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Kilgore KL, Anderson KD, Peckham PH. Neuroprosthesis for individuals with spinal cord injury. Neurol Res 2023; 45:893-905. [PMID: 32727296 PMCID: PMC9415059 DOI: 10.1080/01616412.2020.1798106] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 07/14/2020] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Individuals who sustain a traumatic spinal cord injury (SCI) often have a loss of multiple body systems. Significant functional improvement can be gained by individual SCI through the use of neuroprostheses based on electrical stimulation. The most common actions produced are grasp, overhead reach, trunk posture, standing, stepping, bladder/bowel/sexual function, and respiratory functions. METHODS We review the fundamental principles of electrical stimulation, which are established, allowing stimulation to be safely delivered through implanted devices for many decades. We review four common clinical applications for SCI, including grasp/reach, standing/stepping, bladder/bowel function, and respiratory functions. Systems used to implement these functions have many common features, but are also customized based on the functional goals of each approach. Further, neuroprosthetic systems are customized based on the needs of each user. RESULTS & CONCLUSION The results to date show that implanted neuroprostheses can have a significant impact on the health, function, and quality of life for individuals with SCI. A key focus for the future is to make implanted neuroprostheses broadly available to the SCI population.
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Affiliation(s)
- Kevin L. Kilgore
- – MetroHealth System, Cleveland, Ohio
- – Case Western Reserve University, Cleveland, Ohio
- – VA Northeast Ohio Healthcare System, Cleveland, Ohio
| | - Kimberly D. Anderson
- – MetroHealth System, Cleveland, Ohio
- – Case Western Reserve University, Cleveland, Ohio
| | - P. Hunter Peckham
- – MetroHealth System, Cleveland, Ohio
- – Case Western Reserve University, Cleveland, Ohio
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2
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Mitchell J, Shirota C, Clanchy K. Factors that influence the adoption of rehabilitation technologies: a multi-disciplinary qualitative exploration. J Neuroeng Rehabil 2023; 20:80. [PMID: 37340496 DOI: 10.1186/s12984-023-01194-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 05/23/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Technological innovation is recognised as having the potential to enhance rehabilitation for people with disability. Yet, resistance to, and abandonment of, rehabilitation technology is prevalent and the successful translation of technology into rehabilitation settings remains limited. Therefore, the aim of this work was to develop an in-depth, multi-stakeholder perspective on what influences the adoption of rehabilitation technologies. METHODS Semi-structured focus groups were conducted as part of a larger research project aiming to facilitate the co-design of a novel neurorestorative technology. Focus group data were analysed using a five-phase hybrid deductive-inductive approach to qualitative data analysis. RESULTS Focus groups were attended by 43 stakeholders with expertise in one or more of the following fields: people with disability, allied health, human movement science, computer science, design, engineering, ethics, funding, marketing, business, product development, and research development. Six main themes influencing the adoption of technology in rehabilitation were identified: cost beyond the purchase price, benefits to all stakeholders, trust to be earned in technology, ease of technology operation, ability to access technology, and the 'co' in co-design. All six themes were found to be interrelated; in particular, the importance of direct stakeholder engagement in the development of rehabilitation technologies (the 'co' in co-design) was prevalent in all themes. CONCLUSIONS A range of complex and interrelated factors influence the adoption of rehabilitation technologies. Importantly, many of the issues that have the potential to negatively impact rehabilitation technology adoption may be addressed during development by utilising the experience and expertise of stakeholders who influence its supply and demand. Our findings state that a wider cohort of stakeholders needs to be actively engaged in the development of rehabilitation technologies to better address the factors that contribute to technology underutilisation and abandonment and facilitate better outcomes for people with disability.
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Affiliation(s)
- Jessie Mitchell
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Camila Shirota
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Kelly Clanchy
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Brisbane, Australia.
- School of Health Sciences and Social Work, Griffith University, Southport, Australia.
