Review on design and control aspects of ankle rehabilitation robots.

Science.gov (United States)

Jamwal, Prashant K; Hussain, Shahid; Xie, Sheng Q

2015-03-01

Ankle rehabilitation robots can play an important role in improving outcomes of the rehabilitation treatment by assisting therapists and patients in number of ways. Consequently, few robot designs have been proposed by researchers which fall under either of the two categories, namely, wearable robots or platform-based robots. This paper presents a review of both kinds of ankle robots along with a brief analysis of their design, actuation and control approaches. While reviewing these designs it was observed that most of them are undesirably inspired by industrial robot designs. Taking note of the design concerns of current ankle robots, few improvements in the ankle robot designs have also been suggested. Conventional position control or force control approaches, being used in the existing ankle robots, have been reviewed. Apparently, opportunities of improvement also exist in the actuation as well as control of ankle robots. Subsequently, a discussion on most recent research in the development of novel actuators and advanced controllers based on appropriate physical and cognitive human-robot interaction has also been included in this review. Implications for Rehabilitation Ankle joint functions are restricted/impaired as a consequence of stroke or injury during sports or otherwise. Robots can help in reinstating functions faster and can also work as tool for recording rehabilitation data useful for further analysis. Evolution of ankle robots with respect to their design and control aspects has been discussed in the present paper and a novel design with futuristic control approach has been proposed.

Guidance on the implementation of modifications to mitigate beyond design basis accidents

Energy Technology Data Exchange (ETDEWEB)

Harris, S.; Marczak, J.; O' Neill, M. [Ontario Power Generation, Pickering, ON (Canada)

2014-07-01

Following the events at Fukushima, Canadian Nuclear Power Plants (NPP) procured equipment and initiated modifications to improve response capability for Beyond Design Basis Accidents (BDBA). These changes were not typical of other design modifications to the nuclear power plants and reinforced the need for additional guidance for modifications to address BDBA. This paper describes the guidance that was developed to guide the design, procurement, installation, operation, and maintenance of equipment and modifications to mitigate BDBAs. The guidance developed prescribes a graded approach based on a categorization of the nature of the modification. Four categories of modifications are introduced, with the distinction being the degree of interface with existing design basis systems, structures and components (SSCs). This has resulted in a cost-effective means of implementing additional capability to mitigate BDBA conditions, and yet ensure the design basis capability of SSCs is maintained. Operating experience with use of the guidance is also discussed. (author)

Guidance on the implementation of modifications to mitigate beyond design basis accidents

International Nuclear Information System (INIS)

Harris, S.; Marczak, J.; O'Neill, M.

2014-01-01

Following the events at Fukushima, Canadian Nuclear Power Plants (NPP) procured equipment and initiated modifications to improve response capability for Beyond Design Basis Accidents (BDBA). These changes were not typical of other design modifications to the nuclear power plants and reinforced the need for additional guidance for modifications to address BDBA. This paper describes the guidance that was developed to guide the design, procurement, installation, operation, and maintenance of equipment and modifications to mitigate BDBAs. The guidance developed prescribes a graded approach based on a categorization of the nature of the modification. Four categories of modifications are introduced, with the distinction being the degree of interface with existing design basis systems, structures and components (SSCs). This has resulted in a cost-effective means of implementing additional capability to mitigate BDBA conditions, and yet ensure the design basis capability of SSCs is maintained. Operating experience with use of the guidance is also discussed. (author)

Considerations for designing robotic upper limb rehabilitation devices

Science.gov (United States)

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.

THE RELIGIOUS GUIDANCE FOR PROSTITUTE A Descriptive Study at Palimanan Cirebon

Directory of Open Access Journals (Sweden)

Murip Yahya

2016-02-01

Full Text Available This study attempts to investigate the implementation of religious guidance for prostitute and its influence to Woman Social Institution Silih Asih in Palimanan, Cirebon. It formulated on four research questions: 1 How is the process of religious guidance in Social Institution Silih Asih; 2 What is the participants’s efforts to achieve the goal of religious guidance; 3 How is the material of religious guidance in Social Institution Silih Asih Palimanan; 4 How is the approach and method of religious guidance applied in Social Institution Silih Asih Palimanan to support and achieve the aim of religious guidance. The study used qualitative-naturalistic, research design with descriptive method. The data were collected through observation, interview, and document analysis. The results of the study show that: 1 there were two stages of religious guidance: identification stage and rehabilitation process; 2 the participants were identified by their age, marital status, education background, parents’ job, and reasons of being prostitute; 3 the materials presented on theoretical and natural materials based on Islam thoughts; 4 the religious guidance used various approaches: experience, habituation, emotional, rational, and holistic.

Integrated guidance and control design of a flight vehicle with side-window detection

Directory of Open Access Journals (Sweden)

Tianyu ZHENG

2018-04-01

Full Text Available This paper considers the guidance and control problem of a flight vehicle with side-window detection. In order to guarantee the target remaining in the seeker's sight of view, the line of sight and the attitude of the flight vehicle should be under some constraints caused by the side-window, which leads to coupling between the guidance and the attitude dynamics model. To deal with the side-window constraints and the coupling, a novel Integrated Guidance and Control (IGC design approach is proposed. Firstly, the relative motion equations are derived in the body-Line of Sight (LOS coordinate system. And the guidance and control problem of the flight vehicle is formulated into an IGC problem with state constraints. Then, based on the singular perturbation method, the IGC problem is decomposed into the control design of the quasi-steady-state subsystem and the boundary-layer subsystem which can be designed separately. Finally, the receding horizon control is applied to the control design for the two subsystems. Simulation results show the effectiveness of the proposed approach. Keywords: Integrated guidance and control, Receding horizon control, Side-window detection, Singular perturbation, Terminal guidance

Guidance on the Implementation of Modifications to Mitigate Beyond Design Basis Accidents

Energy Technology Data Exchange (ETDEWEB)

Dermarkar, F.; Marczak, J.; O’Neill, M., E-mail: fred.dermarkar@opg.com [Ontario Power Generation, Pickering, Ontario (Canada)

2014-10-15

Following the events at Fukushima, Canadian Nuclear Power Plants (NPP) procured equipment and initiated modifications to improve response capability for Beyond Design Basis Accidents (BDBA). These changes were not typical of other design modifications to the nuclear power plants and reinforced the need for additional guidance for modifications to address BDBA. This paper describes the guidance that was developed to guide the design, procurement, installation, operation, and maintenance of equipment and modifications to mitigate BDBAs. The guidance developed prescribes a graded approach based on a categorization of the nature of the modification. Four categories of modifications are introduced, with the distinction being the degree of interface with existing design basis systems, structures and components (SSCs). This has resulted in a cost-effective means of implementing additional capability to mitigate BDBA conditions, and yet ensure the design basis capability of SSCs is maintained. (author)

Design and Development of a Hand Exoskeleton Robot for Active and Passive Rehabilitation

Directory of Open Access Journals (Sweden)

Oscar Sandoval-Gonzalez

2016-04-01

Full Text Available The present work, which describes the mechatronic design and development of a novel rehabilitation robotic exoskeleton hand, aims to present a solution for neuromusculoskeletal rehabilitation. It presents a full range of motion for all hand phalanges and was specifically designed to carry out position and force-position control for passive and active rehabilitation routines. System integration and preliminary clinical tests are also presented.

Flexible pavement rehabilitation design based on pavement service life time span left

OpenAIRE

Gamelyak, I.; Shevchuk, V.

2005-01-01

The design of flexible pavement rehabilitation is analysed in terms of durability-cost. A notion of the remaining service life span is described. the model of rehabilitation strategy selection is presented for both design project and operation stages. the results can be used in the pavement management system.

Design, modelling and simulation aspects of an ankle rehabilitation device

Science.gov (United States)

Racu, C. M.; Doroftei, I.

2016-08-01

Ankle injuries are amongst the most common injuries of the lower limb. Besides initial treatment, rehabilitation of the patients plays a crucial role for future activities and proper functionality of the foot. Traditionally, ankle injuries are rehabilitated via physiotherapy, using simple equipment like elastic bands and rollers, requiring intensive efforts of therapists and patients. Thus, the need of robotic devices emerges. In this paper, the design concept and some modelling and simulation aspects of a novel ankle rehabilitation device are presented.

Approach and landing guidance design for reusable launch vehicle using multiple sliding surfaces technique

Directory of Open Access Journals (Sweden)

Xiangdong LIU

2017-08-01

Full Text Available An autonomous approach and landing (A&L guidance law is presented in this paper for landing an unpowered reusable launch vehicle (RLV at the designated runway touchdown. Considering the full nonlinear point-mass dynamics, a guidance scheme is developed in three-dimensional space. In order to guarantee a successful A&L movement, the multiple sliding surfaces guidance (MSSG technique is applied to derive the closed-loop guidance law, which stems from higher order sliding mode control theory and has advantage in the finite time reaching property. The global stability of the proposed guidance approach is proved by the Lyapunov-based method. The designed guidance law can generate new trajectories on-line without any specific requirement on off-line analysis except for the information on the boundary conditions of the A&L phase and instantaneous states of the RLV. Therefore, the designed guidance law is flexible enough to target different touchdown points on the runway and is capable of dealing with large initial condition errors resulted from the previous flight phase. Finally, simulation results show the effectiveness of the proposed guidance law in different scenarios.

Designing Meaningful Game Experiences for Rehabilitation and Sustainable Mobility Settings

Directory of Open Access Journals (Sweden)

Silvia Gabrielli

2014-03-01

Full Text Available This paper presents the approach followed in two ongoing research projects aimed to designing meaningful game-based experiences to support home rehabilitation, eco-sustainable mobility goals and more in general better daily lifestyles. We first introduce the need for designing meaningful game-based experiences that are well-connected to the relevant non-game settings and can be customized by/for users, then, we show examples of how this approach can be realized in the rehabilitation and sustainable mobility contexts.

Video games and rehabilitation: using design principles to enhance engagement in physical therapy.

Science.gov (United States)

Lohse, Keith; Shirzad, Navid; Verster, Alida; Hodges, Nicola; Van der Loos, H F Machiel

2013-12-01

Patient nonadherence with therapy is a major barrier to rehabilitation. Recovery is often limited and requires prolonged, intensive rehabilitation that is time-consuming, expensive, and difficult. We review evidence for the potential use of video games in rehabilitation with respect to the behavioral, physiological, and motivational effects of gameplay. In this Special Interest article, we offer a method to evaluate effects of video game play on motor learning and their potential to increase patient engagement with therapy, particularly commercial games that can be interfaced with adapted control systems. We take the novel approach of integrating research across game design, motor learning, neurophysiology changes, and rehabilitation science to provide criteria by which therapists can assist patients in choosing games appropriate for rehabilitation. Research suggests that video games are beneficial for cognitive and motor skill learning in both rehabilitation science and experimental studies with healthy subjects. Physiological data suggest that gameplay can induce neuroplastic reorganization that leads to long-term retention and transfer of skill; however, more clinical research in this area is needed. There is interdisciplinary evidence suggesting that key factors in game design, including choice, reward, and goals, lead to increased motivation and engagement. We maintain that video game play could be an effective supplement to traditional therapy. Motion controllers can be used to practice rehabilitation-relevant movements, and well-designed game mechanics can augment patient engagement and motivation in rehabilitation. We recommend future research and development exploring rehabilitation-relevant motions to control games and increase time in therapy through gameplay.Video Abstract available (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A61) for more insights from the authors.

Methods for assessing mine site rehabilitation design for erosion impact

International Nuclear Information System (INIS)

Evans, K. G.

2000-01-01

Erosion of rehabilitated mines may result in landform instability, which in turn may result in exposure of encapsulated contaminants, elevated sediment delivery at catchment outlets, and subsequent degradation of downstream water quality. Rehabilitation design can be assessed using erosion and hydrology models calibrated to mine site conditions. Incision rates in containment structures can be quantified using 3-dimensional landform evolution simulation techniques. Sediment delivery at catchment outlets for various landform amelioration techniques can be predicted using process-based and empirical erosion-prediction models and sediment delivery ratios. The predicted sediment delivery can be used to estimate an average annual stream sediment load that can, in turn, be used to assess water quality impacts. Application of these techniques is demonstrated through a case study applied to a proposed rehabilitation design option for the Energy Resources of Australia Ltd (ERA) Ranger Mine in the Northern Territory of Australia. Copyright (2000) CSIRO Australia

Perioperative rehabilitation in operation for lung cancer (PROLUCA) – rationale and design

DEFF Research Database (Denmark)

Sommer, Maja S; Trier, Karen; Vibe-Petersen, Jette

2014-01-01

postoperative rehabilitation (starting six weeks after surgery); (3) early postoperative rehabilitation alone; (4) today's standard care which is postoperative rehabilitation initiated six weeks after surgery. The preoperative rehabilitation program consists of an individually designed, 30-minute home......-based exercise program performed daily. The postoperative rehabilitation program consists of a supervised group exercise program comprising cardiovascular and resistance training two-hour weekly for 12 weeks combined with individual counseling. The primary study endpoint is VO2peak and secondary endpoints...... (Maximal Oxygen Uptake (VO2peak)), 380 patients with non-small cell lung cancer (NSCLC) stage I-IIIa referred for surgical resection will be randomly assigned to one of four groups: (1) preoperative and early postoperative rehabilitation (starting two weeks after surgery); (2) preoperative and late...

Probabilistic design framework for sustainable repari and rehabilitation of civil infrastructure

DEFF Research Database (Denmark)

Lepech, Michael; Geiker, Mette Rica; Stang, Henrik

2011-01-01

This paper presents a probabilistic-based framework for the design of civil infrastructure repair and rehabilitation to achieve targeted improvements in sustainability indicators. The framework consists of two types of models: (i) service life prediction models combining one or several deteriorat......This paper presents a probabilistic-based framework for the design of civil infrastructure repair and rehabilitation to achieve targeted improvements in sustainability indicators. The framework consists of two types of models: (i) service life prediction models combining one or several...

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

SUPPORTING THE INDUSTRY BY DEVELOPING A DESIGN GUIDANCE FOR COMPUTER-BASED PROCEDURES FOR FIELD WORKERS

Energy Technology Data Exchange (ETDEWEB)

Oxstrand, Johanna; LeBlanc, Katya

2017-06-01

The paper-based procedures currently used for nearly all activities in the commercial nuclear power industry have a long history of ensuring safe operation of the plants. However, there is potential to greatly increase efficiency and safety by improving how the human interacts with the procedures, which can be achieved through the use of computer-based procedures (CBPs). A CBP system offers a vast variety of improvements, such as context driven job aids, integrated human performance tools and dynamic step presentation. As a step toward the goal of improving procedure use performance, the U.S. Department of Energy Light Water Reactor Sustainability Program researchers, together with the nuclear industry, have been investigating the possibility and feasibility of replacing current paper-based procedures with CBPs. The main purpose of the CBP research conducted at the Idaho National Laboratory was to provide design guidance to the nuclear industry to be used by both utilities and vendors. After studying existing design guidance for CBP systems, the researchers concluded that the majority of the existing guidance is intended for control room CBP systems, and does not necessarily address the challenges of designing CBP systems for instructions carried out in the field. Further, the guidance is often presented on a high level, which leaves the designer to interpret what is meant by the guidance and how to specifically implement it. The authors developed a design guidance to provide guidance specifically tailored to instructions that are carried out in the field based.

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.

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.

Forging Alliances in Interdisciplinary Rehabilitation Research (FAIRR): A Logic Model.

Science.gov (United States)

Gill, Simone V; Khetani, Mary A; Yinusa-Nyahkoon, Leanne; McManus, Beth; Gardiner, Paula M; Tickle-Degnen, Linda

2017-07-01

In a patient-centered care era, rehabilitation can benefit from researcher-clinician collaboration to effectively and efficiently produce the interdisciplinary science that is needed to improve patient-centered outcomes. The authors propose the use of the Forging Alliances in Interdisciplinary Rehabilitation Research (FAIRR) logic model to provide guidance to rehabilitation scientists and clinicians who are committed to growing their involvement in interdisciplinary rehabilitation research. We describe the importance and key characteristics of the FAIRR model for conducting interdisciplinary rehabilitation research.

Design of Second-Order Sliding Mode Guidance Law Based on the Nonhomogeneous Disturbance Observer

Directory of Open Access Journals (Sweden)

Huibo Zhou

2014-01-01

Full Text Available Considering the guidance problem of relative motion of missile target without the dynamic characteristics of missile autopilot in the interception planar, non-homogeneous disturbance observer is applied for finite-time estimation with respect to the target maneuvering affecting the guidance performance. Two guidance laws with finite-time convergence are designed by using a fast power rate reaching law and the prescribed sliding variable dynamics. The nonsingular terminal sliding mode surface is selected to improve dynamic characteristics of missile autopilot. Furthermore, the finite-time guidance law with dynamic delay characteristics is designed for the target maneuvering through adopting variable structure dynamic compensation. The simulation results demonstrate that, for different target maneuvering, the proposed guidance laws can restrain the sliding mode chattering problem effectively and make the missile hit the maneuvering target quickly and accurately with condition of corresponding assumptions.

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

Science.gov (United States)

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.

Interactive design of patient-oriented video-games for rehabilitation: concept and application.

Science.gov (United States)

Lupinacci, Giorgia; Gatti, Gianluca; Melegari, Corrado; Fontana, Saverio

2018-04-01

Serious video-games are innovative tools used to train the motor skills of subjects affected by neurological disorders. They are often developed to train a specific type of patients and the rules of the game are standardly defined. A system that allows the therapist to design highly patient-oriented video-games, without specific informatics skills, is proposed. The system consists of one personal computer, two screens, a Kinect™ sensor and a specific software developed here for the design of the video-games. It was tested with the collaboration of three therapists and six patients, and two questionnaires were filled in by each patient to evaluate the appreciation of the rehabilitative sessions. The therapists learned easily how to use the system, and no serious difficulties were encountered by the patients. The questionnaires showed an overall good satisfaction by the patients and highlighted the key-role of the therapist in involving the patients during the rehabilitative session. It was found that the proposed system is effective for developing patient-oriented video-games for rehabilitation. The two main advantages are that the therapist is allowed to (i) develop personalized video-games without informatics skills and (ii) adapt the game settings to patients affected by different pathologies. Implications for rehabilitation Virtual reality and serious video games offer the opportunity to transform the traditional therapy into a more pleasant experience, allowing patients to train their motor and cognitive skills. Both the therapists and the patients should be involved in the development of rehabilitative solutions to be highly patient-oriented. A system for the design of rehabilitative games by the therapist is described and the feedback of three therapists and six patients is reported.

Robotic needle steering: design, modeling, planning, and image guidance

NARCIS (Netherlands)

Cowan, Noah J.; Goldberg, Ken; Chirikjian, Gregory S.; Fichtinger, Gabor; Alterovitz, Ron; Reed, Kyle B.; Kallem, Vinutha; Misra, Sarthak; Park, Wooram; Okamura, Allison M.; Rosen, Jacob; Hannaford, Blake; Satava, Richard M.

2010-01-01

This chapter describes how advances in needle design, modeling, planning, and image guidance make it possible to steer flexible needles from outside the body to reach specified anatomical targets not accessible using traditional needle insertion methods. Steering can be achieved using a variety of

Design of active feedback for rehabilitation device

Directory of Open Access Journals (Sweden)

Liska Ondrej

2016-01-01

Full Text Available Sensor systems are an essential part of automated equipment. They are even more important in machines that come in contact with people, because they have a significant impact on safety. This paper describes the design of active feedback for rehabilitation device driven by pneumatic artificial muscles. Here are presented three methods for measuring the load of the robot. The first is a system composed of Force Sensitive Resistors (FSR placed in the handle of the device. Two other methods are intended to measure the load of the actuator composed of artificial muscles. The principle of one method is to measure the difference in filling pressures of the muscles, second is based on strain measurement in the drive cables. The paper describes advantages and disadvantages of using each of these methods in a rehabilitation device

MyReDiary: Co-Designing for Collaborative Articulation in Physical Rehabilitation

DEFF Research Database (Denmark)

Bagalkot, Naveen L.; Sokoler, Tomas

2011-01-01

In this paper we present our exploration of co-designing for supporting a collaborative articulation of rehabilitation process. Based on our reading of key CSCW literature, we describe three facets of a collaboratively articulated rehab process: Interdependence, Distributed Process, and Interoper......In this paper we present our exploration of co-designing for supporting a collaborative articulation of rehabilitation process. Based on our reading of key CSCW literature, we describe three facets of a collaboratively articulated rehab process: Interdependence, Distributed Process......, and Interoperability. We highlight Magic-Mirror- Spiral, the design ideal guiding the co-designing of MyReDiary that is aimed to support the three facets as an example in this regard. We offer the conceptual understanding of Collaborative Articulation, the Magic-Mirror-Spiral and MyReDiary as a ‘compositional Whole...

