical Improvement in Hemiplegic Lower Extremity Rehabilitation in Subjects with Chronic Stroke

Authors: Hassan M. Abo Salem, Xiaolin Huang

Abstract:

Background: The effectiveness of mirror therapy (MT) has been investigated in acute hemiplegia. The present study examines whether MT, given during chronic stroke, was more effective in promoting motor recovery of the lower extremity and walking speed than standard rehabilitation alone. Methods: The study enrolled 30 patients with chronic stroke. Fifteen patients each were assigned to the treatment group and the control group. All patients received a conventional rehabilitation program for a 4-week period. In addition to this rehabilitation program, patients in the treatment group received mirror therapy for 4 weeks, 5 days a week. Main measures: Passive ankle joint dorsiflexion range of motion, gait speed, Brunnstrom stages of motor recovery, plantar flexor muscle tone by Modified Ashworth Scale. Results: No significant difference was found in the outcome measures among groups before treatment. When compared with standard rehabilitation, mirror therapy improved Ankle ROM, Brunnstrom stages and waking speed (p < 0.05). However, there were no significant differences between two groups on MAS (P > 0.05).Conclusion: Mirror therapy combined with a conventional stroke rehabilitation program enhances lowerextremity motor recovery and walking speed in chronic stroke patients.

Keywords: Mirror therapy, stroke, MAS, walking speed.

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254 Virtual Reality for PostCOVID-19 Stroke: A Case Report

Authors: Kasra Afsahi, Maryam Soheilifar, Noureddin Nakhostin Ansari

Abstract:

COVID-19 has been associated with stroke and neurological complications. The patient was a 59-year-old male presented with sudden left hemiparesis and diplopia due to cavernous sinus thrombosis (CST) on 28/03/2020. The COVID-19 test was positive. Multislice computerized tomography (MSCT) showed ischemic infarction. He underwent surgical sinectomy 9 days after admission. Physiotherapy began for him on August 2020. Our game-based virtual reality (VR) technology developed for stroke patients was based on upper extremity exercises and function for stroke. After 6 weeks of VR therapy plus conventional physiotherapy exercises (18 sessions, three times per week, 60 minutes each session), there were significant improvements in Brunnstrom Motor Recovery Stage (from “4” to “5”), Fugl-Meyer Scale score of upper extremity section (from 49 to 54), and Modified Barthel Index (from 15 to 18). There were no adverse effects. This case with stroke post COVID-19 due to the CST showed the usefulness of VR therapy used as an adjunct to conventional physiotherapy in improving affected upper extremity.

Keywords: COVID-19, stroke, virtual reality, rehabilitation.

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253 Effects of Virtual Reality on the Upper Extremity Spasticity and Motor Function in Patients with Stroke: A Single Blinded Randomized Controlled Trial

Authors: K. Afsahi, M. Soheilifar, S. H. Hosseini, O. S. Esmaeili, R. Kezemi, N. Mehrbod, N. Vahed, T. Hajiahmad, N. N. Ansari

Abstract:

Background: Stroke is a disabling neurological disease. Rehabilitative therapies are important treatment methods. This clinical trial was done to compare the effects of virtual reality (VR) beside conventional rehabilitation versus conventional rehabilitation alone on the spasticity and motor function in stroke patients. Materials and methods: In this open-label randomized controlled clinical trial, 40 consecutive patients with stable first-ever ischemic stroke in the past three to 12 months that were referred to a rehabilitation clinic in Tehran, Iran in 2020 were enrolled. After signing the informed written consent form, subjects were randomly assigned by block randomization of five in each block as cases with 1:1 into two groups of 20 cases; conventional plus VR therapy group: 45-minute conventional therapy session plus 15-minute VR therapy, and conventional group: 60-minute conventional therapy session. VR rehabilitation is designed and developed with different stages. Outcomes were Modified Ashworth scale, Recovery Stage score for motor function, range of motion (ROM) of shoulder abduction/wrist extension, and patients’ satisfaction rate. Data were compared after study termination. Results: The satisfaction rate among the patients was significantly better in combination group (P = 0.003). Only wrist extension was varied between groups and was better in combination group. The variables generally had statistically significant difference (P < 0.05). Conclusion: VR plus conventional rehabilitation therapy is superior versus conventional rehabilitation alone on the wrist and elbow spasticity and motor function in patients with stroke.

