Journal of Rehabilitation and Assistive Technologies Engineering最新文献

Introduction: The purpose of this study was to test a novel activity monitor that tracks the time a prosthesis is worn, and the nature of the ambulatory activity conducted with the prosthesis. These capabilities allow prosthesis users' wear and accommodation practices (e.g., temporary doffing) to be monitored, and the intensity of their activities to be assessed.

Methods: A portable limb-socket motion sensing system was used to monitor doffs, walk bouts (≥5 steps), low locomotion (2-4 steps), stationary positions, and weight shifts in a group of transtibial prosthesis users. The relationship between doff time and active motion time was investigated, and durations of low and high intensity active motions were compared.

Results: For the 14 participants tested, the median prosthesis day duration ranged from 12.8-18.8 h. Eleven participants typically doffed five or fewer times per day, and three participants typically doffed 10 or more times per day. Nine participants demonstrated a positive correlation between daily doff duration and active motion duration. Six participants spent more time in weight shifts than walk bouts, while eight participants spent more time in walk bouts than weight shifts.

Conclusion: Capturing don time and temporary doffs and distinguishing weight shifts from walks may provide insight relevant to patient care. Longer-term monitoring studies should be conducted, and the clinical utility of the data evaluated.

Introduction: The combination of virtual reality (VR) with an omnidirectional walking platform (ODWP) may have potential in rehabilitation settings. However, its use, acceptance, safety, and effectiveness are unclear. This preliminary study aims to understand the feasibility, safety, and user experience (including investigating the onset of cybersickness) while walking on the ODWP with fully immersive VR.

Methods: Participants engaged with eight immersive VR walking scenarios. The scenarios were created using 360-degree videos and were programmed to run with the ODWP. Safety modifications for the ODWP were made, with the addition of parallel bars. Quantitative feedback on the perceived safety and acceptance of using VR with an ODWP for rehabilitation was collected. Cybersickness was evaluated using the Simulation Symptoms Questionnaire (SSQ).

Results: Thirty-five participants (n = 8 physiotherapists, n = 27 healthy adults) were recruited for this study. The mean perceived safety score was 78.9/100 and acceptance was 64.5/100. Seventy-one percent of participants experienced mild to moderate symptoms of cybersickness as reported on the SSQ. The SSQ scores were not correlated to participant age or simulation exposure time.

Conclusion: VR while using ODWP has the potential for rehabilitation, however, more consideration is needed to address acceptance and cybersickness.

Introduction: The patient's voice in shared decision-making has progressed from physician's office to regulatory decision-making for medical devices with FDA's Patient Preference Initiative. A discrete-choice preference measure for upper limb prosthetic devices was developed to investigate patient's risk/benefit preference choices for regulatory decision making.

Methods: Rapid ethnographic procedures were used to design a discrete-choice measure describing risk and benefits of osseointegration with myoelectric control and test in a pilot preference study in adults with upper limb loss. Primary outcome is utility of each choice based conjoint (CBC) attribute using mixed-effects regression. Utilities with and without video, and between genders were compared.

Results: Strongest negative preference was for avoiding infection risk (B = -1.77, p < 0.001) and chance of daily pain (B = -1.22, p, 0.001). Strongest positive preference was for attaining complete independence when cooking dinner (B = 1.62, p < 0.001) and smooth grip patterns at all levels (B = 1.62, B = 1.28, B = 1.26, p < 0.001). Trade-offs showed a 1% increase in risk of serious/treatable infection resulted in a 1.77 decrease in relative preference. There were gender differences, and where video was used, preferences were stronger.

Conclusions: Strongest preferences were for attributes of functionality and independence versus connectedness and sensation but showed willingness to make risk-benefit trade-offs. Findings provide valuable information for regulatory benefit-risk decisions for prosthetic device innovations.

Trial registration: This study is not a clinical trial reporting results of a health care intervention so is not registered.

The evaluation of wheelchair cushion performance is of interest to a variety of stakeholders, including standards organizations, cushion manufacturers, clinicians, users and payers. The objective of this project was to develop a family of compliant buttock models that are based upon the anatomical parameters of persons with varying body sizes. The models are parametrically designed so can be scaled to evaluate different sized cushions. This paper will detail the designs, describe the anatomical basis for the design and provide the rationale for the design decisions. The manuscript also serves a secondary purpose to illustrate how anthropometric data can be applied to the design of anatomical phantoms that reflect both soft tissue and skeletal anthropometry. Supplemental material includes greater detail and the full CAD files and model fabrication instructions are available in an open access repository for persons who wish to fabricate the models.

Introduction: Inertial measurement units (IMUs) may be viable options to collect gait data in clinics. This study compared IMU to motion capture data in individuals who use unilateral lower-limb prostheses.

