ROAD: Domestic Assistant and Rehabilitation Robot

This study introduces the concept design and analysis of a robotic system for the assistance and rehabilitation of disabled people. Based on the statistical data of the most common types of disabilities in Spain and other industrialized countries, the different tasks that the device must be able to perform have been determined. In this study, different robots for rehabilitation and assistance previously introduced have been reviewed. This survey is focused on those robots that assist with gait, balance and standing up. The structure of the ROAD robot presents various advantages over these robots, we discuss some of them. The performance of the proposed architecture is analyzed when it performs the sit to stand activity.

On the biomimetic design of agile-robot legs

The development of functional legged robots has encountered its limits in human-made actuation technology. This paper describes research on the biomimetic design of legs for agile quadrupeds. A biomimetic leg concept that extracts key principles from horse legs which are responsible for the agile and powerful locomotion of these animals is presented. The proposed biomimetic leg model defines the effective leg length, leg kinematics, limb mass distribution, actuator power, and elastic energy recovery as determinants of agile locomotion, and values for these five key elements are given. The transfer of the extracted principles to technological instantiations is analyzed in detail, considering the availability of current materials, structures and actuators. A real leg prototype has been developed following the biomimetic leg concept proposed. The actuation system is based on the hybrid use of series elasticity and magneto-rheological dampers which provides variable compliance for natural motion. From the experimental evaluation of this prototype, conclusions on the current technological barriers to achieve real functional legged robots to walk dynamically in agile locomotion are presented.

Ruta del Peregrino

Artículo sobre la Ruta del Peregrino en Jalisco, México. La Ruta del Peregrino tiene 117 kilometros de largo, y es una ruta de peregrinación popular en México que antes tenía poca infraestructura. A través de nuevas estaciones de servicio y monumentos arquitectónicos, ahora es atractiva no sólo durante las fiestas religiosas. -------------------- ABSTRACT: "Every year, especially at Easter, more than 2 million people come from all over Mexico to walk along 117 kilometers of the western mountain range in Jalisco, from the village of Ameca to the sanctuary of the Virgin of the Rosary in Talpa de Allende." Recognizing the importance of this religious tourism the State of Jalisco "commissioned a master plan from Dereik Dellkamp and Tatiana Bilbao for the strategic incorporation of spaces for worship, leisure and services with functional infrastructure for the pilgrims' needs." As a result, 15 interventions have been created, including chapels, rest stops and pavilions. [Quotes from Arquine, Autumn 2010].

Nuevo concepto de elementos estructurales horizontales de vidrio : placa autoportante y pretensada en forma de pi