Keywords: Stroke, virtual therapy, efficacy, rehabilitation.

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252 Modelling Sudden Deaths from Myocardial Infarction and Stroke

Authors: Yusoff Y. S., Streftaris, G., Waters, H. R

Abstract:

Death within 30 days is an important factor to be looked into, as there is a significant risk of deaths immediately following or soon after, myocardial infarction (MI) or stroke. In this paper, we will model the deaths within 30 days following a myocardial infarction (MI) or stroke in the UK. We will see how the probabilities of sudden deaths from MI or stroke have changed over the period 1981-2000. We will model the sudden deaths using a generalized linear model (GLM), fitted using the R statistical package, under a Binomial distribution for the number of sudden deaths. We parameterize our model using the extensive and detailed data from the Framingham Heart Study, adjusted to match UK rates. The results show that there is a reduction for the sudden deaths following a MI over time but no significant improvement for sudden deaths following a stroke.

Keywords: Sudden deaths, myocardial infarction, stroke, ischemic heart disease.

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251 Biomarkers in a Post-Stroke Population: Allied to Health Care in Brazil

Authors: M. Ricardo Lang, A. Costa, I. Iesbik, K. Haag, L. Trindade Buffara, O. Reimann Junior, C. Auswaldt Steclan

Abstract:

Stroke affects not only the individual, but has significant impacts on the social and family context. Therefore, it is necessary to know the peculiarities of each region, in order to contribute to regional public health policies effectively. Thus, the present study discusses biomarkers in a post-stroke population, admitted to a stroke unit (U-stroke) of reference in the southern region of Brazil. Biomarkers were analyzed, such as age, length of stay, mortality rate, survival time, risk factors and family history of stroke in patients after ischemic stroke. In this studied population, comparing men and women, it was identified that men were more affected than women, and the average age of women affected was higher, as they also had the highest mortality rate and the shortest hospital stay. The risk factors identified here were according to the global scenario; with systemic arterial hypertension (SAH) being the most frequent and those associated with sedentary lifestyle in women the most frequent (dyslipidemia, heart disease and obesity). In view of this, the importance of studies that characterize populations regionally is evident, strengthening the strategic planning of policies in favor of health care.

Keywords: Biomarkers, population, stroke, sex, stroke unit.

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250 Stroke Extraction and Approximation with Interpolating Lagrange Curves

Authors: Bence Kővári, ZSolt Kertész

Abstract:

This paper proposes a stroke extraction method for use in off-line signature verification. After giving a brief overview of the current ongoing researches an algorithm is introduced for detecting and following strokes in static images of signatures. Problems like the handling of junctions and variations in line width and line intensity are discussed in detail. Results are validated by both using an existing on-line signature database and by employing image registration methods.

Keywords: Stroke extraction, spline fitting, off-line signatureverification, image registration.

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249 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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248 Creating a Virtual Perception for Upper Limb Rehabilitation

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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247 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.

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246 Study of Tower Grounding Resistance Effected Back Flashover to 500 kV Transmission Line in Thailand by using ATP/EMTP

Authors: B. Marungsri, S. Boonpoke, A. Rawangpai, A. Oonsivilai, C. Kritayakornupong

Abstract:

This study describes analysis of tower grounding resistance effected the back flashover voltage across insulator string in a transmission system. This paper studies the 500 kV transmission lines from Mae Moh, Lampang to Nong Chok, Bangkok, Thailand, which is double circuit in the same steel tower with two overhead ground wires. The factor of this study includes magnitude of lightning stroke, and front time of lightning stroke. Steel tower uses multistory tower model. The assumption of studies based on the return stroke current ranged 1-200 kA, front time of lightning stroke between 1 μs to 3 μs. The simulations study the effect of varying tower grounding resistance that affect the lightning current. Simulation results are analyzed lightning over voltage that causes back flashover at insulator strings. This study helps to know causes of problems of back flashover the transmission line system, and also be as a guideline solving the problem for 500 kV transmission line systems, as well.

