scholarly journals Development and Evaluation of a Prosthetic Ankle Emulator with an Artificial Soleus and Gastrocnemius

2021 ◽  
Author(s):  
David M Ziemnicki ◽  
Joshua M. Caputo ◽  
Kirsty A. McDonald ◽  
Karl E. Zelik

Abstract In individuals with transtibial limb loss, a contributing factor to mobility-related challenges is the disruption of biological calf muscle function due to transection of the soleus and gastrocnemius. Powered prosthetic ankles can restore primary function of the mono-articular soleus muscle, which contributes to ankle plantarflexion. In effect, a powered ankle acts like an artificial soleus. However, the biarticular gastrocnemius connection that simultaneously contributes to ankle plantarflexion and knee flexion torques remains missing, and there are currently no commercially-available prosthetic ankles that incorporate an artificial gastrocnemius. The goal of this work is to describe the design of a novel emulator capable of independently controlling artificial soleus and gastrocnemius behaviors for transtibial prosthesis users during walking. To evaluate the emulator's efficacy in controlling the artificial gastrocnemius behaviors, a case series walking study was conducted with 4 transtibial prosthesis users. Data from this case series showed that the emulator exhibits low resistances to the user's leg swing, low hysteresis during passive spring emulation, and accurate force tracking for a range of artificial soleus and gastrocnemius behaviors. The emulator presented in this paper is versatile and can facilitate experiments studying the effects of various artificial soleus and gastrocnemius dynamics on gait or other movement tasks. Using this system, it is possible to address existing knowledge gaps and explore a wide range of artificial soleus and gastrocnemius behaviors during gait and potentially other activities of daily living.

Author(s):  
Jason K. Hofer ◽  
Ryuichi Gejo ◽  
Michelle H. McGarry ◽  
Thay Q. Lee

Kneeling is an activity that is important in certain occupations and recreational activities. Culturally, kneeling plays a large role in Middle Eastern and Asian countries, where activities of daily living require the ability to kneel and achieve deep knee flexion.


2018 ◽  
Vol 34 (7) ◽  
Author(s):  
Juliana Lustosa Torres ◽  
Erico Castro-Costa ◽  
Juliana Vaz de Melo Mambrini ◽  
Sérgio William Viana Peixoto ◽  
Breno Satler de Oliveira Diniz ◽  
...  

Psychosocial factors appear to be associated with increased risk of disability in later life. However, there is a lack of evidence based on long-term longitudinal data from Western low-middle income countries. We investigated whether psychosocial factors at baseline predict new-onset disability in long term in a population-based cohort of older Brazilians adults. We used 15-year follow-up data from 1,014 participants aged 60 years and older of the Bambuí (Brazil) Cohort Study of Aging. Limitations on activities of daily living (ADL) were measured annually, comprising 9,252 measures. Psychosocial factors included depressive symptoms, social support and social network. Potential covariates included sociodemographic characteristics, lifestyle, cognitive function and a physical health score based on 10 self-reported and objectively measured medical conditions. Statistical analysis was based on competitive-risk framework, having death as the competing risk event. Baseline depressive symptoms and emotional support from the closest person were both associated with future ADL disability, independently of potential covariates wide range. The findings showed a clear graded association, in that the risk gradually increased from low emotional support alone (sub-hazard ratio - SHR = 1.11; 95%CI: 1.01; 1.45) to depressive symptoms alone (SHR = 1.52; 95%CI: 1.13; 2.01) and then to both factors combined (SHR = 1.61; 95%CI: 1.18; 2.18). Marital status and social network size were not associated with incident disability. In a population of older Brazilian adults, lower emotional support and depressive symptoms have independent predictive value for subsequent disability in very long term.