En los últimos años, podemos darnos cuenta de la importancia que tienen las nuevas aplicaciones de vidrio especialmente en edificios turísticos donde el vértigo juega un papel importante en la visita. Sin embargo los sistemas constructivos no tienen un especial interés porque el vidrio laminado está siempre soportado por otro elemento de acero o incluso vidrio en forma de retícula. En la presente tesis voy a desarrollar una nueva solución de elemento autoportante de vidrio de gran tamaño haciendo seguro el uso del elemento para andar en el aire. El sueño de muchos arquitectos ha sido diseñar un edificio completamente transparente y a mí me gustaría contribuir a este sueño empezando a estudiar un forjado de vidrio como elemento estructural horizontal y para ello debemos cumplir requerimientos de seguridad. Uno de los objetivos es lograr un elemento lo más transparente y esbelto posible para el uso de pasarelas en vestíbulos de edificios. Las referencias construidas son bien conocidas, pero por otro lado Universidades europeas estudian continua estudiando el comportamiento del vidrio con diferentes láminas, adhesivos, apilados, insertos, sistemas de laminado, pretensado, pandeo lateral, seguridad post-rotura y muchos más aspectos necesarios. La metodología llevada a cabo en esta tesis ha sido primeramente diseñar un elemento industrial prefabricado horizontal de vidrio teniendo en cuenta todos los conceptos aprendidos en el estado del arte y la investigación para poder predimensionar el elemento. El siguiente paso será verificar el modelo por medio de cálculo analítico, simulación de elementos finitos y ensayos físicos. Para realizar los ensayos hay un paso intermedio teniendo que cambiar la hipótesis de carga uniforme a carga puntal para realizar el ensayo de flexión a 4 puntos normalizado y además cambiar a escala 1:2 para adaptarse al espacio de ensayo y ser viable económicamente. Finalmente compararé los resultados de tensión y deformación obtenidos por los tres métodos para extraer conclusiones. Sin embargo el problema de la seguridad no ha concluido, tendré que demostrar que el sistema es seguro después de que se produzca la rotura y para ello sólo dispongo de los ensayos como medio de demostración. El diseño es el resultado de la evolución de una viga tipo “I”; cuando es pretensada para obtener más resistencia, aparece el problema de pandeo lateral y éste es solucionado con una viga con sección en “T” cuya unión es resuelta con un cajeado longitudinal en la parte inferior del elemento horizontal. Las alas de éste crecen para recoger las cargas superficiales creando a su vez un punto débil en la unión que a su vez se soluciona duplicando la sección “TT” y haciendo trabajar dicho tablero de forma tan óptima como una viga continua. Dicha sección en vidrio como un único elemento pretensado es algo inédito. Además he diseñado unas escuadras metálicas en los extremos de los nervios como apoyo y placa de pretensión, así como una hendidura curva en el centro de los nervios para alojar los tirantes de acero de modo que al pretensar el tirante la placa corrija al menos la deformación por peso propio. Realizados los cambios geométricos de escala y las simplificaciones en el laminado y el adhesivo se programan la extracción de resultados desde 3 estadios diferentes: Sin pretensión y con pretensión de 750 Kg y de 1000Kg en cada nervio. Por cada estadio y por cada uno de los métodos, cálculo, simulación y ensayos, se extraen los datos de deformación y tensión en el punto medio de un nervio con el objetivo de hacer una comparación de resultados para obtener unas conclusiones, siempre en el campo de la elasticidad. Posteriormente incrementaré la carga hasta el momento de la rotura de la placa y después hasta el colapso teniendo en cuenta el tiempo y demostrando una rotura segura. El vidrio no tendrá un comportamiento plástico pero habrá sido controlado su comportamiento frágil manteniendo una carga y una deformación aceptable. ABSTRACT Over the past few years we have realized the importance of the new technologies regarding the application of glass in new buildings, especially those touristic places were the views and the heights are the reason of the visit. However, the construction systems of these glass platforms are not usually as interesting, because the laminated glass is always held by another steel substructure or even a grid-formed glass element. Throughout this thesis I am going to develop a new solution of a self-bearing element with big dimensions made out of glass, ensuring a safe solution to use as an element to walk on the air. The dream of many architects has been to create a building completely transparent, and I would like to contribute to this idea by making a glass slab as a horizontal structural element, for which we have to meet the security requirements. One of the goals is to achieve an element as transparent and slim as possible for the use in walkways of building lobbies. The glass buildings references are well known, but on the other hand the European Universities study the behaviour of the glass with different interlayers, adhesives, laminating systems, stacking, prestressed, buckling, safety, breakage and post-breakage capacity; and many other necessary aspects. The methodology followed in this thesis has been to first create a horizontal industrial prefabricated horizontal element of glass, taking into account all the concepts learned in the state of art and the investigation to be able to predimension this element. The next step will be to verify this model with an analytic calculus, a finite element modelling simulation and physical tests. To fulfil these tests there is an intermediate step, having to change the load hypothesis from a punctual one to make the test with a four points normalized deflexion, and also the scale of the sample was changed to 1:2 to adapt to the space of the test and make it economically possible. Finally, the results of tension and deformation obtained from the three methods have been compared to make the conclusions. However, the problem with safety has not concluded yet, for I will have to demonstrate that this system is safe even after its breakage, for which I can only use physical tests as a way of demonstration. The design is the result of the evolution of a typical “I” beam, which when it is prestressed to achieve more resistance, the effect of buckling overcomes, and this is solved with a “T” shaped beam, where the union is solved with a longitudinal groove on the inferior part of the horizontal element. The boards of this beam grow to cover the superficial loads, creating at the same time a weak point, which is solved by duplicating the section “TT” and therefore making this board work as optimal as a continuous beam. This glass section as a single prestressed element is unique. After the final design of the “π” glass plate was obtained and the composition of the laminated glass and interlayers has been predimensioned, the last connection elements must be contemplated. I have also designed a square steel shoe at the end of the beams, which will be the base and the prestressed board, as well as a curved slot in the centre of the nerves to accommodate the steel braces so that when this brace prestresses the board, at least the deformation due to its self-weight will be amended. Once I made the geometric changes of the scale and the simplifications on the laminating and the adhesive, the extraction on results overcomes from three different stages: without any pretension, with a pretension of 750 kg and with a pretension of 1000 kg on each rib. For each stage and for each one of the methods, calculus, simulation and tests, the deformation datum were extracted to obtain the conclusions, always in the field of the elasticity. Afterwards, I will increase the load until the moment of breakage of this board, and then until the collapse of the element, taking into account the time spent and demonstrating a safe breakage. The glass will not have a plastic behaviour, but its brittle behaviour has been controlled, keeping an acceptable load and deflection.