Keywords: Tower grounding resistance, back flashover, multistory tower model, lightning stroke current.

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245 A Novel EMG Feedback Control Method in Functional Electrical Stimulation Cycling System for Stroke Patients

Authors: Chien-Chih Chen, Ya-Hsin Hsueh, Zong-Cian He

Abstract:

With getting older in the whole population, the prevalence of stroke and its residual disability is getting higher and higher recently in Taiwan. The functional electrical stimulation cycling system (FESCS) is useful for hemiplegic patients. Because that the muscle of stroke patients is under hybrid activation. The raw electromyography (EMG) represents the residual muscle force of stroke subject whereas the peak-to-peak of stimulus EMG indicates the force enhancement benefiting from ES. It seems that EMG signals could be used for a parameter of feedback control mechanism. So, we design the feedback control protocol of FESCS, it includes physiological signal recorder, FPGA biomedical module, DAC and electrical stimulation circuit. Using the intensity of real-time EMG signal obtained from patients, as a feedback control method for the output voltage of FES-cycling system.

Keywords: Functional Electrical Stimulation cycling system EMG, control protocol.

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244 What Do Young People Seeking Professional Help Want and Expect From Therapy?

Authors: Clare Watsford, Debra Rickwood

Abstract:

Client expectations and preferences about therapy represent an important area of investigation as research shows they are linked to engagement in therapy and therapy outcomes. Studies examining young people-s expectations and preferences of therapy remain a neglected area of research. The present study explored what expectations and preferences young people seeking professional help held regarding: their role as a client, their therapist-s role, their therapeutic outcomes, and the processes of therapy. Gender and age differences were also examined. Participants included 188 young people aged 12-25 who completed a survey while attending their initial session at a youth mental health service. Data were analysed using quantitative methods. Results found the young people held significantly more pessimistic expectations around therapy when compared to what they had wanted therapy to be like. Few age and gender differences were found. Results highlight the importance of a collaborative therapy approach when working with young people.

Keywords: Client expectations, mental health services, preferences, young people

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243 Animal-Assisted Therapy for Persons with Disabilities Based on Canine Tail Language Interpretation via Gaussian-Trapezoidal Fuzzy Emotional Behavior Model

Authors: W. Phanwanich, O. Kumdee, P. Ritthipravat, Y. Wongsawat

Abstract:

In order to alleviate the mental and physical problems of persons with disabilities, animal-assisted therapy (AAT) is one of the possible modalities that employs the merit of the human-animal interaction. Nevertheless, to achieve the purpose of AAT for persons with severe disabilities (e.g. spinal cord injury, stroke, and amyotrophic lateral sclerosis), real-time animal language interpretation is desirable. Since canine behaviors can be visually notable from its tail, this paper proposes the automatic real-time interpretation of canine tail language for human-canine interaction in the case of persons with severe disabilities. Canine tail language is captured via two 3-axis accelerometers. Directions and frequencies are selected as our features of interests. The novel fuzzy rules based on Gaussian-Trapezoidal model and center of gravity (COG)-based defuzzification method are proposed in order to interpret the features into four canine emotional behaviors, i.e., agitate, happy, scare and neutral as well as its blended emotional behaviors. The emotional behavior model is performed in the simulated dog and has also been evaluated in the real dog with the perfect recognition rate.

Keywords: Animal-assisted therapy (AAT), Persons with disabilities, Canine tail language, Fuzzy emotional behavior model

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242 Characteristics and Outcomes of COVID-19 Related Stroke: A Cohort Study

Authors: Kasra Afsahi, Maryam Soheilifar

Abstract:

