7 research outputs found
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Evaluation of a training program for persons with SCI paraplegia using the Parastep®1 ambulation system: Part 3. Lack of effect on bone mineral density
Objective: To determine if the bone mineral density loss seen after spinal cord injury (SCI) is reversed by a walking program using the Parastep® 1 system.
Design: Before-after trial.
Setting: Human SCI applied research laboratory.
Participants: Thirteen men and 3 women with thoracic motor- and sensory-complete SCI, mean age 28.8yrs, mean duration postinjury 3.8yrs.
Intervention: Thirty-two functional neuromuscular stimulation (FNS) ambulation training sessions using a commercially available system (Parastep® 1). This system consists of a microprocessor-controlled stimulator and a modified walking frame with finger-operated switches that permit the user to control the stimulation parameters and activate the stepping.
Outcome Measure: Bone mineral density at the femoral head, neck, and Ward's triangle measured using a Lunar®DP3 dual-photon densitometer.
Results: No significant change in bone mineral density was found using repeated measures analyses of variance.
Conclusions: Axial loading combined with muscle stimulation and resistive exercise does not result in significant changes in bone mineral density in persons with complete paraplegia
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Evaluation of a training program for persons with SCI paraplegia using the Parastep®1 ambulation system: Part 5. Lower extremity blood flow and hyperemic responses to occlusion are augmented by ambulation training
Objective: To test whether 12 weeks of exercise conditioning using functional neuromuscular stimulation (FNS) ambulation alters the resting lower extremity blood flow and hyperemic responses to vascular occlusion in subjects with paraplegia, and to determine whether an association exists between limb flow and lower extremity fat-free mass.
Design: Pretest, posttest.
Setting: Academic medical center.
Participants: Subjects with chronic neurologically complete paraplegia.
Intervention: Thirty-two sessions of microprocessor-controlled ambulation using electrically stimulated contractions of lower extremity muscles and a rolling walker.
Outcome Measures: Subjects underwent quantitative Doppler ultrasound examination of the common femoral artery (CFA) before and after training. End-diastolic arterial images and arterial flow-velocity profiles obtained at rest and after 5 minutes of suprasystolic thigh occlusion were computer-digitized for analysis of heart rate (HR), CFA peak systolic velocity (PSV), CFA cross-sectional area (CSA), flow velocity integral (FVI), pulse volume (PV), and CFA (arterial) inflow volume (AIV).
Results: Significant effects of training on CSA (
p < .0001), FVI (
p < .05), computed PV (
p < .001), and computed AIV (
p < .01) were observed. Resting HR was lower following training (
p < .05). The change for resting PSV approached but did not reach significance (
p = .083). Analysis of postocclusion PV and AIV showed significant effects for conditioning status (
p values < .01), postcompression time (
p values < .0001), and their interaction (
p values < .01). At 1 minute after occlusion, the posttraining AIV response was 78.2% greater in absolute magnitude and 17.4% more robust when expressed as a percentage change from its resting value than before training. Significant correlations were found between thigh fat free mass and both AIV and PV (
p values < .05).
Conclusion: Exercise training using FNS ambulation increases the resting lower extremity AIV in individuals with paraplegia and augments the hyperemic response to vascular occlusion. Improved posttraining blood flow is attributable both to vascular structural changes and upregulation of vascular flow control mechanisms. Limb mass is associated with the volume of arterial blood flow
Vulnerabilities of Secure and Reliable Low-Power Embedded Systems and Their Analysis Methods
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Evaluation of a training program for persons with SCI paraplegia using the Parastep®1 ambulation system: Part 2. Effects on physiological responses to peak arm ergometry
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Evaluation of a training program for persons with SCI paraplegia using the Parastep®1 ambulation system: Part 1. Ambulation performance and anthropometric measures
Objective: To describe performance parameters and effects on anthropometric measures in spinal cord injured subjects training with the Parastep® 1 system.
Design: Before-after trial.
Setting: Human spinal cord injury applied research laboratory.
Participants: Thirteen men and 3 women with thoracic (T4–T11) motor-complete spinal cord injury: mean age, 28.8yrs; mean duration postinjury, 3.8yrs.
Intervention: Thirty-two functional neuromuscular stimulation ambulation training sessions using a commercially available system (Parastep-1). The hybrid system consists of a microprocessor-controlled stimulator and a modified walking frame with finger-operated switches that permit the user to control the stimulation parameters and activate the stepping.
Outcome Measures: Distance walked, time spent standing and walking, pace, circumferential (shoulders, chest, abdomen, waist, hips, upper arm, thigh, and calf) and skinfold (chest, triceps, axilla, subscapular, supraillium, abdomen, and thigh) measurements, body weight, thigh cross-sectional area, and calculated lean tissue.
Results: Statistically significant changes in distance, time standing and walking, and pace were found. Increases in thigh and calf girth, thigh cross-sectional area, and calculated lean tissue, as well as a decrease in thigh skinfold measure, were all statistically significant.
Conclusions: The Parastep® 1 system enables persons with thoracic-level spinal cord injuries to stand and ambulate short distances but with a high degree of performance variability across individuals. The factors that influence this variability have not been completely identified