Assessing the Effect of Game System for Rehabilitation on Rehabilitation of Autism and Cerebral Palsy

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Xu Qunxia

2015-01-01

Full Text Available This work presented a system to encourage children and adolescents with autism and cerebral palsy (CP to improve their abilities of self-care, mobility and sociality. A study was conducted with 51 children with autism and 36 children with CP using the Game System for Rehabilitation with Kinect at intervals of one month. The scope of this study was aimed to evaluate the effects of Game System for Rehabilitation in terms of self-care, mobility and social function of children and adolescents with autism and CP. Pediatric Evaluation of Disability Inventory (PEDI was used to determine the functional abilities of self-care, mobility and sociability. Data obtained allowed us to conclude that the positive effects of the Game System for Rehabilitation on the functional abilities of self-care, mobility and social function with disabilities were significant. The Game System for Rehabilitation applied for children and adolescents with autism and CP was effective for the targeted population. And it gives a new light for children with autism and CP to continue their rehabilitation successfully.

The European physical and rehabilitation medicine journal network: historical notes on national journals.

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Negrini, S; Ilieva, E; Moslavac, S; Zampolini, M; Giustini, A

2010-06-01

In the last 40 years, physical and rehabilitation medicine (PRM) has made significant steps forward in Europe with the foundation of the European Federation of Physical Medicine and Rehabilitation (EFPMR) (1963) which gave rise to the European Society of Physical and Rehabilitation Medicine (ESPRM) (2004) the European Academy of Rehabilitation Medicine (1970), the PRM Section of the European Union of Medical Specialists (1974), and the European Board of PRM (1991). Our journal, formerly Europa Medico-physica (1964), the official journal of the EFPMR, now European Journal of Physical and Rehabilitation Medicine (EJPRM) and official journal of the ESPRM since 2008, is distinct for its steadfast European vocation, long-standing Mediter-ranean interests and connections with various national scientific societies. Jointly with the ESPRM, efforts are under way to set up the European Physical and Rehabilitation Medicine Journal Network (EPRMJN). The aim of this article is to present a profile of the national journals in the EPRMJN so as to give a better overview of how the scientific part of PRM in Europe has developed within a national perspective. A profile of the following national journals is presented: Annals of Physical and Rehabilitation Medicine (France), Fizikalna i rehabilitacijska medicina (Physical and Rehabilitation Medicine) (Croatia), Neurorehabilitation (Bulgaria), Physical and Rehabilitation Medicine Portuguese Society Journal (Portugal), Physical Medicine, Rehabilitaton, Health (Bulgaria), Physikalische Medizin - Rehabilitationsmedizin - Kurort-medizin/Journal of Physical and Rehabilitation Medicine (Germany and Austria) Prevention and Rehabilitation (Bulgaria), Rehabilitacija (Rehabilitation) (Slovenia), Rehabilitación (Madr) (Spain), Turkish Journal of Physical Medicine and Rehabilitation (Turkey). Some national journals in Europe have a very long history and tradition of research and education. Having a better knowledge of these realities, usually

Adaptive rehabilitation games.

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Barzilay, Ouriel; Wolf, Alon

2013-02-01

In conventional neuromuscular rehabilitation, patients are required to perform biomechanical exercises to recover their neuromotor abilities. These physiotherapeutic tasks are defined by the physiotherapist, according to his estimate of the patient's pathologic neuromotor function. The definition of the task is mainly qualitative and it is often merely demonstrated to the patient as a gesture to reproduce. Success of the treatment relies then on the accuracy and repetition of the motor training. We propose a novel approach to neuromotor training by combining the advantages of a virtual reality platform with biofeedback information on the training subject from biometric equipment and with the computational power of artificial neural networks. In a calibration stage, the subject performs motor training on a known task to train the network. Once trained, the tuned network generates a new patient-specific task, based on the definition of the subject's expected performance dictated by the therapist. The system was tested for upper limb rehabilitation on healthy subjects. We measured a 33% improvement in the triceps performance (p = 0.027). The novelty of the proposed approach lies in its use of learning systems to the estimation of biological models. Copyright © 2012 Elsevier Ltd. All rights reserved.

An advanced rehabilitation robotic system for augmenting healthcare.

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Hu, John; Lim, Yi-Je; Ding, Ye; Paluska, Daniel; Solochek, Aaron; Laffery, David; Bonato, Paolo; Marchessault, Ronald

2011-01-01

Emerging technologies such as rehabilitation robots (RehaBot) for retraining upper and lower limb functions have shown to carry tremendous potential to improve rehabilitation outcomes. Hstar Technologies is developing a revolutionary rehabilitation robot system enhancing healthcare quality for patients with neurological and muscular injuries or functional impairments. The design of RehaBot is a safe and robust system that can be run at a rehabilitation hospital under the direct monitoring and interactive supervision control and at a remote site via telepresence operation control. RehaBot has a wearable robotic structure design like exoskeleton, which employs a unique robotic actuation--Series Elastic Actuator. These electric actuators provide robotic structural compliance, safety, flexibility, and required strength for upper extremity dexterous manipulation rehabilitation training. RehaBot also features a novel non-treadmill paddle platform capable of haptics feedback locomotion rehabilitation training. In this paper, we concern mainly about the motor incomplete patient and rehabilitation applications.

Rehabilitation of People with a Brain Injury Through the Lens of Networked Learning

DEFF Research Database (Denmark)

Konnerup, Ulla; Castro Rojas, Maria Dolores; Bygholm, Ann

2016-01-01

This paper will demonstrate how avatar-mediated interactions and learning in networks might lead to identity formation and rehabilitation of language after a brain injury. With references to Vygotsky's notion of the social origins of higher mental functions (1978) and Hutchins claims that cognition...... the development of rehabilitation; and, conversely, how our finding add perspectives to NL. In doing so, we will introduce the concept of locale framework, and how a specific setting and embodied interactions might trigger autobiographical memory, relearning communication competencies and renegotiation...

Rehabilitation of a secondary network of forest traffic infrastructure (skid roads - skid trails

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Bajrić Muhamed

2015-01-01

Full Text Available Forest transport infrastructure is the key segment of rational forest resource management. One of its constituent and inseparable segments are skid roads and skid trails whose network density significantly exceeds the primary network, i.e. truck roads. Skid road -skid trail network density in high economic forests of FB&H is most often between 40 and 100 m/ha. Simplified way of construction, non-existence of road construction, objects for surface water drainage as well as significant longitudinal inclination (up to 50% in which they are constructed, makes them subject to erosion processes. The lack of rehabilitation measures on skid roads - skid trails causes significant damages in post-exploitation period, and very often to the extent that the ones in the following exploitation round are unusable for skidding. Utilization of skid roads - skid trails damaged by erosion processes for forest operations often represents a significant expense. This paper considers rehabilitation measures efficient from the point of remedying erosion processes, and at the same time, acceptable from the point of financial expenditure for forest operations.

Performance of freestanding inpatient rehabilitation hospitals before and after the rehabilitation prospective payment system.

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Thompson, Jon M; McCue, Michael J

2010-01-01

Inpatient rehabilitation hospitals provide important services to patients to restore physical and cognitive functioning. Historically, these hospitals have been reimbursed by Medicare under a cost-based system; but in 2002, Medicare implemented a rehabilitation prospective payment system (PPS). Despite the implementation of a PPS for rehabilitation, there is limited published research that addresses the operating and financial performance of these hospitals. We examined operating and financial performance in the pre- and post-PPS periods for for-profit and nonprofit freestanding inpatient rehabilitation hospitals to test for pre- and post-PPS differences within the ownership groups. We identified freestanding inpatient rehabilitation hospitals from the Centers for Medicare and Medicaid Services Health Care Cost Report Information System database for the first two fiscal years under PPS. We excluded facilities that had fiscal years less than 270 days, facilities with missing data, and government facilities. We computed average values for performance variables for the facilities in the two consecutive fiscal years post-PPS. For the pre-PPS period, we collected data on these same facilities and, once facilities with missing data and fiscal years less than 270 days were excluded, computed average values for the two consecutive fiscal years pre-PPS. Our final sample of 140 inpatient rehabilitation facilities was composed of 44 nonprofit hospitals and 96 for-profit hospitals both pre- and post-PPS. We utilized a pairwise comparison test (t-test comparison) to measure the significance of differences on each performance variable between pre- and post-PPS periods within each ownership group. Findings show that both nonprofit and for-profit freestanding inpatient rehabilitation hospitals reduced length of stay, increased discharges, and increased profitability. Within the for-profit ownership group, the percentage of Medicare discharges increased and operating expense per

Development of a Portable Gait Rehabilitation System for Home-Visit Rehabilitation

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Hiroaki Yano

2015-01-01

Full Text Available This paper describes the development of a gait rehabilitation system with a locomotion interface (LI for home-visit rehabilitation. For this purpose, the LI should be compact, small, and easy to move. The LI has two 2 degree-of-freedom (DOF manipulators with footpads to move each foot along a trajectory. When the user stands on the footpads, the system can move his or her feet while the body remains stationary. The footpads can have various trajectories, which are prerecordings of the movements of healthy individuals walking on plane surfaces or slopes. The homes of stroke patients may have not only flat surfaces but also some slopes and staircases. The quadriceps femoris muscle is important for walking up and down slopes and staircases, and the eccentric and concentric contractions of this muscle are, in particular, difficult to train under normal circumstances. Therefore, we developed a graded-walking program for the system used in this study. Using this system, the user can undergo gait rehabilitation in their home, during visits by a physical therapist. An evaluation of the results of tests showed that the vastus medialis muscles of all the subjects were stimulated more than by walking on real slopes.

Customizable Rehabilitation Lower Limb Exoskeleton System

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Riaan Stopforth

2012-10-01

Full Text Available Disabled people require assistance with the motion of their lower limbs to improve rehabilitation. Exoskeletons used for lower limb rehabilitation are highly priced and are not affordable to the lowerincome sector of the population. This paper describes an exoskeleton lower limb system that was designed keeping in mind that the cost must be as low as possible. The forward kinematic system that is used must be a simplified model to decrease computational time, yet allow the exoskeleton to be adjustable according to the patient's leg dimensions.

Communication Framework for Tele-rehabilitation Systems with QoS Guarantee

OpenAIRE

Dandanov Nikolay; Semov Plamen; Ivanov Antoni; Christoff Nicole; Poulkov Vladimir

2017-01-01

Nowadays, there is great interest in developing telemedicine technologies. These technologies will provide health care from distance swiftly and lightly, as well as reduce the expenses for activities, such as rehabilitation. Telemedicine applications are possible due to the advances in information technologies and the ever-expanding communication network infrastructure. The network characteristics bandwidth, packet loss, latency, jitter and policies are crucial for the performance of tele-reh...

Achievement report for fiscal 1999 on research and development of technologies for medical welfare equipment. Home rehabilitation system for aphasia patients; 1999 nendo iryo fukushi kiki gijutsu kenkyu kaihatsu seika hokokusho. Shitsugosho zaitaku rehabilitation shien system

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-05-01

Element technologies under development involve (1) an authoring system for assistance program processing, (2) self-training system for supporting home rehabilitation, (3) human interface for aphasia patients and caregivers, (4) remote rehabilitation evaluation and diagnosis supporting system, and (5) a communication assisting system. Under item (1), a material incorporating interface, training contents layout and combination function, and general-purpose interface specifications are determined, and a one-piece system is designed and developed. Under item (2), a self-training player that behaves in compliance with the authoring specifications is designed and developed. Under item (3), a secondary unit is fabricated on the assumption of its use at an actual treatment scene. Under item (4), remotely controlled two-way face-to-face communication, camera control, shared operation of a training player, training scenario transfer component, etc., are developed and, furthermore, a one-piece system is designed and developed to support the therapist's rehabilitation assessment and diagnosis in coordination with the above-mentioned remotely controlled functions. Under item (5), a network communication component and an auxiliary function using voice synthesis are added for designing and developing a one-piece system that enables long-distance communication between the therapist and patients. (NEDO)

Adaptive rehabilitation gaming system: on-line individualization of stroke rehabilitation.

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Nirme, Jens; Duff, Armin; Verschure, Paul F M J

2011-01-01

The effects of stroke differ considerably in degree and symptoms for different patients. It has been shown that specific, individualized and varied therapy favors recovery. The Rehabilitation Gaming System (RGS) is a Virtual Reality (VR) based rehabilitation system designed following these principles. We have developed two algorithms to control the level of task difficulty that a user of the RGS is exposed to, as well as providing controlled variation in the therapy. In this paper, we compare the two algorithms by running numerical simulations and a study with healthy subjects. We show that both algorithms allow for individualization of the challenge level of the task. Further, the results reveal that the algorithm that iteratively learns a user model for each subject also allows a high variation of the task.

Web-based home rehabilitation gaming system for balance training

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Oleh Kachmar

2014-06-01

Full Text Available Currently, most systems for virtual rehabilitation and motor training require quite complex and expensive hardware and can be used only in clinical settings. Now, a low-cost rehabilitation game training system has been developed for patients with movement disorders; it is suitable for home use under the distant supervision of a therapist. It consists of a patient-side application installed on a home computer and the virtual rehabilitation Game Server in the Internet. System can work with different input gaming devices connected through USB or Bluetooth, such as a Nintendo Wii balance board, a Nintendo Wii remote, a MS Kinect sensor, and custom made rehabilitation gaming devices based on a joystick. The same games can be used with all training devices. Assessment of the Home Rehabilitation Gaming System for balance training was performed on six patients with Cerebral Palsy, who went through daily training sessions for two weeks. Preliminary results showed balance improvement in patients with Cerebral Palsy after they had completed home training courses. Further studies are needed to establish medical requirements and evidence length.

Problematising risk in stroke rehabilitation.

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Egan, Mary Y; Kessler, Dorothy; Ceci, Christine; Laliberté-Rudman, Debbie; McGrath, Colleen; Sikora, Lindsey; Gardner, Paula

2016-11-01

Following stroke, re-engagement in personally valued activities requires some experience of risk. Risk, therefore, must be seen as having positive as well as negative aspects in rehabilitation. Our aim was to identify the dominant understanding of risk in stroke rehabilitation and the assumptions underpinning these understandings, determine how these understandings affect research and practise, and if necessary, propose alternate ways to conceptualise risk in research and practise. Alvesson and Sandberg's method of problematisation was used. We began with a historical overview of stroke rehabilitation, and proceeded through five steps undertaken in an iterative fashion: literature search and selection; data extraction; syntheses across texts; identification of assumptions informing the literature and; generation of alternatives. Discussion of risk in stroke rehabilitation is largely implicit. However, two prominent conceptualisations of risk underpin both knowledge development and clinical practise: the risk to the individual stroke survivor of remaining dependent in activities of daily living and the risk that the health care system will be overwhelmed by the costs of providing stroke rehabilitation. Conceptualisation of risk in stroke rehabilitation, while implicit, drives both research and practise in ways that reinforce a focus on impairment and a generic, decontextualised approach to rehabilitation. Implications for rehabilitation Much of stroke rehabilitation practise and research seems to centre implicitly on two risks: risk to the patient of remaining dependent in ADL and risk to the health care system of bankruptcy due to the provision of stroke rehabilitation. The implicit focus on ADL dependence limits the ability of clinicians and researchers to address other goals supportive of a good life following stroke. The implicit focus on financial risk to the health care system may limit access to rehabilitation for people who have experienced either milder or

Development of a program for tele-rehabilitation of COPD patients across sectors: co-innovation in a network

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Birthe Dinesen

2011-03-01

Full Text Available Introduction: The aim of the Telekat project is to prevent re-admissions of patients with chronic obstructive pulmonary disease (COPD by developing a preventive programof tele-rehabilitation across sectors for COPD patients. The development of the program is based on a co-innovation process between COPD patients, relatives, healthcare professionals and representatives from private firms and universities. This paper discusses theobstacles that arise in the co-innovation process of developing an integrated technique for tele-rehabilitation of COPD patients.Theory: Network and innovation theory.Methods: The casestudy was applied. A triangulation of data collection techniques was used: documents, observations (123 hours, qualitative interviews (n=32 and action research.Findings: Obstacles were identified in the network context; these obstacles included the mindset of the healthcare professionals, inter-professionals relations, views of technology as a tool and competing visions for the goals of tele-rehabilitation.Conclusion: We have identified obstacles that emerge in the co-innovation process when developing a programme for tele-rehabilitation of COPD patients in an inter-organizational context. Action research has been carried out and can have helped to facilitate the co-innovation process.

Home-based mobile cardio-pulmonary rehabilitation consultant system.

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Lee, Hsu-En; Wang, Wen-Chih; Lu, Shao-Wei; Wu, Bo-Yuan; Ko, Li-Wei

2011-01-01

Cardiovascular diseases are the most popular cause of death in the world recently. For postoperatives, cardiac rehabilitation is still asked to maintain at home (phase II) to improve cardiac function. However, only one third of outpatients do the exercise regularly, reflecting the difficulty for home-based healthcare: lacking of monitoring and motivation. Hence, a cardio-pulmonary rehabilitation system was proposed in this research to improve rehabilitation efficiency for better prognosis. The proposed system was built on mobile phone and receiving electrocardiograph (ECG) signal from a wireless ECG holter via Bluetooth connection. Apart from heart rate (HR) monitor, an ECG derived respiration (EDR) technique is also included to provide respiration rate (RR). Both HR and RR are the most important vital signs during exercise but only used one physiological signal recorder in this system. In clinical test, there were 15 subjects affording Bruce Task (treadmill) to simulate rehabilitation procedure. Correlation between this system and commercial product (Custo-Med) was up to 98% in HR and 81% in RR. Considering the prevention of sudden heart attack, an arrhythmia detection expert system and healthcare server at the backend were also integrated to this system for comprehensive cardio-pulmonary monitoring whenever and wherever doing the exercise.

EEG-based motor network biomarkers for identifying target patients with stroke for upper limb rehabilitation and its construct validity.

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Chun-Chuan Chen

Full Text Available Rehabilitation is the main therapeutic approach for reducing poststroke functional deficits in the affected upper limb; however, significant between-patient variability in rehabilitation efficacy indicates the need to target patients who are likely to have clinically significant improvement after treatment. Many studies have determined robust predictors of recovery and treatment gains and yielded many great results using linear approachs. Evidence has emerged that the nonlinearity is a crucial aspect to study the inter-areal communication in human brains and abnormality of oscillatory activities in the motor system is linked to the pathological states. In this study, we hypothesized that combinations of linear and nonlinear (cross-frequency network connectivity parameters are favourable biomarkers for stratifying patients for upper limb rehabilitation with increased accuracy. We identified the biomarkers by using 37 prerehabilitation electroencephalogram (EEG datasets during a movement task through effective connectivity and logistic regression analyses. The predictive power of these biomarkers was then tested by using 16 independent datasets (i.e. construct validation. In addition, 14 right handed healthy subjects were also enrolled for comparisons. The result shows that the beta plus gamma or theta network features provided the best classification accuracy of 92%. The predictive value and the sensitivity of these biomarkers were 81.3% and 90.9%, respectively. Subcortical lesion, the time poststroke and initial Wolf Motor Function Test (WMFT score were identified as the most significant clinical variables affecting the classification accuracy of this predictive model. Moreover, 12 of 14 normal controls were classified as having favourable recovery. In conclusion, EEG-based linear and nonlinear motor network biomarkers are robust and can help clinical decision making.

Assistive and Rehabilitation Robotic System

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Adrian Abrudean

2015-06-01

Full Text Available A short introduction concerning the content of Assistive Technology and Rehabilitation Engineering is followed by a study of robotic systems which combine two or more assistive functions. Based on biomechanical aspects, a complex robotic system is presented, starting with the study of functionality and ending with the practical aspects of the prototype development.

[The mirror neuron system in motor and sensory rehabilitation].

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Oouchida, Yutaka; Izumi, Shinichi

2014-06-01

The discovery of the mirror neuron system has dramatically changed the study of motor control in neuroscience. The mirror neuron system provides a conceptual framework covering the aspects of motor as well as sensory functions in motor control. Previous studies of motor control can be classified as studies of motor or sensory functions, and these two classes of studies appear to have advanced independently. In rehabilitation requiring motor learning, such as relearning movement after limb paresis, however, sensory information of feedback for motor output as well as motor command are essential. During rehabilitation from chronic pain, motor exercise is one of the most effective treatments for pain caused by dysfunction in the sensory system. In rehabilitation where total intervention unifying the motor and sensory aspects of motor control is important, learning through imitation, which is associated with the mirror neuron system can be effective and suitable. In this paper, we introduce the clinical applications of imitated movement in rehabilitation from motor impairment after brain damage and phantom limb pain after limb amputation.

Coordination of a complex welfare system case: rehabilitation entity in Finland.

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Miettinen, Sari; Ashorn, Ulla; Lehto, Juhani; Viitanen, Elina

2011-01-01

The main purpose of this article is to analyse the institutional and political structures of the Finnish rehabilitation entity and the governmental efforts to improve the governance of the rehabilitation policy. Rehabilitation in Finland is a complex welfare system which has undergone several coordination attempts during the last two decades. The centrality of the coordination of this welfare system is obvious. Based on the content analysis of three Government's rehabilitation reports from 1994 to 2002 and their background papers, this article provides two main findings. First, the rehabilitation entity seems to be based on different funding strategies, different governing and different coordination models between the rehabilitation subsystems. Second, the governance discourse in the reports seems to be unchanging with a predominantly hierarchical mode. The article concludes with a discussion on the challenges to coordinate this kind of a complex welfare system as an entity and also how to overcome those challenges. Copyright © 2010 John Wiley & Sons, Ltd.

Computer-based cognitive rehabilitation: the CoRe system.

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Alloni, Anna; Sinforiani, Elena; Zucchella, Chiara; Sandrini, Giorgio; Bernini, Sara; Cattani, Barbara; Pardell, Daniela Tost; Quaglini, Silvana; Pistarini, Caterina

2017-02-01

This work aims at providing a tool for supporting cognitive rehabilitation. This is a wide field, that includes a variety of diseases and related clinical pictures; for this reason the need arises to have a tool available that overcomes the difficulties entailed by what currently is the most common approach, that is, the so-called pen and paper rehabilitation. We first organized a big number of stimuli in an ontology that represents concepts, attributes and a set of relationships among concepts. Stimuli may be words, sounds, 2D and 3D images. Then, we developed an engine that automatically generates exercises by exploiting that ontology. The design of exercises has been carried on in synergy with neuropsychologists and speech therapists. Solutions have been devised aimed at personalizing the exercises according to both patients' preferences and performance. Exercises addressed to rehabilitation of executive functions and aphasia-related diseases have been implemented. The system has been tested on both healthy volunteers (n = 38) and patients (n = 9), obtaining a favourable rating and suggestions for improvements. We created a tool able to automate the execution of cognitive rehabilitation tasks. We hope the variety and personalization of exercises will allow to increase compliance, particularly from elderly people, usually neither familiar with technology nor particularly willing to rely on it. The next step involves the creation of a telerehabilitation tool, to allow therapy sessions to be undergone from home, thus guaranteeing continuity of care and advantages in terms of time and costs for the patients and the National Healthcare System (NHS). Implications for rehabilitation Cognitive impairments can greatly impact an individual's existence, appreciably reducing his abilities and autonomy, as well as sensibly lowering his quality of life. Cognitive rehabilitation can be used to restore lost brain function or slow down degenerative diseases

Selected methods of rehabilitation in systemic sclerosis

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Agnieszka Gerkowicz

2017-09-01

Full Text Available Systemic sclerosis is a chronic connective tissue disease characterized by microvascular abnormalities, immune disturbances and progressive fibrosis of the skin and internal organs. Skin involvement may result in contractures, leading to marked loss of hand mobility, adversely affecting the performance of daily activities and decreasing the quality of life. Face involvement not only causes functional loss, but also lowers the self-esteem of patients. Increasing attention has recently been focused on the need to rehabilitate patients with systemic sclerosis in order to prevent the development of joint contractures and loss of mobility. The study presents a review of the current literature on rehabilitation possibilities in patients with systemic sclerosis, with a special focus on physiotherapy methods.

[Research and Development of A Kinect Based Virtual System for Upper Limb Rehabilitation].

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Ding, Weili; Zheng, Yazhuo; Su, Yuping; Li, Xiaoli; Wei, Xiuli

2015-06-01

We developed a rehabilitation system by using the virtual reality technique and the Kinect in this paper. The system combines rehabilitation training with HMI and serious game organically, and provides a game and motion database to meet different patients' demands. Extended interface of game database is provided in two ways: personalized games can be developed by Virtools and Flash games which are suitable for patients' rehabilitation can be download from the Internet directly. In addition, the system provides patients with flexible interaction and easy control mode, and also presents real time data recording. An objective and subjective evaluation method is proposed to review the effectiveness of the rehabilitation training. According to the results of short questionnaires and the evaluation results of patients' rehabilitation training, the system compared with traditional rehabilitation can record and analyze the training data, which is useful to make rehabilitation plans. More entertainment and lower cost will increase patients' motivation, which helps to increase the rehabilitation effectiveness.

An emerging occupational rehabilitation system in the People's Republic of China.

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Tang, Dan; Chen, Gang; Xu, Yan-Wen; Hui-Lo, Karen Y L; Luo, Xiao-Yuan; Chan, Chetwyn C H

2011-03-01

China has become a major economic influence in Asia and globally. The country is in the position to further develop its workers' insurance and compensation system. This paper aims to introduce the existing workers' compensation policies, explain how these policies guide the operation of the occupational rehabilitation system for injured workers, and suggest ways to further develop an effective and sustainable system for the country. Major government policies and initiative documents and existing literature on occupational rehabilitation were critically reviewed. Shortfalls in our current system were identified and potential further development regimes were propose. Since 2004, China has implemented its national policy on providing timely and comprehensive rehabilitation and return-to-work interventions for workers who are injured at work. The three-tier medical and occupational rehabilitation system appears effective for enabling injured workers to access these services. Such a system is regarded as the most optimal for the country in spearheading the development of quality occupational rehabilitation services, and at the same time incorporating the existing expertise in acute medical care and rehabilitation within the public medical and health system. Problems encountered in the system can be classified under the culture, system and competence building aspects. The future workers' insurance and compensation system can probably put more emphasis on using bio-psychosocial and work disability prevention models in guiding its service development and delivery. Efforts need to be placed on building the competence of professionals in the system who provide services for injured workers. The empowerment of important stakeholders in the workers' insurance and compensation system and their inclusion in the planning of service delivery are crucial for developing a sustainable and effective system for China.

Hand Rehabilitation Learning System With an Exoskeleton Robotic Glove.

Science.gov (United States)

Ma, Zhou; Ben-Tzvi, Pinhas; Danoff, Jerome

2016-12-01

This paper presents a hand rehabilitation learning system, the SAFE Glove, a device that can be utilized to enhance the rehabilitation of subjects with disabilities. This system is able to learn fingertip motion and force for grasping different objects and then record and analyze the common movements of hand function including grip and release patterns. The glove is then able to reproduce these movement patterns in playback fashion to assist a weakened hand to accomplish these movements, or to modulate the assistive level based on the user's or therapist's intent for the purpose of hand rehabilitation therapy. Preliminary data have been collected from healthy hands. To demonstrate the glove's ability to manipulate the hand, the glove has been fitted on a wooden hand and the grasping of various objects was performed. To further prove that hands can be safely driven by this haptic mechanism, force sensor readings placed between each finger and the mechanism are plotted. These experimental results demonstrate the potential of the proposed system in rehabilitation therapy.

An interactive game-based shoulder wheel system for rehabilitation

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Chou LW

2012-11-01

Full Text Available Chun-Ming Chang,1,* Yen-Ching Chang,2,3 Hsiao-Yun Chang,4 Li-Wei Chou5,6,* 1Department of Applied Informatics and Multimedia, Asia University, Taichung, Taiwan; 2Department of Medical Informatics, Chung Shan Medical University, Taichung, Taiwan; 3Department of Medical Imaging, Chung Shan Medical University Hospital, Taichung, Taiwan; 4Department of Biotechnology, Asia University, Taichung, Taiwan; 5Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan; 6School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan*These authors contributed equally to this workBackground: Increases in the aging population and in the number of accidents have resulted in more people suffering from physical impairments or disabilities. Rehabilitation therapy thus attracts greater attention as a means of helping patients recover and return to a normal life. With the extremely long and tedious nature of traditional rehabilitation, patients are reluctant to continue the entire process, thus the expected effects of the therapy cannot be obtained. Games are well known to help patients improve their concentration and shift their attention away from the discomfort of their injuries during rehabilitation. Thus, incorporating game technology into a rehabilitation program may be a promising approach.Methods: In this study, a gaming system used for shoulder rehabilitation was developed. The mechanical parts and electric circuits were integrated to mimic the functionalities of a shoulder wheel. Several games were also designed to suit the rehabilitation needs of the patients based on the age and gender differences among the individual users, enabling individuals to undergo the rehabilitation process by playing games. Two surveys were conducted to evaluate the satisfaction of the participants regarding the gaming system.Results: The results of the online survey among a larger population

Functional organization and restoration of the brain motor-execution network after stroke and rehabilitation

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Sahil eBajaj

2015-03-01

Full Text Available Multiple cortical areas of the human brain motor system interact coherently in the low frequency range (< 0.1 Hz, even in the absence of explicit tasks. Following stroke, cortical interactions are functionally disturbed. How these interactions are affected and how the functional organization is regained from rehabilitative treatments as people begin to recover motor behaviors has not been systematically studied. We recorded the intrinsic functional magnetic resonance imaging (fMRI signals from 30 participants: 17 young healthy controls and 13 aged stroke survivors. Stroke participants underwent mental practice (MP or both mental practice and physical therapy (MP + PT within 14-51 days following stroke. We investigated the network activity of five core areas in the motor-execution network, consisting of the left primary motor area (LM1, the right primary motor area (RM1, the left pre-motor cortex (LPMC, the right pre-motor cortex (RPMC and the supplementary motor area (SMA. We discovered that (i the network activity dominated in the frequency range 0.06 Hz – 0.08 Hz for all the regions, and for both able-bodied and stroke participants (ii the causal information flow between the regions: LM1 and SMA, RPMC and SMA, RPMC and LM1, SMA and RM1, SMA and LPMC, was reduced significantly for stroke survivors (iii the flow did not increase significantly after MP alone and (iv the flow among the regions during MP+PT increased significantly. We also found that sensation and motor scores were significantly higher and correlated with directed functional connectivity measures when the stroke-survivors underwent MP+PT but not MP alone. The findings provide evidence that a combination of mental practice and physical therapy can be an effective means of treatment for stroke survivors to recover or regain the strength of motor behaviors, and that the spectra of causal information flow can be used as a reliable biomarker for evaluating rehabilitation in stroke

Exploring the bases for a mixed reality stroke rehabilitation system, Part II: design of interactive feedback for upper limb rehabilitation.

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Lehrer, Nicole; Chen, Yinpeng; Duff, Margaret; L Wolf, Steven; Rikakis, Thanassis

2011-09-08

Few existing interactive rehabilitation systems can effectively communicate multiple aspects of movement performance simultaneously, in a manner that appropriately adapts across various training scenarios. In order to address the need for such systems within stroke rehabilitation training, a unified approach for designing interactive systems for upper limb rehabilitation of stroke survivors has been developed and applied for the implementation of an Adaptive Mixed Reality Rehabilitation (AMRR) System. The AMRR system provides computational evaluation and multimedia feedback for the upper limb rehabilitation of stroke survivors. A participant's movements are tracked by motion capture technology and evaluated by computational means. The resulting data are used to generate interactive media-based feedback that communicates to the participant detailed, intuitive evaluations of his performance. This article describes how the AMRR system's interactive feedback is designed to address specific movement challenges faced by stroke survivors. Multimedia examples are provided to illustrate each feedback component. Supportive data are provided for three participants of varying impairment levels to demonstrate the system's ability to train both targeted and integrated aspects of movement. The AMRR system supports training of multiple movement aspects together or in isolation, within adaptable sequences, through cohesive feedback that is based on formalized compositional design principles. From preliminary analysis of the data, we infer that the system's ability to train multiple foci together or in isolation in adaptable sequences, utilizing appropriately designed feedback, can lead to functional improvement. The evaluation and feedback frameworks established within the AMRR system will be applied to the development of a novel home-based system to provide an engaging yet low-cost extension of training for longer periods of time.

Advancing the application of systems thinking in health: analysing the contextual and social network factors influencing the use of sustainability indicators in a health system--a comparative study in Nepal and Somaliland.

Science.gov (United States)

Blanchet, Karl; Palmer, Jennifer; Palanchowke, Raju; Boggs, Dorothy; Jama, Ali; Girois, Susan

2014-08-26

Health systems strengthening is becoming a key component of development agendas for low-income countries worldwide. Systems thinking emphasizes the role of diverse stakeholders in designing solutions to system problems, including sustainability. The objective of this paper is to compare the definition and use of sustainability indicators developed through the Sustainability Analysis Process in two rehabilitation sectors, one in Nepal and one in Somaliland, and analyse the contextual factors (including the characteristics of system stakeholder networks) influencing the use of sustainability data. Using the Sustainability Analysis Process, participants collectively clarified the boundaries of their respective systems, defined sustainability, and identified sustainability indicators. Baseline indicator data was gathered, where possible, and then researched again 2 years later. As part of the exercise, system stakeholder networks were mapped at baseline and at the 2-year follow-up. We compared stakeholder networks and interrelationships with baseline and 2-year progress toward self-defined sustainability goals. Using in-depth interviews and observations, additional contextual factors affecting the use of sustainability data were identified. Differences in the selection of sustainability indicators selected by local stakeholders from Nepal and Somaliland reflected differences in the governance and structure of the present rehabilitation system. At 2 years, differences in the structure of social networks were more marked. In Nepal, the system stakeholder network had become more dense and decentralized. Financial support by an international organization facilitated advancement toward self-identified sustainability goals. In Somaliland, the small, centralised stakeholder network suffered a critical rupture between the system's two main information brokers due to competing priorities and withdrawal of international support to one of these. Progress toward self

Game System for Rehabilitation Based on Kinect is Effective for Mental Retardation

Directory of Open Access Journals (Sweden)

Fu Ying

2015-01-01

Full Text Available Kinect has already been widely used in the area of retardation, and this study is to evaluate whether the Game System for Rehabilitation based on Kinect is effective for children with mental retardation. The subjects in this paper are 112 children with mental retardation in Zhejiang province of China. The Game System for Rehabilitation based on Kinect was applied to assist the rehabilitation of children. Before the training, the Pediatric Evaluation of Disability Inventory (PEDI was used to evaluate abilities of children, including self-care, mobility, and social function. And after having been trained for a month, the abilities of these children were evaluated again by PEDI. The results in this paper is that, after the application of Game System for Rehabilitation based on Kinect, the PEDI score of children is significantly higher than the score before training. And it can be concluded that the Game System for Rehabilitation based on Kinect can significantly improve self-care, mobility, and social function of children with MR.

A Wireless Posture Monitoring System for Personalized Home-Based Rehabilitation

Directory of Open Access Journals (Sweden)

Pedro Macedo

2015-06-01

Full Text Available We live in an aging society, an issue that will be exacerbated in the coming decades, due to low birth rates and increasing life expectancy. With the decline in physical and cognitive functions with age, it is of the utmost importance to maintain regular physical activity, in order to preserve an individual’s mobility, motor capabilities and coordination. Within this context, this paper describes the development of a wireless sensor network and its application in a human motion capture system based on wearable inertial and magnetic sensors. The goal is to enable, through continuous real- time monitoring, the creation of a personalized home-based rehabilitation system for the elderly population and/or injured people. Within this system, the user can benefit from an assisted mode, in which their movements can be compared to a reference motion model of the same movements, resulting in visual feedback alerts given by the application. This motion model can be created previously, in a ‘learning phase’, under supervision of a caregiver.

Exoskeleton Technology in Rehabilitation: Towards an EMG-Based Orthosis System for Upper Limb Neuromotor Rehabilitation

Directory of Open Access Journals (Sweden)

Luis Manuel Vaca Benitez

2013-01-01

Full Text Available The rehabilitation of patients should not only be limited to the first phases during intense hospital care but also support and therapy should be guaranteed in later stages, especially during daily life activities if the patient’s state requires this. However, aid should only be given to the patient if needed and as much as it is required. To allow this, automatic self-initiated movement support and patient-cooperative control strategies have to be developed and integrated into assistive systems. In this work, we first give an overview of different kinds of neuromuscular diseases, review different forms of therapy, and explain possible fields of rehabilitation and benefits of robotic aided rehabilitation. Next, the mechanical design and control scheme of an upper limb orthosis for rehabilitation are presented. Two control models for the orthosis are explained which compute the triggering function and the level of assistance provided by the device. As input to the model fused sensor data from the orthosis and physiology data in terms of electromyography (EMG signals are used.

76 FR 59256 - Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal...

Science.gov (United States)

2011-09-26

...; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2012; Changes in Size... [CMS-1349-CN] RIN 0938-AQ28 Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2012; Changes in Size and Square Footage of Inpatient Rehabilitation Units...

[Interactive augmented reality systems : Aid for personalized patient education and rehabilitation].

Science.gov (United States)

Bork, F

2018-04-01

During patient education, information exchange plays a critical role both for patient compliance during medical or rehabilitative treatment and for obtaining an informed consent for an operative procedure. In this article the augmented reality system "Magic Mirror" as an additive tool during patient education, rehabilitation as well as anatomical education is highlighted. The Magic Mirror system allows the user of the system to inspect both a detailed model of the 3‑dimensional anatomy of the human body and volumetric slice images in a virtual mirror environment. First preliminary results from the areas of rehabilitation and learning anatomy indicate the broad potential of the Magic Mirror. Similarly, the system also provides interesting advantages for patient education situations in comparison to traditional methods of information exchange. Novel technologies, such as augmented reality are a door opener for many innovations in medicine. In the future, patient-specific systems, such as the Magic Mirror will be used increasingly more in areas such as patient education and rehabilitation. In order to maximize the benefits of such systems, further evaluation studies are necessary to find out about the best use cases and to start an iterative optimization process of these systems.

BCI-FES system for neuro-rehabilitation of stroke patients

Science.gov (United States)

Jure, Fabricio A.; Carrere, Lucía C.; Gentiletti, Gerardo G.; Tabernig, Carolina B.

2016-04-01

Nowadays, strokes are a growing cause of mortality and many people remain with motor sequelae and troubles in the daily activities. To treat this sequelae, alternative rehabilitation techniques are needed. In this article a Brain Computer Interface (BCI) system to control a Functional Electrical Stimulation (FES) system is presented. It can be used as a novel tool in easy setup clinical routines, to improve the rehabilitation process by mean of detecting patient´s motor intention, performing it by FES and finally receiving appropriate feedback The BCI-FES system presented here, consists of three blocks: the first one decodes the patient´s intention and it is composed by the patient, the acquisition hardware and the processing software (Emotiv EPOC®). The second block, based on Arduino’s technology, transforms the information into a valid command signal. The last one excites the patient´s neuromuscular system by means of a FES device. In order to evaluate the cerebral activity sensed by the device, topographic maps were obtained. The BCI-FES system was able to detect the patient´s motor intention and control the FES device. At the time of this publication, the system it’s being employing in a rehabilitation program with patients post stroke.

A novel upper limb rehabilitation system with self-driven virtual arm illusion.

Science.gov (United States)

Aung, Yee Mon; Al-Jumaily, Adel; Anam, Khairul

2014-01-01

This paper proposes a novel upper extremity rehabilitation system with virtual arm illusion. It aims for fast recovery from lost functions of the upper limb as a result of stroke to provide a novel rehabilitation system for paralyzed patients. The system is integrated with a number of technologies that include Augmented Reality (AR) technology to develop game like exercise, computer vision technology to create the illusion scene, 3D modeling and model simulation, and signal processing to detect user intention via EMG signal. The effectiveness of the developed system has evaluated via usability study and questionnaires which is represented by graphical and analytical methods. The evaluation provides with positive results and this indicates the developed system has potential as an effective rehabilitation system for upper limb impairment.

Principles of Assessment of Rehabilitation Services in Health Systems: Learning from experiences.

Science.gov (United States)

Gutenbrunner, Christoph; Nugraha, Boya

2018-04-18

Strengthening of health-related rehabilitation services must start from the needs of persons with health conditions experiencing disability and should be implemented within health systems. The implementation of rehabilitation services in health systems should be planned and realized according to the World Health Organization's 6 constituents of health systems (i.e. health service delivery; health workforce; health information systems; essential medicines; financing; and leadership and governance). The development of recommendations based on situation analysis and best-available data is crucial. In order to facilitate such data collection at a national level, a checklist and a related questionnaire (Rehabilitation Service Assessment Tool (RSAT)) were developed and implemented. The following steps were followed to develop a checklist for implementation of rehabilitation services: a literature search, drafting, checking and testing the list, and development of the RSAT. The RSAT comprises 8 sections derived from 5 main domains of the most important areas of information (i.e. country profile; health system; disability and rehabilitation; national policies, laws, and responsibilities; and relevant non-governmental stakeholders). The implementation of RSAT in different missions has shown that the principles are working well and that RSAT is feasible and helpful. Further field testing is important and the development of an internationally agreed tool should be promoted.

An activity recognition model using inertial sensor nodes in a wireless sensor network for frozen shoulder rehabilitation exercises.

Science.gov (United States)

Lin, Hsueh-Chun; Chiang, Shu-Yin; Lee, Kai; Kan, Yao-Chiang

2015-01-19

This paper proposes a model for recognizing motions performed during rehabilitation exercises for frozen shoulder conditions. The model consists of wearable wireless sensor network (WSN) inertial sensor nodes, which were developed for this study, and enables the ubiquitous measurement of bodily motions. The model employs the back propagation neural network (BPNN) algorithm to compute motion data that are formed in the WSN packets; herein, six types of rehabilitation exercises were recognized. The packets sent by each node are converted into six components of acceleration and angular velocity according to three axes. Motor features such as basic acceleration, angular velocity, and derivative tilt angle were input into the training procedure of the BPNN algorithm. In measurements of thirteen volunteers, the accelerations and included angles of nodes were adopted from possible features to demonstrate the procedure. Five exercises involving simple swinging and stretching movements were recognized with an accuracy of 85%-95%; however, the accuracy with which exercises entailing spiral rotations were recognized approximately 60%. Thus, a characteristic space and enveloped spectrum improving derivative features were suggested to enable identifying customized parameters. Finally, a real-time monitoring interface was developed for practical implementation. The proposed model can be applied in ubiquitous healthcare self-management to recognize rehabilitation exercises.

An Activity Recognition Model Using Inertial Sensor Nodes in a Wireless Sensor Network for Frozen Shoulder Rehabilitation Exercises

Directory of Open Access Journals (Sweden)

Hsueh-Chun Lin

2015-01-01

Full Text Available This paper proposes a model for recognizing motions performed during rehabilitation exercises for frozen shoulder conditions. The model consists of wearable wireless sensor network (WSN inertial sensor nodes, which were developed for this study, and enables the ubiquitous measurement of bodily motions. The model employs the back propagation neural network (BPNN algorithm to compute motion data that are formed in the WSN packets; herein, six types of rehabilitation exercises were recognized. The packets sent by each node are converted into six components of acceleration and angular velocity according to three axes. Motor features such as basic acceleration, angular velocity, and derivative tilt angle were input into the training procedure of the BPNN algorithm. In measurements of thirteen volunteers, the accelerations and included angles of nodes were adopted from possible features to demonstrate the procedure. Five exercises involving simple swinging and stretching movements were recognized with an accuracy of 85%–95%; however, the accuracy with which exercises entailing spiral rotations were recognized approximately 60%. Thus, a characteristic space and enveloped spectrum improving derivative features were suggested to enable identifying customized parameters. Finally, a real-time monitoring interface was developed for practical implementation. The proposed model can be applied in ubiquitous healthcare self-management to recognize rehabilitation exercises.

A novel virtual motor rehabilitation system for Guillain-Barré syndrome. Two single case studies.

Science.gov (United States)

Albiol-Pérez, S; Forcano-García, M; Muñoz-Tomás, M T; Manzano-Fernández, P; Solsona-Hernández, S; Mashat, M A; Gil-Gómez, J A

2015-01-01

This article is part of the Focus Theme of Methods of Information in Medicine on "New Methodologies for Patients Rehabilitation". For Guillain-Barré patients, motor rehabilitation programs are helpful at the onset to prevent the complications of paralysis and in cases of persistent motor impairment. Traditional motor rehabilitation programs may be tedious and monotonous, resulting in low adherence to the treatments. A Virtual Motor Rehabilitation system has been tested in Guillain-Barré patients to increase patient adherence and to improve clinical results. Two people with Guillain-Barré performed 20 rehabilitation sessions. We tested a novel system based on Motor Virtual Rehabilitation in three periods of time (baseline evaluation, final evaluation, and follow-up. In the training program, the participants carried out a specific treatment using the Active Balance Rehabilitation system (ABAR). The system is composed of customizable virtual games to perform static and dynamic balance rehabilitation. Significant improvements in clinical results were obtained by both participants, with significant results in the static balance clinical test of the Anterior Reach test in the standing position and unipedal stance time. Other significant results were found in dynamic balance clinical tests in the Berg Balance Scale test and the 30-second Sit-to-Stand test. With regard to acceptance of the system, both patients enjoyed the experience, and both patients thought that this system was helpful for their rehabilitation. The results show that Virtual Motor Rehabilitation for Guillain-Barré patients provides clinical improvements in an entertaining way.

Construction of Lower Limbs Rehabilitation System Based on Bodily Features and EMG

Science.gov (United States)

Kushida, Daisuke; Kanazawa, Tomohiro; Kitamura, Akira

In rehabilitation, there are two roles of reinforcement of the expansion of the motion range and muscular power. The diseased part is requested to be operated by the external force in the former, and the load corresponding to patient's muscular power is requested to be given in the latter. Recently, there are a lot of researches that try such rehabilitation by the machine. The principal object is put on the motion control of the machine in those researches. The most important thing is a mechanism that patient's state is quantitatively evaluated. This paper proposes the mechanism that presumes the patient recovery by relating bodily features to EMG of the diseased part in rehabilitation. In addition, a new rehabilitation system, that contained the self adjustment of the load using those mechanisms and the consideration of fatigue, is proposed. Effectiveness of the proposed rehabilitation system is verified by the simulation work.

Principles of Assessment of Rehabilitation Services in Health Systems: Learning from experiences

Directory of Open Access Journals (Sweden)

Christoph Gutenbrunner

2017-06-01

Full Text Available Objective: Strengthening of health-related rehabilitation services must start from the needs of persons with health conditions experiencing disability and should be implemented within health systems. The implementation of rehabilitation services in health systems should be planned and realized according to the World Health Organization’s 6 constituents of health systems (i.e. health service delivery; health workforce; health information systems; essential medicines; financing; and leadership and governance. The development of recommendations based on situation analysis and best-available data is crucial. Methods: In order to facilitate such data collection at a national level, a checklist and a related questionnaire (Rehabilitation Service Assessment Tool (RSAT were developed and implemented. The following steps were followed to develop a checklist for implementation of rehabilitation services: a literature search, drafting, checking and testing the list, and development of the RSAT. Results: The RSAT comprises 8 sections derived from 5 main domains of the most important areas of information (i.e. country profile; health system; disability and rehabilitation; national policies, laws, and responsibilities; and relevant non-governmental stakeholders. Conclusion: The implementation of RSAT in different missions has shown that the principles are working well and that RSAT is feasible and helpful. Further field testing is important and the development of an internationally agreed tool should be promoted.

42 CFR 412.604 - Conditions for payment under the prospective payment system for inpatient rehabilitation facilities.

Science.gov (United States)

2010-10-01

... payment system for inpatient rehabilitation facilities. 412.604 Section 412.604 Public Health CENTERS FOR... SYSTEMS FOR INPATIENT HOSPITAL SERVICES Prospective Payment for Inpatient Rehabilitation Hospitals and Rehabilitation Units § 412.604 Conditions for payment under the prospective payment system for inpatient...

24 CFR 511.75 - Disbursement of rental rehabilitation grant amounts: Cash and Management Information System.

Science.gov (United States)

2010-04-01

... rehabilitation grant amounts: Cash and Management Information System. 511.75 Section 511.75 Housing and Urban... rehabilitation grant amounts: Cash and Management Information System. (a) General. Rental Rehabilitation grants.... Any drawdown is conditioned upon the submission of satisfactory information by the grantee or State...

Strengthening Rehabilitation in Health Systems Worldwide by Integrating Information on Functioning in National Health Information Systems.