Cerebrovascular accident (CVA) is a neurological side effect of COVID-19 disease wit high rate in pandemics. Effect of COVID-19 disease on disorder is unclear. In this cohort, patients with COVID-19 disease were assessed. 60 CVA cases were assessed in a referral hospital in 2020. The major factor was mortality and the cases were those with and without death. The groups were compared for all features about mortality in the patients with COVID-19 and CVA. Totally 23 out of 60 cases (38.3%) were expired. In univariate analysis there was significant association for death by ischemic heart disease (P = 0.015), high-severity stroke (P = 0.012), high C-reactive protein (CRP) (P = 0.001), high ESR (P = 0.009), pleural effusion (P = 0.005), pericardial effusion (P = 0.027), cardiomegaly (P = 0.005), ground glass opacity (P = 0.001), and consolidation (P = 0.001). Among these factors, there was significant association only for CRP (P = 0.001) and consolidation (P = 0.003) in multivariate analysis. Mortality in the cases with COVID-19-related CVA is one-third and it has relationship to elevated CRP and finding the consolidation in the computerized tomography scan of the lungs.

Keywords: COVID-19, stroke, prognosis, C-reactive protein, CRP.

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241 Coupling Phenomenon between the Lightning and High Voltage Networks

Authors: Dib Djalel, Haddouche Ali, Chellali Benachiba

Abstract:

When a lightning strike falls near an overhead power line, the intense electromagnetic field radiated by the current of the lightning return stroke coupled with power lines and there induced transient overvoltages, which can cause a back-flashover in electrical network. The indirect lightning represents a major danger owing to the fact that it is more frequent than that which results from the direct strikes. In this paper we present an analysis of the electromagnetic coupling between an external electromagnetic field generated by the lightning and an electrical overhead lines, so we give an important and original contribution: We are based on our experimental measurements which we carried in the high voltage laboratories of EPFL in Switzerland during the last trimester of 2005, on the recent works of other authors and with our mathematical improvement a new particular analytical expression of the electromagnetic field generated by the lightning return stroke was developed and presented in this paper. The results obtained by this new electromagnetic field formulation were compared with experimental results and give a reasonable approach.

Keywords: Lightning, overhead lines, electromagneticcoupling, return stroke, models, induced overvoltages.

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240 The Effectiveness of Metaphor Therapy on Depression among Female Students

Authors: Marzieh Talebzadeh Shoushtari

Abstract:

The present study aimed to determine the effectiveness of Metaphor therapy on depression among female students. The sample included 60 female students with depression symptoms selected by simple sampling and randomly divided into two equal groups (experimental and control groups). Beck Depression Inventory was used to measure the variables. This was an experimental study with a pre-test/post-test design with control group. Eight metaphor therapy sessions were held for the experimental group. A post-test was administered to both groups. Data were analyzed using multivariate analysis of covariance (MANCOVA). Results showed that the Metaphor therapy decreased depression in the experimental group compared to the control group.

Keywords: Metaphor therapy, depression, female, students.

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239 Virtual Reality in COVID-19 Stroke Rehabilitation: Preliminary Outcomes

Authors: Kasra Afsahi, Maryam Soheilifar, S. Hossein Hosseini

Abstract:

Background: There is growing evidence that Cerebral Vascular Accident (CVA) can be a consequence of COVID-19 infection. Understanding novel treatment approaches is important in optimizing patient outcomes. Case: This case explores the use of Virtual Reality (VR) in the treatment of a 23-year-old COVID-positive female presenting with left hemiparesis in August 2020. Imaging showed right globus pallidus, thalamus, and internal capsule ischemic stroke. Conventional rehabilitation was started two weeks later, with VR included. This game-based VR technology developed for stroke patients was based on upper extremity exercises and functions for stroke. Physical examination showed left hemiparesis with muscle strength 3/5 in the upper extremity and 4/5 in the lower extremity. The range of motion of the shoulder was 90-100 degrees. The speech exam showed a mild decrease in fluency. Mild lower lip dynamic asymmetry was seen. Babinski was positive on the left. Gait speed was decreased (75 steps per minute). Intervention: Our game-based VR system was developed based on upper extremity physiotherapy exercises for post-stroke patients to increase the active, voluntary movement of the upper extremity joints and improve the function. The conventional program was initiated with active exercises, shoulder sanding for joint ROMs, walking shoulder, shoulder wheel, and combination movements of the shoulder, elbow, and wrist joints, alternative flexion-extension, pronation-supination movements, Pegboard and Purdo pegboard exercises. Also, fine movements included smart gloves, biofeedback, finger ladder, and writing. The difficulty of the game increased at each stage of the practice with progress in patient performances. Outcome: After 6 weeks of treatment, gait and speech were normal and upper extremity strength was improved to near normal status. No adverse effects were noted. Conclusion: This case suggests that VR is a useful tool in the treatment of a patient with COVID-19 related CVA. The safety of developed instruments for such cases provides approaches to improve the therapeutic outcomes and prognosis as well as increased satisfaction rate among patients.