Avaliação de boas práticas em saúde mental na atenção psicossocial

A partir do redirecionamento do modelo assistencial no Brasil emerge a necessidade de discussão da reinvenção de práticas alinhadas com o cenário de transformações. As práticas agora devem se desenvolver no sentido de superar o isolamento das grades, dos muros e das chaves, do apagamento do sujeito, da supressão de sintomas e das personalidades dos sujeitos em sofrimento psíquico. Diante disso, é que este estudo tem como objetivos avaliar boas práticas em saúde mental na atenção psicossocial no contexto de um município da região Sul do Brasil. Para tanto, organizou-se como uma pesquisa avaliativa construtivista, com enfoque responsivo, a medida que desenvolve um consenso critico entre os grupos de interesse. Está baseada na Avaliação de Quarta Geração, proposta por Guba e Lincoln (2011), que emerge como opção metodológica e se articula com o referencial teórico das \"Boas Práticas em Saúde Mental Comunitária\", proposto por Thornicroft e Tansella (2010). Este é apresentado de modo a identificar boas práticas na saúde mental, com base na articulação de 3 eixos indispensáveis e indissociáveis: a ética, como princípio fundamental que deverá orientar o planejamento, a assistência e a avaliação dos serviços. A evidência deve embasar as intervenções e serviços. E a experiência como uma evidência do que vem sendo produzido nas experiências locais e regionais de organização da rede de serviços. Como resultado do processo as práticas de Acolhimento, Projeto Terapêutico Singular e Transferência de Cuidados emergiram para discussão. O Acolhimento torna-se concreto nas ações da Porta Aberta, e significa escuta qualificada no momento em que a necessidade emerge, além de representar a oferta de atenção de qualidade baseada no processo relacional que fortalece o estabelecimento de vínculos e a construção de projetos de vida. O Projeto Terapêutico Singular apresenta-se como uma boa prática, a medida que é capaz de dar resposta singularizada e individualizada às necessidades do sujeito, de modo a oportunizar como resultado uma pessoa capaz de andar na vida. É definido de forma compartilhada entre equipe, usuário e família, segundo os objetivos terapêuticos para cada sujeito, e utiliza o técnico de referência, as mini equipes, as oficinas terapêuticas, os grupos terapêuticos, as assembleias, enfim, ofertas e propostas que permitem ao sujeito retomar o envolvimento com os espaços da cidade, no caminho da produção de vida. Com relação à Transferência de Cuidados, esta possibilita ao sujeito que vive o processo não só circular em uma rede de serviços, mas, acima de tudo, buscar, com suporte dela, sua emancipação. Para tanto, investe em práticas que estimulem a autonomia dos sujeitos, por meio de instrumentos como o Acompanhamento Terapêutico, Grupo de Apoio à Alta, espaços de decisões e discussões, estímulo à busca e resolução de problemas, atividades de reconhecimento dos espaços da cidade, transporte, cultura e lazer. Além disso, investe nas ações com a Atenção Básica, a partir do Apoio Matricial com processos de formação continuada com as equipes, e mapeamento da situação da saúde mental nos territórios. Ao final deste estudo, é possível concluir que o modelo de atenção psicossocial demonstrou potencialidade de produzir boas práticas na atenção à saúde mental, e que estas tem transformado a vida dos sujeitos em sofrimento psíquico, bem como tem auxiliado no processo de reconquista de espaços sociais

Pré-condicionamento isquêmico remoto em portadores de claudicação intermitente de membros inferiores