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3
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Tedesco Triccas L, Donovan-Hall M, Dibb B, Burridge JH. A nation-wide survey exploring the views of current and future use of functional electrical stimulation in spinal cord injury. Disabil Rehabil Assist Technol 2021:1-11. [PMID: 34107234 DOI: 10.1080/17483107.2021.1916631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE Functional electrical stimulation (FES) can be effective in assisting physical and psychosocial difficulties experienced by people with spinal cord injury. Perceived benefits and barriers of the current and future use of FES within the wider spinal cord injury community is currently unknown. The main objective of this research was to explore the spinal cord injury community's views of the use of FES to decrease disability in rehabilitation programmes. MATERIALS AND METHODS An online and paper questionnaire was distributed to people with spinal cord injury, health care professionals and researchers working in spinal cord injury settings in the United Kingdom. RESULTS A total of 299 participants completed the survey (152 people with spinal cord injury, 141 health care professionals and 6 researchers). Common views between groups identified were: (1) FES can be beneficial in improving physical and psychosocial aspects and that (2) adequate support and training for FES application was provided to users. Barriers to FES use included a lack of staff time and training, financial cost and availability of the equipment. Sixty three percent of non-users felt they would use FES in the future if they had the opportunity. CONCLUSIONS Users' views were important in identifying that FES application can be beneficial for people with spinal cord injury but also has some resourceful barriers. In order to increase use, future research should focus on reducing the cost of FES clinical service and also address implementation of awareness and training programmes within spinal units and community rehabilitation settings.IMPLICATIONS FOR REHABILITATIONUsers of functional electrical stimulation think that it is beneficial for improving physical and psychosocial limitations after spinal cord injuryBarriers to FES use include a lack of staff time and training, financial cost and availability of the equipment have been suggested by people with spinal cord injury and health care professionals Education and implementation programs for health care professionals and people with spinal cord injury are now necessary to increase the awareness about functional electrical stimulation applicationReduction of FES cost could also increase its uptake in spinal cord injury clinical services.
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Affiliation(s)
- Lisa Tedesco Triccas
- Faculty of Health Sciences, University of Southampton, Southampton, UK.,Rehabilitation Research Center (REVAL), Biomedical Research Institute (BIOMED), Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | | | - Bridget Dibb
- School of Psychology, University of Surrey, Guildford, UK
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4
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Moineau B, Myers M, Ali SS, Popovic MR, Hitzig SL. End-user and clinician perspectives on the viability of wearable functional electrical stimulation garments after stroke and spinal cord injury. Disabil Rehabil Assist Technol 2019; 16:241-250. [PMID: 31592679 DOI: 10.1080/17483107.2019.1668974] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Functional electrical stimulation (FES), through repetitive training (FES-therapy) or continuous assistance (neuro-prosthesis), can restore motor function after paralysis due to spinal cord injury or stroke. With current technology, patients are often incapable of independently applying FES, thereby limiting its use. Novel FES-garments with embedded stimulation electrodes were developed in collaboration with Myant, Canada, to address this problem. The purpose of this study was to collect the views of future end-users to inform the refinement of the device design and to obtain insights on subsequent commercialization of this rehabilitation and assistive technology. METHODS A qualitative study was undertaken to determine the needs of potential users (patients and clinicians; n = 19). Participant took part in interviews or focus groups after a presentation of the garments. An inductive content analysis was used to generate the themes from the data and identify data saturation. RESULTS The identified themes and sub-themes were: (1) User Perspectives: users' characteristics (needs, limitations), expected benefits (beliefs), and anticipated problems (fears); (2) Device Design: technical features, usability, and disadvantages of the garment, cables, stimulator, software, and interface; (3) Acquisition Process: organizational procedures (acquisition and adoption steps); and (4) Business Model: financial and strategic aspects to facilitate commercialization and support users. CONCLUSIONS The insights obtained from end-users and clinicians provide guidelines to optimize the development of novel FES-garments, and strategies for bringing the device to the market. The themes identified can serve to inform other rehabilitation and assistive technology developers with processes and ideas on how to meet these groups' needs.IMPLICATIONS FOR REHABILITATIONParticipants with neurological paralysis have interest and critical views on new rehabilitation and assistive technology, and the repercussions of using new technologies to address their function, health and wellbeing.The FES-garment design presented appeared acceptable to the end-users, pending resolution of certain shortcomings (wiring, operating duration, robustness, easiness to don and doff).End-users and clinicians had specific views regarding the acquisition process of new technologies (training, customization, and follow-up/support), which are important to take into consideration to ensure broad stakeholders uptake.