Science.gov (United States)

Stucki, Gerold; Bickenbach, Jerome; Melvin, John

2017-09-01

A complete understanding of the experience of health requires information relevant not merely to the health indicators of mortality and morbidity but also to functioning-that is, information about what it means to live in a health state, "the lived experience of health." Not only is functioning information relevant to healthcare and the overall objectives of person-centered healthcare but to the successful operation of all components of health systems.In light of population aging and major epidemiological trends, the health strategy of rehabilitation, whose aim has always been to optimize functioning and minimize disability, will become a key health strategy. The increasing prominence of the rehabilitative strategy within the health system drives the argument for the integration of functioning information as an essential component in national health information systems.Rehabilitation professionals and researchers have long recognized in WHO's International Classification of Functioning, Disability and Health the best prospect for an internationally recognized, sufficiently complete and powerful information reference for the documentation of functioning information. This paper opens the discussion of the promise of integrating the ICF as an essential component in national health systems to secure access to functioning information for rehabilitation, across health systems and countries.

A Spatial Augmented Reality rehab system for post-stroke hand rehabilitation.

Science.gov (United States)

Mousavi Hondori, Hossein; Khademi, Maryam; Dodakian, Lucy; Cramer, Steven C; Lopes, Cristina Videira

2013-01-01

This paper features a Spatial Augmented Reality system for rehabilitation of hand and arm movement. The table-top home-based system tracks a subject's hand and creates a virtual audio-visual interface for performing rehabilitation-related tasks that involve wrist, elbow, and shoulder movements. It measures range, speed, and smoothness of movements locally and can send the real-time photos and data to the clinic for further assessment. To evaluate the system, it was tested on two normal subjects and proved functional.

The Australian Centre for Minesite Rehabilitation Research

International Nuclear Information System (INIS)

Bell, L.C.

1994-01-01

The Australian Centre for Minesite Rehabilitation Research (ACMRR) is a joint venture between the Australian mining industry through the Australian Mineral Industries Research Association Ltd. (AMIRA) and three of the organizations working most actively in this area in Australia: CSIRO Minesite Rehabilitation Research Program; University of Queensland Centre for Mined Land Rehabilitation; and Curtin University Mulga Research Centre. The ACMRR was established in July 1993 to provide a national framework to conduct Strategic Research into minesite rehabilitation. It is an industry led and funded initiative. The Goals of the Centre include: to conduct strategic research into minesite rehabilitation to provide sustainable environmental solutions which are acceptable to industry, government and the community; to be recognized as a center of excellence undertaking commissioned research on minesite rehabilitation in an independent and thorough manner; to provide scientific and technological foundations to facilitate industry and government in setting acceptable standards; to act as networking and communications focus; and to enhance education and training in minesite rehabilitation. Strategic Research Programs in: Water Systems--downstream surface and groundwater quality; Land--the long-term behavior and stability of constructed landforms; Ecosystems--the long-term sustainability of constructed landforms; Waste--the long-term treatment and disposal of waste products; will allow the ACMRR to achieve these goals through specific research projects in these areas, developed with industry sponsors. This paper will discuss their progress to date, research projects underway, and plans for the future

The Evolution of Devices and Systems Supporting Rehabilitation of Lower Limbs

Science.gov (United States)

Olinski, M.; Lewandowski, B.; Gronowicz, A.

2015-02-01

This paper presents the process of development, as well as examples of devices and systems supporting rehabilitation of the human lower extremities, developed independently over the years in many parts of the world. Particular emphasis was placed on indicating, which major groups of devices supporting kinesitherapy of the lower limbs can be distinguished, what are the important advantages and disadvantages of particular types of solutions, as well as what directions currently dominating in development of rehabilitation systems may be specified. A deeper analysis and comparison of several selected systems was also conducted, resulting in gathering the outcomes in two tables. They focused on a few features of mechanical design, especially the devices' kinematic structures, and devices' additional functions associated with, among others, interaction, as well as diagnosis of the limb's state and the progress of rehabilitation.

An augmented reality system for upper-limb post-stroke motor rehabilitation: a feasibility study.

Science.gov (United States)

Assis, Gilda Aparecida de; Corrêa, Ana Grasielle Dionísio; Martins, Maria Bernardete Rodrigues; Pedrozo, Wendel Goes; Lopes, Roseli de Deus

2016-08-01

To determine the clinical feasibility of a system based on augmented reality for upper-limb (UL) motor rehabilitation of stroke participants. A physiotherapist instructed the participants to accomplish tasks in augmented reality environment, where they could see themselves and their surroundings, as in a mirror. Two case studies were conducted. Participants were evaluated pre- and post-intervention. The first study evaluated the UL motor function using Fugl-Meyer scale. Data were compared using non-parametric sign tests and effect size. The second study used the gain of motion range of shoulder flexion and abduction assessed by computerized biophotogrammetry. At a significance level of 5%, Fugl-Meyer scores suggested a trend for greater UL motor improvement in the augmented reality group than in the other. Moreover, effect size value 0.86 suggested high practical significance for UL motor rehabilitation using the augmented reality system. System provided promising results for UL motor rehabilitation, since enhancements have been observed in the shoulder range of motion and speed. Implications for Rehabilitation Gain of range of motion of flexion and abduction of the shoulder of post-stroke patients can be achieved through an augmented reality system containing exercises to promote the mental practice. NeuroR system provides a mental practice method combined with visual feedback for motor rehabilitation of chronic stroke patients, giving the illusion of injured upper-limb (UL) movements while the affected UL is resting. Its application is feasible and safe. This system can be used to improve UL rehabilitation, an additional treatment past the traditional period of the stroke patient hospitalization and rehabilitation.

Research in Danish cancer rehabilitation

DEFF Research Database (Denmark)

Høybye, Mette Terp; Dalton, Susanne Oksbjerg; Christensen, Jane

2008-01-01

rate at baseline was 86% (n = 1876). Most participants were younger women with breast cancer. They were generally well educated and working. The cancer survivors reported having comprehensive social networks and being physically active. Several cancer-related symptoms were reported by women...... site, sex, age, family, working status and social position. These challenges might be addressed optimally in multi-dimensional rehabilitation programmes....... of the cancer survivors with respect to cancer site, sociodemographic variables, social network, lifestyle, self-rated health and the prevalence of cancer-related late effects. The study is part of the FOCARE research project, in which the long-term effects of the rehabilitation programme are evaluated...

Simulation of an ankle rehabilitation system based on scotch- yoke mechanism

Science.gov (United States)

Racu (Cazacu, C. M.; Doroftei, I.; Plesu, Ghe; Doroftei, I. A.

2016-08-01

Due to injuries that occur on the ankle joint, everyday all around the world, more and more rehabilitation devices have been developed in recent years. The prices for ankle rehabilitation systems are still high, thus we developed a new device that we indented to be low cost and easy to manufacture. A model of an ankle rehabilitation device is presented in this paper. The device has two degrees of freedom, for flexion-extension and inversion-eversion move, and will ensure functionality with minimum dimensions. For the 3D model that we design, the dimensions are taken so that the proposed system will ensure functionality but also have a small dimensions and low mass, considering the physiological dimensions of the foot and lower leg.

Water system hardware and management rehabilitation: Qualitative evidence from Ghana, Kenya, and Zambia.

Science.gov (United States)

Klug, Tori; Shields, Katherine F; Cronk, Ryan; Kelly, Emma; Behnke, Nikki; Lee, Kristen; Bartram, Jamie

2017-05-01

Sufficient, safe, continuously available drinking water is important for human health and development, yet one in three handpumps in sub-Saharan Africa are non-functional at any given time. Community management, coupled with access to external technical expertise and spare parts, is a widely promoted model for rural water supply management. However, there is limited evidence describing how community management can address common hardware and management failures of rural water systems in sub-Saharan Africa. We identified hardware and management rehabilitation pathways using qualitative data from 267 interviews and 57 focus group discussions in Ghana, Kenya, and Zambia. Study participants were water committee members, community members, and local leaders in 18 communities (six in each study country) with water systems managed by a water committee and supported by World Vision (WV), an international non-governmental organization (NGO). Government, WV or private sector employees engaged in supporting the water systems were also interviewed. Inductive analysis was used to allow for pathways to emerge from the data, based on the perspectives and experiences of study participants. Four hardware rehabilitation pathways were identified, based on the types of support used in rehabilitation. Types of support were differentiated as community or external. External support includes financial and/or technical support from government or WV employees. Community actor understanding of who to contact when a hardware breakdown occurs and easy access to technical experts were consistent reasons for rapid rehabilitation for all hardware rehabilitation pathways. Three management rehabilitation pathways were identified. All require the involvement of community leaders and were best carried out when the action was participatory. The rehabilitation pathways show how available resources can be leveraged to restore hardware breakdowns and management failures for rural water systems in sub

A virtual reality system for arm and hand rehabilitation

Science.gov (United States)

Luo, Zhiqiang; Lim, Chee Kian; Chen, I.-Ming; Yeo, Song Huat

2011-03-01

This paper presents a virtual reality (VR) system for upper limb rehabilitation. The system incorporates two motion track components, the Arm Suit and the Smart Glove which are composed of a range of the optical linear encoders (OLE) and the inertial measurement units (IMU), and two interactive practice applications designed for driving users to perform the required functional and non-functional motor recovery tasks. We describe the technique details about the two motion track components and the rational to design two practice applications. The experiment results show that, compared with the marker-based tracking system, the Arm Suit can accurately track the elbow and wrist positions. The repeatability of the Smart Glove on measuring the five fingers' movement can be satisfied. Given the low cost, high accuracy and easy installation, the system thus promises to be a valuable complement to conventional therapeutic programs offered in rehabilitation clinics and at home.

75 FR 70013 - Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal...

Science.gov (United States)

2010-11-16

... 0938-AP89 Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal... the July 22, 2010 Federal Register entitled, ``Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2011.'' DATES: Effective Date. This correction is effective for IRF...

Design and Implementation study of Remote Home Rehabilitation Training Operating System based on Internet

Science.gov (United States)

Zhuo, Jin; Chung Gun, Jang

2018-03-01

The proportion of rehabilitation doctors and patients mismatch is very grim in the context of social aging. The Family Rehabilitation System captures the profound information of the trainer’s movements through the kinect bone tracing technique, allowing the doctor to remotely master the patient’s training progress. With the help of computers and the Internet, the patient can consult a physician, while the physician can remotely guide and launch the training “prescription” through the Internet according to the training effect. Patients can have rehabilitated training at home. The results of the test showed that the system has a positive effect on the rehabilitation of the patient.

[Clinical application of super-link system theory in spinal cord injury patients during rehabilitation stage].

Science.gov (United States)

Chen, Hsiao-Yu

2008-04-01

The purpose of this paper is to introduce Super-Link System Theory, which is a theory of spinal cord injury rehabilitation. This theory has been developed using the grounded theory research method. By explaining the procedure for establishing a super-link system the paper explains the complex structure of this theory. Super-Link System Theory emphasizes that rehabilitation nurses 'build up their interpersonal relationships' with clients, family caregivers, the interdisciplinary team, and the community, and attempt to 'establish links' among them. They know these links have to be made with appropriate 'timing', and must be able to access the appropriate people when necessary. Super-link systems include the following four links: link to client with spinal cord injury, link to family caregiver, link to interdisciplinary rehabilitation team, and link to community. It can enable rehabilitation nurses to provide a better quality of nursing care to clients and their family caregivers, as well as promote their professional position in the interdisciplinary rehabilitation team.

Hybrid robotic systems for upper limb rehabilitation after stroke: A review.

Science.gov (United States)

Resquín, Francisco; Cuesta Gómez, Alicia; Gonzalez-Vargas, Jose; Brunetti, Fernando; Torricelli, Diego; Molina Rueda, Francisco; Cano de la Cuerda, Roberto; Miangolarra, Juan Carlos; Pons, José Luis

2016-11-01

In recent years the combined use of functional electrical stimulation (FES) and robotic devices, called hybrid robotic rehabilitation systems, has emerged as a promising approach for rehabilitation of lower and upper limb motor functions. This paper presents a review of the state of the art of current hybrid robotic solutions for upper limb rehabilitation after stroke. For this aim, studies have been selected through a search using web databases: IEEE-Xplore, Scopus and PubMed. A total of 10 different hybrid robotic systems were identified, and they are presented in this paper. Selected systems are critically compared considering their technological components and aspects that form part of the hybrid robotic solution, the proposed control strategies that have been implemented, as well as the current technological challenges in this topic. Additionally, we will present and discuss the corresponding evidences on the effectiveness of these hybrid robotic therapies. The review also discusses the future trends in this field. Copyright © 2016 IPEM. Published by Elsevier Ltd. All rights reserved.

Towards Effective Non-Invasive Brain-Computer Interfaces Dedicated to Gait Rehabilitation Systems

Directory of Open Access Journals (Sweden)

Thierry Castermans

2013-12-01

Full Text Available In the last few years, significant progress has been made in the field of walk rehabilitation. Motor cortex signals in bipedal monkeys have been interpreted to predict walk kinematics. Epidural electrical stimulation in rats and in one young paraplegic has been realized to partially restore motor control after spinal cord injury. However, these experimental trials are far from being applicable to all patients suffering from motor impairments. Therefore, it is thought that more simple rehabilitation systems are desirable in the meanwhile. The goal of this review is to describe and summarize the progress made in the development of non-invasive brain-computer interfaces dedicated to motor rehabilitation systems. In the first part, the main principles of human locomotion control are presented. The paper then focuses on the mechanisms of supra-spinal centers active during gait, including results from electroencephalography, functional brain imaging technologies [near-infrared spectroscopy (NIRS, functional magnetic resonance imaging (fMRI, positron-emission tomography (PET, single-photon emission-computed tomography (SPECT] and invasive studies. The first brain-computer interface (BCI applications to gait rehabilitation are then presented, with a discussion about the different strategies developed in the field. The challenges to raise for future systems are identified and discussed. Finally, we present some proposals to address these challenges, in order to contribute to the improvement of BCI for gait rehabilitation.

Modular mechatronic system for stationary bicycles interfaced with virtual environment for rehabilitation.

Science.gov (United States)

Ranky, Richard G; Sivak, Mark L; Lewis, Jeffrey A; Gade, Venkata K; Deutsch, Judith E; Mavroidis, Constantinos

2014-06-05

Cycling has been used in the rehabilitation of individuals with both chronic and post-surgical conditions. Among the challenges with implementing bicycling for rehabilitation is the recruitment of both extremities, in particular when one is weaker or less coordinated. Feedback embedded in virtual reality (VR) augmented cycling may serve to address the requirement for efficacious cycling; specifically recruitment of both extremities and exercising at a high intensity. In this paper a mechatronic rehabilitation bicycling system with an interactive virtual environment, called Virtual Reality Augmented Cycling Kit (VRACK), is presented. Novel hardware components embedded with sensors were implemented on a stationary exercise bicycle to monitor physiological and biomechanical parameters of participants while immersing them in an augmented reality simulation providing the user with visual, auditory and haptic feedback. This modular and adaptable system attaches to commercially-available stationary bicycle systems and interfaces with a personal computer for simulation and data acquisition processes. The complete bicycle system includes: a) handle bars based on hydraulic pressure sensors; b) pedals that monitor pedal kinematics with an inertial measurement unit (IMU) and forces on the pedals while providing vibratory feedback; c) off the shelf electronics to monitor heart rate and d) customized software for rehabilitation. Bench testing for the handle and pedal systems is presented for calibration of the sensors detecting force and angle. The modular mechatronic kit for exercise bicycles was tested in bench testing and human tests. Bench tests performed on the sensorized handle bars and the instrumented pedals validated the measurement accuracy of these components. Rider tests with the VRACK system focused on the pedal system and successfully monitored kinetic and kinematic parameters of the rider's lower extremities. The VRACK system, a virtual reality mechatronic bicycle

Modular mechatronic system for stationary bicycles interfaced with virtual environment for rehabilitation

Science.gov (United States)

2014-01-01

Background Cycling has been used in the rehabilitation of individuals with both chronic and post-surgical conditions. Among the challenges with implementing bicycling for rehabilitation is the recruitment of both extremities, in particular when one is weaker or less coordinated. Feedback embedded in virtual reality (VR) augmented cycling may serve to address the requirement for efficacious cycling; specifically recruitment of both extremities and exercising at a high intensity. Methods In this paper a mechatronic rehabilitation bicycling system with an interactive virtual environment, called Virtual Reality Augmented Cycling Kit (VRACK), is presented. Novel hardware components embedded with sensors were implemented on a stationary exercise bicycle to monitor physiological and biomechanical parameters of participants while immersing them in an augmented reality simulation providing the user with visual, auditory and haptic feedback. This modular and adaptable system attaches to commercially-available stationary bicycle systems and interfaces with a personal computer for simulation and data acquisition processes. The complete bicycle system includes: a) handle bars based on hydraulic pressure sensors; b) pedals that monitor pedal kinematics with an inertial measurement unit (IMU) and forces on the pedals while providing vibratory feedback; c) off the shelf electronics to monitor heart rate and d) customized software for rehabilitation. Bench testing for the handle and pedal systems is presented for calibration of the sensors detecting force and angle. Results The modular mechatronic kit for exercise bicycles was tested in bench testing and human tests. Bench tests performed on the sensorized handle bars and the instrumented pedals validated the measurement accuracy of these components. Rider tests with the VRACK system focused on the pedal system and successfully monitored kinetic and kinematic parameters of the rider’s lower extremities. Conclusions The VRACK

A wearable sensor system for lower-limb rehabilitation evaluation using the GRF and CoP distributions

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Tao, Weijun; Zhang, Jianyun; Li, Guangyi; Liu, Tao; Liu, Fengping; Yi, Jingang; Wang, Hesheng; Inoue, Yoshio

2016-02-01

Wearable sensors are attractive for gait analysis because these systems can measure and obtain real-time human gait and motion information outside of the laboratory for a longer duration. In this paper, we present a new wearable ground reaction force (GRF) sensing system for ambulatory gait measurement. In addition, the GRF sensor system is also used to quantify the patients' lower-limb gait rehabilitation. We conduct a validation experiment for the sensor system on seven volunteer subjects (weight 62.39 +/- 9.69 kg and height 169.13 +/- 5.64 cm). The experiments include the use of the GRF sensing system for the subjects in the following conditions: (1) normal walking; (2) walking with the rehabilitation training device; and (3) walking with a knee brace and the rehabilitation training device. The experiment results support the hypothesis that the wearable GRF sensor system is capable of quantifying patients' lower-limb rehabilitation. The proposed GRF sensing system can also be used for assessing the effectiveness of a gait rehabilitation system and for providing bio-feedback information to the subjects.

Sybar, a human motion analysis system for rehabilition medicine

NARCIS (Netherlands)

Hautus, E.H.

1997-01-01

The Sybar project is a designer's Ph.D project that deals with the development of a motion-analysis system for rehabilitation medicine, at the VU Hospital in Amsterdam. Human motion can be analyzed by biomechanical measurement systems. There are a number of different methods to generate several

Vulnerability of Rehabilitated Agricultural Production Systems to Invasion by Nontarget Plant Species

Science.gov (United States)

Baer, Sara G.; Engle, David M.; Knops, Johannes M. H.; Langeland, Kenneth A.; Maxwell, Bruce D.; Menalled, Fabian D.; Symstad, Amy J.

2009-02-01

Vast areas of arable land have been retired from crop production and “rehabilitated” to improved system states through landowner incentive programs in the United States (e.g., Conservation and Wetland Reserve Programs), as well as Europe (i.e., Agri-Environment Schemes). Our review of studies conducted on invasion of rehabilitated agricultural production systems by nontarget species elucidates several factors that may increase the vulnerability of these systems to invasion. These systems often exist in highly fragmented and agriculturally dominated landscapes, where propagule sources of target species for colonization may be limited, and are established under conditions where legacies of past disturbance persist and prevent target species from persisting. Furthermore, rehabilitation approaches often do not include or successfully attain all target species or historical ecological processes (e.g., hydrology, grazing, and/or fire cycles) key to resisting invasion. Uncertainty surrounds ways in which nontarget species may compromise long term goals of improving biodiversity and ecosystem services through rehabilitation efforts on former agricultural production lands. This review demonstrates that more studies are needed on the extent and ecological impacts of nontarget species as related to the goals of rehabilitation efforts to secure current and future environmental benefits arising from this widespread conservation practice.

Allocation of Rehabilitation Services for Older Adults in the Ontario Home Care System.

Science.gov (United States)

Armstrong, Joshua J; Sims-Gould, Joanie; Stolee, Paul

Background: Physiotherapy and occupational therapy services can play a critical role in maintaining or improving the physical functioning, quality of life, and overall independence of older home care clients. Despite their importance, however, there is limited understanding of the factors that influence how rehabilitation services are allocated to older home care clients. The aim of this pilot study was to develop a preliminary understanding of the factors that influence decisions to allocate rehabilitation therapy services to older clients in the Ontario home care system, as perceived by three stakeholder groups. Methods: Semi-structured interviews were conducted with 10 key informants from three stakeholder groups: case managers, service providers, and health system policymakers. Results: Drivers of the allocation of occupational therapy and physiotherapy for older adults included functional needs and postoperative care. Participants identified challenges in providing home care rehabilitation to older adults, including impaired cognition and limited capacity in the home care system. Conclusions: Considering the changing demands for home care services, knowledge of current practices across the home care system can inform efforts to optimize rehabilitation services for the growing number of older adults. Further research is needed to advance the understanding of, and optimize rehabilitation service allocation to, older frail clients with multiple morbidities. Developing novel decision-support mechanisms and standardized clinical care pathways for older client populations may be beneficial.

Introducing a feedback training system for guided home rehabilitation

Directory of Open Access Journals (Sweden)

Disselhorst-Klug Catherine

2010-01-01

Full Text Available Abstract As the number of people requiring orthopaedic intervention is growing, individualized physiotherapeutic rehabilitation and adequate postoperative care becomes increasingly relevant. The chances of improvement in the patients condition is directly related to the performance and consistency of the physiotherapeutic exercises. In this paper a smart, cost-effective and easy to use Feedback Training System for home rehabilitation based on standard resistive elements is introduced. This ensures high accuracy of the exercises performed and offers guidance and control to the patient by offering direct feedback about the performance of the movements. 46 patients were recruited and performed standard physiotherapeutic training to evaluate the system. The results show a significant increase in the patient's ability to reproduce even simple physiotherapeutic exercises when being supported by the Feedback Training System. Thus physiotherapeutic training can be extended into the home environment whilst ensuring a high quality of training.

Introducing a feedback training system for guided home rehabilitation.

Science.gov (United States)

Kohler, Fabian; Schmitz-Rode, Thomas; Disselhorst-Klug, Catherine

2010-01-15

As the number of people requiring orthopaedic intervention is growing, individualized physiotherapeutic rehabilitation and adequate postoperative care becomes increasingly relevant. The chances of improvement in the patients condition is directly related to the performance and consistency of the physiotherapeutic exercises.In this paper a smart, cost-effective and easy to use Feedback Training System for home rehabilitation based on standard resistive elements is introduced. This ensures high accuracy of the exercises performed and offers guidance and control to the patient by offering direct feedback about the performance of the movements.46 patients were recruited and performed standard physiotherapeutic training to evaluate the system. The results show a significant increase in the patient's ability to reproduce even simple physiotherapeutic exercises when being supported by the Feedback Training System. Thus physiotherapeutic training can be extended into the home environment whilst ensuring a high quality of training.

Cochrane Rehabilitation Methodology Committee: an international survey of priorities for future work.

Science.gov (United States)

Levack, William M; Meyer, Thorsten; Negrini, Stefano; Malmivaara, Antti

2017-10-01

Cochrane Rehabilitation aims to improve the application of evidence-based practice in rehabilitation. It also aims to support Cochrane in the production of reliable, clinically meaningful syntheses of evidence related to the practice of rehabilitation, while accommodating the many methodological challenges facing the field. To this end, Cochrane Rehabilitation established a Methodology Committee to examine, explore and find solutions for the methodological challenges related to evidence synthesis and knowledge translation in rehabilitation. We conducted an international online survey via Cochrane Rehabilitation networks to canvass opinions regarding the future work priorities for this committee and to seek information on people's current capabilities to assist with this work. The survey findings indicated strongest interest in work on how reviewers have interpreted and applied Cochrane methods in reviews on rehabilitation topics in the past, and on gathering a collection of existing publications on review methods for undertaking systematic reviews relevant to rehabilitation. Many people are already interested in contributing to the work of the Methodology Committee and there is a large amount of expertise for this work in the extended Cochrane Rehabilitation network already.

Irrigation network design and reconstruction and its analysis by simulation model

Directory of Open Access Journals (Sweden)

Čistý Milan

2014-06-01

Full Text Available There are many problems related to pipe network rehabilitation, the main one being how to provide an increase in the hydraulic capacity of a system. Because of its complexity the conventional optimizations techniques are poorly suited for solving this task. In recent years some successful attempts to apply modern heuristic methods to this problem have been published. The main part of the paper deals with applying such technique, namely the harmony search methodology, to network rehabilitation optimization considering both technical and economic aspects of the problem. A case study of the sprinkler irrigation system is presented in detail. Two alternatives of the rehabilitation design are compared. The modified linear programming method is used first with new diameters proposed in the existing network so it could satisfy the increased demand conditions with the unchanged topology. This solution is contrasted to the looped one obtained using a harmony search algorithm

Functional electrical stimulation controlled by artificial neural networks: pilot experiments with simple movements are promising for rehabilitation applications.

Science.gov (United States)

Ferrante, Simona; Pedrocchi, Alessandra; Iannò, Marco; De Momi, Elena; Ferrarin, Maurizio; Ferrigno, Giancarlo

2004-01-01

This study falls within the ambit of research on functional electrical stimulation for the design of rehabilitation training for spinal cord injured patients. In this context, a crucial issue is the control of the stimulation parameters in order to optimize the patterns of muscle activation and to increase the duration of the exercises. An adaptive control system (NEURADAPT) based on artificial neural networks (ANNs) was developed to control the knee joint in accordance with desired trajectories by stimulating quadriceps muscles. This strategy includes an inverse neural model of the stimulated limb in the feedforward line and a neural network trained on-line in the feedback loop. NEURADAPT was compared with a linear closed-loop proportional integrative derivative (PID) controller and with a model-based neural controller (NEUROPID). Experiments on two subjects (one healthy and one paraplegic) show the good performance of NEURADAPT, which is able to reduce the time lag introduced by the PID controller. In addition, control systems based on ANN techniques do not require complicated calibration procedures at the beginning of each experimental session. After the initial learning phase, the ANN, thanks to its generalization capacity, is able to cope with a certain range of variability of skeletal muscle properties.

Deterioration and optimal rehabilitation modelling for urban water distribution systems

NARCIS (Netherlands)

Zhou, Y.

2018-01-01

Pipe failures in water distribution systems can have a serious impact and hence it’s important to maintain the condition and integrity of the distribution system. This book presents a whole-life cost optimisation model for the rehabilitation of water distribution systems. It combines a pipe breakage

[Indications and approaches in rehabilitation with children].

Science.gov (United States)

Petermann, F; Bauer, C-P

2011-04-01

Against the background of rising prevalence of chronic diseases in childhood and adolescence, the rehabilitation of children and adolescents plays a major role in medical treatment. Early diagnosis and multimodal intervention are necessary to prevent a chronic course of disease and disease consequences for those affected and their families. In recent years, significant content and structural improvement of child and youth rehabilitation has been observed; currently some trends that affect not only the access to rehabilitation but also the quality of outcomes are becoming apparent. These include salutogenetic approaches, the development of specific diagnostic and treatment guidelines, the establishment of networks, integrated care, modularization, and flexibility of rehabilitation measures.

Talking about the institutional complexity of the integrated rehabilitation system-the importance of coordination.

Science.gov (United States)

Miettinen, Sari; Ashorn, Ulla; Lehto, Juhani

2013-01-01

Rehabilitation in Finland is a good example of functions divided among several welfare sectors, such as health services and social services. The rehabilitation system in Finland is a complex one and there have been many efforts to create a coordinated entity. The purpose of this study is to open up a complex welfare system at the upper policy level and to understand the meaning of coordination at the level of service delivery. We shed light in particular on the national rehabilitation policy in Finland and how the policy has tried to overcome the negative effects of institutional complexity. In this study we used qualitative content analysis and frame analysis. As a result we identified four different welfare state frames with distinct features of policy problems, policy alternatives and institutional failure. The rehabilitation policy in Finland seems to be divided into different components which may cause problems at the level of service delivery and thus in the integration of services. Bringing these components together could at policy level enable a shared view of the rights of different population groups, effective management of integration at the level of service delivery and also an opportunity for change throughout the rehabilitation system.

[Rehabilitation in rheumatology].

Science.gov (United States)

Luttosch, F; Baerwald, C

2010-10-01

Rehabilitation in rheumatology focuses on prevention of functional disorders of the musculoskeletal system, maintenance of working ability and prevention of care dependency. Drug treatment alone rarely results in long-term remission, therefore rehabilitative measures must be integrated into rheumatic care. Rehabilitative therapy in rheumatology includes physiotherapy, patient education and occupational therapy. Positive effects of physical therapy methods have been proven by various studies. Patient education and occupational therapy are important tools for stabilizing the course of the disease. To maintain positive rehabilitative results patients have to be involved in the selection of treatment measures and should take an active part in the long-term treatment process. Despite proven efficacy of physical measures there is evidence for a lack of utilization of rehabilitative therapy due to increasing cost pressure in the health care system which will further increase over time.

[Implementation of control system and software design for limbs rehabilitation training based on PCI-1240].

Science.gov (United States)

Zhu, Wenchao; Xu, Xiulin; Hu, Xiufang; An, Meijun

2017-06-01

This article presents the design of a motion control system for seated lower-limb rehabilitation training. The system is composed of lower limb exoskeleton, motor drive circuit, program of motion control, and so forth. The power of lower limbs joints is provided by six motors. The PCI-1240 motion control card is used as the core. This study achieved repetitive rotation training and gait trajectory training of lower limbs joints, of which the velocity, angle and time can be accurately controlled and adjusted. The experimental results showed that the motion control system can meet the requirement of repetitive rehabilitation training for patients with lower limb dysfunction. This article provides a new method to the research of motion control system in rehabilitation training, which can promote industrial automation technique to be used for health care, and conducive to the further study of the rehabilitation robot.

Robots testing robots: ALAN-Arm, a humanoid arm for the testing of robotic rehabilitation systems.

Science.gov (United States)

Brookes, Jack; Kuznecovs, Maksims; Kanakis, Menelaos; Grigals, Arturs; Narvidas, Mazvydas; Gallagher, Justin; Levesley, Martin

2017-07-01

Robotics is increasing in popularity as a method of providing rich, personalized and cost-effective physiotherapy to individuals with some degree of upper limb paralysis, such as those who have suffered a stroke. These robotic rehabilitation systems are often high powered, and exoskeletal systems can attach to the person in a restrictive manner. Therefore, ensuring the mechanical safety of these devices before they come in contact with individuals is a priority. Additionally, rehabilitation systems may use novel sensor systems to measure current arm position. Used to capture and assess patient movements, these first need to be verified for accuracy by an external system. We present the ALAN-Arm, a humanoid robotic arm designed to be used for both accuracy benchmarking and safety testing of robotic rehabilitation systems. The system can be attached to a rehabilitation device and then replay generated or human movement trajectories, as well as autonomously play rehabilitation games or activities. Tests of the ALAN-Arm indicated it could recreate the path of a generated slow movement path with a maximum error of 14.2mm (mean = 5.8mm) and perform cyclic movements up to 0.6Hz with low gain (<1.5dB). Replaying human data trajectories showed the ability to largely preserve human movement characteristics with slightly higher path length and lower normalised jerk.

Talking about the institutional complexity of the integrated rehabilitation system – the importance of coordination

OpenAIRE

Miettinen, Sari; Ashorn, Ulla; Lehto, Juhani

2013-01-01

Rehabilitation in Finland is a good example of functions divided among several welfare sectors, such as health services and social services.  The rehabilitation system in Finland is a complex one and there have been many efforts to create a coordinated entity. The purpose of this study is to open up a complex welfare system at the upper policy level and to understand the meaning of coordination at the level of service delivery. We shed light in particular on the national rehabilitation policy...

Interaction of a physician and a specialist on physical rehabilitation at violations of activity of the musculoskeletal system

Directory of Open Access Journals (Sweden)

Andrii Hertsyk

2016-08-01

Full Text Available Purpose: the improvement of cooperation and the interaction of an attending physician and a specialist on physical rehabilitation at violations of activity of musculoskeletal system. Material & Methods: physical rehabilitation is considered as a difficult system with the hierarchically-ordered structure. The analysis of references and the system analysis are applied. Results: the modern approaches to coordination of centers of decision-making and the management in hierarchical systems are analyzed. The ways of the interlevel coordination in organizational systems are revealed. The need of coordination of activity of an attending physician and a specialist on physical rehabilitation is proved. The content and the direction of coordination signals for the system of physical rehabilitation at violations of activity of the musculoskeletal system are determined. Conclusions: the coordination of activity of an attending physician and a specialist on physical rehabilitation at violations of activity of the musculoskeletal system has to occur in certain ways: on purposes, on restrictions, in time, on input and output parameters.

The development of an adaptive upper-limb stroke rehabilitation robotic system

Science.gov (United States)

2011-01-01

Background Stroke is the primary cause of adult disability. To support this large population in recovery, robotic technologies are being developed to assist in the delivery of rehabilitation. This paper presents an automated system for a rehabilitation robotic device that guides stroke patients through an upper-limb reaching task. The system uses a decision theoretic model (a partially observable Markov decision process, or POMDP) as its primary engine for decision making. The POMDP allows the system to automatically modify exercise parameters to account for the specific needs and abilities of different individuals, and to use these parameters to take appropriate decisions about stroke rehabilitation exercises. Methods The performance of the system was evaluated by comparing the decisions made by the system with those of a human therapist. A single patient participant was paired up with a therapist participant for the duration of the study, for a total of six sessions. Each session was an hour long and occurred three times a week for two weeks. During each session, three steps were followed: (A) after the system made a decision, the therapist either agreed or disagreed with the decision made; (B) the researcher had the device execute the decision made by the therapist; (C) the patient then performed the reaching exercise. These parts were repeated in the order of A-B-C until the end of the session. Qualitative and quantitative question were asked at the end of each session and at the completion of the study for both participants. Results Overall, the therapist agreed with the system decisions approximately 65% of the time. In general, the therapist thought the system decisions were believable and could envision this system being used in both a clinical and home setting. The patient was satisfied with the system and would use this system as his/her primary method of rehabilitation. Conclusions The data collected in this study can only be used to provide insight into

Visual rehabilitation: visual scanning, multisensory stimulation and vision restoration trainings

Directory of Open Access Journals (Sweden)

Neil M. Dundon

2015-07-01

Full Text Available Neuropsychological training methods of visual rehabilitation for homonymous vision loss caused by postchiasmatic damage fall into two fundamental paradigms: compensation and restoration. Existing methods can be classified into three groups: Visual Scanning Training (VST, Audio-Visual Scanning Training (AViST and Vision Restoration Training (VRT. VST and AViST aim at compensating vision loss by training eye scanning movements, whereas VRT aims at improving lost vision by activating residual visual functions by training light detection and discrimination of visual stimuli. This review discusses the rationale underlying these paradigms and summarizes the available evidence with respect to treatment efficacy. The issues raised in our review should help guide clinical care and stimulate new ideas for future research uncovering the underlying neural correlates of the different treatment paradigms. We propose that both local within-system interactions (i.e., relying on plasticity within peri-lesional spared tissue and changes in more global between-system networks (i.e., recruiting alternative visual pathways contribute to both vision restoration and compensatory rehabilitation that ultimately have implications for the rehabilitation of cognitive functions.

[Implementation of quality management in medical rehabilitation--current challenges for rehabilitation facilities].

Science.gov (United States)

Enge, M; Koch, A; Müller, T; Vorländer, T

2010-12-01

The legal responsibilities imposed upon rehabilitation facilities under section 20 (2a) SGB IX, necessitate fundamental decisions to be taken regarding the development of quality management systems over and above the existing framework. This article is intended to provide ideas and suggestions to assist rehabilitation facilities in implementing a quality management system, which is required in addition to participation in the quality assurance programmes stipulated by the rehabilitation carriers. In this context, the additional internal benefit a functioning quality management system can provide for ensuring a high level of quality and for maintaining the competitiveness of the rehabilitation facility should be taken into account. The core element of these observations, hence, is a list of requirements which enables assessment of the quality of consultants' performance in setting up a quality management system. © Georg Thieme Verlag KG Stuttgart · New York.

Computer Assisted REhabilitation (CARE) Lab: A novel approach towards Pediatric Rehabilitation 2.0.

Science.gov (United States)

Olivieri, Ivana; Meriggi, Paolo; Fedeli, Cristina; Brazzoli, Elena; Castagna, Anna; Roidi, Marina Luisa Rodocanachi; Angelini, Lucia

2018-01-01

Pediatric Rehabilitation therapists have always worked using a variety of off-the-shelf or custom-made objects and devices, more recently including computer based systems. These Information and Communication Technology (ICT) solutions vary widely in complexity, from easy-to-use interactive videogame consoles originally intended for entertainment purposes to sophisticated systems specifically developed for rehabilitation.This paper describes the principles underlying an innovative "Pediatric Rehabilitation 2.0" approach, based on the combination of suitable ICT solutions and traditional rehabilitation, which has been progressively refined while building up and using a computer-assisted rehabilitation laboratory. These principles are thus summarized in the acronym EPIQ, to account for the terms Ecological, Personalized, Interactive and Quantitative. The paper also presents the laboratory, which has been designed to meet the children's rehabilitation needs and to empower therapists in their work. The laboratory is equipped with commercial hardware and specially developed software called VITAMIN: a virtual reality platform for motor and cognitive rehabilitation.

Advances in rehabilitation medicine.

Science.gov (United States)

Ng, Yee Sien; Chew, Effie; Samuel, Geoffrey S; Tan, Yeow Leng; Kong, Keng He

2013-10-01

Rehabilitation medicine is the medical specialty that integrates rehabilitation as its core therapeutic modality in disability management. More than a billion people worldwide are disabled, and the World Health Organization has developed the International Classification of Functioning, Disability and Health as a framework through which disability is addressed. Herein, we explore paradigm shifts in neurorehabilitation, with a focus on restoration, and provide overviews on developments in neuropharmacology, rehabilitation robotics, virtual reality, constraint-induced therapy and brain stimulation. We also discuss important issues in rehabilitation systems of care, including integrated care pathways, very early rehabilitation, early supported discharge and telerehabilitation. Finally, we highlight major new fields of rehabilitation such as spasticity management, frailty and geriatric rehabilitation, intensive care and cancer rehabilitation.

Imaging informatics-based multimedia ePR system for data management and decision support in rehabilitation research

Science.gov (United States)

Wang, Ximing; Verma, Sneha; Qin, Yi; Sterling, Josh; Zhou, Alyssa; Zhang, Jeffrey; Martinez, Clarisa; Casebeer, Narissa; Koh, Hyunwook; Winstein, Carolee; Liu, Brent

2013-03-01

With the rapid development of science and technology, large-scale rehabilitation centers and clinical rehabilitation trials usually involve significant volumes of multimedia data. Due to the global aging crisis, millions of new patients with age-related chronic diseases will produce huge amounts of data and contribute to soaring costs of medical care. Hence, a solution for effective data management and decision support will significantly reduce the expenditure and finally improve the patient life quality. Inspired from the concept of the electronic patient record (ePR), we developed a prototype system for the field of rehabilitation engineering. The system is subject or patient-oriented and customized for specific projects. The system components include data entry modules, multimedia data presentation and data retrieval. To process the multimedia data, the system includes a DICOM viewer with annotation tools and video/audio player. The system also serves as a platform for integrating decision-support tools and data mining tools. Based on the prototype system design, we developed two specific applications: 1) DOSE (a phase 1 randomized clinical trial to determine the optimal dose of therapy for rehabilitation of the arm and hand after stroke.); and 2) NEXUS project from the Rehabilitation Engineering Research Center(RERC, a NIDRR funded Rehabilitation Engineering Research Center). Currently, the system is being evaluated in the context of the DOSE trial with a projected enrollment of 60 participants over 5 years, and will be evaluated by the NEXUS project with 30 subjects. By applying the ePR concept, we developed a system in order to improve the current research workflow, reduce the cost of managing data, and provide a platform for the rapid development of future decision-support tools.

Interactive rehabilitation system for improvement of balance therapies in people with cerebral palsy.

Science.gov (United States)

Jaume-i-Capó, Antoni; Martínez-Bueso, Pau; Moyà-Alcover, Biel; Varona, Javier

2014-03-01

The present study covers a new experimental system, designed to improve the balance and postural control of adults with cerebral palsy. This system is based on a serious game for balance rehabilitation therapy, designed using the prototype development paradigm and features for rehabilitation with serious games: feedback, adaptability, motivational elements, and monitoring. In addition, the employed interaction technology is based on computer vision because motor rehabilitation consists of body movements that can be recorded, and because vision capture technology is noninvasive and can be used for clients who have difficulties in holding physical devices. Previous research has indicated that serious games help to motivate clients in therapy sessions; however, there remains a paucity of clinical evidence involving functionality. We rigorously evaluated the effects of physiotherapy treatment on balance and gait function of adult subjects with cerebral palsy undergoing our experimental system. A 24-week physiotherapy intervention program was conducted with nine adults from a cerebral palsy center who exercised weekly in 20-min sessions. Findings demonstrated a significant increase in balance and gait function scores resulting in indicators of greater independence for our participating adults. Scores improved from 16 to 21 points in a scale of 28, according to the Tinetti Scale for risk of falls, moving from high fall risk to moderate fall risk. Our promising results indicate that our experimental system is feasible for balance rehabilitation therapy.

Applicability of a motor rehabilitation system in stroke victims

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Maíra Izzadora Souza Carneiro

Full Text Available Abstract Introduction: The recovery of stroke patients is long and boring due to the repetitive nature of the exercises used and the length of treatment. Thus, we started using virtual reality as an alternative and, because of its advantages, health professionals are adapting video games for physical therapy. However, there are some limitations, such as the fact that games are designed for entertainment and not for therapeutic purposes. Objective: In order to mitigate gaps in assistive devices for physical therapy, this study describes the development and applicability of a computer support system for motor rehabilitation - Ikapp - in stroke victims. Methods: Twenty-seven stroke patients filled out a socioeconomic questionnaire, tested Ikapp during five minutes and answered a usability and satisfaction questionnaire about handling the tool. The chi-square test was used to analyze any association between sociodemographic factors and the features of the system. Results: The Ikapp system can be an excellent device to assist neurological rehabilitation of stroke patients, as participants questionnaires showed that 85.2% were satisfied in regard to motivation and inclusion of Ikapp in physiotherapy and 77.8% relative to ease of interaction with the tool. Conclusion: The Ikapp system proved to be an easy-to-use and accessible computer support system for patients with functional limitations.

Study on development of active-passive rehabilitation system for upper limbs: Hybrid-PLEMO

International Nuclear Information System (INIS)

Kikuchi, T; Jin, Y; Fukushima, K; Akai, H; Furusho, J

2009-01-01

In recent years, many researchers have studied the potential of using robotics technology to assist and quantify the motor functions for neuron-rehabilitation. Some kinds of haptic devices have been developed and evaluated its efficiency with clinical tests, for example, upper limb training for patients with spasticity after stroke. Active-type (motor-driven) haptic devices can realize a lot of varieties of haptics. But they basically require high-cost safety system. On the other hand, passive-type (brake-based) haptic devices have inherent safety. However, the passive robot system has strong limitation on varieties of haptics. There are not sufficient evidences to clarify how the passive/active haptics effect to the rehabilitation of motor skills. In this paper, we developed an active-passive-switchable rehabilitation system with ER clutch/brake device named 'Hybrid-PLEMO' in order to address these problems. In this paper, basic structures and haptic control methods of the Hybrid-PLEMO are described.

Study on development of active-passive rehabilitation system for upper limbs: Hybrid-PLEMO

Energy Technology Data Exchange (ETDEWEB)

Kikuchi, T; Jin, Y; Fukushima, K; Akai, H; Furusho, J [Department of Mechanical Engineering, Graduate School of Engineering, Osaka University, Osaka (Japan)], E-mail: kikuchi@mech.eng.osaka-u.ac.jp

2009-02-01

In recent years, many researchers have studied the potential of using robotics technology to assist and quantify the motor functions for neuron-rehabilitation. Some kinds of haptic devices have been developed and evaluated its efficiency with clinical tests, for example, upper limb training for patients with spasticity after stroke. Active-type (motor-driven) haptic devices can realize a lot of varieties of haptics. But they basically require high-cost safety system. On the other hand, passive-type (brake-based) haptic devices have inherent safety. However, the passive robot system has strong limitation on varieties of haptics. There are not sufficient evidences to clarify how the passive/active haptics effect to the rehabilitation of motor skills. In this paper, we developed an active-passive-switchable rehabilitation system with ER clutch/brake device named 'Hybrid-PLEMO' in order to address these problems. In this paper, basic structures and haptic control methods of the Hybrid-PLEMO are described.

Reliability and Efficiency Factors in Decision Making for Rehabilitation of Pipelines

Directory of Open Access Journals (Sweden)

Alonso-Guzmán Carlos Daniel

2013-10-01

Full Text Available The methodology that has been developed suggests a sequence of interventions in the water distribution network, identifying the hierarchy of groups of pipes that must be renewed, taking into consideration all the factors associated, both endogenous and exogenous, and the technical limitations in the functioning of the water network considering the annual budget available for the rehabilitation of pipelines. The aim of this work is to develop a model to facilitate the decision-making to the managers of water distribution systems, considering a budget constraint, the amount of linear meters of each group of pipes that provides a maximum benefit in relation to the valuation of influence factors, the benefits and the cost of the rehabilitation. To ac- complish this, we use the genetic algorithms tool through Evolver and fuzzy logic, using EPANET to determine the cost of "saving" electricity and the recovered leak- age flow. This model is applied to a case study in the city of Celaya, Guanajuato, Mexico.

48 CFR 871.208 - Rehabilitation facilities.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Rehabilitation facilities... Vocational Rehabilitation and Employment Service 871.208 Rehabilitation facilities. Charges by rehabilitation facilities for the rehabilitation services provided under 38 U.S.C. Chapter 31 are paid in the same manner as...

Geographic information systems (GIS): an emerging method to assess demand and provision for rehabilitation services.

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Passalent, Laura; Borsy, Emily; Landry, Michel D; Cott, Cheryl

2013-09-01

To illustrate the application of geographic information systems (GIS) as a tool to assess rehabilitation service delivery by presenting results from research recently conducted to assess demand and provision for community rehabilitation service delivery in Ontario, Canada. Secondary analysis of data obtained from existing sources was used to establish demand and provision profiles for community rehabilitation services. These data were integrated using GIS software. A number of descriptive maps were produced that show the geographical distribution of service provision variables (location of individual rehabilitation health care providers and location of private and publicly funded community rehabilitation clinics) in relation to the distribution of demand variables (location of the general population; location of specific populations (i.e., residents age 65 and older) and distribution of household income). GIS provides a set of tools for describing and understanding the spatial organization of the health of populations and the distribution of health services that can aid the development of health policy and answer key research questions with respect to rehabilitation health services delivery. Implications for Rehabilitation It is important to seek out alternative and innovative methods to examine rehabilitation service delivery. GIS is a computer-based program that takes any data linked to a geographically referenced location and processes it through a software system that manages, analyses and displays the data in the form of a map, allowing for an alternative level of analysis. GIS provides a set of tools for describing and understanding the spatial organization of population health and health services that can aid the development of health policy and answer key research questions with respect to rehabilitation health services delivery.

Multisensory stimulation in stroke rehabilitation

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Barbro Birgitta Johansson

2012-04-01

Full Text Available The brain has a large capacity for automatic simultaneous processing and integration of sensory information. Combining information from different sensory modalities facilitates our ability to detect, discriminate, and recognize sensory stimuli, and learning is often optimal in a multisensory environment. Currently used multisensory stimulation methods in stroke rehabilitation include motor imagery, action observation, training with a mirror or in a virtual environment, or various kinds of music therapy. Several studies have shown positive effects been reported but to give general recommendation more studies are needed. Patient heterogeneity and the interactions of age, gender, genes and environment are discussed. Randomized controlled longitudinal trials starting earlier post stroke are needed. The advance in brain network science and neuroimaging enabling longitudinal studies of structural and functional networks are likely to have an important impact on patient selection for specific interventions in future stroke rehabilitation.

