Evidence-based perspective on CP rehabilitation : Reviews on physiotherapy, physiotherapy-related motor-based interventions and orthotic devices

This thesis utilises an evidence-based approach to critically evaluate and summarize effectiveness research on physiotherapy, physiotherapy-related motor-based interventions and orthotic devices in children and adolescents with cerebral palsy (CP). It aims to assess the methodological challenges of the systematic reviews and trials, to evaluate the effectiveness of interventions in current use, and to make suggestions for future trials Methods: Systematic reviews were searched from computerized bibliographic databases up to August 2007 for physiotherapy and physiotherapy-related interventions, and up to May 2003 for orthotic devices. Two reviewers independently identified, selected, and assessed the quality of the reviews using the Overview Quality Assessment Questionnaire complemented with decision rules. From a sample of 14 randomized controlled trials (RCT) published between January 1990 and June 2003 we analysed the methods of sampling, recruitment, and comparability of groups; defined the components of a complex intervention; identified outcome measures based on the International Classification of Functioning, Disability and Health (ICF); analysed the clinical interpretation of score changes; and analysed trial reporting using a modified 33-item CONSORT (Consolidated Standards of Reporting Trials) checklist. The effectiveness of physiotherapy and physiotherapy-related interventions in children with diagnosed CP was evaluated in a systematic review of randomised controlled trials that were searched from computerized databases from January 1990 up to February 2007. Two reviewers independently assessed the methodological quality, extracted the data, classified the outcomes using the ICF, and considered the level of evidence according to van Tulder et al. (2003). Results: We identified 21 reviews on physiotherapy and physiotherapy-related interventions and five on orthotic devices. These reviews summarized 23 or 5 randomised controlled trials and 104 or 27 observational studies, respectively. Only six reviews were of high quality. These found some evidence supporting strength training, constraint-induced movement therapy or hippotherapy, and insufficient evidence on comprehensive interventions. Based on the original studies included in the reviews on orthotic devices we found some short-term effects of lower limb casting on passive range of movement, and of ankle-foot orthoses on equinus walk. Long term effects of lower limb orthoses have not been studied. Evidence of upper limb casting or orthoses is conflicting. In the sample of 14 RCTs, most trials used simple randomisation, complemented with matching or stratification, but only three specified the concealed allocation. Numerous studies provided sufficient details on the components of a complex intervention, but the overlap of outcome measures across studies was poor and the clinical interpretation of observed score changes was mostly missing. Almost half (48%) of the applicable CONSORT-based items (range 28 32) were reported adequately. Most reporting inadequacies were in outcome measures, sample size determination, details of the sequence generation, allocation concealment and implementation of the randomization, success of assessor blinding, recruitment and follow-up dates, intention-to-treat analysis, precision of the effect size, co-interventions, and adverse events. The systematic review identified 22 trials on eight intervention categories. Four trials were of high quality. Moderate evidence of effectiveness was established for upper extremity treatments on attained goals, active supination and developmental status, and of constraint-induced therapy on the amount and quality of hand use and new emerging behaviours. Moderate evidence of ineffectiveness was found for strength training's effect on walking speed and stride length. Conflicting evidence was found for strength training's effect on gross motor function. For the other intervention categories the evidence was limited due to the low methodological quality and the statistically insignificant results of the studies. Conclusions: The high-quality reviews provide both supportive and insufficient evidence on some physiotherapy interventions. The poor quality of most reviews calls for caution, although most reviews drew no conclusions on effectiveness due to the poor quality of the primary studies. A considerable number of RCTs of good to fair methodological and reporting quality indicate that informative and well-reported RCTs on complex interventions in children and adolescents with CP are feasible. Nevertheless, methodological improvement is needed in certain areas of the trial design and performance, and the trial authors are encouraged to follow the CONSORT criteria. Based on RCTs we established moderate evidence for some effectiveness of upper extremity training. Due to limitations in methodological quality and variations in population, interventions and outcomes, mostly limited evidence on the effectiveness of most physiotherapy interventions is available to guide clinical practice. Well-designed trials are needed, especially for focused physiotherapy interventions.