Keywords: COVID-19, stroke, virtual reality, rehabilitation.

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238 Pilot Trial of Evidence-Based Integrative Group Therapy to Improve Executive Functioning among Adults: Implications for Community Mental Health and Training Clinics

Authors: B. Parchem, M. Watanabe, D. Modrakovic, L. Mathew, A. Franklin, M. Cao, R. E. Broudy

Abstract:

Objective: Executive functioning (EF) deficits underlie several mental health diagnoses including ADHD, anxiety, and depression. Community mental health clinics face extensive waitlists for services with many referrals involving EF deficits. A pilot trial of a four-week group therapy was developed using key components from Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and mindfulness with an aim to improve EF skills and offer low-fee services. Method: Eight adults (M = 34.5) waiting for services at a community clinic were enrolled in a four-week group therapy at an in-house training clinic for doctoral trainees. Baseline EF, pre-/post-intervention ADHD and distress symptoms, group satisfaction, and curriculum helpfulness were assessed. Results: Downward trends in ADHD and distress symptoms pre/post-intervention were not significant. Favorable responses on group satisfaction and helpfulness suggest clinical utility. Conclusion: Preliminary pilot data from a brief group therapy to improve EF may be an efficacious, acceptable, and feasible intervention for adults waiting for services at community mental health and training clinics where there are high demands and limits to services and staffs.

Keywords: Executive functioning, cognitive-behavioral therapy, dialectical behavior therapy, mindfulness, adult group therapy.

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237 Cognitive Behaviour Therapy to Treat Social Anxiety Disorder: A Psychology Case

Authors: Yasmin Binti Othman Mydin, Mohd. Fadzillah Abdul Razak

Abstract:

Rational Emotive Behaviour Therapy is the first cognitive behavior therapy which was introduced by Albert Ellis. This is a systematic and structured psychotherapy which is effective in treating various psychological problems. A patient, 25 years old male, experienced intense fear and situational panic attack to return to his faculty and to face his class-mates after a long absence (2 years). This social anxiety disorder was a major factor that impeded the progress of his study. He was treated with the use of behavioural technique such as relaxation breathing technique and cognitive techniques such as imagery, cognitive restructuring, rationalization technique and systematic desensitization. The patient reported positive improvement in the anxiety disorder, able to progress well in studies and lead a better quality of life as a student.

Keywords: Anxiety, behaviour, cognitive, therapy

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236 A Heat-Inducible Transgene Expression System for Gene Therapy

Authors: Masaki Yamaguchi, Akira Ito, Noriaki Okamoto, Yoshinori Kawabe, Masamichi Kamihira

Abstract:

Heat-inducible gene expression vectors are useful for hyperthermia-induced cancer gene therapy, because the combination of hyperthermia and gene therapy can considerably improve the therapeutic effects. In the present study, we developed an enhanced heat-inducible transgene expression system in which a heat-shock protein (HSP) promoter and tetracycline-responsive transactivator were combined. When the transactivator plasmid containing the tetracycline-responsive transactivator gene was co-transfected with the reporter gene expression plasmid, a high level of heat-induced gene expression was observed compared with that using the HSP promoter without the transactivator. In vitro evaluation of the therapeutic effect using HeLa cells showed that heat-induced therapeutic gene expression caused cell death in a high percentage of these cells, indicating that this strategy is promising for cancer gene therapy.

Keywords: Inducible gene expression, Gene therapy, Hyperthermia, Heat shock protein, Tetracycline transactivator.