An efficient auto TPT stitch guidance generation for optimized standard cell design

Science.gov (United States)

Samboju, Nagaraj C.; Choi, Soo-Han; Arikati, Srini; Cilingir, Erdem

2015-03-01

As the technology continues to shrink below 14nm, triple patterning lithography (TPT) is a worthwhile lithography methodology for printing dense layers such as Metal1. However, this increases the complexity of standard cell design, as it is very difficult to develop a TPT compliant layout without compromising on the area. Hence, this emphasizes the importance to have an accurate stitch generation methodology to meet the standard cell area requirement as defined by the technology shrink factor. In this paper, we present an efficient auto TPT stitch guidance generation technique for optimized standard cell design. The basic idea here is to first identify the conflicting polygons based on the Fix Guidance [1] solution developed by Synopsys. Fix Guidance is a reduced sub-graph containing minimum set of edges along with the connecting polygons; by eliminating these edges in a design 3-color conflicts can be resolved. Once the conflicting polygons are identified using this method, they are categorized into four types [2] - (Type 1 to 4). The categorization is based on number of interactions a polygon has with the coloring links and the triangle loops of fix guidance. For each type a certain criteria for keep-out region is defined, based on which the final stitch guidance locations are generated. This technique provides various possible stitch locations to the user and helps the user to select the best stitch location considering both design flexibility (max. pin access/small area) and process-preferences. Based on this technique, a standard cell library for place and route (P and R) can be developed with colorless data and a stitch marker defined by designer using our proposed method. After P and R, the full chip (block) would contain the colorless data and standard cell stitch markers only. These stitch markers are considered as "must be stitch" candidates. Hence during full chip decomposition it is not required to generate and select the stitch markers again for the

Design and kinematic analysis of a novel upper limb exoskeleton for rehabilitation of stroke patients.

Science.gov (United States)

Zeiaee, Amin; Soltani-Zarrin, Rana; Langari, Reza; Tafreshi, Reza

2017-07-01

This paper details the design process and features of a novel upper limb rehabilitation exoskeleton named CLEVER (Compact, Low-weight, Ergonomic, Virtual/Augmented Reality Enhanced Rehabilitation) ARM. The research effort is focused on designing a lightweight and ergonomic upper-limb rehabilitation exoskeleton capable of producing diverse and perceptually rich training scenarios. To this end, the knowledge available in the literature of rehabilitation robotics is used along with formal conceptual design techniques. This paper briefly reviews the systematic approach used for design of the exoskeleton, and elaborates on the specific details of the proposed design concept and its advantages over other design possibilities. The kinematic structure of CLEVER ARM has eight degrees of freedom supporting the motion of shoulder girdle, glenohumeral joint, elbow and wrist. Six degrees of freedom of the exoskeleton are active, and the two degrees of freedom supporting the wrist motion are passive. Kinematics of the proposed design is studied analytically and experimentally with the aid of a 3D printed prototype. The paper is concluded by some remarks on the optimization of the design, motorization of device, and the fabrication challenges.

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.

A Participatory Design Approach to Develop a Web-Based Self-Care Program Supporting Early Rehabilitation among Patients after Total Laryngectomy.

Science.gov (United States)

Cnossen, Ingrid C; van Uden-Kraan, Cornelia F; Eerenstein, Simone E J; Rinkel, Rico N P M; Aalders, Ijke J; van den Berg, Klaske; de Goede, Cees J T; van Stijgeren, Ans J; Cruijff-Bijl, Yvonne; de Bree, Remco; Leemans, C René; Verdonck-de Leeuw, Irma M

2015-01-01

To develop a Web-based self-care program for patients after total laryngectomy according to a participatory design approach. We conducted a needs assessment with laryngectomees (n = 9) and their partners (n = 3) by means of a focus group interview. In 4 focus group sessions, a requirement plan was formulated by a team of health care professionals (n = 10) and translated into a prototype. An e-health application was built including illustrated information on functional changes after total laryngectomy as well as video demonstrations of skills and exercises. Usability of the prototype was tested by end users (n = 4) and expert users (n = 10). Interviews were held to elicit the intention to use and the desired implementation strategy. Six main self-care topics were identified: (1) nutrition, (2) tracheostomy care, (3) voice prosthesis care, (4) speech rehabilitation, (5) smell rehabilitation, and (6) mobility of head, neck, and shoulder muscles. Expert users expressed concerns regarding tailored exercises, indicated a positive intent to implement the intervention in routine care, and expressed a need for guidance when implementing the intervention. End users and expert users appreciated the content completeness and multimedia-based information built into the application. The participatory design is a valuable approach to develop a self-care program to help meet users' needs. © 2016 S. Karger AG, Basel.

A review on the mechanical design elements of ankle rehabilitation robot.

Science.gov (United States)

Khalid, Yusuf M; Gouwanda, Darwin; Parasuraman, Subramanian

2015-06-01

Ankle rehabilitation robots are developed to enhance ankle strength, flexibility and proprioception after injury and to promote motor learning and ankle plasticity in patients with drop foot. This article reviews the design elements that have been incorporated into the existing robots, for example, backdrivability, safety measures and type of actuation. It also discusses numerous challenges faced by engineers in designing this robot, including robot stability and its dynamic characteristics, universal evaluation criteria to assess end-user comfort, safety and training performance and the scientific basis on the optimal rehabilitation strategies to improve ankle condition. This article can serve as a reference to design robot with better stability and dynamic characteristics and good safety measures against internal and external events. It can also serve as a guideline for the engineers to report their designs and findings. © IMechE 2015.

Three-dimensional nonlinear H-infinity guidance design and H-infinity-based pursuit-evasion game

Science.gov (United States)

Chen, Hsin-Yuan; Yang, Chi-Ching

2001-08-01

There are five features in this approach: (1) The complete nonlinear dynamics of the pursuit-evasion motion is considered in 3D spherical coordinate system. Neither linearization nor small signal assumptions are made. (2) The nonlinear H-infinity guidance design is derived analytically and expressed in a very simple form. (3) Unlike adaptive control concept, implementation of the proposed H(infinity ) guidance design does not need the information on target acceleration while ensuring acceptable intercept performance for arbitrary targets with the finite acceleration. (4) The derived guidance design exhibits strong robustness against variations in target acceleration. (5) Finally the issues related to the validation of the control law using Hardware In The Loop simulation are presented. The effects of the Flight Motion Simulator static and dynamic accuracies (time delay etc...) are discussed.

Academic poster design at a national conference: a need for standardised guidance?

Science.gov (United States)

Gopal, Alan; Redman, Melody; Cox, David; Foreman, David; Elsey, Elizabeth; Fleming, Simon

2017-10-01

Academic posters are a common means of disseminating information at conferences. Presentation at conferences is frequently given weight in postgraduate training programme recruitment. Some conferences provide guidance for visual presentation of posters. For the Association of the Study of Medical Education (ASME) Annual Scientific Meeting (ASM) 2015, poster abstract guidance was provided; however, the guidance on poster design was limited to size and orientation. The aim of this study was to investigate academic poster quality at a national medical education conference to identify where standards could be promoted and improved. Presentation at conferences is frequently given weight in postgraduate training programme recruitment METHODS: Six auditors assessed all posters displayed at the ASME ASM (15-17 July 2015) using guidelines based upon a modified checklist for academic posters. Ten criteria were agreed as assessment standards for poster design quality. One-hundred-and-eighty posters were assessed: 29 per cent had appropriate copyright for the materials displayed (n = 52); 41 per cent included suitable contact details (n = 73); 48 per cent (n = 87) had a text to graphic ratio of 50 : 50; 72 per cent (n = 130) met ASME guidance for layout and orientation; 76 per cent (n = 137) had appropriate referencing; 78 per cent showed evidence of proofreading for grammar and spelling (n = 140); 79 per cent (n = 142) were readable at a distance of 2 metres; and 87 per cent used appropriate academic logos (n = 156). There was variability in design quality as assessed by these criteria. We recommend that detailed guidance should be produced and disseminated by the organising conference. This may improve poster quality and aid in the communication of presented material. We aim to re-audit following the production and dissemination of poster presentation guidance. © 2016 John Wiley & Sons Ltd and The Association for the Study of Medical

Key Success Factors and Guidance for International Collaborative Design Projects

Directory of Open Access Journals (Sweden)

Robby Soetanto

2015-11-01

Full Text Available In the built environment (BE sector, the co-creation process of design demands understanding of requirements (as viewed by parties involved, mobilisation of tacit knowledge, negotiation, and complex exchange of information. The need to collaborate over distance has further exacerbated the complexity of the process, and, in itself, represents a significant challenge for BE professionals who are increasingly expected to undertake this process within globally distributed virtual teams. The research aims to identify key success factors and develop guidance for international collaborative design projects, via the implementation of collaborative design courses in UK and Canadian universities over three academic years. Questionnaire surveys, focus groups, observation of online meetings, personal reflections provided data for the analysis. The findings reveal the significance of the perceived risk of collaboration and a difference in preferred communication mode between architects and civil/structural engineers. These findings suggest the impact of training in the subject discipline, and that the opportunity for co-located working has helped the development of trust. The guidance is aimed at BE educators who wish to implement this activity in their courses.

Remedial design and remedial action guidance for the Idaho National Engineering Laboratory

International Nuclear Information System (INIS)

1993-10-01

The US Department of Energy, Idaho Operations Office (DOE-ID), the US Environmental Protection Agency, Region X (EPA), and the Idaho Department of Health and Welfare (IDHW) have developed this guidance on the remedial design and remedial action (RD/RA) process. This guidance is applicable to activities conducted under the Idaho National Engineering Laboratory (INEL) Federal Facility Agreement and Consent Order (FFA/CO) and Action Plan. The INEL FFA/CO and Action Plan provides the framework for performing environmental restoration according to the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA). The guidance is intended for use by the DOE-ID, the EPA, and the IDHW Waste Area Group (WAG) managers and others involved in the planning and implementation of CERCLA environmental restoration activities. The scope of the guidance includes the RD/RA strategy for INEL environmental restoration projects and the approach to development and review of RD/RA documentation. Chapter 2 discusses the general process, roles and responsibilities, and other elements that define the RD/RA strategy. Chapters 3 through 7 describe the RD/RA documents identified in the FFA/CO and Action Plan. Chapter 8 provides examples of how this guidance can be applied to restoration projects. Appendices are included that provide excerpts from the FFA/CO pertinent to RD/RA (Appendix A), a applicable US Department of Energy (DOE) orders (Appendix B), and an EPA Engineering ''Data Gaps in Remedial Design'' (Appendix C)

IAEA Guidance for Safeguards Implementation in Facility Design and Construction

International Nuclear Information System (INIS)

Sprinkle, J.; Hamilton, A.; Poirier, S.; Catton, A.; Ciuculescu, C.; Ingegneri, M.; Plenteda, R.

2015-01-01

One of the IAEA's statutory objectives is to seek to accelerate and enlarge the contribution of nuclear energy to peace, health and prosperity throughout the world. One way the IAEA works to achieve this objective is through the publication of technical series that can provide guidance to Member States. These series include the IAEA Services Series, the IAEA Safety Standard Series, the IAEA Nuclear Security Series and the IAEA Nuclear Energy Series. The Nuclear Energy Series is comprised of publications designed to encourage and assist research and development on, and practical application of, nuclear energy for peaceful purposes. This includes guidance to be used by owners and operators of utilities, academia, vendors and government officials. The IAEA has chosen the Nuclear Energy Series to publish guidance for States regarding the consideration of safeguards in nuclear facility design and construction. Historically, safeguards were often applied after a facility was designed or maybe even after it was built. However, many in the design and construction community would prefer to include consideration of these requirements from the conceptual design phase in order to reduce the need for retro-fits and modifications. One can then also take advantage of possible synergies between safeguards, security, safety and environmental protection and reduce the project risk against cost increments and schedule slippage. The IAEA is responding to this interest with a suite of publications in the IAEA Nuclear Energy Series, developed with the assistance of a number of Member State Support Programmes through a joint support programme task: · International Safeguards in Nuclear Facility Design and Construction (NP-T-2.8, 2013), · International Safeguards in the Design of Nuclear Reactors (NP-T-2.9, 2014), · International Safeguards in the Design of Spent Fuel Management (NF-T-3.1, tbd), · International Safeguards in the Design of Fuel Fabrication Plants (NF-T-4.7, tbd

Advanced alarm system design and human performance: Guidance development and current research

Energy Technology Data Exchange (ETDEWEB)

O` Hara, J M [Brookhaven National Lab., Upton, NY (United States)

1997-09-01

This paper describes a research program sponsored by the U.S. Nuclear Regulatory Commission to address the human factors engineering (HFE) aspects of nuclear power plant alarm systems. The overall objective of the program is to develop HFE review guidance for advanced alarm systems. Guidance has been developed based on a broad base of technical and research literature. As part of the development effort, aspects of alarm system design for which the technical basis was insufficient to support guidance development were identified and prioritized. Research is currently underway to address the highest priority topics: alarm processing and display characteristics. (author). 29 refs, 2 figs.

Advanced alarm system design and human performance: Guidance development and current research

International Nuclear Information System (INIS)

O'Hara, J.M.

1997-01-01

This paper describes a research program sponsored by the U.S. Nuclear Regulatory Commission to address the human factors engineering (HFE) aspects of nuclear power plant alarm systems. The overall objective of the program is to develop HFE review guidance for advanced alarm systems. Guidance has been developed based on a broad base of technical and research literature. As part of the development effort, aspects of alarm system design for which the technical basis was insufficient to support guidance development were identified and prioritized. Research is currently underway to address the highest priority topics: alarm processing and display characteristics. (author). 29 refs, 2 figs

Psychiatric rehabilitation education for physicians.

Science.gov (United States)

Rudnick, Abraham; Eastwood, Diane

2013-06-01

As part of a rapidly spreading reform toward recovery-oriented services, mental health care systems are adopting Psychiatric/Psychosocial Rehabilitation (PSR). Accordingly, PSR education and training programs are now available and accessible. Although psychiatrists and sometimes other physicians (such as family physicians) provide important services to people with serious mental illnesses and may, therefore, need knowledge and skill in PSR, it seems that the medical profession has been slow to participate in PSR education. Based on our experience working in Canada as academic psychiatrists who are also Certified Psychiatric Rehabilitation Practitioners (CPRPs), we offer descriptions of several Canadian initiatives that involve physicians in PSR education. Multiple frameworks guide PSR education for physicians. First, guidance is provided by published PSR principles, such as the importance of self-determination (www.psrrpscanada.ca). Second, guidance is provided by adult education (andragogy) principles, emphasizing the importance of addressing attitudes in addition to knowledge and skills (Knowles, Holton, & Swanson, 2011). Third, guidance in Canada is provided by Canadian Medical Education Directives for Specialists (CanMEDS) principles, which delineate the multiple roles of physicians beyond that of medical expert (Frank, 2005) and have recently been adopted in Australia (Boyce, Spratt, Davies, & McEvoy, 2011). (PsycINFO Database Record (c) 2013 APA, all rights reserved).

Engaging People with Aphasia in Design of Rehabilitation Through Participatory Design

DEFF Research Database (Denmark)

Konnerup, Ulla

2017-01-01

The research literature on participatory design in relation to people with communicative and cognitive disabilities often focuses on the challenges of communication among the participants. This paper presents a case study involving people suffering from communication disabilities after a brain...... injury (aphasia) early in a design process of an avatar-mediated virtual learning environment for rehabilitation. The example demonstrates how providing time and space and supporting the communication with well-suited tools and artefact opens for firth-hand domain knowledge of living with aphasia....... The results demonstrate that participatory design methods might result in much more than just being a step in the design process. In this specific case, it turns out to be a tool to engage, involve, and empower people with communication disabilities to interact and communicate. The paper argues...

[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.

Design strategies to improve patient motivation during robot-aided rehabilitation

Directory of Open Access Journals (Sweden)

Carrozza M Chiara

2007-02-01

Full Text Available Abstract Background Motivation is an important factor in rehabilitation and frequently used as a determinant of rehabilitation outcome. Several factors can influence patient motivation and so improve exercise adherence. This paper presents the design of two robot devices for use in the rehabilitation of upper limb movements, that can motivate patients during the execution of the assigned motor tasks by enhancing the gaming aspects of rehabilitation. In addition, a regular review of the obtained performance can reinforce in patients' minds the importance of exercising and encourage them to continue, so improving their motivation and consequently adherence to the program. In view of this, we also developed an evaluation metric that could characterize the rate of improvement and quantify the changes in the obtained performance. Methods Two groups (G1, n = 8 and G2, n = 12 of patients with chronic stroke were enrolled in a 3-week rehabilitation program including standard physical therapy (45 min. daily plus treatment by means of robot devices (40 min., twice daily respectively for wrist (G1 and elbow-shoulder movements (G2. Both groups were evaluated by means of standard clinical assessment scales and the new robot measured evaluation metric. Patients' motivation was assessed in 9/12 G2 patients by means of the Intrinsic Motivation Inventory (IMI questionnaire. Results Both groups reduced their motor deficit and showed a significant improvement in clinical scales and the robot measured parameters. The IMI assessed in G2 patients showed high scores for interest, usefulness and importance subscales and low values for tension and pain subscales. Conclusion Thanks to the design features of the two robot devices the therapist could easily adapt training to the individual by selecting different difficulty levels of the motor task tailored to each patient's disability. The gaming aspects incorporated in the two rehabilitation robots helped maintain

Design, development and deployment of a hand/wrist exoskeleton for home-based rehabilitation after stroke - SCRIPT project

OpenAIRE

Amirabdollahian, F; Ates, Sedar; Basteris, A.; Cesario, A.; Buurke, Jaap; Hermens, Hermanus J.; Hofs, D.; Johansson, E.; Mountain, G.; Nasr, N.; Nijenhuis, S.M.; Prange, Grada Berendina; Rahman, N.; Sale, P.; Schätzlein, F.

2014-01-01

Objective: this manuscript introduces the Supervised Care and Rehabilitation Involving Personal Tele-robotics (SCRIPT) project. The main goal is to demonstrate design and development steps involved in a complex intervention, while examining feasibility of using an instrumented orthotic device for home-based rehabilitation after stroke. Methods: the project uses a user-centred design methodology to develop a hand/wrist rehabilitation device for home-based therapy after stroke. The patient bene...

Designing Automated Guidance to Promote Productive Revision of Science Explanations

Science.gov (United States)

Tansomboon, Charissa; Gerard, Libby F.; Vitale, Jonathan M.; Linn, Marcia C.

2017-01-01

Supporting students to revise their written explanations in science can help students to integrate disparate ideas and develop a coherent, generative account of complex scientific topics. Using natural language processing to analyze student written work, we compare forms of automated guidance designed to motivate productive revision and help…

Designation and verification of road markings detection and guidance method

Science.gov (United States)

Wang, Runze; Jian, Yabin; Li, Xiyuan; Shang, Yonghong; Wang, Jing; Zhang, JingChuan

2018-01-01

With the rapid development of China's space industry, digitization and intelligent is the tendency of the future. This report is present a foundation research about guidance system which based on the HSV color space. With the help of these research which will help to design the automatic navigation and parking system for the frock transport car and the infrared lamp homogeneity intelligent test equipment. The drive mode, steer mode as well as the navigation method was selected. In consideration of the practicability, it was determined to use the front-wheel-steering chassis. The steering mechanism was controlled by the stepping motors, and it is guided by Machine Vision. The optimization and calibration of the steering mechanism was made. A mathematical model was built and the objective functions was constructed for the steering mechanism. The extraction method of the steering line was studied and the motion controller was designed and optimized. The theory of HSV, RGB color space and analysis of the testing result will be discussed Using the function library OPENCV on the Linux system to fulfill the camera calibration. Based on the HSV color space to design the guidance algorithm.

A community-based, interdisciplinary rehabilitation engineering course.

Science.gov (United States)

Lundy, Mary; Aceros, Juan

2016-08-01

A novel, community-based course was created through collaboration between the School of Engineering and the Physical Therapy program at the University of North Florida. This course offers a hands-on, interdisciplinary training experience for undergraduate engineering students through team-based design projects where engineering students are partnered with physical therapy students. Students learn the process of design, fabrication and testing of low-tech and high-tech rehabilitation technology for children with disabilities, and are exposed to a clinical experience under the guidance of licensed therapists. This course was taught in two consecutive years and pre-test/post-test data evaluating the impact of this interprofessional education experience on the students is presented using the Public Service Motivation Scale, Civic Actions Scale, Civic Attitudes Scale, and the Interprofessional Socialization and Valuing Scale.

The development of an upper limb stroke rehabilitation robot: identification of clinical practices and design requirements through a survey of therapists.

