Arm-plane representation of shoulder compensation during pointing movements in patients with stroke

Improvements in functional motor activities are often accompanied by motor compensations to overcome persistent motor impairment in the upper limb. Kinematic analysis is used to objectively quantify movement patterns including common motor compensations such as excessive trunk displacement during reaching. However, a common motor compensation to assist reaching, shoulder abduction, is not adequately characterized by current motion analysis approaches. We apply the arm-plane representation that accounts for the co-variation between movements of the whole arm, and investigate its ability to identify and quantify compensatory arm movements in stroke subjects when making forward arm reaches. This method has not been previously applied to the analysis of motion deficits. Sixteen adults with right post-stroke hemiparesis and eight healthy age-matched controls reached in three target directions (14 trials/target; sampling rate: 100 Hz). Arm-plane movement was validated against endpoint, joint, and trunk kinematics and compared between groups. In stroke subjects, arm-plane measures were correlated with arm impairment (Fugl-Meyer Assessment) and ability (Box and Blocks) scores and were more sensitive than clinical measures to detect mild motor impairment. Arm-plane motion analysis provides new information about motor compensations involving the co-variation of shoulder and elbow movements that may help to understand the underlying motor deficits in patients with stroke.     

Ascending curbs of progressively higher height increases forward trunk flexion along with upper extremity mechanical and muscular demands in manual wheelchair users with a spinal cord injury

High upper extremity (U/E) demands are required when manual wheelchair users (MWUs) with spinal cord injury (SCI) ascend curbs; this may contribute to the risk of developing U/E musculoskeletal impairments. The aim of this study was to compare movement strategies (kinematics), mechanical loads (kinetics) and muscular demand (EMG) at the non-dominant U/E among 15 MWUs with SCI when ascending curbs of 4 cm (3 trials), 8 cm (3 trials) and 12 cm high (3 trials) from a starting line set 3 m before the curb. Biomechanical data was collected during three trials for each height. The curb ascent task was divided into three adjustment phases: caster pop, rear-wheel ascent and post-ascent. The greatest effort was generated by the shoulder flexors and internal rotators as well as the elbow flexors. A significant difference (p < 0.0167) between the curb heights was found for most outcome measures studied: movement excursion, net joint moments and muscular utilization ratio (MUR) of the main muscles increased with the higher curb heights, mainly around the shoulder joint. These results provide insight that aside from adhering to a highly structured training method for wheelchair curb ascent, rehabilitation professionals need to propose task-specific strength training programs based on the demands documented in this study and continue to advocate for physically accessible environments.     

Biomechanical Analysis of Pedalling for Rehabilitation Purposes: Experimental Results on Two Pathological Subjects and Comparison with Non-pathological Findings

In this paper the experimental results obtained by means of a prototype measuring device dedicated to the evaluation of the rehabilitation level of the lower limb are presented. The analysis of the experimental data collected on non-pathological subjects allows the identification of the characteristic meaning of the most significant parameters typical of healthy subjects. These data have been employed for a systematic comparison with the same parameters measured on two pathological subjects, in order to define quantitative indicators of the rehabilitation degree of the lower limbs and indicators of the “quality” of the movement.     

视觉模拟评分法在全膝关节置换术镇痛后应用体会

目的：观察视觉模拟评级法对于关节置换手术后镇痛的指导意义。方法：对比不同疼痛评估方式在全膝关节置换手术患者术后疼痛治疗中的KSS评分及患肢膝关节主动活动范围改变情况及镇痛药物的使用剂量。结果：使用视觉模拟评级法指导组取得了更好的膝关节活动情况的改善,同时其用镇痛药物药剂剂量较少,两组KSS评分无显著差异。结论：视觉模拟评级法对于关节置换手术后镇痛具有一定的参考价值,可以有效的改善患者的康复效果,并减少镇痛药物使用。     

Haptic/Graphic Rehabilitation: Integrating a Robot into a Virtual Environment Library and Applying it to Stroke Therapy