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235 The Impact of Solution-Focused Brief Therapy on the Improvement of the Psychological Wellbeing of Family Supervisor Women

Authors: Kaveh Qaderi Bagajan, Osman Khanahmadi, Ziba Mamaghani Chaharborj, Majid Chenaparchi

Abstract:

The purpose of this study is to investigate the efficacy of the solution-focused brief therapy on improving the psychological wellbeing of family supervisor woman. This study has been carried out by semi-experimental method and in the form of pre-test, post-test performance on two groups (experimental and control), so that one sample group of 30 individuals was randomly achieved and were randomly divided in two groups of experimental (n=15) and control (n=15). To collect data, Ryff scale psychological wellbeing was used. After conducting pre-test (RSPWB) for two experimental and control groups, Solution-focused brief therapy interference was conducted on the experimental group during five two-hour sessions. Finally, Ryff scale psychological wellbeing was reused for the two groups as post-test and achieved outcomes that were analyzed using covariance. The results indicated that the significant increase of average marks of the experimental group in psychological wellbeing had better function than that of the control group. Finally, solution-focused brief therapy for improving psychological well-being of family supervisor women has a suitable capability and could be used in this way.

Keywords: Solution-Focused Brief Therapy, Short-term Therapy, Family Supervisor Women, Psychological Wellbeing.

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234 Effect of Cold, Warm or Contrast Therapy on Controlling Knee Osteoarthritis Associated Problems

Authors: Amal E. Shehata, Manal E. Fareed

Abstract:

Osteoarthritis (OA) is the most prevalent and far common debilitating form of arthritis which can be defined as a degenerative condition affecting synovial joint. Patients suffering from osteoarthritis often complain of dull ache pain on movement. Physical agents can fight the painful process when correctly indicated and used such as heat or cold therapy Aim. This study was carried out to: Compare the effect of cold, warm and contrast therapy on controlling knee osteoarthritis associated problems. Setting: The study was carried out in orthopedic outpatient clinics of Menoufia University and teaching Hospitals, Egypt. Sample: A convenient sample of 60 adult patients with unilateral knee osteoarthritis. Tools: three tools were utilized to collect the data. Tool I : An interviewing questionnaire. It comprised of three parts covering  sociodemographic data, medical data and adverse effects of the treatment protocol. Tool II : Knee Injury and Osteoarthritis Outcome Score (KOOS) It consists of five main parts. Tool II1 : 0-10 Numeric pain rating scale. Results: reveled that the total knee symptoms score was decreased from moderate symptoms pre intervention to mild symptoms after warm and contrast method of therapy, but the contrast therapy had significant effect in reducing the knee symptoms and pain than the other symptoms. Conclusions: all of the three methods of therapy resulted in improvement in all knee symptoms and pain but the most appropriate protocol of treatment to relive symptoms and pain was contrast therapy.

Keywords: Knee Osteoarthritis, Cold, Warm and Contrast Therapy.

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233 The Efficacy of Self-Administered Danger Ideation Reduction Therapy for a 50-year Old Woman with a 20 Year History of Obsessive- Compulsive Disorder: A Case Study

Authors: Mairwen K. Jones, Lynne Harris, Lisa D. Vaccaro

Abstract:

Obsessive-Compulsive Disorder (OCD) is a common and disabling condition. Therapist-delivered treatments that use exposure and response prevention have been found to be very effective in treating OCD, although they are costly and associated with high rates of attrition. Effective treatments that can be made widely available without the need for therapist contact are urgently needed. This case study represents the first published investigation of a self-administered cognitive treatment for OCD in a 50-year old female with a 20 year history of OCD. The treatment evaluation occurred over 27 weeks, including 12 weeks of self-administration of the Danger Ideation Reduction Therapy (DIRT) program. Decreases of between 23% to 33% on measures from pre-treatment to follow-up were observed. Bearing in mind the methodological limitations associated with a case study, we conclude that the results reported here are encouraging and indicate that further research effort evaluating the effectiveness of self-administered DIRT is warranted.

Keywords: Anxiety Treatment, Cognitive Therapy, Danger Ideation Reduction Therapy, Obsessive–Compulsive Disorder, Self- Administered Danger Ideation Reduction Therapy.