Science.gov (United States)

Lu, Elaine C; Wang, Rosalie H; Hebert, Debbie; Boger, Jennifer; Galea, Mary P; Mihailidis, Alex

2011-01-01

PURPOSE. Timely and adequate rehabilitation after a stroke is crucial to maximising recovery. A way of increasing treatment access could be through robots, which would aid therapists in providing post-stroke rehabilitation. This research sought to discover the needs and preferences of therapists with respect to a robot that focuses on upper limb rehabilitation. Understanding requirements for devices could help to increase integration into clinical practice. METHODS. An international online survey was distributed through professional organisations and e-mail list services to therapists. The survey contained 85 items covering topics such as therapist background and treatment approach, rehabilitation aims and robotic rehabilitation device attributes. RESULTS. Data were analysed for 233 respondents, most of whom were physiotherapists and occupational therapists from Australia, Canada and USA. Top attributes included: facilitating a variety of arm movements, being usable while seated, giving biofeedback to clients, having virtual activities specific to daily living, being useful in-home and having resistance adjustable to client needs. In addition, the device should cost under 6000 USD. CONCLUSIONS. Findings from this survey provide guidance for technology developers regarding therapists' specifications for a robotic device for upper limb rehabilitation. In addition, findings offer a better understanding of how acceptance of such devices may be facilitated.

When self-tracking enters physical rehabilitation

DEFF Research Database (Denmark)

Schwennesen, Nete

2017-01-01

In this paper, I explore what happens when self-tracking technologies and devices travel into the context of physical rehabilitation and come to constitute what Lupton has called ‘pushed’ self-tracking. By unpacking the processes through which a self-tracking technology is put to use in physical...... rehabilitation in Denmark, and the kind of relationships patients and healthcare providers establish with and through this technology, I illustrate how a new geography of responsibility is constituted, where responsibility for professional guidance is delegated to the technology and patients are expected...

Design, implementation and control of rehabilitation robots for upper and lower limbs

OpenAIRE

Ergin, Alper Mehmet

2011-01-01

We present two novel rehabilitation robots for stroke patients. For lower limb stroke rehabilitation, we present a novel self-aligning exoskeleton for the knee joint. The primal novelty of the design originates from its kinematic structure that allows translational movements of the knee joint on the sagittal plane along with the knee rotation. Automatically adjusting its joint axes, the exoskeleton enables a perfect match between human joint axes and the device axes. Thanks to this feature, t...

Hydraulic analysis and optimization design in Guri rehabilitation project

Science.gov (United States)

Cheng, H.; Zhou, L. J.; Gong, L.; Wang, Z. N.; Wen, Q.; Zhao, Y. Z.; Wang, Y. L.

2016-11-01

Recently Dongfang was awarded the contract for rehabilitation of 6 units in Guri power plant, the biggest hydro power project in Venezuela. The rehabilitation includes, but not limited to, the extension of output capacity by about 50% and enhancement of efficiency level. To achieve the targets the runner and the guide vanes will be replaced by the newly optimized designs. In addition, the out-of-date stay vanes with straight plate shape will be modified into proper profiles after considering the application feasibility in field. The runner and vane profiles were optimized by using state-of-the-art flow simulation techniques. And the hydraulic performances were confirmed by the following model tests. This paper describes the flow analysis during the optimization procedure and the comparison between various technical concepts.

Exoskeleton for gait rehabilitation of children: Conceptual design.

Science.gov (United States)

Cornejo, Jorge L; Santana, Jesus F; Salinas, Sergio A

2017-07-01

This paper presents the conceptual design of an exoskeleton for gait rehabilitation of children. This system has electronics, mechanicals and software sections, which are implemented and tested using a mannequin of a child. The prototype uses servomotors to move robotic joints that are attached to simulated patient's legs. The design has 4 DOF (degrees of freedom) two for hip joints and other two for knee joints, in the sagittal plane. A microcontroller measures sensor signals, controls motors and exchanges data with a computer. The user interacts with a graphical interface to configure, control and monitor the exoskeleton activities. The laboratory tests show soften movements in joint angle tracking.

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

Science.gov (United States)

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.

Safeguards-by-Design: Guidance for Independent Spent Fuel Dry Storage Installations (ISFSI)

Energy Technology Data Exchange (ETDEWEB)

Trond Bjornard; Philip C. Durst

2012-05-01

This document summarizes the requirements and best practices for implementing international nuclear safeguards at independent spent fuel storage installations (ISFSIs), also known as Away-from- Reactor (AFR) storage facilities. These installations may provide wet or dry storage of spent fuel, although the safeguards guidance herein focuses on dry storage facilities. In principle, the safeguards guidance applies to both wet and dry storage. The reason for focusing on dry independent spent fuel storage installations is that this is one of the fastest growing nuclear installations worldwide. Independent spent fuel storage installations are typically outside of the safeguards nuclear material balance area (MBA) of the reactor. They may be located on the reactor site, but are generally considered by the International Atomic Energy Agency (IAEA) and the State Regulator/SSAC to be a separate facility. The need for this guidance is becoming increasingly urgent as more and more nuclear power plants move their spent fuel from resident spent fuel ponds to independent spent fuel storage installations. The safeguards requirements and best practices described herein are also relevant to the design and construction of regional independent spent fuel storage installations that nuclear power plant operators are starting to consider in the absence of a national long-term geological spent fuel repository. The following document has been prepared in support of two of the three foundational pillars for implementing Safeguards-by-Design (SBD). These are: i) defining the relevant safeguards requirements, and ii) defining the best practices for meeting the requirements. This document was prepared with the design of the latest independent dry spent fuel storage installations in mind and was prepared specifically as an aid for designers of commercial nuclear facilities to help them understand the relevant international requirements that follow from a country’s safeguards agreement with

Base Stabilization Guidance and Additive Selection for Pavement Design and Rehabilitation

Science.gov (United States)

2017-12-01

Significant improvements have been made in base stabilization practice that include design specifications and methodology, experience with the selection of stabilizing additives, and equipment for distribution and uniform blending of additives. For t...

Investigating patients' preferences for cardiac rehabilitation in Denmark

DEFF Research Database (Denmark)

Kjaer, Trine; Gyrd-Hansen, Dorte; Willaing, Ingrid

2006-01-01

the preferences for the offer of participation in various cardiac rehabilitation program activities: smoking cessation course, physical exercise program, personal meetings with cardiac nurse, group meetings managed by cardiac nurses, and nutritional counseling guidance. The questionnaire was sent to 742 former...

DESIGN OF ROBUST COMMAND TO LINE-OF-SIGHT GUIDANCE LAW: A FUZZY ADAPTIVE APPROACH

Directory of Open Access Journals (Sweden)

ESMAIL SADEGHINASAB

2016-11-01

Full Text Available In this paper, the design of command to line-of-sight (CLOS missile guidance law is addressed. Taking a three dimensional guidance model, the tracking control problem is formulated. To solve the target tracking problem, the feedback linearization controller is first designed. Although such control scheme possesses the simplicity property, but it presents the acceptable performance only in the absence of perturbations. In order to ensure the robustness properties against model uncertainties, a fuzzy adaptive algorithm is proposed with two parts including a fuzzy (Mamdani system, whose rules are constructed based on missile guidance, and a so-called rule modifier to compensate the fuzzy rules, using the negative gradient method. Compared with some previous works, such control strategy provides a faster time response without large control efforts. The performance of feedback linearization controller is also compared with that of fuzzy adaptive strategy via various simulations.

Design and evaluation of a new exoskeleton for gait rehabilitation

Directory of Open Access Journals (Sweden)

I. D. Geonea

2017-10-01

Full Text Available This work addresses the design and numerical characterization of a new exoskeleton solution for human leg motion assistance and rehabilitation. The exoskeleton solution is anthropomorphic, simple, low cost and easy to adapt on the human subject. The design aspect concerns the exoskeleton mechatronic structure, achieved in SolidWorks virtual environment. Numerical simulation is performed in MSC.ADAMS simulation environment. Obtained results for the exoskeleton computed motion are compared with those obtained from experimental walking of healthy subject. The prototype feasibility is studied both for design and operation aspect.

Globalizing rehabilitation psychology: Application of foundational principles to global health and rehabilitation challenges.

Science.gov (United States)

Bentley, Jacob A; Bruyère, Susanne M; LeBlanc, Jeanne; MacLachlan, Malcolm

2016-02-01

This article reviewed foundational principles in rehabilitation psychology and explored their application to global health imperatives as outlined in the World Report on Disability (World Health Organization & World Bank, 2011). Historical theories and perspectives are used to assist with conceptual formulation as applied to emerging international rehabilitation psychology topics. According to the World Report on Disability (World Health Organization & World Bank, 2011), there are approximately 1 billion individuals living with some form of disability globally. An estimated 80% of persons with disabilities live in low- to middle-income countries (WHO, 2006). The primary messages and recommendations of the World Report on Disability have been previously summarized as it relates to potential opportunities for contribution within the field of rehabilitation psychology (MacLachlan & Mannan, 2014). Yet, undeniable barriers remain to realizing the full potential for contributions in low- to middle-income country settings. A vision for engaging in international capacity building and public health efforts is needed within the field of rehabilitation psychology. Foundational rehabilitation psychology principles have application to the service of individuals with disabilities in areas of the world facing complex socioeconomic and sociopolitical challenges. Foundational principles of person-environment interaction, importance of social context, and need for involvement of persons with disabilities can provide guidance to the field as it relates to global health and rehabilitation efforts. The authors illustrate the application of rehabilitation psychology foundational principles through case examples and description of ongoing work, and link foundational principles to discreet domains of intervention going forward. (c) 2016 APA, all rights reserved).

User-centered virtual environment assessment and design for cognitive rehabilitation applications

Science.gov (United States)

Fidopiastis, Cali Michael

Virtual environment (VE) design for cognitive rehabilitation necessitates a new methodology to ensure the validity of the resulting rehabilitation assessment. We propose that benchmarking the VE system technology utilizing a user-centered approach should precede the VE construction. Further, user performance baselines should be measured throughout testing as a control for adaptive effects that may confound the metrics chosen to evaluate the rehabilitation treatment. To support these claims we present data obtained from two modules of a user-centered head-mounted display (HMD) assessment battery, specifically resolution visual acuity and stereoacuity. Resolution visual acuity and stereoacuity assessments provide information about the image quality achieved by an HMD based upon its unique system parameters. When applying a user-centered approach, we were able to quantify limitations in the VE system components (e.g., low microdisplay resolution) and separately point to user characteristics (e.g., changes in dark focus) that may introduce error in the evaluation of VE based rehabilitation protocols. Based on these results, we provide guidelines for calibrating and benchmarking HMDs. In addition, we discuss potential extensions of the assessment to address higher level usability issues. We intend to test the proposed framework within the Human Experience Modeler (HEM), a testbed created at the University of Central Florida to evaluate technologies that may enhance cognitive rehabilitation effectiveness. Preliminary results of a feasibility pilot study conducted with a memory impaired participant showed that the HEM provides the control and repeatability needed to conduct such technology comparisons. Further, the HEM affords the opportunity to integrate new brain imaging technologies (i.e., functional Near Infrared Imaging) to evaluate brain plasticity associated with VE based cognitive rehabilitation.

Towards Optimal Platform-Based Robot Design for Ankle Rehabilitation: The State of the Art and Future Prospects

Directory of Open Access Journals (Sweden)

Qing Miao

2018-01-01

Full Text Available This review aims to compare existing robot-assisted ankle rehabilitation techniques in terms of robot design. Included studies mainly consist of selected papers in two published reviews involving a variety of robot-assisted ankle rehabilitation techniques. A free search was also made in Google Scholar and Scopus by using keywords “ankle∗,” and “robot∗,” and (“rehabilitat∗” or “treat∗”. The search is limited to English-language articles published between January 1980 and September 2016. Results show that existing robot-assisted ankle rehabilitation techniques can be classified into wearable exoskeleton and platform-based devices. Platform-based devices are mostly developed for the treatment of a variety of ankle musculoskeletal and neurological injuries, while wearable ones focus more on ankle-related gait training. In terms of robot design, comparative analysis indicates that an ideal ankle rehabilitation robot should have aligned rotation center as the ankle joint, appropriate workspace, and actuation torque, no matter how many degrees of freedom (DOFs it has. Single-DOF ankle robots are mostly developed for specific applications, while multi-DOF devices are more suitable for comprehensive ankle rehabilitation exercises. Other factors including posture adjustability and sensing functions should also be considered to promote related clinical applications. An ankle rehabilitation robot with reconfigurability to maximize its functions will be a new research point towards optimal design, especially on parallel mechanisms.

Modeling and design of a tendon actuated soft robotic exoskeleton for hemiparetic upper limb rehabilitation.

Science.gov (United States)

Nycz, Christopher J; Delph, Michael A; Fischer, Gregory S

2015-01-01

Robotic technology has recently been explored as a means to rehabilitate and assist individuals suffering from hemiparesis of their upper limbs. Robotic approaches allow for targeted rehabilitation routines which are more personalized and adaptable while providing quantitative measurements of patient outcomes. Development of these technologies into inherently safe and portable devices has the potential to extend the therapy outside of the clinical setting and into the patient's home with benefits to the cost and accessibility of care. To this end, a soft, cable actuated robotic glove and sleeve was designed, modeled, and constructed to provide assistance of finger and elbow movements in a way that mimics the biological function of the tendons. The resulting design increases safety through greater compliance as well as greater tolerance for misalignment with the user's skeletal frame over traditional rigid exoskeletons. Overall this design provides a platform to expand and study the concepts around soft robotic rehabilitation.

Effects of physical guidance on short-term learning of walking on a narrow beam

OpenAIRE

Domingo, Antoinette; Ferris, Daniel P.

2009-01-01

Physical guidance is often used in rehabilitation when teaching patients to re-learn movements. However, the effects of guidance on motor learning of complex skills, such as walking balance, are not clear. We tested four groups of healthy subjects that practiced walking on a narrow (1.27 cm) or wide (2.5 cm) treadmill-mounted balance beam, with or without physical guidance. Assistance was given by springs attached to a hip belt that applied restoring forces towards beam center. Subjects were ...

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.

Rehabilitative Games for Stroke Patients

Directory of Open Access Journals (Sweden)

A. Pyae

2015-07-01

Full Text Available Stroke is one of the major problems in medical and healthcare that can cause severe disability and death of patients especially for older population. Rehabilitation plays an important role in stroke therapy. However, most of the rehabilitative exercises are monotonous and tiring for the patients. For a particular time, they can easily get bored in doing these exercises. The role of patient’s motivation in rehabilitation is vital. Motivation and rehabilitative outcomes are strongly related. Digital games promise to help stroke patients to feel motivated and more engaged in rehabilitative training through motivational gameplay. Most of the commercial games available in the market are not well-designed for stroke patients and their motivational needs in rehabilitation. This study aims at understanding the motivational requirements of stroke patients in doing rehabilitative exercises and living in a post-stroke life. Based on the findings from the literature review, we report factors that can influence the stroke patients’ level of motivation such as social functioning, patient-therapist relationship, goal-setting, and music. These findings are insightful and useful for ideating and designing interactive motivation-driven games for stroke patients. The motivational factors of stroke patients in rehabilitation may help the game designers to design motivation-driven game contexts, contents, and gameplay. Moreover, these findings may also help healthcare professionals who concern stroke patient’s motivation in rehabilitative context. In this paper, we reported our Virtual Nursing Home (VNH concept and the games that we are currently developing and re-designing. Based on this literature review, we will present and test out the ideas how we can integrate these motivational factors in our future game design, development, and enhancement.

Applying Human-performance Models to Designing and Evaluating Nuclear Power Plants: Review Guidance and Technical Basis

Energy Technology Data Exchange (ETDEWEB)

O' Hara, J.M.

2009-11-30

Human performance models (HPMs) are simulations of human behavior with which we can predict human performance. Designers use them to support their human factors engineering (HFE) programs for a wide range of complex systems, including commercial nuclear power plants. Applicants to U.S. Nuclear Regulatory Commission (NRC) can use HPMs for design certifications, operating licenses, and license amendments. In the context of nuclear-plant safety, it is important to assure that HPMs are verified and validated, and their usage is consistent with their intended purpose. Using HPMs improperly may generate misleading or incorrect information, entailing safety concerns. The objective of this research was to develop guidance to support the NRC staff's reviews of an applicant's use of HPMs in an HFE program. The guidance is divided into three topical areas: (1) HPM Verification, (2) HPM Validation, and (3) User Interface Verification. Following this guidance will help ensure the benefits of HPMs are achieved in a technically sound, defensible manner. During the course of developing this guidance, I identified several issues that could not be addressed; they also are discussed.

Applying Human-performance Models to Designing and Evaluating Nuclear Power Plants: Review Guidance and Technical Basis

International Nuclear Information System (INIS)

O'Hara, J.M.

2009-01-01

Human performance models (HPMs) are simulations of human behavior with which we can predict human performance. Designers use them to support their human factors engineering (HFE) programs for a wide range of complex systems, including commercial nuclear power plants. Applicants to U.S. Nuclear Regulatory Commission (NRC) can use HPMs for design certifications, operating licenses, and license amendments. In the context of nuclear-plant safety, it is important to assure that HPMs are verified and validated, and their usage is consistent with their intended purpose. Using HPMs improperly may generate misleading or incorrect information, entailing safety concerns. The objective of this research was to develop guidance to support the NRC staff's reviews of an applicant's use of HPMs in an HFE program. The guidance is divided into three topical areas: (1) HPM Verification, (2) HPM Validation, and (3) User Interface Verification. Following this guidance will help ensure the benefits of HPMs are achieved in a technically sound, defensible manner. During the course of developing this guidance, I identified several issues that could not be addressed; they also are discussed.

Guidance for Developing Principal Design Criteria for Advanced (Non-Light Water) Reactors

Energy Technology Data Exchange (ETDEWEB)

Holbrook, Mark [Idaho National Lab. (INL), Idaho Falls, ID (United States); Kinsey, Jim [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2015-03-01

In July 2013, the US Department of Energy (DOE) and US Nuclear Regulatory Commission (NRC) established a joint initiative to address a key portion of the licensing framework essential to advanced (non-light water) reactor technologies. The initiative addressed the “General Design Criteria for Nuclear Power Plants,” Appendix A to10 Code of Federal Regulations (CFR) 50, which were developed primarily for light water reactors (LWRs), specific to the needs of advanced reactor design and licensing. The need for General Design Criteria (GDC) clarifications in non-LWR applications has been consistently identified as a concern by the industry and varied stakeholders and was acknowledged by the NRC staff in their 2012 Report to Congress1 as an area for enhancement. The initiative to adapt GDC requirements for non-light water advanced reactor applications is being accomplished in two phases. Phase 1, managed by DOE, consisted of reviews, analyses and evaluations resulting in recommendations and deliverables to NRC as input for NRC staff development of regulatory guidance. Idaho National Laboratory (INL) developed this technical report using technical and reactor technology stakeholder inputs coupled with analysis and evaluations provided by a team of knowledgeable DOE national laboratory personnel with input from individual industry licensing consultants. The DOE national laboratory team reviewed six different classes of emerging commercial reactor technologies against 10 CFR 50 Appendix A GDC requirements and proposed guidance for their adapted use in non-LWR applications. The results of the Phase 1 analysis are contained in this report. A set of draft Advanced Reactor Design Criteria (ARDC) has been proposed for consideration by the NRC in the establishment of guidance for use by non-LWR designers and NRC staff. The proposed criteria were developed to preserve the underlying safety bases expressed by the original GDC, and recognizing that advanced reactors may take

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

Home-based versus hospital-based cardiac rehabilitation after myocardial infarction or revascularisation: design and rationale of the Birmingham Rehabilitation Uptake Maximisation Study (BRUM: a randomised controlled trial [ISRCTN72884263

Directory of Open Access Journals (Sweden)

Lane Deirdre

2003-09-01

Full Text Available Abstract Background Cardiac rehabilitation following myocardial infarction reduces subsequent mortality, but uptake and adherence to rehabilitation programmes remains poor, particularly among women, the elderly and ethnic minority groups. Evidence of the effectiveness of home-based cardiac rehabilitation remains limited. This trial evaluates the effectiveness and cost-effectiveness of home-based compared to hospital-based cardiac rehabilitation. Methods/design A pragmatic randomised controlled trial of home-based compared with hospital-based cardiac rehabilitation in four hospitals serving a multi-ethnic inner city population in the United Kingdom was designed. The home programme is nurse-facilitated, manual-based using the Heart Manual. The hospital programmes offer comprehensive cardiac rehabilitation in an out-patient setting. Patients We will randomise 650 adult, English or Punjabi-speaking patients of low-medium risk following myocardial infarction, coronary angioplasty or coronary artery bypass graft who have been referred for cardiac rehabilitation. Main outcome measures Serum cholesterol, smoking cessation, blood pressure, Hospital Anxiety and Depression Score, distance walked on Shuttle walk-test measured at 6, 12 and 24 months. Adherence to the programmes will be estimated using patient self-reports of activity. In-depth interviews with non-attendees and non-adherers will ascertain patient views and the acceptability of the programmes and provide insights about non-attendance and aims to generate a theory of attendance at cardiac rehabilitation. The economic analysis will measure National Health Service costs using resource inputs. Patient costs will be established from the qualitative research, in particular how they affect adherence. Discussion More data are needed on the role of home-based versus hospital-based cardiac rehabilitation for patients following myocardial infarction and revascularisation, which would be provided by the

Monitoring of Entrance Channel Navigation Improvements at Pentwater, Michigan, and Design Guidance for Pocket Wave Absorbers

National Research Council Canada - National Science Library

Thompson, Edward F; Myrick, Glenn B; Zager, Nicholas J; Bottin, Jr., Robert R; Sabol, Margaret A; Selegean, James P; McKinney, James P; Demirbilek, Zeki; Acuff, Jr, Hugh F

2006-01-01

.... The objectives of the monitoring effort at Pentwater Harbor were to evaluate the design of existing pocket wave absorbers and to develop better design guidance for future pocket wave absorber projects...

