ABSTRACT Effective and safe swallowing is one of the basic needs for human survival. Dysphagia or swallowing disorders often occur in the elderly and increase with age. Patients often do not complain of dysphagiaandcompensate by modifying the texture of the food. Frailty is associated with an increased prevalence of dysphagia. Difficulty of chewing, formation and positioning bolus are associated with dysphagia. Inaddition, dysphagia can cause weakness because there is a disturbance due to decrease nutritional status, muscle function, and can cause recurrent aspiration pneumonia. Frailty and dysphagia can be describedas a cycle and affect each other. Several interventions were carried out to overcome dysphagia, eithercompensatory, rehabilitative, or a combination of both
Losing a hand can significantly impact an individual’s physical and emotional well-being. Prosthetic hands can help restore some function and independence for individuals who have lost a hand. However, the prosthetic hands available on the market are prohibitively expensive, especially for developing countries, such as Indonesia. Commercial electronically powered prosthetic hands can be expensive, having prices ranging from $25,000 to $75,000 and annual maintenance costs ranging from $500 to $3000. In contrast, body-powered prosthetic hands are generally cheaper, ranging from $2000 to $10,000, but are still considered expensive for many people in developing countries. To make prosthetic hands more accessible, we have designed a body-powered prosthetic hand, “Karla”, using affordable materials and with as few components as possible. This report presents our proposed designs, the innovations, the parts in detail, and experiences using the designed prosthetic hand. The highlight of our design is a novel whippletree-like mechanism that utilizes the 3-D space to contract the fingers of the prosthetic hand.
Effective and safe swallowing is one of the basic needs for human survival. Dysphagia or swallowing disorders often occur in the elderly and increase with age. Patients often do not complain of dysphagia and compensate by modifying the texture of the food. Frailty is associated with an increased prevalence of dysphagia. Difficulty of chewing, formation and positioning bolus are associated with dysphagia. In addition, dysphagia can cause weakness because there is a disturbance due to decrease nutritional status, muscle function, and can cause recurrent aspiration pneumonia. Frailty and dysphagia can be described as a cycle and affect each other. Several interventions were carried out to overcome dysphagia, either compensatory, rehabilitative, or a combination of both.
Spinal Muscular atrophy (SMA) is a severe neuromuscular disorder which is a hereditary genetic disease. It is an incurable disease due to a defect in the survival motor neuron 1 (SMN1) gene. This report shows the benefit of rehabilitation intervention for the habilitation of a child with SMA Type 2. A 5-year-8-month-old female diagnosed with SMA by genetic testing complained of an inability to stand independently. Her rehabilitation problems were muscle power function, mobility of joint function, respiration function, exercise tolerance function, mobility, self-care, school education, and economic life. We provided rehabilitation programs with a regular follow-up for six months, including flexibility exercises, breathing exercises, cardiopulmonary endurance exercises, standing support exercises, wheeling exercises, and activities of daily living (ADL) exercise. We coordinated with a psychologist and social workers to assess the psychology and socioeconomic condition of the patient and caregiver. The muscle power function, which was evaluated by functional motor ability assessment using the Revised Hammersmith Scale for SMA (RHS), didn't show any deterioration, and she had improvement in the ADL capability. We resolved the mobility of joint function problem in this patient for the joint stiffness in both knees, and Cobb's angle of scoliosis was decreased. Respiration function assessed by peak cough flow and chest expansion showed an increase, and exercise tolerance function was also increased. The patient received some donations from donators to overcome economic issues assisted by a social worker for the activity chair, standing frame, and modified wheelchair. She could mobilize well using her own modified wheelchair, played with friends, and attended school. A follow-up by the psychologist showed good psychological conditions of the patient and family. The quality of life assessment of patients by PedsQL Neuromuscular Modul showed improved results, and the caregiver burden assessment by The Zarit Burden Interview had decreased. Rehabilitation intervention for the habilitation of a child with SMA Type 2 can maintain, restore, and promote the patient's functional ability to provide a better quality of life and control the caregiver burden.
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