Recent research that tests interactive devices for prolonged therapy practice has revealed new prospects for robotics combined with graphical and other forms of biofeedback. Previous human-robot interactive systems have required different software commands to be implemented for each robot leading to unnecessary developmental overhead time each time a new system becomes available. For example, when a haptic/graphic virtual reality environment has been coded for one specific robot to provide haptic feedback, that specific robot would not be able to be traded for another robot without recoding the program. However, recent efforts in the open source community have proposed a wrapper class approach that can elicit nearly identical responses regardless of the robot used. The result can lead researchers across the globe to perform similar experiments using shared code. Therefore modular "switching out"of one robot for another would not affect development time. In this paper, we outline the successful creation and implementation of a wrapper class for one robot into the open-source H3DAPI, which integrates the software commands most commonly used by all robots.     

Bringing the Visible Universe into Focus with Robo-AO

The angular resolution of ground-based optical telescopes is limited by the degrading effects of the turbulent atmosphere. In the absence of an atmosphere, the angular resolution of a typical telescope is limited only by diffraction, i.e., the wavelength of interest, λ, divided by the size of its primary mirror''s aperture, D. For example, the Hubble Space Telescope (HST), with a 2.4-m primary mirror, has an angular resolution at visible wavelengths of ~0.04 arc seconds. The atmosphere is composed of air at slightly different temperatures, and therefore different indices of refraction, constantly mixing. Light waves are bent as they pass through the inhomogeneous atmosphere. When a telescope on the ground focuses these light waves, instantaneous images appear fragmented, changing as a function of time. As a result, long-exposure images acquired using ground-based telescopes - even telescopes with four times the diameter of HST - appear blurry and have an angular resolution of roughly 0.5 to 1.5 arc seconds at best.Astronomical adaptive-optics systems compensate for the effects of atmospheric turbulence. First, the shape of the incoming non-planar wave is determined using measurements of a nearby bright star by a wavefront sensor. Next, an element in the optical system, such as a deformable mirror, is commanded to correct the shape of the incoming light wave. Additional corrections are made at a rate sufficient to keep up with the dynamically changing atmosphere through which the telescope looks, ultimately producing diffraction-limited images.The fidelity of the wavefront sensor measurement is based upon how well the incoming light is spatially and temporally sampled¹. Finer sampling requires brighter reference objects. While the brightest stars can serve as reference objects for imaging targets from several to tens of arc seconds away in the best conditions, most interesting astronomical targets do not have sufficiently bright stars nearby. One solution is to focus a high-power laser beam in the direction of the astronomical target to create an artificial reference of known shape, also known as a ''laser guide star''. The Robo-AO laser adaptive optics system^2,3 employs a 10-W ultraviolet laser focused at a distance of 10 km to generate a laser guide star. Wavefront sensor measurements of the laser guide star drive the adaptive optics correction resulting in diffraction-limited images that have an angular resolution of ~0.1 arc seconds on a 1.5-m telescope.     

Behavioural robustness: a link between distributed mechanisms and coupled transient dynamics

The emergence of a unified cognitive behaviour relies on the coordination of specialized components that distribute across a ‘brain’, body and environment. Although a general dynamical mechanism involved in agent-environment integration is still largely unknown for behavioural robustness, discussions here are focussed on one of the most plausible candidate: the formation of distributed mechanisms working in transient during agent-environment coupling. This article provides discussions on this sort of coordination based on a mobile object-tracking task with situated, embodied and minimal agents, and tests for robust yet adaptive behaviour. The proposed scenario provides examples of behavioural mechanisms that counterbalance the functional organization of internal control activity and agents’ situatedness to enable the evolution of a two-agent interaction task. Discussions in this article suggest that future studies of distributed cognition should take into account that there are at least two possible modes of interpreting distributed mechanisms and that these have a qualitatively different effect on behavioural robustness.     