78 FR 27038 - Final Priorities; National Institute on Disability and Rehabilitation Research-Rehabilitation...

Science.gov (United States)

2013-05-09

... settings, including the community, rehabilitation service- delivery institutions, vocational rehabilitation...) Vocational rehabilitation (VR) practices that contribute to improved employment outcomes for individuals with... or more priorities, we designate the type of each priority as absolute, competitive preference, or...

Measure Guideline: Window Repair, Rehabilitation, and Replacement

Energy Technology Data Exchange (ETDEWEB)

Baker, P.

2012-12-01

This measure guideline provides information and guidance on rehabilitating, retrofitting, and replacing existing window assemblies in residential construction. The intent is to provide information regarding means and methods to improve the energy and comfort performance of existing wood window assemblies in a way that takes into consideration component durability, in-service operation, and long term performance of the strategies.

A novel method for designing and optimizing the layout of facilities in bathroom for the elderly in home-based rehabilitation.

Science.gov (United States)

Wang, Duojin; Wu, Jing; Lin, Qinglian

2018-05-01

The home-based rehabilitation of elderly patients improves their autonomy, independence and reintegration into society. Hence, a suitable environment plays an important role in rehabilitation, as do different assistance technologies. The majority of accidents at home involving elderly people occur in the bathroom. Therefore, the planning of the layout of facilities is important in this potentially dangerous area. This paper proposes an approach towards designing and optimizing the layout of facilities in the bathroom, based on logistical and nonlogistical relationships. A fuzzy-based analytical hierarchical process (fuzzy-AHP) is then proposed for a comprehensive evaluation of the alternatives for this layout plan. This approach was applied to the home of a 71 years old female patient, who was experiencing home-based rehabilitation. After the initial designing and optimizing of the layout of the facilities in her bathroom, a plan could then be created for her particular needs. The results of this research could then enable the home-based rehabilitation of elderly patients to be more effective. Value: This paper develops a new approach to design and optimize the layout of facilities in bathroom for the elderly. Implications for Rehabilitation Develop a new approach to design and optimize the layout of facilities in bathroom. Provide a mathematical and more scientific approach to home layout design for home-based rehabilitation. Provide new opportunities for research, for both the therapist and the patient to analyse the home facility layout.

Mechanical design of EFW Exo II: A hybrid exoskeleton for elbow-forearm-wrist rehabilitation.

Science.gov (United States)

Bian, Hui; Chen, Ziye; Wang, Hao; Zhao, Tieshi

2017-07-01

The use of rehabilitation exoskeleton has become an important means for the treatment of stroke patients. A hybrid exoskeleton named EFW Exo II is developed for the motor function rehabilitation of elbow, forearm and wrist. The EFW Exo II is based on a parallel 2-URR/RRS mechanism and a serial R mechanism. It could fit both left and right arms for the symmetrical and open structure, and the distance between the elbow and wrist could automatically adjust for different forearm length. Details of the mechanical design are introduced. Brushless DC servo motors with planetary gear reducer are used as the actuators of the exoskeleton. Gear drive and belt drive are used for power transmission. A three dimensional force sensor is mounted in the handle to regulate the interaction between the exoskeleton and patient. The EFW Exo II can realize rehabilitation exercise for each joint and the ranges of motion meet the rehabilitation demands of daily living.

An Overview of the Application of Human Factors Guidance to Control Room Design

International Nuclear Information System (INIS)

Yondola, Paul R.; Karlewicz, George T.

2002-01-01

A new power plant design has the goal of making major improvements in cost and ease of operation over previous designs. Improvements in the way information is organized and presented to control room operators based on established Human Factors Engineering (HFE) criteria is key to achieving these goals. An overview of the process and methods being employed in an ongoing design effort will be discussed, including the ways in which current Human Factors guidance is being applied in a unique operating environment

[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.

Measure Guideline. Wood Window Repair, Rehabilitation, and Replacement

Energy Technology Data Exchange (ETDEWEB)

Baker, P. [Building Science Corporation, Somerville, MA (United States); Eng, P. [Building Science Corporation, Somerville, MA (United States)

2012-12-01

This measure guideline provides information and guidance on rehabilitating, retrofitting, and replacing existing window assemblies in residential construction. The intent is to provide information regarding means and methods to improve the energy and comfort performance of existing wood window assemblies in a way that takes into consideration component durability, in-service operation, and long term performance of the strategies.

77 FR 9946 - Draft Guidance for Industry on Drug Interaction Studies-Study Design, Data Analysis, Implications...

Science.gov (United States)

2012-02-21

... industry entitled ``Drug Interaction Studies--Study Design, Data Analysis, Implications for Dosing, and... data analysis in the context of identifying potential drug interactions. The guidance also addresses... Studies--Study Design, Data Analysis, and Implications for Dosing and Labeling.'' Comments were received...

Type synthesis and preliminary design of devices supporting lower limb's rehabilitation.

Science.gov (United States)

Olinski, Michał; Lewandowski, Bogusz; Gronowicz, Antoni

2015-01-01

Based on the analysis of existing solutions, biomechanics of human lower limbs and anticipated applications, results of con- siderations concerning the necessary number of degrees of freedom for the designed device supporting rehabilitation of lower extremities are presented. An analysis was carried out in order to determine the innovative kinematic structure of the device, ensuring sufficient mobility and functionality while minimizing the number of degrees of freedom. With the aid of appropriate formalised meth- ods, for instance, type synthesis, a complete variety of solutions for leg joints were obtained in the form of basic and kinematic schemes, having the potential to find application in devices supporting lower limb rehabilitation. A 3D model of ankle joint module was built in Autodesk Inventor System, then imported to Adams and assembled into a moving numerical model of a mechanism. Several conducted simulations resulted in finding the required maximum stroke of the cylinders. A comparison of the angular ranges of ankle joint and similar devices with the ones achieved by the designed device indicated a sufficient reserve allowing not only movements typical of gait, but approximately achieving the passive range of motion for the ankle joint.

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...

Rehabilitation of pure alexia

DEFF Research Database (Denmark)

Starrfelt, Randi; Ólafsdóttir, Rannveig Rós; Arendt, Ida-Marie

2013-01-01

that pure alexia was an easy target for rehabilitation efforts. We review the literature on rehabilitation of pure alexia from 1990 to the present, and find that patients differ widely on several dimensions like alexia severity, and associated deficits. Many patients reported to have pure alexia......-designed and controlled studies of rehabilitation of pure alexia....

Armenia - Rural Road Rehabilitation

Data.gov (United States)

Millennium Challenge Corporation — The key research questions guiding our design of the RRRP evaluation are: • Did rehabilitating roads affect the quality of roads? • Did rehabilitating roads improve...

The effect of a rehabilitation nursing intervention model on improving the comprehensive health status of patients with hand burns.

Science.gov (United States)

Li, Lin; Dai, Jia-Xi; Xu, Le; Huang, Zhen-Xia; Pan, Qiong; Zhang, Xi; Jiang, Mei-Yun; Chen, Zhao-Hong

2017-06-01

To observe the effect of a rehabilitation intervention on the comprehensive health status of patients with hand burns. Most studies of hand-burn patients have focused on functional recovery. There have been no studies involving a biological-psychological-social rehabilitation model of hand-burn patients. A randomized controlled design was used. Patients with hand burns were recruited to the study, and sixty patients participated. Participants were separated into two groups: (1) The rehabilitation intervention model group (n=30) completed the rehabilitation intervention model, which included the following measures: enhanced social support, intensive health education, comprehensive psychological intervention, and graded exercise. (2) The control group (n=30) completed routine treatment. Intervention lasted 5 weeks. Analysis of variance (ANOVA) and Student's t test were conducted. The rehabilitation intervention group had significantly better scores than the control group for comprehensive health, physical function, psychological function, social function, and general health. The differences between the index scores of the two groups were statistically significant. The rehabilitation intervention improved the comprehensive health status of patients with hand burns and has favorable clinical application. The comprehensive rehabilitation intervention model used here provides scientific guidance for medical staff aiming to improve the integrated health status of hand-burn patients and accelerate their recovery. What does this paper contribute to the wider global clinical community? Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Effect of Rehabilitation Technology Services on Vocational Rehabilitation Outcomes of Individuals with Multiple Sclerosis

Science.gov (United States)

Chiu, Chung-Yi; Tansey, Timothy N.; Chan, Fong; Strauser, David; Frain, Michael P.; Arora, Simran

2015-01-01

Objectives: To examine the effect of rehabilitation technology interventions on the employment or job retention outcomes of individuals with multiple sclerosis (MS) served by the state-federal vocational rehabilitation program using a case-control study design. Participants: Data for this study were extracted from the Rehabilitation Services…

[Diagnossis and treatment of complicated anterior teeth esthetic defects by combination of whole-process digital esthetic rehabilitation with periodontic surgery].

Science.gov (United States)

Li, Z; Liu, Y S; Ye, H Q; Liu, Y S; Hu, W J; Zhou, Y S

2017-02-18

To explore a new method of whole-process digital esthetic prosthodontic rehabilitation combined with periodontic surgery for complicated anterior teeth esthetic defects accompanied by soft tissue morphology, to provide an alternative choice for solving this problem under the guidance of three-dimensional (3D) printing digital dental model and surgical guide, thus completing periodontic surgery and digital esthetic rehabilitation of anterior teeth. In this study, 12 patients with complicated esthetic problems accompanied by soft tissue morphology in their anterior teeth were included. The dentition and facial images were obtained by intra-oral scanning and three-dimensional (3D) facial scanning and then calibrated. Two esthetic designs and prosthodontic outcome predictions were created by computer aided design /computer aided manufacturing (CAD/CAM) software combined with digital photography, including consideration of white esthetics and comprehensive consideration of pink-white esthetics. The predictive design of prostheses and the facial appearances of the two designs were evaluated by the patients. If the patients chose the design of comprehensive consideration of pink-white esthetics, they would choose whether they would receive periodontic surgery before esthetic rehabilitation. The dentition design cast of those who chose periodontic surgery would be 3D printed for the guide of periodontic surgery accordingly. In light of the two digital designs based on intra-oral scanning, facing scanning and digital photography, the satisfaction rate of the patients was significantly higher for the comprehensive consideration of pink-white esthetic design (Pesthetic rehabilitation. The 3D printed digital dental model and surgical guide provided significant instructions for periodontic surgery, and achieved success transfer from digital design to clinical application. The prostheses were fabricated by CAD/CAM, thus realizing the whole-process digital esthetic rehabilitation

Stillness design attributes in non-formal rehabilitation

DEFF Research Database (Denmark)

Brooks, Tony; Petersson, Eva

2007-01-01

Non-invasive sensor technology is used as an interface to a computer system to collect physical movement data that controls elements of a virtual environment. The environment is used for rehabilitation training i.e. physiological learning, for people with profound disabilities, and often no verba...... zones for this targeted community have been subject to limited exposure. This paper describes how these zones are used in rehabilitation training. Findings are presented from the established SoundScapes body of research that has existed for two decades....

Spoil dump design and rehabilitation management practices (Australia)

International Nuclear Information System (INIS)

Goh, E.K.H.; Aspinall, T.O.; Kuszmaul, J.S.

1998-01-01

The environmental impact of mining and evolving environmental legislation has been receiving increased attention worldwide in the last two decades. The potential impacts associated with unstable spoil dumps from mine operations is the focus of concern both by the mining industry, environmental legislative agencies and members of the public. Engineered slopes of mine spoils may be stable at the end of construction, but they can deteriorate over time. There is thus the need to increase the base of knowledge on the existing practices of spoil dump design and rehabilitation. Information concluded from the analysis of the industrial survey carried out on Australian spoil dump management practices at coal, gold and ore mines are presented in this paper. The questionnaire asked for details of soil type of spoils, and factors influencing the design of spoil dumps (climate, rate of erosion, height of dumps, slope gradient and length, overburden handling equipment, soil characteristics, legislation and wastes). 10 refs., 5 figs., 5 tabs

[Principles and methodology for ecological rehabilitation and security pattern design in key project construction].

Science.gov (United States)

Chen, Li-Ding; Lu, Yi-He; Tian, Hui-Ying; Shi, Qian

2007-03-01

Global ecological security becomes increasingly important with the intensive human activities. The function of ecological security is influenced by human activities, and in return, the efficiency of human activities will also be affected by the patterns of regional ecological security. Since the 1990s, China has initiated the construction of key projects "Yangtze Three Gorges Dam", "Qinghai-Tibet Railway", "West-to-East Gas Pipeline", "West-to-East Electricity Transmission" and "South-to-North Water Transfer" , etc. The interaction between these projects and regional ecological security has particularly attracted the attention of Chinese government. It is not only important for the regional environmental protection, but also of significance for the smoothly implementation of various projects aimed to develop an ecological rehabilitation system and to design a regional ecological security pattern. This paper made a systematic analysis on the types and characteristics of key project construction and their effects on the environment, and on the basis of this, brought forward the basic principles and methodology for ecological rehabilitation and security pattern design in this construction. It was considered that the following issues should be addressed in the implementation of a key project: 1) analysis and evaluation of current regional ecological environment, 2) evaluation of anthropogenic disturbances and their ecological risk, 3) regional ecological rehabilitation and security pattern design, 4) scenario analysis of environmental benefits of regional ecological security pattern, 5) re-optimization of regional ecological system framework, and 6) establishment of regional ecosystem management plan.

Onboard guidance system design for reusable launch vehicles in the terminal area energy management phase

Science.gov (United States)

Mu, Lingxia; Yu, Xiang; Zhang, Y. M.; Li, Ping; Wang, Xinmin

2018-02-01

A terminal area energy management (TAEM) guidance system for an unpowered reusable launch vehicle (RLV) is proposed in this paper. The mathematical model representing the RLV gliding motion is provided, followed by a transformation of extracting the required dynamics for reference profile generation. Reference longitudinal profiles are conceived based on the capability of maximum dive and maximum glide that a RLV can perform. The trajectory is obtained by iterating the motion equations at each node of altitude, where the angle of attack and the flight-path angle are regarded as regulating variables. An onboard ground-track predictor is constructed to generate the current range-to-go and lateral commands online. Although the longitudinal profile generation requires pre-processing using the RLV aerodynamics, the ground-track prediction can be executed online. This makes the guidance scheme adaptable to abnormal conditions. Finally, the guidance law is designed to track the reference commands. Numerical simulations demonstrate that the proposed guidance scheme is capable of guiding the RLV to the desired touchdown conditions.

Human Factors Guidance for Control Room and Digital Human-System Interface Design and Modification, Guidelines for Planning, Specification, Design, Licensing, Implementation, Training, Operation and Maintenance

Energy Technology Data Exchange (ETDEWEB)

R. Fink, D. Hill, J. O' Hara

2004-11-30

Nuclear plant operators face a significant challenge designing and modifying control rooms. This report provides guidance on planning, designing, implementing and operating modernized control rooms and digital human-system interfaces.

Human Factors Guidance for Control Room and Digital Human-System Interface Design and Modification. Guidelines for Planning, Specification, Design, Licensing, Implementation, Training, Operation and Maintenance

International Nuclear Information System (INIS)

Fink, R.; Hill, D.; O'Hara, J.

2004-01-01

Nuclear plant operators face a significant challenge designing and modifying control rooms. This report provides guidance on planning, designing, implementing and operating modernized control rooms and digital human-system interfaces

On the design of multi-rate tracking controllers : application to rotorcraft guidance and control

NARCIS (Netherlands)

Guerreiro Tome Antunes, D.J.; Silvestre, C.J.; Cunha, R.

2010-01-01

This paper presents a new methodology for the design and implementation of gain-scheduled controllers for multi-rate systems. The proposed methodology provides a natural way to address the integrated guidance and control problem for autonomous vehicles when the outputs are sampled at different

Home-based tele-assisted robotic rehabilitation of joint impairments in children with cerebral palsy.

Science.gov (United States)

Chen, Kai; Ren, Yupeng; Gaebler-Spira, Deborah; Zhang, Li-Qun

2014-01-01

A portable rehabilitation robot incorporating intelligent stretching, robot-guided voluntary movement training with motivating games and tele-rehabilitation was developed to provide convenient and cost-effective rehabilitation to children with cerebral palsy (CP) and extend rehabilitation care beyond hospital. Clinicians interact with the patients remotely for periodic evaluations and updated guidance. The tele-assisted stretching and active movement training was done over 6-week 18 sessions on the impaired ankle of 23 children with CP in their home setting. Treatment effectiveness was evaluated using biomechanical measures and clinical outcome measures. After the tele-assisted home robotic rehabilitation intervention, there were significant increases in the ankle passive and active range of motion, muscle strength, a decrease in spasticity, and increases in balance and selective control assessment of lower-extremity.

Improving self-efficacy in spinal cord injury patients through "design thinking" rehabilitation workshops.

Science.gov (United States)

Wolstenholme, Daniel; Downes, Tom; Leaver, Jackie; Partridge, Rebecca; Langley, Joseph

2014-01-01

Advances in surgical and medical management have significantly reduced the length of time that patients with spinal cord injury (SCI) have to stay in hospital, but has left patients with potentially less time to psychologically adjust. Following a pilot in 2012, this project was designed to test the effect of "design thinking" workshops on the self-efficacy of people undergoing rehabilitation following spinal injuries. Design thinking is about understanding the approaches and methods that designers use and then applying these to think creatively about problems and suggest ways to solve them. In this instance, design thinking is not about designing new products (although the approaches can be used to do this) but about developing a long term creative and explorative mind-set through skills such as lateral thinking, prototyping and verbal and visual communication. The principles of "design thinking" have underpinned design education and practice for many years, it is also recognised in business and innovation for example, but a literature review indicated that there was no evidence of it being used in rehabilitation or spinal injury settings. Twenty participants took part in the study; 13 (65%) were male and the average age was 37 years (range 16 to 72). Statistically significant improvements were seen for EQ-5D score (t = -3.13, p = 0.007) and Patient Activation Measure score (t = -3.85, p = 0.001). Other outcome measures improved but not statistically. There were no statistical effects on length of stay or readmission rates, but qualitative interviews indicated improved patient experience.

Usability Test of Exercise Games Designed for Rehabilitation of Elderly Patients After Hip Replacement Surgery: Pilot Study

Science.gov (United States)

Ter Meer, Louis P; Yumak, Zerrin; Veltkamp, Remco C

2017-01-01

Background Patients who receive rehabilitation after hip replacement surgery are shown to have increased muscle strength and better functional performance. However, traditional physiotherapy is often tedious and leads to poor adherence. Exercise games, provide ways for increasing the engagement of elderly patients and increase the uptake of rehabilitation exercises. Objective The objective of this study was to evaluate Fietsgame (Dutch for cycling game), which translates existing rehabilitation exercises into fun exercise games. The system connects exercise games with a patient’s personal record and a therapist interface by an Internet of Things server. Thus, both the patient and physiotherapist can monitor the patient’s medical status. Methods This paper describes a pilot study that evaluates the usability of the Fietsgame. The study was conducted in a rehabilitation center with 9 participants, including 2 physiotherapists and 7 patients. The patients were asked to play 6 exercise games, each lasting about 5 min, under the guidance of a physiotherapist. The mean age of the patients was 74.57 years (standard deviation [SD] 8.28); all the patients were in the recovery process after hip surgery. Surveys were developed to quantitatively measure the usability factors, including presence, enjoyment, pain, exertion, and technology acceptance. Comments on advantages and suggested improvements of our game system provided by the physiotherapists and patients were summarized and their implications were discussed. Results The results showed that after successfully playing the games, 75% to 100% of the patients experienced high levels of enjoyment in all the games except the squats game. Patients reported the highest level of exertion in squats when compared with other exercise games. Lunges resulted in the highest dropout rate (43%) due to interference with the Kinect v2 from support chairs. All the patients (100%) found the game system useful and easy to use, felt that

Maxillary arch rehabilitation using implant-supported computer-assisted design-computer-assisted manufacturing-milled titanium framework

Directory of Open Access Journals (Sweden)

Tulika S Khanna

2017-01-01

Full Text Available Esthetic and functional rehabilitation of completely edentulous maxillary arch with fixed implant supported prosthesis is a challenging task. Newer technologies such as computer assisted design computer assisted manufacturing (CAD CAM and cone beam conventional tomography play an important role in achieving predictable results. Full mouth porcelain fused to metal (PFM individual crowns on CAD CAM milled titanium framework provides positive esthetic and functional outcome. This is a case report of rehabilitation of partially edentulous maxillary arch patient. Staged rehabilitation of this patient was planned. In the first stage, root canal treatment of key abutment teeth was done, nonsalvageable teeth were removed, and immediate interim overdenture was provided. In the second stage, five Nobel Biocare dental implants were placed. After integration impressions were made, CAD CAM milled titanium bar was fabricated. Individual PFM crowns were made and cemented. This method gives better esthetic compared to acrylic fused to metal hybrid prosthesis with the advantage of retrievability just like screw retained prosthesis. Hence, this technique is good for rehabilitation of patients with high esthetic demands.