Automatic Path Planning and Control Design for Autonomous Landing of UAVs using Dynamic Inversion

In this paper a nonlinear control has been designed using the dynamic inversion approach for automatic landing of unmanned aerial vehicles (UAVs), along with associated path planning. This is a difficult problem because of light weight of UAVs and strong coupling between longitudinal and lateral modes. The landing maneuver of the UAV is divided into approach, glideslope and flare. In the approach UAV aligns with the centerline of the runway by heading angle correction. In glideslope and flare the UAV follows straight line and exponential curves respectively in the pitch plane with no lateral deviations. The glideslope and flare path are scheduled as a function of approach distance from runway. The trajectory parameters are calculated such that the sink rate at touchdown remains within specified bounds. It is also ensured that the transition from the glideslope to flare path is smooth by ensuring C-1 continuity at the transition. In the outer loop, the roll rate command is generated by assuring a coordinated turn in the alignment segment and by assuring zero bank angle in the glideslope and flare segments. The pitch rate command is generated from the error in altitude to control the deviations from the landing trajectory. The yaw rate command is generated from the required heading correction. In the inner loop, the aileron, elevator and rudder deflections are computed together to track the required body rate commands. Moreover, it is also ensured that the forward velocity of the UAV at the touch down remains close to a desired value by manipulating the thrust of the vehicle. A nonlinear six-DOF model, which has been developed from extensive wind-tunnel testing, is used both for control design as well as to validate it.

Modified ILMI algorithm for practical PID/PD implementation on a Micro Air Vehicle

This paper extends the iterative linear matrix inequality algorithm (ILMI) for systems having non-ideal PI, PD and PID implementations. The new algorithm uses the practical implementation of the feedback blocksto form the equivalent static output feedback plant. The LMI based synthesis techniques are used in the algorithm to design a multi-loop, multi-objective fixed structure control. The benefits of such a control design technique are brought out by applying it to the lateral stabilizing and tracking feedback control problem of a 30cm wingspan micro air vehicle.

Bombs away: Visual thinking and students’ engagement in design studios contexts

In design studio, sketching or visual thinking is part of processes that assist students to achieve final design solutions. At QUT’s First and Third Year industrial design studio classes we engage in a variety of teaching pedagogies from which we identify ‘Concept Bombs’ as instrumental in the development of students’ visual thinking and reflective design process, and also as a vehicle to foster positive student engagement. In First year studios our Concept Bombs’ consist of 20 minute individual design tasks focusing on rapid development of initial concept designs and free-hand sketching. In Third Year studios we adopt a variety of formats and different timing, combining individual and team based tasks. Our experience and surveys tell us that students value intensive studio activities especially when combined with timely assessment and feedback. While conventional longer-duration design projects are essential for allowing students to engage with the full depth and complexity of the design process, short and intensive design activities introduce variety to the learning experience and enhance student engagement. This paper presents a comparative analysis of First and Third Year students’ Concept Bomb sketches to describe the types of design knowledge embedded in them, a discussion of limitations and opportunities of this pedagogical technique, as well as considerations for future development of studio based tasks of this kind as design pedagogies in the midst of current university education trends.

Bond graph model of doubly fed three phase induction motor using the Axis Rotator element for frame transformation

Induction motor is a typical member of a multi-domain, non-linear, high order dynamic system. For speed control a three phase induction motor is modelled as a d–q model where linearity is assumed and non-idealities are ignored. Approximation of the physical characteristic gives a simulated behaviour away from the natural behaviour. This paper proposes a bond graph model of an induction motor that can incorporate the non-linearities and non-idealities thereby resembling the physical system more closely. The model is validated by applying the linearity and idealities constraints which shows that the conventional ‘abc’ model is a special case of the proposed generalised model.

Multilevel Dodecagonal Space Vector Generation for Open-end Winding Induction Motor Drive Using Conventional Three Level Inverters

A novel dodecagonal space vector structure for induction motor drive is presented in this paper. It consists of two dodecagons, with the radius of the outer one twice the inner one. Compared to existing dodecagonal space vector structures, to achieve the same PWM output voltage quality, the proposed topology lowers the switching frequency of the inverters and reduces the device ratings to half. At the same time, other benefits obtained from existing dodecagonal space vector structure are retained here. This includes the extension of the linear modulation range and elimination of all 6+/-1 harmonics (n=odd) from the phase voltage. The proposed structure is realized by feeding an open-end winding induction motor with two conventional three level inverters. A detailed calculation of the PWM timings for switching the space vector points is also presented. Simulation and experimental results indicate the possible application of the proposed idea for high power drives.

