Effects of dance therapy on balance, gait and neuro-psychological performances in patients with Parkinson's disease and postural instability

Postural Instability (PI) is a core feature of Parkinson’s Disease (PD) and a major cause of falls and disabilities. Impairment of executive functions has been called as an aggravating factor on motor performances. Dance therapy has been shown effective for improving gait and has been suggested as an alternative rehabilitative method. To evaluate gait performance, spatial-temporal (S-T) gait parameters and cognitive performances in a cohort of patients with PD and PI modifications in balance after a cycle of dance therapy

Characteristics or Incentives: Why Do Employment Outcomes for the SSA Beneficiary Clients of VR Agencies Differ, on Average, from Those of Other Clients?

This report uses data from the Longitudinal Study of Vocational Rehabilitation Services Programs to compare employment outcomes of state vocational rehabilitation (VR) agency clients who receive Social Security Disability Insurance (DI) or Supplemental Security Income (SSI) -- “beneficiary clients” -- to those of non-beneficiary clients, before and after controlling for detailed information on disability and other characteristics that are likely to affect outcomes. Differences are substantial. Characteristics do explain a substantial share of the differences, but substantial differences remain. For instance, we estimate that only 23 percent of beneficiaries who received services achieved earnings above $500 per month for at least 9 months out of a 15-month period, compared to 54 percent of non-beneficiaries – a 30 percentage point difference. After controlling for other characteristics, the difference is 17 percentage points. One likely explanation for a substantial portion of the remaining difference is work disincentives faced by beneficiary clients. During this period, SSI recipients lost 50 cents in benefits for every dollar earned above certain disregards, and SSDI beneficiaries lost all benefits if they earned more than$500 per month, again net of certain disregards, for more than nine months

Upper limb-rehabilitation service system for chinese mild-stroke patients at home

With the continuous growth in the popularity of stroke patients in China and the increasing demand for rehabilitation services, the existing traditional hospital rehabilitation model can no longer meet the patients’ needs. In recent years, the Chinese government has focused on promoting a new model of “Internet plus medical care” and home rehabilitation. Of all the symptoms of the stroke, upper limb motor dysfunction is the most common one that causes the decline of the patients’ self-care ability and quality of life. Therefore, continuous rehabilitation training plays a vital role in the recovery of limb motor function in stroke patients with hemiplegia and can also serve as a starting point for remote rehabilitation. This thesis first summarized the fundamental upper limb movements as well as theories, high technologies and assessment methods of upper limb rehabilitation. All the literature review assists designers in understanding the necessary medical knowledge of stroke and rehabilitation. Secondly, the existing products and services of upper limb rehabilitation in China and at abroad are compared and analyzed to explore more design opportunities. Furthermore, based on the observations and interviews, the author summarized the rehabilitation needs, information needs and emotional needs of stroke patients in Shanghai, investigated design pain points, and selected target users for remote rehabilitation. Finally, a support remote upper limb rehabilitation system concept was established by adopting service design approaches and tools. Furthermore, the concept of a home rehabilitation device and a digital platform, which were two main touchpoints in this system were designed in-depth and made into the prototype for user feedback. The home rehabilitation device integrated a variety of hand grasping exercises by modularization and integrated different upper limb movements through a point-to-line method to solve the problem of lacking multi-function and miniaturization in the home environment. The digital platform used visual interfaces to provide patients with clear instructions and incentive mechanisms which prevent them from giving up rehabilitation halfway. The findings of this thesis indicated the importance of service design approaches and tools on systemic thinking and creative ideas. The design results of this project can not only help stroke patients to perform active exercises at home and improve their upper limb motor function, but also provide new visions for the development of future remote rehabilitation service system in China

How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program

An investigation of rehabilitation with special reference to lower limb amputation

An investigation was carried out into rehabilitation. The author sought to clarify what appeared to be contradictory practices and the underlying issues. The study centred on the treatment of those who have lost lower limbs but the investigation was carried out in such a way as to reflect more generally on the state of medical rehabilitation.First, the literature on rehabilitation and on amputation was reviewed. This review questions the rationale of the modern rehabilitation movement. In chapter three the concept of rehabilitation is redefined. An investigative and ethological method was devised with which to observe amputee mobility training. Five centres were investigated. The method was developed at a general hospital, centre A. Data was collected at centres B and C and the results checked at centres D and E. This sample includes a DHSS Artificial Limb and Appliance Centre and both NHS geriatric and accident and emergency units.In the light of the redefinition of rehabilitation the data on rehabilitation was analysed. Serious problems in the daily practice and aims of amputeetreatments emerged and services which are widely considered to be the crux of rehabilitation were seen not only to exclude truly rehabilitative elements but also to foster anti-rehabilitative behaviour.This is a broadly based first study in an area where there is nothing similar. The study could provide an impetus for debate and point the way for further research into the treatment of those who have lost limbs. It provides both the ground theory and method for further research into many aspects of medical rehabilitation

In-home and remote use of robotic body surrogates by people with profound motor deficits

By controlling robots comparable to the human body, people with profound motor deficits could potentially perform a variety of physical tasks for themselves, improving their quality of life. The extent to which this is achievable has been unclear due to the lack of suitable interfaces by which to control robotic body surrogates and a dearth of studies involving substantial numbers of people with profound motor deficits. We developed a novel, web-based augmented reality interface that enables people with profound motor deficits to remotely control a PR2 mobile manipulator from Willow Garage, which is a human-scale, wheeled robot with two arms. We then conducted two studies to investigate the use of robotic body surrogates. In the first study, 15 novice users with profound motor deficits from across the United States controlled a PR2 in Atlanta, GA to perform a modified Action Research Arm Test (ARAT) and a simulated self-care task. Participants achieved clinically meaningful improvements on the ARAT and 12 of 15 participants (80%) successfully completed the simulated self-care task. Participants agreed that the robotic system was easy to use, was useful, and would provide a meaningful improvement in their lives. In the second study, one expert user with profound motor deficits had free use of a PR2 in his home for seven days. He performed a variety of self-care and household tasks, and also used the robot in novel ways. Taking both studies together, our results suggest that people with profound motor deficits can improve their quality of life using robotic body surrogates, and that they can gain benefit with only low-level robot autonomy and without invasive interfaces. However, methods to reduce the rate of errors and increase operational speed merit further investigation.Comment: 43 Pages, 13 Figure

Future bathroom: A study of user-centred design principles affecting usability, safety and satisfaction in bathrooms for people living with disabilities

Research and development work relating to assistive technology 2010-11 (Department of Health) Presented to Parliament pursuant to Section 22 of the Chronically Sick and Disabled Persons Act 197