A hybrid system for upper limb movement restoration in quadriplegics

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Generally, quadriplegic individuals have difficulties performing object manipulation. Toward satisfactory manipulation, reach and grasp movements must be performed with voluntary control, and for that, grasp force feedback is essential. A hybrid system aiming at partial upper limb sensory-motor restoration for quadriplegics was built. Such device is composed of an elbow dynamic orthosis that provides elbow flexion/extension (range was approximately from 20 degrees to 120 degrees, and average angular speed was approximately 15 degrees/s) with forearm support, a wrist static orthosis and neuromuscular electrical stimulation for grasping generation, and a glove with force sensors that allows grasping force feedback. The glove presents two user interface modes: visual by light emitting diodes or audio emitted by buzzer. Voice control of the entire system (elbow dynamic orthosis and electrical stimulator) is performed by the patient. The movements provided by the hybrid system, combined with the scapular and shoulder movements performed by the patient, can aid quadriplegic individuals in tasks that involve reach and grasp movements.329725729Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Can Simple Electronic Instrumentation Associated With Basic Training Help Users Of Assistive Devices?: Presenting And Verifying The Effectiveness Of A Biofeedback Module For An Instrumented Crutch

Crutches are prescribed towards compensating lower limb overload and adding sensory information through upper limb. However, adequate loads are required to avoid upper limb lesions and further lower limb injuries. Therefore, this work describes the development and application of a biofeedback module for a Lofstrand crutch, based on a simple electronic instrumentation. The goal is to train the user to apply proper load on the crutch. Basic training was performed by healthy subjects before and after static and dynamic activities. Results showed the feasibility of the device and the effectiveness of the training to reach the target (load on the crutch of 20% of body weight). Copyright © 2014 SCITEPRESS - Science and Technology Publications. All rights reserved.259264Control and Communication (INSTICC),Institute for Systems and Technologies of Information,Agarwal, S., Abidin, A.Z., Chattopadhyay, S., Acharya, U.R., Engineering interventions to improve impaired gait: A review (2012) Advances in Therapeutic Engineering, pp. 335-363. , In: Yu, W., Chattopadhyay, S., Lim, T. C.Acharya, U. R. Boca Raton: CRC Press-Taylor &Francis GroupBaker, R., Clinical gait analysis (2012) Orthopaedic Biomechanics, pp. 419-443. , In: Winkelstein, B. A. Boca Raton: CRC Press-Taylor &Francis GroupBlount, W.P., Don't throw away the cane (1956) The Journal of Bone and Joint Surgery, 38, pp. 695-708Chen, C.L., Chen, H.C., Wong, M.K., Tang, F.T., Chen, R.S., Temporal stride and force analysis of cane-assisted gait in people with hemiplegic stroke (2001) Archives of Physical Medicine and Rehabilitation, 82, pp. 43-48Cook, A.M., Hussey Susan, M., (2002) Assistive Technologies: Principles and Practice, , Missouri: MosbyDelisa, J.A., Gans, B.M., (1993) Rehabilitation Medicine-Principles and Practice, , Philadelphia:Lippincott, J.B., Edelstein, J.N., Assistive devices for ambulation (2013) Physical Medicine &Rehabilitation Clinics of North America, 24, pp. 291-303Laufer, Y., The effect of walking aids on balance and weight-bearing patterns of patients with hemiparesis in various stance positions (2003) Physical Therapy, 83, pp. 112-122Leite, F.I.L., (2002) Development of An Electronic Crutch to Medical Assistance, , Master of Science. University of São PauloMelis, E.H., Torres-Moreno, R., Barbeau, H., Lemaire, E.D., Analysis of assisted-gait characteristics in persons with incomplete spinal cord injury (1999) Spinal Cord, 37, pp. 430-439Moriana, G.C., Roldán, J.R., Rejano, J.J., Martínez, R.C., Serrano, C.S., Design and validation of GCH System 1.0 which measures the weight-bearing exerted on forearm crutches during aided gait (2013) Gait Posture, 37, pp. 564-569Saad, M., Meios auxiliares de marcha (2007) Tratado de Medicina de Reabilitação., pp. 330-333. , In: Greve, J. M. D. São Paulo: RocaSimoneau, G.G., Cinesiologia da marcha (2011) Cinesiologia Do Apararelho Musculoesquelético-Fundamentos Para Reabilitação, pp. 627-676. , In: Neumann, D. A. Rio de Janeiro: ElsevierWall, J.C., (2001) Movimento Functional Humano: Mensuração e Análise, pp. 93-105. , In: Durward, B. R., Baer, G. D., Rowe, P. J. São Paulo: ManoleWaring, W.P., Werner, R.A., Clinical management of carpal tunnel syndrome in patients with long-term sequelae of poliomyelitis (1989) Journal of Hand Surgery (American Volume), 14, pp. 865-86

