Regaining upper extremity function is the primary concern of persons with tetraplegia caused by spinal cord injury (SCI). Robotic rehabilitation has been inadequately tested and underutilized in rehabilitation of the upper extremity in the SCI population. Given the acceptance of robotic training in stroke rehabilitation and SCI gait training, coupled with recent evidence that the spinal cord, like the brain, demonstrates plasticity that can be catalyzed by repetitive movement training such as that available with robotic devices, it is probable that robotic upper-extremity training of persons with SCI could be clinically beneficial. The primary goal of this pilot study was to test the feasibility of using a novel robotic device for the upper extremity (RiceWrist) and to evaluate robotic rehabilitation using the RiceWrist in a tetraplegic person with incomplete SCI. A 24-year-old male with incomplete SCI participated in 10 sessions of robot-assisted therapy involving intensive upper limb training. The subject successfully completed all training sessions and showed improvements in movement smoothness, as well as in the hand function. Results from this study provide valuable information for further developments of robotic devices for upper limb rehabilitation in persons with SCI.
Regaining upper extremity function is the primary concern of persons with tetraplegia caused by spinal cord injury (SCI). Robotic rehabilitation has been inadequately tested and underutilized in rehabilitation of the upper extremity in the SCI population. Given the acceptance of robotic train ing in stroke rehabilitation and SCI gait training, coupled with recent evidence that the spinal cord, like the brain, demonstrates plasticity that can be enhanced by repetitive movement training such as that available with robotic devices, it is probable that robotic upper ext remity train ing of persons with SCI could be clin ically beneficial. The primary goal of th is pilot study was to test the feasibility of using a novel robotic device -the RiceWrist Exoskeleton-for rehabilitation of the upper limbs (UL) of t wo tetraplegic persons with inco mplete SCI. Two pilot experiments were conducted. Experiment 1was the first novel attempt to admin ister treatment with the RiceWrist. The left UL of a tetraplegic subject was treated during seven therapy sessions. The subject's feedback and the investigator's observations were used to enhance the robotic device and the corresponding graphical-interface. In Experiment 2, a second tetraplegic subject underwent 10 three-hour train ing sessions admin istered by a physical therapist. Smoothness factor (F S ) -a new measure developed in Experiment 1-was used as the primary outcome to test the subject's performance before and after the training. The RiceWrist was modified accord ing to the feedback obtained in Experiment 1. Thereafter, the device was successfully administered for upper limb training of the tetraplegic individual. Noticeable improvements in F S were observed for the stronger arm of the subject who co mpleted 10 sessions of train ing. Improvements were also observed in the subject's hand according to the Jebsen-Taylor Hand Function Test. Results fro m this study suggest a potential application of the RiceWrist for rehabilitation of SCI individuals and offer valuable in formation regard ing development of UL robotic devices for this population.
We present a tactile Respiratory Management System (tRMS) to manage and control breathing patterns of cancer patients undergoing radiation therapy. The system comprises of an array of small vibrating motors and a control box that supplies power to and provides a control interface for up to twelve motors through the parallel port of a standard personal computer. The vibrotactile array can be fastened along the forearm, arm, thigh, leg or abdomen in any configuration using Velcro and fabric wraps. All motors are operated in a binary fashion, i.e. on or off, with quick response time and perceivable vibration magnitudes. The tRMS system is inexpensive and portable, providing spatiotemporal variations in tactile cues to regulate respiratory motion during radiotherapy. The system will also be used in future psychophysical studies to determine effective use of tactile cues to control human motor actions.
Cerebral palsy affects movement, muscle tone, and coordination as a result of an injury to, or lesion of, the immature brain. One of the most common manifestations of cerebral palsy is spastic hemiplegia, which limits arm and hand use on the involved side of the body [1]. Many treatment options are available but a major clinical problem is how to evaluate the success of these treatment plans. Currently, video analysis is the standard used for evaluating dexterity of cerebral palsy patients. This requires trained clinicians to spend hours watching video of patients performing specified tasks in order to evaluate baseline dexterity and improvements throughout treatment. VICON is the current state of the art device for motion capture. It captures motion using multiple video cameras around the room and outputs the position data of many points through time. VICON machines must be carefully calibrated and are too bulky to be used throughout a clinic. VICON can also not show the upper extremity dexterity necessary for tracking many cerebral palsy patients’ progress. As can be seen, no portable, efficient, and quantitative dexterity test for cerebral palsy patients currently exists.
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