Ethical Issues Linked to the Development of Telerehabilitation: A Qualitative Study

While telerehabilitation (TR) makes it possible to respond to many significant health system problems, TR still gives rise to debates, particularly concerning ethical issues. This qualitative study collected the opinions of stakeholders with varied profiles. A guided interview focused on discerning strategies that might foster the ethical deployment of TR. Such strategies were found to be linked to the decision-making of the public authorities, the role of scientific and professional bodies, the training of health professionals, and the management of patient information. Ethical issues relating to the development of TR included universal accessibility, patients’ free choice, respect of privacy, and professional confidentiality. The ethical development of TR can be fostered by the provision of information to stakeholders as well as reminding practitioners of the ethical framework that regulates medical practice

Use of kinematic algorithms to distinguish people with chronic non-specific low back pain from asymptomatic subjects: A validation study

Objective: To determine whether kinematic algorithms can distinguish subjects with chronic non-specific low back pain from asymptomatic subjects and subjects simulating low back pain, during trunk motion tasks.Design: Comparative cohort study.Subjects: A total of 90 subjects composed 3 groups; 45 chronic non-specific low back pain patients in the CLBP group; 45 asymptomatic controls people in the asymptomatic controls group. 20/45 subjects from the asymptomatic controls group composed the CLBP simulators group as well. Method: During performance of 7 standardized trunk motion tasks 6 spinal segments from the kinematic spine model were recorded by 8 infrared cameras. Two logit scores, for range of motion and speed, were used to investigate differences between the groups. Group allocation based on logit scores was also calculated, allowing the assessment of sensitivity and specificity of the algorithms. Results: For the 90 subjects (pooled data), the logit scores for range of motion and speed demonstrated highly significant differences between groups (p<0.001). The logit score means and standard deviation (SD) values in the asymptomatic group (n = 45) and chronic non-specific low back pain group (n = 45), respectively, were -1.6 (SD 2.6) and 2.8 (SD 2.8) for range of motion and -2.6 (SD 2.5) and 1.2 (SD 1.9) for speed. The sensitivity and specificity (n = 90) for logit score for range of motion were 0.80/0.82 and for logit score for speed were 0.80/0.87, respectively. Conclusion: These results support the validity of using 2 movement algorithms, range of motion and speed, to discriminate asymptomatic subjects from those with low back pain. However, people simulating low back pain cannot be distinguished from those with real low back pain using this method

Topsoil translocation in extensively managed arable field margins promotes plant species richness and threatened arable plant species

peer reviewedSince the 1950s, agriculture has intensified drastically, which has led to a significant biodiversity decline on arable lands. This decline was especially dramatic for segetal plant species, the specialist species of cereal fields. Due to the low population density and poor dispersal abilities of many segetal species, the recovery of species-rich fields may fail even though the environmental conditions are suitable. Therefore, conservation efforts including active restoration measures aimed at recovering segetal vegetation are needed. To this purpose, we propose to alleviate dispersal limitation by means of topsoil translocation from a species-rich donor arable field. At two receiver sites, we tested this technique using two topsoil-spreading densities, i.e. 2.5Lsoil/m2 and 5Lsoil/m2 in experimental plots (3 m2). At one receiver site, we tested the impact of topsoil translocation from two different donor sites, while in the other receiver site one donor site was used. We compared plant species diversity and composition of treated plots with control plots as well as with the species composition of the donor sites (field survey) and their seed bank (greenhouse survey). Species richness was increased by topsoil spreading, including richness of threatened species. 33% and 71% of the threatened species were successfully translocated respectively at the two receiver sites. At one site, plant cover was also increased, including threatened species cover. Conversely, topsoil spreading did not promote pernicious species that could affect farmer acceptance negatively. Vegetation of translocated plots was more similar in terms of species composition to donor site seed banks than to donor site field survey. The higher spreading density led to increased species richness when seed bank in topsoil had lower density. Our results show that topsoil translocation can be a highly effective method for restoring threatened segetal plant communities in agricultural landscapes. Even when a full plant community was already present (Receiver 1) topsoil transfer led to a doubling in species richness. The seed bank surveys were a good indicator of plant community composition upon topsoil translocation in the field and are therefore advisable to implement in the project-planning phase to evaluate donor site potential. From our results, we recommend to spread soil at an overall rate of 500 seeds/m2 equivalent. Future studies need to assess the long-term fate of the translocated species as well as the impacts of soil harvests on the donor sites to establish sustainable use levels. © 2020 Elsevier Lt

Uncleaned crop seed sowing as a tool to conserve bromus grossus and restore species-rich arable-dependent plant communities

peer reviewedSegetal plants, which grow preferentially or exclusively in cereal fields, experienced a strong decline during the last century. Among them, Bromus grossus received particular attention, as it is highly threatened in Europe. Its decline is thought to be due to crop seed cleaning among other causes. Re-establishing the sowing of uncleaned crop seeds should therefore be considered as a tool for the conservation of this species. In this study, we aimed to evaluate (i) how the conservation of B. grossus relies on transfer in uncleaned crop seed, (ii) how this practice may help to restore new populations of this species, and (iii) the contribution of this practice to the dispersal of other segetal plants. From 2012 to 2016, we monitored eight fields from three farms in Southern Belgium where uncleaned spelt seed containing B. grossus was sown. We found that B. grossus grew in the year following seed sowing, but disappeared in the second year in most cases. This highlights the extreme dependence of B. grossus upon uncleaned spelt-seed sowing. We also showed that, through associated management practices, B. grossus acted as an ‘umbrella species’ to other arable-dependent plants. Transfer of uncleaned seed led to an increase in species richness in an experimental field from 12 species in 2015 to 43 species in 2017. Based on the germination of uncleaned seeds in a greenhouse, we concluded that it was likely to account for the dispersal of at least nine species, and possibly 15 others. © 2018, University of Cambridge. All rights reserved