Upper limb assessment in tetraplegia: clinical, functional and kinematic correlations

The aim of this study was to correlate clinical and functional evaluations with kinematic variables of upper limp reach-to-grasp movement in patients with tetraplegia. Twenty chronic patients were selected to perform reach-to-grasp kinematic assessment using a target placed at a distance equal to the arm's length. Kinematic variables (hand peak velocity, movement time, percent time-to-maximal velocity, index of curvature, number of peaks, and joint range of motion) were correlated to clinical (Standard Neurological Classification of Spinal Cord Injury-American Spinal Injury Association) and functional [Functional Independence Measure (FIM) and Spinal Cord Independence Measure II (SCIM II)) evaluation scores. Twenty control participants were also selected to obtain normal reference parameters. There was a positive correlation between total motor index and FIM (r=0.6089; P=0.0044) and SCIM II (r=0.5229; P=0.018). Both functional scores showed positive correlation with each other (r=0.8283; P<0.0001). A correlation was also observed between the right and left motor indices, the motor AM, and the SCIM II in most of the reach-to-grasp kinematic variables studied (hand peak velocity, movement time, index of curvature, and number of peaks). In contrast, for the joint range of motion (shoulder, elbow, and wrist), only the wrist in the horizontal plane showed correlation with clinical variables. This study shows that muscle strength assessed by the American Spinal Injury Association motor index influences the reach-to-grasp kinematic variables of patients with tetraplegia. However, the functional assessments did not present the same influence.341657