Requirements Elicitation and Prototyping of a Fully Immersive Virtual Reality Gaming System for Upper Limb Stroke Rehabilitation in Saudi Arabia

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Maram AlMousa

2017-01-01

Full Text Available Stroke rehabilitation plays an important role in recovering the lifestyle of stroke survivors. Although existing research proved the effectiveness and engagement of nonimmersive virtual reality- (VR- based rehabilitation systems, limited research is available on the applicability of fully immersive VR-based rehabilitation systems. In this paper, we present the elicited requirements of a fully immersive VR-based rehabilitation system that will be designed for domestic upper limb stroke patients; we will also provide an initial conceptual prototype of the proposed system.

The cybernetic rehabilitation aid: preliminary results for wrist and elbow motions in healthy subjects.

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Akdogan, Erhan; Shima, Keisuke; Kataoka, Hitoshi; Hasegawa, Masaki; Otsuka, Akira; Tsuji, Toshio

2012-09-01

This paper proposes the cybernetic rehabilitation aid (CRA) based on the concept of direct teaching using tactile feedback with electromyography (EMG)-based motor skill evaluation. Evaluation and teaching of motor skills are two important aspects of rehabilitation training, and the CRA provides novel and effective solutions to potentially solve the difficulties inherent in these two processes within a single system. In order to evaluate motor skills, EMG signals measured from a patient are analyzed using a log-linearized Gaussian mixture network that can classify motion patterns and compute the degree of similarity between the patient's measured EMG patterns and the desired pattern provided by the therapist. Tactile stimulators are used to convey motion instructions from the therapist or the system to the patient, and a rehabilitation robot can also be integrated into the developed prototype to increase its rehabilitation capacity. A series of experiments performed using the developed prototype demonstrated that the CRA can work as a human-human, human-computer and human-machine system. The experimental results indicated that the healthy (able-bodied) subjects were able to follow the desired muscular contraction levels instructed by the therapist or the system and perform proper joint motion without relying on visual feedback.

Talking about the institutional complexity of the integrated rehabilitation system – the importance of coordination

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Sari Miettinen

2013-03-01

Full Text Available Rehabilitation in Finland is a good example of functions divided among several welfare sectors, such as health services and social services.  The rehabilitation system in Finland is a complex one and there have been many efforts to create a coordinated entity. The purpose of this study is to open up a complex welfare system at the upper policy level and to understand the meaning of coordination at the level of service delivery. We shed light in particular on the national rehabilitation policy in Finland and how the policy has tried to overcome the negative effects of institutional complexity. In this study we used qualitative content analysis and frame analysis. As a result we identified four different welfare state frames with distinct features of policy problems, policy alternatives and institutional failure. The rehabilitation policy in Finland seems to be divided into different components which may cause problems at the level of service delivery and thus in the integration of services. Bringing these components together could at policy level enable a shared view of the rights of different population groups, effective management of integration at the level of service delivery and also an opportunity for change throughout the rehabilitation system.

Developing a personalised self-management system for post stroke rehabilitation; utilising a user-centred design methodology.

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Mawson, Susan; Nasr, Nasrin; Parker, Jack; Zheng, Huiru; Davies, Richard; Mountain, Gail

2014-11-01

To develop and evaluate an information and communication technology (ICT) solution for a post-stroke Personalised Self-Managed Rehabilitation System (PSMrS). The PSMrS translates current models of stroke rehabilitation and theories underpinning self-management and self-efficacy into an ICT-based system for home-based post-stroke rehabilitation. The interdisciplinary research team applied a hybrid of health and social sciences research methods and user-centred design methods. This included a series of home visits, focus groups, in-depth interviews, cultural probes and technology biographies. The iterative development of both the content of the PSMrS and the interactive interfaces between the system and the user incorporates current models of post-stroke rehabilitation and addresses the factors that promote self-managed behaviour and self-efficacy such as mastery, verbal persuasion and physiological feedback. The methodological approach has ensured that the interactive technology has been driven by the needs of the stroke survivors and their carers in the context of their journey to both recovery and adaptation. Underpinned by theories of motor relearning, neuroplasticity, self-management and behaviour change, the PSMrS developed in this study has resulted in a personalised system for self-managed rehabilitation, which has the potential to change motor behaviour and promote the achievement of life goals for stroke survivors.

Renewal or rehabilitation of urban river and stream corridors

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Matjaž Mikoš

2001-01-01

Full Text Available Analyses of the morphological state of urban streams and rivers in the Municipality of Ljubljana and research concerning the hydrographical network show that the condition of their morphological preservation is alarming. Efforts put in the new spatial development concept, guidelines and proposals for urban rehabilitation are therefore also an opportunity for rehabilitation measures on the municipal hydrographical network. Adequate care should be given to their improved morphological state even because of the recently adopted European framework water directive (annex 5, that after a certain period demands such a status of surface water in signatory countries.

Feedback error learning controller for functional electrical stimulation assistance in a hybrid robotic system for reaching rehabilitation

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Francisco Resquín

2016-07-01

Full Text Available Hybrid robotic systems represent a novel research field, where functional electrical stimulation (FES is combined with a robotic device for rehabilitation of motor impairment. Under this approach, the design of robust FES controllers still remains an open challenge. In this work, we aimed at developing a learning FES controller to assist in the performance of reaching movements in a simple hybrid robotic system setting. We implemented a Feedback Error Learning (FEL control strategy consisting of a feedback PID controller and a feedforward controller based on a neural network. A passive exoskeleton complemented the FES controller by compensating the effects of gravity. We carried out experiments with healthy subjects to validate the performance of the system. Results show that the FEL control strategy is able to adjust the FES intensity to track the desired trajectory accurately without the need of a previous mathematical model.

[Remote intelligent Brunnstrom assessment system for upper limb rehabilitation for post-stroke based on extreme learning machine].

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Wang, Yue; Yu, Lei; Fu, Jianming; Fang, Qiang

2014-04-01

In order to realize an individualized and specialized rehabilitation assessment of remoteness and intelligence, we set up a remote intelligent assessment system of upper limb movement function of post-stroke patients during rehabilitation. By using the remote rehabilitation training sensors and client data sampling software, we collected and uploaded the gesture data from a patient's forearm and upper arm during rehabilitation training to database of the server. Then a remote intelligent assessment system, which had been developed based on the extreme learning machine (ELM) algorithm and Brunnstrom stage assessment standard, was used to evaluate the gesture data. To evaluate the reliability of the proposed method, a group of 23 stroke patients, whose upper limb movement functions were in different recovery stages, and 4 healthy people, whose upper limb movement functions were normal, were recruited to finish the same training task. The results showed that, compared to that of the experienced rehabilitation expert who used the Brunnstrom stage standard table, the accuracy of the proposed remote Brunnstrom intelligent assessment system can reach a higher level, as 92.1%. The practical effects of surgery have proved that the proposed system could realize the intelligent assessment of upper limb movement function of post-stroke patients remotely, and it could also make the rehabilitation of the post-stroke patients at home or in a community care center possible.

The hydraulic capacity of deteriorating sewer systems.

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Pollert, J; Ugarelli, R; Saegrov, S; Schilling, W; Di Federico, V

2005-01-01

Sewer and wastewater systems suffer from insufficient capacity, construction flaws and pipe deterioration. Consequences are structural failures, local floods, surface erosion and pollution of receiving waters bodies. European cities spend in the order of five billion Euro per year for wastewater network rehabilitation. This amount is estimated to increase due to network ageing. The project CARE-S (Computer Aided RE-habilitation of Sewer Networks) deals with sewer and storm water networks. The final project goal is to develop integrated software, which provides the most cost-efficient system of maintenance, repair and rehabilitation of sewer networks. Decisions on investments in rehabilitation often have to be made with uncertain information about the structural condition and the hydraulic performance of a sewer system. Because of this, decision-making involves considerable risks. This paper presents the results of research focused on the study of hydraulic effects caused by failures due to temporal decline of sewer systems. Hydraulic simulations are usually carried out by running commercial models that apply, as input, default values of parameters that strongly influence results. Using CCTV inspections information as dataset to catalogue principal types of failures affecting pipes, a 3D model was used to evaluate their hydraulic consequences. The translation of failures effects in parameters values producing the same hydraulic conditions caused by failures was carried out through the comparison of laboratory experiences and 3D simulations results. Those parameters could be the input of 1D commercial models instead of the default values commonly inserted.

The compatibility of off-grid technologies in the rehabilitation of energy network of minor historical centres

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Chiara Marchionni

2014-05-01

Full Text Available The research links the issue of recovery of the small Italian historic centres to the environmental issue, proposing the sustainable recovery as opportunity to carry out a virtuous action in the territory. The study of these territories, particularly the inner area of Abruzzo Region affected by the earthquake of April 6, 2009, offers the opportunity to carry out a research that aims to redevelop a heritage abandoned for year, now further compromised by the earthquake. An operational methodology aimed at energetic rehabilitation of the minor centres has been drawn up, which starts from an in-depth knowledge of the investigation area, identifying its peculiarity. Then we analyzed the intervention area and highlighted the applicable technologies through a careful “process of compatibility” (Zordan et al., 2002 with the context. In the present study there is an interest in the topic of energy networks, in their state of use and deterioration and possibility of renewable energy sources integration. In particular, we examine/analyze the off-grid technological systems potentiality and criticality, identifying the possibility of their application in the minor centres.

Proposing and Planning the Rehabilitation Works of Mechanical Utility System in Malaysian Nuclear Agency

International Nuclear Information System (INIS)

Jusnan Hasim; Mohamad Suhaimi Yahaya; Abdul Razak Hashim

2015-01-01

Nuclear Malaysia has 2 complex located in Bangi and Jalan Dengkil. The utility in Nuclear Malaysia consists of civil, mechanical and electrical system that has been managed by Bahagian Kejuruteraan (BKJ). The mechanical utilities system has been divided to three main groups which are the main system, supporting system and safety equipment's. The objectives of this paper are to propose and plan the rehabilitation works of mechanical utility system in Nuclear Malaysia and also to explain working procedures in maintaining and repairing the mechanical utility system. The study suggest the rehabilitation works on the mechanical utilities system especially on Thermal Energy Storage (TES) and domestic water system needs to be done which involve process of design, procurement, installation and commissioning. (author)

Mapping biological systems to network systems

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Rathore, Heena

2016-01-01

The book presents the challenges inherent in the paradigm shift of network systems from static to highly dynamic distributed systems – it proposes solutions that the symbiotic nature of biological systems can provide into altering networking systems to adapt to these changes. The author discuss how biological systems – which have the inherent capabilities of evolving, self-organizing, self-repairing and flourishing with time – are inspiring researchers to take opportunities from the biology domain and map them with the problems faced in network domain. The book revolves around the central idea of bio-inspired systems -- it begins by exploring why biology and computer network research are such a natural match. This is followed by presenting a broad overview of biologically inspired research in network systems -- it is classified by the biological field that inspired each topic and by the area of networking in which that topic lies. Each case elucidates how biological concepts have been most successfully ...

[Changes in workers' rehabilitation procedures under the Brazilian social security system: modernization or undermining of social protection?].

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Takahashi, Mara Alice Batista Conti; Iguti, Aparecida Mari

2008-11-01

This article describes the changes in workers' rehabilitation practices under the Brazilian National Social Security Institute (INSS) in the 1990s, in the context of neoliberal economic adjustment measures, based on an analysis of INSS documents from 1992 to 1997. The INSS plan for "modernization" of workers' rehabilitation led to: (1) dismantling of multidisciplinary teams; (2) induction of workers to accept proportional retirement pensions and voluntary layoffs; (3) under-utilization of the remaining INSS professional staff; (4) elimination of treatment programs for workers' rehabilitation; and (5) dismantling of INSS rehabilitation centers and clinics. The changes in the Brazilian social security system undermined the county's social security project and hegemony and reduced social security reform to a mere management and fiscal issue. Current "rehabilitation" falls far short of the institution's original purpose of social protection for workers, while aiming at economic regulation of the system to contain costs of workers' benefits. Workers that suffer work-related accidents are denied occupational rehabilitation, which aggravates their social disadvantage when they return to work.

A Novel Remote Rehabilitation System with the Fusion of Noninvasive Wearable Device and Motion Sensing for Pulmonary Patients.

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Tey, Chuang-Kit; An, Jinyoung; Chung, Wan-Young

2017-01-01

Chronic obstructive pulmonary disease is a type of lung disease caused by chronically poor airflow that makes breathing difficult. As a chronic illness, it typically worsens over time. Therefore, pulmonary rehabilitation exercises and patient management for extensive periods of time are required. This paper presents a remote rehabilitation system for a multimodal sensors-based application for patients who have chronic breathing difficulties. The process involves the fusion of sensory data-captured motion data by stereo-camera and photoplethysmogram signal by a wearable PPG sensor-that are the input variables of a detection and evaluation framework. In addition, we incorporated a set of rehabilitation exercises specific for pulmonary patients into the system by fusing sensory data. Simultaneously, the system also features medical functions that accommodate the needs of medical professionals and those which ease the use of the application for patients, including exercises for tracking progress, patient performance, exercise assignments, and exercise guidance. Finally, the results indicate the accurate determination of pulmonary exercises from the fusion of sensory data. This remote rehabilitation system provides a comfortable and cost-effective option in the healthcare rehabilitation system.

Preliminary Evaluation of a Personal Healthcare System Prototype for Cognitive eRehabilitation in a Living Assistance Domain

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Matteo Pastorino

2014-06-01

Full Text Available The integration of rehabilitation systems in an ambient assisted living environment can provide a powerful and versatile tool for long-term stroke rehabilitation goals. This paper introduces a novel concept of a personalized cognitive rehabilitation system in a naturalistic setting. The proposed platform was developed within the CogWatch project, with the intent of fostering independence in activities of daily living in patients with apraxia and action disorganization syndrome. Technical usability was evaluated in a series of pilot experiments, which illustrate how this approach may help to retrain patients in activities of daily living. The first system prototype has been tested with 36 participants divided into three groups, providing an exploratory evaluation of the usability of this solution and its acceptability. The technical solutions used within the CogWatch project are targeted to meet both the end users’ needs from the interaction and usability point of views and the clinical requirements associated with the use of such systems. The challenges behind the development of ambient assisted living systems for cognitive rehabilitation are discussed.

Tele-rehabilitation using in-house wearable ankle rehabilitation robot.

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Jamwal, Prashant K; Hussain, Shahid; Mir-Nasiri, Nazim; Ghayesh, Mergen H; Xie, Sheng Q

2018-01-01

This article explores wide-ranging potential of the wearable ankle robot for in-house rehabilitation. The presented robot has been conceptualized following a brief analysis of the existing technologies, systems, and solutions for in-house physical ankle rehabilitation. Configuration design analysis and component selection for ankle robot have been discussed as part of the conceptual design. The complexities of human robot interaction are closely encountered while maneuvering a rehabilitation robot. We present a fuzzy logic-based controller to perform the required robot-assisted ankle rehabilitation treatment. Designs of visual haptic interfaces have also been discussed, which will make the treatment interesting, and the subject will be motivated to exert more and regain lost functions rapidly. The complex nature of web-based communication between user and remotely sitting physiotherapy staff has also been discussed. A high-level software architecture appended with robot ensures user-friendly operations. This software is made up of three important components: patient-related database, graphical user interface (GUI), and a library of exercises creating virtual reality-specifically developed for ankle rehabilitation.

Developing and Evaluating Creativity Gamification Rehabilitation System: The Application of PCA-ANFIS Based Emotions Model

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Su, Chung-Ho; Cheng, Ching-Hsue

2016-01-01

This study aims to explore the factors in a patient's rehabilitation achievement after a total knee replacement (TKR) patient exercises, using a PCA-ANFIS emotion model-based game rehabilitation system, which combines virtual reality (VR) and motion capture technology. The researchers combine a principal component analysis (PCA) and an adaptive…

Network operating system

Science.gov (United States)

1985-01-01

Long-term and short-term objectives for the development of a network operating system for the Space Station are stated. The short-term objective is to develop a prototype network operating system for a 100 megabit/second fiber optic data bus. The long-term objective is to establish guidelines for writing a detailed specification for a Space Station network operating system. Major milestones are noted. Information is given in outline form.

Biofeedback in rehabilitation.

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Giggins, Oonagh M; Persson, Ulrik McCarthy; Caulfield, Brian

2013-06-18

This paper reviews the literature relating to the biofeedback used in physical rehabilitation. The biofeedback methods used in rehabilitation are based on biomechanical measurements and measurements of the physiological systems of the body. The physiological systems of the body which can be measured to provide biofeedback are the neuromuscular system, the respiratory system and the cardiovascular system. Neuromuscular biofeedback methods include electromyography (EMG) biofeedback and real-time ultrasound imaging (RTUS) biofeedback. EMG biofeedback is the most widely investigated method of biofeedback and appears to be effective in the treatment of many musculoskeletal conditions and in post cardiovascular accident (CVA) rehabilitation. RTUS biofeedback has been demonstrated effective in the treatment of low back pain (LBP) and pelvic floor muscle dysfunction. Cardiovascular biofeedback methods have been shown to be effective in the treatment of a number of health conditions such as hypertension, heart failure, asthma, fibromyalgia and even psychological disorders however a systematic review in this field has yet to be conducted. Similarly, the number of large scale studies examining the use of respiratory biofeedback in rehabilitation is limited. Measurements of movement, postural control and force output can be made using a number of different devices and used to deliver biomechanical biofeedback. Inertial based sensing biofeedback is the most widely researched biomechanical biofeedback method, with a number of studies showing it to be effective in improving measures of balance in a number of populations. Other types of biomechanical biofeedback include force plate systems, electrogoniometry, pressure biofeedback and camera based systems however the evidence for these is limited. Biofeedback is generally delivered using visual displays, acoustic or haptic signals, however more recently virtual reality (VR) or exergaming technology have been used as biofeedback

Sustainability assessment, rating systems and historical buildings Case study: Rehabilitated construction in a university site

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Sadrykia Somayeh

2016-01-01

Full Text Available This paper explores the relationship between the indicators and different factors that “rating systems for green projects” concentrates on, and principles and factors considered in the rehabilitation of historical buildings. In recent years, different methods and systems concerned and improved for assessing environmental sustainability. LEED (Leadership in Energy and Environmental Design and BREEAM (Building Research Establishment (BRE Environmental Assessment Method are two most commonly used rating systems, established in U.S and UK. These systems comprise some categories and different factors to achieve environmentally responsible design. Firstly, this study focuses on the list of rating systems indicators and criteria. Secondly this paper investigates a historical rehabilitated building in the site of Tabriz Art University, as a case study and has tried to compile its green design elements. Finally, this work intends to compare mentioned elements with indicators and factors of building rating systems. Findings of the study revealed that “Materials and Resources”, “indoor environmental quality” and also “Sustainable Sites” ,the most significant indicator of rating systems, had major and important role in the rehabilitation of the building. Beyond this materials’ life cycle was considerable in construction.

Evaluation of super-link system theory for spinal cord injury patients using participatory action research in a rehabilitation hospital.

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Chen, Hsiao-Yu; Wu, Tzu-Jung; Cheng, Mei-Li; Sung, Hsi-Hui

2012-01-01

The purpose of this study was to integrate and evaluate the spinal cord injury rehabilitation nursing theory named Super-Link System Theory using participatory action research. Data were collected from October 2007 to September 2008 in a rehabilitation hospital by means of interviews, participant observations, documentary resources, case conferences and reports, and participants' self-reflective inquiries. The Super-Link System Theory was introduced to 31 rehabilitation nurses. The nurses selected a key reference group including the researcher to facilitate the participatory action research process to implement and evaluate the theory. Data were analyzed using content analysis. The findings shows that several key concepts were clarified and specific nursing interventions were identified. Furthermore, an integrated link system from the hospital to the community through both rehabilitation nurses and discharge planners was established. The study demonstrated an evidence base for an evolving theory of care, and empowered nurses to make sustainable changes to their practice. © 2012 Association of Rehabilitation Nurses.

Network SCADA System

International Nuclear Information System (INIS)

Milivojevic, Dragan R.; Tasic, Visa; Karabasevic, Dejan

2003-01-01

Copper Institute, Industrial Informatics department, is developing and applying network real time process monitoring and control systems. Some of these systems are already in use. The paper presents some hardware and software general remarks and performances, with special regard to communication sub-systems and network possibilities. (Author)

[Cardiac rehabilitation: current status and future challenges].

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Hahmann, H W

2012-02-01

The goal of cardiac rehabilitation is to support heart patients using a multidisciplinary team in order to obtain the best possible physical and mental health and achieve long-term social reintegration. In addition to improving physical fitness, cardiac rehabilitation restores self-confidence, thus better equipping patients to deal with mental illness and improving their social reintegration ("participation"). Once the causes of disease have been identified and treated as effectively as possible, drug and lifestyle changes form the focus of cardiac rehabilitation measures. In particular diseases, rehabilitation offers the opportunity for targeted educational courses for diabetics or drug dose escalation, as well as special training for heart failure patients. A nationwide network of outpatient heart groups is available for targeted follow-up. Cardiac patients predominantly rehabilitated in follow-up rehabilitation are older and have greater morbidity than in the past; moreover, they generally come out of acute clinical care earlier and are discharged from hospital more quickly. The proportion of severely ill and multimorbid patients presents a diagnostic and therapeutic challenge in cardiac rehabilitation, although cardiac rehabilitation was not initially conceived for this patient group. The benefit of cardiac rehabilitation has been a well documented reduction in morbidity and mortality. However, hurdles remain, partly due to the patients themselves, partly due to the health insurers. Some insurance providers still refuse rehabilitation for non-ST-segment elevation infarction. In principle rehabilitation can be carried out in an inpatient or an outpatient setting. Specific allocation criteria have not yet been established, but the structure and process quality of outpatient rehabilitation should correspond to that of the inpatient setting. The choice between the two settings should be based on pragmatic criteria. Both settings should be possible for an individual

Proprioception rehabilitation training system for stroke patients using virtual reality technology.

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Kim, Sun I; Song, In-Ho; Cho, Sangwoo; Kim, In Young; Ku, Jeonghun; Kang, Youn Joo; Jang, Dong Pyo

2013-01-01

We investigated a virtual reality (VR) proprioceptive rehabilitation system that could manipulate the visual feedback of upper-limb during training and could do training by relying on proprioception feedback only. Virtual environments were designed in order to switch visual feedback on/off during upper-limb training. Two types of VR training tasks were designed for evaluating the effect of the proprioception focused training compared to the training with visual feedback. In order to evaluate the developed proprioception feedback virtual environment system, we recruited ten stroke patients (age: 54.7± 7.83years, on set: 3.29± 3.83 years). All patients performed three times PFVE task in order to check the improvement of proprioception function just before training session, after one week training, and after all training. In a comparison between FMS score and PFVE, the FMS score had a significant relationship with the error distance(r = -.662, n=10, p = .037) and total movement distance(r = -.726, n=10, p = .018) in PFVE. Comparing the training effect between in virtual environment with visual feedback and with proprioception, the click count, error distance and total error distance was more reduced in PFVE than VFVE. (Click count: p = 0.005, error distance: p = 0.001, total error distance: p = 0.007). It suggested that the proprioception feedback rather than visual feedback could be effective means to enhancing motor control during rehabilitation training. The developed VR system for rehabilitation has been verified in that stroke patients improved motor control after VR proprioception feedback training.

What Do Stroke Patients Look for in Game-Based Rehabilitation

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Hung, Ya-Xuan; Huang, Pei-Chen; Chen, Kuan-Ta; Chu, Woei-Chyn

2016-01-01

Abstract Stroke is one of the most common causes of physical disability, and early, intensive, and repetitive rehabilitation exercises are crucial to the recovery of stroke survivors. Unfortunately, research shows that only one third of stroke patients actually perform recommended exercises at home, because of the repetitive and mundane nature of conventional rehabilitation exercises. Thus, to motivate stroke survivors to engage in monotonous rehabilitation is a significant issue in the therapy process. Game-based rehabilitation systems have the potential to encourage patients continuing rehabilitation exercises at home. However, these systems are still rarely adopted at patients’ places. Discovering and eliminating the obstacles in promoting game-based rehabilitation at home is therefore essential. For this purpose, we conducted a study to collect and analyze the opinions and expectations of stroke patients and clinical therapists. The study is composed of 2 parts: Rehab-preference survey – interviews to both patients and therapists to understand the current practices, challenges, and expectations on game-based rehabilitation systems; and Rehab-compatibility survey – a gaming experiment with therapists to elaborate what commercial games are compatible with rehabilitation. The study is conducted with 30 outpatients with stroke and 19 occupational therapists from 2 rehabilitation centers in Taiwan. Our surveys show that game-based rehabilitation systems can turn the rehabilitation exercises more appealing and provide personalized motivation for various stroke patients. Patients prefer to perform rehabilitation exercises with more diverse and fun games, and need cost-effective rehabilitation systems, which are often built on commodity hardware. Our study also sheds light on incorporating the existing design-for-fun games into rehabilitation system. We envision the results are helpful in developing a platform which enables rehab-compatible (i.e., existing

Development of a system based on 3D vision, interactive virtual environments, ergonometric signals and a humanoid for stroke rehabilitation.

Science.gov (United States)

Ibarra Zannatha, Juan Manuel; Tamayo, Alejandro Justo Malo; Sánchez, Angel David Gómez; Delgado, Jorge Enrique Lavín; Cheu, Luis Eduardo Rodríguez; Arévalo, Wilson Alexander Sierra

2013-11-01

This paper presents a stroke rehabilitation (SR) system for the upper limbs, developed as an interactive virtual environment (IVE) based on a commercial 3D vision system (a Microsoft Kinect), a humanoid robot (an Aldebaran's Nao), and devices producing ergonometric signals. In one environment, the rehabilitation routines, developed by specialists, are presented to the patient simultaneously by the humanoid and an avatar inside the IVE. The patient follows the rehabilitation task, while his avatar copies his gestures that are captured by the Kinect 3D vision system. The information of the patient movements, together with the signals obtained from the ergonometric measurement devices, is used also to supervise and to evaluate the rehabilitation progress. The IVE can also present an RGB image of the patient. In another environment, that uses the same base elements, four game routines--Touch the balls 1 and 2, Simon says, and Follow the point--are used for rehabilitation. These environments are designed to create a positive influence in the rehabilitation process, reduce costs, and engage the patient. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

A Personalized Self-Management Rehabilitation System with an Intelligent Shoe for Stroke Survivors: A Realist Evaluation.

Science.gov (United States)

Mawson, Susan; Nasr, Nasrin; Parker, Jack; Davies, Richard; Zheng, Huiru; Mountain, Gail

2016-01-07

In the United Kingdom, stroke is the most significant cause of adult disability. Stroke survivors are frequently left with physical and psychological changes that can profoundly affect their functional ability, independence, and social participation. Research suggests that long-term, intense, task- and context-specific rehabilitation that is goal-oriented and environmentally enriched improves function, independence, and quality of life after a stroke. It is recommended that rehabilitation should continue until maximum recovery has been achieved. However, the increasing demand on services and financial constraints means that needs cannot be met through traditional face-to-face delivery of rehabilitation. Using a participatory design methodology, we developed an information communication technology-enhanced Personalized Self-Managed rehabilitation System (PSMrS) for stroke survivors with integrated insole sensor technology within an "intelligent shoe.". The intervention model was based around a rehabilitation paradigm underpinned by theories of motor relearning and neuroplastic adaptation, motivational feedback, self-efficacy, and knowledge transfer. To understand the conditions under which this technology-based rehabilitation solution would most likely have an impact on the motor behavior of the user, what would work for whom, in what context, and how. We were interested in what aspects of the system would work best to facilitate the motor behavior change associated with self-managed rehabilitation and which user characteristics and circumstances of use could promote improved functional outcomes. We used a Realist Evaluation (RE) framework to evaluate the final prototype PSMrS with the assumption that the intervention consists of a series of configurations that include the Context of use, the underlying Mechanisms of change and the potential Outcomes or impacts (CMOs). We developed the CMOs from literature reviews and engagement with clinicians, users, and

Movement-based interaction applied to physical rehabilitation therapies.

Science.gov (United States)

Garrido Navarro, Juan Enrique; Ruiz Penichet, Victor Manuel; Lozano Pérez, María Dolores

2014-12-09

Health care environments are continuously improving conditions, especially regarding the use of current technology. In the field of rehabilitation, the use of video games and related technology has helped to develop new rehabilitation procedures. Patients are able to work on their disabilities through new processes that are more motivating and entertaining. However, these patients are required to leave their home environment to complete their rehabilitation programs. The focus of our research interests is on finding a solution to eliminate the need for patients to interrupt their daily routines to attend rehabilitation therapy. We have developed an innovative system that allows patients with a balance disorder to perform a specific rehabilitation exercise at home. Additionally, the system features an assistive tool to complement the work of physiotherapists. Medical staff are thus provided with a system that avoids the need for them to be present during the exercise in specific cases in which patients are under suitable supervision. A movement-based interaction device was used to achieve a reliable system for monitoring rehabilitation exercises performed at home. The system accurately utilizes parameters previously defined by the specialist for correct performance of the exercise. Accordingly, the system gives instructions and corrects the patient's actions. The data generated during the session are collected for assessment by the specialist to adapt the difficulty of the exercise to the patient's progress. The evaluation of the system was conducted by two experts in balance disorder rehabilitation. They were required to verify the effectiveness of the system, and they also facilitated the simulation of real patient behavior. They used the system freely for a period of time and provided interesting and optimistic feedback. First, they evaluated the system as a tool for real-life rehabilitation therapy. Second, their interaction with the system allowed us to obtain

A review of wearable sensors and systems with application in rehabilitation

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Patel Shyamal

2012-04-01

Full Text Available Abstract The aim of this review paper is to summarize recent developments in the field of wearable sensors and systems that are relevant to the field of rehabilitation. The growing body of work focused on the application of wearable technology to monitor older adults and subjects with chronic conditions in the home and community settings justifies the emphasis of this review paper on summarizing clinical applications of wearable technology currently undergoing assessment rather than describing the development of new wearable sensors and systems. A short description of key enabling technologies (i.e. sensor technology, communication technology, and data analysis techniques that have allowed researchers to implement wearable systems is followed by a detailed description of major areas of application of wearable technology. Applications described in this review paper include those that focus on health and wellness, safety, home rehabilitation, assessment of treatment efficacy, and early detection of disorders. The integration of wearable and ambient sensors is discussed in the context of achieving home monitoring of older adults and subjects with chronic conditions. Future work required to advance the field toward clinical deployment of wearable sensors and systems is discussed.

Action observation and mirror neuron network: a tool for motor stroke rehabilitation.

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Sale, P; Franceschini, M

2012-06-01

Mirror neurons are a specific class of neurons that are activated and discharge both during observation of the same or similar motor act performed by another individual and during the execution of a motor act. Different studies based on non invasive neuroelectrophysiological assessment or functional brain imaging techniques have demonstrated the presence of the mirror neuron and their mechanism in humans. Various authors have demonstrated that in the human these networks are activated when individuals learn motor actions via execution (as in traditional motor learning), imitation, observation (as in observational learning) and motor imagery. Activation of these brain areas (inferior parietal lobe and the ventral premotor cortex, as well as the caudal part of the inferior frontal gyrus [IFG]) following observation or motor imagery may thereby facilitate subsequent movement execution by directly matching the observed or imagined action to the internal simulation of that action. It is therefore believed that this multi-sensory action-observation system enables individuals to (re) learn impaired motor functions through the activation of these internal action-related representations. In humans, the mirror mechanism is also located in various brain segment: in Broca's area, which is involved in language processing and speech production and not only in centres that mediate voluntary movement, but also in cortical areas that mediate visceromotor emotion-related behaviours. On basis of this finding, during the last 10 years various studies were carry out regarding the clinical use of action observation for motor rehabilitation of sub-acute and chronic stroke patients.

[The development of the system of medical rehabilitation based at the Russian health resort facilities: investment prospects].

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Povazhnaya, E L; Gusakova, E V; Moiseenko, S V

2018-05-21

The present work is devoted to the prospects for attracting investments for the maintenance and development of the medical rehabilitation practices based at the Russian health resort facilities. The article describes the prerequisites for the enhancement of the investment attractiveness of the development of the system of medical rehabilitation in the said institutions including the formulation and strengthening of the legal and regulatory framework, the capacity for the organization of the second and third stages of medical rehabilitation in the existing spa and health resort facilities, the attraction of the funds of compulsory medical insurance as an additional source of the financial support. The main legal documents regulating the organization and provision of medical rehabilitation based at the spa and health resort facilities are presented. The results of the implementation of the investment concept of the development of medical rehabilitation in the framework of the system of health resort treatment as exemplified by the experience of JSC «The group of companies «Medsi» are discussed. It is shown that the development of medical rehabilitation based at the spa and health resort facilities greatly contributes to the significant expansion of the potential customer base and promotes the further growth of business scale.

Computer network defense system

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Urias, Vincent; Stout, William M. S.; Loverro, Caleb

2017-08-22

A method and apparatus for protecting virtual machines. A computer system creates a copy of a group of the virtual machines in an operating network in a deception network to form a group of cloned virtual machines in the deception network when the group of the virtual machines is accessed by an adversary. The computer system creates an emulation of components from the operating network in the deception network. The components are accessible by the group of the cloned virtual machines as if the group of the cloned virtual machines was in the operating network. The computer system moves network connections for the group of the virtual machines in the operating network used by the adversary from the group of the virtual machines in the operating network to the group of the cloned virtual machines, enabling protecting the group of the virtual machines from actions performed by the adversary.

Implementation of Clinical Quality Management for Rehabilitation in Malaysia.

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Engkasan, Julia Patrick; Stucki, Gerold; Ali, Sadeeq; Yusof, Yusniza Mohd; Hussain, Hafez; Latif, Lydia Abdul

2018-04-18

In February 2017, the World Health Organization (WHO) launched its historic "Rehabilitation 2030: A Call for Action". Scaling up rehabilitation in health systems requires concerted action across all 6 components of WHO's Health Systems Framework. For rehabilitation, information about functioning is essential, as it is required for effective rehabilitation at all levels of the health system. What is missing is a countrywide demonstration project involving the implementation of a clinical quality management system for the continuous improvement of rehabilitation, both at the level of clinical care for individual patients and at the level of rehabilitation service provision. Consequently, the Department of Rehabilitation Medicine at the University of Malaya and University Malaya Medical Centre, together with the Cheras Rehabilitation Hospital of the Ministry of Health, and the Social Security Organisation (SOCSO) Rehabilitation Centre in Malacca, Malaysia, initiated a project to develop a Malaysian-wide clinical quality management system for rehabilitation (CQM-R Malaysia). The objective of this paper is to describe CQM-R Malaysia. First, a conceptual description of a CQM-R based on the International Classification of Functioning, Disability and Health (ICF) is set out. The methods, results and conclusions of a situation analysis conducted in January 2017 are then reported. Finally, the building blocks and implementation action plan developed for CQM-R Malaysia are presented.

Implementation of Clinical Quality Management for Rehabilitation in Malaysia

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Julia Patrick Engkasan

2017-11-01

Full Text Available In February 2017, the World Health Organization (WHO launched its historic ”Rehabilitation 2030: A Call for Action”. Scaling up rehabilitation in health systems requires concerted action across all 6 components of WHO’s Health Systems Framework. For rehabilitation, information about functioning is essential, as it is required for effective rehabilitation at all levels of the health system. What is missing is a countrywide demonstration project involving the implementation of a clinical quality management system for the continuous improvement of rehabilitation, both at the level of clinical care for individual patients and at the level of rehabilitation service provision. Consequently, the Department of Rehabilitation Medicine at the University of Malaya and University Malaya Medical Centre, together with the Cheras Rehabilitation Hospital of the Ministry of Health, and the Social Security Organisation (SOCSO Rehabilitation Centre in Malacca, Malaysia, initiated a project to develop a Malaysian-wide clinical quality management system for rehabilitation (CQM-R Malaysia. The objective of this paper is to describe CQM-R Malaysia. First, a conceptual description of a CQM-R based on the International Classification of Functioning, Disability and Health (ICF is set out. The methods, results and conclusions of a situation analysis conducted in January 2017 are then reported. Finally, the building blocks and implementation action plan developed for CQM-R Malaysia are presented.

Adaptive Inverse Optimal Control for Rehabilitation Robot Systems Using Actor-Critic Algorithm

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Fancheng Meng

2014-01-01

Full Text Available The higher goal of rehabilitation robot is to aid a person to achieve a desired functional task (e.g., tracking trajectory based on assisted-as-needed principle. To this goal, a new adaptive inverse optimal hybrid control (AHC combining inverse optimal control and actor-critic learning is proposed. Specifically, an uncertain nonlinear rehabilitation robot model is firstly developed that includes human motor behavior dynamics. Then, based on this model, an open-loop error system is formed; thereafter, an inverse optimal control input is designed to minimize the cost functional and a NN-based actor-critic feedforward signal is responsible for the nonlinear dynamic part contaminated by uncertainties. Finally, the AHC controller is proven (through a Lyapunov-based stability analysis to yield a global uniformly ultimately bounded stability result, and the resulting cost functional is meaningful. Simulation and experiment on rehabilitation robot demonstrate the effectiveness of the proposed control scheme.

Standards in Neurological Rehabilitation, June 1997

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Michael P. Barnes

1997-01-01

Full Text Available The European Federation of Neurological Societies (EFNS Scientific Panel on Neurorehabilitation established a Task Force on standards in neurological rehabilitation in June 1996. The remit for the Task Force was to: (1 produce a report on the state of neurological rehabilitation across Europe; and (2 recommend standards for the provision of neurological services for disabled people. The main conclusions of the Task Force were as follows: (1 A questionnaire circulated to each European member country has indicated a significant lack of adequate neurological rehabilitation facilities across Europe. Very few countries have any established network of neurological rehabilitation centres. Few countries have adequately trained neurological rehabilitation physicians, therapists or nurses. Such poor facilities should be seen in the context of the large numbers and increasing prevalence of people with neurological disabilities. (2 The Task Force has summarized the significant benefits that can follow from the establishment of a dedicated and cost effective neurological rehabilitation service including functional improvement, reduction of unnecessary complications, better coordination and use of limited resources, improved opportunities for education, training and research and a clear point of contact for the disabled person. (3 The Task Force recommends minimum standards for the prevention of neurological disability including access to health education, genetic counselling and emergency resources. The Task Force also encourages governments to invest in improved legislation for accident prevention. (4 The Task Force has outlined some minimum standards for the staffing of a neurological rehabilitation service including improved training both for neurologists and rehabilitation physicians. Such training could include a cross-national training programme both for physicians and other health care staff. (5 The Task Force supports a two-tier system of

Spinal Cord Injury Rehabilitation in Nepal

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Nabina Shah

2013-06-01

Full Text Available Spinal cord injury is a major trauma, with its short and long term effects and consequences to the patient, his friends and family. Spinal cord injury is addressed in the developed countries with standard trauma care system commencing immediately after injury and continuing to the specialized rehabilitation units. Rehabilitation is important to those with spinal injury for both functional and psychosocial reintegration. It has been an emerging concept in Nepal, which has been evident with the establishment of the various hospitals with rehabilitation units, rehabilitation centres and physical therapy units in different institutions. However, the spinal cord injury rehabilitation setting and scenario is different in Nepal from those in the developed countries since spinal cord injury rehabilitation care has not been adequately incorporated into the health care delivery system nor its importance has been realized within the medical community of Nepal. To name few, lack of human resource for the rehabilitation care, awareness among the medical personnel and general population, adequate scientific research evidence regarding situation of spinal injury and exorbitant health care policy are the important hurdles that has led to the current situation. Hence, it is our responsibility to address these apparent barriers to successful implementation and functioning of rehabilitation so that those with spinal injury would benefit from enhanced quality of life. Keywords: rehabilitation; spinal injury.

A small, portable, battery-powered brain-computer interface system for motor rehabilitation.

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McCrimmon, Colin M; Ming Wang; Silva Lopes, Lucas; Wang, Po T; Karimi-Bidhendi, Alireza; Liu, Charles Y; Heydari, Payam; Nenadic, Zoran; Do, An H

2016-08-01

Motor rehabilitation using brain-computer interface (BCI) systems may facilitate functional recovery in individuals after stroke or spinal cord injury. Nevertheless, these systems are typically ill-suited for widespread adoption due to their size, cost, and complexity. In this paper, a small, portable, and extremely cost-efficient (microcontroller and touchscreen. The system's performance was tested using a movement-related BCI task in 3 able-bodied subjects with minimal previous BCI experience. Specifically, subjects were instructed to alternate between relaxing and dorsiflexing their right foot, while their EEG was acquired and analyzed in real-time by the BCI system to decode their underlying movement state. The EEG signals acquired by the custom amplifier array were similar to those acquired by a commercial amplifier (maximum correlation coefficient ρ=0.85). During real-time BCI operation, the average correlation between instructional cues and decoded BCI states across all subjects (ρ=0.70) was comparable to that of full-size BCI systems. Small, portable, and inexpensive BCI systems such as the one reported here may promote a widespread adoption of BCI-based movement rehabilitation devices in stroke and spinal cord injury populations.

Some Knowledge Areas in Blindness Rehabilitation.

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Giesen, J. Martin; Cavenaugh, Brenda S.; Johnson, Cherie A.

1998-01-01

Provides an outline of knowledge areas in rehabilitation counseling and rehabilitation teaching related to visual impairments such as: core areas; planning and delivery services; job development, placement, and follow-along; job engineering; Braille and other tactual systems; communication systems; computers for individuals with visual…

The effect of the sensitivity of the BAS and BAS motivational systems on performance in stroke rehabilitation tasks

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Maja Milavec

2012-03-01

Full Text Available Stroke rehabilitation programs are often too short and not intensive enough, possibly due to a lack of patient motivation. This study examined whether the patient's mood, task success and psychophysiological responses are affected by the sensitivity of two motivational systems: the Behavioral Activation System (BAS and the Behavioral Inhibition System (BIS. 22 subacute stroke patients participated in the study. They performed an easier and harder version of a motor rehabilition task as well as the Stroop task. The sensitivities of the two motivational systems were measured using the BIS/BAS scale. Additionally, psychophysiological measurements (heart rate, skin conductance, respiration and skin temperature were taken and the Self-Assessment Manikin was used to measure self-reported valence and arousal. Results showed that valence and arousal are not significantly correlated with BIS/BAS subscales during the rehabilitation task. A negative correlation between valence and the BAS subscales was found in the Stroop task. Results also confirmed the initial hypothesis that the BAS would be correlated with task performance during the rehabilitation task while the BIS would be negatively correlated with task performance during the Stroop task. Only partial confirmation was found for the hypothesis that tasks that include a reward would affect heart rate in subjects with a sensitive BAS while tasks without a reward would affect skin conductance in subjects with a sensitive BIS. In both versions of the rehabilitation task, which includes a reward, the BAS reward subscale was negatively correlated with mean skin temperature. In the harder rehabilitation task, the BAS reward responsiveness subscale was positively correlated with mean heart rate. In the Stroop task, which has no reward, the BIS scale was positively correlated with mean heart rate. The BAS subscale was also negatively correlated with the RMSSD measure of heart rate variability. The results of

Metamorphosis: How Missouri Rehabilitates Juvenile Offenders

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Dubin, Jennifer

2012-01-01

Juveniles convicted of serious offenses usually end up in large correctional facilities that focus on punishment--not rehabilitation. The state of Missouri, however, has found a better way to help end the cycle of crime: by creating a network of small facilities that provide therapy and educational opportunities, it has dramatically reduced…

Exploring the bases for a mixed reality stroke rehabilitation system, Part I: A unified approach for representing action, quantitative evaluation, and interactive feedback

Science.gov (United States)

2011-01-01

Background Although principles based in motor learning, rehabilitation, and human-computer interfaces can guide the design of effective interactive systems for rehabilitation, a unified approach that connects these key principles into an integrated design, and can form a methodology that can be generalized to interactive stroke rehabilitation, is presently unavailable. Results This paper integrates phenomenological approaches to interaction and embodied knowledge with rehabilitation practices and theories to achieve the basis for a methodology that can support effective adaptive, interactive rehabilitation. Our resulting methodology provides guidelines for the development of an action representation, quantification of action, and the design of interactive feedback. As Part I of a two-part series, this paper presents key principles of the unified approach. Part II then describes the application of this approach within the implementation of the Adaptive Mixed Reality Rehabilitation (AMRR) system for stroke rehabilitation. Conclusions The accompanying principles for composing novel mixed reality environments for stroke rehabilitation can advance the design and implementation of effective mixed reality systems for the clinical setting, and ultimately be adapted for home-based application. They furthermore can be applied to other rehabilitation needs beyond stroke. PMID:21875441

Comparison of Multi-Criteria Decision Support Methods for Integrated Rehabilitation Prioritization

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Franz Tscheikner-Gratl

2017-01-01

Full Text Available The decisions taken in rehabilitation planning for the urban water networks will have a long lasting impact on the functionality and quality of future services provided by urban infrastructure. These decisions can be assisted by different approaches ranging from linear depreciation for estimating the economic value of the network over using a deterioration model to assess the probability of failure or the technical service life to sophisticated multi-criteria decision support systems. Subsequently, the aim of this paper is to compare five available multi-criteria decision-making (MCDM methods (ELECTRE, AHP, WSM, TOPSIS, and PROMETHEE for the application in an integrated rehabilitation management scheme for a real world case study and analyze them with respect to their suitability to be used in integrated asset management of water systems. The results of the different methods are not equal. This occurs because the chosen score scales, weights and the resulting distributions of the scores within the criteria do not have the same impact on all the methods. Independently of the method used, the decision maker must be familiar with its strengths but also weaknesses. Therefore, in some cases, it would be rational to use one of the simplest methods. However, to check for consistency and increase the reliability of the results, the application of several methods is encouraged.

Measuring acute rehabilitation needs in trauma: preliminary evaluation of the Rehabilitation Complexity Scale.

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Hoffman, Karen; West, Anita; Nott, Philippa; Cole, Elaine; Playford, Diane; Liu, Clarence; Brohi, Karim

2013-01-01

Injury severity, disability and care dependency are frequently used as surrogate measures for rehabilitation requirements following trauma. The true rehabilitation needs of patients may be different but there are no validated tools for the measurement of rehabilitation complexity in acute trauma care. The aim of the study was to evaluate the potential utility of the Rehabilitation Complexity Scale (RCS) version 2 in measuring acute rehabilitation needs in trauma patients. A prospective observation study of 103 patients with traumatic injuries in a Major Trauma Centre. Rehabilitation complexity was measured using the RCS and disability was measured using the Barthel Index. Demographic information and injury characteristics were obtained from the trauma database. The RCS was closely correlated with injury severity (r=0.69, p<0.001) and the Barthel Index (r=0.91, p<0.001). However the Barthel was poor at discriminating between patients rehabilitation needs, especially for patients with higher injury severities. Of 58 patients classified as 'very dependent' by the Barthel, 21 (36%) had low or moderate rehabilitation complexity. The RCS correlated with acute hospital length of stay (r=0.64, p=<0.001) and patients with a low RCS were more likely to be discharged home. The Barthel which had a flooring effect (56% of patients classified as very dependent were discharged home) and lacked discrimination despite close statistical correlation. The RCS outperformed the ISS and the Barthel in its ability to identify rehabilitation requirements in relation to injury severity, rehabilitation complexity, length of stay and discharge destination. The RCS is potentially a feasible and useful tool for the assessment of rehabilitation complexity in acute trauma care by providing specific measurement of patients' rehabilitation requirements. A larger longitudinal study is needed to evaluate the RCS in the assessment of patient need, service provision and trauma system performance

PROBLEMS AND CHANCES AT THE INTERFACE BETWEEN HOSPITAL CARE AND GERIATRIC REHABILITATION

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Fastenmeier Heribert

2011-07-01

Full Text Available Available statistical data offer valuable information on recent demographic changes and developments within European healthcare and welfare systems. The demographic evolution is expected to have considerable impact upon various, major aspects of the economic and social life in all European countries. The healthcare system plays an important role especially in the context of ageing societies, such as Germany. This paper focuses on the evolution of the prevention or rehabilitation service sector during the last years in Germany, analyzes the specific characteristics of the elderly patients being cared for in these facilities and underlines important aspects at the interface between (acute hospital and geriatric rehabilitative care. Networking, integrated care services and models will be of even greater importance in the future demographic setting generating (most probably increasing numbers and percentages of elderly, multimorbid hospitalized patients. More than this, the cooperation at regional level between acute geriatric hospital departments and geriatric rehabilitation facilities has become a mandatory quality criterion in the Free State of Bavaria. This paper presents and analyzes issues referring to a precise cooperation model (between acute and rehabilitative care recommended for implementation even by the Free State of Bavaria while emphasizing several examples of good practice that have guaranteed the success of this cooperation model. The analysis of the main causes leading to longer length of stay (and thus delayed discharges for the elderly patients transferred to geriatric rehabilitation facilities within the reference model for acute-rehabilitative care provides important information and points at the existing potential for optimization in the acute hospital setting. Vicinity, tight communication and cooperation, early screening, implementation of standard procedures and case management are some of the activities that have

Psychological Distress After Orthopedic Trauma: Prevalence in Patients and Implications for Rehabilitation.