Finding an optimal rehabilitation paradigm after stroke: Enhancing fiber growth and training of the brain at the right moment

Directory of Open Access Journals (Sweden)

Anna-Sophia eWahl

2014-06-01

Full Text Available After stroke the central nervous system reveals a spectrum of intrinsic capacities to react as a highly dynamic system which can change the properties of its circuits, form new contacts, erase others, and remap related cortical and spinal cord regions. This plasticity can lead to a surprising degree of spontaneous recovery. It includes the activation of neuronal molecular mechanisms of growth and of extrinsic growth promoting factors and guidance signals in the tissue. Rehabilitative training and pharmacological interventions may modify and boost these neuronal processes, but almost nothing is known on the optimal timing of the different processes and therapeutic interventions and on their detailed interactions. Finding optimal rehabilitation paradigms requires an optimal orchestration of the internal processes of re‐organization and the therapeutic interventions in accordance with defined plastic time windows.In this review we summarize the mechanisms of spontaneous plasticity after stroke and experimental interventions to enhance growth and plasticity, with an emphasis on anti‐Nogo‐A immunotherapy. We highlight critical time windows of growth and of rehabilitative training and consider different approaches of combinatorial rehabilitative schedules. Finally, we discuss potential future strategies for designing repair and rehabilitation paradigms by introducing a 3 step model: determination of the metabolic and plastic status of the brain, pharmacological enhancement of its plastic mechanisms, and stabilization of newly formed functional connections by rehabilitative training.

An esthetics rehabilitation with computer-aided design/ computer-aided manufacturing technology.

Science.gov (United States)

Mazaro, Josá Vitor Quinelli; de Mello, Caroline Cantieri; Zavanelli, Adriana Cristina; Santiago, Joel Ferreira; Amoroso, Andressa Paschoal; Pellizzer, Eduardo Piza

2014-07-01

This paper describes a case of a rehabilitation involving Computer Aided Design/Computer Aided Manufacturing (CAD-CAM) system in implant supported and dental supported prostheses using zirconia as framework. The CAD-CAM technology has developed considerably over last few years, becoming a reality in dental practice. Among the widely used systems are the systems based on zirconia which demonstrate important physical and mechanical properties of high strength, adequate fracture toughness, biocompatibility and esthetics, and are indicated for unitary prosthetic restorations and posterior and anterior framework. All the modeling was performed by using CAD-CAM system and prostheses were cemented using resin cement best suited for each situation. The rehabilitation of the maxillary arch using zirconia framework demonstrated satisfactory esthetic and functional results after a 12-month control and revealed no biological and technical complications. This article shows the important of use technology CAD/CAM in the manufacture of dental prosthesis and implant-supported.

Rehabilitation after total joint replacement: a scoping study.

Science.gov (United States)

L Snell, Deborah; Hipango, Julia; Sinnott, K Anne; Dunn, Jennifer A; Rothwell, Alastair; Hsieh, C Jean; DeJong, Gerben; Hooper, Gary

2018-07-01

The evidence supporting rehabilitation after joint replacement, while vast, is of variable quality making it difficult for clinicians to apply the best evidence to their practice. We aimed to map key issues for rehabilitation following joint replacement, highlighting potential avenues for new research. We conducted a scoping study including research published between January 2013 and December 2016, evaluating effectiveness of rehabilitation following hip and knee total joint replacement. We reviewed this work in the context of outcomes described from previously published research. Thirty individual studies and seven systematic reviews were included, with most research examining the effectiveness of physiotherapy-based exercise rehabilitation after total knee replacement using randomized control trial methods. Rehabilitation after hip and knee replacement whether carried out at the clinic or monitored at home, appears beneficial but type, intensity and duration of interventions were not consistently associated with outcomes. The burden of comorbidities rather than specific rehabilitation approach may better predict rehabilitation outcome. Monitoring of recovery and therapeutic attention appear important but little is known about optimal levels and methods required to maximize outcomes. More work exploring the role of comorbidities and key components of therapeutic attention and the therapy relationship, using a wider range of study methods may help to advance the field. Implications for Rehabilitation Physiotherapy-based exercise rehabilitation after total hip replacement and total knee replacement, whether carried out at the clinic or monitored at home, appears beneficial. Type, intensity, and duration of interventions do not appear consistently associated with outcomes. Monitoring a patient's recovery appears to be an important component. The available research provides limited guidance regarding optimal levels of monitoring needed to achieve gains following hip

Design of a robotic gait trainer using spring over muscle actuators for ankle stroke rehabilitation.

Science.gov (United States)

Bharadwaj, Kartik; Sugar, Thomas G; Koeneman, James B; Koeneman, Edward J

2005-11-01

Repetitive task training is an effective form of rehabilitation for people suffering from debilitating injuries of stroke. We present the design and working concept of a robotic gait trainer (RGT), an ankle rehabilitation device for assisting stroke patients during gait. Structurally based on a tripod mechanism, the device is a parallel robot that incorporates two pneumatically powered, double-acting, compliant, spring over muscle actuators as actuation links which move the ankle in dorsiflex ion/plantarflexion and inversion/eversion. A unique feature in the tripod design is that the human anatomy is part of the robot, the first fixed link being the patient's leg. The kinematics and workspace of the tripod device have been analyzed determining its range of motion. Experimental gait data from an able-bodied person wearing the working RGT prototype are presented.

An Evaluation of the Design and Usability of a Novel Robotic Bilateral Arm Rehabilitation Device for Patients with Stroke

Directory of Open Access Journals (Sweden)

Yu-Cheng Pei

2017-07-01

Full Text Available Study designCase series.Evidence levelIV (case series.IntroductionRobot-assisted therapy for upper limb rehabilitation is an emerging research topic and its design process must integrate engineering, neurological pathophysiology, and clinical needs.Purpose of the studyThis study developed/evaluated the usefulness of a novel rehabilitation device, the MirrorPath, designed for the upper limb rehabilitation of patients with hemiplegic stroke.MethodsThe process follows Tseng’s methodology for innovative product design and development, namely two stages, device development and usability assessment. During the development process, the design was guided by patients’ rehabilitation needs as defined by patients and their therapists. The design applied synchronic movement of the bilateral upper limbs, an approach that is compatible with the bilateral movement therapy and proprioceptive neuromuscular facilitation theories. MirrorPath consists of a robotic device that guides upper limb movement linked to a control module containing software controlling the robotic movement.ResultsFive healthy subjects were recruited in the pretest, and 4 patients, 4 caregivers, and 4 therapists were recruited in the formal test for usability. All recruited subjects were allocated to the test group, completed the evaluation, and their data were all analyzed. The total system usability scale score obtained from the patients, caregivers, and therapists was 71.8 ± 11.9, indicating a high level of usability and product acceptance.Discussion and conclusionFollowing a standard development process, we could yield a design that meets clinical needs. This low-cost device provides a feasible platform for carrying out robot-assisted bilateral movement therapy of patients with hemiplegic stroke.Clinical Trial Registrationidentifier NCT02698605.

Design Guidance for Computer-Based Procedures for Field Workers

Energy Technology Data Exchange (ETDEWEB)

Oxstrand, Johanna [Idaho National Lab. (INL), Idaho Falls, ID (United States); Le Blanc, Katya [Idaho National Lab. (INL), Idaho Falls, ID (United States); Bly, Aaron [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2016-09-01

on other sources of additional information to ensure a functional and accurate understanding of the current plant status (Converse, 1995; Fink, Killian, Hanes, and Naser, 2009; Le Blanc, Oxstrand, and Waicosky, 2012). This report provides design guidance to be used when designing the human-system interaction and the design of the graphical user interface for a CBP system. The guidance is based on human factors research related to the design and usability of CBPs conducted by Idaho National Laboratory, 2012 - 2016.

A bio-inspired design of a hand robotic exoskeleton for rehabilitation

Science.gov (United States)

Ong, Aira Patrice R.; Bugtai, Nilo T.

2018-02-01

This paper presents the methodology for the design of a five-degree of freedom wearable robotic exoskeleton for hand rehabilitation. The design is inspired by the biological structure and mechanism of the human hand. One of the distinct features of the device is the cable-driven actuation, which provides the flexion and extension motion. A prototype of the orthotic device has been developed to prove the model of the system and has been tested in a 3D printed mechanical hand. The result showed that the proposed device was consistent with the requirements of bionics and was able to demonstrate the flexion and extension of the system.

75 FR 8968 - Draft Guidance for Industry on Adaptive Design Clinical Trials for Drugs and Biologics; Availability

Science.gov (United States)

2010-02-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2010-D-0090] Draft Guidance for Industry on Adaptive Design Clinical Trials for Drugs and Biologics; Availability... familiar and less familiar approaches. As more experience is obtained with the less familiar designs...

Non-cable vehicle guidance

Energy Technology Data Exchange (ETDEWEB)

Daugela, G.C.; Willott, A.M.; Chopiuk, R.G.; Thornton, S.E.

1988-06-01

The purpose is to determine the most promising driverless mine vehicle guidance systems that are not dependent on buried cables, and to plan their development. The project is presented in two phases: a preliminary study and literature review to determine whether suitable technologies exist to justify further work; and an in-depth assessment and selection of technologies for vehicle guidance. A large number of guidance elements are involved in a completely automated vehicle. The technologies that hold the best potential for development of guidance systems for mine vehicles are ultrasonics, radar, lasers, dead reckoning, and guidance algorithms. The best approach to adaptation of these technologies is on a step by step basis. Guidance modules that are complete in themselves and are designed to be integrated with other modules can provide short term benefits. Two modules are selected for development: the dragline operations monitor and automated machine control for optimized mining (AMCOM). 99 refs., 20 figs., 40 tabs.

The contribution of case study design to supporting research on Clubhouse psychosocial rehabilitation.

Science.gov (United States)

Raeburn, Toby; Schmied, Virginia; Hungerford, Catherine; Cleary, Michelle

2015-10-01

Psychosocial Clubhouses provide recovery-focused psychosocial rehabilitation to people with serious mental illness at over 300 sites in more than 30 countries worldwide. To deliver the services involved, Clubhouses employ a complex mix of theory, programs and relationships, with this complexity presenting a number of challenges to those undertaking Clubhouse research. This paper provides an overview of the usefulness of case study designs for Clubhouse researchers; and suggests ways in which the evaluation of Clubhouse models can be facilitated. The paper begins by providing a brief explanation of the Clubhouse model of psychosocial rehabilitation, and the need for ongoing evaluation of the services delivered. This explanation is followed by an introduction to case study design, with consideration given to the way in which case studies have been used in past Clubhouse research. It is posited that case study design provides a methodological framework that supports the analysis of either quantitative, qualitative or a mixture of both types of data to investigate complex phenomena in their everyday contexts, and thereby support the development of theory. As such, case study approaches to research are well suited to the Clubhouse environment. The paper concludes with recommendations for future Clubhouse researchers who choose to employ a case study design. While the quality of case study research that explores Clubhouses has been variable in the past, if applied in a diligent manner, case study design has a valuable contribution to make in future Clubhouse research.

Constituent aspects of workplace guidance in secondary VET

NARCIS (Netherlands)

Swager, Robert; Klarus, Ruud; Van Merriënboer, Jeroen; Nieuwenhuis, Loek

2018-01-01

Purpose – This paper aims to present an integrated model of workplace guidance to enhance awareness of what constitutes good guidance, to improve workplace guidance practices in vocational education and training. Design/methodology/approach – To identify constituent aspects of workplace guidance,

Reliability of computer designed surgical guides in six implant rehabilitations with two years follow-up.

Science.gov (United States)

Giordano, Mauro; Ausiello, Pietro; Martorelli, Massimo; Sorrentino, Roberto

2012-09-01

To evaluate the reliability and accuracy of computer-designed surgical guides in osseointegrated oral implant rehabilitation. Six implant rehabilitations, with a total of 17 implants, were completed with computer-designed surgical guides, performed with the master model developed by muco-compressive and muco-static impressions. In the first case, the surgical guide had exclusively mucosal support, in the second case exclusively dental support. For all six cases computer-aided surgical planning was performed by virtual analyses with 3D models obtained by dental scan DICOM data. The accuracy and stability of implant osseointegration over two years post surgery was then evaluated with clinical and radiographic examinations. Radiographic examination, performed with digital acquisitions (RVG - Radio Video graph) and parallel techniques, allowed two-dimensional feedback with a margin of linear error of 10%. Implant osseointegration was recorded for all the examined rehabilitations. During the clinical and radiographic post-surgical assessments, over the following two years, the peri-implant bone level was found to be stable and without appearance of any complications. The margin of error recorded between pre-operative positions assigned by virtual analysis and the post-surgical digital radiographic observations was as low as 0.2mm. Computer-guided implant surgery can be very effective in oral rehabilitations, providing an opportunity for the surgeon: (a) to avoid the necessity of muco-periosteal detachments and then (b) to perform minimally invasive interventions, whenever appropriate, with a flapless approach. Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Trends in the design of nerve guidance channels in peripheral nerve tissue engineering.

Science.gov (United States)

Chiono, Valeria; Tonda-Turo, Chiara

2015-08-01

The current trend of peripheral nerve tissue engineering is the design of advanced nerve guidance channels (NGCs) acting as physical guidance for regeneration of nerves across lesions. NGCs should present multifunctional properties aiming to direct the sprouting of axons from the proximal nerve end, to concentrate growth factors secreted by the injured nerve ends, and to reduce the ingrowth of scar tissue into the injury site. A critical aspect in the design of NGCs is conferring them the ability to provide topographic, chemotactic and haptotactic cues that lead to functional nerve regeneration thus increasing the axon growth rate and avoiding or minimizing end-organ (e.g. muscle) atrophy. The present work reviews the recent state of the art in NGCs engineering and defines the external guide and internal fillers structural and compositional requirements that should be satisfied to improve nerve regeneration, especially in the case of large gaps (>2 cm). Techniques for NGCs fabrication were described highlighting the innovative approaches direct to enhance the regeneration of axon stumps compared to current clinical treatments. Furthermore, the possibility to apply stem cells as internal cues to the NGCs was discussed focusing on scaffold properties necessary to ensure cell survival. Finally, the optimized features for NGCs design were summarized showing as multifunctional cues are needed to produce NGCs having improved results in clinics. Copyright © 2015 Elsevier Ltd. All rights reserved.

Risk-informed design guidance for future reactor systems

International Nuclear Information System (INIS)

Delaney, Michael J.; Apostolakis, George E.; Driscoll, Michael J.

2005-01-01

Future reactor designs face an uncertain regulatory environment. It is anticipated that there will be some level of probabilistic insights in the regulations and supporting regulatory documents for Generation-IV nuclear reactors. Central to current regulations are design basis accidents (DBAs) and the general design criteria (GDC), which were established before probabilistic risk assessments (PRAs) were developed. These regulations implement a structuralist approach to safety through traditional defense in depth and large safety margins. In a rationalist approach to safety, accident frequencies are quantified and protective measures are introduced to make these frequencies acceptably low. Both approaches have advantages and disadvantages and future reactor design and licensing processes will have to implement a hybrid approach. This paper presents an iterative four-step risk-informed methodology to guide the design of future-reactor systems using a gas-cooled fast reactor emergency core cooling system as an example. This methodology helps designers to analyze alternative designs under potential risk-informed regulations and to anticipate design justifications the regulator may require during the licensing process. The analysis demonstrated the importance of common-cause failures and the need for guidance on how to change the quantitative impact of these potential failures on the frequency of accident sequences as the design changes. Deliberation is an important part of the four-step methodology because it supplements the quantitative results by allowing the inclusion in the design choice of elements such as best design practices and ease of online maintenance, which usually cannot be quantified. The case study showed that, in some instances, the structuralist and the rationalist approaches were inconsistent. In particular, GDC 35 treats the double-ended break of the largest pipe in the reactor coolant system with concurrent loss of offsite power and a single

Interactive Design and Development of Real Arm Movements for Application in Rehabilitation

Science.gov (United States)

Rosman, Rafidah; Hadi, Muhammad Zaidan Abdul; Abu Bakar, Nurulliyana

2018-03-01

An interactive real arm movements for application in rehabilitation is designed and developed. The aim is to encourage hand paralysis patients performing their physical therapy by introducing games application in replacing conventional hand therapy module and methods. In this project, the accelerometer is used for tracking the orientation of the arm. As the arm moves, the values from x, y and z axis from the accelerometer changes and are being read by the Analog Inputs of the Arduino Board. After being read by the Analog Inputs of the Arduino Board, the 3D model moves as well. Solidworks software was used to modeled the hand in which the data is then transferred to Matlab/Simulink using SimMechanicalLink from Mathworks. Lastly, the sensor glove was programmed to work as a controller of games application in hand rehabilitation thus makes it an enjoyable therapy process.

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.

Writing a case report for the American Journal of Physical Medicine & Rehabilitation and the European Journal of Physical and Rehabilitation Medicine.

Science.gov (United States)

Ozçakar, Levent; Franchignoni, Franco; Negrini, Stefano; Frontera, Walter

2013-02-01

Case reports (CRs) have led to the description and discovery of new diseases, syndromes, therapeutic complications or side effects, and previously unknown potential benefits of pharmacologic agents. CRs may also be used as an effective training strategy for novice authors to develop the skills needed for medical writing. However, too often, CRs do not follow standards for excellence in scientific writing. Therefore, in this article, the American Journal of Physical Medicine & Rehabilitation and the European Journal of Physical and Rehabilitation Medicine collaborate with the purpose of providing guidance to authors in selecting CRs that might be appropriate for publication. In addition, the authors discuss different aspects of the preparation of a well written CR in accordance with the mission and editorial views of both journals.

Usability Test of Exercise Games Designed for Rehabilitation of Elderly Patients After Hip Replacement Surgery: Pilot Study.

Science.gov (United States)

Ling, Yun; Ter Meer, Louis P; Yumak, Zerrin; Veltkamp, Remco C

2017-10-12

Patients who receive rehabilitation after hip replacement surgery are shown to have increased muscle strength and better functional performance. However, traditional physiotherapy is often tedious and leads to poor adherence. Exercise games, provide ways for increasing the engagement of elderly patients and increase the uptake of rehabilitation exercises. The objective of this study was to evaluate Fietsgame (Dutch for cycling game), which translates existing rehabilitation exercises into fun exercise games. The system connects exercise games with a patient's personal record and a therapist interface by an Internet of Things server. Thus, both the patient and physiotherapist can monitor the patient's medical status. This paper describes a pilot study that evaluates the usability of the Fietsgame. The study was conducted in a rehabilitation center with 9 participants, including 2 physiotherapists and 7 patients. The patients were asked to play 6 exercise games, each lasting about 5 min, under the guidance of a physiotherapist. The mean age of the patients was 74.57 years (standard deviation [SD] 8.28); all the patients were in the recovery process after hip surgery. Surveys were developed to quantitatively measure the usability factors, including presence, enjoyment, pain, exertion, and technology acceptance. Comments on advantages and suggested improvements of our game system provided by the physiotherapists and patients were summarized and their implications were discussed. The results showed that after successfully playing the games, 75% to 100% of the patients experienced high levels of enjoyment in all the games except the squats game. Patients reported the highest level of exertion in squats when compared with other exercise games. Lunges resulted in the highest dropout rate (43%) due to interference with the Kinect v2 from support chairs. All the patients (100%) found the game system useful and easy to use, felt that it would be a useful tool in their further

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

Science.gov (United States)

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.

Design and characterization of the OpenWrist: A robotic wrist exoskeleton for coordinated hand-wrist rehabilitation.

Science.gov (United States)

Pezent, Evan; Rose, Chad G; Deshpande, Ashish D; O'Malley, Marcia K

2017-07-01

Robotic devices have been clinically verified for use in long duration and high intensity rehabilitation needed for motor recovery after neurological injury. Targeted and coordinated hand and wrist therapy, often overlooked in rehabilitation robotics, is required to regain the ability to perform activities of daily living. To this end, a new coupled hand-wrist exoskeleton has been designed. This paper details the design of the wrist module and several human-related considerations made to maximize its potential as a coordinated hand-wrist device. The serial wrist mechanism has been engineered to facilitate donning and doffing for impaired subjects and to insure compatibility with the hand module in virtual and assisted grasping tasks. Several other practical requirements have also been addressed, including device ergonomics, clinician-friendliness, and ambidextrous reconfigurability. The wrist module's capabilities as a rehabilitation device are quantified experimentally in terms of functional workspace and dynamic properties. Specifically, the device possesses favorable performance in terms of range of motion, torque output, friction, and closed-loop position bandwidth when compared with existing devices. The presented wrist module's performance and operational considerations support its use in a wide range of future clinical investigations.