Author(s):  
Amber N. Reeve ◽  
Chadd W. Clary ◽  
Amit M. Mane ◽  
Lorin P. Maletsky

Many activities of daily living during work, exercise, religious worship, and hobbies require deep knee flexion. Activities such as rising from a low chair or getting into or out of a bath require between 100° and 160° of knee flexion [1]. Other activities such as kneeling or squatting to pick an item off the ground can be difficult with a limited range of motion. Beside deep knee flexion being important for daily living activities, it is essential in non-Western cultures that commonly sit in deep knee-bending positions. In vitro studies looking at knee function often focus solely on the knee joint, ignoring the effect of the muscle, ligament, and tendon constraints of the ankle, and simplifying or neglecting muscle loads. The effects of these assumptions on kinematics are unknown. The purpose of this study was to compare a squatting activity for: 1) whole leg versus knee specimens, and 2) different combinations of quadriceps and hamstrings loading.


2019 ◽  
Vol 30 (4) ◽  
pp. 583-597
Author(s):  
Deborah Lambotte ◽  
An-Sofie Smetcoren ◽  
G. A. Rixt Zijlstra ◽  
Jan De Lepeleire ◽  
Liesbeth De Donder ◽  
...  

Researchers propose that the convoy of care model should be used to study care networks of frail, older individuals. Care convoys are defined as the evolving collection of individuals who may or may not have close personal connections to the recipient or to one another, but who provide care, including help with activities of daily living (ADLs) and instrumental activities of daily living (IADLs), socio-emotional care, skilled health care, monitoring, and advocacy. This study reports on community-dwelling older adults’ experiences of their care convoy, how care convoys change over time, and perceived (positive) outcomes. A qualitative analysis among 65 semi-structured interviews with frail, community-dwelling older adults demonstrates a great variety in the composition of care convoys. Participants were often actively involved in their care convoy and valued the social/relational aspect of care. Care and support covered a wide range of activities, with some activities being provided by specific types of caregivers. Participants expressed the adequacy of their care convoy in terms of satisfaction and sufficiency. Noteworthy, participants who were satisfied with their care convoy did not necessarily receive sufficient help. Policies and practice should recognize the relational aspect of care, the complex interplay between all actors, and the dynamic character of care convoys.


2006 ◽  
Vol 64 (4) ◽  
pp. 946-949 ◽  
Author(s):  
Jerson Laks ◽  
Leonardo F. Fontenelle ◽  
Adriana Chalita ◽  
Mauro V. Mendlowicz

BACKGROUND: Cognitive deficits of late-onset schizophrenia (LOS) patients have been reported as stable, although some prospective studies show that a sub-group develop a significant cognitive decline. Data on LOS from developing countries are scarce. OBJECTIVE: To evaluate the cognitive performance of Brazilian patients with LOS over the course of one year. METHOD: Thirteen LOS patients were evaluated at baseline and after one year with the Mini-Mental State Examination (MMSE), the CAMCOG, the Positive and Negative Symptoms Scale, the Pfeffer’s Activities of Daily Living (ADL), and the Neuropsychiatric Inventory (NPI). RESULTS: Cognition and activities of daily living remained stable over the course of one year [baseline MMSE= 21.31 (4.87) and CAMCOG=80.31 (16.68); end-point MMSE=20.77 (3.86) and CAMCOG=82.92 (14.42) (Z=-0.831; p=0.40); baseline ADL=4.31 (5.65); end-point ADL= 5.92 (3.86) (Z=-0.831; p=0.40)]; end-point NPI=10.54 (10.69) (Z=-0.737; p=0.46]. CONCLUSION: Like patients from developed countries, Brazilian patients with LOS do not seem develop dementia, at least over the course of one year.