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Affiliation(s)
- Bastien Moineau
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,CRANIA, University Health Network, Toronto, ON, Canada.,Myant Inc, Etobicoke, ON, Canada
| | - Matthew Myers
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,CRANIA, University Health Network, Toronto, ON, Canada
| | - Saima Shaheen Ali
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,CRANIA, University Health Network, Toronto, ON, Canada
| | - Milos R Popovic
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,CRANIA, University Health Network, Toronto, ON, Canada
| | - Sander L Hitzig
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.,Rehabilitation Sciences Institute, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,St-John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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5
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Taylor MJ, Ruys AJ, Fornusek C, Bijak M, Russold M, Bauman AE. Lessons from Vienna: stakeholder perceptions of functional electrical stimulation technology and a conceptual model for practice. Disabil Rehabil Assist Technol 2018; 15:37-44. [DOI: 10.1080/17483107.2018.1513573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Matthew J. Taylor
- Faculty of Engineering and IT, The University of Sydney, Camperdown, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia
| | - Andrew J. Ruys
- Faculty of Engineering and IT, The University of Sydney, Camperdown, Australia
| | - Ché Fornusek
- Faculty of Health Sciences, The University of Sydney, Lidcombe, Australia
| | - Manfred Bijak
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | | | - Adrian E. Bauman
- Charles Perkins Centre, The University of Sydney, Camperdown, Australia
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6
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Sajer S, Guardiero GS, Scicchitano BM. Myokines in Home-Based Functional Electrical Stimulation-Induced Recovery of Skeletal Muscle in Elderly and Permanent Denervation. Eur J Transl Myol 2018; 28:7905. [PMID: 30662701 PMCID: PMC6317133 DOI: 10.4081/ejtm.2018.7905] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 11/08/2018] [Indexed: 12/14/2022] Open
Abstract
Neuromuscular disorders, disuse, inadequate nutrition, metabolic diseases, cancer and aging produce muscle atrophy and this implies that there are different types of molecular triggers and signaling pathways for muscle wasting. Exercise and muscle contractions may counteract muscle atrophy by releasing a group of peptides, termed myokines, to protect the functionality and to enhance the exercise capacity of skeletal muscle. In this review, we are looking at the role of myokines in the recovery of permanent denervated and elderly skeletal muscle tissue. Since sub-clinical denervation events contribute to both atrophy and the decreased contractile speed of aged muscle, we saw a parallel to spinal cord injury and decided to look at both groups together. The muscle from lifelong active seniors has more muscle bulk and more slow fiber-type groupings than those of sedentary seniors, demonstrating that physical activity maintains slow motoneurons that reinnervate the transiently denervated muscle fibers. Furthermore, we summarized the evidence that muscle degeneration occur with irreversible Conus and Cauda Equina syndrome, a spinal cord injury in which the human leg muscles may be permanently disconnected from the peripheral nervous system. In these patients, suffering with an estreme case of muscle disuse, a complete loss of muscle fibers occurs within five to ten years after injury. Their recovered tetanic contractility, induced by home-based Functional Electrical Stimulation, can restore the muscle size and function in compliant Spinal Cord Injury patients, allowing them to perform electrical stimulation-supported stand-up training. Myokines are produced and released by muscle fibers under contraction and exert both local and systemic effects. Changes in patterns of myokine secretion, particularly of IGF-1 isoforms, occur in long-term Spinal Cord Injury persons and also in very aged people. Their modulation in Spinal Cord Injury and late aging are also key factors of home-based Functional Electrical Stimulation - mediated muscle recovery. Thus, Functional Electrical Stimulation should be prescribed in critical care units and nursing facilities, if persons are unable or reluctant to exercise. This will result in less frequent hospitalizations and a reduced burden on patients' families and public health services.