Constituent Aspects of Workplace Guidance in Secondary VET

Science.gov (United States)

Swager, Robert; Klarus, Ruud; van Merriënboer, Jeroen J. G.; Nieuwenhuis, Loek F. M.

2015-01-01

Purpose: This paper aims to present an integrated model of workplace guidance to enhance awareness of what constitutes good guidance, to improve workplace guidance practices in vocational education and training. Design/methodology/approach: To identify constituent aspects of workplace guidance, a systematic search of Web of Science was conducted,…

Urban wetlands: restoration or designed rehabilitation?

Directory of Open Access Journals (Sweden)

Beth Ravit

2017-05-01

Full Text Available The continuing loss of urban wetlands due to an expanding human population and urban development pressures makes restoration or creation of urban wetlands a high priority. However, urban wetland restorations are particularly challenging due to altered hydrologic patterns, a high proportion of impervious surface and stormwater runoff, degraded urban soils, historic contamination, and competitive pressure from non-native species. Urban wetland projects must also consider human-desired socio-economic benefits. We argue that using current wetland restoration approaches and existing regulatory “success” criteria, such as meeting restoration targets for vegetation structure based on reference sites in non-urban locations, will result in “failed” urban restorations. Using three wetland Case Studies in highly urbanized locations, we describe geophysical tools, stormwater management methods, and design approaches useful in addressing urban challenges and in supporting “successful” urban rehabilitation outcomes. We suggest that in human-dominated landscapes, the current paradigm of “restoration” to a previous state must shift to a paradigm of “rehabilitation”, which prioritizes wetland functions and values rather than vegetation structure in order to provide increased ecological benefits and much needed urban open space amenities.

Safeguards-by-Design: Guidance for High Temperature Gas Reactors (HTGRs) With Pebble Fuel

Energy Technology Data Exchange (ETDEWEB)

Philip Casey Durst; Mark Schanfein

2012-08-01

The following is a guidance document from a series prepared for the U.S. Department of Energy (DOE) National Nuclear Security Administration (NNSA), under the Next Generation Safeguards Initiative (NGSI), to assist facility designers and operators in implementing international Safeguards-by-Design (SBD). SBD has two main objectives: (1) to avoid costly and time consuming redesign work or retrofits of new nuclear fuel cycle facilities and (2) to make the implementation of international safeguards more effective and efficient at such facilities. In the long term, the attainment of these goals would save industry and the International Atomic Energy Agency (IAEA) time, money, and resources and be mutually beneficial. This particular safeguards guidance document focuses on pebble fuel high temperature gas reactors (HTGR). The purpose of the IAEA safeguards system is to provide credible assurance to the international community that nuclear material and other specified items are not diverted from peaceful nuclear uses. The safeguards system consists of the IAEA’s statutory authority to establish safeguards; safeguards rights and obligations in safeguards agreements and additional protocols; and technical measures implemented pursuant to those agreements. Of foremost importance is the international safeguards agreement between the country and the IAEA, concluded pursuant to the Treaty on the Non-Proliferation of Nuclear Weapons (NPT). According to a 1992 IAEA Board of Governors decision, countries must: notify the IAEA of a decision to construct a new nuclear facility as soon as such decision is taken; provide design information on such facilities as the designs develop; and provide detailed design information based on construction plans at least 180 days prior to the start of construction, and on "as-built" designs at least 180 days before the first receipt of nuclear material. Ultimately, the design information will be captured in an IAEA Design Information

Sustainability in rehabilitation and in its education

NARCIS (Netherlands)

Eliziario, J.S.; Pereira Roders, A.R.; Valverde, I.; Bragança, L.; Pinheiro, M.; Mateus, R.; Amoêda, R.; Correia Guedes, M.

2007-01-01

Rehabilitation design is not an activity restrictedly practiced in Architectural offices, but also taught and practiced at Architecture schools. Architects and students have to define their own method to approach rehabilitation design developments; however, they can be theoretically supported. The

UV DISINFECTION GUIDANCE MANUAL FOR THE ...

Science.gov (United States)

Provides technical information on selection, design and operation of UV systems; provides regulatory agencies with guidance and the necessary tools to assess UV systems at the design, start-up, and routine operation phase; provides manufacturers with the testing and performance standards for UV components and systems for treating drinking water. Provide guidance to water systems, regulators and manufacturers on UV disinfection of drinking water.

[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.

Writing a case report for the American Journal of Physical Medicine and Rehabilitation and the European Journal of Physical and Rehabilitation Medicine.

Science.gov (United States)

Özçakar, L; Franchignoni, F; Frontera, W; Negrini, S

2013-04-01

Case reports (CR) have led to the description and discovery of new diseases, syndromes, therapeutic complications or side-effects, and previously unknown potential benefits of pharmacologic agents. CRs may also be used as an effective training strategy for novice authors to develop the skills needed for medical writing. Yet, too often, CRs do not follow standards for excellence in scientific writing. Therefore, in this article, the American Journal of Physical Medicine and Rehabilitation (AJPMR) and the European Journal of Physical and Rehabilitation Medicine (EJPRM) collaborate with the purpose of providing guidance to authors in selecting CRs that might be appropriate for publication. In addition, we discuss different aspects of the preparation of a well-written CR in accordance with the mission and editorial views of both journals.

Design of a mechanical system in gait rehabilitation with progressive addition of weight

Science.gov (United States)

Braidot, Ariel A. A.; Aleman, Guillermo L.

2011-12-01

In this paper we designed and developed a mechanical device for gait rehabilitation based on the application of "partial body weight reduction therapy". An evaluation of the characteristics of devices based on this therapy currently available on the market was carried out obtaining information of the different mechanisms used in it. The device was designed to adapt to different height and weight of patients and to be used with additional equipment in gait rehabilitation, for example, treadmills, elliptical trainers and vertical scalers. It was envisaged to be used by patients with asymmetry in the lower extremities capabilities. We developed a stable structure in steel ASTM A36 which does not depend on the building conditions of the installation site. RamAdvanse software was used to calculate structural stability. A winch with automatic brake mechanism was used to raise/lower the patient, who was tied to a comfortable harness which provided safety to the patient and therapist. It was possible to quantify precisely, using counterweights, the weight borne by the patient during therapy. We obtained a small-sized and ergonomic low-cost prototype, with similar features to those currently considered cutting-edge devices.

Design of a mechanical system in gait rehabilitation with progressive addition of weight

International Nuclear Information System (INIS)

Braidot, Ariel A A; Aleman, Guillermo L

2011-01-01

In this paper we designed and developed a mechanical device for gait rehabilitation based on the application of p artial body weight reduction therapy . An evaluation of the characteristics of devices based on this therapy currently available on the market was carried out obtaining information of the different mechanisms used in it. The device was designed to adapt to different height and weight of patients and to be used with additional equipment in gait rehabilitation, for example, treadmills, elliptical trainers and vertical scalers. It was envisaged to be used by patients with asymmetry in the lower extremities capabilities. We developed a stable structure in steel ASTM A36 which does not depend on the building conditions of the installation site. RamAdvanse software was used to calculate structural stability. A winch with automatic brake mechanism was used to raise/lower the patient, who was tied to a comfortable harness which provided safety to the patient and therapist. It was possible to quantify precisely, using counterweights, the weight borne by the patient during therapy. We obtained a small-sized and ergonomic low-cost prototype, with similar features to those currently considered cutting-edge devices.

Design and Characterization of Hand Module for Whole-Arm Rehabilitation Following Stroke

Science.gov (United States)

Masia, L.; Krebs, Hermano Igo; Cappa, P.; Hogan, N.

2009-01-01

In 1991, a novel robot named MIT-MANUS was introduced as a test bed to study the potential of using robots to assist in and quantify the neurorehabilitation of motor function. It introduced a new modality of therapy, offering a highly backdrivable experience with a soft and stable feel for the user. MIT-MANUS proved an excellent fit for shoulder and elbow rehabilitation in stroke patients, showing a reduction of impairment in clinical trials with well over 300 stroke patients. The greatest impairment reduction was observed in the group of muscles exercised. This suggests a need for additional robots to rehabilitate other target areas of the body. Previous work has expanded the planar MIT-MANUS to include an antigravity robot for shoulder and elbow, and a wrist robot. In this paper we present the “missing link”: a hand robot. It consists of a single-degree-of-freedom (DOF) mechanism in a novel statorless configuration, which enables rehabilitation of grasping. The system uses the kinematic configuration of a double crank and slider where the members are linked to stator and rotor; a free base motor, i.e., a motor having two rotors that are free to rotate instead of a fixed stator and a single rotatable rotor (dual-rotor statorless motor). A cylindrical structure, made of six panels and driven by the relative rotation of the rotors, is able to increase its radius linearly, moving or guiding the hand of the patients during grasping. This module completes our development of robots for the upper extremity, yielding for the first time a whole-arm rehabilitation experience. In this paper, we will discuss in detail the design and characterization of the device. PMID:20228969

Process engineering considerations in the design of the water treatment plant for the Rum Jungle rehabilitation project

International Nuclear Information System (INIS)

Ackland, M.C.

1983-01-01

The Rum Jungle rehabilitation programme includes the treatment of around 4 million cubic metres of water that has been polluted by previous treatment operations and acidic seepage containing heavy metal salts from slowly oxidising overburden dumps. The water to be treated is of low pH and contains high sulphate levels. Project rehabilitation criteria and the basic chemistry of metal salts in solution were considered in arriving at the final process design. In order to achieve a cost effective plant design, the process was translated into a flow sheet that used unit operations that are more typical of the extractive metallurgical than the traditional water treatment industry. Consideration of the unit operations and the operating aspects of the plant are discussed

The neuropsychological rehabilitation of visual agnosia and Balint's syndrome.

Science.gov (United States)

Heutink, Joost; Indorf, Dana L; Cordes, Christina

2018-01-24

Visual agnosia and Balint's syndrome are complex neurological disorders of the higher visual system that can have a remarkable impact on individuals' lives. Rehabilitation of these individuals is important to enable participation in everyday activities despite the impairment. However, the literature about the rehabilitation of these disorders is virtually silent. Therefore, the aim of this systematic review is to give an overview of available literature describing treatment approaches and their effectiveness with regard to these disorders. The search engines Psychinfo, Amed, and Medline were used, resulting in 22 articles meeting the criteria for inclusion. Only articles describing acquired disorders were considered. These articles revealed that there is some information available on the major subtypes of visual agnosia as well as on Balint's syndrome which practising clinicians can consult for guidance. With regard to the type of rehabilitation, compensatory strategies have proven to be beneficial in most of the cases. Restorative training on the other hand has produced mixed results. Concluding, although still scarce, a scientific foundation about the rehabilitation of visual agnosia and Balint's syndrome is evolving. The available approaches give valuable information that can be built upon in the future.

A Novel Surgical Template Design in Staged Dental Implant Rehabilitations

Directory of Open Access Journals (Sweden)

Michael Patras

2012-05-01

Full Text Available Background: The philosophy of a gradual transition to an implant retained prosthesis in cases of full-mouth or extensive rehabilitation usually involves a staged treatment concept. In this therapeutic approach, the placement of implants may sometimes be divided into phases. During a subsequent surgical phase of treatment, the pre-existing implants can serve as anchors for the surgical template. Those modified surgical templates help in the precise transferring of restorative information into the surgical field and guide the optimal three-dimensional implant positioning. Methods: This article highlights the rationale of implant-retained surgical templates and illustrates them through the presentation of two clinical cases. The templates are duplicates of the provisional restorations and are secured to the existing implants through the utilization of implant mounts. Results: This template design in such staged procedures provided stability in the surgical field and enhanced the accuracy in implant positioning based upon the planned restoration, thus ensuring predictable treatment outcomes.Conclusions: Successful rehabilitation lies in the correct sequence of surgical and prosthetic procedures. Whenever a staged approach of implant placement is planned, the clinician can effectively use the initially placed implants as anchors for the surgical template during the second phase of implant surgery.

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.

Safety of magnetic fusion facilities: Guidance

International Nuclear Information System (INIS)

1996-05-01

This document provides guidance for the implementation of the requirements identified in DOE-STD-6002-96, Safety of Magnetic Fusion Facilities: Requirements. This guidance is intended for the managers, designers, operators, and other personnel with safety responsibilities for facilities designated as magnetic fusion facilities. While the requirements in DOE-STD-6002-96 are generally applicable to a wide range of fusion facilities, this Standard, DOE-STD-6003-96, is concerned mainly with the implementation of those requirements in large facilities such as the International Thermonuclear Experimental Reactor (ITER). Using a risk-based prioritization, the concepts presented here may also be applied to other magnetic fusion facilities. This Standard is oriented toward regulation in the Department of Energy (DOE) environment as opposed to regulation by other regulatory agencies. As the need for guidance involving other types of fusion facilities or other regulatory environments emerges, additional guidance volumes should be prepared. The concepts, processes, and recommendations set forth here are for guidance only. They will contribute to safety at magnetic fusion facilities

Facilities of Early Rehabilitation post Stroke in Poland 2010

DEFF Research Database (Denmark)

Opara, Jozef; Langhorne, Peter; Larsen, Torben

2012-01-01

Rationale -The aim of this work was to survey the contemporary facilities for early poststroke rehabilitation in Poland. The main research questions were: what is the availability of inpatient rehabilitation for post-stroke patients in neurological departments and in rehabilitation departments......? Aims - Growing costs of health care are encouraging healthcare planners to look for new organizational solutions of services which could enable rehabilitation as early as possible after disease onset. Early post-stroke rehabilitation consists of many elements that provide for early onset rehabilitation...... and its continuation after discharge from stroke unit. Participants - Two questionnaires evaluating neurorehabilitation of people who underwent stroke was designed and distributed: first to 221 neurological wards and second to 154 rehabilitation departments in Poland. Design - We asked about delay before...

Integrating medical, assistive, and universal design products and technologies: Assistive Technology Service Method (ATSM).

Science.gov (United States)

Elsaesser, Linda-Jeanne; Bauer, Stephen

2012-07-01

ISO26000 provides guidance on effective organizational performance that recognizes social responsibility (including rights of persons with disabilities (PWD)), engages stakeholders, and contributes to sustainable development [1]. Millennium Development Goals 2010 state: while progress has been made, insufficient dedication to sustainable development, and inequalities to the most vulnerable people require attention [2]. World Report on Disability 2011 recommendations includes improved data collection and removal of barriers to rehabilitation that empower PWD [3]. The Assistive Technology Service Method (ATSM), Assistive Technology Device Classification (ATDC) and Matching Person and Technology (MPT) provide an evidence-based, standardized, internationally comparable framework to improve rehabilitation interventions [4-6]. The ATSM and ATDC support universal design (UD) principles and provision of universal technology. The MPT assures interventions are effective and satisfactory to end-users [7]. The ICF conceptual framework and common language are used throughout [8]. Research findings on healthcare needs are translated. ATSM applications in support of these findings are presented. National initiatives demonstrate the need and value of the ATSM as an evidence-based, user-centric, interdisciplinary method to improve individual and organizational performance for rehabilitation [including AT] services. Two Disability & Rehabilitation: Assistive Technology articles demonstrate ATSM and ATDC use to strengthen rehabilitation services and integrate Universal Design principles for socially responsible behavior.

Mechanical design of a distal arm exoskeleton for stroke and spinal cord injury rehabilitation.

Science.gov (United States)

Pehlivan, Ali Utku; Celik, Ozkan; O'Malley, Marcia K

2011-01-01

Robotic rehabilitation has gained significant traction in recent years, due to the clinical demonstration of its efficacy in restoring function for upper extremity movements and locomotor skills, demonstrated primarily in stroke populations. In this paper, we present the design of MAHI Exo II, a robotic exoskeleton for the rehabilitation of upper extremity after stroke, spinal cord injury, or other brain injuries. The five degree-of-freedom robot enables elbow flexion-extension, forearm pronation-supination, wrist flexion-extension, and radial-ulnar deviation. The device offers several significant design improvements compared to its predecessor, MAHI Exo I. Specifically, issues with backlash and singularities in the wrist mechanism have been resolved, torque output has been increased in the forearm and elbow joints, a passive degree of freedom has been added to allow shoulder abduction thereby improving alignment especially for users who are wheelchair-bound, and the hardware now enables simplified and fast swapping of treatment side. These modifications are discussed in the paper, and results for the range of motion and maximum torque output capabilities of the new design and its predecessor are presented. The efficacy of the MAHI Exo II will soon be validated in a series of clinical evaluations with both stroke and spinal cord injury patients. © 2011 IEEE

Maintain and Regain Well Clear: Maneuver Guidance Designs for Pilots Performing the Detect-and-Avoid Task

Science.gov (United States)

Monk, Kevin J.; Roberts, Zachary

2017-01-01

In order to support the future expansion and integration of Unmanned Aircraft Systems (UAS), ongoing research efforts have sought to produce findings that inform the minimum display information elements required for acceptable UAS pilot response times and traffic avoidance. Previous simulations have revealed performance benefits associated with DAA displays containing predictive information and suggestive maneuver guidance tools in the form of banding. The present study investigated the impact of various maneuver guidance display configurations on detect-and-avoid (DAA) task performance in a simulated airspace environment. UAS pilots ability to maintain DAA well clear was compared between displays with either the presence or absence of green DAA bands, which indicated conflict-free flight regions. Additional display comparisons assessed pilots ability to regain DAA well clear with two different guidance presentations designed to aid in DAA well clear recovery during critical encounters. Performance implications and display considerations for future UAS DAA systems are discussed.

77 FR 74195 - Draft Guidance for Industry and Food and Drug Administration Staff; Design Considerations for...

Science.gov (United States)

2012-12-13

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-D-1161] Draft Guidance for Industry and Food and Drug Administration Staff; Design Considerations for Devices Intended for Home Use; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The...

Whole-body isometric force/torque measurements for functional assessment in neuro-rehabilitation: platform design, development and verification

Directory of Open Access Journals (Sweden)

Cavallo Giuseppe

2009-10-01

Full Text Available Abstract Background One of the main scientific and technological challenges of rehabilitation bioengineering is the development of innovative methodologies, based on the use of appropriate technological devices, for an objective assessment of patients undergoing a rehabilitation treatment. Such tools should be as fast and cheap to use as clinical scales, which are currently the daily instruments most widely used in the routine clinical practice. Methods A human-centered approach was used in the design and development of a mechanical structure equipped with eight force/torque sensors that record quantitative data during the initiation of a predefined set of Activities of Daily Living (ADL tasks, in isometric conditions. Results Preliminary results validated the appropriateness, acceptability and functionality of the proposed platform, that has become now a tool used for clinical research in three clinical centres. Conclusion This paper presented the design and development of an innovative platform for whole-body force and torque measurements on human subjects. The platform has been designed to perform accurate quantitative measurements in isometric conditions with the specific aim to address the needs for functional assessment tests of patients undergoing a rehabilitation treatment as a consequence of a stroke. The versatility of the system also enlightens several other interesting possible areas of application for therapy in neurorehabilitation, for research in basic neuroscience, and more.

Mobile Traffic Alert and Tourist Route Guidance System Design Using Geospatial Data

Science.gov (United States)

Bhattacharya, D.; Painho, M.; Mishra, S.; Gupta, A.

2017-09-01

The present study describes an integrated system for traffic data collection and alert warning. Geographical information based decision making related to traffic destinations and routes is proposed through the design. The system includes a geospatial database having profile relating to a user of a mobile device. The processing and understanding of scanned maps, other digital data input leads to route guidance. The system includes a server configured to receive traffic information relating to a route and location information relating to the mobile device. Server is configured to send a traffic alert to the mobile device when the traffic information and the location information indicate that the mobile device is traveling toward traffic congestion. Proposed system has geospatial and mobile data sets pertaining to Bangalore city in India. It is envisaged to be helpful for touristic purposes as a route guidance and alert relaying information system to tourists for proximity to sites worth seeing in a city they have entered into. The system is modular in architecture and the novelty lies in integration of different modules carrying different technologies for a complete traffic information system. Generic information processing and delivery system has been tested to be functional and speedy under test geospatial domains. In a restricted prototype model with geo-referenced route data required information has been delivered correctly over sustained trials to designated cell numbers, with average time frame of 27.5 seconds, maximum 50 and minimum 5 seconds. Traffic geo-data set trials testing is underway.

An advanced rehabilitation robotic system for augmenting healthcare.

Science.gov (United States)

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.

Enhancing public involvement in assistive technology design research.