Kinematic Assessment Of Transfer Of Paraplegic Subjects From The Wheelchair

Objective: To evaluate the transfer strategy of paraplegic subjects from their wheelchairs. Methods: Twelve thoracic spinal cord injured subjects participated in this study (T2 to T12). The subjects were able to independently transfer from a wheelchair to a one square meter (m2) platform, half a meter in height. Images of reflexive anatomic markers were captured by six ProReflex infrared cameras and processed using a QTRac Capture software. Kinematic parameters of the trunk, head, shoulders and elbows were evaluated. Results: The data analyzed compared the subjects' preferential side for performing transfers, according to the functions performed by each body segment. Angular displacement of the head on sagittal plan (y-z), and the shoulders on the transversal plan (x-y), showed statistical differences (p<0.05). Conclusion: The data obtained on this study showed that there are differences in transfer strategies of paraplegic subjects to their preferential side, in comparison with the non-preferential side. Level of Evidence II, Development of diagnostic criteria on consecutive patients (with universally applied reference "gold" standard).196346352Gianni, P.E.S., Chamlian, T.R., Arakaki, J.C., Shoulder pain in spinal Cord injury (2006) Acta Ortop Bras, 14, pp. 44-47Kilkens, O.J., Dallmeijer, A.J., De Witte, L.P., Van Der Woude, L.H., Post, M.W., The Wheelchair Circuit: Construct validity and responsiveness of a test to assess manual wheelchair mobility in persons with spinal cord injury (2004) Arch Phys Med Rehabil, 85, pp. 424-431Gagnon, D., Nadeau, S., Noreau, L., Eng, J.J., Gravel, D., Trunk and upper extremity kinematics during sitting pivot transfers performed by individuals with spinal cord injury (2008) Clin Biomech (Bristol, Avon), 23, pp. 279-290Nyland, J., Snouse, S.L., Anderson, M., Kelly, T., Sterling, J.C., Soft tissue injuries to USA paralympians at the 1996 summer games (2000) Arch Phys Med Rehabil, 81, pp. 368-373Boninger, M.L., Souza, A.L., Cooper, R.A., Fitzgerald, S.G., Koontz, A.M., Fay, B.T., Propulsion patterns and pushrim biomechanics in manual wheelchair propulsion (2002) Arch Phys Med Rehabil, 83, pp. 718-723Nawoczenski, D.A., Clobes, S.M., Gore, S.L., Neu, J.L., Olsen, J.E., Borstad, J.D., Ludewig, P.M., Three-dimensional shoulder kinematics during a pressure relief technique and wheelchair transfer (2003) Arch Phys Med Rehabil, 84, pp. 1293-1300Shirado, O., Kawase, M., Minami, A., Strax, T.E., Quantitative evaluation of long sitting in paraplegic patients with spinal cord injury (2004) Arch Phys Med Rehabil, 85, pp. 1251-1256Chen, C.L., Yeung, K.T., Bih, L.I., Wang, C.H., Chen, M.I., Chien, J.C., The relationship between sitting stability and functional performance in patients with paraplegia (2003) Arch Phys Med Rehabil, 84, pp. 1276-1281Janssen-Potten, Y.J., Seelen, H.A., Drukker, J., Huson, T., Drost, M.R., The effect of seat tilting on pelvic position, balance control, and compensatory postural muscle use in paraplegic subjects (2001) Arch Phys Med Rehabil, 82, pp. 1393-1402Seelen, H.A., Potten, Y.J., Drukker, J., Reulen, J.P., Pons, C., Development of new muscle synergies in postural control in spinal cord injured subjects (1998) J Electromyogr Kinesiol, 8, pp. 23-34Forslund, E.B., Granström, A., Levi, R., Westgren, N., Hirschfeld, H., Transfer from table to wheelchair in men and women with spinal cord injury: coordination of body movement and arm forces (2007) Spinal Cord, 45, pp. 41-48Ninomyia, A.F., Jesus, C.L.M., Auletta, L.L., Rimkus, C.M., Ferreira, D.M., Filho, A.Z., Cliquet Jr., A., Shoulders of patients with spinal cord injuries submitted to rehabilitation program - a Clinical and ultrasound-based assessment (2007) Acta Ortop Bras, 15, pp. 109-113Perry, J., Gronley, J.K., Newsam, C.J., Reyes, M.L., Mulroy, S.J., Electromyographic analysis of the shoulder muscles during depression transfers in subjects with low-level paraplegia (1996) Arch Phys Med Rehabil, 77, pp. 350-355Gagnon, D., Nadeau, S., Gravel, D., Noreau, L., Larivière, C., McFadyen, B., Movement patterns and muscular demands during posterior transfers toward an elevated surface in individuals with spinal cord injury (2005) Spinal Cord, 43, pp. 74-84Norkin, C.C., White, D.J., (1995) Measurement of Joint Motion: A Guide to Goniometry, , 2nd ed. Philadelphia: E. A Davis Company;Van Drongelen, S., Van der Woude, L.H., Janssen, T.W., Angenot, E.L., Chadwick, E.K., Veeger, D.H., Mechanical load on the upper extremity during wheelchair activities (2005) Arch Phys Med Rehabil, 86, pp. 1214-1220Kapanji, A.I., (2007) Physiologie Articulaire, , 6nd ed. Paris: Maloin

Relationship between function, strength and electromyography of upper extremities of persons with tetraplegia

To analyze the relationships between functional tests, arm strength and root mean square of surface electromyography (EMG). Twenty-four individuals with chronic tetraplegia participated. Upper extremity motor score (UEMS), functional independence measure (FIM) motor score, spinal cord independence measure III and capabilities of upper extremity (CUE) were performed. Muscle strength of the right elbow flexors–extensors was assessed using dynamometry and manual muscle test (MMT) and EMG of right biceps and triceps brachii were performed. Spearman's rank correlation coefficients and Mann–Whitney's U-test were used. Functional tests and UEMS correlated strongly among them. UEMS highly correlated with triceps dynamometry and EMG. The dynamometry showed a very high correlation with MMT on the extensor group and a moderate correlation with flexor group. Triceps EMG showed moderate correlation with FIM and CUE. High correlations between triceps EMG and elbow extensors dynamometry and MMT were observed. A significant better performance on functional tests was observed on lower ASIA motor levels. The low-tetraplegia group showed a significant higher score on triceps EMG and dynamometry. Arm strength and EMG seem to be related to functional capabilities and independence in chronic tetraplegia.502832FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPNão te

Portable Custom Built Device For Thermal Sensitivity Assessment: An Auxiliary Tool To Characterize The Neuropathic Pain Following Spinal Cord Injury