Rehabilitation of research chimpanzees: stress and coping after long-term isolation

We report on the permanent retirement of chimpanzees from biomedical research and on resocialization after long-term social isolation. Our aim was to investigate to what extent behavioral and endocrine measures of stress in deprived laboratory chimpanzees can be improved by a more species-typical social life style. Personality in terms of novelty responses, social dominance after resocialization and hormonal stress susceptibility were affected by the onset of maternal separation of infant chimpanzees and duration of deprivation. Chimpanzees, who were separated from their mothers at a younger age and kept in isolation for more years appeared to be more timid personalities, less socially active, less dominant and more susceptible to stress, as compared to chimpanzees with a less severe deprivation history. However, permanent retirement from biomedical research in combination with therapeutic resocialization maximizing chimpanzees' situation control resulted in reduced fecal cortisol metabolite levels. Our results indicate that chimpanzees can recover from severe social deprivation, and may experience resocialization as less stressful than solitary housing.     

The effects of electromyography-assisted modelling in estimating musculotendon forces during gait in children with cerebral palsy

Neuro-musculoskeletal modelling can provide insight into the aberrant muscle function during walking in those suffering cerebral palsy (CP). However, such modelling employs optimization to estimate muscle activation that may not account for disturbed motor control and muscle weakness in CP. This study evaluated different forms of neuro-musculoskeletal model personalization and optimization to estimate musculotendon forces during gait of nine children with CP (GMFCS I-II) and nine typically developing (TD) children. Data collection included 3D-kinematics, ground reaction forces, and electromyography (EMG) of eight lower limb muscles. Four different optimization methods estimated muscle activation and musculotendon forces of a scaled-generic musculoskeletal model for each child walking, i.e. (i) static optimization that minimized summed-excitation squared; (ii) static optimization with maximum isometric muscle forces scaled to body mass; (iii) an EMG-assisted approach using optimization to minimize summed-excitation squared while reducing tracking errors of experimental EMG-linear envelopes and joint moments; and (iv) EMG-assisted with musculotendon model parameters first personalized by calibration. Both static optimization approaches showed a relatively low model performance compared to EMG envelopes. EMG-assisted approaches performed much better, especially in CP, with only a minor mismatch in joint moments. Calibration did not affect model performance significantly, however it did affect musculotendon forces, especially in CP. A model more consistent with experimental measures is more likely to yield more physiologically representative results. Therefore, this study highlights the importance of calibrated EMG-assisted modelling when estimating musculotendon forces in TD children and even more so in children with CP.     

感觉统合训练结合常规康复训练对痉挛型脑瘫患儿平衡控制及运动功能的影响

目的:探讨感觉统合训练结合常规康复训练对痉挛型脑瘫患儿平衡控制及运动功能的影响。方法:选取2016年1月到2017年12月期间成都市妇女儿童中心医院康复科收治的痉挛型脑瘫患儿80例为研究对象,根据随机数字表法将80例患儿分为对照组(40例)和观察组(40例)。对照组患儿采用常规康复训练进行治疗,观察组患儿采用感觉统合训练结合常规康复训练进行治疗。比较两组脑瘫患儿的平衡控制功能、步态、粗大运动功能测试量表-88(GMFM-88)D区和E区的评分。结果:治疗3个月后两组患儿的Rivermead活动指数、Berg平衡量表得分均明显升高,且观察组患儿的Rivermead活动指数、Berg平衡量表得分高于对照组(P0.05)。治疗3个月后两组患儿的步行足长、步速明显增加,步宽明显减小(P0.05),且观察组患儿步行足长、步速大于对照组,步宽小于对照组(P0.05)。治疗3个月后两组患儿的GMFM-88 D区、GMFM-88 E区得分均分别明显升高(P0.05),且观察组患儿的GMFM-88 D区、GMFM-88 E区得分均分别高于对照组(P0.05)。结论:感觉统合训练结合常规康复训练可有效改善痉挛型脑瘫患儿的平衡控制功能、步态以及粗大运动功能。