Science.gov (United States)

Williamson, Tracey; Kenney, Laurence; Barker, Anthony T; Cooper, Glen; Good, Tim; Healey, Jamie; Heller, Ben; Howard, David; Matthews, Martin; Prenton, Sarah; Ryan, Julia; Smith, Christine

2015-05-01

To appraise the application of accepted good practice guidance on public involvement in assistive technology research and to identify its impact on the research team, the public, device and trial design. Critical reflection and within-project evaluation were undertaken in a case study of the development of a functional electrical stimulation device. Individual and group interviews were undertaken with lay members of a 10 strong study user advisory group and also research team members. Public involvement was seen positively by research team members, who reported a positive impact on device and study designs. The public identified positive impact on confidence, skills, self-esteem, enjoyment, contribution to improving the care of others and opportunities for further involvement in research. A negative impact concerned the challenge of engaging the public in dissemination after the study end. The public were able to impact significantly on the design of an assistive technology device which was made more fit for purpose. Research team attitudes to public involvement were more positive after having witnessed its potential first hand. Within-project evaluation underpins this case study which presents a much needed detailed account of public involvement in assistive technology design research to add to the existing weak evidence base. The evidence base for impact of public involvement in rehabilitation technology design is in need of development. Public involvement in co-design of rehabilitation devices can lead to technologies that are fit for purpose. Rehabilitation researchers need to consider the merits of active public involvement in research.

Optimal guidance law in quantum mechanics

International Nuclear Information System (INIS)

Yang, Ciann-Dong; Cheng, Lieh-Lieh

2013-01-01

Following de Broglie’s idea of a pilot wave, this paper treats quantum mechanics as a problem of stochastic optimal guidance law design. The guidance scenario considered in the quantum world is that an electron is the flight vehicle to be guided and its accompanying pilot wave is the guidance law to be designed so as to guide the electron to a random target driven by the Wiener process, while minimizing a cost-to-go function. After solving the stochastic optimal guidance problem by differential dynamic programming, we point out that the optimal pilot wave guiding the particle’s motion is just the wavefunction Ψ(t,x), a solution to the Schrödinger equation; meanwhile, the closed-loop guidance system forms a complex state–space dynamics for Ψ(t,x), from which quantum operators emerge naturally. Quantum trajectories under the action of the optimal guidance law are solved and their statistical distribution is shown to coincide with the prediction of the probability density function Ψ ∗ Ψ. -- Highlights: •Treating quantum mechanics as a pursuit-evasion game. •Reveal an interesting analogy between guided flight motion and guided quantum motion. •Solve optimal quantum guidance problem by dynamic programming. •Gives a formal proof of de Broglie–Bohm’s idea of a pilot wave. •The optimal pilot wave is shown to be a wavefunction solved from Schrödinger equation

Optimal guidance law in quantum mechanics

Energy Technology Data Exchange (ETDEWEB)

Yang, Ciann-Dong, E-mail: cdyang@mail.ncku.edu.tw; Cheng, Lieh-Lieh, E-mail: leo8101@hotmail.com

2013-11-15

Following de Broglie’s idea of a pilot wave, this paper treats quantum mechanics as a problem of stochastic optimal guidance law design. The guidance scenario considered in the quantum world is that an electron is the flight vehicle to be guided and its accompanying pilot wave is the guidance law to be designed so as to guide the electron to a random target driven by the Wiener process, while minimizing a cost-to-go function. After solving the stochastic optimal guidance problem by differential dynamic programming, we point out that the optimal pilot wave guiding the particle’s motion is just the wavefunction Ψ(t,x), a solution to the Schrödinger equation; meanwhile, the closed-loop guidance system forms a complex state–space dynamics for Ψ(t,x), from which quantum operators emerge naturally. Quantum trajectories under the action of the optimal guidance law are solved and their statistical distribution is shown to coincide with the prediction of the probability density function Ψ{sup ∗}Ψ. -- Highlights: •Treating quantum mechanics as a pursuit-evasion game. •Reveal an interesting analogy between guided flight motion and guided quantum motion. •Solve optimal quantum guidance problem by dynamic programming. •Gives a formal proof of de Broglie–Bohm’s idea of a pilot wave. •The optimal pilot wave is shown to be a wavefunction solved from Schrödinger equation.

FUNCTIONAL OUTCOME OF ACCELERATED REHABILITATION IN ARTHROSCOPIC ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION WITH BONE PATELLAR TENDON BONE GRAFT A PROSPECTIVE STUDY

Directory of Open Access Journals (Sweden)

Hiranyakumar

2016-03-01

Full Text Available INTRODUCTION An ideal rehabilitation program post anterior cruciate ligament reconstruction enables an individual to return to pre injury levels at a faster rate with minimal to no risk of reinjury to the graft. Rehabilitation protocols have changed considerably over time in the past. It has become “aggressive”, meaning an intensive rehabilitation which includes greater variety of exercises and sports related training. AIM OF THE STUDY The aim of our study is to assess the outcome of accelerated rehabilitation post anterior cruciate ligament (ACL reconstruction. METHODOLOGY 106 patients were operated by a single surgeon underwent arthroscopic anterior cruciate ligament reconstruction using bone patella tendon bone graft and partial meniscectomy for associated meniscal tear. Patients were put on an accelerated rehabilitation protocol designed in our institute on first post-operative day, under the guidance of a physical therapist in consultation with the operated surgeon. Patients were followed up at 3 weeks, 6 months and 9 months, post onset of rehabilitation, patients were assessed using KT1000 Arthrometer and Lysholm knee scoring system. RESULTS Out of 106 patients, who were selected, 96(91% were males and 10(9% were females. The mean pre-operative Lysholm score was 55.09. Post operatively, while on accelerated rehabilitation program the Lysholm scores were 69.73 at 3 weeks, 89.13 at 6 months and 89.19 at 9 months. In our pre-operative evaluation mean KT 1000 arthrometer score was 10.53 and post-operative at six months was 3.49. At nine months 105 patients had excellent results whereas 1 patient had good result. CONCLUSION Accelerated rehabilitation protocol enables the patient to functionally recover faster to pre injury levels. A rehabilitation protocol for 6 months is sufficient in enabling a patient to get back to pre-injury levels. Functional outcome is the same with or without associated meniscal injuries.

HUMAN FACTORS GUIDANCE FOR CONTROL ROOM EVALUATION

International Nuclear Information System (INIS)

OHARA, J.; BROWN, W.; STUBLER, W.; HIGGINS, J.; WACHTEL, J.; PERSENSKY, J.J.

2000-01-01

The Human-System Interface Design Review Guideline (NUREG-0700, Revision 1) was developed by the US Nuclear Regulatory Commission (NRC) to provide human factors guidance as a basis for the review of advanced human-system interface technologies. The guidance consists of three components: design review procedures, human factors engineering guidelines, and a software application to provide design review support called the ''Design Review Guideline.'' Since it was published in June 1996, Rev. 1 to NUREG-0700 has been used successfully by NRC staff, contractors and nuclear industry organizations, as well as by interested organizations outside the nuclear industry. The NRC has committed to the periodic update and improvement of the guidance to ensure that it remains a state-of-the-art design evaluation tool in the face of emerging and rapidly changing technology. This paper addresses the current research to update of NUREG-0700 based on the substantial work that has taken place since the publication of Revision 1

Restorative Rehabilitation of a Patient with Dental Erosion.

Science.gov (United States)

AlShahrani, Mohammed Thamer; Haralur, Satheesh B; Alqarni, Mohammed

2017-01-01

Dental erosion is the chemical dissolution of the tooth structure. Factors like eating disorders and gastrointestinal diseases are recognized as intrinsic factors for dental erosion. Advanced stages of dental erosion extensively damage the tooth morphology, consequently affecting both esthetics and functions. Reports indicate the growing prevalence of erosion, and hence knowledge of restorative rehabilitation of tooth erosion is an integral part of the contemporary dental practice. This clinical report describes an adult patient with gastroesophageal reflux induced dental erosion involving the palatal surface of the maxillary anterior teeth. The extensive involvement of the palatal surfaces compromised the esthetics, incisal guidance, and functional occlusal efficiency. Indirect all-ceramic restorations were utilized to restore the esthetics and occlusal reconstruction. In conclusion, patients affected by severe dental erosion require prosthetic rehabilitation besides the management of the associated medical condition.

Restorative Rehabilitation of a Patient with Dental Erosion

Directory of Open Access Journals (Sweden)

Mohammed Thamer AlShahrani

2017-01-01

Full Text Available Dental erosion is the chemical dissolution of the tooth structure. Factors like eating disorders and gastrointestinal diseases are recognized as intrinsic factors for dental erosion. Advanced stages of dental erosion extensively damage the tooth morphology, consequently affecting both esthetics and functions. Reports indicate the growing prevalence of erosion, and hence knowledge of restorative rehabilitation of tooth erosion is an integral part of the contemporary dental practice. This clinical report describes an adult patient with gastroesophageal reflux induced dental erosion involving the palatal surface of the maxillary anterior teeth. The extensive involvement of the palatal surfaces compromised the esthetics, incisal guidance, and functional occlusal efficiency. Indirect all-ceramic restorations were utilized to restore the esthetics and occlusal reconstruction. In conclusion, patients affected by severe dental erosion require prosthetic rehabilitation besides the management of the associated medical condition.

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

Automated low-thrust guidance for the orbital maneuvering vehicle

Science.gov (United States)

Rose, Richard E.; Schmeichel, Harry; Shortwell, Charles P.; Werner, Ronald A.

1988-01-01

This paper describes the highly autonomous OMV Guidance Navigation and Control system. Emphasis is placed on a key feature of the design, the low thrust guidance algorithm. The two guidance modes, orbit change guidance and rendezvous guidance, are discussed in detail. It is shown how OMV will automatically transfer from its initial orbit to an arbitrary target orbit and reach a specified rendezvous position relative to the target vehicle.

Need for strengthened focus on cancer rehabilitation in Danish municipalities

DEFF Research Database (Denmark)

Kristiansen, Maria; Adamsen, Lis; Kjær Brinkmann, Fie

2015-01-01

by “stop smoking” courses, dietary advice, physical training guidance, patient education and individual physical training. Inequality in referral by ethnicity, age and gender was reported.Challenges encountered included low patient numbers, inadequate collaboration within and across sectors and lack......Introduction: Danish municipalities have recently been given a mandate to organise cancer rehabilitation services.Knowledge is therefore needed about the services providedand their utilisation. The aim of this national Danish baseline survey was to explore the availability, utilisation, content...... and organisation of municipal cancer rehabilitation services. Methods: Electronic questionnaires were sent to all 98 Danish municipalities in January 2013. The questionnaire consisted of closed-ended and open-ended questions. Descriptive statistics and contents analysis were used. Results: A total of 91...

Need for strengthened focus on cancer rehabilitation in Danish municipalities

DEFF Research Database (Denmark)

Kristiansen, Maria; Adamsen, Lis; Brinkmann, Fie Kjær

2015-01-01

by "stop smoking" courses, dietary advice, physical training guidance, patient education and individual physical training. Inequality in referral by ethnicity, age and gender was reported. Challenges encountered included low patient numbers, inadequate collaboration within and across sectors and lack......INTRODUCTION: Danish municipalities have recently been given a mandate to organise cancer rehabilitation services. Knowledge is therefore needed about the services provided and their utilisation. The aim of this national Danish baseline survey was to explore the availability, utilisation, content...... and organisation of municipal cancer rehabilitation services. METHODS: Electronic questionnaires were sent to all 98 Danish municipalities in January 2013. The questionnaire consisted of closed-ended and open-ended questions. Descriptive statistics and contents analysis were used. RESULTS: A total of 91...

MOBILE TRAFFIC ALERT AND TOURIST ROUTE GUIDANCE SYSTEM DESIGN USING GEOSPATIAL DATA

Directory of Open Access Journals (Sweden)

D. Bhattacharya

2017-09-01

Full Text Available The present study describes an integrated system for traffic data collection and alert warning. Geographical information based decision making related to traffic destinations and routes is proposed through the design. The system includes a geospatial database having profile relating to a user of a mobile device. The processing and understanding of scanned maps, other digital data input leads to route guidance. The system includes a server configured to receive traffic information relating to a route and location information relating to the mobile device. Server is configured to send a traffic alert to the mobile device when the traffic information and the location information indicate that the mobile device is traveling toward traffic congestion. Proposed system has geospatial and mobile data sets pertaining to Bangalore city in India. It is envisaged to be helpful for touristic purposes as a route guidance and alert relaying information system to tourists for proximity to sites worth seeing in a city they have entered into. The system is modular in architecture and the novelty lies in integration of different modules carrying different technologies for a complete traffic information system. Generic information processing and delivery system has been tested to be functional and speedy under test geospatial domains. In a restricted prototype model with geo-referenced route data required information has been delivered correctly over sustained trials to designated cell numbers, with average time frame of 27.5 seconds, maximum 50 and minimum 5 seconds. Traffic geo-data set trials testing is underway.

76 FR 17160 - Office of New Reactors; Final Interim Staff Guidance on the Review of Nuclear Power Plant Designs...

Science.gov (United States)

2011-03-28

... design certification (DC) application for new nuclear power reactors under Title 10 of the Code of... NUCLEAR REGULATORY COMMISSION [NRC-2010-0033; DC/COL-ISG-021] Office of New Reactors; Final Interim Staff Guidance on the Review of Nuclear Power Plant Designs Using a Gas Turbine Driven Standby...

Design, development and deployment of a hand/wrist exoskeleton for home-based rehabilitation after stroke - SCRIPT project

NARCIS (Netherlands)

Amirabdollahian, F; Ates, Sedar; Basteris, A.; Cesario, A.; Buurke, Jaap; Hermens, Hermanus J.; Hofs, D.; Johansson, E.; Mountain, G.; Nasr, N.; Nijenhuis, S.M.; Prange, Grada Berendina; Rahman, N.; Sale, P.; Schätzlein, F.; van Schooten, B.; Stienen, Arno

2014-01-01

Objective: this manuscript introduces the Supervised Care and Rehabilitation Involving Personal Tele-robotics (SCRIPT) project. The main goal is to demonstrate design and development steps involved in a complex intervention, while examining feasibility of using an instrumented orthotic device for

Integrated Targeting and Guidance for Powered Planetary Descent

Science.gov (United States)

Azimov, Dilmurat M.; Bishop, Robert H.

2018-02-01

This paper presents an on-board guidance and targeting design that enables explicit state and thrust vector control and on-board targeting for planetary descent and landing. These capabilities are developed utilizing a new closed-form solution for the constant thrust arc of the braking phase of the powered descent trajectory. The key elements of proven targeting and guidance architectures, including braking and approach phase quartics, are employed. It is demonstrated that implementation of the proposed solution avoids numerical simulation iterations, thereby facilitating on-board execution of targeting procedures during the descent. It is shown that the shape of the braking phase constant thrust arc is highly dependent on initial mass and propulsion system parameters. The analytic solution process is explicit in terms of targeting and guidance parameters, while remaining generic with respect to planetary body and descent trajectory design. These features increase the feasibility of extending the proposed integrated targeting and guidance design to future cargo and robotic landing missions.

Reachability analysis to design zero-wait entry guidance

NARCIS (Netherlands)

Gonzalez-Puerta, Alejandro; Mooij, E.; Valles, Celia Yabar

2018-01-01

This paper presents a novel reentry guidance architecture that aims to improve cur- rent mission safety by enabling zero-wait orbital aborts. To do so, an on-board trajectory planner based on Adaptive Multivariate Pseudospectral Interpolation (AMPI) is devel- oped. This planner generates

Design of an exercise glove for hand rehabilitation using spring mechanism

NARCIS (Netherlands)

Serbest, K.; Ates, Sedar; Stienen, Arno; Isler, Y.

2017-01-01

Hand muscles do not perform their functions because of different reasons such as disease, injury and trauma. It is implemented some treatments for the hand therapy at hospitals and rehabilitation centers. One of these is using orthotic or robotic devices for rehabilitation. One of the important

Online thesis guidance management information system

Science.gov (United States)

Nasution, T. H.; Pratama, F.; Tanjung, K.; Siregar, I.; Amalia, A.

2018-03-01

The development of internet technology in education is still not maximized, especially in the process of thesis guidance between students and lecturers. Difficulties met the lecturers to help students during thesis guidance is the limited communication time and the compatibility of schedule between students and lecturer. To solve this problem, we designed an online thesis guidance management information system that helps students and lecturers to do thesis tutoring process anytime, anywhere. The system consists of a web-based admin app for usage management and an android-based app for students and lecturers.

Design & control of a 3D stroke rehabilitation platform.

Science.gov (United States)

Cai, Z; Tong, D; Meadmore, K L; Freeman, C T; Hughes, A M; Rogers, E; Burridge, J H

2011-01-01

An upper limb stroke rehabilitation system is developed which combines electrical stimulation with mechanical arm support, to assist patients performing 3D reaching tasks in a virtual reality environment. The Stimulation Assistance through Iterative Learning (SAIL) platform applies electrical stimulation to two muscles in the arm using model-based control schemes which learn from previous trials of the task. This results in accurate movement which maximises the therapeutic effect of treatment. The principal components of the system are described and experimental results confirm its efficacy for clinical use in upper limb stroke rehabilitation. © 2011 IEEE

78 FR 39736 - Draft Guidance for Industry: Considerations for the Design of Early-Phase Clinical Trials of...

Science.gov (United States)

2013-07-02

... collectively as CGT products) with recommendations to assist in designing early-phase clinical trials of CGT...-addressed adhesive label to assist the office in processing your requests. The draft guidance may also be...-305), Food and Drug Administration, 5630 Fishers Lane, rm. 1061, Rockville, MD 20852. FOR FURTHER...

VISTA-Rehab: a resource for stroke rehabilitation trials.

Science.gov (United States)

Ali, Myzoon; Ashburn, Ann; Bowen, Audrey; Brodie, Eric; Corr, Susan; Drummond, Avril; Edmans, Judi; Gladman, John; Kalra, Lalit; Langhorne, Peter; Lees, Kennedy R; Lincoln, Nadina; Logan, Pip; Mead, Gillian; Patchick, Emma; Pollock, Alex; Pomeroy, Val; Sackley, Catherine; Sunnerhagen, Katherina S; van Vliet, Paulette; Walker, Marion; Brady, Marian

2010-12-01

Stroke rehabilitation is a complex intervention. Many factors influence the interaction between the patient and the elements of the intervention. Rehabilitation interventions are aimed at altering different domains of patient outcome including body functions, activity and participation. As a consequence, randomised clinical trials in this area are difficult to design. We developed an archive of stroke rehabilitation trials (VISTA-Rehab) to act as a resource to help trialists model and design future rehabilitation studies. We developed specific eligibility criteria for the entry of stroke rehabilitation trials into the archive. We established a Steering Committee to oversee projects and publications and commenced the recruitment of rehabilitation trials into this resource. As of August 2009, VISTA-Rehab contains data from 23 stroke rehabilitation trials (>3400 patients). Demographic data, including age [median=73, interquartile range (63,79)], gender (male=53%) and initial dependency [median baseline Barthel index score=6, interquartile range (9,19)], are available for all patients. Outcome measures include the modified Rankin Scale, Barthel Index, Rivermead Motor Assessment, Fugl-Meyer Assessment, General Health Questionnaire and Nottingham Extended Activities of Daily Living Scale. VISTA-Rehab expands the Virtual International Stroke Trials Archive to include rehabilitation trials. Anonymised data can be used to examine questions specific to stroke rehabilitation and to generate novel hypotheses. © 2010 The Authors. International Journal of Stroke © 2010 World Stroke Organization.

Smartphone-Based Cardiac Rehabilitation Program: Feasibility Study.

Science.gov (United States)

Chung, Heewon; Ko, Hoon; Thap, Tharoeun; Jeong, Changwon; Noh, Se-Eung; Yoon, Kwon-Ha; Lee, Jinseok

2016-01-01

We introduce a cardiac rehabilitation program (CRP) that utilizes only a smartphone, with no external devices. As an efficient guide for cardiac rehabilitation exercise, we developed an application to automatically indicate the exercise intensity by comparing the estimated heart rate (HR) with the target heart rate zone (THZ). The HR is estimated using video images of a fingertip taken by the smartphone's built-in camera. The introduced CRP app includes pre-exercise, exercise with intensity guidance, and post-exercise. In the pre-exercise period, information such as THZ, exercise type, exercise stage order, and duration of each stage are set up. In the exercise with intensity guidance, the app estimates HR from the pulse obtained using the smartphone's built-in camera and compares the estimated HR with the THZ. Based on this comparison, the app adjusts the exercise intensity to shift the patient's HR to the THZ during exercise. In the post-exercise period, the app manages the ratio of the estimated HR to the THZ and provides a questionnaire on factors such as chest pain, shortness of breath, and leg pain during exercise, as objective and subjective evaluation indicators. As a key issue, HR estimation upon signal corruption due to motion artifacts is also considered. Through the smartphone-based CRP, we estimated the HR accuracy as mean absolute error and root mean squared error of 6.16 and 4.30bpm, respectively, with signal corruption due to motion artifacts being detected by combining the turning point ratio and kurtosis.