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Affiliation(s)
- Sascha Sajer
- Department of Physiko&Rheuma-Therapie, Institute for Physical Medicine, St. Pölten, Austria
| | - Giulio Sauro Guardiero
- A&C M-C Foundation for Translational Myology, Padova, Italy
- Interdepartmental Research Centre of Myology, University of Padova, Italy
| | - Bianca Maria Scicchitano
- Istituto di Istologia ed Embriologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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BOCHKEZANIAN VANESA, NEWTON ROBERTU, TRAJANO GABRIELS, BLAZEVICH ANTHONYJ. Effects of Neuromuscular Electrical Stimulation in People with Spinal Cord Injury. Med Sci Sports Exerc 2018; 50:1733-1739. [DOI: 10.1249/mss.0000000000001637] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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8
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Taylor MJ, Fornusek C, Ruys AJ, Bijak M, Bauman AE. The Vienna FES Interview Protocol - A mixed-methods protocol to elucidate the opinions of various individuals responsible for the provision of FES exercise. Eur J Transl Myol 2017; 27:6604. [PMID: 29118956 PMCID: PMC5656807 DOI: 10.4081/ejtm.2017.6604] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Revised: 08/23/2017] [Accepted: 08/25/2017] [Indexed: 02/08/2023] Open
Abstract
Functional Electrical Stimulation (FES) is the production of electrically elicited muscle contractions to perform a function or task. It has been used as a method to regain lost body functions or support weak body functions, and as such, has been clinically available since the early seventies. Some methods are applied routinely while others have not been translated to the bedside, or are still largely restricted to laboratory use. Progress in this field might be achieved by a strong cooperation of patients, clinicians, therapists and engineers. A better insight into multiple perspectives may help in understanding the shortcomings of current FES technology. This will help direct future research efforts into design of systems and potential application in relevant populations. In addition, these findings can assist with the translation of FES technology into a community context. We outline an interview protocol designed for use at the 12th Vienna International Workshop on Functional Electrical Stimulation where the mentioned experts from the field of FES met.
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Affiliation(s)
| | - Ché Fornusek
- Faculty of Health Sciences, University of Sydney, Lidcombe, Australia
| | - Andrew J Ruys
- Faculty of Engineering and IT, University of Sydney, Camperdown, Australia
| | - Manfred Bijak
- Centre for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
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9
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Carraro U, Kern H, Gava P, Hofer C, Loefler S, Gargiulo P, Edmunds K, Árnadóttir ÍD, Zampieri S, Ravara B, Gava F, Nori A, Gobbo V, Masiero S, Marcante A, Baba A, Piccione F, Schils S, Pond A, Mosole S. Recovery from muscle weakness by exercise and FES: lessons from Masters, active or sedentary seniors and SCI patients. Aging Clin Exp Res 2017; 29:579-590. [PMID: 27592133 DOI: 10.1007/s40520-016-0619-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 08/09/2016] [Indexed: 12/17/2022]
Abstract
Many factors contribute to the decline of skeletal muscle that occurs as we age. This is a reality that we may combat, but not prevent because it is written into our genome. The series of records from World Master Athletes reveals that skeletal muscle power begins to decline at the age of 30 years and continues, almost linearly, to zero at the age of 110 years. Here we discuss evidence that denervation contributes to the atrophy and slowness of aged muscle. We compared muscle from lifelong active seniors to that of sedentary elderly people and found that the sportsmen have more muscle bulk and slow fiber type groupings, providing evidence that physical activity maintains slow motoneurons which reinnervate muscle fibers. Further, accelerated muscle atrophy/degeneration occurs with irreversible Conus and Cauda Equina syndrome, a spinal cord injury in which the human leg muscles may be permanently disconnected from the nervous system with complete loss of muscle fibers within 5-8 years. We used histological morphometry and Muscle Color Computed Tomography to evaluate muscle from these peculiar persons and reveal that contraction produced by home-based Functional Electrical Stimulation (h-bFES) recovers muscle size and function which is reversed if h-bFES is discontinued. FES also reverses muscle atrophy in sedentary seniors and modulates mitochondria in horse muscles. All together these observations indicate that FES modifies muscle fibers by increasing contractions per day. Thus, FES should be considered in critical care units, rehabilitation centers and nursing facilities when patients are unable or reluctant to exercise.