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Vincent, Heather K; Horodyski, MaryBeth; Vincent, Kevin R; Brisbane, Sonya T; Sadasivan, Kalia K

2015-09-01

Orthopedic trauma is an unforeseen life-changing event. Serious injuries include multiple fractures and amputation. Physical rehabilitation has traditionally focused on addressing functional deficits after traumatic injury, but important psychological factors also can dramatically affect acute and long-term recovery. This review presents the effects of orthopedic trauma on psychological distress, potential interventions for distress reduction after trauma, and implications for participation in rehabilitation. Survivors commonly experience post-traumatic stress syndrome, depression, and anxiety, all of which interfere with functional gains and quality of life. More than 50% of survivors have psychological distress that can last decades after the physical injury has been treated. Early identification of patients with distress can help care teams provide the resources and support to offset the distress. Several options that help trauma patients navigate their short-term recovery include holistic approaches, pastoral care, coping skills, mindfulness, peer visitation, and educational resources. The long-term physical and mental health of the trauma survivor can be enhanced by strategies that connect the survivor to a network of people with similar experiences or injuries, facilitate support groups, and social support networking (The Trauma Survivors Network). Rehabilitation specialists can help optimize patient outcomes and quality of life by participating in and advocating these strategies. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Find a Physical Medicine & Rehabilitation Physician

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78 FR 26879 - Medicare Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal...

Science.gov (United States)

2013-05-08

... Prospective Payment System for Federal Fiscal Year 2014; Proposed Rule #0;#0;Federal Register / Vol. 78, No... Program; Inpatient Rehabilitation Facility Prospective Payment System for Federal Fiscal Year 2014 AGENCY... IRF prospective payment system's (PPS) case-mix groups and a description of the methodology and data...

Virtual reality and physical rehabilitation: a new toy or a new research and rehabilitation tool?

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Keshner Emily A

2004-12-01

Full Text Available Abstract Virtual reality (VR technology is rapidly becoming a popular application for physical rehabilitation and motor control research. But questions remain about whether this technology really extends our ability to influence the nervous system or whether moving within a virtual environment just motivates the individual to perform. I served as guest editor of this month's issue of the Journal of NeuroEngineering and Rehabilitation (JNER for a group of papers on augmented and virtual reality in rehabilitation. These papers demonstrate a variety of approaches taken for applying VR technology to physical rehabilitation. The papers by Kenyon et al. and Sparto et al. address critical questions about how this technology can be applied to physical rehabilitation and research. The papers by Sveistrup and Viau et al. explore whether action within a virtual environment is equivalent to motor performance within the physical environment. Finally, papers by Riva et al. and Weiss et al. discuss the important characteristics of a virtual environment that will be most effective for obtaining changes in the motor system.

Gesture Therapy: A Vision-Based System for Arm Rehabilitation after Stroke

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Sucar, L. Enrique; Azcárate, Gildardo; Leder, Ron S.; Reinkensmeyer, David; Hernández, Jorge; Sanchez, Israel; Saucedo, Pedro

Each year millions of people in the world survive a stroke, in the U.S. alone the figure is over 600,000 people per year. Movement impairments after stroke are typically treated with intensive, hands-on physical and occupational therapy for several weeks after the initial injury. However, due to economic pressures, stroke patients are receiving less therapy and going home sooner, so the potential benefit of the therapy is not completely realized. Thus, it is important to develop rehabilitation technology that allows individuals who had suffered a stroke to practice intensive movement training without the expense of an always-present therapist. Current solutions are too expensive, as they require a robotic system for rehabilitation. We have developed a low-cost, computer vision system that allows individuals with stroke to practice arm movement exercises at home or at the clinic, with periodic interactions with a therapist. The system integrates a web based virtual environment for facilitating repetitive movement training, with state-of-the art computer vision algorithms that track the hand of a patient and obtain its 3-D coordinates, using two inexpensive cameras and a conventional personal computer. An initial prototype of the system has been evaluated in a pilot clinical study with promising results.

Challenges of rehabilitation case mix measurement in Ontario hospitals.

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Sutherland, Jason Murray; Walker, Jan

2008-03-01

Case mix classification systems have been adopted in many countries as a method to manage and finance healthcare in acute care settings; the most popular systems are based on diagnosis related groups. The most successful of those case mix systems differentiate patient types by reflecting both the intensity of resources consumed and patient acuity. Case mix systems for use with non-acute hospital activity have not been as wide-spread; other than in the United States, little attention has been directed towards case mix classification for rehabilitation activity. In a province with over 13 million inhabitants with 2496 rehabilitation beds, inpatient rehabilitation is an important component of hospital care in Ontario, Canada, and consists of the spectrum of intensive rehabilitation activities intended to restore function. Although case mix adjusted activity has been the currency in Ontario's Integrated Population Based Allocation hospital funding formula, rehabilitation activity has not been subjected to case mix measurement. A project to examine case mix classification for adult inpatient rehabilitation activity was initiated by the Ontario Ministry of Health and Long-Term Care whose outcome was a case mix system and associated cost weights that would result in rehabilitation activity being incorporated into the hospital funding formula. The process described in this study provides Ontario's provincial government with a case mix classification system for adult inpatient rehabilitation activity although there remain areas for improvement.

The APS control system network

International Nuclear Information System (INIS)

Sidorowicz, K.V.; McDowell, W.P.

1995-01-01

The APS accelerator control system is a distributed system consisting of operator interfaces, a network, and computer-controlled interfaces to hardware. This implementation of a control system has come to be called the open-quotes Standard Model.close quotes The operator interface is a UNDC-based workstation with an X-windows graphical user interface. The workstation may be located at any point on the facility network and maintain full functionality. The function of the network is to provide a generalized communication path between the host computers, operator workstations, input/output crates, and other hardware that comprise the control system. The crate or input/output controller (IOC) provides direct control and input/output interfaces for each accelerator subsystem. The network is an integral part of all modem control systems and network performance will determine many characteristics of a control system. This paper will describe the overall APS network and examine the APS control system network in detail. Metrics are provided on the performance of the system under various conditions

Considerations for designing robotic upper limb rehabilitation devices

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Nadas, I.; Vaida, C.; Gherman, B.; Pisla, D.; Carbone, G.

2017-12-01

The present study highlights the advantages of robotic systems for post-stroke rehabilitation of the upper limb. The latest demographic studies illustrate a continuous increase of the average life span, which leads to a continuous increase of stroke incidents and patients requiring rehabilitation. Some studies estimate that by 2030 the number of physical therapists will be insufficient for the patients requiring physical rehabilitation, imposing a shift in the current methodologies. A viable option is the implementation of robotic systems that assist the patient in performing rehabilitation exercises, the physical therapist role being to establish the therapeutic program for each patient and monitor their individual progress. Using a set of clinical measurements for the upper limb motions, the analysis of rehabilitation robotic systems provides a comparative study between the motions required by clinicians and the ones that robotic systems perform for different therapeutic exercises. A critical analysis of existing robots is performed using several classifications: mechanical design, assistance type, actuation and power transmission, control systems and human robot interaction (HRI) strategies. This classification will determine a set of pre-requirements for the definition of new concepts and efficient solutions for robotic assisted rehabilitation therapy.

Recent Development of Rehabilitation Robots

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Zhiqin Qian

2015-02-01

Full Text Available We have conducted a critical review on the development of rehabilitation robots to identify the limitations of existing studies and clarify some promising research directions in this field. This paper is presented to summarize our findings and understanding. The demands for assistive technologies for elderly and disabled population have been discussed, the advantages and disadvantages of rehabilitation robots as assistive technologies have been explored, the issues involved in the development of rehabilitation robots are investigated, some representative robots in this field by leading research institutes have been introduced, and a few of critical challenges in developing advanced rehabilitation robots have been identified. Finally to meet the challenges of developing practical rehabilitation robots, reconfigurable and modular systems have been proposed to meet the identified challenges, and a few of critical areas leading to the potential success of rehabilitation robots have been discussed.

Promoting Social Network Awareness: A Social Network Monitoring System

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Cadima, Rita; Ferreira, Carlos; Monguet, Josep; Ojeda, Jordi; Fernandez, Joaquin

2010-01-01

To increase communication and collaboration opportunities, members of a community must be aware of the social networks that exist within that community. This paper describes a social network monitoring system--the KIWI system--that enables users to register their interactions and visualize their social networks. The system was implemented in a…

Triangulation positioning system network

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Sfendourakis Marios

2017-01-01

Full Text Available This paper presents ongoing work on localization and positioning through triangulation procedure for a Fixed Sensors Network - FSN.The FSN has to work as a system.As the triangulation problem becomes high complicated in a case with large numbers of sensors and transmitters, an adequate grid topology is needed in order to tackle the detection complexity.For that reason a Network grid topology is presented and areas that are problematic and need further analysis are analyzed.The Network System in order to deal with problems of saturation and False Triangulations - FTRNs will have to find adequate methods in every sub-area of the Area Of Interest - AOI.Also, concepts like Sensor blindness and overall Network blindness, are presented. All these concepts affect the Network detection rate and its performance and ought to be considered in a way that the network overall performance won’t be degraded.Network performance should be monitored contentiously, with right algorithms and methods.It is also shown that as the number of TRNs and FTRNs is increased Detection Complexity - DC is increased.It is hoped that with further research all the characteristics of a triangulation system network for positioning will be gained and the system will be able to perform autonomously with a high detection rate.

Applications of Brain–Machine Interface Systems in Stroke Recovery and Rehabilitation

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Francisco, Gerard E.; Contreras-Vidal, Jose L.

2014-01-01

Stroke is a leading cause of disability, significantly impacting the quality of life (QOL) in survivors, and rehabilitation remains the mainstay of treatment in these patients. Recent engineering and technological advances such as brain-machine interfaces (BMI) and robotic rehabilitative devices are promising to enhance stroke neu-rorehabilitation, to accelerate functional recovery and improve QOL. This review discusses the recent applications of BMI and robotic-assisted rehabilitation in stroke patients. We present the framework for integrated BMI and robotic-assisted therapies, and discuss their potential therapeutic, assistive and diagnostic functions in stroke rehabilitation. Finally, we conclude with an outlook on the potential challenges and future directions of these neurotechnologies, and their impact on clinical rehabilitation. PMID:25110624

SafeNet: a methodology for integrating general-purpose unsafe devices in safe-robot rehabilitation systems.

Science.gov (United States)

Vicentini, Federico; Pedrocchi, Nicola; Malosio, Matteo; Molinari Tosatti, Lorenzo

2014-09-01

Robot-assisted neurorehabilitation often involves networked systems of sensors ("sensory rooms") and powerful devices in physical interaction with weak users. Safety is unquestionably a primary concern. Some lightweight robot platforms and devices designed on purpose include safety properties using redundant sensors or intrinsic safety design (e.g. compliance and backdrivability, limited exchange of energy). Nonetheless, the entire "sensory room" shall be required to be fail-safe and safely monitored as a system at large. Yet, sensor capabilities and control algorithms used in functional therapies require, in general, frequent updates or re-configurations, making a safety-grade release of such devices hardly sustainable in cost-effectiveness and development time. As such, promising integrated platforms for human-in-the-loop therapies could not find clinical application and manufacturing support because of lacking in the maintenance of global fail-safe properties. Under the general context of cross-machinery safety standards, the paper presents a methodology called SafeNet for helping in extending the safety rate of Human Robot Interaction (HRI) systems using unsafe components, including sensors and controllers. SafeNet considers, in fact, the robotic system as a device at large and applies the principles of functional safety (as in ISO 13489-1) through a set of architectural procedures and implementation rules. The enabled capability of monitoring a network of unsafe devices through redundant computational nodes, allows the usage of any custom sensors and algorithms, usually planned and assembled at therapy planning-time rather than at platform design-time. A case study is presented with an actual implementation of the proposed methodology. A specific architectural solution is applied to an example of robot-assisted upper-limb rehabilitation with online motion tracking. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Development of Pavement Maintenance Management System (PMMS of Urban Road Network Using HDM-4 Model

Directory of Open Access Journals (Sweden)

Tanuj Chopra

2017-04-01

Full Text Available The aim of the study is to develop Pavement Maintenance Management System (PMMS for four road sections of urban road network (Patiala, Punjab, India using Highway Development and Management (HDM-4 model. The HDM-4 provides a deterministic approach in data input and process data of existing road condition, traffic volume and pavement composition to predict road deterioration as per the urban road conditions in terms of International Roughness Index (IRI value. This study presents the use of HDM-4 model for the computation of optimum Maintenance and Rehabilitation (M&R strategy for each road section and comparative study of scheduled and condition responsive M&R strategies. The results of present study will be useful for gaining better support for decision-makers for adequate and timely fund allocations for preservation of the urban road network.

A Portable Gait Asymmetry Rehabilitation System for Individuals with Stroke Using a Vibrotactile Feedback

Directory of Open Access Journals (Sweden)

Muhammad Raheel Afzal

2015-01-01

Full Text Available Gait asymmetry caused by hemiparesis results in reduced gait efficiency and reduced activity levels. In this paper, a portable rehabilitation device is proposed that can serve as a tool in diagnosing gait abnormalities in individuals with stroke and has the capability of providing vibration feedback to help compensate for the asymmetric gait. Force-sensitive resistor (FSR based insoles are used to detect ground contact and estimate stance time. A controller (Arduino provides different vibration feedback based on the gait phase measurement. It also allows wireless interaction with a personal computer (PC workstation using the XBee transceiver module, featuring data logging capabilities for subsequent analysis. Walking trials conducted with healthy young subjects allowed us to observe that the system can influence abnormality in the gait. The results of trials showed that a vibration cue based on temporal information was more effective than intensity information. With clinical experiments conducted for individuals with stroke, significant improvement in gait symmetry was observed with minimal disturbance caused to the balance and gait speed as an effect of the biofeedback. Future studies of the long-term rehabilitation effects of the proposed system and further improvements to the system will result in an inexpensive, easy-to-use, and effective rehabilitation device.

Nutritional rehabilitation of persistent diarrhea in childhood : Factors determining recovery and the relationship of systemic infections with intestinal function

OpenAIRE

Bhutta, Zulfiqar Ahmed

1996-01-01

Nutritional rehabilitation of persistent diarrhea in childhood: factors determining recovery and the relationship of systemic infections with intestinal function Zulfiqar A. Bhutta Nutritional rehabilitation of persistent diarrhea (PD), a major killer of children in the third world, poses an enormous challenge. We validated the efficacy of a traditional local weaning diet based on rice-lentils (Khitchri) and yogurt (K-Y diet) for nutritional rehabilitation of PD. ...

Robot-Aided Upper-Limb Rehabilitation Based on Motor Imagery EEG

Directory of Open Access Journals (Sweden)

Baoguo Xu

2011-09-01

Full Text Available Stroke is a leading cause of disability worldwide. In this paper, a novel robot-assisted rehabilitation system based on motor imagery electroencephalography (EEG is developed for regular training of neurological rehabilitation for upper limb stroke patients. Firstly, three-dimensional animation was used to guide the patient image the upper limb movement and EEG signals were acquired by EEG amplifier. Secondly, eigenvectors were extracted by harmonic wavelet transform (HWT and linear discriminant analysis (LDA classifier was utilized to classify the pattern of the left and right upper limb motor imagery EEG signals. Finally, PC triggered the upper limb rehabilitation robot to perform motor therapy and gave the virtual feedback. Using this robot-assisted upper limb rehabilitation system, the patient's EEG of upper limb movement imagination is translated to control rehabilitation robot directly. Consequently, the proposed rehabilitation system can fully explore the patient's motivation and attention and directly facilitate upper limb post-stroke rehabilitation therapy. Experimental results on unimpaired participants were presented to demonstrate the feasibility of the rehabilitation system. Combining robot-assisted training with motor imagery-based BCI will make future rehabilitation therapy more effective. Clinical testing is still required for further proving this assumption.

Rehabilitation of district heating networks

Energy Technology Data Exchange (ETDEWEB)

Ottosson, Peter [AaF-Energikonsult Syd AB (Sweden)

1996-11-01

Often the choice is between reparation or exchange of a damaged section of the network. If the exchange is based on the wrong assumptions, large sections of undamaged pipelines could be removed. Most important for the district heating company is to decide which strategy to use for the future exchange of the pipelines. Whichever strategy used, it has to based on an assessment of the network and/or assumptions based on that assessment. The question if it is possible extend the life span of the pipelines arises. What is the most economical choice, the exchange or the renovation. (au)

Vocational rehabilitation: a multidisciplinary intervention.

Science.gov (United States)

Gobelet, C; Luthi, F; Al-Khodairy, A T; Chamberlain, M A

2007-09-15

Vocational rehabilitation is by definition a multidisciplinary intervention in a process linked to the facilitation of return to work or to the prevention of loss of the work. Clinical staff in contact with a person who has lost his job (general practitioner, specialized physician) must promote vocational rehabilitation. Medical rehabilitation for those with disabilities, whether new or old, has to be followed without delay by vocational rehabilitation. It is even better if these two intertwined processes are overlapping. They involve many professionals including physiotherapists, occupational therapists, psychologists, vocational trainers, job counsellors, teachers, case-managers, job placement agencies. Vocational rehabilitation has a financial cost, borne by many state organizations (security, social system, social affairs) as well as by employers and private insurances, which are in case of accident, concerned by this process. However, the evidence suggests that this is recouped 2- to 10-fold as suggested by the British Society of Rehabilitation Medicine.

Advances in wearable technology for rehabilitation.

Science.gov (United States)

Bonato, Paolo

2009-01-01

Assessing the impact of rehabilitation interventions on the real life of individuals is a key element of the decision-making process required to choose a rehabilitation strategy. In the past, therapists and physicians inferred the effectiveness of a given rehabilitation approach from observations performed in a clinical setting and self-reports by patients. Recent developments in wearable technology have provided tools to complement the information gathered by rehabilitation personnel via patient's direct observation and via interviews and questionnaires. A new generation of wearable sensors and systems has emerged that allows clinicians to gather measures in the home and community settings that capture patients' activity level and exercise compliance, the effectiveness of pharmacological interventions, and the ability of patients to perform efficiently specific motor tasks. Available unobtrusive sensors allow clinical personnel to monitor patients' movement and physiological data such as heart rate, respiratory rate, and oxygen saturation. Cell phone technology and the widespread access to the Internet provide means to implement systems designed to remotely monitor patients' status and optimize interventions based on individual responses to different rehabilitation approaches. This chapter summarizes recent advances in the field of wearable technology and presents examples of application of this technology in rehabilitation.

Creation and modelling of bio-cleaning, and rehabilitation systems of territories

International Nuclear Information System (INIS)

Mineeva, N.Ya.; Markelov, A.V.; Markelov, D.A.; Dmitriev, S.A.; Sobolev, A.I.; Petrov, A.S.; Prokuronov, I.B.

2005-01-01

Classification and inventory of bio-cleaning and rehabilitation system for areas were developed on the basis of functional capabilities of biota. The paper provides the principal schemes and models of biopotential use in target barriers - 'Radioactive contamination localization', 'Environmental Sanitation','Contaminated Areas Restoration' - and algorithms for creation of bio-barriers and determination of tolerance of regional limits. (author)

Fiscal 2000 achievement report on the research and development of medical and welfare apparatus/technology. Home rehabilitation system for aphasia patients; 2000 nendo iryo fukushi kiki gijutsu kenkyu kaihatsu seika hokokusho. Shitsugosho zaitaku rehabilitation shien system

Energy Technology Data Exchange (ETDEWEB)

NONE

2001-05-01

In the effort to develop an authoring system for assistance programs, a self-training system to enhance home rehabilitation, a remote rehabilitation evaluation/diagnosis supporting system, and a communication assisting system, the systems developed in the preceding fiscal years were customized and, together with their operation manuals, introduced to seven hospitals and subjected to evaluation. The results were analyzed, and improvement centering on the ease of operation was carried out. Various development efforts were exerted to improve on what were strongly demanded. As for the aphasiac/caregiver interface, it was distributed to every hospital concerned. There was a demand for immediate introduction, and then the interface was developed into a practical tool to satisfy the demand. This enabled aphasiac patients to receive training stimuli effectively through various sense organs. (NEDO)

Interactive Healthcare Systems in the Home: Vestibular Rehabilitation

DEFF Research Database (Denmark)

Aarhus, Rikke; Grönvall, Erik; Larsen, Simon Bo

2010-01-01

Vestibular dysfunction is a balance disorder, causing dizziness that provokes discomfort and fall situations. This paper discusses early results from a project that aims to develop assistive technologies to support home-based rehabilitation for elderly affected by Vestibular dysfunction.......Vestibular dysfunction is a balance disorder, causing dizziness that provokes discomfort and fall situations. This paper discusses early results from a project that aims to develop assistive technologies to support home-based rehabilitation for elderly affected by Vestibular dysfunction....

Operational experience of UNESCO centres for psychosocial rehabilitation

International Nuclear Information System (INIS)

Garnets, O.

2003-01-01

Community Centres of social and psychological rehabilitation for the population suffered from Chernobyl catastrophe have been created in Ukraine, Russia and Belarus. Objectives assigned to the Community Centres for psychosocial rehabilitation on the affected population were as follows: improving mental health of all age and social groups in the community; encouraging interactions within the community; empowering community members to take control over their lives; developing social responsibility; promoting problem-solving skills. The Community Centres network has developed psychosocial assistance models relevant to post-catastrophe period (aggravated by social and economic crisis) that might be applied to different types of crises in communities

The use of contact lens telescopic systems in low vision rehabilitation.

Science.gov (United States)

Vincent, Stephen J

2017-06-01

Refracting telescopes are afocal compound optical systems consisting of two lenses that produce an apparent magnification of the retinal image. They are routinely used in visual rehabilitation in the form of monocular or binocular hand held low vision aids, and head or spectacle-mounted devices to improve distance visual acuity, and with slight modifications, to enhance acuity for near and intermediate tasks. Since the advent of ground glass haptic lenses in the 1930's, contact lenses have been employed as a useful refracting element of telescopic systems; primarily as a mobile ocular lens (the eyepiece), that moves with the eye. Telescopes which incorporate a contact lens eyepiece significantly improve the weight, comesis, and field of view compared to traditional spectacle-mounted telescopes, in addition to potential related psycho-social benefits. This review summarises the underlying optics and use of contact lenses to provide telescopic magnification from the era of Descartes, to Dallos, and the present day. The limitations and clinical challenges associated with such devices are discussed, along with the potential future use of reflecting telescopes incorporated within scleral lenses and tactile contact lens systems in low vision rehabilitation. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Robot-Aided Upper-Limb Rehabilitation Based on Motor Imagery EEG

Directory of Open Access Journals (Sweden)

Baoguo Xu

2011-09-01

Full Text Available Stroke is a leading cause of disability worldwide. In this paper, a novel robot‐assisted rehabilitation system based on motor imagery electroencephalography (EEG is developed for regular training of neurological rehabilitation for upper limb stroke patients. Firstly, three‐dimensional animation was used to guide the patient image the upper limb movement and EEG signals were acquired by EEG amplifier. Secondly, eigenvectors were extracted by harmonic wavelet transform (HWT and linear discriminant analysis (LDA classifier was utilized to classify the pattern of the left and right upper limb motor imagery EEG signals. Finally, PC triggered the upper limb rehabilitation robot to perform motor therapy and gave the virtual feedback. Using this robot‐assisted upper limb rehabilitation system, the patientʹs EEG of upper limb movement imagination is translated to control rehabilitation robot directly. Consequently, the proposed rehabilitation system can fully explore the patientʹs motivation and attention and directly facilitate upper limb post‐stroke rehabilitation therapy. Experimental results on unimpaired participants were presented to demonstrate the feasibility of the rehabilitation system. Combining robot‐assisted training with motor imagery‐ based BCI will make future rehabilitation therapy more effective. Clinical testing is still required for further proving this assumption.

Orthopaedic Rehabilitation Device Actuated with Pneumatic Muscles

Directory of Open Access Journals (Sweden)

Ioana Petre

2014-07-01

Full Text Available Year after year recovery clinics worldwide report significant numbers of lower limb bearing joint disabilities. An effective method for the speedy rehabilitation of patients with such afflictions is Continuous Passive Motion (CPM, drawing upon a range of specific equipment. This paper presents an innovative constructive solution for such orthopaedic rehabilitation equipment, designed to ensure a swift reintegration of patients at as low a cost as possible. The absolute novelty consists in the utilization of the linear pneumatic muscle as actuator of the orthopaedic rehabilitation equipment, thus achieving a light and highly compliant construction that satisfies safety requirements related to man-machine interaction. Pneumatic muscles are bio-inspired actuation systems characterized by a passive variable compliant behaviour. This property, deployed in rehabilitation systems, enables the development of human friendly devices, which are comfortable for the patients, and capable of safe interaction. This paper presents the constructive schematic of the orthopaedic rehabilitation equipment, the structure of the actuation and positioning system, and several of its functional characteristics.

Hand Rehabilitation Robotics on Poststroke Motor Recovery

Science.gov (United States)

2017-01-01

The recovery of hand function is one of the most challenging topics in stroke rehabilitation. Although the robot-assisted therapy has got some good results in the latest decades, the development of hand rehabilitation robotics is left behind. Existing reviews of hand rehabilitation robotics focus either on the mechanical design on designers' view or on the training paradigms on the clinicians' view, while these two parts are interconnected and both important for designers and clinicians. In this review, we explore the current literature surrounding hand rehabilitation robots, to help designers make better choices among varied components and thus promoting the application of hand rehabilitation robots. An overview of hand rehabilitation robotics is provided in this paper firstly, to give a general view of the relationship between subjects, rehabilitation theories, hand rehabilitation robots, and its evaluation. Secondly, the state of the art hand rehabilitation robotics is introduced in detail according to the classification of the hardware system and the training paradigm. As a result, the discussion gives available arguments behind the classification and comprehensive overview of hand rehabilitation robotics. PMID:29230081

[Domiciliary rehabilitation: an innovative form of outpatient medical rehabilitation].

Science.gov (United States)

Schmidt-Ohlemann, M; Schweizer, C

2009-02-01

Domiciliary rehabilitation is an innovative form of outpatient medical rehabilitation. All components of service provision are delivered in the rehabilitant's home by a multidisciplinary team headed by a physician. The key context factors in the rehab process can be taken into account firsthand. The target group of domiciliary rehabilitation consists of multimorbid patients with severe functional limitations and complex assistance needs, whose rehabilitation options would be poor without this outreach service. Here, as suggested by the WHO concept of functional health, the interaction between health condition and environmental factors is kept in view much better than in other forms of rehabilitation. The positive effects and the efficiency of the rehabilitation measures provided can be assessed very well at a high descriptive level. This fact had been a precondition for legal establishment of domiciliary rehabilitation as a regular service. Domiciliary rehabilitation not only complies with key demands in the health and social policy fields, such as priority of outpatient over inpatient treatment or rehabilitation to precede and accompany long term care, it also constitutes an alternative concept challenging the traditional inpatient rehabilitation approach. The patient, hence, no longer is to fit into the institutional framework of outpatient or inpatient rehabilitation, but the team will fit into the specifics of the patient's unique social and material situation.

Neurorehabilitation using the virtual reality based Rehabilitation Gaming System: methodology, design, psychometrics, usability and validation

Directory of Open Access Journals (Sweden)

Verschure Paul FMJ

2010-09-01

Full Text Available Abstract Background Stroke is a frequent cause of adult disability that can lead to enduring impairments. However, given the life-long plasticity of the brain one could assume that recovery could be facilitated by the harnessing of mechanisms underlying neuronal reorganization. Currently it is not clear how this reorganization can be mobilized. Novel technology based neurorehabilitation techniques hold promise to address this issue. Here we describe a Virtual Reality (VR based system, the Rehabilitation Gaming System (RGS that is based on a number of hypotheses on the neuronal mechanisms underlying recovery, the structure of training and the role of individualization. We investigate the psychometrics of the RGS in stroke patients and healthy controls. Methods We describe the key components of the RGS and the psychometrics of one rehabilitation scenario called Spheroids. We performed trials with 21 acute/subacute stroke patients and 20 healthy controls to study the effect of the training parameters on task performance. This allowed us to develop a Personalized Training Module (PTM for online adjustment of task difficulty. In addition, we studied task transfer between physical and virtual environments. Finally, we assessed the usability and acceptance of the RGS as a rehabilitation tool. Results We show that the PTM implemented in RGS allows us to effectively adjust the difficulty and the parameters of the task to the user by capturing specific features of the movements of the arms. The results reported here also show a consistent transfer of movement kinematics between physical and virtual tasks. Moreover, our usability assessment shows that the RGS is highly accepted by stroke patients as a rehabilitation tool. Conclusions We introduce a novel VR based paradigm for neurorehabilitation, RGS, which combines specific rehabilitative principles with a psychometric evaluation to provide a personalized and automated training. Our results show that the

Neurorehabilitation using the virtual reality based Rehabilitation Gaming System: methodology, design, psychometrics, usability and validation.

Science.gov (United States)

Cameirão, Mónica S; Badia, Sergi Bermúdez I; Oller, Esther Duarte; Verschure, Paul F M J

2010-09-22

Stroke is a frequent cause of adult disability that can lead to enduring impairments. However, given the life-long plasticity of the brain one could assume that recovery could be facilitated by the harnessing of mechanisms underlying neuronal reorganization. Currently it is not clear how this reorganization can be mobilized. Novel technology based neurorehabilitation techniques hold promise to address this issue. Here we describe a Virtual Reality (VR) based system, the Rehabilitation Gaming System (RGS) that is based on a number of hypotheses on the neuronal mechanisms underlying recovery, the structure of training and the role of individualization. We investigate the psychometrics of the RGS in stroke patients and healthy controls. We describe the key components of the RGS and the psychometrics of one rehabilitation scenario called Spheroids. We performed trials with 21 acute/subacute stroke patients and 20 healthy controls to study the effect of the training parameters on task performance. This allowed us to develop a Personalized Training Module (PTM) for online adjustment of task difficulty. In addition, we studied task transfer between physical and virtual environments. Finally, we assessed the usability and acceptance of the RGS as a rehabilitation tool. We show that the PTM implemented in RGS allows us to effectively adjust the difficulty and the parameters of the task to the user by capturing specific features of the movements of the arms. The results reported here also show a consistent transfer of movement kinematics between physical and virtual tasks. Moreover, our usability assessment shows that the RGS is highly accepted by stroke patients as a rehabilitation tool. We introduce a novel VR based paradigm for neurorehabilitation, RGS, which combines specific rehabilitative principles with a psychometric evaluation to provide a personalized and automated training. Our results show that the RGS effectively adjusts to the individual features of the user

Disability and health-related rehabilitation in international disaster relief

Science.gov (United States)

Reinhardt, Jan D.; Li, Jianan; Gosney, James; Rathore, Farooq A.; Haig, Andrew J.; Marx, Michael; Delisa, Joel A.

2011-01-01

Background Natural disasters result in significant numbers of disabling impairments. Paradoxically, however, the traditional health system response to natural disasters largely neglects health-related rehabilitation as a strategic intervention. Objectives To examine the role of health-related rehabilitation in natural disaster relief along three lines of inquiry: (1) epidemiology of injury and disability, (2) impact on health and rehabilitation systems, and (3) the assessment and measurement of disability. Design Qualitative literature review and secondary data analysis. Results Absolute numbers of injuries as well as injury to death ratios in natural disasters have increased significantly over the last 40 years. Major impairments requiring health-related rehabilitation include amputations, traumatic brain injuries, spinal cord injuries (SCI), and long bone fractures. Studies show that persons with pre-existing disabilities are more likely to die in a natural disaster. Lack of health-related rehabilitation in natural disaster relief may result in additional burdening of the health system capacity, exacerbating baseline weak rehabilitation and health system infrastructure. Little scientific evidence on the effectiveness of health-related rehabilitation interventions following natural disaster exists, however. Although systematic assessment and measurement of disability after a natural disaster is currently lacking, new approaches have been suggested. Conclusion Health-related rehabilitation potentially results in decreased morbidity due to disabling injuries sustained during a natural disaster and is, therefore, an essential component of the medical response by the host and international communities. Significant systematic challenges to effective delivery of rehabilitation interventions during disaster include a lack of trained responders as well as a lack of medical recordkeeping, data collection, and established outcome measures. Additional development of health

The Feasibility and Validity of a Remote Pulse Oximetry System for Pulmonary Rehabilitation: A Pilot Study

Directory of Open Access Journals (Sweden)

Jonathan Tang

2012-01-01

Full Text Available Pulmonary rehabilitation is an effective treatment for people with chronic obstructive pulmonary disease. However, access to these services is limited especially in rural and remote areas. Telerehabilitation has the potential to deliver pulmonary rehabilitation programs to these communities. The aim of this study was threefold: to establish the technical feasibility of transmitting real-time pulse oximetry data, determine the validity of remote measurements compared to conventional face-to-face measures, and evaluate the participants’ perception of the usability of the technology. Thirty-seven healthy individuals participated in a single remote pulmonary rehabilitation exercise session, conducted using the eHAB telerehabilitation system. Validity was assessed by comparing the participant's oxygen saturation and heart rate with the data set received at the therapist’s remote location. There was an 80% exact agreement between participant and therapist data sets. The mean absolute difference and Bland and Altman’s limits of agreement fell within the minimum clinically important difference for both oxygen saturation and heart rate values. Participants found the system easy to use and felt confident that they would be able to use it at home. Remote measurement of pulse oximetry data for a pulmonary rehabilitation exercise session was feasible and valid when compared to conventional face-to-face methods.

On the character and production of 'active participation' in neuro-rehabilitation: an Actor-Network perspective.

Science.gov (United States)

Horton, Simon; Mares, Kathryn; Coull, Neil; Poland, Fiona

2017-11-01

The importance of patients' active involvement in neuro-rehabilitation after acquired brain injury has been consistently emphasised in recent years. However, most approaches fail to show how 'active participation' is practically enacted, focusing on individualised explanations of patient choice and behaviours, or notions of inherent patient traits. Using actor-network theory (ANT) as a sensitising concept, we investigated neuro-rehabilitation practices, asking how participation is shaped through biological and socio-material specificities, how rights to knowledge and expertise are constructed, and how a body acclimatises and adjusts within an order of participation and transformation. We analysed video-recorded fieldwork extracts, examining the work of adjusting, testing and transforming; the construction of competence and incompetence; and material and social processes involved in the division of the body and its re-composition. Our findings show how an ANT-sensitised approach provides a critical understanding and context-specific characterisation of 'active participation', produced through the association of heterogeneous actors at any one time. Such specificity and the distribution of work suggest that efforts to account for optimum therapy 'dosages', and clinical attention to establishing individually-located levels of 'self-efficacy' or 'motivation' are misdirected. The performance of 'active participation', rather, should be re-imagined as a product of diverse, mutually attuned entities. A Virtual Abstract of this paper can be viewed at: https://www.youtube.com/channel/UC_979cmCmR9rLrKuD7z0ycA. © 2017 Foundation for the Sociology of Health & Illness.

The Teletón Centers Of Child Rehabilitation Mexico: 'El amor y la ciencia al servicio del hombre'.

Science.gov (United States)

Carbajal, Alejandro Parodi

2008-07-01

This paper describes the foundation and distribution of the Teleton and Oritel networks of rehabilitation. An essential component of the Pan-American network, as reported by Dr. Jorge Hernandez Franco, Teleton follows a humanistic perspective in offering a comprehensive biopsychosocial model of therapy and care. Public engagement is central to the success of Teleton and highlights the importance of increasing public understanding of rehabilitation needs and service delivery.

Development of Quasi-3DOF upper limb rehabilitation system using ER brake: PLEMO-P1

International Nuclear Information System (INIS)

Kikuchi, T; Fukushima, K; Furusho, J; Ozawa, T

2009-01-01

In recent years, many researchers have studied the potential of using robotics technology to assist and quantify the motor functions for neuron-rehabilitation. Some kinds of haptic devices have been developed and evaluated its efficiency with clinical tests, for example, upper limb training for patients with spasticity after stroke. However, almost all the devices are active-type (motor-driven) haptic devices and they basically require high-cost safety system compared to passive-type (brake-based) devices. In this study, we developed a new practical haptic device 'PLEMO-P1'; this system adopted ER brakes as its force generators. In this paper, the mechanism of PLEMO-P1 and its software for a reaching rehabilitation are described.

Development of Quasi-3DOF upper limb rehabilitation system using ER brake: PLEMO-P1

Energy Technology Data Exchange (ETDEWEB)

Kikuchi, T; Fukushima, K; Furusho, J; Ozawa, T [Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka 565-0871 (Japan)], E-mail: kikuchi@mech.eng.osaka-u.ac.jp

2009-02-01

In recent years, many researchers have studied the potential of using robotics technology to assist and quantify the motor functions for neuron-rehabilitation. Some kinds of haptic devices have been developed and evaluated its efficiency with clinical tests, for example, upper limb training for patients with spasticity after stroke. However, almost all the devices are active-type (motor-driven) haptic devices and they basically require high-cost safety system compared to passive-type (brake-based) devices. In this study, we developed a new practical haptic device 'PLEMO-P1'; this system adopted ER brakes as its force generators. In this paper, the mechanism of PLEMO-P1 and its software for a reaching rehabilitation are described.

Langfristige Wiedereingliederung nach der beruflichen Rehabilitation : Ergebnisse einer Langzeituntersuchung der Arbeitsgemeinschaft Deutscher Berufsförderungswerke (Long-term reintegration after occupational rehabilitation : results of a longitudinal study by the working group of German occupational rehabilitation centres)

OpenAIRE

Beiderwieden, Kay

2001-01-01

"In Germany a complex system of rehabilitation has developed in which the occupational rehabilitation centres (Berufsförderungswerken) are allocated the occupational rehabilitation of the 'more difficult cases'. In order to investigate how many of those undergoing rehabilitation find work after completing the training measure, the occupational rehabilitation centres have been conducting so-called 'follow-up surveys' since the mid-1960s. In addition to short-term and medium-term follow-up surv...

Computer Networks A Systems Approach

CERN Document Server

Peterson, Larry L

2011-01-01

This best-selling and classic book teaches you the key principles of computer networks with examples drawn from the real world of network and protocol design. Using the Internet as the primary example, the authors explain various protocols and networking technologies. Their systems-oriented approach encourages you to think about how individual network components fit into a larger, complex system of interactions. Whatever your perspective, whether it be that of an application developer, network administrator, or a designer of network equipment or protocols, you will come away with a "big pictur

Network Traffic Features for Anomaly Detection in Specific Industrial Control System Network

Directory of Open Access Journals (Sweden)

Matti Mantere

2013-09-01

Full Text Available The deterministic and restricted nature of industrial control system networks sets them apart from more open networks, such as local area networks in office environments. This improves the usability of network security, monitoring approaches that would be less feasible in more open environments. One of such approaches is machine learning based anomaly detection. Without proper customization for the special requirements of the industrial control system network environment, many existing anomaly or misuse detection systems will perform sub-optimally. A machine learning based approach could reduce the amount of manual customization required for different industrial control system networks. In this paper we analyze a possible set of features to be used in a machine learning based anomaly detection system in the real world industrial control system network environment under investigation. The network under investigation is represented by architectural drawing and results derived from network trace analysis. The network trace is captured from a live running industrial process control network and includes both control data and the data flowing between the control network and the office network. We limit the investigation to the IP traffic in the traces.

Network speech systems technology program

Science.gov (United States)

Weinstein, C. J.

1981-09-01

This report documents work performed during FY 1981 on the DCA-sponsored Network Speech Systems Technology Program. The two areas of work reported are: (1) communication system studies in support of the evolving Defense Switched Network (DSN) and (2) design and implementation of satellite/terrestrial interfaces for the Experimental Integrated Switched Network (EISN). The system studies focus on the development and evaluation of economical and endurable network routing procedures. Satellite/terrestrial interface development includes circuit-switched and packet-switched connections to the experimental wideband satellite network. Efforts in planning and coordination of EISN experiments are reported in detail in a separate EISN Experiment Plan.

[Ten years of early complex geriatric rehabilitation therapy in the DRG system].

Science.gov (United States)

Kolb, G; Breuninger, K; Gronemeyer, S; van den Heuvel, D; Lübke, N; Lüttje, D; Wittrich, A; Wolff, J

2014-01-01

Geriatric medicine, as a specialized form of treatment for the elderly, is gaining in importance due to demographic changes. Especially important for geriatric medicine is combining acute care with the need to maintain functionality and participation. This includes prevention of dependency on structured care or chronic disability and handicap by means of rehabilitation. Ten years ago, the German DRG system tried to incorporate procedures (e.g., "early rehabilitation in geriatric medicine") in the hospital reimbursement system. OPS 8-550.x, defined by structural quality, days of treatment, and number of therapeutic interventions, triggers 17 different geriatric DRGs, covering most of the fields of medicine. OPS 8-550.x had been revised continuously to give a clear structure to quality aspects of geriatric procedures. However, OPS 8-550.x is based on proven need of in-hospital treatment. In the last 10 years, no such definition has been produced taking aspects of the German hospital system into account as well as aspects of transparency and benefit in everyday work. The German DRG system covers just basic reimbursement aspects of geriatric medicine quite well; however, a practicable and patient-oriented definition of "hospital necessity" is still lacking, but is absolutely essential for proper compensation. A further problem concerning geriatric medicine reimbursement in the DRG system is due to the different structures of providing geriatric in-hospital care throughout Germany.

Networks as systems.

Science.gov (United States)

Best, Allan; Berland, Alex; Greenhalgh, Trisha; Bourgeault, Ivy L; Saul, Jessie E; Barker, Brittany

2018-03-19

Purpose The purpose of this paper is to present a case study of the World Health Organization's Global Healthcare Workforce Alliance (GHWA). Based on a commissioned evaluation of GHWA, it applies network theory and key concepts from systems thinking to explore network emergence, effectiveness, and evolution to over a ten-year period. The research was designed to provide high-level strategic guidance for further evolution of global governance in human resources for health (HRH). Design/methodology/approach Methods included a review of published literature on HRH governance and current practice in the field and an in-depth case study whose main data sources were relevant GHWA background documents and key informant interviews with GHWA leaders, staff, and stakeholders. Sampling was purposive and at a senior level, focusing on board members, executive directors, funders, and academics. Data were analyzed thematically with reference to systems theory and Shiffman's theory of network development. Findings Five key lessons emerged: effective management and leadership are critical; networks need to balance "tight" and "loose" approaches to their structure and processes; an active communication strategy is key to create and maintain support; the goals, priorities, and membership must be carefully focused; and the network needs to support shared measurement of progress on agreed-upon goals. Shiffman's middle-range network theory is a useful tool when guided by the principles of complex systems that illuminate dynamic situations and shifting interests as global alliances evolve. Research limitations/implications This study was implemented at the end of the ten-year funding cycle. A more continuous evaluation throughout the term would have provided richer understanding of issues. Experience and perspectives at the country level were not assessed. Practical implications Design and management of large, complex networks requires ongoing attention to key issues like leadership

What Do Stroke Patients Look for in Game-Based Rehabilitation: A Survey Study.

Science.gov (United States)

Hung, Ya-Xuan; Huang, Pei-Chen; Chen, Kuan-Ta; Chu, Woei-Chyn

2016-03-01

Stroke is one of the most common causes of physical disability, and early, intensive, and repetitive rehabilitation exercises are crucial to the recovery of stroke survivors. Unfortunately, research shows that only one third of stroke patients actually perform recommended exercises at home, because of the repetitive and mundane nature of conventional rehabilitation exercises. Thus, to motivate stroke survivors to engage in monotonous rehabilitation is a significant issue in the therapy process. Game-based rehabilitation systems have the potential to encourage patients continuing rehabilitation exercises at home. However, these systems are still rarely adopted at patients' places. Discovering and eliminating the obstacles in promoting game-based rehabilitation at home is therefore essential. For this purpose, we conducted a study to collect and analyze the opinions and expectations of stroke patients and clinical therapists. The study is composed of 2 parts: Rehab-preference survey - interviews to both patients and therapists to understand the current practices, challenges, and expectations on game-based rehabilitation systems; and Rehab-compatibility survey - a gaming experiment with therapists to elaborate what commercial games are compatible with rehabilitation. The study is conducted with 30 outpatients with stroke and 19 occupational therapists from 2 rehabilitation centers in Taiwan. Our surveys show that game-based rehabilitation systems can turn the rehabilitation exercises more appealing and provide personalized motivation for various stroke patients. Patients prefer to perform rehabilitation exercises with more diverse and fun games, and need cost-effective rehabilitation systems, which are often built on commodity hardware. Our study also sheds light on incorporating the existing design-for-fun games into rehabilitation system. We envision the results are helpful in developing a platform which enables rehab-compatible (i.e., existing, appropriately

Automatic referral to cardiac rehabilitation.

Science.gov (United States)

Fischer, Jane P

2008-01-01

The pervasive negative impact of cardiovascular disease in the United States is well documented. Although advances have been made, the campaign to reduce the occurrence, progression, and mortality continues. Determining evidence-based data is only half the battle. Implementing new and updated clinical guidelines into daily practice is a challenging task. Cardiac rehabilitation is an example of a proven intervention whose benefit is hindered through erratic implementation. The American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR), the American College of Cardiology (ACC), and the American Heart Association (AHA) have responded to this problem by publishing the AACVPR/ACC/AHA 2007 Performance Measures on Cardiac Rehabilitation for Referral to and Delivery of Cardiac Rehabilitation/Secondary Prevention Services. This new national guideline recommends automatic referral to cardiac rehabilitation for every eligible patient (performance measure A-1). This article offers guidance for the initiation of an automatic referral system, including individualizing your protocol with regard to electronic or paper-based order entry structures.

The entire network topology display system of terminal communication access network

OpenAIRE

An Yi

2016-01-01

Now order terminal communication access network is network technology in Shanxi Province is diversiform, device type complex, lack of unified technical standard, the terminal communication access network management system of construction constitutes a great obstacle. Need to build a “unified communication interface and communication standard, unified communications network management” of the terminal communication access network cut in the integrated network management system, for the termina...

Experiment for ambulatory inhalation rehabilitation of occupational dust-radiation injuries of the respiratory system

International Nuclear Information System (INIS)

Ivanov, Z.; Nikolova, M.E.; Todorov, A.; Kuteva, E.

1984-01-01

An experiment was carried out for ambulatory inhalation rehabilitation on a group of 172 subjects with pronounced injuries of the respiratory system. Parallely with them was a rehabilitated group of 8 pensioners. Because of the specific nature of the production etiopathogenetic complex including inhalation introduced radioactive and stable aerosols and their uninterrupted action during rehabilitation, the experiment conducted is of special importance for the perspective elaboration and implementation of health measures in a numerous contingent of workers in industrial important branches without discontinuing work. A positive effect was obtained in 54,2% of the treated non-smokers. No improvement was found of the objective ventilation indices of respiration in smokers and pensioners. As far as physical and anamnestic indices are concerned, such as rales, cough, dyspnea, pains in the chest etc., there was impovement in all treated subjects. Finally, some conclusions are drawn about the future trends of inhalation prophylaxis in the respective branches of production

Realization of Intelligent Measurement and Control System for Limb Rehabilitation Based on PLC and Touch Screen

Science.gov (United States)

Liu, Xiangquan

According to the treatment needs of patients with limb movement disorder, on the basis of the limb rehabilitative training prototype, function of measure and control system are analyzed, design of system hardware and software is completed. The touch screen which is adopt as host computer and man-machine interaction window is responsible for sending commands and training information display; The PLC which is adopt as slave computer is responsible for receiving control command from touch screen, collecting the sensor data, regulating torque and speed of motor by analog output according to the different training mode, realizing ultimately active and passive training for limb rehabilitation therapy.

Biomechatronics in medical rehabilitation biomodelling, interface, and control

CERN Document Server

Xie, Shane (S Q )

2017-01-01

This book focuses on the key technologies in developing biomechatronic systems for medical rehabilitation purposes. It includes a detailed analysis of biosignal processing, biomechanics modelling, neural and muscular interfaces, artificial actuators, robot-assisted training, clinical setup/implementation and rehabilitation robot control. Encompassing highly multidisciplinary themes in the engineering and medical fields, it presents researchers’ insights into the emerging technologies and developments that are being utilized in biomechatronics for medical purposes. Presenting a detailed analysis of five key areas in rehabilitation robotics: (i) biosignal processing; (ii) biomechanics modelling; (iii) neural and muscular interfaces; (iv) artificial actuators and devices; and (v) the use of neurological and muscular interfaces in rehabilitation robots control, the book describes the design of biomechatronic systems, the methods and control systems used and the implementation and testing in order to show how th...

Large scale network-centric distributed systems

CERN Document Server

Sarbazi-Azad, Hamid

2014-01-01

A highly accessible reference offering a broad range of topics and insights on large scale network-centric distributed systems Evolving from the fields of high-performance computing and networking, large scale network-centric distributed systems continues to grow as one of the most important topics in computing and communication and many interdisciplinary areas. Dealing with both wired and wireless networks, this book focuses on the design and performance issues of such systems. Large Scale Network-Centric Distributed Systems provides in-depth coverage ranging from ground-level hardware issu

Seamless integrated network system for wireless communication systems

NARCIS (Netherlands)

Wu, Gang; Mizuno, Mitsuhiko; Hase, Yoshihiro; Havinga, Paul J.M.

2006-01-01

To create a network that connects a plurality of wireless communication systems to create optimal systems for various environments, and that seamlessly integrates the resulting systems together in order to provide more efficient and advanced service in general. A network system that can seamlessly

Seamless integrated network system for wireless communication systems

NARCIS (Netherlands)

Wu, Gang; Mizuno, Mitsuhiko; Hase, Yoshihiro; Havinga, Paul J.M.

2002-01-01

To create a network that connects a plurality of wireless communication systems to create optimal systems for various environments, and that seamlessly integrates the resulting systems together in order to provide more efficient and advanced service in general. A network system that can seamlessly

Automatic Detection of Compensation During Robotic Stroke Rehabilitation Therapy.

Science.gov (United States)

Zhi, Ying Xuan; Lukasik, Michelle; Li, Michael H; Dolatabadi, Elham; Wang, Rosalie H; Taati, Babak

2018-01-01

Robotic stroke rehabilitation therapy can greatly increase the efficiency of therapy delivery. However, when left unsupervised, users often compensate for limitations in affected muscles and joints by recruiting unaffected muscles and joints, leading to undesirable rehabilitation outcomes. This paper aims to develop a computer vision system that augments robotic stroke rehabilitation therapy by automatically detecting such compensatory motions. Nine stroke survivors and ten healthy adults participated in this study. All participants completed scripted motions using a table-top rehabilitation robot. The healthy participants also simulated three types of compensatory motions. The 3-D trajectories of upper body joint positions tracked over time were used for multiclass classification of postures. A support vector machine (SVM) classifier detected lean-forward compensation from healthy participants with excellent accuracy (AUC = 0.98, F1 = 0.82), followed by trunk-rotation compensation (AUC = 0.77, F1 = 0.57). Shoulder-elevation compensation was not well detected (AUC = 0.66, F1 = 0.07). A recurrent neural network (RNN) classifier, which encodes the temporal dependency of video frames, obtained similar results. In contrast, F1-scores in stroke survivors were low for all three compensations while using RNN: lean-forward compensation (AUC = 0.77, F1 = 0.17), trunk-rotation compensation (AUC = 0.81, F1 = 0.27), and shoulder-elevation compensation (AUC = 0.27, F1 = 0.07). The result was similar while using SVM. To improve detection accuracy for stroke survivors, future work should focus on predefining the range of motion, direct camera placement, delivering exercise intensity tantamount to that of real stroke therapies, adjusting seat height, and recording full therapy sessions.

Knowledge translation in rehabilitation engineering research and development: a knowledge ecosystem framework.

Science.gov (United States)

Chau, Tom; Moghimi, Saba; Popovic, Milos R

2013-01-01

Rehabilitation engineering is concerned with technology innovations and technology-mediated treatments for the improvement of quality of care and quality of life of individuals with disability. Unlike many other fields of health research, the knowledge translation (KT) cycle of rehabilitation engineering research and development (R&D) is often considered incomplete until a technology product or technology-facilitated therapy is available to target clientele. As such, the KT journey of rehabilitation engineering R&D is extremely challenging, necessarily involving knowledge exchange among numerous players across multiple sectors. In this article, we draw on recent literature about the knowledge trichotomy in technology-based rehabilitation R&D and propose a knowledge ecosystem to frame the rehabilitation engineering KT process from need to product. Identifying the principal process of the ecosystem as one of knowledge flow, we elucidate the roles of repository and networked knowledge, identify key consumers and producers in a trinity of communities of practice, and draw on knowledge management literature to describe different knowledge flows. The article concludes with instantiations of this knowledge ecosystem for 2 local rehabilitation engineering research-development-commercialization endeavors. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Design and implementation of visual-haptic assistive control system for virtual rehabilitation exercise and teleoperation manipulation.

Science.gov (United States)

Veras, Eduardo J; De Laurentis, Kathryn J; Dubey, Rajiv

2008-01-01

This paper describes the design and implementation of a control system that integrates visual and haptic information to give assistive force feedback through a haptic controller (Omni Phantom) to the user. A sensor-based assistive function and velocity scaling program provides force feedback that helps the user complete trajectory following exercises for rehabilitation purposes. This system also incorporates a PUMA robot for teleoperation, which implements a camera and a laser range finder, controlled in real time by a PC, were implemented into the system to help the user to define the intended path to the selected target. The real-time force feedback from the remote robot to the haptic controller is made possible by using effective multithreading programming strategies in the control system design and by novel sensor integration. The sensor-based assistant function concept applied to teleoperation as well as shared control enhances the motion range and manipulation capabilities of the users executing rehabilitation exercises such as trajectory following along a sensor-based defined path. The system is modularly designed to allow for integration of different master devices and sensors. Furthermore, because this real-time system is versatile the haptic component can be used separately from the telerobotic component; in other words, one can use the haptic device for rehabilitation purposes for cases in which assistance is needed to perform tasks (e.g., stroke rehab) and also for teleoperation with force feedback and sensor assistance in either supervisory or automatic modes.

Organizing vocational rehabilitation through interorganizational integration--a case study in Sweden.

Science.gov (United States)

Wihlman, Ulla; Lundborg, Cecilia Stålsby; Holmström, Inger; Axelsson, Runo

2011-01-01

This study describes and analysis five years of experiences from organising an interorganisational project on vocational rehabilitation. A qualitative case study approach was used based on interviews, focus group discussions and documents. The aim was to analyse how and why the project was organised in the way it was in relation to theories of integration, organisational change and learning. The results show that the vocational rehabilitation project was initiated mainly for financial reasons. It was organised as a mechanistic system with the aim of producing different activities, where financial control and support from all the levels of the organisations involved was important. A new bureaucracy between the different authorities involved was built up, where the vertical (top-down) integration was more important than the horizontal. The result was scattered islands of interprofessional work in different teams, but without contacts between them. The project did not influence the processes or workflows of the organisations involved in the project, which would be important from a service-user perspective. It may therefore be questionnable to organise the development of interorganisational integration for vocational rehabilitation in a separate project organisation. Instead, interorganisational networks with focus on interconnections of processes and workflows may be more flexible and adaptable. Copyright © 2010 John Wiley & Sons, Ltd.

Rehabilitation System based on the Use of Biomechanical Analysis and Videogames through the Kinect Sensor

Directory of Open Access Journals (Sweden)

John E. Muñoz-Cardona

2013-11-01

Full Text Available This paper presents development of a novel system for physical rehabilitation of patients with multiple pathologies, through dynamic with exercise videogames (exergames and analysis of the movements of patients using developed software. This system is based on the use of the Kinect sensor for both purposes: amusing the patient in therapy through of specialist exergames and provide a tool to record and analyze MoCap data taken through the Kinect sensor and processed using biomechanical analysis through Euler angles. All interactive system is installed in a rehabilitation center and works with different pathologies (stroke, IMOC, craneoencephallic trauma, etc., patients interact with the platform while the specialist records data for later analysis, which is performed by software designed for this purpose. The motion graphics are shown in the sagittal, frontal and rotationalplanefrom20 points distributed in the body. The final system is portable, non-invasive, inexpensive, natural interaction with the patient and easily implemented for medical purposes.

Communicating embedded systems networks applications

CERN Document Server

Krief, Francine

2013-01-01

Embedded systems become more and more complex and require having some knowledge in various disciplines such as electronics, data processing, telecommunications and networks. Without detailing all the aspects related to the design of embedded systems, this book, which was written by specialists in electronics, data processing and telecommunications and networks, gives an interesting point of view of communication techniques and problems in embedded systems. This choice is easily justified by the fact that embedded systems are today massively communicating and that telecommunications and network

The World Health Organization "Rehabilitation 2030: a call for action".

Science.gov (United States)

Gimigliano, Francesca; Negrini, Stefano

2017-04-01

February 6th-7th, 2017 might become a memorable date in the future of rehabilitation. On these two days, the World Health Organization (WHO) has summoned over 200 stakeholders in the Executive Board Room of the WHO Headquarters in Geneva, Switzerland. Their common aim was to a launch the "Rehabilitation 2030" call to action and to present the WHO Recommendations on rehabilitation in health systems. These initiatives are meant to draw attention to the increasing unmet need for rehabilitation in the world; to highlight the role of rehabilitation in achieving the Sustainable Development Goals proposed by the United Nations; to call for coordinated and concerted global action towards strengthening rehabilitation in health systems. The aim of this paper is to report on the scientific events of these 2 days, which will most likely mark the history of rehabilitation.

[Economic rehabilitation management among patients with chronic low back pain].

Science.gov (United States)

Seitz, R; Schweikert, B; Jacobi, E; Tschirdewahn, B; Leidl, R

2001-12-01

Back pain causes high costs to society. In Germany, these amount to an estimated total of 5 billion euro of direct costs per year and 13 billion euro of indirect costs, the latter being caused by incapacity to work. The purpose of this study is to develop a concept for economic rehabilitation management. This concept is based on the managed care approach and aims at improving efficiency of care. The concept development consists of a theoretical and an empirical part. The method of the theoretical part is based on a systematic literature review on managed care (not included in this article), health systems research and the analysis of economic incentives. For the empirical investigation, long term effects and costs were calculated. For the evaluation of effects, we psychometrically tested and used the EuroQol (EQ-5D) as a measure of health-related quality of life (HRQL). The calculation of costs (both direct and indirect) is based on routine data of payers, a cost diary and the internal cost accounting systems of rehabilitation clinics. We statistically analysed the cost distribution and identified predictors of the management targets (e.g., costs of care) by means of regression analyses. The market-driven managed care approach is based on three tools: (1) a primary care system with case management and gatekeeping, (2) direct influence on providers by utilisation review and setting guidelines, and (3) indirect influence by setting supply-side economic incentives via the remuneration mode. The third managed care tool is most important when managing the rehabilitation of working age patients with chronic low back pain from an economic point of view. This concept consists of three components: (1) a case-based budget for direct costs; this is a prospective remuneration mode for an integrated primary care network including a rehabilitation facility, (2) retrospective bonus payments which are related to savings of indirect costs, and (3) retrospective bonus payments which

Sanitary sewer rehabilitation at Lawrence Livermore National Laboratory

Energy Technology Data Exchange (ETDEWEB)

Vellinger, R. J.; Burton, R.; Fritschy, B.

1995-04-01

The objectives of this paper are the following: to present LLNL`s collection system and innovative approach to sanitary sewer rehabilitation; share issues identified and lessons learned from over four (4) years of rehabilitation work; and discuss proposed system standards for ongoing maintenance and repair activities.

The Effect of Balance Training on Postural Control in Patients with Parkinson's Disease Using a Virtual Rehabilitation System.

Science.gov (United States)

Albiol-Pérez, Sergio; Gil-Gómez, José-Antonio; Muñoz-Tomás, María-Teresa; Gil-Gómez, Hermenegildo; Vial-Escolano, Raquel; Lozano-Quilis, José-Antonio

2017-03-23

Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor clinical alterations among others. Postural problems have serious consequences for patients, not only limiting their daily life but also increasing some risks, like the risk of fall. Inadequate postural control and postural instability is a major problem in PD patients. A Virtual Motor Rehabilitation System (VMR) has been tested in patients with PD in the intervention period. Our purpose was to analyze the evolution of the spatial postural control during the intervention period, to see if there are any changes caused precisely by this intervention. Ten people with PD carried out 15 virtual rehabilitation sessions. We tested a groundbreaking system based on Virtual Motor Rehabilitation in two periods of time (baseline evaluation and final evaluation). In the training sessions, the participants performed a customizable treatment using a low-cost system, the Active Balance Rehabilitation system (ABAR). We stored the pressure performed by the participants every five hundredths of a second, and we analyzed the patients' pressure when they maintained their body on the left, on the right, and in the center in sitting position. Our system was able to measure postural control in every patient in each of the virtual rehabilitation sessions. There are no significant differences in the performance of postural control in any of the positions evaluated throughout the sessions. Moreover, the results show a trend to an improvement in all positions. This improvement is especially remarkable in the left/right positions, which are the most important positions in order to avoid problems such as the risk of fall. With regard to the suitability of the ABAR system, we have found outstanding results in enjoyment, success, clarity, and helpfulness. Although PD is a progressive neurodegenerative disorder, the results demonstrate that patients with PD maintain or even improve their postural control

A COMPARATIVE STUDY OF SYSTEM NETWORK ARCHITECTURE Vs DIGITAL NETWORK ARCHITECTURE

OpenAIRE

Seema; Mukesh Arya

2011-01-01

The efficient managing system of sources is mandatory for the successful running of any network. Here this paper describes the most popular network architectures one of developed by IBM, System Network Architecture (SNA) and other is Digital Network Architecture (DNA). As we know that the network standards and protocols are needed for the network developers as well as users. Some standards are The IEEE 802.3 standards (The Institute of Electrical and Electronics Engineers 1980) (LAN), IBM Sta...

Delays and networked control systems

CERN Document Server

Hetel, Laurentiu; Daafouz, Jamal; Johansson, Karl

2016-01-01

This edited monograph includes state-of-the-art contributions on continuous time dynamical networks with delays. The book is divided into four parts. The first part presents tools and methods for the analysis of time-delay systems with a particular attention on control problems of large scale or infinite-dimensional systems with delays. The second part of the book is dedicated to the use of time-delay models for the analysis and design of Networked Control Systems. The third part of the book focuses on the analysis and design of systems with asynchronous sampling intervals which occur in Networked Control Systems. The last part of the book exposes several contributions dealing with the design of cooperative control and observation laws for networked control systems. The target audience primarily comprises researchers and experts in the field of control theory, but the book may also be beneficial for graduate students. .

From Spinal Central Pattern Generators to Cortical Network: Integrated BCI for Walking Rehabilitation

Directory of Open Access Journals (Sweden)

G. Cheron

2012-01-01

Full Text Available Success in locomotor rehabilitation programs can be improved with the use of brain-computer interfaces (BCIs. Although a wealth of research has demonstrated that locomotion is largely controlled by spinal mechanisms, the brain is of utmost importance in monitoring locomotor patterns and therefore contains information regarding central pattern generation functioning. In addition, there is also a tight coordination between the upper and lower limbs, which can also be useful in controlling locomotion. The current paper critically investigates different approaches that are applicable to this field: the use of electroencephalogram (EEG, upper limb electromyogram (EMG, or a hybrid of the two neurophysiological signals to control assistive exoskeletons used in locomotion based on programmable central pattern generators (PCPGs or dynamic recurrent neural networks (DRNNs. Plantar surface tactile stimulation devices combined with virtual reality may provide the sensation of walking while in a supine position for use of training brain signals generated during locomotion. These methods may exploit mechanisms of brain plasticity and assist in the neurorehabilitation of gait in a variety of clinical conditions, including stroke, spinal trauma, multiple sclerosis, and cerebral palsy.

Focused and Sustained Attention Is Modified by a Goal-Based Rehabilitation in Parkinsonian Patients.

Science.gov (United States)

Ferrazzoli, Davide; Ortelli, Paola; Maestri, Roberto; Bera, Rossana; Gargantini, Roberto; Palamara, Grazia; Zarucchi, Marianna; Giladi, Nir; Frazzitta, Giuseppe

2017-01-01

Rehabilitation for patients with Parkinson's disease (PD) is based on cognitive strategies that exploit attention. Parkinsonians exhibit impairments in divided attention and interference control. Nevertheless, the effectiveness of specific rehabilitation treatments based on attention suggests that other attentional functions are preserved. Data about attention are conflicting in PD, and it is not clear whether rehabilitative treatments that entail attentional strategies affect attention itself. Reaction times (RTs) represent an instrument to explore attention and investigate whether changes in attentional performances parallel rehabilitation induced-gains. RTs of 103 parkinsonian patients in "on" state, without cognitive deficits, were compared with those of a population of 34 healthy controls. We studied those attentional networks that subtend the use of cognitive strategies in motor rehabilitation: alertness and focused and sustained attention, which is a component of the executive system. We used visual and auditory RTs to evaluate alertness and multiple choices RTs (MC RTs) to explore focused and sustained attention. Parkinsonian patients underwent these tasks before and after a 4-week multidisciplinary, intensive and goal-based rehabilitation treatment (MIRT). Unified Parkinson's Disease Rating Scale (UPDRS) III and Timed Up and Go test (TUG) were assessed at the enrollment and at the end of MIRT to evaluate the motor-functional effectiveness of treatment. We did not find differences in RTs between parkinsonian patients and controls. Further, we found that improvements in motor-functional outcome measures after MIRT ( p attention, are preserved in "on" state. This explains why Parkinsonians benefit from a goal-based rehabilitation that entails the use of attention. The reduction in MC RTs suggests a positive effect of MIRT on the executive component of attention and indicates that this type of rehabilitation provides benefits by exploiting executive functions

Network Intrusion Detection System using Apache Storm

Directory of Open Access Journals (Sweden)

Muhammad Asif Manzoor

2017-06-01

Full Text Available Network security implements various strategies for the identification and prevention of security breaches. Network intrusion detection is a critical component of network management for security, quality of service and other purposes. These systems allow early detection of network intrusion and malicious activities; so that the Network Security infrastructure can react to mitigate these threats. Various systems are proposed to enhance the network security. We are proposing to use anomaly based network intrusion detection system in this work. Anomaly based intrusion detection system can identify the new network threats. We also propose to use Real-time Big Data Stream Processing Framework, Apache Storm, for the implementation of network intrusion detection system. Apache Storm can help to manage the network traffic which is generated at enormous speed and size and the network traffic speed and size is constantly increasing. We have used Support Vector Machine in this work. We use Knowledge Discovery and Data Mining 1999 (KDD’99 dataset to test and evaluate our proposed solution.

NASDA knowledge-based network planning system

Science.gov (United States)

Yamaya, K.; Fujiwara, M.; Kosugi, S.; Yambe, M.; Ohmori, M.

1993-01-01

One of the SODS (space operation and data system) sub-systems, NP (network planning) was the first expert system used by NASDA (national space development agency of Japan) for tracking and control of satellite. The major responsibilities of the NP system are: first, the allocation of network and satellite control resources and, second, the generation of the network operation plan data (NOP) used in automated control of the stations and control center facilities. Up to now, the first task of network resource scheduling was done by network operators. NP system automatically generates schedules using its knowledge base, which contains information on satellite orbits, station availability, which computer is dedicated to which satellite, and how many stations must be available for a particular satellite pass or a certain time period. The NP system is introduced.

PHYSICAL REHABILITATION OF LOW BACK PAIN BASED ON A CONCEPTUAL SYSTEM APPROACHES

Directory of Open Access Journals (Sweden)

Olena LAZARIEVA

2014-11-01

Full Text Available In Europe, back pain is a common disease, this is according to European statistics. In accordance with the new case, the pain each year occurs in 5% of the population. The aim of this work is to develop a conceptual approaches to the physical rehabilitation process at the surgical treatment of patients with back pain. Materials and methods . There was researched an experience of the domestic and foreign researches in physical rehabilitation area. Methods of the research were the analysis of the references and theoretical research methods (as an analysis, interpretation and synthesis of scientific and educational literature on the study problem. Abstraction (or idealization and schematization is the allocation of the essential foundations. Also we used experimenting with schemes (as a development of their content, sophistication and usability testing at development of concepts, practical models and physical rehabilitation programs. Results. The physical rehabilitation concept at the surgical treatment of patients with back pain was developed, given by the modern science in the diagnostics field, performing difficult complex spinal surgery with the using of new tools and the knowledge from the physical rehabilitation improvement. Conclusion. The using of a systematic methodology for physical rehabilitation in the surgical treatment of patients with vertebral pathology, helps to optimize research, diagnostic, therapeutic, rehabilitative and preventive measures, providing them with the required comprehensiveness, consistency, orderliness.

Autonomous power networks based power system

International Nuclear Information System (INIS)

Jokic, A.; Van den Bosch, P.P.J.

2006-01-01

This paper presented the concept of autonomous networks to cope with this increased complexity in power systems while enhancing market-based operation. The operation of future power systems will be more challenging and demanding than present systems because of increased uncertainties, less inertia in the system, replacement of centralized coordinating activities by decentralized parties and the reliance on dynamic markets for both power balancing and system reliability. An autonomous network includes the aggregation of networked producers and consumers in a relatively small area with respect to the overall system. The operation of an autonomous network is coordinated and controlled with one central unit acting as an interface between internal producers/consumers and the rest of the power system. In this study, the power balance problem and system reliability through provision of ancillary services was formulated as an optimization problem for the overall autonomous networks based power system. This paper described the simulation of an optimal autonomous network dispatching in day ahead markets, based on predicted spot prices for real power, and two ancillary services. It was concluded that large changes occur in a power systems structure and operation, most of them adding to the uncertainty and complexity of the system. The introduced concept of an autonomous power network-based power system was shown to be a realistic and consistent approach to formulate and operate a market-based dispatch of both power and ancillary services. 9 refs., 4 figs

Design and Implementation of an Assistive Controller for Rehabilitation Robotic Systems

Directory of Open Access Journals (Sweden)

Duygun Erol

2007-09-01

Full Text Available The goal of our research is to develop an assistive controller for robotic rehabilitation of the upper extremity after stroke. The controller is used to provide robotic assistance to participants to help them to track a desired motion trajectory required for the rehabilitation task in an accurate and concentrated manner. This rehabilitation task is designed to ensure concentrated repetitive motion that requires cognitive processing. Experimental results on unimpaired participants are presented to demonstrate the effectiveness and feasibility of the proposed controller.

Rehabilitation of the contaminated territories

International Nuclear Information System (INIS)

Lych, G.M.; Babosov, E.M.; Firsakova, S.K.

1997-01-01

In the chapter the system of management of socio economical development of contaminated territories in conditions of transition of the republic to market economy is described. The scientific substantiation of the complex programs of rehabilitation of both Bragin and Vetka areas of the Gomel Region is given. The methods of social support and socio psychological rehabilitation of the population having suffered after the Chernobyl accident are offered

Naturalness and Place in River Rehabilitation

Directory of Open Access Journals (Sweden)

Kirstie Fryirs

2009-06-01

Full Text Available An authentic approach to river rehabilitation emphasizes concerns for the natural values of a given place. As landscape considerations fashion the physical template upon which biotic associations take place, various geomorphic issues must be addressed in framing rehabilitation activities that strive to improve river health. An open-ended approach to river classification promotes applications that appreciate the values of a given river, rather than pigeonholing reality. As the geomorphic structure of some rivers is naturally simple, promoting heterogeneity as a basis for management may not always be appropriate. Efforts to protect unique attributes of river systems must be balanced with procedures that look after common features. Concerns for ecosystem functionality must relate to the behavioral regime of a given river, remembering that some rivers are inherently sensitive to disturbance. Responses to human disturbance must be viewed in relation to natural variability, recognizing how spatial relationships in a catchment, and responses to past disturbances, fashion the operation of contemporary fluxes. These fluxes, in turn, influence what is achievable in the rehabilitation of a given reach. Given the inherently adjusting and evolutionary nature of river systems, notional endpoints do not provide an appropriate basis upon which to promote concepts of naturalness and place in the rehabilitation process. These themes are drawn together to promote rehabilitation practices that relate to the natural values of each river system, in preference to applications of "cookbook" measures that build upon textbook geomorphology.

CNNs for sinusoidal signal recognition in hearing rehabilitation

Science.gov (United States)

Carnimeo, Leonarda; Giaquinto, Antonio

2003-04-01

In this paper, a contribution is given to provide a tool to the recognition of sinusoidal signals with a particular reference to the field of pediatric hearing rehabilitation. To this purpose, a synthesis technique previously developed by the authors' is used to design a Cellular Neural Network for an Associative Memory able to compare submitted discrete-time sinusoidal signals with memorized ones. A robustness analysis of the synthesized associative memory is also developed both for noisy inputs and for parameter variations. Simulation results are then reported to illustrate the performances of the designed network.

ENERGY AWARE NETWORK: BAYESIAN BELIEF NETWORKS BASED DECISION MANAGEMENT SYSTEM

Directory of Open Access Journals (Sweden)

Santosh Kumar Chaudhari

2011-06-01

Full Text Available A Network Management System (NMS plays a very important role in managing an ever-evolving telecommunication network. Generally an NMS monitors & maintains the health of network elements. The growing size of the network warrants extra functionalities from the NMS. An NMS provides all kinds of information about networks which can be used for other purposes apart from monitoring & maintaining networks like improving QoS & saving energy in the network. In this paper, we add another dimension to NMS services, namely, making an NMS energy aware. We propose a Decision Management System (DMS framework which uses a machine learning technique called Bayesian Belief Networks (BBN, to make the NMS energy aware. The DMS is capable of analysing and making control decisions based on network traffic. We factor in the cost of rerouting and power saving per port. Simulations are performed on standard network topologies, namely, ARPANet and IndiaNet. It is found that ~2.5-6.5% power can be saved.

Virtual reality based rehabilitation speeds up functional recovery of the upper extremities after stroke: a randomized controlled pilot study in the acute phase of stroke using the rehabilitation gaming system.

Science.gov (United States)

da Silva Cameirão, Mónica; Bermúdez I Badia, Sergi; Duarte, Esther; Verschure, Paul F M J

2011-01-01

Given the incidence of stroke, the need has arisen to consider more self-managed rehabilitation approaches. A promising technology is Virtual Reality (VR). Thus far, however, it is not clear what the benefits of VR systems are when compared to conventional methods. Here we investigated the clinical impact of one such system, the Rehabilitation Gaming System (RGS), on the recovery time course of acute stroke. RGS combines concepts of action execution and observation with an automatic individualization of training. METHODS. Acute stroke patients (n = 8) used the RGS during 12 weeks in addition to conventional therapy. A control group (n = 8) performed a time matched alternative treatment, which consisted of intense occupational therapy or non-specific interactive games. RESULTS. At the end of the treatment, between-group comparisons showed that the RGS group displayed significantly improved performance in paretic arm speed that was matched by better performance in the arm subpart of the Fugl-Meyer Assessment Test and the Chedoke Arm and Hand Activity Inventory. In addition, the RGS group presented a significantly faster improvement over time for all the clinical scales during the treatment period. CONCLUSIONS. Our results suggest that rehabilitation with the RGS facilitates the functional recovery of the upper extremities and that this system is therefore a promising tool for stroke neurorehabilitation.

[Design of an embedded stroke rehabilitation apparatus system based on Linux computer engineering].

Science.gov (United States)

Zhuang, Pengfei; Tian, XueLong; Zhu, Lin

2014-04-01

A realizaton project of electrical stimulator aimed at motor dysfunction of stroke is proposed in this paper. Based on neurophysiological biofeedback, this system, using an ARM9 S3C2440 as the core processor, integrates collection and display of surface electromyography (sEMG) signal, as well as neuromuscular electrical stimulation (NMES) into one system. By embedding Linux system, the project is able to use Qt/Embedded as a graphical interface design tool to accomplish the design of stroke rehabilitation apparatus. Experiments showed that this system worked well.

Rehabilitation of the contaminated territories

International Nuclear Information System (INIS)

Ageets, V.Yu.; Kenigsberg, Ya.Eh.; Skurat, V.V.; Tikhonova, L.E.; Shevchuk, V.E.; Ipat'ev, V.A.; Klimova, T.A.

1998-01-01

The purpose of the activity is development of the scientific reasonable projects of socio-economic and social-psychological rehabilitation of specific areas and populated localities on the contaminated territories of the both Gomel and Mogilev Regions. The results of economic researches allow to decrease expenses for realization of protective measures, to increase feedback of counter-measures, to speed up process of development of the plans and their realization, to decrease the labour input of planning of the rehabilitation measures, to increase quantity of considered alternative variants of strategy of the contaminated regions rehabilitation. On the basis of the sociological and psychological researches the recommendations for the most effective formation of adaptation strategies of behaviour of the people on the contaminated territories, formation of post accidental culture and active life image at teenagers, ways of fastening of youth in these areas, more address specialized social support and protection of the irradiated persons, perfection of social demographic policy on rehabilitated territories are offered. In the report are described following directions: scientific ground and development of the complex programmes of rehabilitation of administrative regions on the contaminated territories; development of administration system of the social economical development of the territories having suffered after the Chernobyl accident; social support and socio-psychological rehabilitation of the population of Belarus

Pinning control of complex networked systems synchronization, consensus and flocking of networked systems via pinning

CERN Document Server

Su, Housheng

2013-01-01

Synchronization, consensus and flocking are ubiquitous requirements in networked systems. Pinning Control of Complex Networked Systems investigates these requirements by using the pinning control strategy, which aims to control the whole dynamical network with huge numbers of nodes by imposing controllers for only a fraction of the nodes. As the direct control of every node in a dynamical network with huge numbers of nodes might be impossible or unnecessary, it’s then very important to use the pinning control strategy for the synchronization of complex dynamical networks. The research on pinning control strategy in consensus and flocking of multi-agent systems can not only help us to better understand the mechanisms of natural collective phenomena, but also benefit applications in mobile sensor/robot networks. This book offers a valuable resource for researchers and engineers working in the fields of control theory and control engineering.   Housheng Su is an Associate Professor at the Department of Contro...

REHABILITATING CRIMINAL SELVES: Gendered Strategies in Community Corrections.

Science.gov (United States)

Wyse, Jessica J B

2013-04-01

As the community corrections system has moved away from a focus on rehabilitation, it has been suggested that criminal offenders are no longer understood psychologically, but rather as rational actors for whom criminality is a choice. Rehabilitative efforts thus aim to guide these choices. Utilizing mixed methodology that draws on observational, interview, and case note data collected within the probation/parole system of a western U.S. state, I suggest that both officers' conceptualizations of the criminal self and the rehabilitative strategies they use are gendered. I find that officers view the male criminal self as flawed or underdeveloped and the female as permeable and amorphous, that is, lacking firm boundaries. In response to these constructions, officers aim to rehabilitate men largely by encouraging economic roles and responsibilities, while for women, rehabilitation aims to solidify boundaries: discouraging relationship formation and containing emotions. The differences identified point to ways in which gendered concepts of the criminal self contribute to gender disparities in contemporary supervision.

Cancer rehabilitation in Austria--aspects of Physical Medicine and Rehabilitation.

Science.gov (United States)

Maehr, Bruno; Keilani, Mohammad; Wiltschke, Christoph; Hassler, Marco; Licht, Thomas; Marosi, Christine; Huetterer, Elisabeth; Cenik, Fadime; Crevenna, Richard

2016-02-01

In Austria, cancer rehabilitation is an important issue in the management of cancer patients. Survival rates and survival time of cancer patients are increasing, and cancer rehabilitation is an important part in the treatment and care of cancer patients with the goal to improve functional status, quality of life, and (social) participation. Today, in Austria there are approximately 600 beds for inpatient rehabilitation. The field of outpatient rehabilitation will maybe be expanded after evaluating the existing pilot projects. Beside other specialities, the field of Physical Medicine and Rehabilitation (PM&R) plays an important role in cancer rehabilitation. In cancer rehabilitation, especially activating modalities from PM&R such as exercise are very important and well-accepted parts to improve functional status, quality of life, and participation of patients.

Motor Rehabilitation Using Kinect: A Systematic Review.

Science.gov (United States)

Da Gama, Alana; Fallavollita, Pascal; Teichrieb, Veronica; Navab, Nassir

2015-04-01

Interactive systems are being developed with the intention to help in the engagement of patients on various therapies. Amid the recent technological advances, Kinect™ from Microsoft (Redmond, WA) has helped pave the way on how user interaction technology facilitates and complements many clinical applications. In order to examine the actual status of Kinect developments for rehabilitation, this article presents a systematic review of articles that involve interactive, evaluative, and technical advances related to motor rehabilitation. Systematic research was performed in the IEEE Xplore and PubMed databases using the key word combination "Kinect AND rehabilitation" with the following inclusion criteria: (1) English language, (2) page number >4, (3) Kinect system for assistive interaction or clinical evaluation, or (4) Kinect system for improvement or evaluation of the sensor tracking or movement recognition. Quality assessment was performed by QualSyst standards. In total, 109 articles were found in the database research, from which 31 were included in the review: 13 were focused on the development of assistive systems for rehabilitation, 3 in evaluation, 3 in the applicability category, 7 on validation of Kinect anatomic and clinical evaluation, and 5 on improvement techniques. Quality analysis of all included articles is also presented with their respective QualSyst checklist scores. Research and development possibilities and future works with the Kinect for rehabilitation application are extensive. Methodological improvements when performing studies on this area need to be further investigated.

Networking systems design and development

CERN Document Server

Chao, Lee

2009-01-01

Effectively integrating theory and hands-on practice, Networking Systems Design and Development provides students and IT professionals with the knowledge and skills needed to design, implement, and manage fully functioning network systems using readily available Linux networking tools. Recognizing that most students are beginners in the field of networking, the text provides step-by-step instruction for setting up a virtual lab environment at home. Grounded in real-world applications, this book provides the ideal blend of conceptual instruction and lab work to give students and IT professional

Developing a User Interface for the iPAM Stroke Rehabilitation System

NARCIS (Netherlands)

Kemna, Stephanie; Culmer, Peter R.; Jackson, Andrew E.; Makower, Sophie; Gallagher, Justin F.; Holt, Ray; Cnossen, Fokie; Cozens, J. Alastair; Levesley, Martin C.; Bhakta, Bipin B.

2009-01-01

The increasing population of older people is leading to growing healthcare demands. Stroke is the commonest cause of severe disability in developed countries leaving one third of patients with long term disability. Rehabilitation is the cornerstone of recovery. Lack of rehabilitation manpower

Strengthening health-related rehabilitation services at national levels.

Science.gov (United States)

Gutenbrunner, Christoph; Bickenbach, Jerome; Melvin, John; Lains, Jorge; Nugraha, Boya

2018-04-18

One of the aims of the World Health Organization's Global Disability Action Plan is to strengthen rehabilitation services. Some countries have requested support to develop (scale-up) rehabilitation services. This paper describes the measures required and how (advisory) missions can support this purpose, with the aim of developing National Disability, Health and Rehabilitation Plans. It is important to clarify the involvement of governments in the mission, to define clear terms of reference, and to use a systematic pathway for situation assessment. Information must be collected regarding policies, health, disability, rehabilitation, social security systems, the need for rehabilitation, and the existing rehabilitation services and workforce. Site visits and stakeholder dialogues must be done. In order to develop a Rehabilitation Service Implementation Framework, existing rehabilitation services, workforce, and models for service implementation and development of rehabilitation professions are described. Governance, political will and a common understanding of disability and rehabilitation are crucial for implementation of the process. The recommendations of the World Report on Disability are used for reporting purposes. This concept is feasible, and leads to concrete recommendations and proposals for projects and a high level of consensus stakeholders.

Strengthening health-related rehabilitation services at national levels

Directory of Open Access Journals (Sweden)

Christoph Gutenbrunner

2017-04-01

Full Text Available Objective: One of the aims of the World Health Organization’s Global Disability Action Plan is to strengthen rehabilitation services. Some countries have requested support to develop (scale-up rehabilitation services. This paper describes the measures required and how (advisory missions can support this purpose, with the aim of developing National Disability, Health and Rehabilitation Plans. Recommendations: It is important to clarify the involvement of governments in the mission, to define clear terms of reference, and to use a systematic pathway for situation assessment. Information must be collected regarding policies, health, disability, rehabilitation, social security systems, the need for rehabilitation, and the existing rehabilitation services and workforce. Site visits and stakeholder dialogues must be done. In order to develop a Rehabilitation Service Implementation Framework, existing rehabilitation services, workforce, and models for service implementation and development of rehabilitation professions are described. Governance, political will and a common understanding of disability and rehabilitation are crucial for implementation of the process. The recommendations of the World Report on Disability are used for reporting purposes. Conclusion: This concept is feasible, and leads to concrete recommendations and proposals for projects and a high level of consensus stakeholders.

76 FR 38124 - Applications for New Awards; Americans With Disabilities Act (ADA) National Network Regional...

Science.gov (United States)

2011-06-29

... DEPARTMENT OF EDUCATION Applications for New Awards; Americans With Disabilities Act (ADA) National Network Regional Centers and ADA National Network Collaborative Research Projects AGENCY: Office... Rehabilitation Research Projects and Centers Program--Disability Rehabilitation Research Projects (DRRP)--ADA...

Multilevel Complex Networks and Systems

Science.gov (United States)

Caldarelli, Guido

2014-03-01

Network theory has been a powerful tool to model isolated complex systems. However, the classical approach does not take into account the interactions often present among different systems. Hence, the scientific community is nowadays concentrating the efforts on the foundations of new mathematical tools for understanding what happens when multiple networks interact. The case of economic and financial networks represents a paramount example of multilevel networks. In the case of trade, trade among countries the different levels can be described by the different granularity of the trading relations. Indeed, we have now data from the scale of consumers to that of the country level. In the case of financial institutions, we have a variety of levels at the same scale. For example one bank can appear in the interbank networks, ownership network and cds networks in which the same institution can take place. In both cases the systemically important vertices need to be determined by different procedures of centrality definition and community detection. In this talk I will present some specific cases of study related to these topics and present the regularities found. Acknowledged support from EU FET Project ``Multiplex'' 317532.

[Network structures in biological systems].

Science.gov (United States)

Oleskin, A V

2013-01-01

Network structures (networks) that have been extensively studied in the humanities are characterized by cohesion, a lack of a central control unit, and predominantly fractal properties. They are contrasted with structures that contain a single centre (hierarchies) as well as with those whose elements predominantly compete with one another (market-type structures). As far as biological systems are concerned, their network structures can be subdivided into a number of types involving different organizational mechanisms. Network organization is characteristic of various structural levels of biological systems ranging from single cells to integrated societies. These networks can be classified into two main subgroups: (i) flat (leaderless) network structures typical of systems that are composed of uniform elements and represent modular organisms or at least possess manifest integral properties and (ii) three-dimensional, partly hierarchical structures characterized by significant individual and/or intergroup (intercaste) differences between their elements. All network structures include an element that performs structural, protective, and communication-promoting functions. By analogy to cell structures, this element is denoted as the matrix of a network structure. The matrix includes a material and an immaterial component. The material component comprises various structures that belong to the whole structure and not to any of its elements per se. The immaterial (ideal) component of the matrix includes social norms and rules regulating network elements' behavior. These behavioral rules can be described in terms of algorithms. Algorithmization enables modeling the behavior of various network structures, particularly of neuron networks and their artificial analogs.

Network systems security analysis

Science.gov (United States)

Yilmaz, Ä.°smail

2015-05-01

Network Systems Security Analysis has utmost importance in today's world. Many companies, like banks which give priority to data management, test their own data security systems with "Penetration Tests" by time to time. In this context, companies must also test their own network/server systems and take precautions, as the data security draws attention. Based on this idea, the study cyber-attacks are researched throughoutly and Penetration Test technics are examined. With these information on, classification is made for the cyber-attacks and later network systems' security is tested systematically. After the testing period, all data is reported and filed for future reference. Consequently, it is found out that human beings are the weakest circle of the chain and simple mistakes may unintentionally cause huge problems. Thus, it is clear that some precautions must be taken to avoid such threats like updating the security software.

White Book on Physical and Rehabilitation Medicine (PRM) in Europe. Chapter 5. The PRM organizations in Europe: structure and activities.

Science.gov (United States)

2018-04-01

In the context of the White Book of Physical and Rehabilitation Medicine (PRM) in Europe, this paper addresses the structure, organization and activities of PRM bodies in Europe. There are four main bodies, the Section of Physical and Rehabilitation Medicine of the European Union of Medical Specialists (UEMS) very close to the European Union and is committed to define the professional competencies of PRM, the quality management and accreditation and with the Board the educational matters. The European College of PRM is served by the UEMS PRM Board and its main activities are analyzed below in the description of the Board of the UEMS PRM Section. The European Society of Physical and Rehabilitation Medicine (ESPRM) mainly dedicated to promoting research in rehabilitation and create a network of knowledge of PRM across the Europe. The European Academy of Rehabilitation Medicine mainly dedicated to defining the ethical issues in rehabilitation and finding strategies for better educational approaches in rehabilitation. There are 2 further bodies (the regional Fora) aimed to create bridges across the Mediterranean area (Mediterranean Forum of PRM) and across the northern Europe including the eastern countries such as Russia, Belarus and Ukraine (Baltic and North Sea Forum of PRM). To support the knowledge, we have in Europe 7 main journals dedicated to Rehabilitation with a growing impact factor. Last but not least the PRM bodies have an important role across the world with a connection with the International Society of PRM and WHO. The UEMS Section approved motion of international collaboration. In conclusion, PRM activity in Europe is not limited to the official border but in the network included eastern countries and Mediterranean area. The European extended network is strongly connected with the international PRM bodies, first of all the International Society of PRM.

Stroke rehabilitation: recent advances and future therapies.

LENUS (Irish Health Repository)

Brewer, L

2012-09-27

Despite advances in the acute management of stroke, a large proportion of stroke patients are left with significant impairments. Over the coming decades the prevalence of stroke-related disability is expected to increase worldwide and this will impact greatly on families, healthcare systems and economies. Effective neuro-rehabilitation is a key factor in reducing disability after stroke. In this review, we discuss the effects of stroke, principles of stroke rehabilitative care and predictors of recovery. We also discuss novel therapies in stroke rehabilitation, including non-invasive brain stimulation, robotics and pharmacological augmentation. Many trials are currently underway, which, in time, may impact on future rehabilitative practice.

Financial Network Systemic Risk Contributions

NARCIS (Netherlands)

Hautsch, N.; Schaumburg, J.; Schienle, M.

2015-01-01

We propose the realized systemic risk beta as a measure of financial companies' contribution to systemic risk, given network interdependence between firms' tail risk exposures. Conditional on statistically pre-identified network spillover effects and market and balance sheet information, we define

Signal-regulated systems and networks

CSIR Research Space (South Africa)

Van Zyl, TL

2010-07-01

Full Text Available The article presents the use of signal regulatory networks (SRNs), a biologically inspired model based on gene regulatory networks. SRNs are a way of understanding a class of self-organizing IT systems, signal-regulated systems (SRSs). This article...

Prioritizing sewer rehabilitation projects using AHP-PROMETHEE II ranking method.

Science.gov (United States)

Kessili, Abdelhak; Benmamar, Saadia

2016-01-01

The aim of this paper is to develop a methodology for the prioritization of sewer rehabilitation projects for Algiers (Algeria) sewer networks to support the National Sanitation Office in its challenge to make decisions on prioritization of sewer rehabilitation projects. The methodology applies multiple-criteria decision making. The study includes 47 projects (collectors) and 12 criteria to evaluate them. These criteria represent the different issues considered in the prioritization of the projects, which are structural, hydraulic, environmental, financial, social and technical. The analytic hierarchy process (AHP) is used to determine weights of the criteria and the Preference Ranking Organization Method for Enrichment Evaluations (PROMETHEE II) method is used to obtain the final ranking of the projects. The model was verified using the sewer data of Algiers. The results have shown that the method can be used for prioritizing sewer rehabilitation projects.

Pipeline rehabilitation planning

Energy Technology Data Exchange (ETDEWEB)

Palmer-Jones, Roland; Hopkins, Phil; Eyre, David [PENSPEN (United Kingdom)

2005-07-01

An operator faced with an onshore pipeline that has extensive damage must consider the need for rehabilitation, the sort of rehabilitation to be used, and the rehabilitation schedule. This paper will consider pipeline rehabilitation based on the authors' experiences from recent projects, and recommend a simple strategy for planning pipeline rehabilitation. It will also consider rehabilitation options: external re-coating; internal lining; internal painting; programmed repairs. The main focus will be external re-coating. Consideration will be given to rehabilitation coating types, including tape wraps, epoxy, and polyurethane. Finally it will discuss different options for scheduling the rehabilitation of corrosion damage including: the statistical comparison of signals from inspection pigs; statistical comparison of selected measurements from inspection pigs and other inspections; the use of corrosion rates estimated for the mechanisms and conditions; expert judgement. (author)

A multimedia comprehensive informatics system with decision support tools for a multi-site collaboration research of stroke rehabilitation

Science.gov (United States)

Wang, Ximing; Documet, Jorge; Garrison, Kathleen A.; Winstein, Carolee J.; Liu, Brent

2012-02-01

Stroke is a major cause of adult disability. The Interdisciplinary Comprehensive Arm Rehabilitation Evaluation (I-CARE) clinical trial aims to evaluate a therapy for arm rehabilitation after stroke. A primary outcome measure is correlative analysis between stroke lesion characteristics and standard measures of rehabilitation progress, from data collected at seven research facilities across the country. Sharing and communication of brain imaging and behavioral data is thus a challenge for collaboration. A solution is proposed as a web-based system with tools supporting imaging and informatics related data. In this system, users may upload anonymized brain images through a secure internet connection and the system will sort the imaging data for storage in a centralized database. Users may utilize an annotation tool to mark up images. In addition to imaging informatics, electronic data forms, for example, clinical data forms, are also integrated. Clinical information is processed and stored in the database to enable future data mining related development. Tele-consultation is facilitated through the development of a thin-client image viewing application. For convenience, the system supports access through desktop PC, laptops, and iPAD. Thus, clinicians may enter data directly into the system via iPAD while working with participants in the study. Overall, this comprehensive imaging informatics system enables users to collect, organize and analyze stroke cases efficiently.

International casemix and funding models: lessons for rehabilitation.

Science.gov (United States)

Turner-Stokes, Lynne; Sutch, Stephen; Dredge, Robert; Eagar, Kathy

2012-03-01

This series of articles for rehabilitation in practice aims to cover a knowledge element of the rehabilitation medicine curriculum. Nevertheless they are intended to be of interest to a multidisciplinary audience. The competency addressed in this article is 'An understanding of the different international models for funding of health care services and casemix systems, as exemplified by those in the US, Australia and the UK.' Payment for treatment in healthcare systems around the world is increasingly based on fixed tariff models to drive up efficiency and contain costs. Casemix classifications, however, must account adequately for the resource implications of varying case complexity. Rehabilitation poses some particular challenges for casemix development. The objectives of this educational narrative review are (a) to provide an overview of the development of casemix in rehabilitation, (b) to describe key characteristics of some well-established casemix and payment models in operation around the world and (c) to explore opportunities for future development arising from the lessons learned. Diagnosis alone does not adequately describe cost variation in rehabilitation. Functional dependency is considered a better cost indicator, and casemix classifications for inpatient rehabilitation in the United States and Australia rely on the Functional Independence Measure (FIM). Fixed episode-based prospective payment systems are shown to contain costs, but at the expense of poorer functional outcomes. More sophisticated models incorporating a mixture of episode and weighted per diem rates may offer greater flexibility to optimize outcome, while still providing incentive for throughput. The development of casemix in rehabilitation poses similar challenges for healthcare systems all around the world. Well-established casemix systems in the United States and Australia have afforded valuable lessons for other countries to learn from, but have not provided all the answers. A range

Asynchronous control for networked systems

CERN Document Server

Rubio, Francisco; Bencomo, Sebastián

2015-01-01

This book sheds light on networked control systems; it describes different techniques for asynchronous control, moving away from the periodic actions of classical control, replacing them with state-based decisions and reducing the frequency with which communication between subsystems is required. The text focuses specially on event-based control. Split into two parts, Asynchronous Control for Networked Systems begins by addressing the problems of single-loop networked control systems, laying out various solutions which include two alternative model-based control schemes (anticipatory and predictive) and the use of H2/H∞ robust control to deal with network delays and packet losses. Results on self-triggering and send-on-delta sampling are presented to reduce the need for feedback in the loop. In Part II, the authors present solutions for distributed estimation and control. They deal first with reliable networks and then extend their results to scenarios in which delays and packet losses may occur. The novel ...

Operating systems and network protocols for wireless sensor networks.

Science.gov (United States)

Dutta, Prabal; Dunkels, Adam

2012-01-13

Sensor network protocols exist to satisfy the communication needs of diverse applications, including data collection, event detection, target tracking and control. Network protocols to enable these services are constrained by the extreme resource scarcity of sensor nodes-including energy, computing, communications and storage-which must be carefully managed and multiplexed by the operating system. These challenges have led to new protocols and operating systems that are efficient in their energy consumption, careful in their computational needs and miserly in their memory footprints, all while discovering neighbours, forming networks, delivering data and correcting failures.

The APS control system network upgrade

International Nuclear Information System (INIS)

Sidorowicz, K. v.; Leibfritz, D.; McDowell, W. P.

1999-01-01

When it was installed,the Advanced Photon Source (APS) control system network was at the state-of-the-art. Different aspects of the system have been reported at previous meetings [1,2]. As loads on the controls network have increased due to newer and faster workstations and front-end computers, we have found performance of the system declining and have implemented an upgraded network. There have been dramatic advances in networking hardware in the last several years. The upgraded APS controls network replaces the original FDDI backbone and shared Ethernet hubs with redundant gigabit uplinks and fully switched 10/100 Ethernet switches with backplane fabrics in excess of 20 Gbits/s (Gbps). The central collapsed backbone FDDI concentrator has been replaced with a Gigabit Ethernet switch with greater than 30 Gbps backplane fabric. Full redundancy of the system has been maintained. This paper will discuss this upgrade and include performance data and performance comparisons with the original network

COPD online-rehabilitation versus conventional COPD rehabilitation

DEFF Research Database (Denmark)

Hansen, Henrik; Bieler, Theresa; Beyer, Nina

2017-01-01

BACKGROUND: Rehabilitation of patients with chronic obstructive pulmonary disease (COPD) is a key treatment in COPD. However, despite the existing evidence and a strong recommendation from lung associations worldwide, 50% of patients with COPD decline to participate in COPD rehabilitation program......, symptoms, anxiety and depression symptoms, disease specific and generic quality of life. Primary endpoint is 10/12 weeks from baseline, while secondary endpoints are 22, 36, 62 weeks from baseline assessments. DISCUSSION: The study will likely contribute to knowledge regarding COPD tele...... accessibility and compliance. The aim of this multicenter RCT study is to compare the potential benefits of a 10-week online COPD rehabilitation program (CORe) with conventional outpatient COPD rehabilitation (CCRe). METHODS: This study is a randomized assessor- and statistician blinded superiority multicenter...

Filtering and control of wireless networked systems

CERN Document Server

Zhang, Dan; Yu, Li

2017-01-01

This self-contained book, written by leading experts, offers a cutting-edge, in-depth overview of the filtering and control of wireless networked systems. It addresses the energy constraint and filter/controller gain variation problems, and presents both the centralized and the distributed solutions. The first two chapters provide an introduction to networked control systems and basic information on system analysis. Chapters (3–6) then discuss the centralized filtering of wireless networked systems, presenting different approaches to deal with energy efficiency and filter/controller gain variation problems. The next part (chapters 7–10) explores the distributed filtering of wireless networked systems, addressing the main problems of energy constraint and filter gain variation. The final part (chapters 11–14) focuses on the distributed control of wireless networked systems. networked systems for communication and control applications, the bo...

The Rehabilitation Medicine Scientist Training Program

Science.gov (United States)

Whyte, John; Boninger, Michael; Helkowski, Wendy; Braddom-Ritzler, Carolyn

2016-01-01

Physician scientists are seen as important in healthcare research. However, the number of physician scientists and their success in obtaining NIH funding have been declining for many years. The shortage of physician scientists in Physical Medicine and Rehabilitation is particularly severe, and can be attributed to many of the same factors that affect physician scientists in general, as well as to the lack of well developed models for research training. In 1995, the Rehabilitation Medicine Scientist Training Program (RMSTP) was funded by a K12 grant from the National Center of Medical Rehabilitation Research (NCMRR), as one strategy for increasing the number of research-productive physiatrists. The RMSTP's structure was revised in 2001 to improve the level of preparation of incoming trainees, and to provide a stronger central mentorship support network. Here we describe the original and revised structure of the RMSTP and review subjective and objective data on the productivity of the trainees who have completed the program. These data suggest that RMSTP trainees are, in general, successful in obtaining and maintaining academic faculty positions and that the productivity of the cohort trained after the revision, in particular, shows impressive growth after about 3 years of training. PMID:19847126

EMG based FES for post-stroke rehabilitation

Science.gov (United States)

Piyus, Ceethal K.; Anjaly Cherian, V.; Nageswaran, Sharmila

2017-11-01

Annually, 15 million in world population experiences stroke. Nearly 9 million stroke survivors every year experience mild to severe disability. The loss of upper extremity function in stroke survivors still remains a major rehabilitation challenge. The proposed EMG Abstract—Annually, 15 million in world population experiences stroke. Nearly 9 million stroke survivors every year experience mild to severe disability. The loss of upper extremity function in stroke survivors still remains a major rehabilitation challenge. The proposed EMG based FES system can be used for effective upper limb motor re-education in post stroke upper limb rehabilitation. The governing feature of the designed system is its synchronous activation, in which the FES stimulation is dependent on the amplitude of the EMG signal acquired from the unaffected upper limb muscle of the hemiplegic patient. This proportionate operation eliminates the undesirable damage to the patient’s skin by generating stimulus in proportion to voluntary EMG signals. This feature overcomes the disadvantages of currently available manual motor re-education systems. This model can be used in home-based post stroke rehabilitation, to effectively improve the upper limb functions.

Rehabilitation Engineering Sourcebook [and] Rehabilitation Engineering Sourcebook Supplement I.

Science.gov (United States)

Institute for Information Studies, Falls Church, VA.

Intended for use by rehabilitation counselors and work supervisors, the sourcebook contains 173 problems and solutions provided by rehabilitation engineering. A section titled "Guidelines for Formulating Problem Statements" is intended to summarize the most effective ways for either disabled individuals or rehabilitation practitioners to…

RECOMMENDER SYSTEMS IN SOCIAL NETWORKS

Directory of Open Access Journals (Sweden)

Cleomar Valois Batista Jr

2011-12-01

Full Text Available The continued and diversified growth of social networks has changed the way in which users interact with them. With these changes, what once was limited to social contact is now used for exchanging ideas and opinions, creating the need for new features. Users have so much information at their fingertips that they are unable to process it by themselves; hence, the need to develop new tools. Recommender systems were developed to address this need and many techniques were used for different approaches to the problem. To make relevant recommendations, these systems use large sets of data, not taking the social network of the user into consideration. Developing a recommender system that takes into account the social network of the user is another way of tackling the problem. The purpose of this project is to use the theory of six degrees of separation (Watts 2003 amongst users of a social network to enhance existing recommender systems.

Impact of systemic diseases on oral health related quality of life after implant-prosthodontic rehabilitation

Directory of Open Access Journals (Sweden)

Tina Pretnar

2014-08-01

Full Text Available Background: Implant-prosthodontic rehabilitation improves oral health related quality of life (OHRQoL, but the presence of systemic diseases can also affect the well-being of an individual.The study was carried out to determine the relationship between systemic diseases and OHRQoL after implant-prosthodontic rehabilitation on the basis of psychometric testing by a standardized questionnaire »Oral Health Impact Profile« (OHIP.Methods: 130 patients, who received one to eight Ankylos® implants (on average 2.6 ± 1.8 were included in this retrospective study in which all aspects of the OHRQoL construct were evaluated with a Slovenian version of the OHIP questionnaire. Data on all present systemic diseases were obtained from the existing health records. Dental status and dental restorations were identified on the basis of orthopantomographic images.Results: The majority of subjects had a cardiovascular disease (N = 37; 28.5 %, followed by a headache (N = 15, 11.5 %, allergies and asthma (n = 13, 10 %, and a rheumatic disease (N = 11, 8.5 %. Only osteoporosis was statistically significantly related to OHRQoL after implant-prosthodontic rehabilitation (p = 0.024. The best multiple linear regression model for the summary score for the questionnaire »Oral Health Impact Profile« for Slovenia (OHIP, and taking into account gender and age as confounding factors, included the number of remaining teeth and the presence of osteoporosis (p = 0.003, adjusted R2 = 0.104.Conclusions: The total number of remaining teeth in the oral cavity (p = 0.031, the presence of osteoporosis (p = 0.024, and taking into account the subject’s gender and age, are the most important clinical factors that affect the functioning of the SGS as well as psychosocial behavior of the patients after an implant-prosthodontic rehabilitation (adjusted R2 = 0.104. Other systemic diseases (cardiovascular disease, headache, allergies and

System-Level Design Methodologies for Networked Multiprocessor Systems-on-Chip

DEFF Research Database (Denmark)

Virk, Kashif Munir

2008-01-01

is the first such attempt in the published literature. The second part of the thesis deals with the issues related to the development of system-level design methodologies for networked multiprocessor systems-on-chip at various levels of design abstraction with special focus on the modeling and design...... at the system-level. The multiprocessor modeling framework is then extended to include models of networked multiprocessor systems-on-chip which is then employed to model wireless sensor networks both at the sensor node level as well as the wireless network level. In the third and the final part, the thesis...... to the transaction-level model. The thesis, as a whole makes contributions by describing a design methodology for networked multiprocessor embedded systems at three layers of abstraction from system-level through transaction-level to the cycle accurate level as well as demonstrating it practically by implementing...

Regional brain morphometry predicts memory rehabilitation outcome after traumatic brain injury

Directory of Open Access Journals (Sweden)

Gary E Strangman

2010-10-01

Full Text Available Cognitive deficits following traumatic brain injury (TBI commonly include difficulties with memory, attention, and executive dysfunction. These deficits are amenable to cognitive rehabilitation, but optimally selecting rehabilitation programs for individual patients remains a challenge. Recent methods for quantifying regional brain morphometry allow for automated quantification of tissue volumes in numerous distinct brain structures. We hypothesized that such quantitative structural information could help identify individuals more or less likely to benefit from memory rehabilitation. Fifty individuals with TBI of all severities who reported having memory difficulties first underwent structural MRI scanning. They then participated in a 12 session memory rehabilitation program emphasizing internal memory strategies (I-MEMS. Primary outcome measures (HVLT, RBMT were collected at the time of the MRI scan, immediately following therapy, and again at one month post-therapy. Regional brain volumes were used to predict outcome, adjusting for standard predictors (e.g., injury severity, age, education, pretest scores. We identified several brain regions that provided significant predictions of rehabilitation outcome, including the volume of the hippocampus, the lateral prefrontal cortex, the thalamus, and several subregions of the cingulate cortex. The prediction range of regional brain volumes were in some cases nearly equal in magnitude to prediction ranges provided by pretest scores on the outcome variable. We conclude that specific cerebral networks including these regions may contribute to learning during I-MEMS rehabilitation, and suggest that morphometric measures may provide substantial predictive value for rehabilitation outcome in other cognitive interventions as well.

Exercise therapy in oncology rehabilitation in Australia: A mixed-methods study.

Science.gov (United States)

Dennett, Amy M; Peiris, Casey L; Shields, Nora; Morgan, Delwyn; Taylor, Nicholas F

2017-10-01

Oncology rehabilitation improves outcomes for cancer survivors but little is known about program availability in Australia. The aims of this study were: to describe oncology rehabilitation programs in Australia: determine whether the exercise component of programs is consistent with guidelines: and to explore barriers and facilitators to program implementation. A sequential, explanatory mixed-methods study was completed in two phases: (1) a survey of Australian oncology rehabilitation programs; and (2) purposively sampled follow-up semistructured interviews with senior clinicians working in oncology rehabilitation who were involved with exercise prescription. Hospitals and/or cancer centers from 42 public hospital health networks (representing 163 hospitals) and 39 private hospitals were contacted to identify 31 oncology rehabilitation programs. All 31 surveys were returned (100% response rate). Programs were typically multidisciplinary, ran twice weekly, provided education and exercise and included self-management strategies. Exercise prescription and progression was patient centered and included a combination of resistance and aerobic training supplemented by balance, pelvic floor, and core stability exercises. Challenges to implementation included a lack of awareness of programs in the community and organizational barriers such as funding. Strong links with oncologists facilitated program referrals. Despite evidence to support oncology rehabilitation, there are few programs in Australia and there are challenges that limit it becoming part of standard practice. Programs that exist are multidisciplinary with a focus on exercise with the majority of programs following a cardiac rehabilitation model of care. © 2016 John Wiley & Sons Australia, Ltd.

Attitudes of COPD patients towards tele-rehabilitation

DEFF Research Database (Denmark)

Dinesen, Birthe; Huniche, Lotte; Toft, Egon

2013-01-01

about their tele-rehabilitation: indifference, learning as part of situations in everyday life, feeling of security and motivation for performing physical training. The patients express the view that they circulate between these attitudes depending on their physical and emotional state as they perform......The aim of this paper is to describe patients’ attitudes towards tele-rehabilitation in the Danish TELEKAT (for Telehomecare, Chronic Patients and the Integrated Healthcare System) project, in order to better understand patients’ behavior when performing tele-rehabilitation activities in home...

Endogenous network of firms and systemic risk

Science.gov (United States)

Ma, Qianting; He, Jianmin; Li, Shouwei

2018-02-01

We construct an endogenous network characterized by commercial credit relationships connecting the upstream and downstream firms. Simulation results indicate that the endogenous network model displays a scale-free property which exists in real-world firm systems. In terms of the network structure, with the expansion of the scale of network nodes, the systemic risk increases significantly, while the heterogeneities of network nodes have no effect on systemic risk. As for firm micro-behaviors, including the selection range of trading partners, actual output, labor requirement, price of intermediate products and employee salaries, increase of all these parameters will lead to higher systemic risk.

Artificial Neural Network Analysis System

Science.gov (United States)

2001-02-27

Contract No. DASG60-00-M-0201 Purchase request no.: Foot in the Door-01 Title Name: Artificial Neural Network Analysis System Company: Atlantic... Artificial Neural Network Analysis System 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Powell, Bruce C 5d. PROJECT NUMBER 5e. TASK NUMBER...34) 27-02-2001 Report Type N/A Dates Covered (from... to) ("DD MON YYYY") 28-10-2000 27-02-2001 Title and Subtitle Artificial Neural Network Analysis

Review: Psychological Factors Affecting Rehabilitation of Neurologic Patients

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Mahshid Foroughan

2001-01-01

Full Text Available Psychological factors imply their negative effects on neurologic patients in two ways. Directly, through pathogenic processes of central nervous system, and indirectly, through maladaptive reactions toward disability. Depression: is a common finding in many neurologic diseases and may interfere with rehabilitation process. Correcting patient's attitude toward disability, reducing environmental stresses and potentiating social support network along with antidepressant drugs often help these patients remain in rehabilitation program. Chronic fatigue: decreases the activity levels of patients and the possibility for them to achieve set goals of rehabilitation in proper times. Support, reassurance and sometimes antidepressant drugs may help. Conversion reactions: often accompany chronic illnesses and disabilities and make evaluation and diagnosis difficult. Application of behavioral Techniques may lead to better results. Altered self image: is a prominent feature in patients with spinal cord injury. Counseling and Free discussion on altered self image and sexual problems are essential and other forms of sexual expression must be taught to these patients. Chronic pain: is a disabling condition. Usually physical findings are minor and it seems psychological factors play a more important role in causing it. Antidepressant drugs are effective in most cases. Intensive physical and occupational therapy must be avoided. Excessive emotionality: is a consequence of executive dysfunction arising from frontal lobe injury and mostly seen in stroke, brain injured, and demented patients, Impulsivity and disinhibition may lead to aggressive behavior and socially inappropriate forms of sexual expression. Judicious administration of psychotherapy drugs, behavioral techniques and short-term hospitalization may be helpful. Altered cognition: is a common feature of many pathological conditions of brain. Attention deficit, slowed information processing, disturbed

STRATEGIES OF COMPLETE ORAL REHABILITATION IN PATIENTS WITH DISFUNCTIONAL SYNDROM OF THE STOMATOGNATE SYSTEM

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Vasile BURLUI

2015-12-01

Full Text Available The complete oral and dental rehabilitation (ROC or (CODR requires an advanced understanding level, based on the capacity to prepare and successfully fix the complete strategy for the complex oral rehabilitation had in view.The method applied was to subject a representative group of patients to the algorithm of diagnosis and clinical solution. The strategies of complete oral rehabilitation applied included surgical-periodontal, implanto-surgical, implanto-prosthetic rehabilitation techniques.

Strategies for stroke rehabilitation.

Science.gov (United States)

Dobkin, Bruce H

2004-09-01

Rehabilitation after hemiplegic stroke has typically relied on the training of patients in compensatory strategies. The translation of neuroscientific research into care has led to new approaches and renewed promise for better outcomes. Improved motor control can progress with task-specific training incorporating increased use of proximal and distal movements during intensive practice of real-world activities. Functional gains are incorrectly said to plateau by 3-6 months. Many patients retain latent sensorimotor function that can be realised any time after stroke with a pulse of goal-directed therapy. The amount of practice probably best determines gains for a given level of residual movement ability. Clinicians should encourage patients to build greater strength, speed, endurance, and precision of multijoint movements on tasks that increase independence and enrich daily activity. Imaging tools may help clinicians determine the capacity of residual networks to respond to a therapeutic approach and help establish optimal dose-response curves for training. Promising adjunct approaches include practice with robotic devices or in a virtual environment, electrical stimulation to increase cortical excitability during training, and drugs to optimise molecular mechanisms for learning. Biological strategies for neural repair may augment rehabilitation in the next decade.

Virtual reality rehabilitation for stroke patients: Recent review and research issues

Science.gov (United States)

Arip, Eza Surya Mohd; Ismail, Waidah; Nordin, Md Jan; Radman, Abduljalil

2017-11-01

Stroke is one of the main causes of disability in the world. In order for stroke survivors to reduce their disability, they need to go through a rehabilitation process to regain back their independence and improve their quality of life. To guide patients in their rehabilitation process and improve their receptiveness in performing repetitive exercises, a new rehabilitation training program using Virtual Reality (VR) technology has been introduced. This has attracted many researchers to explore more on VR technology as a new tool for stroke patient's rehabilitation. This paper presents a review on existing VR systems that have been developed for stroke rehabilitation. First, recent VR systems utilized for rehabilitation after stroke are delineated and categorized. Each of these categories concludes with a discussion on limitations and any issues that arise from it. Finally, a concise summary with significant findings and future possibilities in VR rehabilitation research is presented in table format.

Language Networks as Complex Systems

Science.gov (United States)

Lee, Max Kueiming; Ou, Sheue-Jen

2008-01-01

Starting in the late eighties, with a growing discontent with analytical methods in science and the growing power of computers, researchers began to study complex systems such as living organisms, evolution of genes, biological systems, brain neural networks, epidemics, ecology, economy, social networks, etc. In the early nineties, the research…

Evaluating the Effectiveness Of Postfire Rehabilitation Treatments

Science.gov (United States)

Peter R. Robichaud; Jan L. Beyers; Daniel G. Neary

2000-01-01

Spending on postfire emergency watershed rehabilitation has increased during the past decade. A west-wide evaluation of USDA Forest Service burned area emergency rehabilitation (BAER) treatment effectiveness was undertaken as a joint project by USDA Forest Service Research and National Forest System staffs. This evaluation covers 470 fires and 321 BAER projects, from...

Knowledge Translation in Rehabilitation: A Shared Vision.

Science.gov (United States)

Moore, Jennifer L; Shikako-Thomas, Keiko; Backus, Deborah

2017-07-01

Advances in rehabilitation provide the infrastructure for research and clinical data to improve care and patient outcomes. However, gaps between research and practice are prevalent. Knowledge translation (KT) aims to decrease the gap between research and its clinical use. This special communication summarizes KT-related proceedings from the 2016 IV STEP conference, describes current KT in rehabilitation science, and provides suggestions for its application in clinical care. We propose a vision for rehabilitation clinical practice and research that includes the development, adaptation, and implementation of evidence-based practice recommendations, which will contribute to a learning health care system. A clinical research culture that supports this vision and methods to engage key stakeholders to innovate rehabilitation science and practice are described. Through implementation of this vision, we can lead an evolution in rehabilitation practice to ultimately prevent disabilities, predict better outcomes, exploit plasticity, and promote participation.

Network-Aware DHT-Based P2P Systems

Science.gov (United States)

Fayçal, Marguerite; Serhrouchni, Ahmed

P2P networks lay over existing IP networks and infrastructure. This chapter investigates the relation between both layers, details the motivations for network awareness in P2P systems, and elucidates the requirements P2P systems have to meet for efficient network awareness. Since new P2P systems are mostly based on DHTs, we also present and analyse DHT-based architectures. And after a brief presentation of different existing network-awareness solutions, the chapter goes on effective cooperation between P2P traffic and network providers' business agreements, and introduces emerging DHT-based P2P systems that are network aware through a semantic defined for resource sharing. These new systems ensure also a certain context-awareness. So, they are analyzed and compared before an open end on prospects of network awareness in P2P systems.

Rehabilitation in multiple sclerosis.

Science.gov (United States)

Kubsik-Gidlewska, Anna M; Klimkiewicz, Paulina; Klimkiewicz, Robert; Janczewska, Katarzyna; Woldańska-Okońska, Marta

2017-07-01

The aim of the study is to present a strategy of rehabilitation in multiple sclerosis on the basis of the latest developments in the field of physiotherapy. The publications on the problem discuss a wide range of methods of physiotherapy that can be used in order to reduce the degree of disability and alleviate the symptoms associated with the disease. The complexity of the disease, the difficulty in determining the appropriate treatment and a wide range of symptoms require a comprehensive approach to the patient, which would include both pharmacology and neurorehabilitation. Rehabilitation, which includes psychotherapy and symptomatic therapy, is regarded nowadays as the best form of treatment for multiple sclerosis. An indepth diagnostic assessment of functional status and prognosis should be carried out before the start of the rehabilitation process. The prognosis should take into account the mental state, the neurological status and the awareness of the patient. The kinesiotherapy program in multiple sclerosis is based on a gradation of physiotherapy which assumes a gradual transition from basic movements to more complex ones till global functions are obtained. The most appropriate form of treatment is functional rehabilitation combined with physical procedures. Recent reports indicate the need for aerobic training to be included in the rehabilitation program. The introduction of physical activities, regardless of the severity of the disease, will reduce the negative effects of akinesia, and thus increase the functional capabilities of all body systems.

42 CFR 412.632 - Method of payment under the inpatient rehabilitation facility prospective payment system.

Science.gov (United States)

2010-10-01

... rehabilitation facility receives payment under this subpart for inpatient operating costs and capital-related... & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICARE PROGRAM PROSPECTIVE PAYMENT SYSTEMS FOR... and for costs of an approved education program and other costs paid outside the prospective payment...

Action Observation and Motor Imagery: Innovative Cognitive Tools in the Rehabilitation of Parkinson’s Disease

Directory of Open Access Journals (Sweden)

Giovanni Abbruzzese

2015-01-01

Full Text Available Parkinson’s disease (PD is characterized by a progressive impairment of motor skills with deterioration of autonomy in daily living activities. Physiotherapy is regarded as an adjuvant to pharmacological and neurosurgical treatment and may provide small and short-lasting clinical benefits in PD patients. However, the development of innovative rehabilitation approaches with greater long-term efficacy is a major unmet need. Motor imagery (MI and action observation (AO have been recently proposed as a promising rehabilitation tool. MI is the ability to imagine a movement without actual performance (or muscle activation. The same cortical-subcortical network active during motor execution is engaged in MI. The physiological basis of AO is represented by the activation of the “mirror neuron system.” Both MI and AO are involved in motor learning and can induce improvements of motor performance, possibly mediated by the development of plastic changes in the motor cortex. The review of available evidences indicated that MI ability and AO feasibility are substantially preserved in PD subjects. A few preliminary studies suggested the possibility of using MI and AO as parts of rehabilitation protocols for PD patients.

Adaptive intelligent power systems: Active distribution networks

International Nuclear Information System (INIS)

McDonald, Jim

2008-01-01

Electricity networks are extensive and well established. They form a key part of the infrastructure that supports industrialised society. These networks are moving from a period of stability to a time of potentially major transition, driven by a need for old equipment to be replaced, by government policy commitments to cleaner and renewable sources of electricity generation, and by change in the power industry. This paper looks at moves towards active distribution networks. The novel transmission and distribution systems of the future will challenge today's system designs. They will cope with variable voltages and frequencies, and will offer more flexible, sustainable options. Intelligent power networks will need innovation in several key areas of information technology. Active control of flexible, large-scale electrical power systems is required. Protection and control systems will have to react to faults and unusual transient behaviour and ensure recovery after such events. Real-time network simulation and performance analysis will be needed to provide decision support for system operators, and the inputs to energy and distribution management systems. Advanced sensors and measurement will be used to achieve higher degrees of network automation and better system control, while pervasive communications will allow networks to be reconfigured by intelligent systems

Upper-Extremity Rehabilitation Robot RehabRoby: Methodology, Design, Usability and Validation

Directory of Open Access Journals (Sweden)

Fatih Ozkul

2013-12-01

Full Text Available In this study, an exoskeleton type robot-assisted rehabilitation system, called RehabRoby, is developed for rehabilitation purposes. A control architecture, which contains a high-level controller and a low-level controller, is designed so that RehabRoby can complete the given rehabilitation task in a desired and safe manner. A hybrid system modelling technique is used for the high-level controller. An admittance control with an inner robust position control loop is used for the low-level control of the RehabRoby. Real-time experiments are performed to evaluate the control architecture of the robot-assisted rehabilitation system, RehabRoby. Furthermore, the usability of RehabRoby is evaluated.

Comprehensive Outpatient Rehabilitation Program: Hospital-Based Stroke Outpatient Rehabilitation.

Science.gov (United States)

Rice, Danielle; Janzen, Shannon; McIntyre, Amanda; Vermeer, Julianne; Britt, Eileen; Teasell, Robert

2016-05-01

Few studies have considered the effectiveness of outpatient rehabilitation programs for stroke patients. The objective of this study was to assess the effectiveness of a hospital-based interdisciplinary outpatient stroke rehabilitation program with respect to physical functioning, mobility, and balance. The Comprehensive Outpatient Rehabilitation Program provides a hospital-based interdisciplinary approach to stroke rehabilitation in Southwestern Ontario. Outcome measures from physiotherapy and occupational therapy sessions were available at intake and discharge from the program. A series of paired sample t-tests were performed to assess patient changes between time points for each outcome measure. A total of 271 patients met the inclusion criteria for analysis (56.1% male; mean age = 62.9 ± 13.9 years). Significant improvements were found between admission and discharge for the Functional Independence Measure, grip strength, Chedoke-McMaster Stroke Assessment, two-minute walk test, maximum walk test, Timed Up and Go, Berg Balance Scale, and one-legged stance (P rehabilitation program was effective at improving the physical functioning, mobility, and balance of individuals after a stroke. A hospital-based, stroke-specific rehabilitation program should be considered when patients continue to experience deficits after inpatient rehabilitation. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Sensorimotor enhancement with a mixed reality system for balance and mobility rehabilitation.

Science.gov (United States)

Fung, Joyce; Perez, Claire F

2011-01-01

We have developed a mixed reality system incorporating virtual reality (VR), surface perturbations and light touch for gait rehabilitation. Haptic touch has emerged as a novel and efficient technique to improve postural control and dynamic stability. Our system combines visual display with the manipulation of physical environments and addition of haptic feedback to enhance balance and mobility post stroke. A research study involving 9 participants with stroke and 9 age-matched healthy individuals show that the haptic cue provided while walking is an effective means of improving gait stability in people post stroke, especially during challenging environmental conditions such as downslope walking.

Computational Intelligence and Game Design for Effective At-Home Stroke Rehabilitation.

Science.gov (United States)

Borghese, Nunzio Alberto; Pirovano, Michele; Lanzi, Pier Luca; Wüest, Seline; de Bruin, Eling D

2013-04-01

The aim of this article is to describe a game engine that has all the characteristics needed to support rehabilitation at home. The low-cost tracking devices recently introduced in the entertainment market allow measuring reliably at home, in real time, players' motion with a hands-free approach. Such systems have also become a source of inspiration for researchers working in rehabilitation. Computer games appear suited to guide rehabilitation because of their ability to engage the users. However, commercial videogames and game engines lack the peculiar functionalities required in rehabilitation: Games should be adapted to each patient's functional status, and monitoring the patient's motion is mandatory to avoid maladaptation. Feedback on performance and progression of the exercises should be provided. Lastly, several tracking devices should be considered, according to the patient's pathology and rehabilitation aims. We have analyzed the needs of the clinicians and of the patients associated in performing rehabilitation at home, identifying the characteristics that the game engine should have. The result of this analysis has led us to develop the Intelligent Game Engine for Rehabilitation (IGER) system, which combines the principles upon which commercial games are designed with the needs of rehabilitation. IGER is heavily based on computational intelligence: Adaptation of the difficulty level of the exercise is carried out through a Bayesian framework from the observation of the patient's success rate. Monitoring is implemented in fuzzy systems and based on rules defined for the exercises by clinicians. Several devices can be attached to IGER through an input abstraction layer, like the Nintendo ® (Kyoto, Japan) Wii™ Balance Board™, the Microsoft ® (Redmond, WA) Kinect, the Falcon from Novint Technologies (Albuquerque, NM), or the Tyromotion (Graz, Austria) Timo ® plate balance board. IGER is complemented with videogames embedded in a specific taxonomy

Haptic Systems for Post-Stroke Rehabilitation: from Virtual Reality to Remote Rehabilitation

OpenAIRE

Daud, Omar Andres

2011-01-01

Haptic devices are becoming a common and significant tool in the perspective of robotic neurorehabilitation for motor learning, particularly in post-stroke patients. As a standard approach, this kind of devices are used in a local environment, where the patient interacts with a virtual environment recreated in the computer's screen. In this sense, a general framework for virtual reality based rehabilitation was developed. All the features of the framework, such as the control loop and the ext...

Rehabilitation of living conditions in the post-Chernobyl context: Implementation of an inclusive radiation monitoring system in the Bragin district in Belarus

International Nuclear Information System (INIS)

Crouail, Pascal; Bataille, C.

2008-01-01

Just after the Chernobyl accident, in the mid nineties, a radiation monitoring system was introduced to allow the Belarusian authorities to manage the situation but it failed to involve the general population. This resulted in the fact that a significant fraction of people living in contaminated areas continued to receive exposures that could have been avoided or reduced, if authorities had better taken into account the individual behaviours. Face to this situation, the goal of this project is to contribute to the development of a sustainable system of radiological monitoring handled by the local professionals and the population. It was launched in 2004 in the Bragin district (Belarus) in the framework of the CORE Programme (Cooperation for Rehabilitation) whose general objective is to improve the living conditions of the inhabitants of the territories affected by the Chernobyl catastrophe. The Bragin district is adjacent to the 30-kilometre exclusion zone around the Chernobyl nuclear power plant. Beginning in April 2004, existing infrastructure and means of measurement in the Bragin district were significantly modernised and completed. Today, the monitoring system relies on measurements of contamination of the body and measurements of the radiological quality of food stuffs (measurements of the caesium-137 concentration). In particular, whole-body scan measurement campaigns are carried out every six months in the schools in the district. On the basis of the results of measurements, the most severely contaminated children are systematically identified. Local health professionals and specialists of measurements work, with their families, to determine causes of the contamination and identify the scope for practical reduction of the intake of caesium. In a general manner, they periodically diffuse the results of measurements in the villages of the district via brochures or articles in newspapers. They also constitute a solid network that provides people with reliable

Intelligent neural network diagnostic system

International Nuclear Information System (INIS)

Mohamed, A.H.

2010-01-01

Recently, artificial neural network (ANN) has made a significant mark in the domain of diagnostic applications. Neural networks are used to implement complex non-linear mappings (functions) using simple elementary units interrelated through connections with adaptive weights. The performance of the ANN is mainly depending on their topology structure and weights. Some systems have been developed using genetic algorithm (GA) to optimize the topology of the ANN. But, they suffer from some limitations. They are : (1) The computation time requires for training the ANN several time reaching for the average weight required, (2) Slowness of GA for optimization process and (3) Fitness noise appeared in the optimization of ANN. This research suggests new issues to overcome these limitations for finding optimal neural network architectures to learn particular problems. This proposed methodology is used to develop a diagnostic neural network system. It has been applied for a 600 MW turbo-generator as a case of real complex systems. The proposed system has proved its significant performance compared to two common methods used in the diagnostic applications.

Ethical Issues in Network System Design

Directory of Open Access Journals (Sweden)

Duncan Langford

1997-05-01

Full Text Available Today, most desktop computers and PCs are networked that is, they have the ability to link to other machines, usually to access data and other information held remotely. Such machines may sometimes be connected directly to each other, as part of an office or company computer system. More frequently, however, connected machines are at a considerable distance from each other, typically connected through links to global systems such as the Internet, or World Wide Web (WWW. The networked machine itself may be anything from a powerful company computer with direct Internet connections, to a small hobbyist machine, accessing a bulletin board through telephone and modem. It is important to remember that, whatever the type or the location of networked machines, their access to the network, and the network itself, was planned and constructed following deliberate design considerations. In this paper I discuss some ways in which the technical design of computer systems might appropriately be influenced by ethical issues, and examine pressures on computer scientists and others to technically control network related actions perceived as 'unethical'. After examination of the current situation, I draw together the issues, and conclude by suggesting some ethically based recommendations for the future design of networked systems.

Occupational rehabilitation in Singapore and Malaysia.

Science.gov (United States)

Chan, Kay-Fei; Tan, Charlie W C; Yeo, Doreen S C; Tan, Heidi S K; Tan, F L; Tan, E W; Szeto, Grace P Y; Cheng, Andy S K

2011-03-01

Asia is the new and favored magnet of economic attention and foreign investments after it made an almost uneventful rebound from the depths of financial crisis of 2008/2009. Not many Western observers fully understand the diversity that is Asia other than perhaps its 2 growing economic giants of China and India. Indeed many smaller countries like Singapore and Malaysia in South East Asia along with Australia and Hong Kong (a Special Administrative Region within China) look to symbiotic relationships with these two economic giants. The purpose of this discussion paper is to examine the current issues related to the development and provision of occupational rehabilitation services in Singapore and Malaysia with a forward-looking view of how Asia's different developing societies could potentially benefit from better alignment of occupational rehabilitation practices and sharing of expertise through international collaboration and dialogue platforms. Seven therapists and one physician who are frequently involved in occupational rehabilitation services in their home countries critically reviewed the current issues in Singapore and Malaysia which included analysis of the prevalence and cost of occupational injury; overview of workers' compensation system; current practices, obstacles, and challenges in providing occupational rehabilitation and return to work practices. They also offered opinions about how to improve the occupational rehabilitation programs of their two home countries. Even though Malaysia and Singapore are two different countries, in many ways their current provision of occupational rehabilitation services and the problems they face with are very similar. There is a lot of room for systemic improvements that require government support and action. Most prominently, the training of more healthcare professionals in the assessment and rehabilitation of the injured worker should be encouraged. There could be better liaison between the many stakeholders and

Design on the Control System of a Gait Rehabilitation Training Robot Based on Brain-Computer Interface and Virtual Reality Technology

Directory of Open Access Journals (Sweden)

Hui Wang

2012-10-01

Full Text Available In this paper a control system of a gait rehabilitation training robot based on Brain-Computer Interface (BCI and virtual reality technology is proposed, which makes the patients' rehabilitation training process more interesting. A technique for measuring the mental states of the human and associated applications based on normal brain signals are examined and evaluated firstly. Secondly, the virtual game starts with the information from the BCI and then it runs in the form of a thread, with the singleton design pattern as the main mode. Thirdly, through the synergistic cooperation with the main software, the virtual game can achieve quick and effective access to blood oxygen, heart rate and other physiological information of the patients. At the same time, by means of the hardware control system, the start-up of the gait rehabilitation training robot could be controlled accurately and effectively. Therefore, the plantar pressure information and the velocity information, together with the physiological information of the patients, would be properly reflected in the game lastly and the physical condition of the patients participating in rehabilitation training would also be reflected to a great extent.

COMPARISON OF REHABILITATION POLICIES IN LITHUANIA AND THE UNITED KINGDOM

Directory of Open Access Journals (Sweden)

Danguolė Jankauskienė

2017-03-01

Full Text Available The article analyses the formation, implementation and evaluation of rehabilitation policy in Lithuania and the United Kingdom through a comparative analysis and two empirical sociological qualitative studies. The following scientific problematic issues were raised: what is the situation in the field of rehabilitation policy formation, development and assessment in the historical perspective in Lithuania and the United Kingdom, what are the advantages and disadvantages of the implementation of rehabilitation policy in Lithuania and the UK, and what are the possibilities to change and improve the formation and implementation of rehabilitation policy. A comparative analysis of the principles of development, financing, legal regulation, advantages and disadvantages has been carried out, using scientific publications, reports, publications of foreign research papers, legal acts as well as qualitative researches of experts in Lithuania and the United Kingdom. Rehabilitation policies have been found to have similarities in the United Kingdom and Lithuania, but they are quite different as well. Lithuania developed its rehabilitation policy in a relatively short time in all areas of development amid a rapidly changing environment, with effective legal regulation, ambitious measures and limited resources. The United Kingdom’s rehabilitation policy has a much longer history; it changed in many ways to adapt to the needs of patients and society. It is based on the approach to the patient as an individual having a particular disorder, and the rehabilitation system promotes an individual rehab program in which the patient is an active participant and can even contribute to the plan, select services they need, and control the rehabilitation budget assigned to them. The system of rehabilitation policy between Lithuania and the UK varies considerably. In the UK, the focus is on the improvement of rehabilitation policy, working with communities, introducing

Social Rehabilitation of Minors in the United States of America

Directory of Open Access Journals (Sweden)

Agnieszka Barczykowska

2015-06-01

Full Text Available The United States of America was one of the first countries in the world, which at the turn of the nineteenth and twentieth century took to building the justice and social rehabilitation system for minors. To date, many reforms have been made, initiated by a variety of circumstances, with their participation. Currently, due to the increase in juvenile criminality, the high costs and low efficiency, questions are posed about the future of the American social rehabilitation system. Next to the typical social rehabilitation trends, ideas of strict punishment of juveniles, on an equal footing with adults, are being implemented. In light of the above, this article is to show the historical and institutional conditions of actions undertaken towards minors, and an attempt to answer the question of what direction the American juvenile social rehabilitation system is heading.

Community-based rehabilitation offers cost-effective epilepsy treatment in rural Guinea-Bissau

NARCIS (Netherlands)

van Diessen, Eric; van der Maas, Frank; Cabral, Vladimir; Otte, Willem M

Treatment of epilepsy in low-income countries is a challenge considering the lack of resources, availability of antiepileptic drugs, and cultural beliefs. We used a community-based rehabilitation (CBR) service for the detection, monitoring, and treatment of epilepsy. A local network of trained

Accelerometer-based wireless body area network to estimate intensity of therapy in post-acute rehabilitation

Directory of Open Access Journals (Sweden)

Hamel Mathieu

2008-09-01

Full Text Available Abstract Background It has been suggested that there is a dose-response relationship between the amount of therapy and functional recovery in post-acute rehabilitation care. To this day, only the total time of therapy has been investigated as a potential determinant of this dose-response relationship because of methodological and measurement challenges. The primary objective of this study was to compare time and motion measures during real life physical therapy with estimates of active time (i.e. the time during which a patient is active physically obtained with a wireless body area network (WBAN of 3D accelerometer modules positioned at the hip, wrist and ankle. The secondary objective was to assess the differences in estimates of active time when using a single accelerometer module positioned at the hip. Methods Five patients (77.4 ± 5.2 y with 4 different admission diagnoses (stroke, lower limb fracture, amputation and immobilization syndrome were recruited in a post-acute rehabilitation center and observed during their physical therapy sessions throughout their stay. Active time was recorded by a trained observer using a continuous time and motion analysis program running on a Tablet-PC. Two WBAN configurations were used: 1 three accelerometer modules located at the hip, wrist and ankle (M3 and 2 one accelerometer located at the hip (M1. Acceleration signals from the WBANs were synchronized with the observations. Estimates of active time were computed based on the temporal density of the acceleration signals. Results A total of 62 physical therapy sessions were observed. Strong associations were found between WBANs estimates of active time and time and motion measures of active time. For the combined sessions, the intraclass correlation coefficient (ICC was 0.93 (P ≤ 0.001 for M3 and 0.79 (P ≤ 0.001 for M1. The mean percentage of differences between observation measures and estimates from the WBAN of active time was -8.7% ± 2.0% using

Tracking Systems for Virtual Rehabilitation: Objective Performance vs. Subjective Experience. A Practical Scenario

Directory of Open Access Journals (Sweden)

Roberto Lloréns

2015-03-01

Full Text Available Motion tracking systems are commonly used in virtual reality-based interventions to detect movements in the real world and transfer them to the virtual environment. There are different tracking solutions based on different physical principles, which mainly define their performance parameters. However, special requirements have to be considered for rehabilitation purposes. This paper studies and compares the accuracy and jitter of three tracking solutions (optical, electromagnetic, and skeleton tracking in a practical scenario and analyzes the subjective perceptions of 19 healthy subjects, 22 stroke survivors, and 14 physical therapists. The optical tracking system provided the best accuracy (1.074 ± 0.417 cm while the electromagnetic device provided the most inaccurate results (11.027 ± 2.364 cm. However, this tracking solution provided the best jitter values (0.324 ± 0.093 cm, in contrast to the skeleton tracking, which had the worst results (1.522 ± 0.858 cm. Healthy individuals and professionals preferred the skeleton tracking solution rather than the optical and electromagnetic solution (in that order. Individuals with stroke chose the optical solution over the other options. Our results show that subjective perceptions and preferences are far from being constant among different populations, thus suggesting that these considerations, together with the performance parameters, should be also taken into account when designing a rehabilitation system.

Rehabilitation services after the implementation of the nursing home prospective payment system: differences related to patient and nursing home characteristics.

Science.gov (United States)

Murray, Patrick K; Love, Thomas E; Dawson, Neal V; Thomas, Charles L; Cebul, Randall D

2005-11-01

The prospective payment system (PPS) for nursing homes was designed to curtail the rapid expansion of Medicare costs for skilled nursing care. This study examines the changes that occurred in nursing home patients and rehabilitation services following the PPS. Free-standing Medicare and/or Medicaid certified nursing homes in Ohio. The percent of new admissions receiving therapy and the amount of rehabilitation therapy provided. A total of 7006 first admissions in 1994-6 (pre-PPS) and 61,569 first admissions in 2000-1 (post-PPS). A logistic model predicting likelihood of rehabilitation was developed and validated in pre-PPS admissions and applied to the post-PPS patients. Rehabilitation services were compared in the pre-PPS and post-PPS cohorts overall, stratified by quintile of predicted score, diagnosis group, and by nursing home profit status. Post-PPS patients had less cognitive impairment, more depression, and more family support. The amount of rehabilitation services declined the most in the higher quintiles of predicted likelihood of rehabilitation and among patients with stroke. The percent of patients receiving rehabilitation services increased the most in the lowest quintile and among patients with medical conditions. These changes were greater in for-profit nursing homes. The implementation of the PPS in nursing homes has been associated with a decrease in the amount of rehabilitation services, targeted at those predicted to receive higher amounts and an increased frequency of providing services targeted at those predicted to be less likely to receive them. The outcomes of the changes deserve further study.

A Compressed Sensing-Based Wearable Sensor Network for Quantitative Assessment of Stroke Patients

Directory of Open Access Journals (Sweden)

Lei Yu

2016-02-01

Full Text Available Clinical rehabilitation assessment is an important part of the therapy process because it is the premise for prescribing suitable rehabilitation interventions. However, the commonly used assessment scales have the following two drawbacks: (1 they are susceptible to subjective factors; (2 they only have several rating levels and are influenced by a ceiling effect, making it impossible to exactly detect any further improvement in the movement. Meanwhile, energy constraints are a primary design consideration in wearable sensor network systems since they are often battery-operated. Traditionally, for wearable sensor network systems that follow the Shannon/Nyquist sampling theorem, there are many data that need to be sampled and transmitted. This paper proposes a novel wearable sensor network system to monitor and quantitatively assess the upper limb motion function, based on compressed sensing technology. With the sparse representation model, less data is transmitted to the computer than with traditional systems. The experimental results show that the accelerometer signals of Bobath handshake and shoulder touch exercises can be compressed, and the length of the compressed signal is less than 1/3 of the raw signal length. More importantly, the reconstruction errors have no influence on the predictive accuracy of the Brunnstrom stage classification model. It also indicated that the proposed system can not only reduce the amount of data during the sampling and transmission processes, but also, the reconstructed accelerometer signals can be used for quantitative assessment without any loss of useful information.

A Compressed Sensing-Based Wearable Sensor Network for Quantitative Assessment of Stroke Patients

Science.gov (United States)

Yu, Lei; Xiong, Daxi; Guo, Liquan; Wang, Jiping

2016-01-01

Clinical rehabilitation assessment is an important part of the therapy process because it is the premise for prescribing suitable rehabilitation interventions. However, the commonly used assessment scales have the following two drawbacks: (1) they are susceptible to subjective factors; (2) they only have several rating levels and are influenced by a ceiling effect, making it impossible to exactly detect any further improvement in the movement. Meanwhile, energy constraints are a primary design consideration in wearable sensor network systems since they are often battery-operated. Traditionally, for wearable sensor network systems that follow the Shannon/Nyquist sampling theorem, there are many data that need to be sampled and transmitted. This paper proposes a novel wearable sensor network system to monitor and quantitatively assess the upper limb motion function, based on compressed sensing technology. With the sparse representation model, less data is transmitted to the computer than with traditional systems. The experimental results show that the accelerometer signals of Bobath handshake and shoulder touch exercises can be compressed, and the length of the compressed signal is less than 1/3 of the raw signal length. More importantly, the reconstruction errors have no influence on the predictive accuracy of the Brunnstrom stage classification model. It also indicated that the proposed system can not only reduce the amount of data during the sampling and transmission processes, but also, the reconstructed accelerometer signals can be used for quantitative assessment without any loss of useful information. PMID:26861337

MECHANOKINESITHERAPY IN REHABILITATION OF INDUSTRIAL INJURIES

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Раиса Васильевна Гордеева

2018-03-01

Full Text Available The method for the speeded-up restoration of the movements in the injured joints, which raises the range of motions in a short time, quickly relieving a painful syndrome, warning the development of dystrophic changes in the musculoskeletal system has been offered. Subject. Indices of statodynamic functions of the locomotor apparatus in the patients with industrial injuries of the joints at the stage of early rehabilitation with the consistent application of continuous passive motion therapy (CPM-therapy and the pendant system EKZARTA. Objective – rapid recovery of movement functions of the injured joints as a result of industrial traumas at the stage of early patient rehabilitation. Methods. All the patients have been divided into two equivalent groups: the basic and the control. The patients of the basic group from the first days were assigned the restoration of movement functions on the machine-tool of «Kinetec» series with the subsequent transition to kinesitherapy of the pendant systems EKZARTA. The control group of the patients received only СРМ-therapy. Before and after the treatment we carried out the study of statodynamic functions on stable platform along with the definition of significant indices: flexor hip (FH, coefficient of weight load on the foot (CWLF, asymmetry between the extremities (АE, vertical posture (VP. Main results. In the basic group the painful syndrome decreased by 5-7 days before; adaptation to functional loads on injured joints raised. All the patients of the basic group after a rehabilitation course restored the range of motions to the full while in the control group movement restrictions were kept. Scope of application. Occupational pathology, rehabilitation medicine, orthopedics. Conclusions. For the speeded-up restoration of the range of motions in the injured joints resulting from industrial injuries and the decrease in a painful syndrome at the stage of early rehabilitation it is advisable to assign

Useful Method To Optimize The Rehabilitation Effort At A SCI Rehabilitation Centre

DEFF Research Database (Denmark)

Steensgaard, Randi; Dahl Hoffmann, Dorte

“Useful Method To Optimize The Rehabilitation Effort At A SCI Rehabilitation Centre” The Nordic Spinal Cord Society (NoSCoS) Meeting, Trondheim......“Useful Method To Optimize The Rehabilitation Effort At A SCI Rehabilitation Centre” The Nordic Spinal Cord Society (NoSCoS) Meeting, Trondheim...

