Clinical potential and design of programmable mechanical impedances for orthotic applications

A person with a moderate or severe motor disability will often use specialised or adapted tools to assist their interaction with a general environment. Such tools can assist with the movement of a person's arms so as to facilitate manipulation, can provide postural supports, or interface to computers, wheelchairs or similar assistive technologies. Designing such devices with programmable stiffness and damping may offer a better means for the person to have effective control of their surroundings. This paper addresses the possibility of designing some assistive technologies using impedance elements that can adapt to the user and the circumstances. Two impedance elements are proposed. The first, based on magnetic particle brakes, allows control of the damping coefficient in a passive element. The second, based on detuning the P-D controller in a servo-motor mechanism, allows control of both stiffness and damping. Such a mechanical impedance can be modulated to the conditions imposed by the task in hand. The limits of linear theory are explored and possible uses of programmable impedance elements are proposed.

O acolhimento no ambulatório de um hospital universitário na visão de usuários

This present study of quantitative/qualitative approach, aims to analyze the outpatient care at the Hospital Universitário Onofre Lopes (HUOL), and, having as guide, the reception of the user. In this regard were invited and interviewed 20 users. Besides the interviews, conducted in a period of 45 days, in this same period of time was used a field diary for more significant notes of observations more significant. In the analysis, we drafted the socio-demographic profile of the group and identified their main complaints, problems and suggestions. For this, we have built graphics, tables and pictures, in addition to standing out their testimony, as a resource for better understanding of the subjective aspects. The theoretical reference consisted of documents from the Ministry of Health about the reception and humanization, and the studies of Merhy, Franco, Pinheiro, Matumoto, Mariotti, Teixeira, among others. The results show the ambulatory of HUOL as a privileged space and of credibility, where users commonly, find answers to their problems. However, these same users were unanimous in saying the difficulties they face in obtaining consultations, from the basic unit, until the hospital. Regarding the service, although they feel satisfied as for the assistance received, they list a series of problems, of structural relationship order: lack of visual signalling, information, wheelchairs, hygiene, in the waiting rooms that offer some comfort, besides the inattention of some professionals. In summary, in the study, undertaken now, we cannot say that there is in the reality studied, the reception, in its full meaning, but the HUOL as hospital-school, has all the potential to accomplish it

Uma contribuição crítica para o redesenho de cadeiras de rodas adaptadas para crianças e adolescentes com paralisia cerebral

This work was aimed at making a critical analysis of the product wheelchair, both for using four different models, which were objects of study of the dissertation of Cláudia Regina Cabral Galvão, entitled Critical Analysis of the Mobility Products Seated a wheelchair - Used by Children and Adolescents with Cerebral Palsy in Natal / RN and other municipalities of Rio Grande do Norte . This product is considered an instrument in the social rehabilitation of great importance for people with physical disabilities. This study aims to position the issue and develop comments on technical up grading of certain models according to the needs of the user. Describes features of four models in search searched through catalogs in order to know its advantages and disadvantages of use. Were presented the definitions of ergonomics and ergonomic aspects to be considered on a design, the study of anthropometry and its recommendations. Discussions the methodology of project design in two parts: the first, on the structuring of design problem (formulation, analysis, synthesis and evaluation.) And the second on the project (design and development, implementation and evaluation and solution). With that review will include the possibilities for a new redesign of the wheelchair, based on forms of adaptation in order to achieve the target that was compressed by the average population studied. Seeks to that this project makes an improvement in quality of life of people in wheelchairs by including these people in society but also the improvement of rehabilitation

Desenvolvimento de protótipo de cadeira de banho para indivíduos com paralisia cerebral tetraparética espástica