Neuropathic pain is characterized to arise without stimulation of nociceptors, but due to injury or dysfunction of Peripheral and Central Nervous Systems. It involves altered mechanisms of impulse transmission in somatosensory pathways, causing abnormal sensations. Quantitative sensory testing, by the detection of thermal stimuli, is a method used to characterize and study the neuropathic pain. Therefore, this work describes the development and application of portable custom built device for cutaneous thermal sensitivity assessment in spinal cord injured subjects (SCIS). Using method of levels, the assessment was applied in healthy subjects and SCIS with and without neuropathic pain. The thresholds determined for healthy subjects during thermal sensitivity assessment are consistent and other results provided by clinical trials are according to previous works, demonstrating the device feasibility as an auxiliary tool for neuropathic pain study.2834 Inst. Syst. Technol. Inf., Control Commun. (INSTICC)Bonica, J.J., Introduction: Semantic, epidemiologic, and educational issues (1991) Pain and Central Nervous System Disease: The Central Pain Syndromes, pp. 13-29. , Casey, K. L. Raven Pr. New York: Raven PrCallister Jr., W.D., (2001) Fundamentals of Material Science and Engineering, , 5th ed. New York: John Wiley &ampSons, IncCatafau, S., Bosque, Q., (2003) Mecanismos fisiopatológicos da dor neuropática, , 1st ed. Madrid: Medica PanamericanaDahlberg, A., Alaranta, H., Sintonen, H., Health-related quality of life in persons with traumatic spinal cord lesion in helsinki (2005) Journal of Rehabilitation Medicine, 37, pp. 312-316Dimitrijevic, M.R., Residual motor functions in spinal cord injury (1988) Advances in Neurology, 47, pp. 138-155Eng, J.J., Miller, W.C., Rehabilitation: From bedside to community following spinal cord injury (SCI) (2006) Spinal Cord Injury Rehabilitation Evidence, pp. 16-29. , Eng, J. J., Teasell, R. W., Miller, W. C., Wolfe, D. L., Townson, A. F., Aubut, J., Abramson, C., Hsieh, J. T. C., Connolly, S VancouverFinnerup, N.B., Johannesen, I.L., Fuglsang-Frederiksen, A., Bach, F.W., Jensen, T.S., Sensory function in spinal cord injury patients with and without central pain (2003) Brain, 126, pp. 57-70Finnerup, N.B., Gyldensted, C., Fuglsang-Frederiksen, A., Bach, F.W., Jensen, T.S., Sensory perception in complete spinal cord injury (2004) Acta Neurologica Scandinavica, 109, pp. 194-199Kaplan, S.A., Chancellor, M.B., Blaivas, J.G., Bladder and sphincter behavior in patients with spinal cord lesions (1991) Journal of Urology, 146, pp. 113-117Kenshalo, D.R., Bergen, D.C., A device to measure cutaneous temperature sensitivity in humans and subhuman species (1975) Journal of Applied Physiology, 39, pp. 1038-1040Kirillova, I., Rausch, V.H., Baron, R., Jänig, W., Mechano- and thermosensitivity of injured muscle afferents (2011) Journal of Neurophysiology, 105, pp. 2058-2073Kirshblum, S.C., Burns, S.P., Biering-Sorensen, F., Donovan, W., Graves, D.E., Jha, A., Johansen, M., Waring, W., International standards for neurological classification of spinal cord injury (Revised 2011) (2011) The Journal of Spinal Cord Medicine, 34, pp. 535-546Maynard Jr., F.M., Bracken, M.B., Creasey, G., Ditunno Jr., J.F., Donovan, W.H., Ducker, T.B., Garber, S.L., Young, W., International standards for neurological and functional classification of spinal cord injury (1997) Spinal Cord, 35, pp. 266-274Melzack, R., The McGill pain questionnaire: Major properties and scoring methods (1975) Pain, 1, pp. 277-299Melzack, R., Torgerson, W.S., On the language of pain (1971) Anesthesiology, 422, pp. 50-59Nomoto, S., Shibata, M., Iriki, M., Riedel, W., Role of afferent pathways of heat and cold in body temperature regulation (2004) International Journal of Biometeorology, 49, pp. 67-85De Pimenta, C.A.M., Teixeira, M.J., Questionário de dor McGill: proposta de adaptação para a língua portuguesa (1996) Revista da Escola de Enfermagem da USP, 30, pp. 473-483Raineteau, O., Schwab, M.E., Plasticity of motor systems after incomplete spinal cord injury (2001) Nature reviews. Neuroscience, 2, pp. 263-273Richards, J.S., Meredith, R.L., Nepomuceno, C., Fine, P.R., Bennett, G., Psychosocial aspects of chronic pain in spinal cord injury (1980) Pain, 8, pp. 355-408Schepers, R.J., Ringkamp, M., Thermoreceptors and thermosensitive afferents (2010) Neuroscience and Biobehavioral Reviews, 34, pp. 177-184Sherwood, A.M., Dimitrijevic, M.R., Mckay, W.B., Evidence of subclinical brain influence in clinically complete spinal cord injury: Discomplete SCI (1992) Journal of the Neurological Sciences, 110, pp. 90-98Shy, M.E., Frohman, E.M., So, Y.T., Arezzo, J.C., Cornblath, D.R., Giuliani, M.J., Kincaid, J.C., Weimer, L.H., Quantitative sensory testing (2003) Neurology, 60, pp. 898-904Summers, J.D., Rapoff, M.A., Varghese, G., Porter, K., Palmer, R.E., Psychosocial factors in chronic spinal cord injury pain (1991) Pain, 47, pp. 183-189Verschueren, J.H.M., Post, M.W.M., De Groot, S., Van Der Woude, L.H.V., Van Asbeck, F.W.A., Rol, M., Occurrence and predictors of pressure ulcers during primary in-patient spinal cord injury rehabilitation (2011) Spinal Cord, 49, pp. 106-112Wasner, G., Lee, B.B., Engel, S., Mclachlan, E., Residual spinothalamic tract pathways predict development of central pain after spinal cord injury (2008) Brain, 131, pp. 2387-2400Wolfe, D.L., Hsieh, J.T.C., Rehabilitation practice and associated outcomes following spinal cord injury (2006) Spinal Cord Injury Rehabilitation Evidence, pp. 44-90. , Eng, J. J., Teasell, R. W., Miller, W. C., Wolfe, D. L., Townson, A. F., Aubut, J., Abramson, C., Hsieh, J. T. C., Connolly, S Vancouve

