Prediction of functional outcome after spinal cord injury: a task for the rehabilitation team and the patient

Study design: Descriptive analysis of data gathered in an information system.Objectives: To explore the predictions of professionals and patients regarding functional outcome after spinal cord injury related to the final results after inpatient rehabilitation, in order to make prognostics of rehabilitation outcome more successful and enlarge the role of the patient in selecting realistic rehabilitation goals.Methods: Data from 55 patients with spinal cord injury admitted to the rehabilitation centre. Expectations of the rehabilitation team and the patients regarding future independence in performing six daily activities were compared to the functional results at discharge. The results of patients with different level and extent of lesion were analyzed.Results: In 52% of all performed skills, independence was achieved at discharge. Professionals and patients made similar predictions. If they both expected independence after rehabilitation, 90% of the skills were performed independently at discharge. If they both did not expect independence only 3% of the functional results were positive. Of all combined predictions 64% was correct. Correct predictions were most often found regarding self-care skills of patients with paraplegia and regarding mobility of patients with complete lesions. Prediction of self-care outcome of patients with tetraplegia is far more complicated. There was a considerable variation in predictions of mobility potential, especially regarding patients with incomplete lesions. If the team and patients agreed upon expected independence in mobility skills of these patients, the final results were mostly positive.Conclusions: Prediction of functional outcome after spinal cord injury was most successful if the expectations of the team and patients were combined. Prognosis of self-care outcome of patients with paraplegia and mobility potential of patients with complete spinal cord lesions was usually clear at admission. However, selection of realistic goals concerning self-care skills of patients with tetraplegia and mobility skills of patients with incomplete lesions is far more complicated. Gradual adjustment of objectives is needed during the rehabilitation process in close collaboration between the professionals and the patients

Mobility deficit – Rehabilitate, an opportunity for functionality

There are many pathological conditions that cause mobility deficits and that ultimately influence someone’s autonomy.Aims: to evaluate patients with mobility deficits functional status; to implement a Rehabilitation Nursing intervention plan; to monitor health gains through mobility deficits rehabilitation.Conclusion: Early intervention and the implementation of a nursing rehabilitation intervention plan results in health gains (direct or indirect), decreases the risk of developing Pressure Ulcers (PU) and the risk of developing a situation of immobility that affects patients’ autonomy and quality of life

What does the vibration therapy add?: a quasi-experimental, pilot study on the short term effects of whole-body vibration as mode of exercise for nursing home residents aged 80+

Aims: To compare the responses of nursing home residents aged 80+ to an 8 weeks exercise program performed on a vibratory device and to the same exercise program preformed without vibration on lower limb performance, functional dependence and quality of life. Methods:Lower limb performance was evaluated using the 30 seconds Chair Sit to Stand test. Functional mobility was assessed using the timed up and go test. Postural stability was measured using a force platform. The Barthel Index was used to assess functional dependence and the EuroQol was used to evaluate Health-Related Quality of Life. 44 participants were allocated to the whole-body vibration group (n= 15), non-vibration group (n= 15) or to the control group (n= 14). Results:Significant differences were detected in favour of the whole-body vibration group in lower limb muscle performance (p= 0.001), mobility (p= 0.001), functional independence (p= 0.009) and quality of life (p <0.001) as compared to the control and non-vibration groups. Conclusions: Whole body vibration based interventions may add additional benefits to conventional exercise programs in terms of lower limb muscle performance, functional dependence and quality of life among nursing home residents over 80 years

Biomechanics of Pediatric Manual Wheelchair Mobility

Currently, there is limited research of the biomechanics of pediatric manual wheelchair mobility. Specifically, the biomechanics of functional tasks and their relationship to joint pain and health is not well understood. To contribute to this knowledge gap, a quantitative rehabilitation approach was applied for characterizing upper extremity biomechanics of manual wheelchair mobility in children and adolescents during propulsion, starting, and stopping tasks. A Vicon motion analysis system captured movement, while a SmartWheel simultaneously collected three-dimensional forces and moments occurring at the handrim. A custom pediatric inverse dynamics model was used to evaluate three-dimensional upper extremity joint motions, forces, and moments of 14 children with spinal cord injury (SCI) during the functional tasks. Additionally, pain and health-related quality of life outcomes were assessed. This research found that joint demands are significantly different amongst functional tasks, with greatest demands placed on the shoulder during the starting task. Propulsion was significantly different from starting and stopping at all joints. We identified multiple stroke patterns used by the children, some of which are not standard in adults. One subject reported average daily pain, which was minimal. Lower than normal physical health and higher than normal mental health was found in this population. It can be concluded that functional tasks should be considered in addition to propulsion for rehabilitation and SCI treatment planning. This research provides wheelchair users and clinicians with a comprehensive, biomechanical, mobility assessment approach for wheelchair prescription, training, and long-term care of children with SCI

Equilibrium Mobility

This paper proposes to measure the mobility of a stochastic process as the expected value of a "mobility functional" with respect to its stationary distribution. The mobility functional thereby measures the valuation of movements between states. We not only highlight the conceptual advantages of our approach, but also show how this so-called "equilibrium mobility index" relates to the axiomatic approach by Fields and Ok (7) and the approach based on monotone transition matrices by Conlisk (4) and Dardanoni (5))Mobility indices; mobility functional; equilibrium mobility

Ab-Initio Simulations of Deformation Potentials and Electron Mobility in Chemically Modified Graphene and two-dimensional hexagonal Boron-Nitride

We present an ab-initio study of electron mobility and electron-phonon coupling in chemically modified graphene, considering fluorinated and hydrogenated graphene at different percentage coverage. Hexagonal Boron Carbon Nitrogen (h-BCN) is also investigated due the increased interest shown by the research community towards this material. In particular, the Deformation Potentials are computed by means of Density Functional Theory (DFT), while the carrier mobility is obtained according to the Takagi model (S. Takagi, A. Toriumi, and H. Tango, IEEE Trans. Electr. Dev. 41, 2363 (1994)). We will show that graphene with a reduced degree of hydrogenation can compete, in terms of mobility, with silicon technology.Comment: 9 pages, 2 figures, 2 table

Development and Performance Evaluation of a Connected Vehicle Application Development Platform (CVDeP)

Connected vehicle (CV) application developers need a development platform to build, test and debug real-world CV applications, such as safety, mobility, and environmental applications, in edge-centric cyber-physical systems. Our study objective is to develop and evaluate a scalable and secure CV application development platform (CVDeP) that enables application developers to build, test and debug CV applications in realtime. CVDeP ensures that the functional requirements of the CV applications meet the corresponding requirements imposed by the specific applications. We evaluated the efficacy of CVDeP using two CV applications (one safety and one mobility application) and validated them through a field experiment at the Clemson University Connected Vehicle Testbed (CU-CVT). Analyses prove the efficacy of CVDeP, which satisfies the functional requirements (i.e., latency and throughput) of a CV application while maintaining scalability and security of the platform and applications