An IoT-Enabled Stroke Rehabilitation System Based on Smart Wearable Armband and Machine Learning.

Science.gov (United States)

Yang, Geng; Deng, Jia; Pang, Gaoyang; Zhang, Hao; Li, Jiayi; Deng, Bin; Pang, Zhibo; Xu, Juan; Jiang, Mingzhe; Liljeberg, Pasi; Xie, Haibo; Yang, Huayong

2018-01-01

Surface electromyography signal plays an important role in hand function recovery training. In this paper, an IoT-enabled stroke rehabilitation system was introduced which was based on a smart wearable armband (SWA), machine learning (ML) algorithms, and a 3-D printed dexterous robot hand. User comfort is one of the key issues which should be addressed for wearable devices. The SWA was developed by integrating a low-power and tiny-sized IoT sensing device with textile electrodes, which can measure, pre-process, and wirelessly transmit bio-potential signals. By evenly distributing surface electrodes over user's forearm, drawbacks of classification accuracy poor performance can be mitigated. A new method was put forward to find the optimal feature set. ML algorithms were leveraged to analyze and discriminate features of different hand movements, and their performances were appraised by classification complexity estimating algorithms and principal components analysis. According to the verification results, all nine gestures can be successfully identified with an average accuracy up to 96.20%. In addition, a 3-D printed five-finger robot hand was implemented for hand rehabilitation training purpose. Correspondingly, user's hand movement intentions were extracted and converted into a series of commands which were used to drive motors assembled inside the dexterous robot hand. As a result, the dexterous robot hand can mimic the user's gesture in a real-time manner, which shows the proposed system can be used as a training tool to facilitate rehabilitation process for the patients after stroke.

Virtualized Network Function Orchestration System and Experimental Network Based QR Recognition for a 5G Mobile Access Network

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Misun Ahn

2017-12-01

Full Text Available This paper proposes a virtualized network function orchestration system based on Network Function Virtualization (NFV, one of the main technologies in 5G mobile networks. This system should provide connectivity between network devices and be able to create flexible network function and distribution. This system focuses more on access networks. By experimenting with various scenarios of user service established and activated in a network, we examine whether rapid adoption of new service is possible and whether network resources can be managed efficiently. The proposed method is based on Bluetooth transfer technology and mesh networking to provide automatic connections between network machines and on a Docker flat form, which is a container virtualization technology for setting and managing key functions. Additionally, the system includes a clustering and recovery measure regarding network function based on the Docker platform. We will briefly introduce the QR code perceived service as a user service to examine the proposal and based on this given service, we evaluate the function of the proposal and present analysis. Through the proposed approach, container relocation has been implemented according to a network device’s CPU usage and we confirm successful service through function evaluation on a real test bed. We estimate QR code recognition speed as the amount of network equipment is gradually increased, improving user service and confirm that the speed of recognition is increased as the assigned number of network devices is increased by the user service.

Stroke Rehabilitation.

Science.gov (United States)

Belagaje, Samir R

2017-02-01

Rehabilitation is an important aspect of the continuum of care in stroke. With advances in the acute treatment of stroke, more patients will survive stroke with varying degrees of disability. Research in the past decade has expanded our understanding of the mechanisms underlying stroke recovery and has led to the development of new treatment modalities. This article reviews and summarizes the key concepts related to poststroke recovery. Good data now exist by which one can predict recovery, especially motor recovery, very soon after stroke onset. Recent trials have not demonstrated a clear benefit associated with very early initiation of rehabilitative therapy after stroke in terms of improvement in poststroke outcomes. However, growing evidence suggests that shorter and more frequent sessions of therapy can be safely started in the first 24 to 48 hours after a stroke. The optimal amount or dose of therapy for stroke remains undetermined, as more intensive treatments have not been associated with better outcomes compared to standard intensities of therapy. Poststroke depression adversely affects recovery across a variety of measures and is an important target for therapy. Additionally, the use of selective serotonin reuptake inhibitors (SSRIs) appears to benefit motor recovery through pleiotropic mechanisms beyond their antidepressant effect. Other pharmacologic approaches also appear to have a benefit in stroke rehabilitation. A comprehensive rehabilitation program is essential to optimize poststroke outcomes. Rehabilitation is a process that uses three major principles of recovery: adaptation, restitution, and neuroplasticity. Based on these principles, multiple different approaches, both pharmacologic and nonpharmacologic, exist to enhance rehabilitation. In addition to neurologists, a variety of health care professionals are involved in stroke rehabilitation. Successful rehabilitation involves understanding the natural history of stroke recovery and a

The Network Information Management System (NIMS) in the Deep Space Network

Science.gov (United States)

Wales, K. J.

1983-01-01

In an effort to better manage enormous amounts of administrative, engineering, and management data that is distributed worldwide, a study was conducted which identified the need for a network support system. The Network Information Management System (NIMS) will provide the Deep Space Network with the tools to provide an easily accessible source of valid information to support management activities and provide a more cost-effective method of acquiring, maintaining, and retrieval data.

Network performance for graphical control systems

International Nuclear Information System (INIS)

Clout, P.; Geib, M.; Westervelt, R.

1992-01-01

Vsystem is a toolbox for building graphically-based control systems. The real-tiem database component, Vaccess, includes all the networking support necessary to build multi-computer control systems. Vaccess has two modes of database access, synchronous and asynchronous. Vdraw is another component of Vsystem that allows developers and users to develop control screens and windows by drawing rather than programming. Based on X-windows, Vsystem provides the possibility of running Vdraw either on the workstation with the graphics or on the computer with the database. We have made some measurements on the cpu loading, elapsed time and the network loading to give some guidance in system configuration performance. It will be seen that asynchronous network access gives large performance increases and that the network database change notification protocol can be either more or less efficient than the X-window network protocol, depending on the graphical representation of the data. (author)

Control theory of digitally networked dynamic systems

CERN Document Server

Lunze, Jan

2013-01-01

The book gives an introduction to networked control systems and describes new modeling paradigms, analysis methods for event-driven, digitally networked systems, and design methods for distributed estimation and control. Networked model predictive control is developed as a means to tolerate time delays and packet loss brought about by the communication network. In event-based control the traditional periodic sampling is replaced by state-dependent triggering schemes. Novel methods for multi-agent systems ensure complete or clustered synchrony of agents with identical or with individual dynamic

Creating a system of medical and psychological rehabilitation of extreme professions representatives (firemen-rescuers as a model

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J. Chumaeva

2015-08-01

2Odessa National Maritime Academy, Odessa, Ukraine   Abstract Background. Working conditions of representatives of extreme professions (firemen-rescuers are a good example, are connected with disregulations and disorders of physiologic functions, fatigue accumulation and disadaptation. The medical and psychological rehabilitation is an effective way for occupational health and reliability restoration. However, last one is characterized by an empirical approach and conducted by priority of medical component, that significantly reduces effectiveness of the undertaken measures. So, it is necessary to develop a system of combined medical and psychological rehabilitation (MPR. Materials and methods. In this progect MPR was carried out in 238 specialists of three professional groups:  firemen-rescuers (146, fire-engine drivers (44 and inspectors of fire safety (48 - control. Psychophysiological examination included the computerized program “MORTEST”, variant “SPAS-14” performance, answers to the individual-typological questionnaire (ITQ and Eysenck personal test (EPT. The levels of epinephrine (Е, norepinephrine (NЕ, dopamine (DА  and dioxyphenylalanine (DOPA urinal excretion, the vanillylmandelic (VMA and homovanillic acids (HVA levels in urine were also defined. The survey is conducted three times: at the beginning, middle and the end of a 12-day rehabilitation course. Statistical data processing  was carried out by common programs in  Microsoft Excel. Results and discussion. The studies have shown that the attributes to identify individual-typological differences are indicators of extroversion-introversion and anxiety in tests ITO and EPT. The results  were divided into three clusters: extroverts with low anxiety (52.9%; ambiverts with low (27.7% and high anxiety (19.4%. Simultaneously it was assigned different types of SAS response in the rehabilitation process: basic or balanced, epinephrinic, norepinephrinic, and with low secretory activity. Low

Network Physiology: How Organ Systems Dynamically Interact

Science.gov (United States)

Bartsch, Ronny P.; Liu, Kang K. L.; Bashan, Amir; Ivanov, Plamen Ch.

2015-01-01

We systematically study how diverse physiologic systems in the human organism dynamically interact and collectively behave to produce distinct physiologic states and functions. This is a fundamental question in the new interdisciplinary field of Network Physiology, and has not been previously explored. Introducing the novel concept of Time Delay Stability (TDS), we develop a computational approach to identify and quantify networks of physiologic interactions from long-term continuous, multi-channel physiological recordings. We also develop a physiologically-motivated visualization framework to map networks of dynamical organ interactions to graphical objects encoded with information about the coupling strength of network links quantified using the TDS measure. Applying a system-wide integrative approach, we identify distinct patterns in the network structure of organ interactions, as well as the frequency bands through which these interactions are mediated. We establish first maps representing physiologic organ network interactions and discover basic rules underlying the complex hierarchical reorganization in physiologic networks with transitions across physiologic states. Our findings demonstrate a direct association between network topology and physiologic function, and provide new insights into understanding how health and distinct physiologic states emerge from networked interactions among nonlinear multi-component complex systems. The presented here investigations are initial steps in building a first atlas of dynamic interactions among organ systems. PMID:26555073

Network Physiology: How Organ Systems Dynamically Interact.

Science.gov (United States)

Bartsch, Ronny P; Liu, Kang K L; Bashan, Amir; Ivanov, Plamen Ch

2015-01-01

We systematically study how diverse physiologic systems in the human organism dynamically interact and collectively behave to produce distinct physiologic states and functions. This is a fundamental question in the new interdisciplinary field of Network Physiology, and has not been previously explored. Introducing the novel concept of Time Delay Stability (TDS), we develop a computational approach to identify and quantify networks of physiologic interactions from long-term continuous, multi-channel physiological recordings. We also develop a physiologically-motivated visualization framework to map networks of dynamical organ interactions to graphical objects encoded with information about the coupling strength of network links quantified using the TDS measure. Applying a system-wide integrative approach, we identify distinct patterns in the network structure of organ interactions, as well as the frequency bands through which these interactions are mediated. We establish first maps representing physiologic organ network interactions and discover basic rules underlying the complex hierarchical reorganization in physiologic networks with transitions across physiologic states. Our findings demonstrate a direct association between network topology and physiologic function, and provide new insights into understanding how health and distinct physiologic states emerge from networked interactions among nonlinear multi-component complex systems. The presented here investigations are initial steps in building a first atlas of dynamic interactions among organ systems.

Cooperative Control for A Hybrid Rehabilitation System Combining Functional Electrical Stimulation and Robotic Exoskeleton

Directory of Open Access Journals (Sweden)

Dingguo Zhang

2017-12-01

Full Text Available Functional electrical stimulation (FES and robotic exoskeletons are two important technologies widely used for physical rehabilitation of paraplegic patients. We developed a hybrid rehabilitation system (FEXO Knee that combined FES and an exoskeleton for swinging movement control of human knee joints. This study proposed a novel cooperative control strategy, which could realize arbitrary distribution of torque generated by FES and exoskeleton, and guarantee harmonic movements. The cooperative control adopted feedfoward control for FES and feedback control for exoskeleton. A parameter regulator was designed to update key parameters in real time to coordinate FES controller and exoskeleton controller. Two muscle groups (quadriceps and hamstrings were stimulated to generate active torque for knee joint in synchronization with torque compensation from exoskeleton. The knee joint angle and the interactive torque between exoskeleton and shank were used as feedback signals for the control system. Central pattern generator (CPG was adopted that acted as a phase predictor to deal with phase confliction of motor patterns, and realized synchronization between the two different bodies (shank and exoskeleton. Experimental evaluation of the hybrid FES-exoskeleton system was conducted on five healthy subjects and four paraplegic patients. Experimental results and statistical analysis showed good control performance of the cooperative control on torque distribution, trajectory tracking, and phase synchronization.

Wearable kinesthetic system for capturing and classifying upper limb gesture in post-stroke rehabilitation.

Science.gov (United States)

Tognetti, Alessandro; Lorussi, Federico; Bartalesi, Raphael; Quaglini, Silvana; Tesconi, Mario; Zupone, Giuseppe; De Rossi, Danilo

2005-03-02

BACKGROUND: Monitoring body kinematics has fundamental relevance in several biological and technical disciplines. In particular the possibility to exactly know the posture may furnish a main aid in rehabilitation topics. In the present work an innovative and unobtrusive garment able to detect the posture and the movement of the upper limb has been introduced, with particular care to its application in post stroke rehabilitation field by describing the integration of the prototype in a healthcare service. METHODS: This paper deals with the design, the development and implementation of a sensing garment, from the characterization of innovative comfortable and diffuse sensors we used to the methodologies employed to gather information on the posture and movement which derive from the entire garments. Several new algorithms devoted to the signal acquisition, the treatment and posture and gesture reconstruction are introduced and tested. RESULTS: Data obtained by means of the sensing garment are analyzed and compared with the ones recorded using a traditional movement tracking system. CONCLUSION: The main results treated in this work are summarized and remarked. The system was compared with a commercial movement tracking system (a set of electrogoniometers) and it performed the same accuracy in detecting upper limb postures and movements.

Wearable kinesthetic system for capturing and classifying upper limb gesture in post-stroke rehabilitation

Directory of Open Access Journals (Sweden)

Tesconi Mario

2005-03-01

Full Text Available Abstract Background Monitoring body kinematics has fundamental relevance in several biological and technical disciplines. In particular the possibility to exactly know the posture may furnish a main aid in rehabilitation topics. In the present work an innovative and unobtrusive garment able to detect the posture and the movement of the upper limb has been introduced, with particular care to its application in post stroke rehabilitation field by describing the integration of the prototype in a healthcare service. Methods This paper deals with the design, the development and implementation of a sensing garment, from the characterization of innovative comfortable and diffuse sensors we used to the methodologies employed to gather information on the posture and movement which derive from the entire garments. Several new algorithms devoted to the signal acquisition, the treatment and posture and gesture reconstruction are introduced and tested. Results Data obtained by means of the sensing garment are analyzed and compared with the ones recorded using a traditional movement tracking system. Conclusion The main results treated in this work are summarized and remarked. The system was compared with a commercial movement tracking system (a set of electrogoniometers and it performed the same accuracy in detecting upper limb postures and movements.

Cooperative Control for A Hybrid Rehabilitation System Combining Functional Electrical Stimulation and Robotic Exoskeleton.

Science.gov (United States)

Zhang, Dingguo; Ren, Yong; Gui, Kai; Jia, Jie; Xu, Wendong

2017-01-01

Functional electrical stimulation (FES) and robotic exoskeletons are two important technologies widely used for physical rehabilitation of paraplegic patients. We developed a hybrid rehabilitation system (FEXO Knee) that combined FES and an exoskeleton for swinging movement control of human knee joints. This study proposed a novel cooperative control strategy, which could realize arbitrary distribution of torque generated by FES and exoskeleton, and guarantee harmonic movements. The cooperative control adopted feedfoward control for FES and feedback control for exoskeleton. A parameter regulator was designed to update key parameters in real time to coordinate FES controller and exoskeleton controller. Two muscle groups (quadriceps and hamstrings) were stimulated to generate active torque for knee joint in synchronization with torque compensation from exoskeleton. The knee joint angle and the interactive torque between exoskeleton and shank were used as feedback signals for the control system. Central pattern generator (CPG) was adopted that acted as a phase predictor to deal with phase confliction of motor patterns, and realized synchronization between the two different bodies (shank and exoskeleton). Experimental evaluation of the hybrid FES-exoskeleton system was conducted on five healthy subjects and four paraplegic patients. Experimental results and statistical analysis showed good control performance of the cooperative control on torque distribution, trajectory tracking, and phase synchronization.

Future Wireless Networks and Information Systems Volume 1

CERN Document Server

2012-01-01

This volume contains revised and extended research articles written by prominent researchers participating in ICFWI 2011 conference. The 2011 International Conference on Future Wireless Networks and Information Systems (ICFWI 2011) has been held on November 30 ~ December 1, 2011, Macao, China. Topics covered include Wireless Information Networks, Wireless Networking Technologies, Mobile Software and Services, intelligent computing, network management, power engineering, control engineering, Signal and Image Processing, Machine Learning, Control Systems and Applications, The book will offer the states of arts of tremendous advances in Wireless Networks and Information Systems and also serve as an excellent reference work for researchers and graduate students working on Wireless Networks and Information Systems.

A Comprehensive Rehabilitation Approach in a Patient With Serious Neuropsychiatric Systemic Lupus Erythematosus.

Science.gov (United States)

Ko, Yong Jae; Lee, Yang Gyun; Park, Ji Woong; Ahn, Sung Ho; Kwak, Jin Myoung; Choi, Yoon-Hee

2016-08-01

Neuropsychiatric systemic lupus erythematosus (NPSLE) involves the central and peripheral nervous system in patients with systemic lupus erythematosus (SLE). It is essential to specify the problems faced by patients with NPSLE because it causes diverse disabilities and impairs quality of life. After performing a comprehensive evaluation, tailored management should be provided for the patient's specific problems. We report here the case of a 30-year-old female with SLE who experienced serious neuropsychiatric symptoms cerebral infarction followed by posterior reversible encephalopathy syndrome and peripheral polyneuropathy. We systemically assessed the patient using the International Classification of Functioning, Disability and Health model as a clinical problem-solving tool and provided comprehensive rehabilitation by focusing on her problems.

BCI and FES Based Therapy for Stroke Rehabilitation Using VR Facilities

Directory of Open Access Journals (Sweden)

Robert Gabriel Lupu

2018-01-01

Full Text Available In recent years, the assistive technologies and stroke rehabilitation methods have been empowered by the use of virtual reality environments and the facilities offered by brain computer interface systems and functional electrical stimulators. In this paper, a therapy system for stroke rehabilitation based on these revolutionary techniques is presented. Using a virtual reality Oculus Rift device, the proposed system ushers the patient in a virtual scenario where a virtual therapist coordinates the exercises aimed at restoring brain function. The electrical stimulator helps the patient to perform rehabilitation exercises and the brain computer interface system and an electrooculography device are used to determine if the exercises are executed properly. Laboratory tests on healthy people led to system validation from technical point of view. The clinical tests are in progress, but the preliminary results of the clinical tests have highlighted the good satisfaction degree of patients, the quick accommodation with the proposed therapy, and rapid progress for each user rehabilitation.

K-means cluster analysis of rehabilitation service users in the Home Health Care System of Ontario: examining the heterogeneity of a complex geriatric population.

Science.gov (United States)

Armstrong, Joshua J; Zhu, Mu; Hirdes, John P; Stolee, Paul

2012-12-01

To examine the heterogeneity of home care clients who use rehabilitation services by using the K-means algorithm to identify previously unknown patterns of clinical characteristics. Observational study of secondary data. Home care system. Assessment information was collected on 150,253 home care clients using the provincially mandated Resident Assessment Instrument-Home Care (RAI-HC) data system. Not applicable. Assessment information from every long-stay (>60 d) home care client that entered the home care system between 2005 and 2008 and used rehabilitation services within 3 months of their initial assessment was analyzed. The K-means clustering algorithm was applied using 37 variables from the RAI-HC assessment. The K-means cluster analysis resulted in the identification of 7 relatively homogeneous subgroups that differed on characteristics such as age, sex, cognition, and functional impairment. Client profiles were created to illustrate the diversity of this geriatric population. The K-means algorithm provided a useful way to segment a heterogeneous rehabilitation client population into more homogeneous subgroups. This analysis provides an enhanced understanding of client characteristics and needs, and could enable more appropriate targeting of rehabilitation services for home care clients. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Rehabilitation robotics.

Science.gov (United States)

Krebs, H I; Volpe, B T

2013-01-01

This chapter focuses on rehabilitation robotics which can be used to augment the clinician's toolbox in order to deliver meaningful restorative therapy for an aging population, as well as on advances in orthotics to augment an individual's functional abilities beyond neurorestoration potential. The interest in rehabilitation robotics and orthotics is increasing steadily with marked growth in the last 10 years. This growth is understandable in view of the increased demand for caregivers and rehabilitation services escalating apace with the graying of the population. We provide an overview on improving function in people with a weak limb due to a neurological disorder who cannot properly control it to interact with the environment (orthotics); we then focus on tools to assist the clinician in promoting rehabilitation of an individual so that s/he can interact with the environment unassisted (rehabilitation robotics). We present a few clinical results occurring immediately poststroke as well as during the chronic phase that demonstrate superior gains for the upper extremity when employing rehabilitation robotics instead of usual care. These include the landmark VA-ROBOTICS multisite, randomized clinical study which demonstrates clinical gains for chronic stroke that go beyond usual care at no additional cost. Copyright © 2013 Elsevier B.V. All rights reserved.

Topological resilience in non-normal networked systems

Science.gov (United States)

Asllani, Malbor; Carletti, Timoteo

2018-04-01

The network of interactions in complex systems strongly influences their resilience and the system capability to resist external perturbations or structural damages and to promptly recover thereafter. The phenomenon manifests itself in different domains, e.g., parasitic species invasion in ecosystems or cascade failures in human-made networks. Understanding the topological features of the networks that affect the resilience phenomenon remains a challenging goal for the design of robust complex systems. We hereby introduce the concept of non-normal networks, namely networks whose adjacency matrices are non-normal, propose a generating model, and show that such a feature can drastically change the global dynamics through an amplification of the system response to exogenous disturbances and eventually impact the system resilience. This early stage transient period can induce the formation of inhomogeneous patterns, even in systems involving a single diffusing agent, providing thus a new kind of dynamical instability complementary to the Turing one. We provide, first, an illustrative application of this result to ecology by proposing a mechanism to mute the Allee effect and, second, we propose a model of virus spreading in a population of commuters moving using a non-normal transport network, the London Tube.

Critical Thinking Skills for Rehabilitation Professionals in the 21st Century

Science.gov (United States)

Lewis, Allen N.; King, Eric S.; Pitt, Jenelle S.; Getachew, Almaz; Shamburger, Aisha

2010-01-01

Critical thinking (CT) is an essential tool for rehabilitation professionals in the 21st century. Well developed CT skills are indicated for rehabilitation professionals in the new century to promote continuous quality improvement of the service delivery system. Such improvement will occur as rehabilitation professionals learn to routinely…

Rehabilitation and older people.

OpenAIRE

Young, J.

1996-01-01

Rehabilitation is concerned with lessening the impact of disabling conditions. These are particularly common in older people and considerable health gain can be achieved by successful rehabilitation. Hospital doctors and general practitioners should be aware of the core principles of rehabilitation, be able to recognise rehabilitation need in their patients, and have sufficient knowledge of their local rehabilitation services to trigger the referral process.

Autonomous rehabilitation at stroke patients home for balance and gait: safety, usability and compliance of a virtual reality system.

Science.gov (United States)

Held, Jeremia P; Ferrer, Begoña; Mainetti, Renato; Steblin, Alexander; Hertler, Benjamin; Moreno-Conde, Alberto; Dueñas, Alvaro; Pajaro, Marta; L-Parra-Calderón, Carlos; Vargiu, Eloisa; Zarco, Maria J; Barrera, Maria; Echevarria, Carmen; Jódar-Sánchez, Francisco; Luft, Andreas R; Borghese, Nunzio A

2017-09-25

New technologies, such as telerehabilitation and gaming devices offer the possibility for patients to train at home. This opens the challenge of safety for the patient as he is called to exercise neither with a therapist on the patients' side nor with a therapist linked remotely to supervise the sessions. To study the safety, usability and patient acceptance of an autonomous telerehabilitation system for balance and gait (the REWIRE platform) in the patients home. Cohort study. Community, in the stroke patients' home. 15 participants with first-ever stroke, with a mild to moderate residual deficit of the lower extremities. Autonomous rehabilitation based on virtual rehabilitation was provided at the participants' home for twelve weeks. The primary outcome was compliance (the ratio between days of actual and scheduled training), analysed with the two-tailed Wilcoxon Mann- Whitney test. Furthermore safety is defined by adverse events. The secondary endpoint was the acceptance of the system measured with the Technology Acceptance Model. Additionally, the cumulative duration of weekly training was analysed. During the study there were no adverse events related to the therapy. Patients performed on average 71% (range 39 to 92%) of the scheduled sessions. The Technology Acceptance Model Questionnaire showed excellent values for stroke patients after the training. The average training duration per week was 99 ±53min. Autonomous telerehabilitation for balance and gait training with the REWIRE-system is safe, feasible and can help to intensive rehabilitative therapy at home. Telerehabilitation enables safe training in home environment and supports of the standard rehabilitation therapy.

Intrusion Detection in Networked Control Systems: From System Knowledge to Network Security

NARCIS (Netherlands)

Caselli, M.

2016-01-01

“Networked control system‿ (NCS) is an umbrella term encompassing a broad variety of infrastructures such as industrial control systems (ICSs) and building automation systems (BASs). Nowadays, all these infrastructures play an important role in several aspects of our daily life, from managing

Phase-space networks of geometrically frustrated systems.

Science.gov (United States)

Han, Yilong

2009-11-01

We illustrate a network approach to the phase-space study by using two geometrical frustration models: antiferromagnet on triangular lattice and square ice. Their highly degenerated ground states are mapped as discrete networks such that the quantitative network analysis can be applied to phase-space studies. The resulting phase spaces share some comon features and establish a class of complex networks with unique Gaussian spectral densities. Although phase-space networks are heterogeneously connected, the systems are still ergodic due to the random Poisson processes. This network approach can be generalized to phase spaces of some other complex systems.

The Efficacy of a Haptic-Enhanced Virtual Reality System for Precision Grasp Acquisition in Stroke Rehabilitation

Directory of Open Access Journals (Sweden)

Shih-Ching Yeh

2017-01-01

Full Text Available Stroke is a leading cause of long-term disability, and virtual reality- (VR- based stroke rehabilitation is effective in increasing motivation and the functional performance. Although much of the functional reach and grasp capabilities of the upper extremities were regained, the pinch movement remains impaired following stroke. In this study, we developed a haptic-enhanced VR system to simulate haptic pinch tasks to assist the recovery of upper-extremity fine motor function. We recruited 16 adults with stroke to verify the efficacy of this new VR system. Each patient received 30 min VR training sessions 3 times per week for 8 weeks. Outcome measures, Fugl-Meyer assessment (FMA, Test Evaluant les Membres superieurs des Personnes Agees (TEMPA, Wolf motor function test (WMFT, Box and Block test (BBT, and Jamar grip dynamometer, showed statistically significant progress from pretest to posttest and follow-up, indicating that the proposed system effectively promoted fine motor recovery of function. Additionally, our evidence suggests that this system was also effective under certain challenging conditions such as being in the chronic stroke phase or a coside of lesion and dominant hand (nondominant hand impaired. System usability assessment indicated that the participants strongly intended to continue using this VR-based system in rehabilitation.

Network biology: Describing biological systems by complex networks. Comment on "Network science of biological systems at different scales: A review" by M. Gosak et al.

Science.gov (United States)

Jalili, Mahdi

2018-03-01

I enjoyed reading Gosak et al. review on analysing biological systems from network science perspective [1]. Network science, first started within Physics community, is now a mature multidisciplinary field of science with many applications ranging from Ecology to biology, medicine, social sciences, engineering and computer science. Gosak et al. discussed how biological systems can be modelled and described by complex network theory which is an important application of network science. Although there has been considerable progress in network biology over the past two decades, this is just the beginning and network science has a great deal to offer to biology and medical sciences.

Rehabilitation of compensable workplace injuries: effective payment models for quality vocational rehabilitation outcomes in a changing social landscape.

Science.gov (United States)

Matthews, Lynda R; Hanley, Francine; Lewis, Virginia; Howe, Caroline

2015-01-01

With social and economic costs of workplace injury on the increase, efficient payment models that deliver quality rehabilitation outcomes are of increasing interest. This paper provides a perspective on the issue informed by both refereed literature and published research material not available commercially (gray literature). A review of payment models, workers' compensation and compensable injury identified relevant peer-reviewed and gray literature that informed our discussion. Fee-for-service and performance-based payment models dominate the health and rehabilitation literature, each described as having benefits and challenges to achieving quality outcomes for consumers. There appears to be a movement toward performance-based payments in compensable workplace injury settings as they are perceived to promote time-efficient services and support innovation in rehabilitation practice. However, it appears that the challenges that arise for workplace-based rehabilitation providers and professionals when working under the various payment models, such as staff retention and quality of client-practitioner relationship, are absent from the literature and this could lead to flawed policy decisions. Robust evidence of the benefits and costs associated with different payment models - from the perspectives of clients/consumers, funders and service providers - is needed to inform best practice in rehabilitation of compensable workplace injuries. Available but limited evidence suggests that payment models providing financial incentives for stakeholder-agreed vocational rehabilitation outcomes tend to improve service effectiveness in workers' compensation settings, although there is little evidence of service quality or client satisfaction. Working in a system that identifies payments for stakeholder-agreed outcomes may be more satisfying for rehabilitation practitioners in workers' compensation settings by allowing more clinical autonomy and innovative practice. Researchers

Community-Based Rehabilitation to Improve Stroke Survivors' Rehabilitation Participation and Functional Recovery.

Science.gov (United States)

Ru, Xiaojuan; Dai, Hong; Jiang, Bin; Li, Ninghua; Zhao, Xingquan; Hong, Zhen; He, Li; Wang, Wenzhi

2017-07-01

The aim of this study was to evaluate the effectiveness of a community-based rehabilitation appropriate technique (CRAT) intervention program in increasing rehabilitation participation and improving functional recovery of stroke survivors. This study followed a quasi-experimental design. In each of 5 centers servicing approximately 50,000 individuals, 2 communities were designated as either the intervention or control community. A CRAT intervention program, including 2-year rehabilitation education and 3-month CRAT treatment, was regularly implemented in the intervention communities, whereas there was no special intervention in the control community. Two sampling surveys, at baseline and after intervention, were administered to evaluate the rehabilitation activity undertaken. In intervention communities, stroke survivor's motor function, daily activity, and social activity were evaluated pretreatment and posttreatment, using the Fugl-Meyer Motor Function Assessment, Barthel index, and Social Functional Activities Questionnaire. The proportion of individuals participating in rehabilitation-related activity was increased significantly (P rehabilitation (P 0.05). Community-based rehabilitation appropriate technique increases rehabilitation participation rates and enhances motor function, daily activity, and social activity of stroke survivors.

78 FR 35758 - Final Priority; National Institute on Disability and Rehabilitation Research-Rehabilitation...

Science.gov (United States)

2013-06-14

... Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY... for the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority...

Slovenian and European legal stipulations concerning protection and rehabilitation of river corridors

Directory of Open Access Journals (Sweden)

Matjaž Mikoš

2003-01-01

Full Text Available In view of the state of hydromorphological preservation of river corridors in the Slovenian hydrographic network and because of demands imposed by domestic and European legislature concerning water resource management and environmental protection, certain sections of rivers and streams that were for various reasons regulated in the past, will have to be rehabilitated. Permanent solutions to such issues demand careful planning of rehabilitation on suitable sections of rivers and streams, adequate positioning within physical planning acts, as well as streamlined administrative procedures and devised maintenance of rehabilitation areas. Because the process demands the return of formerly taken water surfaces into the domain of water ecosystems and dynamics of hydromorphological processes, and consequentially maintenance of regained surfaces, the public becomes an important factor, which is a position, granted by domestic and European laws. Last, but not least, successful execution of rehabilitation of water corridors, besides planning, administration and consistent public participation, demands knowledge about good practices of project management, as well as technical execution of such projects.

Effect of systemic family therapy on rehabilitation in patients with schizophrenia

Directory of Open Access Journals (Sweden)

Wei Zhang

2016-12-01

Full Text Available Objective: To explore the effect of systemic family therapy on the rehabilitation in patients with schizophrenia. Methods: A total of 86 patients with schizophrenia who were admitted in our hospital from February, 2011 to February, 2014 were included in the study and randomized into the observation group and the control group. A total of 43 healthy individuals for physical examinations were served as the healthy group. The patients in the control group were given risperidone in a single dose, and telephone follow-up. On this basis, the patients in the observation group were given systemic family therapy. The morning fasting venous blood before treatment and 3 months after treatment in the healthy group and patients with schizophrenia was collected. BDNF, NGF, GFAP, IL-6, and TNF-α were detected. After 6-month treatment, SCL-90 was used to evaluate the psychological state. Results: The serum BDNF and NGF levels before and after treatment in the observation group and the control group were significantly lower than those in the healthy group, while GFAP level was significantly higher than that in the healthy group (P0.05. The serum IL-6 and TNF-α levels before and after treatment in the observation group and the control group were significantly higher than those in the healthy group (P0.05. After 6-month treatment, the scores of somatization, interpersonal relationship, fear, anxiety, hostility, paranoid, depression, obsession, and mental disorder in the observation group were significantly reduced when compared with before treatment (P0.05. Conclusions: The systemic family therapy is an effective adjuvant method for the rehabilitation in patients with schizophrenia, and can effectively improve the mental health status; therefore, it deserves to be widely recommended in the clinic.

Effect of systemic family therapy on rehabilitation in patients with schizophrenia

Institute of Scientific and Technical Information of China (English)

Wei Zhang; Na Li; Ying-Ting Li; Shu-Qing Dong; Li-Mei Feng

2016-01-01

Objective:To explore the effect of systemic family therapy on the rehabilitation in patients with schizophrenia.Methods: A total of 86 patients with schizophrenia who were admitted in our hospital from February, 2011 to February, 2014 were included in the study and randomized into the observation group and the control group. A total of 43 healthy individuals for physical examinations were served as the healthy group. The patients in the control group were given risperidone in a single dose, and telephone follow-up. On this basis, the patients in the observation group were given systemic family therapy. The morning fasting venous blood before treatment and 3 months after treatment in the healthy group and patients with schizophrenia was collected. BDNF, NGF, GFAP, IL-6, and TNF-α were detected. After 6-month treatment, SCL-90 was used to evaluate the psychological state.Results: The serum BDNF and NGF levels before and after treatment in the observation group and the control group were significantly lower than those in the healthy group, while GFAP level was significantly higher than that in the healthy group (P0.05). The serum IL-6 and TNF-α levels before and after treatment in the observation group and the control group were significantly higher than those in the healthy group (P0.05). After 6-month treatment, the scores of somatization, interpersonal relationship, fear, anxiety, hostility, paranoid, depression, obsession, and mental disorder in the observation group were significantly reduced when compared with before treatment (P0.05).Conclusions:The systemic family therapy is an effective adjuvant method for the rehabilitation in patients with schizophrenia, and can effectively improve the mental health status; therefore, it deserves to be widely recommended in the clinic.

Home-based pulmonary rehabilitation improves clinical features and systemic inflammation in chronic obstructive pulmonary disease patients

Directory of Open Access Journals (Sweden)

Nascimento ESP

2015-03-01

Full Text Available Eloisa Sanches Pereira do Nascimento,1 Luciana Maria Malosá Sampaio,1 Fabiana Sobral Peixoto-Souza,1 Fernanda Dultra Dias,1 Evelim Leal Freitas Dantas Gomes,1 Flavia Regina Greiffo,2 Ana Paula Ligeiro de Oliveira,2 Roberto Stirbulov,3 Rodolfo Paula Vieira,2 Dirceu Costa11Laboratory of Functional Respiratory Evaluation (LARESP, 2Laboratory of Pulmonary and Exercise Immunology (LABPEI, Nove de Julho University (UNINOVE, São Paulo, SP, Brazil; 3Department of Pneumology, Santa Casa University Hospital, São Paulo, SP, BrazilAbstract: Chronic obstructive pulmonary disease (COPD is a respiratory disease characterized by chronic airflow limitation that leads beyond the pulmonary changes to important systemic effects. COPD is characterized by pulmonary and systemic inflammation. However, increases in the levels of inflammatory cytokines in plasma are found even when the disease is stable. Pulmonary rehabilitation improves physical exercise capacity and quality of life and decreases dyspnea. The aim of this study was to evaluate whether a home-based pulmonary rehabilitation (HBPR program improves exercise tolerance in COPD patients, as well as health-related quality of life and systemic inflammation. This prospective study was conducted at the Laboratory of Functional Respiratory Evaluation, Nove de Julho University, São Paulo, Brazil. After anamnesis, patients were subjected to evaluations of health-related quality of life and dyspnea, spirometry, respiratory muscle strength, upper limbs incremental test, incremental shuttle walk test, and blood test for quantification of systemic inflammatory markers (interleukin [IL]-6 and IL-8. At the end of the evaluations, patients received a booklet containing the physical exercises to be performed at home, three times per week for 8 consecutive weeks. Around 25 patients were enrolled, and 14 completed the pre- and post-HBPR ratings. There was a significant increase in the walked distance and the maximal

Ambivalence in rehabilitation

DEFF Research Database (Denmark)

Christensen, Jan; Langberg, Henning; Doherty, Patrick

2017-01-01

BACKGROUND: Knowledge about the organization and factors of importance to rehabilitation of veterans with lower limb amputation is sparse. The aim of this study was, therefore, to improve understanding of the influences of "military identity" on the organization of rehabilitation services...... and to investigate those factors influential in achieving successful rehabilitation, including interprofessional collaboration between different sectors involved in the rehabilitation of veterans with lower limb amputations. METHODS: We used a qualitative exploratory design, triangulating interviews and participant...... observation. Data were generated using in-depth semi-structured interviews (n = 6) exploring in-hospital and post-hospital rehabilitation in Danish veterans after unilateral lower limb amputation due to trauma. We conducted four sessions of participant observation, during weekly post...

Rehabilitating torture survivors

DEFF Research Database (Denmark)

Sjölund, Bengt H; Kastrup, Marianne; Montgomery, Edith

2009-01-01

survivors can be addressed from an evidence base generated both from traumatized and non-traumatized patient populations. Thus, trauma-focused cognitive behavioural therapy and/or eye movement desensitization and reprocessing, as well as interdisciplinary pain rehabilitation, should be components......, in December 2008. The main topics were: the context of torture; mental problems including psychotherapy; internet-based therapy and pharmaco-therapy; chronic pain; social integration and family; and functioning and rehabilitation. Available evidence highlights the importance of an interdisciplinary approach......, "Rehabilitating Torture Survivors", was organized by the Rehabilitation and Research Centre for Torture Victims (a rehabilitation clinic and global knowledge and research centre with government support) in collaboration with the Centre for Transcultural Psychiatry at Rigshospitalet in Copenhagen, Denmark...

Purposefulness of early application of physical rehabilitation means for improvement of external respiration system functional state of women with post mastectomies syndrome

Directory of Open Access Journals (Sweden)

Y.A. Briskin

2015-12-01

Full Text Available Purpose: to determine purposefulness of early application of physical rehabilitation means for improvement of external respiration system functional state of women with post mastectomies syndrome. Material: in the research 135 women with post mastectomies syndrome, who endured radical mastectomy by Madden, participated. Women of main groups were trained in compliance with appropriate programs during one year. Effectiveness of trainings was controlled after half of year. Admission to trainings was given by oncologist. Patients of these groups belonged to third clinical group. At the beginning of dispensary period the groups were equal by all indicators of external system function. Results: it was found that early rehabilitation is more effective exclusively for indicators of bronchial patency. Complex, personality oriented program included: aqua-fitness; conditional swimming; health related aerobic and Pilates. It was found that after half year training advantages of early physical rehabilitation were noticed only in indicators of forced exhale volume at first second. Conclusions: we stated importance of early rehabilitation trainings of women with post mastectomies syndrome.

Synchronization coupled systems to complex networks

CERN Document Server

Boccaletti, Stefano; del Genio, Charo I; Amann, Andreas

2018-01-01

A modern introduction to synchronization phenomena, this text presents recent discoveries and the current state of research in the field, from low-dimensional systems to complex networks. The book describes some of the main mechanisms of collective behaviour in dynamical systems, including simple coupled systems, chaotic systems, and systems of infinite-dimension. After introducing the reader to the basic concepts of nonlinear dynamics, the book explores the main synchronized states of coupled systems and describes the influence of noise and the occurrence of synchronous motion in multistable and spatially-extended systems. Finally, the authors discuss the underlying principles of collective dynamics on complex networks, providing an understanding of how networked systems are able to function as a whole in order to process information, perform coordinated tasks, and respond collectively to external perturbations. The demonstrations, numerous illustrations and application examples will help advanced graduate s...

Conceptual bases of Christian, faith-based substance abuse rehabilitation programs: qualitative analysis of staff interviews.

Science.gov (United States)

McCoy, Lisa K; Hermos, John A; Bokhour, Barbara G; Frayne, Susan M

2004-09-01

Faith-based substance abuse rehabilitation programs provide residential treatment for many substance abusers. To determine key governing concepts of such programs, we conducted semi-structured interviews with sample of eleven clinical and administrative staff referred to us by program directors at six, Evangelical Christian, faith-based, residential rehabilitation programs representing two large, nationwide networks. Qualitative analysis using grounded theory methods examined how spirituality is incorporated into treatment and elicited key theories of addiction and recovery. Although containing comprehensive secular components, the core activities are strongly rooted in a Christian belief system that informs their understanding of addiction and recovery and drives the treatment format. These governing conceptions, that addiction stems from attempts to fill a spiritual void through substance use and recovery through salvation and a long-term relationship with God, provide an explicit, theory-driven model upon which they base their core treatment activities. Knowledge of these core concepts and practices should be helpful to clinicians in considering referrals to faith-based recovery programs.

Spinal Cord Injury Rehabilitation in Nepal

OpenAIRE

Nabina Shah; Binav Shrestha; Kamana Subba

2013-01-01

Spinal cord injury is a major trauma, with its short and long term effects and consequences to the patient, his friends and family. Spinal cord injury is addressed in the developed countries with standard trauma care system commencing immediately after injury and continuing to the specialized rehabilitation units. Rehabilitation is important to those with spinal injury for both functional and psychosocial reintegration. It has been an emerging concept in Nepal, which has been evident with the...

Apriori-based network intrusion detection system

International Nuclear Information System (INIS)

Wang Wenjin; Liu Junrong; Liu Baoxu

2012-01-01

With the development of network communication technology, more and more social activities run by Internet. In the meantime, the network information security is getting increasingly serious. Intrusion Detection System (IDS) has greatly improved the general security level of whole network. But there are still many problem exists in current IDS, e.g. high leak rate detection/false alarm rates and feature library need frequently upgrade. This paper presents an association-rule based IDS. This system can detect unknown attack by generate rules from training data. Experiment in last chapter proved the system has great accuracy on unknown attack detection. (authors)

Smart portable rehabilitation devices

Directory of Open Access Journals (Sweden)

Leahey Matt

2005-07-01

Full Text Available Abstract Background The majority of current portable orthotic devices and rehabilitative braces provide stability, apply precise pressure, or help maintain alignment of the joints with out the capability for real time monitoring of the patient's motions and forces and without the ability for real time adjustments of the applied forces and motions. Improved technology has allowed for advancements where these devices can be designed to apply a form of tension to resist motion of the joint. These devices induce quicker recovery and are more effective at restoring proper biomechanics and improving muscle function. However, their shortcoming is in their inability to be adjusted in real-time, which is the most ideal form of a device for rehabilitation. This introduces a second class of devices beyond passive orthotics. It is comprised of "active" or powered devices, and although more complicated in design, they are definitely the most versatile. An active or powered orthotic, usually employs some type of actuator(s. Methods In this paper we present several new advancements in the area of smart rehabilitation devices that have been developed by the Northeastern University Robotics and Mechatronics Laboratory. They are all compact, wearable and portable devices and boast re-programmable, real time computer controlled functions as the central theme behind their operation. The sensory information and computer control of the three described devices make for highly efficient and versatile systems that represent a whole new breed in wearable rehabilitation devices. Their applications range from active-assistive rehabilitation to resistance exercise and even have applications in gait training. The three devices described are: a transportable continuous passive motion elbow device, a wearable electro-rheological fluid based knee resistance device, and a wearable electrical stimulation and biofeedback knee device. Results Laboratory tests of the devices

Smart portable rehabilitation devices.

Science.gov (United States)

Mavroidis, Constantinos; Nikitczuk, Jason; Weinberg, Brian; Danaher, Gil; Jensen, Katherine; Pelletier, Philip; Prugnarola, Jennifer; Stuart, Ryan; Arango, Roberto; Leahey, Matt; Pavone, Robert; Provo, Andrew; Yasevac, Dan

2005-07-12

The majority of current portable orthotic devices and rehabilitative braces provide stability, apply precise pressure, or help maintain alignment of the joints with out the capability for real time monitoring of the patient's motions and forces and without the ability for real time adjustments of the applied forces and motions. Improved technology has allowed for advancements where these devices can be designed to apply a form of tension to resist motion of the joint. These devices induce quicker recovery and are more effective at restoring proper biomechanics and improving muscle function. However, their shortcoming is in their inability to be adjusted in real-time, which is the most ideal form of a device for rehabilitation. This introduces a second class of devices beyond passive orthotics. It is comprised of "active" or powered devices, and although more complicated in design, they are definitely the most versatile. An active or powered orthotic, usually employs some type of actuator(s). In this paper we present several new advancements in the area of smart rehabilitation devices that have been developed by the Northeastern University Robotics and Mechatronics Laboratory. They are all compact, wearable and portable devices and boast re-programmable, real time computer controlled functions as the central theme behind their operation. The sensory information and computer control of the three described devices make for highly efficient and versatile systems that represent a whole new breed in wearable rehabilitation devices. Their applications range from active-assistive rehabilitation to resistance exercise and even have applications in gait training. The three devices described are: a transportable continuous passive motion elbow device, a wearable electro-rheological fluid based knee resistance device, and a wearable electrical stimulation and biofeedback knee device. Laboratory tests of the devices demonstrated that they were able to meet their design

Excessive sedentary time during in-patient stroke rehabilitation.

Science.gov (United States)

Barrett, Matthew; Snow, John Charles; Kirkland, Megan C; Kelly, Liam P; Gehue, Maria; Downer, Matthew B; McCarthy, Jason; Ploughman, Michelle

2018-04-03

Background and Purpose Previous research suggests that patients receiving inpatient stroke rehabilitation are sedentary although there is little data to confirm this supposition within the Canadian healthcare system. The purpose of this cross-sectional study was to observe two weeks of inpatient rehabilitation in a tertiary stroke center to determine patients' activity levels and sedentary time. Methods Heart rate (HR) and accelerometer data were measured using an Actiheart monitor for seven consecutive days, 24 h/day, on the second week and the last week of admission. Participants or their proxies completed a daily logbook. Metabolic equivalent (MET) values were calculated and time with MET rehabilitation, there was excessive sedentary time and therapy sessions were less frequent and of lower intensity than recommended levels. Conclusions In this sample of people attending inpatient stroke rehabilitation, institutional structure of rehabilitation rather than patient-related factors contributed to sedentary time.

Evaluation of an ontology-based system for computerized cognitive rehabilitation.

Science.gov (United States)

Alloni, Anna; Quaglini, Silvana; Panzarasa, Silvia; Sinforiani, Elena; Bernini, Sara

2018-07-01

This paper describes the results of a randomized clinical trial about the effectiveness of a computerized rehabilitation treatment on a sample of 31 patients affected by Parkinson disease. Computerized exercises were administered by the therapists to the intervention group (n = 17) through the CoRe tool, which automatically generates a big variety of exercises leveraging on a stimuli set (words, sounds and images) organized into a dedicated ontology. A battery of standard neuropsychological tests was performed for patients' assessment at baseline, after the treatment (that lasted 1 month), and after 6 months from the treatment stop. The control group underwent a sham intervention. Results show a statistically significant clinical benefit from computerized rehabilitation with respect to sham treatment. For the intervention group, response time and response accuracy were integrated into a weighted score that accounts also for the specific cognitive burden of each exercise. Differently from the control group, the majority of patients in the intervention group showed an improvement in that score, more marked in the first week of treatment, and which lasts for the entire treatment period, which could account both for a quick learning effect and for an improvement of cognitive conditions. Good usability of CoRe, already observed in previous studies, was confirmed by the present trial, where the percentage of protocol completion in the intervention group is very high (all but one patient are above 90%). The CoRe system showed to be effective to improve some cognitive abilities in patients with Parkinson disease. However, after the end of the training, the benefit is hardly maintained over time. These findings support the implementation of CoRe in the clinical routine and the continuation of the treatment after discharge through the use of a homecare version of the system. Copyright © 2018 Elsevier B.V. All rights reserved.