This study proposes to develop an equipment that attends the demands of tetraplegic people due to cerebral palsy and that promotes an adequate caregivers postural biomechanics during the shower activity of daily living. First, a bibliographic review was performed to define the terms refering to cerebral palsy, activity of daily living (specifically shower), and assistive technology, besides listing the wheelchairs made on the mainly national assistive technology companies. Therefore, this is a descriptive-exploratory study based on a literature review and on a based-field exploration research. On the field research a survey was adopted as a methodological procedure as it is related to a direct investigation related to a phenomenon, on the case, represented by the current shower situation of the people investigated in this study. Data were collected with the application of a form to the caregivers and consumers of the medical-therapeutic treatment and place used by the participants. Such form, which was made up of open and close questions, tried to identify, besides the personal data of evaluated users and consumers, the characteristics of the current shower activity, such as the place where it takes place in the house, the used equipmentS, in the case there is any, and how often it occurs. The form also was used to identify the caregivers and consumers desires and perceptions in relation to the present characteristics of the new dispositive besides the users and consumers anthropometric data. The evaluation of the results obtained through the form, together with the practice and clinical experience of the researchers and engineers involved in this study, made it possible to develop and make up a real shower chair prototype with the specific adjusts destined to adequate the equipment to be used according to the needs of each user and consumer

Análise crítica dos produtos de mobilidade sentada - cadeiras de rodas - utilizados por crianças e adolescentes com paralisia cerebral em Natal/RN e outros municípios do Rio Grande do Norte

The objective of this work is to critically analyze the seated mobility adaptive equipment, wheelchair, used by non-ambulatory children/adolescents diagnosed with cerebral palsy of the quadriplegy type with ages in between 0-18 years old in the municipal city of Natal/RN and of other ones in the state of Rio Grande do Norte. This study is characterized as descriptive as it took into consideration the individualized conditions of each child/adolescent and of their home environment, and also evaluates the condition of the used seated mobility devices such as wheelchairs or strollers. Thirty three (33) subjects which had a wheelchair prescribed by a healthcare professional specialist in adaptive equipment within the past 3 years were selected. A questionnaire was applied through a phone with the patient s primary care giver or parents. The results obtained showed that all the equipment being used had an anatomical seat and back and the tilt system mechanism and even though most of the patients required small individual adjustments upon receiving the wheelchair in order to accommodate to the patients characteristics. From the point of view of the caregiver/parents interviewed, 97% described satisfied with the equipment and report assistance with mobility (97%), comfort (82%) and good posture (82%) as the main positive aspects from the equipment. The results also describe the aspects related to the maintenance, time used and activities developed that were reported by the patients. The conclusion therefore is that in order to select the equipment to meet the needs of the consumer it is necessary that: an appropriate wheelchair prescription takes place, the up-to-date knowledge of equipment available in the market, the appropriate use of the resources from the concession programs of the government that purchase equipment and the establishment of link in between the manufacturers, patients and the caregivers

Locomoção, distúrbios neuropsiquiátricos e alterações do sono de pacientes com demência e seus cuidadores

INTRODUÇÃO: Os distúrbios neurodegenerativos representam condições clínicas graves, por provocar declínio neuropsíquico. OBJETIVO: Analisar a prevalência dos distúrbios neuropsiquiátricos em pacientes com demência, em relação à sua locomoção (independentes vs. dependentes), e no que se refere ao desgaste emocional e à qualidade do sono dos cuidadores. MATERIAIS E MÉTODOS: Participaram do estudo 34 sujeitos, assim divididos: dez pacientes independentes para locomoção e sete dependentes (cadeirantes); dez cuidadores dos pacientes independentes e sete cuidadores de pacientes dependentes. Os sujeitos foram avaliados no Ambulatório de Neuropsiquiatria da Universidade Estadual de Campinas. Para avaliar as funções cognitivas, utilizou-se o CAMCOOG; para quantificar frequência, intensidade e desgaste do cuidador, aplicou-se o Inventário Neuropsiquiátrico; e para mensurar as alterações do sono dos cuidadores, foi utilizado o Miniquestionário do Sono. A análise estatística foi realizada por meio dos testes U - Mann Whitney e índice de correlação de Spearman, ambos com 5% de significância. RESULTADOS: Com relação à prevalência dos distúrbios neuropsiquiátricos entre os pacientes, observou-se diferença estatisticamente significativa entre os grupos, especificamente no que se refere à irritabilidade (p < 0,05) e ao escore total dos distúrbios neuropsiquiátricos (p < 0,01). Também foram encontradas diferenças entre os grupos de cuidadores, com relação às alterações do sono (p < 0,05). CONCLUSÃO: Idosos independentes para locomoção apresentam menor prevalência dos distúrbios neuropsiquiátricos, quando comparados a idosos dependentes de cadeira de rodas. A locomoção parece não influenciar no desgaste físico e emocional do cuidador, mas constitui uma variável relevante na qualidade do sono dos cuidadores de idosos com diagnóstico de demência vascular e mista.

