Current Rehabilitation Methods for Cerebral Palsy

In rehabilitation of children with cerebral palsy (CP), varying approaches and techniques are used, ranging from very conservative and conventional techniques, such as muscle strengthening, manual stretching, and massage, to more complex motor learning-based theories, such as neurodevelopmental treatment, conductive education, and several others. The motor disorders seen in CP are frequently accompanied by disturbances of sensation, cognition, communication, perception, and/or behavior disorders; thus, therapy approaches are arranged to meet the individual child’s needs. The approaches can be divided into two groups as with equipment and without equipment. Examples for without equipment rehabilitation approaches are neurodevelopmental treatment, conductive education constraint-induced movement therapy, and task-oriented therapy, whereas robotic therapy, virtual reality, and horse-back riding therapy are the examples of rehabilitation approaches with equipment. CP is a prevalent, disabling condition. Application of evidence-based methods ensures maximum gains in children. The concept that intense, task-specific exercises capitalize on the potential plasticity of the CNS and thus improve motor recovery has led to the development of several successful interventions for children with CP. Also approaches that improve the patient’s motivation and target the activities of daily living and participation are the most effective approaches for functional recovery of the children with CP

Acquisition and distribution of synergistic reactive control skills

Learning from demonstration is an afficient way to attain a new skill. In the context of autonomous robots, using a demonstration to teach a robot accelerates the robot learning process significantly. It helps to identify feasible solutions as starting points for future exploration or to avoid actions that lead to failure. But the acquisition of pertinent observationa is predicated on first segmenting the data into meaningful sequences. These segments form the basis for learning models capable of recognising future actions and reconstructing the motion to control a robot. Furthermore, learning algorithms for generative models are generally not tuned to produce stable trajectories and suffer from parameter redundancy for high degree of freedom robots This thesis addresses these issues by firstly investigating algorithms, based on dynamic programming and mixture models, for segmentation sensitivity and recognition accuracy on human motion capture data sets of repetitive and categorical motion classes. A stability analysis of the non-linear dynamical systems derived from the resultant mixture model representations aims to ensure that any trajectories converge to the intended target motion as observed in the demonstrations. Finally, these concepts are extended to humanoid robots by deploying a factor analyser for each mixture model component and coordinating the structure into a low dimensional representation of the demonstrated trajectories. This representation can be constructed as a correspondence map is learned between the demonstrator and robot for joint space actions. Applying these algorithms for demonstrating movement skills to robot is a further step towards autonomous incremental robot learning

A sensory-motor integration programme for boys with autism spectrum disorder : two case studies