Process of pulmonary rehabilitation and program organization.

Science.gov (United States)

Wouters, E F M; Augustin, I M L

2011-09-01

Pulmonary rehabilitation programs are highly directed to return patients suffering from chronic lung diseases to a state of self-help. These programs are largely organized as temporary interventions in a highly fragmented delivery care system for patients with chronic respiratory conditions. In an optimal health care organizational structure, pulmonary rehabilitation needs to be considered as an essential part of an individualized, integrated care process, organized from the vantage point of the patient and the patients'health continuum. Pulmonary rehabilitation programs need to become organized as patient-centered care, respectful of and responsive to individual patient preferences, needs and values. Partnering and communication skills are considered as drivers for successful rehabilitation. Assessment is considered as the cornerstone to evaluate the individual needs and problems in order to develop an individualized intervention. Pulmonary rehabilitation programs need to move away from a supply-driven functional organizational structure towards integrated structures, including the full range of medical expertise, technical skills and specialized facilities needed to compete on added value in the management of patients with chronic respiratory diseases.

Systemic risk on different interbank network topologies

Science.gov (United States)

Lenzu, Simone; Tedeschi, Gabriele

2012-09-01

In this paper we develop an interbank market with heterogeneous financial institutions that enter into lending agreements on different network structures. Credit relationships (links) evolve endogenously via a fitness mechanism based on agents' performance. By changing the agent's trust on its neighbor's performance, interbank linkages self-organize themselves into very different network architectures, ranging from random to scale-free topologies. We study which network architecture can make the financial system more resilient to random attacks and how systemic risk spreads over the network. To perturb the system, we generate a random attack via a liquidity shock. The hit bank is not automatically eliminated, but its failure is endogenously driven by its incapacity to raise liquidity in the interbank network. Our analysis shows that a random financial network can be more resilient than a scale free one in case of agents' heterogeneity.

Networking of safeguards systems

International Nuclear Information System (INIS)

Chare, P.; Dutrannois, A.; Kloeckner, W.; Swinhoe, M.

1995-01-01

This paper discusses the design of a safeguards system that can be incorporated into a plant during the final phase of its construction to permit the acquisition and transmission of data during plant operation in the absence of an inspector. The system is an example of a networked data system of weighing, identity, and NDA information. It collects all of its non-surveillance data produced by safeguards equipment in a fuel fabrication plant. The data collection and transfer tasks are carried out by two software packages: NEGUS, a redundant data acquisition system designed to record neutron coincidence data, high-resolution gamma spectra, and sensor data for the NDA information and associated barcode identity information, and BRANCH, which deals with weighing and associated identity information. These processes collect data from local electronics using an ethernet network and provide information to the main review program

Rehabilitation of patients with laryngeal and lung cancer after radiotherapy

International Nuclear Information System (INIS)

Strashinin, A.I.; Gerasimyak, V.G.; Vladimirova, V.A.; Ivanova, L.V.

1980-01-01

The ways of medical and social-occupational rehabilitation after a course of radiotherapy in patients with respiratory system cancer have been determined. Medical rehabilitation in patients with lung cancer comprises expedient planning of radiotherapy by means of systematic medicamental treatment. It is shown that it is necessary to place the patients in special rehabilitation departments after radiotherapy of carry out the treatment of pneumonities

Changes in the cardiac rehabilitation workflow process needed for the implementation of a self-management system

NARCIS (Netherlands)

Wiggers, Anne-Marieke; Vosbergen, Sandra; Kraaijenhagen, Roderik; Jaspers, Monique; Peek, Niels

2013-01-01

E-health interventions are of a growing importance for self-management of chronic conditions. This study aimed to describe the process adaptions that are needed in cardiac rehabilitation (CR) to implement a self-management system, called MyCARDSS. We created a generic workflow model based on

Delphi Study to Determine Rehabilitation Research Priorities for Older Adults With Cancer.

Science.gov (United States)

Lyons, Kathleen Doyle; Radomski, Mary Vining; Alfano, Catherine M; Finkelstein, Marsha; Sleight, Alix G; Marshall, Timothy F; McKenna, Raymond; Fu, Jack B

2017-05-01

To solicit expert opinions and develop consensus around the research that is needed to improve cancer rehabilitation for older adults. Delphi methods provided a structured process to elicit and prioritize research questions from national experts. National, Web-based survey. Members (N=32) of the American Congress of Rehabilitation Medicine completed at least 1 of 3 investigator-developed surveys. Not applicable. In the first survey, participants identified up to 5 research questions that needed to be answered to improve cancer rehabilitation for older adults. In 2 subsequent surveys, participants viewed the compilation of questions, rated the importance of each question, and identified the 5 most important questions. This generated priority scores for each question. Consensus scores were created to describe the degree of agreement around the priority of each question. Highest priority research concerns the epidemiology and measurement of function and disability in older adult cancer survivors; the effects of cancer rehabilitation interventions on falls, disability, participation, survival, costs, quality of care, and health care utilization; and testing models of care that facilitate referrals from oncology to rehabilitation providers as part of coordinated, multicomponent care. A multipronged approach is needed to fill these gaps, including targeted funding opportunities developed with an advisory panel of cancer rehabilitation experts, development of a research network to facilitate novel collaborations and grant proposals, and coordinated efforts of clinical groups to advocate for funding, practice change, and policy change. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Challenges of being a scholarly clinician as perceived by stroke rehabilitation professionals.

Science.gov (United States)

Fillion, Barbara; Rochette, Annie; Girard, Anik

2014-01-01

Stroke rehabilitation clinicians are responsible for offering quality services through evidence-based practices. How is this role fulfilled on a daily basis? (1) To explore the perceptions, experiences, and attitudes of rehabilitation professionals regarding their scholar role; (2) To identify factors that facilitate or hinder this role in their practices. Qualitative design of a phenomenological orientation. Face-to-face interviews conducted with professionals with at least 1 year experience in stroke rehabilitation using a pre-tested interview guide. Transcripts were coded using QDA-Miner software. Mean age of the participants was 40.7 years ± 11.2. Participants were mostly women (n = 9/11). The role of scholar emerged as not having great value. Main themes (5) emerging from the analysis are emphasis on tacit knowledge; experience and clinical intuition leading to self-confidence and comfort in clinical practice; dissatisfaction with the lack of knowledge sharing among clinicians; importance of diversifying clinical tasks; and the underdevelopment of reflective practice. Four factors identified as influencing the role of scholar: motivation, critical incident as a main trigger of reflective practice, interns facilitating reflective practice, and lack of time. From these results emerged questions about measures to encourage the scholar role and facilitate reflective practice in stroke rehabilitation. Implications for Rehabilitation Reflective practice has to be encouraged in professional rehabilitation of stroke. Managers' involvement is crucial to promote and support the role of scholar among professionals in stroke rehabilitation. The updated knowledge and networking from reading scientific paper, participation in trainings and conferences should be systematically disseminated.

Network aspects of the Fermilab control system

International Nuclear Information System (INIS)

Barton, H.R. Jr.

1977-01-01

The control system of the Fermi National Accelerator is a heavily computerized network of distributed processors. One part of the control system includes a multidrop network of eleven Lockheed MAC-16 processors, a Digital Equipment Corporation PDP-11 computer, a Xerox 530, and a Control Data 6600 system. These computers exchange information using serial hardware and dedicated cable buses. The individual functions of the central processing units in this network, the message protocols for computer communications, and design guidelines for future distributed processing control systems are discussed

[Acute Care Rehabilitation is the First Link in a Chain of Rehabilitation Interventions].

Science.gov (United States)

Beyer, Joachim; Seidel, Egbert J

2017-08-01

An early, intensive rehabilitative therapy accelerates the recovery of the functions of patients. It contributes to a reduction in the complication rate as well as an improvement in physical and social functioning/participation in the long-term follow-up. Early rehabilitation must be strengthened on the basis of the existing structures: the creation and maintenance of adequately qualified early-stage rehabilitation facilities, at least in hospitals with priority and maximum supply contracts. Patients with long-term intensive care and polytrauma must be rehabilitated as soon as possible (intensive medical rehabilitation).Specialists in physical and rehabilitative medicine, rehabilitative geriatrists, neurologists, orthopaedists and accident surgeons and other regional physicians must cooperate in a targeted manner. Exclusion criteria using corresponding OPS codes must be canceled. Additional specialist physician groups (anesthetists and intensive care physicians, general practitioners, accident and thoracic surgeons, internists) must be sensitized to the importance of early rehabilitation.In the case of more than 500,000 hospital beds, 25,000 beds should be identified as age- and diagnosis-independent early-care beds in the country-specific bed-care plans. A cost-covering financing of the different, personal and cost-intensive early rehabilitation must be ensured. A phase model similar to the BAR guidelines for neurological-neurosurgical early rehabilitation is to be considered for other disease entities.In order to make the rehabilitation process as successful as possible, medical (acute) treatment, medical rehabilitation, occupational integration and social integration have to be understood as a holistic event and are effectively interrelated, as a continuous process which accompanies the entire disease phase-wise. For this purpose, a continuous case management or a rehabilitation guidance has to be established. © Georg Thieme Verlag KG Stuttgart · New York.

HISTORY OF NEUROPSYCHOLOGICAL REHABILITATION

Directory of Open Access Journals (Sweden)

N. A. Varako

2014-01-01

Full Text Available ABSTRACT. The article reviews the history of neuropsychological rehabilitation. It begins with the description of first rehabilitation programs developed by Paul Broca and Shepherd Franz. Franz’s experimental work for motor recovery in monkeys and correlation between active movement or affected limb immobilization and rehabilitation outcomes are described in further details. Special focus is given on ideas of famous German neurologist and psychiatrist Kurt Goldstein, who laid the foundation for modern approach in rehabilitation. Goldstein developed the idea of connection between rehabilitation and patient’s daily life. He also pointed out the necessity of psychological care of patients with brain damage.Russian neuropsychological approach is presented by its founders L.S. Vygotskiy and A.R. Luriya. Aspects of higher mental processes structure and options of its correction such as “cognitive prosthesis” are described in the sense of the approach.Y. Ben-Yishay, G. Prigatano, B. Wilson represent neuropsychological rehabilitation of the second half of the 20th century. The idea of a holistic approach for rehabilitation consists of such important principles as patient’s active involvement in a process of rehabilitation, work of a special team of rehabilitation professionals, inclusion of patient’s family members. The short review of a new rehabilitation approach for patients in coma, vegetative states and critical patients under resuscitation is given. 

An examination of current stroke rehabilitation practice in Peru: Implications for interprofessional education.

Science.gov (United States)

McDonald, Cody L; Fuhs, Amy K; Kartin, Deborah

2018-05-01

This study aimed to better understand current clinical practice of rehabilitation professionals in Lima, Peru, and to explore the existence of and potential for interprofessional collaboration. A secondary purpose was to assess rehabilitation professionals' agreement with evidence-based stroke rehabilitation statements and confidence performing stroke rehabilitation tasks prior to and following an interprofessional stroke rehabilitation training. Current clinical practice for rehabilitation professionals in Peru differs from high-income counties like the United States, as physical therapists work with dysphagia and feeding, prosthetist orthotists serve a strictly technical role, and nurses have a limited role in rehabilitation. Additionally, while opportunity for future interprofessional collaboration within stroke rehabilitation exists, it appears to be discouraged by current health system policies. Pre- and post-training surveys were conducted with a convenience sample of 107 rehabilitation professionals in Peru. Survey response options included endorsement of professionals for rehabilitation tasks and a Likert scale of agreement and confidence. Training participants largely agreed with evidence-based stroke rehabilitation statements. Differences in opinion remained regarding the prevalence of dysphagia and optimal frequency of therapy post-stroke. Substantially increased agreement post-training was seen in favour of early initiation of stroke rehabilitation and ankle foot orthosis use. Participants were generally confident performing traditional profession-specific interventions and educating patients and families. Substantial increases were seen in respondents' confidence to safely and independently conduct bed to chair transfers and determine physiological stability. Identification of key differences in rehabilitation professionals' clinical practice in Peru is a first step toward strengthening the development of sustainable rehabilitation systems and

75 FR 21273 - Office of Special Education and Rehabilitative Services; Overview Information; Rehabilitation...

Science.gov (United States)

2010-04-23

... Rehabilitation of Individuals Who are Mentally Ill. 84.129J Rehabilitation Psychology. 84.129P Specialized... students with community-based rehabilitation service providers are encouraged. Projects must include an... Mentally Ill. 84.129J Rehabilitation 100,000 2 Psychology. 84.129P Specialized Personnel 100,000 3 for...

Rehabilitation therapies for older clients of the Ontario home care system: regional variation and client-level predictors of service provision.

Science.gov (United States)

Armstrong, Joshua J; Zhu, Mu; Hirdes, John P; Stolee, Paul

2015-01-01

To examine regional variation in service provision and identify the client characteristics associated with occupational therapy (OT) and physiotherapy (PT) services for older adults in the Ontario Home Care System. Secondary analyses of a provincial database containing comprehensive assessments (RAI-HC) linked with service utilization data from every older long-stay home care client in the system between 2005 and 2010 (n = 299 262). Hierarchical logistic regression models were used to model the dependent variables of OT and PT service use within 90 d of the initial assessment. Regional differences accounted for 9% of the variation in PT service provision and 20% of OT service provision. After controlling for the differences across regions, the most powerful predictors of service provision were identified for both OT and PT. The most highly associated client characteristics related to PT service provision were hip fracture, impairments in activities of daily living/instrumental activities of daily living, cerebrovascular accidents, and cognitive impairment. For OT, hazards in the home environment was the most powerful predictor of future service provision. Where a client lived was an important determinant of service provision in Ontario, raising the possibility of inequities in access to rehabilitation services. Health care planners and policy makers should review current practices and make adjustments to meet the increasing and changing needs for rehabilitation therapies of the aging population. Implications for Rehabilitation For older adults in home care, the goal of rehabilitation therapy services is to allow individuals to maintain or improve physical functioning, quality of life and overall independence while living within their community. Previous research has demonstrated that a large proportion of home care clients specifically identified as having rehabilitation potential do not receive it. This article used clinical assessment data to identify the

Advances in network systems architectures, security, and applications

CERN Document Server

Awad, Ali; Furtak, Janusz; Legierski, Jarosław

2017-01-01

This book provides the reader with a comprehensive selection of cutting–edge algorithms, technologies, and applications. The volume offers new insights into a range of fundamentally important topics in network architectures, network security, and network applications. It serves as a reference for researchers and practitioners by featuring research contributions exemplifying research done in the field of network systems. In addition, the book highlights several key topics in both theoretical and practical aspects of networking. These include wireless sensor networks, performance of TCP connections in mobile networks, photonic data transport networks, security policies, credentials management, data encryption for network transmission, risk management, live TV services, and multicore energy harvesting in distributed systems. .

ANDERS: future of concrete bridge deck evaluation and rehabilitation

Science.gov (United States)

Gucunski, Nenad; Moon, Franklin

2011-04-01

The Automated Nondestructive Evaluation and Rehabilitation System (ANDERS) aims to provide a uniquely comprehensive tool that will transform the manner in which bridge decks are assessed and rehabilitated. It is going to be achieved through: 1) much higher evaluation detail and comprehensiveness of detection at an early stage deterioration, 2) comprehensive condition and structural assessment at all stages of deterioration, and 3) integrated assessment and rehabilitation that will be minimally invasive, rapid and cost effective. ANDERS is composed of four systems. that merge novel imaging and NDE techniques, together with novel intervention approaches to arrest the deterioration processes. These technologies are incorporated within a series of human-operated and robotic vehicles. To perform assessments, ANDERS will be equipped with two complimentary nondestructive approaches. The first, Multi-Modal Nondestructive Evaluation (MM-NDE) System aims to identify and characterize localized deterioration with a high degree of resolution. The second, Global Structural Assessment (GSA) System aims to capture global structural characteristics and identify any appreciable effects of deterioration on a bridge structure. Output from these two approaches will be merged through a novel Automated Structural Identification (Auto St-Id) approach that will construct, calibrate, and utilize simulation models to assess overall structural vulnerability and capacity. These three systems comprise the assessment suite of ANDERS and will directly inform the Nondestructive Rehabilitation (NDR) System. The NDR System leverages robotics for the precision and rapid delivery of novel materials capable of halting the early-stage deterioration identified.

Integrated system for rehabilitation of mine wastes and exploitation of added-value compounds from Cistus ladanifer

Science.gov (United States)

Santos, Erika S.; Balseiro-Romero, Maria; Abreu, Maria Manuela; Macías, Felipe

2017-04-01

The rehabilitation of mining areas with sulfide materials, both abandoned and active mines, is a priority because these areas are sources of acid mine drainage and multielemental contamination and, consequently, environmental and health risk. The combined use of Technosols and Phytostabilisation accelerates the area recovery, and ensures the sustainability at long-term of the physical, chemical and biological processes involved in the rehabilitation due to the functional complementarity of the components. Nowadays the rehabilitation strategy of contaminated areas must be based on circular economy, environmental improvements and economic approaches. Cistus ladanifer L. is an autochthones and spontaneous species that contributes to natural rehabilitation of contaminated soils from mining areas. Moreover, bioextracts obtained from C. ladanifer growing in São Domingos mining area (Iberian Pyrite Belt) presented several valuable compounds, which can provide an economic return by their use for fragrance and pharmaceutical approaches. This study aimed to evaluate, under controlled conditions, the efficiency of an integrated system for the rehabilitation of sulfide-rich and gossan tailings, which combines the application of Technosols and Phytostabilisation, and exploitation of added-value compounds from C. ladanifer bioextracts. The rehabilitation system comprised a surface layer of Technosol and a barrier of alkaline residues (biomass ashes and limestone wastes) that covered sulfide-rich wastes. Two Tecnosols composed of gossan wastes and different mixtures of agro-industrial wastes (from distilleries and greenhouse agriculture without any valorisation) at 150 Mg/ha were tested. In the Technosols was seeded C. ladanifer. After three years of plant growth, shoots biomass was quantified and used to obtain bioextracts (extraction with n-hexane). The organic composition of the bioextracts was determined and some compounds with added value (α-pinene, camphene, camphor

Towards a network operating system

OpenAIRE

López Álvarez, Victor; Gonzalez de Dios, Oscar; Fuentes, Beatriz; Yannuzzi, Marcelo; Fernández Palacios, Juan Pedro; Lopez, Diego

2014-01-01

A Network Operating System (NetOS) is a novel paradigm for developing a next-generation network management and operation platform. As we shall describe, NetOS not only goes far beyond the SDN concepts but also constitutes a fundamental enabler for NFV. © 2014 OSA.

The Implementation of Data Warehouse and OLAP for Rehabilitation Outcome Evaluation: ReDWinE System

Science.gov (United States)

Guo, Fei-Ran; Parmanto, Bambang; Irrgang, James J.; Wang, Jiunjie; Fang, Huaijin

2000-01-01

We created a data warehouse and OLAP system on the web for outcome evaluation of rehabilitation services. Thirteen outcome indicators were use in this research. Efficiency of therapists and clinics, expected utility of treatments and graphic patterns were generated for data exploration, data mining and decision support. Users can retrieve plenty of graphs and statistical tables without knowing database structure or attributes. Our experiences showed that multi-dimensional database and OLAP could serve as a decision support system.

Rehabilitation after stroke.

Science.gov (United States)

Knecht, Stefan; Hesse, Stefan; Oster, Peter

2011-09-01

Stroke is becoming more common in Germany as the population ages. Its long-term sequelae can be alleviated by early reperfusion in stroke units and by complication management and functional restoration in early-rehabilitation and rehabilitation centers. Selective review of the literature. Successful rehabilitation depends on systematic treatment by an interdisciplinary team of experienced specialists. In the area of functional restoration, there has been major progress in our understanding of the physiology of learning, relearning, training, and neuroenhancement. There have also been advances in supportive pharmacotherapy and robot technology. Well-organized acute and intermediate rehabilitation after stroke can provide patients with the best functional results attainable on the basis of our current scientific understanding. Further experimental and clinical studies will be needed to expand our knowledge and improve the efficacy of rehabilitation.

Athletic pubalgia and associated rehabilitation.

Science.gov (United States)

Ellsworth, Abigail A; Zoland, Mark P; Tyler, Timothy F

2014-11-01

Evaluation and treatment of groin pain in athletes is challenging. The anatomy is complex, and multiple pathologies often coexist. Different pathologies may cause similar symptoms, and many systems can refer pain to the groin. Many athletes with groin pain have tried prolonged rest and various treatment regimens, and received differing opinions as to the cause of their pain. The rehabilitation specialist is often given a non-specific referral of "groin pain" or "sports hernia." The cause of pain could be as simple as the effects of an adductor strain, or as complex as athletic pubalgia or inguinal disruption. The term "sports hernia" is starting to be replaced with more specific terms that better describe the injury. Inguinal disruption is used to describe the syndromes related to the injury of the inguinal canal soft tissue environs ultimately causing the pain syndrome. The term athletic pubalgia is used to describe the disruption and/or separation of the more medial common aponeurosis from the pubis, usually with some degree of adductor tendon pathology. Both non-operative and post-operative treatment options share the goal of returning the athlete back to pain free activity. There is little research available to reference for rehabilitation guidelines and creation of a plan of care. Although each surgeon has their own specific set of post-operative guidelines, some common concepts are consistent among most surgeons. Effective rehabilitation of the high level athlete to pain free return to play requires addressing the differences in the biomechanics of the dysfunction when comparing athletic pubalgia and inguinal disruption. Proper evaluation and diagnostic skills for identifying and specifying the difference between athletic pubalgia and inguinal disruption allows for an excellent and efficient rehabilitative plan of care. Progression through the rehabilitative stages whether non-operative or post-operative allows for a focused rehabilitative program. As more

Development of a Decision Support System to Predict Physicians' Rehabilitation Protocols for Patients with Knee Osteoarthritis

Science.gov (United States)

Hawamdeh, Ziad M.; Alshraideh, Mohammad A.; Al-Ajlouni, Jihad M.; Salah, Imad K.; Holm, Margo B.; Otom, Ali H.

2012-01-01

To design a medical decision support system (MDSS) that would accurately predict the rehabilitation protocols prescribed by the physicians for patients with knee osteoarthritis (OA) using only their demographic and clinical characteristics. The demographic and clinical variables for 170 patients receiving one of three treatment protocols for knee…

REHABILITATION NEEDS AND PLANS AMONG PATIENTS WITH CANCER, ASSESSED AT HOSPITALS AND WHEN REHABILITATION BEGINS

DEFF Research Database (Denmark)

Handberg, Charlotte; Maribo, Thomas; Jensen, Charlotte Maria

and the specifics of needs and plans facilitates targeted rehabilitation interventions. Implications: Systematic needs assessment in cancer rehabilitation unveil the requirement of physical rehabilitation. Supervised physical activity renders an intervention possible tailored the special needs cancer patients have......Background: Systematic assessment of rehabilitation needs is prerequisite for sufficient rehabilitation, but little is known about patients' needs. Purpose: The aim of this study was to describe specific stated rehabilitation needs and plans among patients with cancer at hospitals when diagnosed...... and when municipal rehabilitation begins. Methods: Needs-assessment-forms for rehabilitation from 188 cancer patients from two hospitals and two municipal cancer rehabilitation programmes were analysed. The forms included 1) stated needs: 58 fixed areas categorised in six domains and 2) an area to document...

Cancer rehabilitation in Denmark

DEFF Research Database (Denmark)

Hansen, Helle Ploug; Tjørnhøj-Thomsen, Tine

2008-01-01

A fundamental assumption behind cancer rehabilitation in many Western societies is that cancer survivors can return to normal life by learning to deal with the consequences of their illness and their treatment. This assumption is supported by increasing political attention to cancer rehabilitation...... and a growth in residential cancer-rehabilitation initiatives in Denmark (Danish Cancer Society 1999; Government of Denmark 2003). On the basis of their ethnographic fieldwork in residential-cancer rehabilitation courses, the authors examine the new rehabilitation discourse. They argue that this discourse has...

A Process Management System for Networked Manufacturing

Science.gov (United States)

Liu, Tingting; Wang, Huifen; Liu, Linyan

With the development of computer, communication and network, networked manufacturing has become one of the main manufacturing paradigms in the 21st century. Under the networked manufacturing environment, there exist a large number of cooperative tasks susceptible to alterations, conflicts caused by resources and problems of cost and quality. This increases the complexity of administration. Process management is a technology used to design, enact, control, and analyze networked manufacturing processes. It supports efficient execution, effective management, conflict resolution, cost containment and quality control. In this paper we propose an integrated process management system for networked manufacturing. Requirements of process management are analyzed and architecture of the system is presented. And a process model considering process cost and quality is developed. Finally a case study is provided to explain how the system runs efficiently.

Importance of early physical rehabilitation in improving functional state of vegetative nervous system of women with postmastectomy syndrome

Directory of Open Access Journals (Sweden)

Tatiana Odynets

2016-02-01

Full Text Available Purpose: to determine the expediency of early application of physical rehabilitation to improve the functional state of vegetative nervous system of women with postmastectomy syndrome. Material & Methods: theoretical analysis of scientific and methodical literature, analysis of heart rate variability, methods of mathematical statistics. The study involved 135 women with postmastectomy syndrome who underwent radical mastectomy for Madden. Results: at the end of the research value of high-frequency component of the spectrum was significantly higher in women MG1 compared to MG on 257,72 ms² (p<0,01 and the stress index was lower on 107,01 c. u (p<0,001. Conclusions: the feasibility of early rehabilitation intervention to improve the functional state of the autonomic nervous system is not detected during the year classes on problem-oriented programs.

Diagnostic Neural Network Systems for the Electronic Circuits

International Nuclear Information System (INIS)

Mohamed, A.H.

2014-01-01

Neural Networks is one of the most important artificial intelligent approaches for solving the diagnostic processes. This research concerns with uses the neural networks for diagnosis of the electronic circuits. Modern electronic systems contain both the analog and digital circuits. But, diagnosis of the analog circuits suffers from great complexity due to their nonlinearity. To overcome this problem, the proposed system introduces a diagnostic system that uses the neural network to diagnose both the digital and analog circuits. So, it can face the new requirements for the modern electronic systems. A fault dictionary method was implemented in the system. Experimental results are presented on three electronic systems. They are: artificial kidney, wireless network and personal computer systems. The proposed system has improved the performance of the diagnostic systems when applied for these practical cases

Selection for inpatient rehabilitation after severe stroke: what factors influence rehabilitation assessor decision-making?

Science.gov (United States)

Hakkennes, Sharon; Hill, Keith D; Brock, Kim; Bernhardt, Julie; Churilov, Leonid

2013-01-01

This study aimed to identify factors that assessors considered important in decision-making regarding suitability for inpatient rehabilitation after acute severe stroke. Multi-site prospective observational cohort study. Consecutive acute, severe stroke patients and their assessors for inpatient rehabilitation. Rehabilitation assessors completed a questionnaire, rating the importance (10 point visual analogue scale) and direction (positive, negative or neutral) of 15 patient related and 2 organisational items potentially affecting their decision regarding patients' acceptance to rehabilitation. Of the 75 patients referred to rehabilitation and included in this study 61 (81.3%) were accepted for inpatient rehabilitation. The items considered to be most important in the decision to accept the patient for rehabilitation were pre-morbid cognition, pre-morbid mobility and pre-morbid communication. For those not accepted the most important items were current mobility, social support and current cognition. Factor analysis revealed 3 underlying factors, interpreted as post-stroke status, pre-morbid status, and social attributes, accounting for 61.8% of the total variance. All were independently associated with acceptance for rehabilitation (p decision making process for acceptance to rehabilitation following severe stroke. Future models for selection for rehabilitation should consider inclusion of these factors.

Object and event recognition for stroke rehabilitation

Science.gov (United States)

Ghali, Ahmed; Cunningham, Andrew S.; Pridmore, Tony P.

2003-06-01

Stroke is a major cause of disability and health care expenditure around the world. Existing stroke rehabilitation methods can be effective but are costly and need to be improved. Even modest improvements in the effectiveness of rehabilitation techniques could produce large benefits in terms of quality of life. The work reported here is part of an ongoing effort to integrate virtual reality and machine vision technologies to produce innovative stroke rehabilitation methods. We describe a combined object recognition and event detection system that provides real time feedback to stroke patients performing everyday kitchen tasks necessary for independent living, e.g. making a cup of coffee. The image plane position of each object, including the patient"s hand, is monitored using histogram-based recognition methods. The relative positions of hand and objects are then reported to a task monitor that compares the patient"s actions against a model of the target task. A prototype system has been constructed and is currently undergoing technical and clinical evaluation.

Integration of healthcare rehabilitation in chronic conditions

Directory of Open Access Journals (Sweden)

Anne Frølich

2010-02-01

Full Text Available Introduction: Quality of care provided to people with chronic conditions does not often fulfil standards of care in Denmark and in other countries. Inadequate organisation of healthcare systems has been identified as one of the most important causes for observed performance inadequacies, and providing integrated healthcare has been identified as an important organisational challenge for healthcare systems. Three entities—Bispebjerg University Hospital, the City of Copenhagen, and the GPs in Copenhagen—collaborated on a quality improvement project focusing on integration and implementation of rehabilitation programmes in four conditions. Description of care practice: Four multidisciplinary rehabilitation intervention programmes, one for each chronic condition: chronic obstructive pulmonary disease, type 2 diabetes, chronic heart failure, and falls in elderly people were developed and implemented during the project period. The chronic care model was used as a framework for support of implementing and integration of the four rehabilitation programmes. Conclusion and discussion: The chronic care model provided support for implementing rehabilitation programmes for four chronic conditions in Bispebjerg University Hospital, the City of Copenhagen, and GPs' offices. New management practices were developed, known practices were improved to support integration, and known practices were used for implementation purposes. Several barriers to integrated care were identified.

The Human Eye Position Control System in a Rehabilitation Setting

Directory of Open Access Journals (Sweden)

Yvonne Nolan

2005-01-01

Full Text Available Our work at Ireland’s National Rehabilitation Hospital involves designing communication systems for people suffering from profound physical disabilities. One such system uses the electro-oculogram, which is an (x,y system of voltages picked up by pairs of electrodes placed, respectively, above and below and on either side of the eyes. The eyeball has a dc polarisation between cornea and back, arising from the photoreceptor rods and cones in the retina. As the eye rotates, the varying voltages projected onto the electrodes drive a cursor over a mimic keyboard on a computer screen. Symbols are selected with a switching action derived, for example, from a blink. Experience in using this mode of communication has given us limited facilities to study the eye position control system. We present here a resulting new feedback model for rotation in either the vertical or the horizontal plane, which involves the eyeball controlled by an agonist-antagonist muscle pair, modelled by a single equivalent bidirectional muscle with torque falling off linearly with angular velocity. We have incorporated muscle spindles and have tuned them by pole assignment associated with an optimum stability criterion.

Neurophysiological basis of rehabilitation of adolescent idiopathic scoliosis.

Science.gov (United States)

Smania, Nicola; Picelli, Alessandro; Romano, Michele; Negrini, Stefano

2008-01-01

Knowledge on mechanisms of neurophysiological control of trunk movement and posture could help in the development of rehabilitation programs and brace treatment in adolescent idiopathic scoliosis (AIS). Reviewing up-to-date research on neurophysiology of movement and posture control with the aim of providing basis for new researches in the field of AIS rehabilitation and background understanding for clinicians engaged in management of AIS. Review of literature. We considered several neurophysiological issues relevant for AIS rehabilitation, namely, the peculiar organization of patterns of trunk muscle recruitment, the structure of the neural hardware subserving axial and arm muscle control, and the relevance of cognitive systems allowing mapping of spatial coordinates and building of body schema. We made clear the reason why trunk control is generally carried out by means of very fast, feedforward or feedback driven patterns of muscle activation which are deeply rooted in our neural control system and very difficult to modify by training. We hypothesized that augmented sensory feedback and strength exercises could be an important stage in a rehabilitation program aimed at hindering, or possibly reversing, scoliosis progression. In this context we considered bracing not only as a corrective biomechanical device but also as a tool for continuous sensory stimulation that could help awareness of body misalignment. Future research aimed at developing strategies of trunk postural control learning is essential in the rehabilitation of adolescent idiopathic scoliosis.

Validation of the complex of measures of medical rehabilitation of children victims of Chernobyl accident

International Nuclear Information System (INIS)

Paramonov, Z.M.

1999-01-01

Special complex program including social medical, organizational and hygienic aspects of studying state of health of children and the characteristics of the system of medical service have been worked out. The peculiarities of changes in the state of health in children and its correlation with the level of the internal irradiation as well as the ways to form the latter in the chain 'soil-water complex - food stuffs - organism' have been determined. Special rehabilitation measures and their application in the network of therapeutic sanatorium centers for radiation protection are validated. The expediency and necessity of medico-hygienic protection of children was established

Customising games for non-formal rehabilitation

DEFF Research Database (Denmark)

Herbelin, Bruno; Ciger, Jan; Brooks, A.L.

2011-01-01

The field of rehabilitation has increasingly adopted commercially available games using perceptual interfaces as a means for physically training patients. The adaptability of such systems to match each person ’ s need and rehabilitation goal remains problematic. This paper presents a rapid...... prototyping approach for customising gaming technology using various affordable commercial devices and open source software. We fi rst demonstrate how a freely available game is adapted for training disabled people through different sensors and control modes. We then show how an open online virtual world...

Heating networks and domestic central heating systems

Energy Technology Data Exchange (ETDEWEB)

Kamler, W; Wasilewski, W

1976-08-01

This is a comprehensive survey of the 26 contributions from 8 European countries submitted to the 3rd International District Heating Conference in Warsaw held on the subject 'Heating Networks and Domestic Central Heating Systems'. The contributions are grouped according to 8 groups of subjects: (1) heat carriers and their parameters; (2) system of heating networks; (3) calculation and optimization of heating networks; (4) construction of heating networks; (5) operation control and automation; (6) operational problems; (7) corrosion problems; and (8) methods of heat accounting.

Stabilization of model-based networked control systems

Energy Technology Data Exchange (ETDEWEB)

Miranda, Francisco [CIDMA, Universidade de Aveiro, Aveiro (Portugal); Instituto Politécnico de Viana do Castelo, Viana do Castelo (Portugal); Abreu, Carlos [Instituto Politécnico de Viana do Castelo, Viana do Castelo (Portugal); CMEMS-UMINHO, Universidade do Minho, Braga (Portugal); Mendes, Paulo M. [CMEMS-UMINHO, Universidade do Minho, Braga (Portugal)

2016-06-08

A class of networked control systems called Model-Based Networked Control Systems (MB-NCSs) is considered. Stabilization of MB-NCSs is studied using feedback controls and simulation of stabilization for different feedbacks is made with the purpose to reduce the network trafic. The feedback control input is applied in a compensated model of the plant that approximates the plant dynamics and stabilizes the plant even under slow network conditions. Conditions for global exponential stabilizability and for the choosing of a feedback control input for a given constant time between the information moments of the network are derived. An optimal control problem to obtain an optimal feedback control is also presented.

Gamified In-Home Rehabilitation for Stroke Survivors: Analytical Review

Directory of Open Access Journals (Sweden)

Paul Tamayo-Serrano

2018-03-01

Full Text Available A stroke is a life-changing event that may end up as a disability, with repercussions on the patient’s quality of life. Stroke rehabilitation therapies are helpful to regain some of the patient’s lost functionality. However, in practice stroke patients may suffer from a gradual loss of motivation. Gamified systems are used to increase user motivation, hence, gamified elements have been implemented into stroke rehabilitation therapies in order to improve patients’ engagement and adherence. This review work focuses on selecting and analyzing developed and validated gamified stroke rehabilitation systems published between 2009 and 2017 to identify the most important features of these systems. After extensive research, 32 articles have met the selection criteria, resulting in a total of 28 unique works. The works were analyzed and a total of 20 features were identified. The features are explained, making emphasis on the works that implement them extensively. Finally, a classification of features based on objectives is proposed, which was used to identify the relationships between features and implementation gaps. It was found that there is a tendency to develop low-cost solutions as in-home therapy systems and provide a variety of games. This review allowed the definition of the opportunities for future research direction such as systems addressing the three rehabilitation areas; data analytics to make decisions; motivational content identification based on automatic engagement detection and emotion recognition; and alert systems for patient´s safety.

System for prediction of environmental emergency dose information network system

International Nuclear Information System (INIS)

Misawa, Makoto; Nagamori, Fumio

2009-01-01

In cases when an accident happens to arise with some risk for emission of a large amount radioactivity from the nuclear facilities, the environmental emergency due to this accident should be predicted rapidly and be informed immediately. The SPEEDI network system for such purpose was completed and now operated by Nuclear Safety Technology Center (NUSTEC) commissioned to do by Ministry of Education, Culture, Sports, Science and Technology, Japan. Fujitsu has been contributing to this project by developing the principal parts of the network performance, by introducing necessary servers, and also by keeping the network in good condition, such as with construction of the system followed by continuous operation and maintenance of the system. Real-time prediction of atmospheric diffusion of radionuclides for nuclear accidents in the world is now available with experimental verification for the real-time emergency response system. Improvement of worldwide version of the SPEEDI network system, accidental discharge of radionuclides with the function of simultaneous prediction for multiple domains and its evaluation is possible. (S. Ohno)

Stroke rehabilitation in ontario: an opportunity for health care transformation.

Science.gov (United States)

Meyer, Matthew J; Meyer, John P; Foley, Norine; Salter, Katherine; McClure, J Andrew; Teasell, Robert

2011-11-01

In this article, Ontario's stroke rehabilitation system is used to exemplify the challenges faced by rehabilitation and healthcare systems across Canada who are attempting to provide quality care to patients in the face of increasing demands. Currently, Ontario's rehabilitation system struggles in its efforts to provide accessible and comprehensive care to patients recovering from stroke. We begin our exploration by identifying both the primary stakeholders and the underlying factors that have contributed to the current challenges. The framework put forward in the Canadian Medical Association's recommendations for transformation is then used to suggest a vision for a more patient-focused system incorporating three key principles: a broader perspective, a patient-first approach, and greater unity. The use of health information technology, proper incentives, and greater accountability are discussed as mechanisms to improve the quality and efficiency of care.

Structural analysis of a rehabilitative training system based on a ceiling rail for safety of hemiplegia patients.

Science.gov (United States)

Kim, Kyong; Song, Won Kyung; Chong, Woo Suk; Yu, Chang Ho

2018-04-17

The body-weight support (BWS) function, which helps to decrease load stresses on a user, is an effective tool for gait and balance rehabilitation training for elderly people with weakened lower-extremity muscular strength, hemiplegic patients, etc. This study conducts structural analysis to secure user safety in order to develop a rail-type gait and balance rehabilitation training system (RRTS). The RRTS comprises a rail, trolley, and brain-machine interface. The rail (platform) is connected to the ceiling structure, bearing the loads of the RRTS and of the user and allowing locomobility. The trolley consists of a smart drive unit (SDU) that assists the user with forward and backward mobility and a body-weight support (BWS) unit that helps the user to control his/her body-weight load, depending on the severity of his/her hemiplegia. The brain-machine interface estimates and measures on a real-time basis the body-weight (load) of the user and the intended direction of his/her movement. Considering the weight of the system and the user, the mechanical safety performance of the system frame under an applied 250-kg static load is verified through structural analysis using ABAQUS (6.14-3) software. The maximum stresses applied on the rail and trolley under the given gravity load of 250 kg, respectively, are 18.52 MPa and 48.44 MPa. The respective safety factors are computed to be 7.83 and 5.26, confirming the RRTS's mechanical safety. An RRTS with verified structural safety could be utilized for gait movement and balance rehabilitation and training for patients with hemiplegia.

Priority Scale of Drainage Rehabilitation of Cilacap City

Science.gov (United States)

Rudiono, Jatmiko

2018-03-01

Characteristics of physical condition of Cilacap City is relatively flat and low to sea level (approximately 6 m above sea level). In the event of a relatively heavy rainfall resulting in inundation at several locations. The problem of inundation is a serious problem if there is in a dense residential area or occurs in publicly-used infrastructure, such as roads and settlements. These problems require improved management of which include how to plan a sustainable urban drainage system and environmentally friendly. The development of Cilacap City is increasing rapidly, this causes drainage system based on the Drainage Masterplan Cilacap made in 2006 has not been able to accommodate rain water, so, it is necessary to evaluate the drainage masterplan for subsequent rehabilitation. Priority scale rehabilitation of the drainage sections as a guideline is an urgent need of rehabilitation in the next time period.

Toward a new payment system for inpatient rehabilitation. Part II: Reimbursing providers.

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Saitto, Carlo; Marino, Claudia; Fusco, Danilo; Arcà, Massimo; Perucci, Carlo A

2005-09-01

The major fault with existing reimbursement systems lies in their failure to discriminate for the effectiveness of stay, both when paying per day and when paying per episode of treatment. We sought to define an average length of effective stay and recovery trends by impairment category, to design a prospective payment system that takes into account costs and expected recovery trends, and to compare the calculated reimbursement with the predicted costs estimated in a previous study (Saitto C, Marino C, Fusco D, et al. A new prospective payment system for inpatient rehabilitation. Part I: predicting resource consumption. Med Care. 2005;43:844-855). We considered all rehabilitation admissions from 5 Italian inpatient facilities during a 12-month period for which total cost of care had already been estimated and daily cost predicted through regression model. We ascertained recovery trends by impairment category through repeated MDS-PAC schedules and factorial analysis of functional status. We defined effective stay and daily resource consumption by impairment category and used these parameters to calculate reimbursement for the admission. We compared our reimbursement with predicted cost through regression analysis and evaluated the goodness of fit through residual analysis. We calculated reimbursement for 2079 admissions. The r(2) values for the reimbursement to cost correlation ranged from 0.54 in the whole population to 0.56 for "multiple trauma" to 0.85 for "other medical disorders." The best fit was found in the central quintiles of the cost and severity distributions. For each impairment category, we determined the number of days of effective hospital stay and the trends of functional gain. We demonstrated, at least within the Italian health care system, the feasibility of a reimbursement system that matches costs with functional recovery. By linking reimbursement to effective stay adjusted for trends of functional gain, we suggest it is possible to avoid both

Evaluation of a Cyber Security System for Hospital Network.

Science.gov (United States)

Faysel, Mohammad A

2015-01-01

Most of the cyber security systems use simulated data in evaluating their detection capabilities. The proposed cyber security system utilizes real hospital network connections. It uses a probabilistic data mining algorithm to detect anomalous events and takes appropriate response in real-time. On an evaluation using real-world hospital network data consisting of incoming network connections collected for a 24-hour period, the proposed system detected 15 unusual connections which were undetected by a commercial intrusion prevention system for the same network connections. Evaluation of the proposed system shows a potential to secure protected patient health information on a hospital network.

Medico-social characteristics of patients treated in rehabilitation centres

Directory of Open Access Journals (Sweden)

Shapovalenko T.V.

2013-12-01

Full Text Available Aim: analysis of the medical social characteristics of patients of rehabilitation center. Material and methods. The data that had been got by extracting from medical records of patients of the Center of restorative medicine and rehabilitation «Medical rehabilitation center» MOH of Russia on a specially developed «Patient card» were analyzed. Results. Among the majority of patients (who got treatment in the center with diseases of the musculoskeletal system and connective tissue (44,9%, almost 1/3 (29,2% were patients with diseases of the circulatory system, in the third place — patients with injuries (14,1 %. Conclusion. As a result of the peculiarities of a patient health condition of different age and social position had been revealed.

Predicting efficacy of robot-aided rehabilitation in chronic stroke patients using an MRI-compatible robotic device.

Science.gov (United States)

Sergi, Fabrizio; Krebs, Hermano Igo; Groissier, Benjamin; Rykman, Avrielle; Guglielmelli, Eugenio; Volpe, Bruce T; Schaechter, Judith D

2011-01-01

We are investigating the neural correlates of motor recovery promoted by robot-mediated therapy in chronic stroke. This pilot study asked whether efficacy of robot-aided motor rehabilitation in chronic stroke could be predicted by a change in functional connectivity within the sensorimotor network in response to a bout of motor rehabilitation. To address this question, two stroke patients participated in a functional connectivity MRI study pre and post a 12-week robot-aided motor rehabilitation program. Functional connectivity was evaluated during three consecutive scans before the rehabilitation program: resting-state; point-to-point reaching movements executed by the paretic upper extremity (UE) using a newly developed MRI-compatible sensorized passive manipulandum; resting-state. A single resting-state scan was conducted after the rehabilitation program. Before the program, UE movement reduced functional connectivity between the ipsilesional and contralesional primary motor cortex. Reduced interhemispheric functional connectivity persisted during the second resting-state scan relative to the first and during the resting-state scan after the rehabilitation program. Greater reduction in interhemispheric functional connectivity during the resting-state was associated with greater gains in UE motor function induced by the 12-week robotic therapy program. These findings suggest that greater reduction in interhemispheric functional connectivity in response to a bout of motor rehabilitation may predict greater efficacy of the full rehabilitation program.

Newly blind persons using virtual environment system in a traditional orientation and mobility rehabilitation program: a case study.

Science.gov (United States)

Lahav, Orly; Schloerb, David W; Srinivasan, Mandayam A

2012-09-01

This paper presents a virtual reality system (the BlindAid) developed for orientation and mobility training of people who are newly blind. The BlindAid allows users to interact with different virtual structures and objects via auditory and haptic feedback. This case study aims to examine if and how the BlindAid, in conjunction with a traditional rehabilitation programme, can help people who are newly blind develop new orientation and mobility methods. Follow-up research based on this study, with a large experiment and control group, could contribute to the area of orientation and mobility rehabilitation training for the newly blind. The case study research focused on A., a woman who is newly blind, for 17 virtual sessions spanning ten weeks, during the 12 weeks of her traditional orientation and mobility rehabilitation programme. The research was implemented by using virtual environment (VE) exploration and orientation tasks in VE and physical spaces. The research methodology used both qualitative and quantitative methods, including interviews, questionnaire, videotape recording, and user computer logs. The results of this study helped elucidate several issues concerning the contribution of the BlindAid system to the exploration strategies and learning processes experienced by the participant in her encounters with familiar and unfamiliar physical surroundings. [Box: see text].

Several facts concerning health and questions about rehabilitative-restorative treatment of miners of the BAM zone

Energy Technology Data Exchange (ETDEWEB)

German, G N

1985-06-01

The Yuzhnaya-Yakutiya coal basin containing one of the largest deposits of coking coal (40 billion tons to a depth of 600 m, 60% of this to a depth of 300 m) in the USSR lies in the BAM zone. Average yearly temperature of the region is 7-10 C. Brittle enclosing rock, longterm frozen soil, concentration of coal deposits and machinery in small areas increase vibration, noise, dust and gas in working areas. Surveys revealed predominant illnesses are diseases of the nervous system: osteochondrosis, with secondary neuritis, and radiculitis. Eighty-two percent of miners with osteochondrosis work in occupations with high vibration risk. To prevent disease and rehabilitate miners with degenerative changes of motor apparatus and osteochondrosis, a network of rehabilitation rooms was created at health centers near the workplace. Miners with osteochondrosis, myositis and arthritis receive heat treatments, massage and curative physical culture. A course of treatment is given 2 or 3 times a year. The courses are given after work without interrupting employment. Miners are directed to take vacations every year. Preventive-rehabilitative treatment of miners of the Far North makes it possible to keep highly qualified workers actively employed which is important considering the shortage of miners in these regions. 2 references.

Method and system for mesh network embedded devices

Science.gov (United States)

Wang, Ray (Inventor)

2009-01-01

A method and system for managing mesh network devices. A mesh network device with integrated features creates an N-way mesh network with a full mesh network topology or a partial mesh network topology.

Complex systems and networks dynamics, controls and applications

CERN Document Server

Yu, Xinghuo; Chen, Guanrong; Yu, Wenwu

2016-01-01

This elementary book provides some state-of-the-art research results on broad disciplinary sciences on complex networks. It presents an in-depth study with detailed description of dynamics, controls and applications of complex networks. The contents of this book can be summarized as follows. First, the dynamics of complex networks, for example, the cluster dynamic analysis by using kernel spectral methods, community detection algorithms in bipartite networks, epidemiological modeling with demographics and epidemic spreading on multi-layer networks, are studied. Second, the controls of complex networks are investigated including topics like distributed finite-time cooperative control of multi-agent systems by applying homogenous-degree and Lyapunov methods, composite finite-time containment control for disturbed second-order multi-agent systems, fractional-order observer design of multi-agent systems, chaos control and anticontrol of complex systems via Parrondos game and many more. Third, the applications of ...