Using Swing Resistance and Assistance to Improve Gait Symmetry in Individuals Post-Stroke

A major characteristic of hemiplegic gait observed in individuals post-stroke is spatial and temporal asymmetry, which may increase energy expenditure and the risk of falls. The purpose of this study was to examine the effects of swing resistance/assistance applied to the affected leg on gait symmetry in individuals post-stroke. We recruited 10 subjects with chronic stroke who demonstrated a shorter step length with their affected leg in comparison to the non-affected leg during walking. They participated in two test sessions for swing resistance and swing assistance, respectively. During the adaptation period, subjects counteracted the step length deviation caused by the applied swing resistance force, resulting in an aftereffect consisting of improved step length symmetry during the post-adaptation period. In contrast, subjects did not counteract step length deviation caused by swing assistance during adaptation period and produced no aftereffect during the post-adaptation period. Locomotor training with swing resistance applied to the affected leg may improve step length symmetry through error-based learning. Swing assistance reduces errors in step length during stepping; however, it is unclear whether this approach would improve step length symmetry. Results from this study may be used to develop training paradigms for improving gait symmetry of stroke survivors

A huge traumatic pulmonary pseudocyst

AbstractTraumatic pulmonary pseudocyst (TPP) is a rare complication following blunt trauma. We report a 26-year-old male patient who presented to the emergency room with internal bleeding and shock. Huge TPP (14 cm in diameter) was seen on whole-body computed tomography scan and complicated with bronchial bleeding. He deteriorated to respiratory failure soon after arriving at the emergency room. TPPs imply high-energy impact on the chest region and frequently complicated with pulmonary contusions, hemo- and pneumo-thorax, multiple rib fractures, flail chest, and concurrent with abdominal injuries. Emergency physicians should be aware of such rare entity and manage correctly

Robotic Resistance/Assistance Training Improves Locomotor Function in Individuals Poststroke: A Randomized Controlled Study

Objective To determine whether providing a controlled resistance versus assistance to the paretic leg at the ankle during treadmill training will improve walking function in individuals poststroke. Design Repeated assessment of the same patients with parallel design and randomized controlled study between 2 groups. Setting Research units of rehabilitation hospitals. Participants Patients (N=30) with chronic stroke. Intervention Subjects were stratified based on self-selected walking speed and were randomly assigned to the resistance or assistance training group. For the resistance group, a controlled resistance load was applied to the paretic leg at the ankle to resist leg swing during treadmill walking. For the assistance group, a load that assists swing was applied. Main Outcome Measures Primary outcome measures were walking speed and 6-minute walking distance. Secondary measures included clinical assessments of balance, muscle tone, and quality of life. Outcome measures were evaluated before and after 6 weeks of training and at 8 weeks\u27 follow-up, and compared within group and between the 2 groups. Results After 6 weeks of robotic training, walking speed significantly increased for both groups, with no significant differences in walking speed gains observed between the 2 groups. In addition, 6-minute walking distance and balance significantly improved for the assistance group but not for the resistance group. Conclusions Applying a controlled resistance or an assistance load to the paretic leg during treadmill training may induce improvements in walking speed in individuals poststroke. Resistance training was not superior to assistance training in improving locomotor function in individuals poststroke

A Novel Cable-Driven Robotic Training Improves Locomotor Function in Individuals Post-Stroke

A novel cable-driven robotic gait training system has been tested to improve the locomotor function in individuals post stroke. Seven subjects with chronic stroke were recruited to participate in this 6 weeks robot-assisted treadmill training paradigm. A controlled assistance force was applied to the paretic leg at the ankle through a cable-driven robotic system. The force was applied from late stance to mid-swing during treadmill training. Body weight support was provided as necessary to prevent knee buckling or toe drag. Subjects were trained 3 times a week for 6 weeks. Overground gait speed, 6 minute walking distance, and balance were evaluated at pre, post 6 weeks robotic training, and at 8 weeks follow up. Significant improvements in gait speed and 6 minute walking distance were obtained following robotic treadmill training through a cable-driven robotic system. Results from this study indicate that it is feasible to improve the locomotor function in individuals post stroke through a flexible cable-driven robot

A MDA-BASED DEVELOPMENT APPROACH FOR 3-TIERS APPLICATIONS

This study presents a MDA transformation approach for 3-tiers applications. CIM-to-PIM and PIM-to-PSM transformation rules are developed. This approach is demonstrated using an on-line bookshop application. With this approach, the weak link of MDA, CIM-to-PIM transformation, can be tackled, and 3-tiers applications can more systematically be analysed, designed, and generated and, thereby, increase system development productivity

Are there contagion effects in the REIT market? The case of Brexit

On June 23, 2016 the Brexit event that tremendously surprised and shocked investors around the world was considered the largest black swan with a political earthquake in 2016, and even spread to the international financial market and real estate market. This study uses the heteroscedasticity biases based on correlation coefficients by Forbes and Rigobon and the GJR-GARCH model to examine the contagion effects of the Brexit event on global REITs markets. The data are collected at the daily interval covering the time period from June 23, 2015 to December 30, 2016. Evidence reveals that no REITs markets suffered from Brexit, suggesting no transmission of Brexit across REITs markets, even the neighbouring markets, is found

Persistent spin current in mesoscopic ferrimagnetic spin ring

Using a semiclassical approach, we study the persistent magnetization current of a mesoscopic ferrimagnetic ring in a nonuniform magnetic field. At zero temperature, there exists persistent spin current because of the quantum fluctuation of magnons, similar to the case of an antiferromagnetic spin ring. At low temperature, the current shows activation behavior because of the field-induced gap. At higher temperature, the magnitude of the spin current is proportional to temperature T, similar to the reported result of a ferromagnetic spin ring.Comment: 6 pages, 3 figures, one more reference adde

Locomotor Adaptation to Resistance During Treadmill Training Transfers to Overground Walking in Human SCI

Treadmill training has been used as a promising technique to improve overground walking in patients with spinal cord injury (SCI). Previous findings showed that a gait pattern may adapt to a force perturbation during treadmill training and show aftereffects following removal of the force perturbation. We hypothesized that aftereffects would transfer to overground walking to a greater extent when the force perturbation was resisting rather than assisting leg swing during treadmill training. Ten subjects with incomplete SCI were recruited into this study for two treadmill training sessions: one using swing resistance and the other using swing assistance during treadmill stepping. A controlled resistance/assistance was provided to the subjects’ right knee using a customized cable-driven robot. The subjects’ spatial and temporal parameters were recorded during the training. The same parameters during overground walking were also recorded before and after the training session using an instrumented walkway. Results indicated that stride length during treadmill stepping increased following the release of resistance load and the aftereffect transferred to overground walking. In contrast, stride length during treadmill stepping decreased following the release of assistance load, but the aftereffect did not transfer to overground walking. Providing swing resistance during treadmill training could enhance the active involvement of the subjects in the gait motor task, thereby aiding in the transfer to overground walking. Such a paradigm may be useful as an adjunct approach to improve the locomotor function in patients with incomplete SCI