Development And Application Of A Portable Device For Cutaneous Thermal Sensitivity Assessment: Characterizing The Neuropathic Pain Following Spinal Cord Injury

 Neuropathic pain is characterized to arise due to injury or dysfunction of Peripheral and Central Nervous Systems, without stimulation of nociceptors, being one of the major problems following spinal cord injury (SCI). It involves altered mechanisms of impulse transmission in somatosensory pathways, causing abnormal sensations. Quantitative and qualitative sensory tests, by the detection of tactile and thermal stimuli and McGill Pain Questionnaire, are methods used to characterize and study the neuropathic pain. Therefore, this work describes the development and application of a portable device for cutaneous thermal sensitivity assessment in spinal cord injured subjects (SCIS). Using method of levels, the assessment was applied in healthy subjects and SCIS with and without neuropathic pain. The thresholds determined for healthy subjects during thermal sensitivity assessment are consistent and other results provided by clinical trials are according to previous works, demonstrating the device feasibility as an auxiliary tool for neuropathic pain study.4524153Institute for Systems and Technologies of Information, Control and Communication, INSTICC,University of Maynard, F.M., Bracken, M.B., Creasey, G., Ditunno, J.F., Donovan, W.H., Ducker, T.B., Garber, S.L., Young, W., International standards for neurological and functional classification of spinal cord injury (1997) Spin. Cord, 35, pp. 266-274Eng, J.J., Miller, W.C., Rehabilitation: From bedside to community following spinal cord injury (SCI) (2006) Eng, J.J., Teasell, R.W., Miller, W.C., Wolfe, D.L., Townson, A.F., Aubut, J., Abramson, C., Hsieh, J.T.C., Connolly, S, pp. 16-29. , (eds.) Spinal Cord Injury Rehabilitation Evidence, Vancouver, CanadaRaineteau, O., Schwab, M.E., Plasticity of motor systems after incomplete spinal cord injury. Nat (2001) Rev. Neurosci, 2, pp. 263-273Kaplan, S.A., Chancellor, M.B., Blaivas, J.G., Bladder and sphincter behavior in patients with spinal cord lesions (1991) J. Urol, 146, pp. 113-117Verschueren, J.H.M., Post, M.W.M., De Groot, S., Van Der Woude, L.H.V., Van Asbeck, F.W.A., Rol, M., Occurrence and predictors of pressure ulcers during primary in-patient spinal cord injury rehabilitation. Spin (2011) Cord, 49, pp. 106-112Bonica, J.J., Introduction: Semantic, epidemiologic, and educational issues (1991) Pain and Central Nervous System Disease: The Central Pain Syndromes, pp. 13-29. , In: Casey, K.L. (ed.), Raven Pr, New YorkRichards, J.S., Meredith, R.L., Nepomuceno, C., Fine, P.R., Bennett, G., Psychosocial aspects of chronic pain in spinal cord injury (1980) Pain, 8, pp. 355-408Summers, J.D., Rapoff, M.A., Varghese, G., Porter, K., Palmer, R.E., Psychosocial factors in chronic spinal cord injury pain (1991) Pain, 47, pp. 183-189Catafau, S., Bosque, Q., (2003) Mecanismos Fisiopatológicos da Dor Neuropática, , Medica Panamericana, MadridWasner, G., Lee, B.B., Engel, S., McLachlan, E., Residual spinothalamic tract pathways predict development of central pain after spinal cord injury (2008) Brain, 131, pp. 2387-2400Kirillova, I., Rausch, V.H., Baron, R., Jänig, W., Mechano- and