Author(s):  
Nádia Boldi Coutinho ◽  
Paulo Vinícius Braga Mendes ◽  
Mariana Midori Sime

Atualmente, dentre as diversas possibilidades para a reabilitação de pessoas com sequelas de Acidente Vascular Cerebral (AVC), os jogos de realidade virtual representam um recurso inovador no tratamento, com o incentivo do uso de funções motoras, através da experiência do indivíduo com o meio virtual, aumentando o engajamento, pelo caráter lúdico. O Nintendo Wii® é um equipamento muito utilizado terapeuticamente por apresentar uma gama variada de jogos, proporcionando diversos benefícios. Esta pesquisa objetivou verificar a influência do jogo de boxe do Nintendo Wii® no processo de reabilitação de um sujeito com sequelas de AVC. O indivíduo participou, duas vezes por semana, durante um mês, jogando partidas de boxe a partir de um protocolo estabelecido para este estudo. Foram aplicados instrumentos de avaliação (anamnese, Goniometria, Índice de Barthel, COPM, Escala de Ashworth, Escala de Lawton e Brody e questionário pré e pós sessão) a fim de avaliar aspectos do desempenho ocupacional antes e após a fase de jogos. Os dados foram analisados de forma descritiva e comparativa pré e pós-teste. Os resultados não apresentaram alterações significativas, sendo uma possível explicação o fato de o participante já apresentar importante independência em suas atividades da vida diária e atividades instrumentais da vida diária. No entanto, qualitativamente, relatou melhoras na movimentação no hemicorpo afetado e no desempenho das atividades em que apontava maiores dificuldades. Conclui-se que a reabilitação através do jogo de boxe do Nintendo Wii®, utilizado concomitante a outros tratamentos, pode contribuir na melhora na funcionalidade do indivíduo com sequelas de AVC.Palavras-chave: Terapia de Exposição à Realidade Virtual; Reabilitação; Acidente Vascular Cerebral Abstract: Currently, among the many possibilities for rehabilitation of people with stroke impairments, virtual reality games represent an innovative resource in the treatment, with the encouragement of the use of motor functions, through the individual's experience with the virtual environment, increasing the engagement, by the playful character. Nintendo Wii® is a device widely used therapeutically because it has a wide range of games, providing several benefits. This research aimed to verify the influence of the Nintendo Wii® boxing game on the rehabilitation process of a subject with stroke sequelae. The subject participated twice a week for a month, playing boxing matches following a protocol established for this study. Assessment instruments (anamnesis, Goniometry, Barthel Index, COPM, Ashworth Scale, Lawton and Brody Scale and pre and post session questionnaire) were applied to evaluate aspects of occupational performance before and after the games phase. Data were analyzed descriptively and comparatively before and after the test. The results did not present significant alterations, being a possible explanation the fact that the participant already presents important independence in their activities of daily living and instrumental activities of daily living. However, qualitatively, reported improvements in movement in the affected hemibody and in the performance of activities in which it pointed to greater difficulties. It is concluded that rehabilitation through Nintendo Wii® boxing game, used concomitantly with other treatments, can contribute to the improvement of the individual's functionality with stroke sequelae.Keywords: Virtual Reality Exposure Therapy; Rehabilitation; Stroke Resumen: Actualmente, entre las varias posibilidades de rehabilitación de personas com secuelas de accidente cerebrovascular (ACV), los juegos de realidad virtual representan un recurso innovador en el tratamiento, con el fomento del uso de funciones motoras, a través de la experiencia del individuo con la realidad virtual, aumentando los procesos de participación, por por su caracteristica lúdica. La Nintendo Wii® es el equipo ampliamente utilizado terapéuticamente porque tiene una amplia gama de juegos, proporcionando muchos beneficios. Esta investigación tuvo como objetivo verificar la influencia del juego de boxeo de la Nintendo Wii® en el proceso de rehabilitación de un sujeto con secuelas de ACV. El individuo participó dos veces por semana durante un mes, jugando partidos de boxeo siguiendo un protocolo establecido para este estudio. Se aplicaron herramientas de evaluación (anamnesis, goniometría, índice de Barthel, COPM, escala de Ashworth, escala de Lawton y Brody y cuestionario pre y post sesión) para evaluar aspectos del desempeño ocupacional antes y después de la fase de juegos. Los datos fueron analizados de forma descriptiva y comparativa pre y post-test. Los resultados no presentaron alteraciones significativas, siendo una posible explicación el hecho de que el participante ya tiene una independencia importante en sus actividades de la vida diaria y actividades instrumentales de la vida diaria. Sin embargo, cualitativamente, el informó mejoras en el movimiento en el hemi-cuerpo afectado y en el desempeño de actividades en las que señaló mayores dificultades. Se concluye que la rehabilitación a través del juego de boxeo Nintendo Wii®, usado concomitantemente con otros tratamientos, puede contribuir a la mejora de la funcionalidad del individuo con secuelas de ACV.Palabras-clave: Terapia de Exposición Mediante Realidad Virtual, Rehabilitación, Accidente Cerebrovascular


