We present a hand functions assessment system (BEAGLE) for kinematic tracking of hand and finger movements, envisioned as a technology-mediated rehabilitation tool. The system is custom-designed for fast and easy placement on an impaired hand (spastic or flaccid), featuring inertial sensors integrated into simple finger caps and a hand strap. An algorithm for a range of motion (ROM) estimation was implemented to provide an objective assessment of hand functions.The efficacy and feasibility of the BEAGLE system were examined in a pilot clinical study performed with ten stroke survivors in the subacute phase. Participants received therapy within two consecutive intensity-matched rehabilitation cycles. The first consisted of conventional therapy, while the second involved a combination of conventional therapy and advanced functional electrical stimulation. Assessments were performed before and after each phase. These included BEAGLE estimates of active voluntary ROM for wrist and various digits, as well as two referent clinical measures for hand functions assessment, Fugl-Meyer and Action Research Arm Test.The results indicate that the ROM assessments can detect change with sensitivity comparable to the standardized clinical scales. Statistically significant changes between the beginning and the end of the second cycle existed in all observed measures, whereas none of these measurements showed a statistically significant improvement in the first therapy cycle. The noted usability metrics indicate that the BEAGLE could be integrated into the rehabilitation workflow in a clinical environment.
Bol je neprijatno senzorno iskustvo, povezano sa postojećim ili potencijalnim oštećenjem tkiva. Iako je u osnovi bol senzorni stimulus, on je višedimenzionalno senzorno iskustvo zato što ima snažne kognitivne i emocionalne komponente. Stimulus koji uzrokuje bol, prolazi kroz proces nocicepcije koji se sastoji od transdukcije, transmisije, modulacije i percepcije bolnog stimulusa. Zavisno od vrste stimulusa, modeli eksperimentalnog bola se mogu podeliti na mehaničke, električne, termalne i hemijske. Informacije o mehanizmima bola dobijamo iz: 1) in vitro studija, 2) animalnih eksperimenata, 3) humanih eksperimentalnih studija sa bolom i 4) kliničkih studija. Ključnu ulogu u dizajnu studije igra i odabir adekvatne metode za procenu bola, a kombinacijom sa različitim elektrofiziološkim i imaging metodama možemo dobiti veću objektivnost kao i bolju kvantifikaciju i objašnjenje mehanizama bola.
Fokus u eksperimentalnim studijama bola se postepeno prebacuje sa statičkih parametara poput praga bola i maksimalne tolerancije na dinamičke parametre koji mogu pružiti uvid u očuvanost sistema endogene analgezije, što se sprovodi primenom kondicionirane modulacije bola.
Primena eksperimentalnog bola na zdravim ispitanicima je ključni korak u prelasku sa animalnih modela na kliničke studije, pre svega zbog validizacije podataka dobijenih na animalnim modelima, što čini ove eksperimentalne studije bitnim u translacionom istraživanju. Rezultati dobijeni iz eksperimentalnih studija bola nam mogu pomoći u daljem razumevanju nociceptivnih mehanizama akutnog i hroničnog bola i razvoju novih terapijskih modaliteta.
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