Estimating Physical Assistance Need Using a Musculoskeletal Model.

Estimating Physical Assistance Need using a Musculoskeletal Model.

Filed under: Rehab Centers

IEEE Trans Biomed Eng. 2013 Feb 1;
Carmichael M, Liu D

Technologies that provide physical assistance during tasks are often required to provide assistance specific to the task and person performing it. An example is robotic rehabilitation in which the Assistance-As-Needed paradigm aims to provide operators with the minimum assistance required to perform the task. Current approaches use empirical performance-based methods which require repeated observation of the specific task before an estimate of the needed assistance can be determined. In this paper we present a new approach utilizing a musculoskeletal model of the upper limb to estimate the operators assistance needs with respect to physical tasks. With capabilities of the operator defined at the muscular level of the musculoskeletal model, an optimization model is used to estimate the operators strength capability. Strength required to perform a task is calculated using a task model. The difference or gap between the operators strength capability and the strength required to execute a task forms the basis for the new Assistance-As-Needed paradigm. We show how this approach estimates the effects of limb pose, load direction, and muscle impairments on a persons ability to perform tasks.
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Effect of Rehabilitation on a Child with Atlantoaxial Rotatory Fixation: A Case Report.

Filed under: Rehab Centers

Spine (Phila Pa 1976). 2013 Feb 1;
Hsu PT, Liou IH, Sun SF, Hwang CW, Wang JL

ABSTRACT: Study Design: Case report.Objective: To discuss a case of atlantoaxial rotatory fixation (AARF) successfully treated with manual therapy.Summary of Background Data: A 9-year-old girl suffered from acute torticollis and neck stiffness after a traffic accident. Image studies revealed atlantoaxial rotatory fixation, a cause of pediatric torticollis. She received closed reduction with the aid of C-arm fluoroscopy under general anesthesia. She was referred to the researchers’ rehabilitation clinic because of unsolved torticollis and limited head rotation. At her initial visit, we found that her head tilted to the right and rotated to the left. Tenderness and muscle guarding over the right suboccipital region were also apparent. The first manual therapy significantly improved neck motion after soft tissue release applying to the suboccipital muscle group.Methods: We arranged for her to enter a rehabilitation program including (1) soft tissue release technique to the suboccipital muscle group for 10 minutes, and (2) muscle energy technique for neck flexion, extension, lateral bending, and rotation for 10-15 minutes.Results: After 3 months’ rehabilitation, her symptoms of torticollis, neck pain, and limited range of motion achieved near-total recovery.Conclusion: This case report presenting the association between suboccipital muscles and AARF, suggesting that the soft tissue release of suboccipital muscle group may facilitate recovery from AARF. More studies are needed to verify the inferences of this case report.
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Satisfaction with life among veterans with spinal cord injuries completing multidisciplinary rehabilitation.

Filed under: Rehab Centers

Spinal Cord. 2013 Feb 5;
Fortmann AL, Rutledge T, Corey McCulloch R, Shivpuri S, Nisenzon AN, Muse J

Study Design:This is a single-group, retrospective study.Objectives:The objective of this study was to understand the factors contributing to satisfaction with life (SWL) among veterans with a spinal cord injury (SCI) completing rehabilitation.Setting:This study was conducted at Veterans Administration Medical Center, San Diego.MethodsBetween 1998 and 2010, N=118 Veterans participated in a Commission on Accreditation of Rehabilitation Facilities (CARF)-accredited rehabilitation program after a new SCI. Pre-rehabilitation measures of impairment at the organ/body level, activity limitation at the person level and participation restriction at the societal level were used to predict Satisfaction with Life Scale (SWLS) scores upon discharge.Results:Although overall mean SWLS admission and discharge scores were not significantly different (P>0.10), individual change in SWLS scores during rehabilitation was notable, ranging from a 17-point improvement to a 22-point decline across veterans (mean ?=+1.18, s.d.=6.04). Veterans who exhibited less activity limitation (higher cognitive functioning, r=0.31, P<0.01) and less participation restriction (greater social integration, r=0.21, P<0.05; a trend toward greater economic sufficiency, r=0.16, P<0.10) at baseline had higher SWLS scores after rehabilitation. When these factors were entered together into a single regression model, only cognitive functioning remained statistically significant (P<0.05).Conclusion:Findings highlight potential targets for interventions, aiming to improve SWL post SCI among US veterans. In addition to directly targeting SWL with psychosocial interventions, results suggest that rehabilitation settings should continue and/or expand upon programs targeting cognitive functioning (activity limitation) and social integration (participation restriction). Nevertheless, additional research is warranted to identify the biopsychosocial factors most reliably associated with SWL and/or other aspects of quality of life.Spinal Cord advance online publication, 5 February 2013; doi:10.1038/sc.2012.172. HubMed – rehab


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