Author(s):  
Roland Zahn ◽  
Alistair Burns

• Dementia is a clinical syndrome which comprises three domains: cognitive impairments, behavioural symptoms and impairments of activities of daily living• Dementia may be caused by a wide range of brain disorders and systemic conditions. Alzheimer’s disease (AD) is the most frequent cause of dementia...


2012 ◽  
Vol 24 (6) ◽  
pp. 974-986 ◽  
Author(s):  
Patricia De Vriendt ◽  
Ellen Gorus ◽  
Elise Cornelis ◽  
Anja Velghe ◽  
Mirko Petrovic ◽  
...  

ABSTRACTBackground: The notion of “minimal impairment in instrumental activities of daily living (i-ADL)” is important in the diagnosis of mild cognitive impairment (MCI), but is presently not adequately operationalized. ADL is stratified according to difficulty, complexity, and also to vulnerability to early cognitive changes in a threefold hierarchy: basic activities of daily living (b-ADL), i-ADL, and advanced activities of daily living (a-ADL). This study aims to gain a deeper understanding of the functional decline in the process of MCI.Methods: In a qualitative design, 37 consecutive patients diagnosed with amnestic (a)-MCI and their proxies were interviewed at two geriatric day hospitals. Constant comparative analysis was used for the analysis.Results: The a-ADL-concept emerged as important in the diagnosis of MCI. All participants were engaged in a wide range of activities, which could be clustered according to the International Classification of Functioning, Disability and Health (ICF). Participants reported subtle difficulties in performance. A process of functional decline was identified in which adaptation and coping mechanisms interacted with the process of reduced skills, leading to an activity disruption and an insufficiency in functioning.Conclusion: This study asserts the inclusion of an evaluation of a-ADL in the assessment of older persons. When evaluating ADL at three levels (b-ADL, i-ADL, and a-ADL), all the activities one can perform in daily living are covered.


Sensors ◽  
2021 ◽  
Vol 21 (16) ◽  
pp. 5569
Author(s):  
Guangyuan Zhang ◽  
Stefan Poslad ◽  
Xiaoping Rui ◽  
Guangxia Yu ◽  
Yonglei Fan ◽  
...  

This study aims to quantitatively model rather than to presuppose whether or not air pollution in Beijing (China) affects people’s activities of daily living (ADLs) based on an Internet of Behaviours (IoB), in which IoT sensor data can signal environmental events that can change human behaviour on mass. Peoples’ density distribution computed by call detail records (CDRs) and air quality data are used to build a fixed effect model (FEM) to analyse the influence of air pollution on four types of ADLs. The following four effects are discovered: Air pollution negatively impacts people going sightseeing in the afternoon; has a positive impact on people staying-in, in the morning and the middle of the day. Air pollution lowers people’s desire to go to restaurants for lunch, but far less so in the evening. As air quality worsens, people tend to decrease their walking and cycling and tend to travel more by bus or subway. We also find a monotonically decreasing nonlinear relationship between air quality index and the average CDR-based distance for each person of two citizen groups that go walking or cycling. Our key and novel contributions are that we first define IoB as a ubiquitous concept. Based on this, we propose a methodology to better understand the link between bad air pollution events and citizens’ activities of daily life. We applied this methodology in the first comprehensive study that provides quantitative evidence of the actual effect, not the presumed effect, that air pollution can significantly affect a wide range of citizens’ activities of daily living.


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