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232 Mechanical Design and Theoretical Analysis of a Skip-Cycle Mechanism for an Internal Combustion Engine

Authors: Ismail Gerzeli, Cemal Baykara, Osman Akin Kutlar

Abstract:

Skip cycle is a working strategy for spark ignition engines, which allows changing the effective stroke of an engine through skipping some of the four stroke cycles. This study proposes a new mechanism to achieve the desired skip-cycle strategy for internal combustion engines. The air and fuel leakage, which occurs through the gas exchange, negatively affects the efficiency of the engine at high speeds and loads. An absolute sealing is assured by direct use of poppet valves, which are kept in fully closed position during the skipped mode. All the components of the mechanism were designed according to the real dimensions of the Anadolu Motor's gasoline engine and modeled in 3D by means of CAD software. As the mechanism operates in two modes, two dynamically equivalent models are established to obtain the force and strength analysis for critical components.

Keywords: Dynamic Model, Mechanical Design, Skip Cycle System (SCS), Valve Disabling Mechanism

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231 A Vortex Plate Theory of Hovering Animal Flight

Authors: Khaled. M. Faqih

Abstract:

A model of vortex wake is suggested to determine the induced power during animal hovering flight. The wake is modeled by a series of equi-spaced rigid rectangular vortex plates, positioned horizontally and moving vertically downwards with identical speeds; each plate is generated during powering of the functionally wing stroke. The vortex representation of the wake considered in the current theory allows a considerable loss of momentum to occur. The current approach accords well with the nature of the wingbeat since it considers the unsteadiness in the wake as an important fluid dynamical characteristic. Induced power in hovering is calculated as the aerodynamic power required to generate the vortex wake system. Specific mean induced power to mean wing tip velocity ratio is determined by solely the normal spacing parameter (f) for a given wing stroke amplitude. The current theory gives much higher specific induced power estimate than anticipated by classical methods.

Keywords: vortex theory, hovering flight, induced power, Prandlt's tip theory.

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230 The Efficacy of Danger Ideation Reduction Therapy for an 86-Year Old Man with a 63-Year History of Obsessive-Compulsive Disorder: A Case Study

Authors: Mairwen K. Jones, Bethany M. Wootton, Lisa D. Vaccaro

Abstract:

While OCD is one of the most commonly occurring psychiatric conditions experienced by older adults, there is a paucity of research conducted into the treatment of older adults with OCD. This case study represents the first published investigation of a cognitive treatment for geriatric OCD. It describes the successful treatment of an 86-year old man with a 63-year history of OCD using Danger Ideation Reduction Therapy (DIRT). The client received 14 individual, 50-minute treatment sessions of DIRT over 13 weeks. Clinician-based Y-BOCS scores reduced 84% from 25 (severe) at pre-treatment, to 4 (subclinical) at 6-month post-treatment follow-up interview, demonstrating the efficacy of DIRT for this client. DIRT may have particular advantages over ERP and pharmacological approaches, however further research is required in older adults with OCD.

Keywords: Cognitive Therapy, Danger Ideation Reduction Therapy, Obsessive-Compulsive Disorder, Older adults, Psychogeriatrics

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229 The Use of Music Therapy to Improve Non-Verbal Communication Skills for Children with Autism

Authors: Maria Vinca Novenia

Abstract:

The number of school-aged children with autism in Indonesia has been increasing each year. Autism is a developmental disorder which can be diagnosed in childhood. One of the symptoms is the lack of communication skills. Music therapy is known as an effective treatment for children with autism. Music elements and structures create a good space for children with autism to express their feelings and communicate their thoughts. School-aged children are expected to be able to communicate non-verbally very well, but children with autism experience the difficulties of communicating non-verbally. The aim of this research is to analyze the significance of music therapy treatment to improve non-verbal communication tools for children with autism. This research informs teachers and parents on how music can be used as a media to communicate with children with autism. The qualitative method is used to analyze this research, while the result is described with the microanalysis technique. The result is measured specifically from the whole experiment, hours of every week, minutes of every session, and second of every moment. The samples taken are four school-aged children with autism in the age range of six to 11 years old. This research is conducted within four months started with observation, interview, literature research, and direct experiment. The result demonstrates that music therapy could be effectively used as a non-verbal communication tool for children with autism, such as changes of body gesture, eye contact, and facial expression.