thermosensitivity of injured muscle afferents (2011) J. Neurophysiol, 105, pp. 2058-2073Finnerup, N.B., Johannesen, I.L., Fuglsang-Frederiksen, A., Bach, F.W., Jensen, T.S., Sensory function in spinal cord injury patients with and without central pain (2003) Brain, 126, pp. 57-70Kido, R.Y.Z., Zorzenoni, F.O., Tanhoffer, R., Varoto, R., Lima, V.M.F., Beinotti, F., Gaspar, M.I.F.A.S., Cliquet, A., Neuropathic pain in spinal cord injury subjects: Somatosensory differences (2011) 16th International Functional Electrical Stimulation Society Annual Conference, CD-ROM. Atha Comunicação e Editora, São PauloMelzack, R., The McGill pain questionnaire: Major properties and scoring methods (1975) Pain, 1, pp. 277-299De Mattos Pimenta, C.A., Teixeira, M.J., Questionário de Dor McGill: Proposta de Adaptação para a Língua Portuguesa (1996) Rev. Esc. Enferm. USP, 30, pp. 473-483Melzack, R., Torgerson, W.S., On the language of pain (1971) Anesthesiology, 422, pp. 50-59Shy, M.E., Frohman, E.M., So, Y.T., Arezzo, J.C., Cornblath, D.R., Giuliani, M.J., Kincaid, J.C., Weimer, L.H., Quantitative sensory testing (2003) Neurology, 60, pp. 898-904Arezzo, J.C., Schaumburg, H.H., Laudadio, C., Thermal sensitivity tester (1986) Diabetes, 35, pp. 590-592Yang, G.H., Kyung, K.U., Srinivasan, M.A., Kwon, D.S., Qualitative tactile display device with pin-array type tactile feedback and thermal feedback (2006) 2006 IEEE International Conference on Robotics and Automation, pp. 3917-3922. , OrlandoKenshalo, D.R., Bergen, D.C., A device to measure cutaneous temperature sensitivity in humans and subhuman species (1975) J. Appl. Physiol, 39, pp. 1038-1040Dahlberg, A., Alaranta, H., Sintonen, H., Health-related quality of life in persons with traumatic spinal cord lesion in helsinki (2005) J. Rehabil. Med, 37, pp. 312-316Wolfe, D.L., Hsieh, J.T.C., Rehabilitation practice and associated outcomes following spinal cord injury (2006) Eng, J.J., Teasell, R.W., Miller, W.C., Wolfe, D.L., Townson, A.F., Aubut, J., Abramson, C., Hsieh, J.T.C., Connolly, S, pp. 44-90. , (eds.) Spinal Cord Injury Rehabilitation Evidence, Vancouver, CanadaKirshblum, S.C., Burns, S.P., Biering-Sorensen, F., Donovan, W., Graves, D.E., Jha, A., Johansen, M., Waring, W., International standards for neurological classification of spinal cord injury (Revised 2011) (2011) J. Spinal Cord Med, 34, pp. 535-546Callister, W.D., (2001) Fundamentals of Material Science and Engineering, , Wiley, New YorkNomoto, S., Shibata, M., Iriki, M., Riedel, W., Role of afferent pathways of heat and cold in body temperature regulation (2004) Int. J. Biometeorol, 49, pp. 67-85Schepers, R.J., Ringkamp, M., Thermoreceptors and thermosensitive afferents. Neurosci. Biobehav (2010) Rev, 34, pp. 177-184Dimitrijevic, M.R., Residual motor functions in spinal cord injury. Adv (1988) Neurol, 47, pp. 138-155Sherwood, A.M., Dimitrijevic, M.R., McKay, W.B., Evidence of subclinical brain influence in clinically complete spinal cord injury: Discomplete SCI (1992) J. Neurol. Sci, 110, pp. 90-98Finnerup, N.B., Gyldensted, C., Fuglsang-Frederiksen, A., Bach, F.W., Jensen, T.S., Sensory perception in complete spinal cord injury. Acta Neurol (2004) Scand, 109, pp. 194-19

