Desarrollo de un exo-traje para la rehabilitación de miembro superior

La gran existencia de personas con discapacidades congénitas y/o adquiridas forman en la sociedad actual española un número significativo de dependientes. Estos pacientes carecen de la autonomía suficiente para vivir una vida independiente. Las actividades de la vida diaria son, en muchos casos, difíciles de lograr para un paciente con algún tipo de discapacidad leve o moderada. Este gran número de personas con discapacidades físicas en los últimos años y el posterior crecimiento de la demanda de programas de rehabilitación eficaces está disparando el mercado de los exoesqueletos con finalidades médicas en todo el mundo. Estos dispositivos están evolucionando cada día, y las versiones modernas de los exoesqueletos han evolucionado en lo que se denominan exo-trajes (exo-suit), dispositivos vestibles capaces de adaptarse a cualquier usuario, más ligeros y versátiles. Este artículo presenta el prototipo de un exo-traje para la asistencia y rehabilitación de miembro superior. Se describen tanto la arquitectura hardware como software del sistema, presentando además unas pruebas de usabilidad del dispositivo.The high prevalence of individuals with congenital and/or acquired disabilities constitutes a significant number of dependents in today's Spanish society. These patients lack sufficient autonomy to lead an independent life. Daily activities are often d ifficult to accomplish for patients with mild to moderate disabilities. The increasing number of individuals with physical disabilities in recent years and the subsequent rise in demand for effective rehabilitation programs are fueling the market for medical exoskeletons worldwide. These devices are evolving each day, and modern versions of exoskeletons have transformed into what are known as exosuits (exo-suits), wearable devices capable of adapting to any user, lighter and more versatile. This article presents the prototype of an exosuit for the assistance and rehabilitation of the upper limb. Both the hardware and software architecture of the system are described, along with usability tests of the device

Safety of hospital discharge before return of bowel function after elective colorectal surgery

© 2020 BJS Society Ltd Published by John Wiley & Sons LtdBackground: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien–Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4–7) and 7 (6–8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients