The effect of assistive devices on gait patterns in Parkinson’s disease: preliminary results

Poster presented at the First international Congress of CiiEM “From Basic Sciences to Clinical Research”, 27-28 November 2015, Egas Moniz, Caparica, Portugal.

Vibration-enhanced posture stabilization achieved by tactile supplementation: May blind individuals get extra benefits?

Diminished balance ability poses a serious health risk due to the increased likelihood of falling, and impaired postural stability is significantly associated with blindness and poor vision. Noise stimulation (by improving the detection of sub-threshold somatosensory information) and tactile supplementation (i.e. additional haptic information provided by an external contact surface) have been shown to improve the performance of the postural control system. Moreover, vibratory noise added to the source of tactile supplementation (e.g. applied to a surface that the fingertip touches) has been shown to enhance balance stability more effectively than tactile supplementation alone. In view of the above findings, in addition to the well established consensus that blind subjects show superior abilities in the use of tactile information, we hypothesized that blind subjects may take extra benefits from the vibratory noise added to the tactile supplementation and hence show greater improvements in postural stability than those observed for sighted subjects. If confirmed, this hypothesis may lay the foundation for the development of noise-based assistive devices (e.g. canes, walking sticks) for improving somatosensation and hence prevent falls in blind individuals. (C) 2011 Elsevier Ltd. All rights reserved.

Relationship between use of technology and employment rates for people with physical disabilities in Australia: Implications for education and training programmes

This study examined the impact of computer and assistive device use on the employment status and vocational modes of people with physical disabilities in Australia. A survey was distributed to people over 15 years in age with physical disabilities living in the Brisbane area. Responses were received from 82 people, including those with spinal cord injuries, cerebral palsy and muscular dystrophy. Of respondents 46 were employed, 22 were unemployed, and 12 were either students or undertaking voluntary work. Three-quarters of respondents used a computer in their occupations, while 15 used assistive devices. Using logistic regression analysis it was found that gender, education, level of computer skill and computer training were significant predictors of employment outcomes. Neither the age of respondent nor use of assistive software were significant predictors. From information obtained in this study guidelines for a training programme designed to maximize the employability of people with physical disabilities were developed.

Induktiosilmukka kuulolaitteen käyttäjän apuvälineenä

Tämä insinöörityö tehtiin Kuulonhuoltoliitto ry:n Esteetön kuuntelu -projektille. Työ käsittelee kuulolaitteen käyttäjän apuvälineenä käytettäviä induktiosilmukkajärjestelmiä. Induktiivisen äänensiirtojärjestelmän avulla huonokuuloinen saa kuunteluympäristöstään paremman signaali-kohinasuhteen ilman tilan kaikua ja taustahälyä. Tämä helpottaa kuuntelua esimerkiksi puhetilaisuuksissa. Työn tarkoituksena oli päivittää aiempia tutkimuksia kokoamalla uusin tietous induktiosilmukoiden tekniikasta. Kirjallisuustutkimuksen lisäksi kartoitettiin nykyinen silmukkavahvistinkanta haastattelemalla maahantuojia ja jälleenmyyjiä. Silmukkavahvistimien hintakartoituksen tarkoituksena oli rakentaa perusteet sopivan tehoisen ja hintaisen vahvistimen hankintaa varten suunniteltaessa induktiivisella äänensiirtojärjestelmällä varustettavia tiloja. Työ tarkastelee induktiivisen äänensiirtojärjestelmän ensisijaisen kohderyhmän, kuulokojeita käyttävien huonokuuloisten keskeisiä tarpeita ja heidän käyttämäänsä apuvälinetekniikkaa. Työ käy läpi audiotekniikan perusteita, sähkömagneettisen induktioilmiön, induktiivisen äänensiirtojärjestelmän rakenteen, sen ylikuulumisongelmat ja häiriötekijät sekä IEC:n 60118-4 edition 2.0 standardin CDV-luonnoksen mukaiset periaatteelliset asennusja mittausohjeet. IEC:n tuleva standardi tekee työstä ajankohtaisen. Työn tuloksena saatua tietoa voidaan käyttää Kuulonhuoltoliitto ry:n opas- ja tiedotusmateriaalin uudistamisessa, pohjana hyvän kuunteluympäristön malliratkaisujen ja esteettömyyskriteerien soveltamisessa. Työstä on hyötyä erityisesti Kuulonhuoltoliitto ry:n vapaaehtoiskartoittajille kuten myös kenelle tahansa aiheesta syvemmin kiinnostuneelle.

Vanhusten hyvä kotona asuminen: tutkimusta kuntatuottavuudesta, älykodeista ja apuvälinepalveluprosesseista

The purpose of the research was to investigate operational processes related to home care of the elderly as well as use of assistive devices in smart home environments, and operational processes that are generally related to use of assistive devices – from the point of view of productivity improvement. The themes were looked into from the points of view of both the elderly and care personnel. In addition, perspectives of near relatives of the elderly, of the larger service system as well as of companies that provided assistive devices to the smart homes were taken into consideration. In the study of home care processes, 32 customer interviews and 17 employee interviews were carried out. This report contains a summary that is based on a separate report of the home care study. The study of home care was conducted in 2006. The use of technological and mechanical assistive devices and the related operational processes were investigated with the help of the smart home pilot in 2007–2008. The study is described in this report. The smart home pilot was implemented in four different housing service units for elderly people at Lahti, Nastola and Hollola. They were in use during short-term housing periods related to, for instance, end of hospitalisation, holidays of caring relatives and assessment of living and housing conditions. More than 60 different assistive devices and technologies were brought to the smart homes. During the pilot period, experiences of customers and personnel as well as processes related to the use of assistive devices were investigated. The research material consisted of 20 survey questionnaires of personnel and customers, four interviews with customers, five interviews with personnel, feedback survey responses from 14 companies, and other data that were collected, for instance, in orientation events. The research results highlighted the need for tailored services based on an elderly person’s needs and wishes, while taking advantage of innovative and technological solutions. As in the earlier home care study, also assistive device-related operational processes were looked into with the help of concepts of ‘resource focus’, ‘lost motion’ and ‘intermediate landing’. The following were identified as central operational processes in assistive device-related services (regardless of the service provider): (1) acquisition process of technologies and assistive devices as well as of rearrangement and rebuilding works in the home, (2) introduction and orientation process (of the elderly, their relatives and care personnel), (3) information and communication process, and (4) service and monitoring process. In addition, the research focused on design and desirability of assistive devices as well as their costs, such as opportunity costs. The process-based points of view gave new knowledge that may be used in the future to develop service processes and clarify their ownership so that separately managed cross-functional processes could be built with participants from different sectors to operate alongside organisations of elderly care. Development of functionality of assistive device-related services is a societally significant issue.

Apuvälineiden hankintaprosessin kehittäminen

Työ lähti liikkeelle Etelä-Karjalan sosiaali- ja terveyspiirin Apuvälinekeskuksen tarpeesta. Eksoten, apuvälinekeskuksen ja Etelä-Karjalan hankintapalveluiden perustaminen sekä muut organisaatiomuutokset muuttivat apuvälineiden hankintaprosessi niin paljon, että sen etenemisestä kaivattiin selventävää kuvausta. Julkisten hankintojen lain mukaan kilpailutettavat hankinnat siirtyivät hankintapalveluiden hoidettavaksi ja niitä varten tarvittiin tarjouspyyntömalli, jonka perusteella tarjouksia voidaan vertailla. Teoriaosuudessa käsitellään hankintaprosessia, julkisten hankintojen erityispiirteitä ja lakia julkisista hankinnoista. Lisäksi käsitellään apuvälinepalveluprosessia ja suosituksia apuvälineiden hankinnasta. Organisaation tutustuttiin henkilökohtaisesti sekä haastattelujen ja sähköpostikyselyiden avulla. Näitä tietoja hyödyntäen luotiin prosessikuvaukset sekä apuvälinepalveluprosessista että apuvälineiden kausisopimustuotteiden hankinnasta. Molempiin kuvauksiin sisältyy selittäviä lisäosia. Tarjouspyyntömallin kehittämisen pohjaksi pyydettiin sähköpostikyselyllä 10 alueellisesta apuvälinekeskuksesta tietoa heidän käyttämistään tarjouspyynnöistä. Vastauksia saatiin 4 kappaletta. Tiedoista tehtiin yhteenveto, joka luovutettiin apuvälinekeskuksen hankintatyöryhmän käyttöön.

Évaluation de l'équilibre chez la population lésée médullaire: validation de l'échelle de Berg et étude des interrelations avec les données cliniques.

L'évolution des soins médicaux auprès de la population ayant une lésion médullaire (LM) s'est traduite par une amélioration du profil fonctionnel des personnes atteintes. Ainsi une proportion importante retrouve une capacité à se tenir debout et à marcher qu'il convient d'évaluer adéquatement. Si quelques outils spécifiques à la population lésée médullaire existent pour évaluer leur ambulation, aucune évaluation de l'équilibre debout n'a été validée auprès de cette clientèle. L'échelle de Berg est un outil recommandé auprès de diverses populations, entre autres celles possédant des pathologies d'origine neurologique; et le score obtenu semble lié au niveau d'autonomie à la marche ainsi qu'aux aides techniques utilisées. L'objectif de ce projet de recherche était donc d'établir la validité concomitante de l'échelle de Berg auprès de la population LM et d'explorer les liens entre le score Berg et l'aide technique utilisée. Pour ce faire, trente-deux sujets BM ASIA D ont été recrutés parmi la clientèle hospitalisée de l'Institut de réadaptation Gingras-Lindsay de Montréal. L'évaluation de l'équilibre debout a été réalisée à l'aide de l'échelle de Berg ainsi que des tests statiques, dynamiques et des limites de stabilité du Balance Master. Le Walking Index for Spinal Cord Injury (WISCI), le Spinal Cord Injury Functional Ambulation Inventory (SCI-FAI), la vitesse de marche sur 10m et le Timed up and go ont été utilisés pour évaluer l'ambulation. Des analyses descriptives et corrélatives ont été effectuées sur les données obtenues. Une corrélation forte (0.714

Exploration of the neural correlates of cerebral palsy for sensorimotor BCI control

Cerebral palsy (CP) includes a broad range of disorders, which can result in impairment of posture and movement control. Brain-computer interfaces (BCIs) have been proposed as assistive devices for individuals with CP. Better understanding of the neural processing underlying motor control in affected individuals could lead to more targeted BCI rehabilitation and treatment options. We have explored well-known neural correlates of movement, including event-related desynchronization (ERD), phase synchrony, and a recently-introduced measure of phase dynamics, in participants with CP and healthy control participants. Although present, significantly less ERD and phase locking were found in the group with CP. Additionally, inter-group differences in phase dynamics were also significant. Taken together these findings suggest that users with CP exhibit lower levels of motor cortex activation during motor imagery, as reflected in lower levels of ongoing mu suppression and less functional connectivity. These differences indicate that development of BCIs for individuals with CP may pose additional challenges beyond those faced in providing BCIs to healthy individuals.

Efeitos do treino em esteira com suporte parcial de peso e do método de facilitação neuromuscular proprioceptiva na marcha hemiparética: estudo comparativo

Objective: To compare the effects of the treadmill training with partial body-weight support (TPBWS) and Proprioceptive Neuromuscular Facilitation (PNF) method on gait of subjects with chronic stroke. Design: Quasi-experimental study. Setting: Laboratorial research. Participants: Twenty-three subjects (13 men and 10 women), with a mean age of 56,7 ± 8,0 years and a mean time since the onset of the stroke of 27,7 ± 20,3 months, and able to walk with personal assistance or assistive devices. Interventions: Two experimental groups underwent gait training based on PNF method (PNF group, n=11) or using the TPBWS - Gait Trainer System 2, Biodex, USA (TPBWS group, n=12), for three weekly sessions, during four weeks. Measures: Evaluation of motor function - using the Stroke Rehabilitation Assessment of Movement (STREAM) and the motor subscale of the Functional Independence Measure (motor FIM) -, and kinematic gait analyze with the Qualisys System (Qualisys Medical AB, Gothenburg, Sweden) were carried out before and after the interventions. Results: Increases in the STREAM scores (F=49.189, P<0.001) and in motor FIM scores (F=7.093, P=0.016), as well as improvement in symmetry ratio (F=7.729, P=0.012) were observed for both groups. Speed, stride length and double-support time showed no change after training. Differences between groups were observed only for the maximum ankle dorsiflexion over the swing phase (F=6.046, P=0.024), which showed an increase for the PNF group. Other angular parameters remain unchanged. Conclusion: Improvement in motor function and in gait symmetry was observed for both groups, suggesting similarity of interventions. The cost-effectiveness of each treatment should be considered for your choice

Protótipo de sistema automotor para cadeira de rodas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Desenvolvimento de um protótipo para medida da pressão plantar durante a marcha, com e sem o uso de um dispositivo de auxílio

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Effectiveness of individual resource-oriented joint protection education in people with rheumatoid arthritis. A randomized controlled trial

the modern joint protection (JP) concept for people with rheumatoid arthritis (RA) is an active coping strategy to improve daily tasks and role performance by changing working methods and using assistive devices. Effective group JP education includes psycho-educational interventions. The Pictorial Representation of Illness and Self Measure (PRISM) is an interactive hands-on-tool, assessing (a) the individual's perceived burden of illness and (b) relevant individual resources. Both issues are important for intrinsic motivation to take action and change behaviour. This study compared individual conventional JP education (C-JP) with PRISM-based JP education (PRISM-JP).

Processing of speech signals for physical and sensory disabilities.

Assistive technology involving voice communication is used primarily by people who are deaf, hard of hearing, or who have speech and/or language disabilities. It is also used to a lesser extent by people with visual or motor disabilities. A very wide range of devices has been developed for people with hearing loss. These devices can be categorized not only by the modality of stimulation [i.e., auditory, visual, tactile, or direct electrical stimulation of the auditory nerve (auditory-neural)] but also in terms of the degree of speech processing that is used. At least four such categories can be distinguished: assistive devices (a) that are not designed specifically for speech, (b) that take the average characteristics of speech into account, (c) that process articulatory or phonetic characteristics of speech, and (d) that embody some degree of automatic speech recognition. Assistive devices for people with speech and/or language disabilities typically involve some form of speech synthesis or symbol generation for severe forms of language disability. Speech synthesis is also used in text-to-speech systems for sightless persons. Other applications of assistive technology involving voice communication include voice control of wheelchairs and other devices for people with mobility disabilities.

The late effects of poliomyelitis in Queensland

This paper reports an investigation of new health problems reported by Queensland residents with a prior history of poliomyelitis. 126 people with a past history of paralytic poliomyelitis were recruited from the waiting list for the trial Post Polio Clinic at Queen Elizabeth II Hospital, Brisbane. A self-administered postal questionnaire was used to examine a number of variables including acute poliomyelitis histories; presence, duration and severity of new symptoms consistent with the late effects of poliomyelitis; changes in functional status between the maximal recovery period and the time of the survey and the impact of post-polio symptoms on lifestyle and employment. The most frequent new symptoms reported were muscle weakness (87 per cent), unusual tiredness (79 per cent), joint pain (79 per cent), muscle pain (61 per cent) and muscle cramps (71 per cent). Subjects reported an increased reliance on assistive devices and a decreased level of independence with activities of daily living, particularly with mobility-related tasks. Eight three per cent of subjects had made lifestyle changes as a result of post-polio symptoms and 67 per cent of those subjects in the workforce reported making changes to their employment, such as reduced hours of work. (author abstract)

Qualidade de Vida e Atitudes dos Idosos Face à Velhice

A problemática do envelhecimento tem assumido, nos últimos anos, uma crescente importância na consciência coletiva da população, tornando-se cada vez mais importante compreender a população idosa e a sua realidade. Posto isto, foi realizado um estudo quantitativo e correlacional, que teve como objectivo avaliar a qualidade de vida e atitudes face à velhice de idosos, bem como a relação entre estas e as variáveis sociodemográficas e familiares. Foram inquiridos 100 idosos, com mais de 65 anos e sem deficit cognitivo . Para a recolha de dados utilizou-se uma entrevista estruturada, constituída dados sóciodemográficos do idoso, WHOQOL-AGE (Caballero, Miret, Power, Chatterji, Tobiasz-Adamczyk, Koskinen, Leonardi, Olaya, Haro &Ayuso-Mateos, 2013) e o AAQ ( Laidlaw, Power, Schmidt and the WHOQOL-OLD Group, 2007). Dos resultados destacamos os seguintes: A amostra é constituída por 52% de idosos do sexo masculino tendo uma média de idades de 74,7 (DP=6,8). È no fator Perdas Psicossociais e no Desenvolvimento Psicológico que os idosos têm uma melhor atitude face ao envelhecimento. É no item “Tem dinheiro suficiente para satisfazer as suas necessidades?” que os idosos apresentam uma menor qualidade de vida. Não ter doença diagnosticada e ser do sexo masculino permitem ter melhores atitudes face ao envelhecimento. A Qualidade de Vida está relacionada com a idade, com o estado de saúde e com a intensidade de preocupação da família. Constatou-se que os idosos que não estão institucionalizados apresentam uma melhor qualidade de vida e uma melhor atitude face à velhice. Quem não precisa de ajudas técnicas para se movimentar apresenta uma melhor qualidade de vida. Diferenças nas atitudes face ao envelhecimento consoante a residência onde habita são significativas nas mudanças físicas e no desenvolvimento psicológico sendo que os idosos que não vivem em lares têm uma atitude mais positiva em ambos os fatores. / Over the past few years the issue of aging has played a growing importance in the population`s collective consciousness becoming increasingly important to understand the elderly population and this reality. Therefore a quantitative correlational study was performed to assess the quality of life of seniors and their attitudes towards old age, and the relationship between these and the socio-demographic and family factors. 100 seniors with more than 65 years and without cognitive deficit were surveyed. For data collection we used a structured interview consisting of sociodemographic data of the elderly, WHOQOL-AGE (Caballero Miret Power Chatterji Tobiasz-Adamczyk Koskinen Leonardi Olaya Ayuso-Mateos & Haro 2013) and AAQ (Laidlaw Power Schmidt and the WHOQOL-OLD Group 2007). We highlight: The sample is composed of 52% of males with a mean age of 74.7 (SD = 6.8). It is in the factor Psychosocial Losses and Psychological Development that elderly people have a better attitude towards aging. It is in the item "Do you have enough money to meet your needs?" that seniors show less quality of life. Not having illness and being male allows having better attitudes towards aging. Quality of Life is related to age, health condition and the intensity of family concerns. It was observed that the elderly who are not institutionalized have a better quality of life and a better attitude towards old age. Who does not need assistive devices to move around has a better quality of life. Differences in attitudes towards aging, according to residency, are significant in physical changes and psychological development, thus verifying that elderly who do not live in nursing homes have a more positive attitude in both factors.