Relationship Between Function, Strength And Electromyography Of Upper Extremities Of Persons With Tetraplegia.

Cross-sectional. To analyze the relationships between functional tests, arm strength and root mean square of surface electromyography (EMG). Sao Paulo, Brazil. Twenty-four individuals with chronic tetraplegia participated. Upper extremity motor score (UEMS), functional independence measure (FIM) motor score, spinal cord independence measure III and capabilities of upper extremity (CUE) were performed. Muscle strength of the right elbow flexors-extensors was assessed using dynamometry and manual muscle test (MMT) and EMG of right biceps and triceps brachii were performed. Spearman's rank correlation coefficients and Mann-Whitney's U-test were used. Functional tests and UEMS correlated strongly among them. UEMS highly correlated with triceps dynamometry and EMG. The dynamometry showed a very high correlation with MMT on the extensor group and a moderate correlation with flexor group. Triceps EMG showed moderate correlation with FIM and CUE. High correlations between triceps EMG and elbow extensors dynamometry and MMT were observed. A significant better performance on functional tests was observed on lower ASIA motor levels. The low-tetraplegia group showed a significant higher score on triceps EMG and dynamometry. Arm strength and EMG seem to be related to functional capabilities and independence in chronic tetraplegia.5028-3

A state-space modeling approach for active structural acoustic control

The demands for improvement in sound quality and reduction of noise generated by vehicles are constantly increasing, as well as the penalties for space and weight of the control solutions. A promising approach to cope with this challenge is the use of active structural-acoustic control. Usually, the low frequency noise is transmitted into the vehicle`s cabin through structural paths, which raises the necessity of dealing with vibro-acoustic models. This kind of models should allow the inclusion of sensors and actuators models, if accurate performance indexes are to be accessed. The challenge thus resides in deriving reasonable sized models that integrate structural, acoustic, electrical components and the controller algorithm. The advantages of adequate active control simulation strategies relies on the cost and time reduction in the development phase. Therefore, the aim of this paper is to present a methodology for simulating vibro-acoustic systems including this coupled model in a closed loop control simulation framework that also takes into account the interaction between the system and the control sensors/actuators. It is shown that neglecting the sensor/actuator dynamics can lead to inaccurate performance predictions.KU LeuvenUniversity of Sao Paulo (USP)European FP6 Integrated Projec

Custom Built Device For Spasticity Evaluation Associated To Spinal Cord Injury: A Redundant Signal To Electrogoniometer In Pendulum Test