INTRODUÇÃO: Pré-condicionamento isquêmico remoto (PCIR) é o fenômeno pelo qual curtos períodos de isquemia sub-letal sobre um órgão ou tecido, intercalados com reperfusão do mesmo, conferem a outros órgãos ou tecidos distantes deste, um aumento na capacidade da resistir a episódios subsequentes de isquemia, a qual os mesmos possam ser expostos. Com base nesse fato, testamos a hipótese de que o pré-condicionamento isquêmico remoto em pacientes portadores de claudicação intermitente de membros inferiores poderia aumentar a capacidade de deambulação desses pacientes, extrapolando o conceito do PCIR de aumento da capacidade de preservação da integridade celular frente à isquemia, para a manutenção da função celular, tornando a célula mais apta ao trabalho em situações de privação de oxigênio, geradas pela restrição do fluxo sanguíneo, como ocorre nos pacientes com claudicação intermitente de membros inferiores, durante o exercício. OBJETIVOS: Avaliar se o PCIR aumenta a distância de início de claudicação e/ou a distância total de claudicação em pacientes com doença arterial obstrutiva periférica. MÉTODOS: Foram estudados 52 pacientes ambulatoriais que apresentavam queixa de claudicação intermitente dos membros inferiores, associada a um pulso arterial ausente ou reduzido no membro sintomático e/ou um índice tornozelo-braço <0,90. Estes pacientes foram randomizados em três grupos (A, B e C). Todos os pacientes foram submetidos a dois testes de caminhada em esteira de acordo com o protocolo de Gardner. O grupo A fez o primeiro teste de esteira sem o pré-condicionamento isquêmico remoto e, após 7 dias, foi submetido a um novo teste de esteira, agora precedido pelo pré-condicionamento isquêmico remoto. O grupo B foi submetido ao pré-condicionamento isquêmico remoto antes do primeiro teste de esteira e, após 7 dias, realizou novo teste de esteira, agora sem o pré-condicionamento isquêmico remoto. Já no Grupo C (grupo controle), ambos os testes de esteira foram realizados sem pré-condicionamento isquêmico remoto, também com 7 dias de intervalo. RESULTADOS: Os grupos A e C mostraram um aumento na distância de início de claudicação, no segundo teste, em comparação com o primeiro teste. O grupo A teve um aumento estatisticamente significativo, em relação ao grupo C (grupo controle). Com relação à distância total de claudicação, todos os grupos (A, B e C), mostraram um aumento estatisticamente significativo a favor do segundo teste, porém não foi observada diferença entre os grupos (A, B e C). CONCLUSÕES: O pré-condicionamento isquêmico remoto aumentou a distância inicial de claudicação em pacientes com claudicação intermitente, no entanto, ele não afetou a distância total de claudicação dos pacientes portadores de claudicação intermitente de membros inferiores

Escoliose no contexto de distrofia muscular

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

In-home Assessment of Turning and Transitions using Inertial Sensors in Older Adults with Dementia and Older Caregivers

Thesis (Master's)--University of Washington, 2016-06

Physical activity cost in children following an acquired brain injury - a comparative study

Background: Alterations in energy expenditure during activity post head injury has not been investigated due primarily to the difficulty of measurement. Objective: The aim of this study was to compare energy expenditure during activity and body composition of children following acquired brain injury (ABI) with data from a group of normal. controls. Design: Energy expenditure was measured using the Cosmed K4b(2) in a group of 15 children with ABI and a group of 67 normal children during rest and when walking and running. Mean number of steps taken per 3 min run was also recorded and body composition was measured. Results: The energy expended during walking was not significantly different between both groups. A significant difference was found between the two groups in the energy expended during running and also for the number of steps taken as children with ABI took significantly less steps than the normal controls during a 3 min run. Conclusions: Children with ABI exert more energy per activity than healthy controls when controlled for velocity or distance. However, they expend less energy to walk and run when they are free to choose their own desirable, comfortable pace than normal controls. (C) 2003 Elsevier Ltd. All rights reserved.

Associations of location and perceived environmental attributes with walking in neighborhoods

Purpose. Ecological models highlight the importance of environmental influences. We examined associations of coastal versus noncoastal location and perceived environmental attributes with neighborhood walking, total walking, and total activity. Methods. Telephone interviews with 800 faculty and general staff of an Australian university. Results. Men were significantly more likely to walk in their neighborhood if they lived in a coastal location (odds ratio [OR] = 1.66), and they highly rated environmental aesthetics (OR = 1.91), convenience of facilities (OR = 2.20), and access to facilities (OR = 1.98). For women, neighborhood walking was associated with high ratings of convenience (OR = 3.78) but was significantly less likely if they had high ratings for access (OR = 0.48). For total walking and total physical activity, few significant associations emerged. Conclusions. Environmental attributes were related to walking in the neighborhood but not to more general activity indices. Understanding gender-specific environmental correlates of physical activity should be a priority.