Thesis (MScSportSc)--Stellenbosch University, 2014.ENGLISH ABSTRACT: Autism Spectrum Disorder (ASD) has been described as a neuro-developmental disorder influencing the social interaction and communication skills of individuals. Those with ASD have been observed to experience sensory input challenges, which could result in motor delays. Descriptive research was conducted with two case studies, who were boys aged 6- and 8-years, diagnosed with ASD. The purpose of the study was to design and implement a Sensory-Motor Integration (SMI) programme for each boy and to assess the effect it had on the sensory motor skills of the boys over time. At the start of the intervention, the boys were assessed with three neuro-developmental and diagnostic evaluations (Social Communication Questionnaire, Autism Diagnostic Interview Revised and Autism Diagnostic Observation Schedule-2nd Edition) conducted by a psychiatrist to re-affirm their previous ASD diagnoses. The two boys (Subject A and Subject G) participated in individualised sessions of 30 minutes each, twice a week for seven months. The SMI programme focused on vestibular and somato-sensory (proprioceptor) variables. The Quick Neurological Screening Test-3 (QNST III) and the Sensory Input Systems Screening Test (SISST) were used to evaluate the latter at baseline. These were repeated regularly, every 4 to 5 weeks, over the 7-month period and included a retention test of 5 weeks. Based on the results from the subtests of the motor skill tests, a self-designed SMI programme was integrated into the planning of the intervention programme for each boy according to their sensory-motor needs. Subject A showed improvement in the following vestibular subtests in the QNST-III: Stand on one leg (67%) and Tandem walk (83%) and retaining his standard from the Post-test to the Retention test. For muscle tone ability and proprioception, the Arm and leg extension subtest also demonstrated improvement (67%) from the Pre-to the Post-test. The results of the subtest were not retained over the retention period and increased only slightly being 33% from the baseline score. The proprioceptive function of Subject A showed great improvement in the following QNSTIII subtests: Finger to nose (67%), Rapidly reversing repetitive hand movements (88%) and Left and right discrimination (67%). The results of vestibular-related subtests for Subject G showed improvement in the following: Stand on one leg (33%) and the Arm and leg extension task (33%). Some of the scores of Subject G started in the functional category of “severe discrepancy”; however there was improvement in the following proprioceptionrelated subtests: Finger to nose (43%), Thumb and finger circles (20%), and Reversing repetitive hand movements (86%). Although Subject G showed gradual improvement over time, his two sensory systems struggled to integrate with the more complex tasks. The outcome of the individualised SMI programmes showed that the sensory-motor skills improved by enhancing the stimulation of their vestibular and somato-sensory (proprioception) function. Regarding the SISST, Subject A progressed from a ‘fail’ to ‘pass’, in the following test items: the Tonic Labyrinthine Supine (TLS), Tonic Labyrinthine Prone (TLP), Positive Support Reflex (PSR) and the Ocular Alignment test items. Results from the Vestibular test for both Subject A and Subject G appeared to be ‘hypo-vestibular’ (under-stimulated) according to the Post- Rotary Nystagmus test (PRN) score at baseline. These scores were inconsistent during the intervention. The only test item to show positive improvement for Subject G was the Equilibrium Reactions. Lastly, both Subject A and Subject G remained in the ‘fail’ category for Kinaesthesis, which may indicate their ongoing poor proprioception and spatial orientation. There is a need for further research in the area of sensory-motor individualised programmes for children with ASD. Suggestions for future research interventions are to conduct the individualised programmes either over a longer period of time and more frequently at three times a week.AFRIKAANSE OPSOMMING: Outisme Spektrum Versteuring (OSV) word beskryf as 'n neuro-ontwikkelingsversteuring wat die sosiale interaksie en kommunikasie van individue beïnvloed. Daar is waargeneem dat diegene met OSV, uitdagings met betrekking tot sensoriese insette ervaar, wat kan lei tot motoriese agterstande. Beskrywende navorsing is toegepas met twee gevalle-studies. Die ouderdom van die twee seuns wat met outisme gediagnoseer was, was 6- en 8-jaar oud. Die doel van die studie was om ʼn Sensories-Motoriese Integrasie (SMI) program te ontwikkel en te implementeer as intervensie wat op elk van die seuns spesifiek toegespits is. Die intervensie-program het voorsiening gemaak om aan die uitvoering van bepaalde motoriese vaardighede aandag te skenk en om die uitwerking daarvan oor die 7-maande tydperk te assesseer. Die twee seuns (Geval A en Geval G) het individuele sessies van 30 minute elk twee keer per week bygewoon. Die SMI program het op die vestibulêre en somato-sensoriese (proprioseptor) sisteme gefokus om hul vermoë en vordering waar te neem. Aan die begin van die studie is drie neuro-ontwikkelings- en diagnostiese meetinstrumente (SCQ, ADIR-R en ADOS) deur 'n psigiater gelei om die vorige OSV diagnose van die seuns te bevestig. Die “Quick Neurological Screening Test” (QNST III) en die “Sensory Input Systems Screening Test“ (SISST) is benut om hul aanvangsvermoë as basislyn te bepaal. Hierdie toetse was gereeld herhaal, elke 4 tot 5 weke oor ʼn tydperk van 7 maande en het ʼn retensie toets van 5 weke ingesluit. Op grond van die resultate van die sub-toetse van die vermelde motoriese vaardigheidstoetse, is die self-ontwerpte SMI intervensie-program vir elke seun, volgens sy persoonlike sensoriese-motoriese behoeftes, beplan. Geval A het verbetering getoon in die volgende QNST-III sub-toets: Staan op een been (67%) en Tandemloop (83%), en handhaaf sy standaard vanaf die na-toets tot en met die retensie toets. Vir spiertonus en propriosepsie, het die Arm- en been-ekstensie sub-toets ook ʼn verbetering (67%) van die voor-toets tot die na-toets getoon. Die resultaat van hierdie subtoets is nie oor die hele tydperk gehandhaaf nie, en het net effens verhoog (33%) van die basislyn telling. Die proprioseptiewe funksie van Geval A het 'n groot verbetering in die volgende QNST-III sub-toetse getoon: Vinger na neus (67%), Vinnige omkeer, herhalende hand bewegings (88%) en Links en regs diskriminasie (67%). Geval G se resultate vir die vestibulêre-verwante sub-toetse het verbetering in die volgende getoon: Een been staan (33%) en Arm- en Been-ekstensie (33%). Sommige van die resultate van Geval G het op 'n ernstige diskripansie begin, maar daar was verbetering in die volgende proprioseptiewe verwante sub-toetse: Vinger na neus (43%), Duim en vinger sirkels (20%) en Vinnige omkeer, herhalende hand bewegings (86%). Ten spyte daarvan dat Geval G ʼn geleidelike verbetering oor tyd getoon het, het sy twee sensoriese stelsels gesukkel om met die meer komplekse take met mekaar te integreer. Die uitkoms van die geïndividualiseerde SMI programme het getoon dat die sensoriesemotoriese vaardighede by beide seuns verbeter as gevolg van die verbeterde stimulering van hul vestibulêre en somato-sensoriese (proprioseptiewe) funksie. Die SSIST resultate toon dat Geval A van ‘druip’ na ‘slaag’ in die volgende toetsitems gevorder het: Tonic Labyrinthine Supine (TLS), Tonic Labyrinthine Prone (TLP), Positive Support Reflex (PSR) en die Ocular Alignment toetsitems. Resultate van die vestibulêre toets, blyk dit dat sowel Geval A as Geval G ‘hipo-vestibulêr’ (onder-gestimuleer) was volgens die “Post-Rotary Nystagmus toets” (PRN) meting wat by die basislyn toetsing behaal is. Hierdie tellings was veranderlik tydens die intervensie. Die enigste toetsitem wat ʼn positiewe verbetering by Geval G getoon het, was die Ekwilibriumsreaksie. Laastens, beide Geval A en Geval G het in die ‘druip’ kategorie vir Kinestese gebly wat daarop dui dat hul swak propriosepsie en ruimtelike oriëntasie steeds teenwoordig was. Daar is 'n behoefte aan verdere navorsing op die gebied van sensoriese-motoriese individuele programme vir kinders met OSV. Toekomstige navorsing wat individuele programme benut, moet oorweeg om die intervensie oor ʼn langer tydperk (bv. een jaar) te laat geskied met meer sessies per week (bv. drie sessies)