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Affiliation(s)
- Ugo Carraro
- IRCCS Fondazione Ospedale San Camillo, Venice, Italy
| | - Helmut Kern
- Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria
- Institute of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria
| | - Paolo Gava
- Laboratory of Translational Myology of the Interdepartmental Research Center of Myology, Department of Biomedical Science, University of Padova, Via Ugo Bassi 58/B, 35131, Padua, Italy
| | - Christian Hofer
- Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria
| | - Stefan Loefler
- Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria
| | - Paolo Gargiulo
- Institute for Biomedical and Neural Engineering, Reykjavík, Iceland
- Landspítali, Reykjavík, Iceland
| | - Kyle Edmunds
- Institute for Biomedical and Neural Engineering, Reykjavík, Iceland
| | | | - Sandra Zampieri
- Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria
- Laboratory of Translational Myology of the Interdepartmental Research Center of Myology, Department of Biomedical Science, University of Padova, Via Ugo Bassi 58/B, 35131, Padua, Italy
| | - Barbara Ravara
- Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria
- Laboratory of Translational Myology of the Interdepartmental Research Center of Myology, Department of Biomedical Science, University of Padova, Via Ugo Bassi 58/B, 35131, Padua, Italy
| | - Francesco Gava
- Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria
- Laboratory of Translational Myology of the Interdepartmental Research Center of Myology, Department of Biomedical Science, University of Padova, Via Ugo Bassi 58/B, 35131, Padua, Italy
| | - Alessandra Nori
- Laboratory of Translational Myology of the Interdepartmental Research Center of Myology, Department of Biomedical Science, University of Padova, Via Ugo Bassi 58/B, 35131, Padua, Italy
| | - Valerio Gobbo
- Department of Biomedical Science, C.N.R. Institute of Neuroscience, University of Padova, Padua, Italy
| | - Stefano Masiero
- Rehabilitation Unit, Department of Neuroscience, University of Padova, Padua, Italy
| | | | - Alfonc Baba
- IRCCS Fondazione Ospedale San Camillo, Venice, Italy
| | | | | | - Amber Pond
- Anatomy Department, Southern Illinois University, School of Medicine, Carbondale, IL, USA
| | - Simone Mosole
- Ludwig Boltzmann Institute of Electrical Stimulation and Physical Rehabilitation, Vienna, Austria.
- Laboratory of Translational Myology of the Interdepartmental Research Center of Myology, Department of Biomedical Science, University of Padova, Via Ugo Bassi 58/B, 35131, Padua, Italy.
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10
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Application of Empirical Mode Decomposition Combined With Notch Filtering for Interpretation of Surface Electromyograms During Functional Electrical Stimulation. IEEE Trans Neural Syst Rehabil Eng 2017; 25:1268-1277. [DOI: 10.1109/tnsre.2016.2624763] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Triccas LT, Donovan-Hall M, Burridge J, Ellis-Hill C, Dibb B, Rushton D. Cognitive interviewing techniques used in developing questionnaires on functional electrical stimulation in spinal cord injury. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2016. [DOI: 10.12968/ijtr.2016.23.3.114] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Lisa Tedesco Triccas
- Research fellow, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Maggie Donovan-Hall
- Associate professor, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Jane Burridge
- Professor of restorative neuroscience, Faculty of Health Sciences, University of Southampton, Southampton, UK
| | | | - Bridget Dibb
- Lecturer, Psychology, Department of Life Sciences, Brunel University London, Uxbridge, Middlesex, UK
| | - David Rushton
- Medical doctor, King's College Hospital, Frank Cooksey Rehabilitation Unit, London, UK
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12
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Veale AJ, Xie SQ. Towards compliant and wearable robotic orthoses: A review of current and emerging actuator technologies. Med Eng Phys 2016; 38:317-25. [PMID: 26923385 DOI: 10.1016/j.medengphy.2016.01.010] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 01/01/2016] [Accepted: 01/31/2016] [Indexed: 11/25/2022]
Abstract
Robotic orthoses, or exoskeletons, have the potential to provide effective rehabilitation while overcoming the availability and cost constraints of therapists. However, current orthosis actuation systems use components designed for industrial applications, not specifically for interacting with humans. This can limit orthoses' capabilities and, if their users' needs are not adequately considered, contribute to their abandonment. Here, a user centered review is presented on: requirements for orthosis actuators; the electric, hydraulic, and pneumatic actuators currently used in orthoses and their advantages and limitations; the potential of new actuator technologies, including smart materials, to actuate orthoses; and the future of orthosis actuator research.