Age Effects on Upper Limb Kinematics Assessed by the REAplan Robotin Healthy School-Aged Children

The use of kinematics is recommended to quantitatively evaluate upper limb movements. The aims of this study were to determine the age effects on upper limb kinematics and establish norms in healthy children. Ninetythree healthy children, aged 3–12 years, participated in this study. Twenty-eight kinematic indices were computed from four tasks. Each task was performed with the REAplan, a distal effector robotic device that allows upper limb displacements in the horizontal plane. Twenty-four of the 28 indices showed an improvement during childhood. Indeed, older children showed better upper limb movements. This study was the first to use a robotic device to show the age effects on upper limb kinematics and establish norms in healthy children

Wanted ! Avez-vous vu ces plantes ? La conservation des plantes messicoles dans le cadre du Programme Agroenvironnemental wallon

Afin de mener à bien un projet de conservation des plantes messicoles menacées, la Faculté AgroBioTech de Gembloux appelle à diffuser vos observations de terrain au DEMN

A robotic device to assess and rehabilitate upper limb movements in cerebral palsy children and stroke adults

Cerebral palsy (CP) and stroke are major causes of permanent disabilities. These disabilities justify intensive interdisciplinary rehabilitation and regular assessments, which could be optimized using robotics. This PhD thesis investigated the clinical interest in robotic devices to assess and rehabilitate upper limb movements in CP children and stroke adults. This investigation was performed with the REAplan robot, which is an end-effector robotic device that moves the patient’s upper limb in a horizontal plane using various assistance modes (i.e., active, active-passive, passive). The first part of this thesis investigated how a robotic device could quantitatively assess upper limb movements in both populations. A standardized protocol was developed to assess upper limb kinematics using the REAplan robot in CP children and stroke adults. The reproducibility, validity, responsiveness and reference standards of this protocol were established, and a short version of this protocol was provided to facilitate the assessment of upper limb kinematics in routine clinical practice. The second part of this thesis investigated how a robotic device could efficiently rehabilitate upper limb movements in CP children. A standardized protocol for robot-assisted therapy (RAT) was first developed according to the current recommendations in CP neuro-rehabilitation. This protocol was used in a single-blind randomized controlled trial that assessed the efficacy of RAT in CP children. This trial showed that the combination of conventional therapy (CT) and RAT could significantly improve upper limb kinematics and manual dexterity in CP children compared with CT alone. Thus, robotic devices could quantitatively assess and efficiently rehabilitate upper limb movements in CP children and stroke adults. These findings would not have been possible without close collaboration between engineers, technicians, clinicians and researchers. Further similar collaborations should be encouraged to facilitate technological integration in rehabilitation.L’infirmité motrice d’origine cérébrale (IMoC) et les accidents vasculaires cérébraux (AVC) sont les principales causes d'invalidités permanentes. Ces pathologies justifient une rééducation interdisciplinaire intensive et des évaluations régulières, pouvant être optimisées par la robotique. Cette thèse de doctorat a étudié l'intérêt clinique de dispositifs robotiques afin d'évaluer et de rééduquer les mouvements du membre supérieur chez les enfants IMoC et les adultes AVC. Cette investigation a été réalisée à l’aide du robot REAplan. REAplan est un dispositif robotique à effecteur distal permettant la mobilisation du membre supérieur dans le plan horizontal grâce à différents modes d'assistance (i.e., actif, activo-passif, passif). La première partie de cette thèse a investigué comment un dispositif robotique pouvait évaluer quantitativement les mouvements du membre supérieur au sein des deux populations. Un protocole standardisé a été développé afin d’évaluer la cinématique du membre supérieur chez les enfants et adultes cérébro-lésés, en utilisant le dispositif robotique REAplan. La reproductibilité, la validité, la sensibilité au changement et les normes de référence de ce protocole ont été établies. Une version courte de ce protocole a été créée afin de faciliter l'évaluation de la cinématique du membre supérieur en routine clinique. La deuxième partie de cette thèse a étudié comment un dispositif robotique pouvait efficacement rééduquer le membre supérieur chez les enfants IMoC. Un protocole standardisé de thérapie assistée par la robotique (TAR) a été développé en tenant compte des recommandations connues en rééducation neuro-pédiatrique. Ce protocole a été utilisé dans une étude randomisée contrôlée en simple aveugle afin d'évaluer l'efficacité de la TAR chez les enfants IMoC. Cette étude a montré que la combinaison d'une thérapie conventionnelle (TC) et de la TAR améliorait significativement la cinématique du membre supérieur et la dextérité manuelle des enfants IMoC par rapport à la TC seul. Cette thèse de doctorat a montré que les dispositifs robotiques pouvaient quantitativement évaluer et efficacement rééduquer les mouvements du membre supérieur chez les enfants et adultes cérébro-lésés. Cette recherche n'aurait pas été possible sans l'étroite collaboration entre ingénieurs, techniciens, cliniciens et chercheurs. Nous encourageons la continuation de telles collaborations afin de favoriser l'intégration de la technologie en rééducation.(MOTR - Sciences de la motricité) -- UCL, 201