Design of first- and second-order sliding mode observers for induction motors using a stator-flux model

We extend current research in the area of 'sensorless' control of induction motors by presenting two observers based on first- and second-order sliding mode control theories for the simultaneous estimation of flux and speed. We base the observers on the stator-flux model of the motor instead of the usual rotor-flux model mainly because of the uncertain rotor resistance that plays a significant role in the latter. By designing the observers as if they are sliding mode controllers, we lend the properties of parameter insensitive closed-loop dynamics and finite time convergence to the stator flux and speed estimation schemes. We also present simulation and experimental results to validate the operation of the observers.

Robust fixed order lateral H-2 controller for micro air vehicle

This paper presents a robust fixed order H-2 controller design using Strengthened discrete optimal projection equations, which approximate the first order necessary optimality condition. The novelty of this work is the application of the robust H-2 controller to a micro aerial vehicle named Sarika2 developed in house. The controller is designed in discrete domain for the lateral dynamics of Sarika2 in the presence of low frequency atmospheric turbulence (gust) and high frequency sensor noise. The design specification includes simultaneous stabilization, disturbance rejection and noise attenuation over the entire flight envelope of the vehicle. The resulting controller performance is comprehensively analyzed by means of simulation.

Multi power port converter for hybrid electric vehicles using multi phase bidirectional fly-back topology

For hybrid electric vehicles the batteries and the drive dc-link may be at different voltages. The batteries are at low voltage to obtain higher volumetric efficiencies and the dc-link is at higher voltage to have higher efficiency on the motor side. Therefore a power interface between the batteries and the drive's dc-link is essential. This power interface should handle power flow from battery to motor, motor to battery, external genset to battery and grid to battery. This paper proposes a multi power port topology which is capable of handling multiple power sources and still maintains simplicity and features like obtaining any gain, wide load variations, lower output current ripple and capability of parallel battery energy due to the modular structure. The development and testing of a bi-directional fly-back DC-DC converter for hybrid electric vehicle is described in this paper. Simple hysteresis voltage control is used for DC link voltage regulation. The experimental results are presented to show the working of the proposed converter.

An improved representation of vehicle incompatibility in frontal NCAP tests using a modified rigid barrier

With the objective of better understanding the significance of New Car Assessment Program (NCAP) tests conducted by the National Highway Traffic Safety Administration (NHTSA), head-on collisions between two identical cars of different sizes and between cars and a pickup truck are studied in the present paper using LS-DYNA models. Available finite element models of a compact car (Dodge Neon), midsize car (Dodge Intrepid), and pickup truck (Chevrolet C1500) are first improved and validated by comparing theanalysis-based vehicle deceleration pulses against corresponding NCAP crash test histories reported by NHTSA. In confirmation of prevalent perception, simulation-bascd results indicate that an NCAP test against a rigid barrier is a good representation of a collision between two similar cars approaching each other at a speed of 56.3 kmph (35 mph) both in terms of peak deceleration and intrusions. However, analyses carried out for collisions between two incompatible vehicles, such as an Intrepid or Neon against a C1500, point to the inability of the NCAP tests in representing the substantially higher intrusions in the front upper regions experienced by the cars, although peak decelerations in cars arc comparable to those observed in NCAP tests. In an attempt to improve the capability of a front NCAP test to better represent real-world crashes between incompatible vehicles, i.e., ones with contrasting ride height and lower body stiffness, two modified rigid barriers are studied. One of these barriers, which is of stepped geometry with a curved front face, leads to significantly improved correlation of intrusions in the upper regions of cars with respect to those yielded in the simulation of collisions between incompatible vehicles, together with the yielding of similar vehicle peak decelerations obtained in NCAP tests.