Cerebral Palsy

Nowadays, cerebral palsy (CP) rehabilitation, along with medical and surgical interventions in children with CP, leads to better motor and postural control and can ensure ambulation and functional independence. In achieving these improvements, many modern practices may be used, such as comprehensive multidisciplinary assessment, clinical decision making, multilevel surgery, botulinum toxin applications, robotic ambulation applications, treadmill, and other walking aids to increase the quality and endurance of walking. Trainings are based on neurodevelopmental therapy, muscle training and strength applications, adaptive equipment and orthotics, communication, technological solves, and many others beyond the scope of this book. In the years of clinical and academic experiences, children with cerebral palsy have shown us that the world needs a book to give clinical knowledge to health professionals regarding these important issue. This book is an attempt to fulfill and to give “current steps” about CP. The book is intended for use by physicians, therapists, and allied health professionals who treat/rehabilitate children with CP. We focus on the recent concepts in the treatment of body and structure problems and describe the associated disability, providing suggestions for further reading. All authors presented the most frequently used and accepted treatment methods with scientifically proven efficacy and included references at the end of each chapter

Aerospace Medicine and Biology: A continuing supplement 180, May 1978

This special bibliography lists 201 reports, articles, and other documents introduced into the NASA scientific and technical information system in April 1978

A virtual hand assessment system for efficient outcome measures of hand rehabilitation