Keywords: Autism, non-verbal communication, microanalysis, music therapy, school-aged children.

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228 The Effectiveness of Solution-Focused Group Therapy on Improving Depressed Mothers of Child Abuser Families

Authors: Roya Maqami, Kaveh Qaderi Bagajan, Mohammad Mahdi Yousefi, Saeed Moradi

Abstract:

The purpose of this study is to investigate the efficacy of solution-focused group therapy on improving the depressed mothers of child abuser families. This study was carried out in the form of a semi-pilot, pre-test and post-test on two groups (experimental and control). Subjects include all mothers and their children that are the members of Shush and Naser Khosro child home. Beck Depression Inventory and Child Trauma Questionnaire were used to collect data. First, child abuse questionnaire was completed by children, Then Beck Depression Inventory was completed by their mothers that 22 of them were recognized as depressed and randomly divided in two groups of experimental and control. After applying pre-test for both of these groups, the intervention of solution- focused group therapy was performed in five sessions on experimental group. Finally, post-test was applied on both groups and subsequently in a month, follow-up test was performed. T-test, multivariate variance, and repeated measurement analysis of variance were used to analyze the data. According to the findings, it can be concluded that this therapy leads to the improvement of depressed mother's mood. As a result, the intervention of solution-focused group therapy is useful in order to improve the depressing mood of mothers of child abuser families.

Keywords: Child Abuse, Depressed Mothers, Child Abuser Families, Solution-focused Group Therapy.

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227 Acceptance and Commitment Therapy for Work Stress: Variation in Perceived Group Process and Outcomes

Authors: William H. O'Brien, Erin Bannon, M.A., Heather McCarren, Eileen Delaney

Abstract:

Employees commonly encounter unpredictable and unavoidable work related stressors. Exposure to such stressors can evoke negative appraisals and associated adverse mental, physical, and behavioral responses. Because Acceptance and Commitment Therapy (ACT) emphasizes acceptance of unavoidable stressors and diffusion from negative appraisals, it may be particularly beneficial for work stress. Forty-five workers were randomly assigned to an ACT intervention for work stress (n = 21) or a waitlist control group (n = 24). The intervention consisted of two 3-hour sessions spaced one week apart. An examination of group process and outcomes was conducted using the Revised Sessions Rating Scale. Results indicated that the ACT participants reported that they perceived the intervention to be supportive, task focused, and without adverse therapist behaviors (e.g., feelings of being criticized or discounted). Additionally, the second session (values clarification and commitment to action) was perceived to be more supportive and task focused than the first session (mindfulness, defusion). Process ratings were correlated with outcomes. Results indicated that perceptions of therapy supportiveness and task focus were associated with reduced psychological distress and improved perceived physical health.

Keywords: Work stress, Acceptance and Commitment Therapy, therapy process.

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226 A Second Look at Gesture-Based Passwords: Usability and Vulnerability to Shoulder-Surfing Attacks

Authors: Lakshmidevi Sreeramareddy, Komalpreet Kaur, Nane Pothier

Abstract:

For security purposes, it is important to detect passwords entered by unauthorized users. With traditional alphanumeric passwords, if the content of a password is acquired and correctly entered by an intruder, it is impossible to differentiate the password entered by the intruder from those entered by the authorized user because the password entries contain precisely the same character set. However, no two entries for the gesture-based passwords, even those entered by the person who created the password, will be identical. There are always variations between entries, such as the shape and length of each stroke, the location of each stroke, and the speed of drawing. It is possible that passwords entered by the unauthorized user contain higher levels of variations when compared with those entered by the authorized user (the creator). The difference in the levels of variations may provide cues to detect unauthorized entries. To test this hypothesis, we designed an empirical study, collected and analyzed the data with the help of machine-learning algorithms. The results of the study are significant.

Keywords: Authentication, gesture-based passwords, machine learning algorithms, shoulder-surfing attacks, usability.

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