Methods: Participants walked with lower-body IMUs and reflective markers in a motion analysis space. Sagittal plane hip, knee, and ankle waveforms were extracted for the entire gait cycle. Discrete points of peak flexion, peak extension, and range of motion were extracted from the waveforms. Stance times were also extracted to assess the IMU software's accuracy at detecting gait events. IMU and motion capture-derived data were compared using absolute differences and root mean square error (RMSE).

Results: Five individuals (n = 3 transtibial; n = 2 transfemoral) participated. IMU prosthetic limb data was similar to motion capture (RMSE: waveform ≤4.65°; discrete point ≤9.04°; stance ≤0.03s). However, one transfemoral participant had larger differences at the microprocessor knee joint (RMSE: waveform ≤15.64°; discrete ≤29.21°) from IMU magnetometer interference. Intact limbs tended to have minimal differences between IMU and motion capture data (RMSE: waveform ≤6.33°; discrete ≤9.87°; stance ≤0.04s).

Conclusion: Findings from this pilot study suggest IMUs have the potential to collect data similar to motion capture systems in sagittal plane kinematics and stance time.

Introduction: An electrically stimulated intermittent fatigue test using mechanomyography was recently proposed as a possible tool for detecting clinically relevant changes in muscle function. This study was designed to determine whether the proposed test can detect additional fatigue when it should be present. Methods: Subjects (n = 10) underwent two trials each (occluded and normal blood flow) with a standardized fatigue protocol on the Ankle Dorsiflexors (AD) and Wrist Extensors (WE) using a clinical electrical stimulator. Results: Mean normalized twitch acceleration was strongly predictive of mean normalized torque (R ² = 0.828). The WE experienced lower twitch magnitudes throughout the tourniquet trial (10.81 ± 1.25 m/s²) compared to normal blood flow (18.05 ± 1.06 m/s²). The AD twitches were overall reduced in the tourniquet trial (3.87 ± 0.48 m/s²) compared with the control trial (8.57 ± 0.91 m/s²). Conclusion: Occluding blood flow to a muscle should cause greater muscle fatigue. The ability to detect reduced contraction magnitudes during an electrically stimulated fatigue protocol resulting from low blood flow suggests the proposed test may be capable of detecting clinically relevant muscle deficits.

Introduction: Electrical stimulation is increasingly relevant in a variety of medical treatments. In this study, the quality of referred sensations evoked using surface electrical stimulation was evaluated using the rubber hand and foot illusions.

Methods: The rubber hand and foot illusions were attempted under 4 conditions: (1) multi-location tapping; (2) one-location tapping; (3) electrical stimulation of sensation referred to the hand or foot; (4) asynchronous control. The strength of each illusion was quantified using a questionnaire and proprioceptive drift, where a stronger response suggested embodiment of the rubber limb.

Results: 45 able-bodied individuals and two individuals with amputations participated in this study. Overall, the illusion evoked by nerve stimulation was not as strong as illusions evoked by physically tapping but stronger than the control illusion.

Conclusion: This study has found that the rubber hand and foot illusion can be performed without touching the distal limb of the participant. Electrical stimulation that produced referred sensation in the distal extremity was realistic enough to partially incorporate the rubber limb into a person's body image.

Dr. Tamsyn Street is an interdisciplinary researcher working for the National Health Service (NHS) in the UK with a background in motor neurorehabilitation. In the last couple of decades there has been a rapid advancement in assistive technology solutions using electrical stimulation for neurorehabilitation. This editorial examines whether these advancements have translated into good inclusive design performance for clinician and patient end users. Suggestions for overcoming some of the existing challenges are proposed.

Introduction: Task-specific neurorehabilitation is crucial to optimize hand recovery shortly after a stroke, but intensive neurorehabilitation remains limited in resource-constrained healthcare systems. This has led to a growing interest in the use of robotic gloves as an adjunct intervention to intensify hand-specific neurorehabilitation. This study aims to develop and assess the usability of an operating interface supporting such a technology coupled with a virtual environment through a user-centered design approach.

Methods: Fourteen participants with hand hemiparesis following a stroke were invited to don the robotic glove before browsing through the operating interface and its functionalities, and perform two mobility exercises in a virtual environment. Feedback was collected for improving technology usability. Participants completed the System Usability Scale and ABILHAND questionnaires and their recommendations were gathered and prioritized in a Pugh Matrix.

Results: The System Usability Scale (SUS) score for the operating interface was excellent (M = 87.0 SD = 11.6). A total of 74 recommendations to improve the user interface, calibration process, and exercise usability were identified.

Conclusion: The application of a full cycle of user-centred design approach confirms the high level of usability of the system which is perceived by end users as acceptable and useful for intensifying neurorehabilitation.