A biomechanical model was successfully applied to study shoulder biomechanics in adult patients with SCI walking with crutches in two different gait patterns. Greater loads exerted on the shoulder walking with SG were confirmed compared to RG.
BACKGROUND: There is a growing interest in the use of technology in the field of neurorehabilitation in order to quantify and generate knowledge about sensorimotor disorders after neurological diseases, understanding that the technology has a high potential for its use as therapeutic tools. Taking into account that the rehabilitative process of motor disorders should extend beyond the inpatient condition, it’s necessary to involve low-cost technology, in order to have technological solutions that can approach the outpatient period at home. OBJECTIVE: to present the virtual applications-based RehabHand prototype for the rehabilitation of manipulative skills of the upper limbs in patients with neurological conditions and to determine the target population with respect to spinal cord injured patients. METHODS: Seven virtual reality applications have been designed and developed with a therapeutic sense, manipulated by means of Leap Motion Controller. The target population was determined from a sample of 40 people, healthy and patients, analyzing hand movements and gestures. RESULTS: The hand movements and gestures were estimated with a fitting rate between the range 0.607–0.953, determining the target population by cervical levels and upper extremity motor score. CONCLUSIONS: Leap Motion is suitable for a determined sample of cervical patients with a rehabilitation purpose.
Background: The Box and Block clinical test is a validated and standardized scale for use in the clinical environment that allows the assessment of rough manipulative dexterity. Proposing virtual methods to carry out these assessments is an attempt to eliminate some of the subjectivity that the test may entail depending on the observer and the way in which the patient gives instructions. Applied to the assessment of skills after neurological pathologies, previous experiences in stroke patients have been found. So, this work was centered on the Spinal Cord Injury. Objective: To present the virtual application of the Box and Block scale, as well as details about its design and development for its manipulation based on Leap Motion Controller. Methodology: The relationship between the results obtained in the actual test and in the virtual application in healthy subjects and, mostly, patients with cervical spinal cord injury is analyzed, obtaining a high correlation index between both tests' performance. Results: A high correlation index was obtained between both tests performance, the real and virtual version of the Box and Block Test. Conclusion: This virtual test can serve as an element to evaluate in the future the effectiveness of the RehabHand prototype based on virtual reality applications with a therapeutic and a rehabilitative sense that, manipulated from Leap Motion Controller, allow the improvement of the manipulative dexterity in patients with neurological diseases such as spinal cord injury.
Manual wheelchair propulsion results in physical demand of the upper limb extremities that, because of its repetitive nature, can lead to chronic pathologies on spinal cord injury patients. The aim of this study was to design and test a methodology to compare kinematic and kinetic variables of the upper limb joints when propelling different wheelchairs. Moreover, this methodology was used to analyze the differences that may exist between paraplegic and tetraplegic patients when propelling two different wheelchairs. Five adults with paraplegia and five adults with tetraplegia performed several propulsion tests. Participants propelled two different wheelchairs for three minutes at 0.833 m/s (3 km/h) with one minute break between the tests. Kinematic and kinetic variables of the upper limb as well as variables with respect to the propulsion style were recorded. Important differences in the kinetic and kinematic variables of the joints of the upper limb were found when comparing paraplegic and tetraplegic patients. Nevertheless, this difference depends on the wheelchair used. As expected, in all tests, the shoulder shows to be the most impacted joint.
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