Effects of adjustments to wheelchair seat to back support angle on head, neck, and shoulder postures in subjects with cerebral palsy

The Effect of TMJ Intervention on Instant Postural Changes and Dystonic Contractions in Patients Diagnosed with Dystonia: A Pilot Study

(1) Background: The aim of the present study is to analyze the instant postural changes and changes in the dystonic contractions among patients with dystonia following the use of an intraoral device called a key integrative dynamic TMJ treatment appliance (KIDTA). (2) Methods: Twelve subjects, previously diagnosed with dystonia were enrolled. Their existing records were utilized to assess the changes in their posture and dystonic contractions. The posture analysis was conducted using a mobile application (APECS). The initial records (T0) and records acquired after the delivery of the KIDTA (T1) were utilized in the analysis. The Wilcoxon signed-rank test was performed to compare parameters between T0 and T1, with a significance level set at p < 0.05. (3) Results: Based on the Wilcoxon signed-rank test, statistically significant differences in T1 compared to T0 were observed in the severity of dystonic spasms, body alignment, head shift, head tilt, shoulder alignment, shoulder angle, axillae alignment, ribcage tilt, pelvic tilt, knee angle, and tibia angle (p < 0.05). (4) Conclusions: Within the limitations of the present pilot study, an intervention to the TMJ through a KIDTA appliance seems to mitigate the severity of dystonic contractions and improve the posture with respect to certain postural parameters.

Ergonomic guidelines for the design interfaces of additive modules for manual wheelchairs: sagittal plane

When designing wheelchair propulsion systems operated with the upper limb, there is a noticeable lack of ergonomic analyses informing about the areas on the wheelchair frame where hand-operated controls can be installed. With that in mind, a research goal was set to measure the areas of human hand reach within the area defined by the structural elements of a manual wheelchair. An ergonomic analysis was performed on a group of ten patients representing 50% of anthropometric dimensions. Motion capture and image analysis software based on the openCV library were used for the measurement. The conducted research resulted in the development of a map of the hands range in the lateral plane of the wheelchair, parallel to the sagittal plane. In addition, the map was divided into three zones of hand reach, taking into account various levels of comfort of hand manipulation. The total hand reach area was 1269 mm long and 731 mm high, while the most comfortable manipulation area was 352 mm long and 649 mm high. The plotted hands reach areas act as a map informing the designer where on the sagittal plane additional accessories operated by the user can be installed.

Relationships between cervical sagittal posture, muscle endurance, joint position sense, range of motion and level of smartphone addiction

BACKGROUND

Frequent smartphone use in a pathological way forces the user to adopt a compromised posture. This gradually results in changes to both the postural and musculoskeletal systems. This study's objectives were evaluation of head posture, muscle endurance, neck range of motion (ROM) and joint position sense in two separate smartphone user groups, one 'Addicted', the other 'Non-Addicted'.

METHODS

A sample of convenience (n = 60) was recruited from medical students (age 24.57 ± 4.38, 53.3% male) with a history of smartphones use > 2 h/day for 1-year. Based on the cut-off values of the smartphone addiction scale-short version (SAS-SV), participants were entered into each group (cut-off for male ≥ 31, female ≥ 33). Neck muscle endurance time, joint position error and cervical ROM, along with forward head posture parameters of craniovertebral angle (CVA), shoulder angle (SA), sagittal head angle (SHA) and forward head distance (FHD)) were evaluated. A Mann-Whitney test and Spearman correlation coefficient were used to determine the difference between groups and the correlations between variables.

RESULTS

The difference between 'Addicted' and 'Non-Addicted' groups was confirmed by the values for SAS-SV scores (25.23 ± 5.5 versus 43.9 ± 6.61) (p < 0.001). There were statistically significant differences between groups for the CVA and FHD parameters (p < 0.001). Further, the neck extensor muscle endurance (97 ± 3.79 versus 74.86 ± 2.23 s), was significantly different between groups (p = 0.010) but not after Bonferroni correction. There was no notable difference in the neck flexor muscle endurance, joint position error, SA, and SHA parameters between groups (p > 0.05).

CONCLUSIONS

There is a positive correlation between smartphone addiction and both decreased extensor muscle endurance and changes in neck postural alignment.

Design of an Automated Multiposition Dynamic Wheelchair

This work presents a design for an automatized multiposition dynamic wheelchair used to transport quadriplegic patients by reconfiguring a manual wheelchair structure. An electric actuator is attached to a four-bar mechanism fixed to each side of a wheelchair’s backrest to reach multiposition. The entire device is actuated through a PID controller. An experimental test is carried out in a simplified wheelchair structure. Finally, the structure of the wheelchair is evaluated through the Dynamic analysis and Finite Element Method under the payload computed with the most critical position reached by the mechanism.