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Affiliation(s)
- Allan Joshua Veale
- Department of Mechanical Engineering, The University of Auckland, 20 Symonds Street, Auckland 1010, New Zealand.
| | - Shane Quan Xie
- Department of Mechanical Engineering, The University of Auckland, 20 Symonds Street, Auckland 1010, New Zealand
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13
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Nevedal A, Kratz AL, Tate DG. Women's experiences of living with neurogenic bladder and bowel after spinal cord injury: life controlled by bladder and bowel. Disabil Rehabil 2015; 38:573-81. [DOI: 10.3109/09638288.2015.1049378] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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14
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Dibb B, Ellis-Hill C, Donovan-Hall M, Burridge J, Rushton D. Exploring positive adjustment in people with spinal cord injury. J Health Psychol 2013; 19:1043-54. [DOI: 10.1177/1359105313483158] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study explored adjustment in people with spinal cord injury; data from four focus groups are presented. Thematic analysis revealed four themes, managing goals and expectations, comparison with others, feeling useful and acceptance, showing participants positively engaged in life, positively interpreted social comparison information and set realistic goals and expectations. These positive strategies show support for adjustment theories, such as the Cognitive Adaptation Theory, the Control Process Theory and Response Shift Theory. These results also provide insight into the adjustment process of a person with spinal cord injury and may be useful in tailoring support during rehabilitation.
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Crema A, McNaught A, Albisser U, Bolliger M, Micera S, Curt A, Morari M. A hybrid tool for reaching and grasping rehabilitation: the ArmeoFES. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2012; 2011:3047-50. [PMID: 22254982 DOI: 10.1109/iembs.2011.6090833] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Many research groups are currently working with robotic devices for hand grasp rehabilitation and restoration. A common problem in this area is the fact that existing and commercially available robotic exoskeletons are able to provide gravity compensation of the shoulder and elbow but do not provide any support for the grasping and releasing movements of the hand. The lack of a flexible support technology for the hand reduces the possible ways in which clinicians can deal with the issue of a personalized, effective rehabilitation. This paper presents new software that allows FES assisted grasping to integrate with the ArmeoSpring (Hocoma AG). The system uses a Man-In-The-Loop control approach, whereby surface EMG signals from proximal muscles are used to trigger and modulate multichannel FES applied to distal muscles, thus allowing patient induced and strength adapted movement control of the hand. Combining volitionally controlled FES with arm-weight-compensation allows early adoption of FES assisted therapy for patients, augmenting their functionalities and extending training capabilities with the ArmeoSpring.
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Affiliation(s)
- A Crema
- Automatic Control Laboratory, Swiss Federal Institute of Technology, Zurich, Switzerland.