A Simple Five-Level Inverter Topology for Induction Motor Drive Using Conventional Two-Level Inverters and Flying Capacitor Technique

This paper proposes a new five-level inverter topology for open-end winding induction motor (IM) drive. The popular existing circuit configurations for five-level inverter include the NPC inverter and flying capacitor topologies. Compared to the NPC inverter, the proposed topology eliminates eighteen clamping diodes having different voltage ratings in the present circuit. Moreover it requires only one capacitor bank per phase, whereas flying capacitor schemes for five level topologies require six capacitor banks per phase. The proposed topology is realized by feeding the phase winding of an open-end induction motor with two-level inverters in series with flying capacitors. The flying capacitor voltages are balanced using the switching state redundancy for full modulation range. The proposed inverter scheme is capable of producing two-level to five-level pulse width modulated voltage across the phase winding depending on the modulation range. Additionally, in case of any switch failure in the flying capacitor connection, the proposed inverter topology can be operated as a three-level inverter for full modulation range. The proposed scheme is experimentally verified on a four pole, 5hp induction motor drive.

Suboptimal reentry guidance of a reusable launch vehicle using pitch plane maneuver

Using the recently developed model predictive static programming (MPSP) technique, a nonlinear suboptimal reentry guidance scheme is presented in this paper for a reusable launch vehicle (RLV). Unlike traditional RLV guidance, the problem considered over here is restricted only to pitch plane maneuver of the vehicle, which allows simpler mission planning and vehicle load management. The computationally efficient MPSP technique brings in the philosophy of trajectory optimization into the framework of guidance design, which in turn results in very effective guidance schemes in general. In the problem addressed in this paper, it successfully guides the RLV through the critical reentry phase both by constraining it to the allowable narrow flight corridor as well as by meeting the terminal constraints at the end of the reentry segment. The guidance design is validated by considering possible aerodynamic uncertainties as well as dispersions in the initial conditions. (C) 2010 Elsevier Masson SAS. All rights reserved.

A Five-Level Inverter Scheme for a Four-Pole Induction Motor Drive by Feeding the Identical Voltage-Profile Windings From Both Sides

This paper presents a five-level inverter scheme with four two-level inverters for a four-pole induction motor (IM) drive. In a conventional three-phase four-pole IM, there exists two identical voltage-profile winding coil groups per phase around the armature, which are connected in series and spatially apart by two pole pitches. In this paper, these two identical voltage-profile pole-pair winding coils in each phase of the IM are disconnected and fed from four two-level inverters from four sides of the windings with one-fourth dc-link voltage as compared to a conventional five-level neutral-point-clamped inverter. The scheme presented in this paper does not require any special design modification for the induction machine. For this paper, a four-pole IM drive is used, and the scheme can be easily extended to IMs with more than four poles. The proposed scheme is experimentally verified on a four-pole 5-hp IM drive.

A Hybrid Multilevel Inverter Topology for an Open-End Winding Induction-Motor Drive Using Two-Level Inverters in Series With a Capacitor-Fed H-Bridge Cell

In this paper, a new five-level inverter topology for open-end winding induction-motor (IM) drive is proposed. The open-end winding IM is fed from one end with a two-level inverter in series with a capacitor-fed H-bridge cell, while the other end is connected to a conventional two-level inverter. The combined inverter system produces voltage space-vector locations identical to that of a conventional five-level inverter. A total of 2744 space-vector combinations are distributed over 61 space-vector locations in the proposed scheme. With such a high number of switching state redundancies, it is possible to balance the H-bridge capacitor voltages under all operating conditions including overmodulation region. In addition to that, the proposed topology eliminates 18 clamping diodes having different voltage ratings compared with the neutral point clamped inverter. On the other hand, it requires only one capacitor bank per phase, whereas the flying-capacitor scheme for a five-level topology requires more than one capacitor bank per phase. The proposed inverter topology can be operated as a three-level inverter for full modulation range, in case of any switch failure in the capacitor-fed H-bridge cell. This will increase the reliability of the system. The proposed scheme is experimentally verified on a four-pole 5-hp IM drive.

Vibration confinement in a generic launch vehicle

A controller design for vibration control and alignment maintenance at critical location is developed in a generic launch vehicle whose equipment bay (EB) houses the main inertial platform. The controller uses active control to reduce the attitude disturbance in the attitude at the EB due to elastic deformation. The vibration energy is redistributed by the technique of vibration confinement, which enables the response at the EB to reach its steady state faster in the remaining portion of the structure. (AIAA)