Equipamentos para estimulação elétrica funcional

Estimulação Elétrica Funcional (FES) Objetivos: Avaliação da técnica FES em pacientes com patologias neurológicas diversas, utilizando equipamentos desenvolvidos pela Engenharia Biomédica do Hospital de Clínicas de Porto Alegre. Os objetivos principais deste trabalho são: redução da espasticidade muscular, fortalecimento muscular e melhora no padrão de marcha. Material: FES-I1 portátil, 2 canais, Engenharia Biomédica - HCPA FES-I1 clínico, 2 canais, Engenharia Biomédica - HCPA  Métodos: Metodologia da Escola de Lubljana. Sessões periódicas de 10 minutos cada, aplicadas a pacientes previamente selecionados. Os resultados foram avaliados pela análise dos padrões de marcha e o exame clínico dos músculos estimulados. Resultados: Redução da espasticidade muscular: 81,8 % pacientes. Melhora no padrão de marcha: 73,7 % pacientes. Alívio no ombro doloroso: 100 % pacientes. Conclusões : A técnica de Estimulação Elétrica Funcional (FES) é um meio eficiente de obter contrações musculares controladas em membros paralisados, e, se possível, restaurar as funções destes membros. FES é clinicamente indicado para pacientes com lesões na medula espinhal (04), acidentes vasculares cerebrais, paralisia central, esclerose múltipla, etc ... (05). A aplicação regular da estimulação neuromuscular, usando FES, provou ser eficiente no tratamento de pacientes com deficiências motoras causadas por diferentes patologias do sistema nervoso central.Title: Functional Electrical Stimulation (FES) Aims: Evaluation of FES technique in patients with different neurologic pathologies, using devices developed by the Biomedical Engineering Division - HCPA. The basic aims are: muscular spasticity reduction, muscle strengthening and gait pattern improvement. Material: FES-I1 portable, 2 channels, Biomedical Engineering Division – HCPA FES-I1 clinicai, 2 channels, Biomedical Engineering Division - HCPA These FES equipments have the following characteristics: Channels: 2 isolated channels Current output amplitude: O to 80 mA Pulse width: 100 to 700 Pulse frequency: 10 to 60 Hz Burst controls: Atack, sustain, decay and resting times: adjustables Automatic and manual control Automatically assisted human gait using two specially designed foot-palms. Mehtods: Lubljana method. Periodic sessions of 10 minutes each applied to selected patients. The results were evaluated according to gait pattern analysis and clinicai examinations of the stimulated muscles. Results: Muscular spasticity reduction: 27/33 81,8 % patients Gait pattern improvement: 14/19 73,7 % patients Shoulder pain relief: 12/12 100 % patients Conclusions: Functional Electrical Stimulation (FES) technique is an effective means of obtaining muscular contractions of the paralyzed limbs, and, if possible, restoring controllable limb function in high-level spinal cord injury patients. FES is clinically indicated for patients with: spinal cord injury4, cerebrovascular disorders (stroke), central paralysis, brain injury, multiple sclerosis, etc ... 5

Dispositivo para emulação de mouse dedicado a pacientes tetraplégicos ou portadores de doença degenerativa do sistema neuromuscular

O trabalho descreve o desenvolvimento de um dispositivo que emula um mouse serial MicrosoftÒ. Este dispositivo permite ao deficiente físico tetraplégico acessar os recursos de informática em ambiente WindowsÒ 95/98 (ler e editar textos, navegar na Internet e utilizar o correio eletrônico) e auxilia o paciente de doenças degenerativas do sistema neuromuscular, como a esclerose lateral amiotrófica (ELA), com disartria, a comunicar-se com as pessoas ao seu redor. O movimento do cursor na tela do computador é produzido a partir do movimento de flexão e extensão da cabeça do usuário, sendo utilizado para medir os ângulos de inclinação um sensor de aceleração estática e dinâmica de dois eixos. Para emular o botão do mouse, são captados os sinais EMG (eletromiográficos) produzidos a partir do movimento voluntário dos músculos mímicos da região frontal do usuário. O processamento digital é realizado por um microcontrolador de oito bits e os dados são transmitidos para um computador padrão IBM-PC através da interface RS232C.This work describes the development of a pointing data entry device that emulates a MicrosoftÒ serial mouse. The device is aimed to individuals with a spinal cord injury or amyotrophic lateral sclerosys (A.L.S.), a degenerative disease of the neuromuscular system. This equipment allows individuals without hand movements to acess some computing resources such as reading, writing, surfing on the web, etc. The user’s head tilt, measured by a dual axis accelerometer, is responsible for the cursor movements on the computer screen. The click and double-click are produced by the voluntary movement of the user’s forehead muscle, which are acquired using electromyographic techniques. An eight bit microcontroller is used for the digital processing and interface to the computer via a RS232 port

Oxygen desaturation during the six-minute walk test in COPD patients

Objective: To evaluate the behavior of oxygen saturation curves throughout the six-minute walk test (6MWT) in patients with COPD. Methods: We included 85 patients, all of whom underwent spirometry and were classified as having moderate COPD (modCOPD, n = 30) or severe COPD (sevCOPD, n = 55). All of the patients performed a 6MWT, in a 27-m corridor with continuous SpO2 and HR monitoring by telemetry. We studied the SpO2 curves in order to determine the time to a 4% decrease in SpO2, the time to the minimum SpO2 (Tmin), and the post-6MWT time to return to the initial SpO2, the last designated recovery time (RT). For each of those curves, we calculated the slope. Results: The mean age in the modCOPD and sevCOPD groups was 66 ± 10 years and 62 ± 11 years, respectively. At baseline, SpO2 was > 94% in all of the patients; none received supplemental oxygen during the 6MWT; and none of the tests were interrupted. The six-minute walk distance did not differ significantly between the groups. The SpO2 values were lowest in the sevCOPD group. There was no difference between the groups regarding RT. In 71% and 63% of the sevCOPD and modCOPD group patients, respectively, a ≥ 4% decrease in SpO2 occurred within the first minute. We found that FEV1% correlated significantly with the ΔSpO2 (r = −0.398; p < 0.001), Tmin (r = −0.449; p < 0.001), and minimum SpO2 (r = 0.356; p < 0.005). Conclusions: In the sevCOPD group, in comparison with the modCOPD group, SpO2 was lower and the Tmin was greater, suggesting a worse prognosis in the former