Axonal regeneration and lack of astrocytic gliosis in EphA4-deficient mice

Spinal cord injury usually results in permanent paralysis because of lack of regrowth of damaged neurons. Here we demonstrate that adult mice lacking EphA4 (-/-), a molecule essential for correct guidance of spinal cord axons during development, exhibit axonal regeneration and functional recovery after spinal cord hemisection. Anterograde and retrograde tracing showed that axons from multiple pathways, including corticospinal and rubrospinal tracts, crossed the lesion site. EphA4 -/- mice recovered stride length, the ability to walk on and climb a grid, and the ability to grasp with the affected hindpaw within 1-3 months of injury. EphA4 expression was upregulated on astrocytes at the lesion site in wild-type mice, whereas astrocytic gliosis and the glial scar were greatly reduced in lesioned EphA4-/- spinal cords. EphA4 -/- astrocytes failed to respond to the inflammatory cytokines, interferon-gamma or leukemia inhibitory factor, in vitro. Neurons grown on wild-type astrocytes extended shorter neurites than on EphA4 -/- astrocytes, but longer neurites when the astrocyte EphA4 was blocked by monomeric EphrinA5-Fc. Thus, EphA4 regulates two important features of spinal cord injury, axonal inhibition, and astrocytic gliosis.

Routine physiotherapy does not induce cardiorespiratory training effect post-stroke

Background and Purpose. Cardiorespiratory fitness is increasingly being recognized as an impairment requiring physiotherapy intervention after stroke. The present study seeks to investigate if routine physiotherapy treatment is capable of inducing a cardiorespiratory training effect and if stroke patients attending physiotherapy who are unable to walk experience less cardiorespiratory stress during physiotherapy when compared to those who are able to walk. Method. A descriptive, observational study, with heart rate monitoring and video-recording of physiotherapy rehabilitation, was conducted. Thirty consecutive stroke patients from a geriatric and rehabilitation unit of a tertiary metropolitan hospital, admitted for rehabilitation, and requiring physiotherapy were included in the study. The main measures of the study were duration (time) and intensity (percentage of heart rate reserve) of standing and walking activities during physiotherapy rehabilitation for non-walking and walking stroke patients. Results. Stroke patients spent an average of 21 minutes participating in standing and walking activities that were capable of inducing a cardiorespiratory training effect. Stroke patients who were able to walk spent longer in these activities during physiotherapy rehabilitation than non-walking stroke patients (p < 0.05). An average intensity of 24% heart rate reserve (HRR) during standing and walking activities was insufficient to result in a cardiorespiratory training effect, with a maximum of 35% achieved for the stroke patients able to walk and 30% for those unable to walk. Conclusions. Routine physiotherapy rehabilitation had insufficient duration and intensity to result in a cardiorespiratory training effect in our group of stroke patients. Copyright © 2006 John Wiley & Sons, Ltd.

Socio-demographic variations in walking for transport and for recreation or exercise among adult Australians

Background: Walking is integral to strategies to promote physical activity. We identified socio-demographic variations in walking for transport, and for recreation or exercise. Methods: Representative population data (n = 3392) from Australia were collected using computer assisted telephone interviewing, to examine adults’ participation in moderate- or brisk-paced walking for transport and walking for recreation or exercise; walking “sufficient” to meet the current public health guideline (> 150 min/wk); and, the contributions of total walking to meeting the guideline for total physical activity. Results: Rates of sufficient walking for transport (10% for men, 9% for women) were lower than those for walking for recreation or exercise (14% for both genders). Few socio-demographic differences emerged. Men over age 60 y were significantly less likely (OR = 0.40) to walk for transport; men age 45 to 59 y were more likely (OR = 1.56) to walk for recreation or exercise. Walking contributed more toward meeting the current public health guideline among women (15% to 21%) than among men (6% to 8%). Conclusions: There is potential for socially equitable increases in participation, through a focus on both walking for transport and on walking for recreation or exercise; attention to gender differences would be helpful.

Examining links between cognitive markers, movement initiation and change, and pedestrian safety in older adults

Objective: The purpose of this study was to determine the extent to which mobility indices (such as walking speed and postural sway), motor initiation, and cognitive function, specifically executive functions, including spatial planning, visual attention, and within participant variability, differentially predicted collisions in the near and far sides of the road with increasing age. Methods: Adults aged over 45 years participated in cognitive tests measuring executive function and visual attention (using Useful Field of View; UFoV®), mobility assessments (walking speed, sit-to-stand, self-reported mobility, and postural sway assessed using motion capture cameras), and gave road crossing choices in a two-way filmed real traffic pedestrian simulation. Results: A stepwise regression model of walking speed, start-up delay variability, and processing speed) explained 49.4% of the variance in near-side crossing errors. Walking speed, start-up delay measures (average & variability), and spatial planning explained 54.8% of the variance in far-side unsafe crossing errors. Start-up delay was predicted by walking speed only (explained 30.5%). Conclusion: Walking speed and start-up delay measures were consistent predictors of unsafe crossing behaviours. Cognitive measures, however, differentially predicted near-side errors (processing speed), and far-side errors (spatial planning). These findings offer potential contributions for identifying and rehabilitating at-risk older pedestrians.