The proposal of this project was the development of a more objective system to evaluate spasticity, dysfunction often presented by spinal cord injured people. As result, it will be possible to follow patient's progress in moments before and after any treatment, drawing comparisons through the acquired data. One accelerometer was added to the original pendulum test, providing redundant and alternative signal to the electrogoniometer, even in critical situations. Also, tests were performed in patients during treatments, what confirmed the feasibility of the present system in this method of evaluation.120126Abreu, D.C., Cliquet Jr., A., Rondina, J.M., Cendes, F., Electrical stimulation during gait promotes increase of muscle cross-sectional area in quadriplegics (2009) Clinical Orthopaedics and Related Research, 467, pp. 553-557(1998) Measurement Specialties: Datasheet, , http://www.meas-spec.com/, Accelerometer ACH-04-98-05 Accessed in: March, 2008(1999) Piezo Film Sensors - Technical Manual, , Accelerometer Norristown, PA: Measurement Specialties, Inc(2001) Piezo Film Sensors - Product Guide and Price List, , ACH-04-08-05 (Multi-Axis) and ACH-04-08-05 Analog Test PCB Norristown, PA: Measurement Specialties, IncBadj, T., Vodovnik, L., Pendulum testing of spasticity (1984) Journal of Biomedical Engineering, 6, pp. 9-16Carvalho, D.C., Martins, C.L., Cardoso, S.D., Cliquet Jr., A., Improvement of metabolic and cardiorespiratory responses through treadmill gait training with neuromuscular electrical stimulation in quadriplegic subjects (2006) Artificial Organs, 30, pp. 56-63Chuang, L., Wu, C., Lin, K., Myotonometric measurement of muscular properties of hemiparetic arms ins stroke patients (2012) Rehabilitation Medicine, , Chong-Tae Kim InTech. Rijeka, 1st editionDietz, V., Body weight supported gait training: From laboratory to clinical setting (2008) Brain Research Bulletin, 74, pp. 459-463Esteves, A.C., Stolt, L.R.O.G., Leite, R.M., Dos Reis, D.C., Borges Jr., N.G., (2007) Validação de um eletrogoniômetro Digital, , http://www2.rc.unesp.br/eventos/educacao_fisica/biomecanica2007/upload/ 115-10-A-ELETROGONIOMETRO%20IDENTIFICADO.pdf, Accessed in: July, 2012Guyton, A.C.M.D., (1997) Tratado de fisiologia médica, Guanabara Koogan, , Rio de Janeiro, 9th editionKirshblum, S.C., Burns, S.P., Biering-Sorensen, F., Donovan, W., Graves, D.E., Jha, A., Johansen, M., Waring, W., International standards for neurological classification of spinal cord injury (2011) The Journal of Spinal Cord Medicine, 34, pp. 535-546Leitão, A.V., Musse, C.A.I., Granero, L.H.M., Rossetto, R., Pavan, K., Lianza, S., Espasticidade: Avaliação Clínica (2006) Sociedade Brasileira de Medicina Física e Reabilitaçã o - Projeto DiretrizesLianza, S., Pavan, K., Lourenço, A.F., Fonseca, A.P., Leitão, A.V., Musse, C.A.I., Santos, C.A., Sposito, M.M.M., Diagnóstico e Tratamento da Espasticidade (2001) Sociedade Brasileira de Medicina Física e Reabilitaçã o - Projeto DiretrizesLiu, T., Inoue, Y., Shibata, K., Zheng, R., Wearable sensor system for human dynamics analysis (2010) Mechatronic Systems Applications, , Annalisa Milella, Donato di Paola, Grazia Cicirelli InTech. Vukovar, 1st editionMiyazaki, E.G., Da Rosa, T.S., Nascimento, A.P.H., Oberg, T.D., Influência da estimulação elétrica funcional para adequação de tono muscular e controle motor em hemiplégicos (2008) INTELLECTUS - Revista Acadêmica Digital do Grupo POLIS Educacional, (5), pp. 2-3. , Ano 04(2001) S700/S720 Joint Angle SHAPE SENSOR - Instruction Manual, , S700 Joint Angle SHAPE SENSOR Fredericton, NB: Measurand IncSalmela, L.F.T., Nadeau, S., Olney, S.J., Brouwer, B., Pêndulo: Um teste simples de medida de espasticidade (2002) Acta Fisiátrica, 9, pp. 63-70Stillman, B., McMeeken, J., A video-based version of the pendulum test: Technique and normal response (1995) Archives of physical medicine and rehabilitation, 76, pp. 166-176Teive, H.A.G., Zonta, M., Kumagai, Y., Tratamento da espasticidade: uma atualização (1998) Arquivos de Neuro-Psiquiatria, 56 (4), pp. 852-858Yakamoto, Y., Jikuya, K., Toshimasa, K., Nakamura, T., Michinishi, H., Okamoto, T., Precise measurement system for knee joint motion during the pendulum test using two linear accelerometers (2012) Advanced Topics in Measurement, , Md. Zahurul Haq InTech. Rijeka, 1st editio