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BackgroundThe aim of this prospective study was to identify clinical factors associated with the development of shoulder pain in stroke patients with pronounced arm paresis.MethodsAt stroke onset, 485 patients were initially assessed in 2007–2009. Sixty-three patients with pronounced arm paresis completed the study, and 21 of these developed shoulder pain. Clinical findings were recorded fortnightly by the attending physiotherapist during hospital stay.ResultsHand oedema on the paretic side was more common in patients developing shoulder pain compared with those who did not develop shoulder pain. The onset of shoulder pain was associated with concomitant hand oedema. High NIHSS score was associated with developing shoulder pain. Patients with a history of shoulder pain developed pain earlier than those without previous shoulder pain. Patients with haemorrhagic stroke were significantly more prone to developing shoulder pain.ConclusionsOne-third of the stroke patients with pronounced arm paresis developed shoulder pain. Concomitant hand oedema seems to be an additional symptom of shoulder injury. Patients with low general status are more vulnerable to develop post-stroke shoulder pain.
Many promising robotics research results were obtained during the late 1970s and early 1980s. Some examples include Cartesian force control and advanced motion planning. Now, 20 years and many research projects later, many technologies still have not reached industrial usage. An important question to consider is how this situation can be improved for future deployment of necessary technologies.Today, modern robot control systems used in industry provide highly optimized motion control that works well in a variety of standard applications. To this end, computationally intensive, model-based robot motion control techniques have become standard during the last decade. While the principles employed have been known for many years, deployment in products required affordable computing power, efficient engineering tools, customer needs for productivity/performance, and improved end-user competence in the utilization of performance features.However, applications that are considered nonstandard today motivate a variety of research efforts and system development to package results in a usable form. Actually, robots are not useful for many manufacturing tasks today, in particular those found in small and medium enterprises (SMEs). Reasons include complex configuration, nonintuitive (for the shop floor) programming, and difficulties instructing robots to deal with variations in their environment. The latter challenge includes both task definitions and definition of motion control utilizing external sensors. The key word here is flexibility, and flexible motion control is particularly difficult since the user or system integrator needs to influence the core real-time software functions that are critical for the performance and safe operation of the system. We must find techniques that permit real-time motion controllers to be extended for new, demanding application areas.
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