538 research outputs found

    Modeling and Design of a Spring-loaded, Cable-driven, Wearable Exoskeleton for the Upper Extremity

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    An approach to the design of wearable exoskeletons on the basis of simulation of the exoskeleton and a human body model is proposed in this paper. The new approach, addressing the problem of physical human-exoskeleton interactions, models and simulates the mechanics of both the exoskeleton and the human body, which allows designers to effectively analyze and evaluate an exoskeleton design for their function in concert with the human body. A simulation platform is developed by integrating a biomechanical model of the human body and the exoskeleton. With the proposed approach, an exoskeleton is designed for assisting patients with neuromuscular injuries. Results of the analysis and optimization are included

    Brachial Plexus Injury

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    In this book, specialists from different countries and continents share their knowledge and experience in brachial plexus surgery. It discusses the different types of brachial plexus injury and advances in surgical treatments

    Instruction with 3D Computer Generated Anatomy

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    Research objectives. 1) To create an original and useful software application; 2) to investigate the utility of dyna-linking for teaching upper limb anatomy. Dyna-linking is an arrangement whereby interaction with one representation automatically drives the behaviour of another representation. Method. An iterative user-centred software development methodology was used to build, test and refine successive prototypes of an upper limb software tutorial. A randomised trial then tested the null hypothesis: There will be no significant difference in learning outcomes between participants using dyna-linked 2D and 3D representations of the upper limb and those using non dyna-linked representations. Data was analysed in SPSS using factorial analysis of variance (ANOVA). Results and analysis. The study failed to reject the null hypothesis as there was no signi cant di fference between experimental conditions. Post-hoc analysis revealed that participants with low prior knowledge performed significantly better (p = 0.036) without dyna-linking (mean gain = 7.45) than with dyna-linking (mean gain = 4.58). Participants with high prior knowledge performed equally well with or without dyna-linking. These findings reveal an aptitude by treatment interaction (ATI) whereby the effectiveness of dyna-linking varies according to learner ability. On average, participants using the non dyna-linked system spent 3 minutes and 4 seconds longer studying the tutorial. Participants using the non dyna-linked system clicked 30% more on the representations. Dyna-linking had a high perceived value in questionnaire surveys (n=48) and a focus group (n=7). Conclusion. Dyna-linking has a high perceived value but may actually over-automate learning by prematurely giving novice learners a fully worked solution. Further research is required to confirm if this finding is repeated in other domains, with different learners and more sophisticated implementations of dyna-linking

    Frontiers of Brachial Plexus Injury: Future Revolutions in the Field

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    The field of brachial plexus surgery has undergone dramatic changes in the past 40 years. Most of these have been incremental in nature. We have seen increased use of nerve grafts and nerve transfers. We have seen the introduction of robotic limb replacements for the most severe flail limbs where surgical intervention has failed. In some cases, we have seen an increase in the use of computer simulation and virtual reality to train surgeons to plan and execute surgeries. More recently, we have seen the introduction of technologies derived from regenerative medicine research

    Development of a Wearable Mechatronic Elbow Brace for Postoperative Motion Rehabilitation

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    This thesis describes the development of a wearable mechatronic brace for upper limb rehabilitation that can be used at any stage of motion training after surgical reconstruction of brachial plexus nerves. The results of the mechanical design and the work completed towards finding the best torque transmission system are presented herein. As part of this mechatronic system, a customized control system was designed, tested and modified. The control strategy was improved by replacing a PID controller with a cascade controller. Although the experiments have shown that the proposed device can be successfully used for muscle training, further assessment of the device, with the help of data from the patients with brachial plexus injury (BPI), is required to improve the control strategy. Unique features of this device include the combination of adjustability and modularity, as well as the passive adjustment required to compensate for the carrying angle

    Assessment of techniques for measuring hand pressures in mock deliveries on a mannequin

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    Shoulder dystocia is a serious obstetric emergency. Brachial plexus injuries can be caused by hyperextension of the neck or misalignment of the fetal head during traction. To address knowledge gaps relating to clinician applied forces associated with deliveries, this study analyzed hand pressures applied by obstetricians in mock deliveries and suggests improvements for pressure-sensing gloves. The subjects were obstetricians, both residents and staff, recruited from the University of Kansas Hospital. A Laerdal PROMPT Birthing Simulator was used for the mock deliveries. The experimental design involved two pressure measurement strategies. Force Sensitive Applications (FSA) pressure sensitive gloves (Vista Medical) with twelve pressure sensors for each hand provided pressure measurements with time. Fujifilm Pressure Measurement Film Prescale [Two-Sheet Type for Extreme Low Pressure (4LW)] recorded areas where pressure was applied. The two measurement techniques compared well in capturing the spatial distribution of pressures across the hands. Both indicated pressure was exerted primarily with the middle, index, and ring fingers. Pressures due to the thumb and the palm were significantly smaller. Nonzero average pressures produced by the left hand were higher than the right but not significantly so. The pressure-film data indicated that pressures applied by resident and staff subgroups were comparable, except for the left hand where staff members applied significantly higher pressure with the little finger. With the glove sensors, there were three conditions: downward traction only, excessive force, which simulated conditions where damage could occur, and full delivery. The downward traction only, excessive force, and full delivery conditions had similar results with few significant differences. The residents and staff had few significant differences for these conditions between each other and between the conditions. The staff may have been more adept at using all the regions of their hands efficiently to apply balanced pressures. The glove sensors covered a range from 0 to 20 psi (0 to 0.14 MPa). If pressures exceeded the maximum of the range, the accuracy of the data decreased. This suggested that perhaps the sensor range should be improved in newer designs. Other important design changes could include increasing the numbers of sensors

    Action Observation for Neurorehabilitation in Apraxia

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    Neurorehabilitation and brain stimulation studies of post-stroke patients suggest that action-observation effects can lead to rapid improvements in the recovery of motor functions and long-term motor cortical reorganization. Apraxia is a clinically important disorder characterized by marked impairment in representing and performing skillful movements [gestures], which limits many daily activities and impedes independent functioning. Recent clinical research has revealed errors of visuo-motor integration in patients with apraxia. This paper presents a rehabilitative perspective focusing on the possibility of action observation as a therapeutic treatment for patients with apraxia. This perspective also outlines impacts on neurorehabilitation and brain repair following the reinforcement of the perceptual-motor coupling. To date, interventions based primarily on action observation in apraxia have not been undertaken
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