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Abstract
In this Editor's Review, articles published in 2011 are organized by category and briefly summarized. As the official journal of The International Federation for Artificial Organs, The International Faculty for Artificial Organs, and the International Society for Rotary Blood Pumps, Artificial Organs continues in the original mission of its founders "to foster communications in the field of artificial organs on an international level."Artificial Organs continues to publish developments and clinical applications of artificial organ technologies in this broad and expanding field of organ replacement, recovery, and regeneration from all over the world. We take this time also to express our gratitude to our authors for offering their work to this journal. We offer our very special thanks to our reviewers who give so generously of time and expertise to review, critique, and especially provide meaningful suggestions to the author's work whether eventually accepted or rejected. Without these excellent and dedicated reviewers, the quality expected from such a journal would not be possible. We also express our special thanks to our Publisher, Wiley-Blackwell, for their expert attention and support in the production and marketing of Artificial Organs. In this Editor's Review, that historically has been widely well-received by our readership, we aim to provide a brief reflection of the currently available worldwide knowledge that is intended to advance and better human life while providing insight for continued application of technologies and methods of organ replacement, recovery, and regeneration. We look forward to recording further advances in the coming years.
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Affiliation(s)
- Paul S Malchesky
- Artificial Organs Editorial Office, 10 West Erie Street, Painesville, OH 44077, USA.
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Abstract
SETTING Spinal cord injury (SCI) causes devastating loss of function and can result in serious secondary complications. Although significant advances are being made to develop cellular and molecular therapies to promote regeneration, it is important to optimize physical interventions. OBJECTIVES The objective of this review was to examine the evidence for the effects of physical rehabilitation strategies on health and fitness, and maintenance of target systems below the level of injury (for example, muscle, bone, circulation). RESULTS Exercise appears to be a potent means of achieving these goals, using a variety of strategies. CONCLUSION Physical rehabilitation after SCI needs to move beyond the goal of maximizing independence to focus on maintenance of optimum health and fitness as well as maintenance of target system function below the level of injury. Issues requiring further investigation include identification of the optimum dosage of interventions to achieve specific goals, for example, prevention of muscle atrophy and osteoporosis, and development and validation of simple clinical measures to monitor the changes in body composition. Adoption of a classification system for physical interventions and standardized outcome measures would facilitate large-scale observational studies to identify the critical variables contributing to better outcomes.
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Affiliation(s)
- M P Galea
- Rehabilitation Sciences Research Centre, The University of Melbourne, Parkville, Victoria, Australia.
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Brurok B, Tørhaug T, Leivseth G, Karlsen T, Helgerud J, Hoff J. Effect of leg vascular occlusion on arm cycling peak oxygen uptake in spinal cord-injured individuals. Spinal Cord 2011; 50:298-302. [PMID: 22124351 DOI: 10.1038/sc.2011.129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional single-subject design. OBJECTIVES To determine whether leg vascular occlusion (LEVO) augment arm cycling (ACE) peak oxygen uptake in spinal cord-injured individuals. SETTING University Hospital, Norway. METHODS Fifteen individuals with C(4) to T(12) spinal cord injury (SCI) were recruited and divided into two groups: injury above (SCI-high, n=8) or below (SCI-low, n=7) the T(6) level. Peak oxygen uptake (VO(2peak)) was measured during (1) ACE combined with LEVO, (2) ACE alone and (3) ACE combined with functional electrical stimulation cycling (FES hybrid cycling). RESULTS In the SCI-high group, VO(2peak) and peak Watt during ACE with LEVO were higher than ACE alone: 20.0 (±5.0) versus 17.6 (±5.0) ml kg(-1) min(-1) (P=0.006), and 72.5(±32) versus 80.0 (±34) Watt (P=0.016), respectively. However, FES hybrid cycling VO(2peak) was significantly higher than ACE with LEVO: 24.4 (±4.1) versus 20.0 (±5.0) ml kg(-1) min(-1) (P=0.006). In the SCI-low group, there was no difference in VO(2peak) and related parameters between the three modalities. CONCLUSIONS For spinal cord-injured individuals with injury level above T(6) (high) in the present study, LEVO combined with ACE augment VO(2peak). However, this acute increase in VO(2peak) was lower than when FES cycling was combined with ACE. These findings may have future implications for exercise prescription for spinal cord-injured individuals.
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Affiliation(s)
- B Brurok
- Department of Physical Medicine and Rehabilitation, St Olav's University Hospital, Trondheim, Norway.
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