Previously held under moratorium from 1st December 2016 until 1st December 2021.Hand rehabilitation is an extremely complex and critical process in the medical rehabilitation field. This is mainly due to the high articulation of the hand functionality. Recent research has focused on employing new technologies, such as robotics and system control, in order to improve the precision and efficiency of the standard clinical methods used in hand rehabilitation. However, the designs of these devices were either oriented toward a particular hand injury or heavily dependent on subjective assessment techniques to evaluate the progress. These limitations reduce the efficiency of the hand rehabilitation devices by providing less effective results for restoring the lost functionalities of the dysfunctional hands. In this project, a novel technological solution and efficient hand assessment system is produced that can objectively measure the restoration outcome and, dynamically, evaluate its performance. The proposed system uses a data glove sensorial device to measure the multiple ranges of motion for the hand joints, and a Virtual Reality system to return an illustrative and safe visual assistance environment that can self-adjust with the subject’s performance. The system application implements an original finger performance measurement method for analysing the various hand functionalities. This is achieved by extracting the multiple features of the hand digits’ motions; such as speed, consistency of finger movements and stability during the hold positions. Furthermore, an advanced data glove calibration method was developed and implemented in order to accurately manipulate the virtual hand model and calculate the hand kinematic movements in compliance with the biomechanical structure of the hand. The experimental studies were performed on a controlled group of 10 healthy subjects (25 to 42 years age). The results showed intra-subject reliability between the trials (average of crosscorrelation ρ = 0.7), inter-subject repeatability across the subject’s performance (p > 0.01 for the session with real objects and with few departures in some of the virtual reality sessions). In addition, the finger performance values were found to be very efficient in detecting the multiple elements of the fingers’ performance including the load effect on the forearm. Moreover, the electromyography measurements, in the virtual reality sessions, showed high sensitivity in detecting the tremor effect (the mean power frequency difference on the right Vextensor digitorum muscle is 176 Hz). Also, the finger performance values for the virtual reality sessions have the same average distance as the real life sessions (RSQ =0.07). The system, besides offering an efficient and quantitative evaluation of hand performance, it was proven compatible with different hand rehabilitation techniques where it can outline the primarily affected parts in the hand dysfunction. It also can be easily adjusted to comply with the subject’s specifications and clinical hand assessment procedures to autonomously detect the classification task events and analyse them with high reliability. The developed system is also adaptable with different disciplines’ involvements, other than the hand rehabilitation, such as ergonomic studies, hand robot control, brain-computer interface and various fields involving hand control.Hand rehabilitation is an extremely complex and critical process in the medical rehabilitation field. This is mainly due to the high articulation of the hand functionality. Recent research has focused on employing new technologies, such as robotics and system control, in order to improve the precision and efficiency of the standard clinical methods used in hand rehabilitation. However, the designs of these devices were either oriented toward a particular hand injury or heavily dependent on subjective assessment techniques to evaluate the progress. These limitations reduce the efficiency of the hand rehabilitation devices by providing less effective results for restoring the lost functionalities of the dysfunctional hands. In this project, a novel technological solution and efficient hand assessment system is produced that can objectively measure the restoration outcome and, dynamically, evaluate its performance. The proposed system uses a data glove sensorial device to measure the multiple ranges of motion for the hand joints, and a Virtual Reality system to return an illustrative and safe visual assistance environment that can self-adjust with the subject’s performance. The system application implements an original finger performance measurement method for analysing the various hand functionalities. This is achieved by extracting the multiple features of the hand digits’ motions; such as speed, consistency of finger movements and stability during the hold positions. Furthermore, an advanced data glove calibration method was developed and implemented in order to accurately manipulate the virtual hand model and calculate the hand kinematic movements in compliance with the biomechanical structure of the hand. The experimental studies were performed on a controlled group of 10 healthy subjects (25 to 42 years age). The results showed intra-subject reliability between the trials (average of crosscorrelation ρ = 0.7), inter-subject repeatability across the subject’s performance (p > 0.01 for the session with real objects and with few departures in some of the virtual reality sessions). In addition, the finger performance values were found to be very efficient in detecting the multiple elements of the fingers’ performance including the load effect on the forearm. Moreover, the electromyography measurements, in the virtual reality sessions, showed high sensitivity in detecting the tremor effect (the mean power frequency difference on the right Vextensor digitorum muscle is 176 Hz). Also, the finger performance values for the virtual reality sessions have the same average distance as the real life sessions (RSQ =0.07). The system, besides offering an efficient and quantitative evaluation of hand performance, it was proven compatible with different hand rehabilitation techniques where it can outline the primarily affected parts in the hand dysfunction. It also can be easily adjusted to comply with the subject’s specifications and clinical hand assessment procedures to autonomously detect the classification task events and analyse them with high reliability. The developed system is also adaptable with different disciplines’ involvements, other than the hand rehabilitation, such as ergonomic studies, hand robot control, brain-computer interface and various fields involving hand control

User needs, benefits and integration of robotic systems in a space station laboratory

The methodology, results and conclusions of the User Needs, Benefits, and Integration Study (UNBIS) of Robotic Systems in the Space Station Microgravity and Materials Processing Facility are summarized. Study goals include the determination of user requirements for robotics within the Space Station, United States Laboratory. Three experiments were selected to determine user needs and to allow detailed investigation of microgravity requirements. A NASTRAN analysis of Space Station response to robotic disturbances, and acceleration measurement of a standard industrial robot (Intelledex Model 660) resulted in selection of two ranges of low gravity manipulation: Level 1 (10-3 to 10-5 G at greater than 1 Hz.) and Level 2 (less than = 10-6 G at 0.1 Hz). This included an evaluation of microstepping methods for controlling stepper motors and concluded that an industrial robot actuator can perform milli-G motion without modification. Relative merits of end-effectors and manipulators were studied in order to determine their ability to perform a range of tasks related to the three low gravity experiments. An Effectivity Rating was established for evaluating these robotic system capabilities. Preliminary interface requirements were determined such that definition of requirements for an orbital flight demonstration experiment may be established