The influence of the flexibility of the chair seat on pressure peak and distribution of the contact area in individuals with cerebral palsy during the execution of a task

This study aimed to determine the influence of flexibility of the chair seat surface on the pressure peak and on the contact area during the execution of a task of handling an object on the seated position by individuals with spastic cerebral palsy. Ten individuals of both genders with diagnosis of spastic cerebral palsy, who had some control to voluntarily move the body and the upper limbs, participated in this study. Quantification of data was carried out in two experimental situations: (1) execution of a task of fitting with upper limbs, and with the individual placed on an adapted canvas seat; (2) execution of a task of fitting with the participant positioned on an adapted wooden seat. Data obtained were submitted to a non-parametric and descriptive statistical analysis using the Wilcoxon test. Results indicated that the use of canvas seat increased the contact area and decreased the pressure peak and the medio-lateral displacement of centre pressure on the seated posture. © 2011 Informa UK, Ltd.

Recomendações ergonômicas para o projeto de cadeira de rodas: considerando os aspectos fisiológicos e cognitivos dos idosos

Pós-graduação em Design - FAAC

Avaliação da força aplicada à articulação do ombro em cadeirantes durante a manobra de transferência

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Protótipo de sistema automotor para cadeira de rodas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Aspects of Manual Wheelchair Configuration Affecting Mobility: A Review

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Proposta de um dispositivo para ajuste automático da altura de uma cama hospitalar

This paper proposes a mechanical device to adapt a simple model of hospital bed used in the Emergency Department at Santa Casa of Guaratinguetá, allowing the bed’s height adjustment with electromechanical drive. This adaptation aims to introduce improvements in the routine work of nurses and reduce ergonomic problems stemming from repetitive strain during the transfer of patients to stretchers and wheelchairs, as well as providing more comfort to the bedridden patient. The device is mainly composed of: an electric induction motor used to drive the engine, a steel spindle with square thread, which allows axial displacement of the bed, a transmission system with pulleys and belt, which transmits power supplied by the motor to the spindle. The mechanism allows the height of the bed is regulated between 400 and 800 mm. The estimated implementation cost of this proposal is lower than the acquisition cost of a commercial hospital bed with the same features, which confirms the feasibility of the proposed solution

The influence of handrim design on the contact forces on hands'surface: a preliminary study

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Adjustable Art Table Project

An adjustable art table was designed for the artists at Passion Works Studio to fulfill a need for a wheelchair-friendly art table. The client desired that the table be sturdy, not electronic and can be used by multiple users. In response, a mechanical approach was taken and various raising devices were explored. A mechanical height adjustment would make for a more stable table and would not require any electricity or motor to adjust. The table also was built with a large, smooth tabletop designed specifically for multiple users making art. The highlight feature is the height adjustment which allows the table to adjust between 29 and 42.5 inches. The table requires just one person to raise, and two people to lower. To raise the table, an individual only needs to unlock the legs and then press in a button to activate the gas springs, which raise the table. Once the table is set to the desired height, the table can lock into place securely. To lower the table, one person must activate the gas springs and push down simultaneously with another person pushing down on the other side of the table. There is enough room for three people, depending on the size of the wheelchairs. With no wheelchairs, as many as six people can use the table. Therefore, the specifications were met, since it raises and lowers within the desired range, and it provides a solid surface for multiple users to do art work.

Dynamic control of a reconfigurable stair-climbing mobility system

Electric-powered wheelchairs improve the mobility of people with physical disabilities, but the problem to deal with certain architectural barriers has not been resolved satisfactorily. In order to solve this problem, a stair-climbing mobility system (SCMS) was developed. This paper presents a practical dynamic control system that allows the SCMS to exhibit a successful climbing process when faced with typical architectural barriers such as curbs, ramps, or staircases. The implemented control system depicts high simplicity, computational efficiency, and the possibility of an easy implementation in a microprocessor-/microcontroller-based system. Finally, experiments are included to support theoretical results.