Smartphone-Based Cardiac Rehabilitation Program: Feasibility Study.

Directory of Open Access Journals (Sweden)

Heewon Chung

Full Text Available We introduce a cardiac rehabilitation program (CRP that utilizes only a smartphone, with no external devices. As an efficient guide for cardiac rehabilitation exercise, we developed an application to automatically indicate the exercise intensity by comparing the estimated heart rate (HR with the target heart rate zone (THZ. The HR is estimated using video images of a fingertip taken by the smartphone's built-in camera. The introduced CRP app includes pre-exercise, exercise with intensity guidance, and post-exercise. In the pre-exercise period, information such as THZ, exercise type, exercise stage order, and duration of each stage are set up. In the exercise with intensity guidance, the app estimates HR from the pulse obtained using the smartphone's built-in camera and compares the estimated HR with the THZ. Based on this comparison, the app adjusts the exercise intensity to shift the patient's HR to the THZ during exercise. In the post-exercise period, the app manages the ratio of the estimated HR to the THZ and provides a questionnaire on factors such as chest pain, shortness of breath, and leg pain during exercise, as objective and subjective evaluation indicators. As a key issue, HR estimation upon signal corruption due to motion artifacts is also considered. Through the smartphone-based CRP, we estimated the HR accuracy as mean absolute error and root mean squared error of 6.16 and 4.30bpm, respectively, with signal corruption due to motion artifacts being detected by combining the turning point ratio and kurtosis.

NRC ARDC Guidance Support Status Report

Energy Technology Data Exchange (ETDEWEB)

Holbrook, Mark R. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2017-07-01

This report provides a summary that reflects the progress and status of proposed regulatory design criteria for advanced non-light water reactor (LWR) designs in accordance with the Level 3 milestone M3AT-17IN2001013 in work package AT-17IN200101. These criteria have been designated as advanced reactor design criteria (ARDC) and they provide guidance to future applicants for addressing the general design criteria (GDC) that are currently applied specifically to LWR designs. This report provides a summary of Phase 2 activities related to the various tasks associated with ARDC development and the subsequent development of ARDC regulatory guidance for sodium fast reactor (SFR) and modular high-temperature gas-cooled reactor (HTGR) designs. Status Report Organization: Section 2 discusses the origin of the GDC and their application to LWRs. Section 3 addresses the objective of this initiative and how it benefits the advanced non-LWR reactor vendors. Section 4 discusses the scope and structure of the initiative. Section 5 provides background on the U.S. Department of Energy (DOE) ARDC team’s original development of the proposed ARDC that were submitted to the NRC for consideration. Section 6 provides a summary of recent ARDC Phase 2 activities. Appendices A through E document the DOE ARDC team’s public comments on various sections of the NRC’s draft regulatory guide DG–1330, “Guidance for Developing Principal Design Criteria for Non-Light Water Reactors.”

NRC ARDC Guidance Support Status Report

International Nuclear Information System (INIS)

Holbrook, Mark R.

2017-01-01

This report provides a summary that reflects the progress and status of proposed regulatory design criteria for advanced non-light water reactor (LWR) designs in accordance with the Level 3 milestone M3AT-17IN2001013 in work package AT-17IN200101. These criteria have been designated as advanced reactor design criteria (ARDC) and they provide guidance to future applicants for addressing the general design criteria (GDC) that are currently applied specifically to LWR designs. This report provides a summary of Phase 2 activities related to the various tasks associated with ARDC development and the subsequent development of ARDC regulatory guidance for sodium fast reactor (SFR) and modular high-temperature gas-cooled reactor (HTGR) designs. Status Report Organization: Section 2 discusses the origin of the GDC and their application to LWRs. Section 3 addresses the objective of this initiative and how it benefits the advanced non-LWR reactor vendors. Section 4 discusses the scope and structure of the initiative. Section 5 provides background on the U.S. Department of Energy (DOE) ARDC team’s original development of the proposed ARDC that were submitted to the NRC for consideration. Section 6 provides a summary of recent ARDC Phase 2 activities. Appendices A through E document the DOE ARDC team’s public comments on various sections of the NRC’s draft regulatory guide DG–1330, “Guidance for Developing Principal Design Criteria for Non-Light Water Reactors.”

The impact of patient's weight on post-stroke rehabilitation.

Science.gov (United States)

Kalichman, Leonid; Alperovitch-Najenson, Deborah; Treger, Iuly

2016-08-01

Purpose To evaluate the influence of patient's weight on rehabilitation outcomes in first-event stroke patients. Design Retrospective, observational comparative study. 102 first-time stroke male and female patients admitted to the 52-bed neurology rehabilitation department in a rehabilitation hospital were included in the study. Body mass index (BMI), Functional Independence Measure (FIM) on admission and at discharge, as well as the delta-FIM (FIM on admission - FIM at discharge) were evaluated. The Kruskal-Wallis test was used to compare the FIM and the NIHSS scores between BMI groups (normal, overweight, moderate and severe obesity). Results A statistically significant negative correlation (rho = -0.20, p = 0.049) was found between FIM change and BMI, that remained significant after adjustments for age, sex and hospitalisation days. No difference was found between groups in FIM or NIHSS change between BMI groups. Conclusions In sub-acute post-stroke patients undergoing rehabilitation in rehabilitation hospital, BMI was negatively associated with the improvement of functional parameters. Patients' BMI should be taken into consideration when predicting rehabilitation outcome for stroke patients. Further investigations are needed to identify the functional parameters affected by the patients' BMI. Implications for Rehabilitation In sub-acute post-stroke patients undergoing rehabilitation in rehabilitation hospital, BMI was negatively associated with the improvement of functional parameters. Patients' BMI should be taken into consideration when predicting rehabilitation outcome for stroke patients. New rehabilitation strategies should be designed to improve the functional outcomes of rehabilitation of obese patients.

MGR COMPLIANCE PROGRAM GUIDANCE PACKAGE FOR RADIATION PROTECTION EQUIPMENT, INSTRUMENTATION, AND FACILITIES

International Nuclear Information System (INIS)

2000-01-01

This Compliance Program Guidance Package identifies the regulatory guidance and industry codes and standards addressing radiation protection equipment, instrumentation, and support facilities considered to be appropriate for radiation protection at the Monitored Geologic Repository (MGR). Included are considerations relevant to radiation monitoring instruments, calibration, contamination control and decontamination, respiratory protection equipment, and general radiation protection facilities. The scope of this Guidance Package does not include design guidance relevant to criticality monitoring, area radiation monitoring, effluent monitoring, and airborne radioactivity monitoring systems since they are considered to be the topics of specific design and construction requirements (i.e., ''fixed'' or ''built-in'' systems). This Guidance Package does not address radiation protection design issues; it addresses the selection and calibration of radiation monitoring instrumentation to the extent that the guidance is relevant to the operational radiation protection program. Radon and radon progeny monitoring instrumentation is not included in the Guidance Package since such naturally occurring radioactive materials do not fall within the NRC's jurisdiction at the MGR

COED Transactions, Vol. X, No. 1, January 1978. Design and Simulation of an Automobile Guidance Control System.

Science.gov (United States)

Stefani, R. T.

This document describes the design of an automatic guidance and control system for a passenger car. A simulation of that system is presented. Analog outputs are provided which compare human operator control to automatic control. One human control possibility is to provide the operator with sufficient feedback information that resulting performance…

Enhancing Your Public Relations. A Guide for Designing Effective Communication Strategies for Community-Based Vocational Rehabilitation Programs.

Science.gov (United States)

DePoint, Beth

This document is intended to assist agencies in formulating and initiating a financially realistic public relations plan specifically designed for their community-based vocational rehabilitation organizations. The document consists of 6 chapters, a 43-item bibliography, a glossary, and information about the author. Chapter 1 defines public…

Randomized controlled trial of postoperative exercise rehabilitation program after lumbar spine fusion: study protocol

Directory of Open Access Journals (Sweden)

Tarnanen Sami

2012-07-01

Full Text Available Abstract Background Lumbar spine fusion (LSF effectively decreases pain and disability in specific spinal disorders; however, the disability rate following surgery remains high. This, combined with the fact that in Western countries the number of LSF surgeries is increasing rapidly it is important to develop rehabilitation interventions that improve outcomes. Methods/design In the present RCT-study we aim to assess the effectiveness of a combined back-specific and aerobic exercise intervention for patients after LSF surgery. One hundred patients will be randomly allocated to a 12-month exercise intervention arm or a usual care arm. The exercise intervention will start three months after surgery and consist of six individual guidance sessions with a physiotherapist and a home-based exercise program. The primary outcome measures are low back pain, lower extremity pain, disability and quality of life. Secondary outcomes are back function and kinesiophobia. Exercise adherence will also be evaluated. The outcome measurements will be assessed at baseline (3 months postoperatively, at the end of the exercise intervention period (15 months postoperatively, and after a 1-year follow-up. Discussion The present RCT will evaluate the effectiveness of a long-term rehabilitation program after LSF. To our knowledge this will be the first study to evaluate a combination of strength training, control of the neutral lumbar spine position and aerobic training principles in rehabilitation after LSF. Trial registration ClinicalTrials.gov Identifier NCT00834015

Dissecting Attending Surgeons' Operating Room Guidance: Factors That Affect Guidance Decision Making.

Science.gov (United States)

Chen, Xiaodong Phoenix; Williams, Reed G; Smink, Douglas S

2015-01-01

The amount of guidance provided by the attending surgeon in the operating room (OR) is a key element in developing residents' autonomy. The purpose of this study is to explore factors that affect attending surgeons' decision making regarding OR guidance provided to the resident. We used video-stimulated recall interviews (VSRI) throughout this 2-phase study. In Phase 1, 3 attending surgeons were invited to review separately 30 to 45 minute video segments of their prerecorded surgical operations to explore factors that influenced their OR guidance decision making. In Phase 2, 3 attending surgeons were observed and documented in the OR (4 operations, 341min). Each operating surgeon reviewed their videotaped surgical performance within 5 days of the operation to reflect on factors that affected their decision making during the targeted guidance events. All VSRI were recorded. Thematic analysis and manual coding were used to synthesize and analyze data from VSRI transcripts, OR observation documents, and field notes. A total of 255 minutes of VSRI involving 6 surgeons and 7 surgical operations from 5 different procedures were conducted. A total of 13 guidance decision-making influence factors from 4 categories were identified (Cohen's κ = 0.674): Setting (case schedule and patient morbidity), content (procedure attributes and case progress), resident (current competency level, trustworthiness, self-confidence, and personal traits), and attending surgeon (level of experience, level of comfort, preferred surgical technique, OR training philosophy, and responsibility as surgeon). A total of 5 factors (case schedule, patient morbidity, procedure attributes, resident current competency level, and trustworthiness) influenced attending surgeons' pre-OR guidance plans. "OR training philosophy" and "responsibility as surgeon" were anchor factors that affected attending surgeons' OR guidance decision-making patterns. Surgeons' OR guidance decision making is a dynamic process

Robotics in Lower-Limb Rehabilitation after Stroke.

Science.gov (United States)

Zhang, Xue; Yue, Zan; Wang, Jing

2017-01-01

With the increase in the elderly, stroke has become a common disease, often leading to motor dysfunction and even permanent disability. Lower-limb rehabilitation robots can help patients to carry out reasonable and effective training to improve the motor function of paralyzed extremity. In this paper, the developments of lower-limb rehabilitation robots in the past decades are reviewed. Specifically, we provide a classification, a comparison, and a design overview of the driving modes, training paradigm, and control strategy of the lower-limb rehabilitation robots in the reviewed literature. A brief review on the gait detection technology of lower-limb rehabilitation robots is also presented. Finally, we discuss the future directions of the lower-limb rehabilitation robots.

The Design of a Modified PSO Guidance Law Using Predictor and LOS Rate Evaluation

Directory of Open Access Journals (Sweden)

Lee Yung-Lung

2016-01-01

Full Text Available This paper proposes a modified particle swarm optimization guidance (MPSOG for the pursuit-evasion optimization problem. If the line-of-sight (LOS rate equals zero, the curvature of the missile’s trajectory would be smaller and the probability of intercept greater. Thus, we propose using a MPSOG to improve the guidance performance. The MPSOG uses a Kalman filter to predict a target’s dynamic. The lateral acceleration commands of the y- and z-axis are optimized by the particle swarm optimization (PSO algorithm, respectively. Numerical simulation results show that the MPSOG have better guidance performance than proportional navigation guidance and particle swarm optimization guidance in miss distance, time-to-go, and final lateral acceleration commands.

Exploration of the methodological quality and clinical usefulness of a cross-sectional sample of published guidance about exercise training and physical activity for the secondary prevention of coronary heart disease.

Science.gov (United States)

Abell, Bridget; Glasziou, Paul; Hoffmann, Tammy

2017-06-13

Clinicians are encouraged to use guidelines to assist in providing evidence-based secondary prevention to patients with coronary heart disease. However, the expanding number of publications providing guidance about exercise training may confuse cardiac rehabilitation clinicians. We therefore sought to explore the number, scope, publication characteristics, methodological quality, and clinical usefulness of published exercise-based cardiac rehabilitation guidance. We included publications recommending physical activity, exercise or cardiac rehabilitation for patients with coronary heart disease. These included systematically developed clinical practice guidelines, as well as other publications intended to support clinician decision making, such as position papers or consensus statements. Publications were obtained via electronic searches of preventive cardiology societies, guideline databases and PubMed, to November 2016. Publication characteristics were extracted, and two independent assessors evaluated quality using the 23-item Appraisal of Guidelines Research and Evaluation II (AGREE) tool. Fifty-four international publications from 1994 to 2016 were identified. Most were found on preventive cardiology association websites (n = 35; 65%) and were freely accessible (n = 50; 93%). Thirty (56%) publications contained only broad recommendations for physical activity and cardiac rehabilitation referral, while 24 (44%) contained the necessary detailed exercise training recommendations. Many were labelled as "guidelines", however publications with other titles (e.g. scientific statements) were common (n = 24; 44%). This latter group of publications contained a significantly greater proportion of detailed exercise training recommendations than clinical guidelines (p = 0.017). Wide variation in quality also existed, with 'applicability' the worst scoring AGREE II domain for clinical guidelines (mean score 53%) and 'rigour of development' rated lowest for other

Rehabilitation after labral repair and femoroacetabular decompression: criteria-based progression through the return to sport phase.

Science.gov (United States)

Wahoff, Michael; Dischiavi, Steve; Hodge, Jenna; Pharez, Joseph D

2014-11-01

Rehabilitation following hip arthroscopy for femoroacetabular impingement (FAI) and labral-chondral dysfunction has evolved rapidly over the past 15 years. There have been multiple commentaries published on rehabilitation following hip arthroscopy without any published standardized objective criteria to address the advancement of the athlete through the phases of rehabilitation. The purpose of this clinical commentary is to describe a criteria driven algorithm for safe integration and return to sport rehabilitation following hip arthroscopy. The criteria based program allows for individuality of the athlete while providing guidance from early post-operative phases through late return to sport phases of rehabilitation. Emphasis is placed on the minimum criteria to advance including healing restraints, patient reported outcomes, range of motion, core and hip stability, postural control, symmetry with functional tasks and gait, strength, power, endurance, agility, and sport-specific tasks. Evidence to support the criteria will be offered as available. Despite limitations, this clinical commentary will offer a guideline for safe return to sport for the athlete while identifying areas for further investigation. 5.

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.

Robot - a member of (re)habilitation team

OpenAIRE

Komazec Zoran; Lemajić-Komazec Slobodanka; Golubović Špela; Mikov Aleksandra; Krasnik Rastislava

2012-01-01

Introduction. The rehabilitation process involves a whole team of experts who participate in it over a long period of time. Development of Robotics and its Application in Medicine. The Intensive development of science and technology has made it possible to design a number of robots which are used for therapeutic purposes and participate in the rehabilitation process. Robotics in Medical Rehabilitation. During the long history of technological development of mankind, a number of conceptu...

Guidance and Control Architecture Design and Demonstration for Low Ballistic Coefficient Atmospheric Entry

Science.gov (United States)

Swei, Sean

2014-01-01

We propose to develop a robust guidance and control system for the ADEPT (Adaptable Deployable Entry and Placement Technology) entry vehicle. A control-centric model of ADEPT will be developed to quantify the performance of candidate guidance and control architectures for both aerocapture and precision landing missions. The evaluation will be based on recent breakthroughs in constrained controllability/reachability analysis of control systems and constrained-based energy-minimum trajectory optimization for guidance development operating in complex environments.

Shoulder-elbow exoskeleton as rehabilitation exerciser

Science.gov (United States)

Ianoşi, A.; Dimitrova, A.; Noveanu, S.; Tătar, O. M.; Mândru, D. S.

2016-08-01

This paper presents a 2 degree of freedom exoskeleton designed for the rehabilitation of the shoulder and elbow movement in the sagittal plane; a semi-portable design strategy was chosen, which enables an easy attachment to a standard medical chair as well as the patient upper limb. A dedicated driver enables the control from a graphical user interface, which also provides the option of customized rehabilitation exercises. The potential of future improvements is assessed, and recommendations of research direction are made in order to broaden the usability of the proposed device.

Rehabilitation Robots: Concepts and Applications in Stroke Rehabilitation

Directory of Open Access Journals (Sweden)

Mohammad Ali Ahmadi-Pajouh

2017-02-01

Full Text Available Robotics is a tool to assist human in different applications from industry to medicine. There are many reasons that human tends to use these machines. They are very reliable in repetitive, high precision, preprogrammed and high risk jobs in which human is not too good enough. In medicine, robotic applications are evolving so fast that in near future nobody can imagine a surgery without a robot involved. In Rehabilitation we have the same scenario; there are commercialized robots to assist disable people to eat and perform daily activities. There are also clinical rehabilitation robots which can train handicaps. They can help subjects as a passive tool that improves low level impairments such as rigidity. On the other hand robots can train brain as an active tool to have a better movement again. We will see how robots can help therapist to apply repetitive passive movements in quadriplegic subject (i.e. in Brunnstrom stages 1 to 3. On the other hand they can teach subjects how to complete a task in an active manner (i.e. in stages 5 and 6 which can facilitate neuroplasticity. There are different robots designed for different organs; for example rehabilitation of upper extremities (e.g. Gloreha or lower extremities (e.g. Lokomat. There are also exoskeleton robots to help subjects to grip objects and perform ADLs easily (e.g. Bioservo or help paraplegic patient to walk again (e.g. Rewalk. In this talk, we will also discuss about how robots are helping rehab specialist to improve standard protocols. For example we will show how action observation therapy, bimanual therapy, assistive active therapy, proprioceptive facilitation and passive mobilization therapy are realized using an upper extremity rehabilitation robot. Robotics is the future of technology and rehabilitation needs this technology. Be part of this technology!

[Application of the International Classification of Functioning, Disability and Health (ICF) in Psychosomatic Rehabilitation and Addiction Rehabilitation in Germany - The Current State].

Science.gov (United States)

Spies, M; Brütt, A L; Freitag, M; Buchholz, A

2015-10-01

The aim of this study was to gather information on the current state of the implementation of the International Classification of Functioning, Disability and Health (ICF) in psychosomatic and addiction rehabilitation. In the summer of 2013, rehabilitation clinics in Germany were surveyed online on their ICF utilization. The questionnaire covered scope and purpose of ICF use, application of ICF core sets and assessments as well as barriers to the use of ICF. Of 359 clinics invited, 104 (30%) participated in the survey. Of those surveyed, 60 (61.9%) claimed to have taken measures to implement the ICF in their clinic; only 37 (38.5%), however, reported using the ICF in their daily work. The main barriers identified were complexity of the ICF, time management issues and training deficits. Approaches to ICF use are not uniform. There is a need for training programs, and guidance from health care insurance providers could help towards uniform implementation of the ICF. © Georg Thieme Verlag KG Stuttgart · New York.

OARSI Clinical Trials Recommendations: Design and conduct of clinical trials of rehabilitation interventions for osteoarthritis.

Science.gov (United States)

Fitzgerald, G K; Hinman, R S; Zeni, J; Risberg, M A; Snyder-Mackler, L; Bennell, K L

2015-05-01

A Task Force of the Osteoarthritis Research Society International (OARSI) has previously published a set of guidelines for the conduct of clinical trials in osteoarthritis (OA) of the hip and knee. Limited material available on clinical trials of rehabilitation in people with OA has prompted OARSI to establish a separate Task Force to elaborate guidelines encompassing special issues relating to rehabilitation of OA. The Task Force identified three main categories of rehabilitation clinical trials. The categories included non-operative rehabilitation trials, post-operative rehabilitation trials, and trials examining the effectiveness of devices (e.g., assistive devices, bracing, physical agents, electrical stimulation, etc.) that are used in rehabilitation of people with OA. In addition, the Task Force identified two main categories of outcomes in rehabilitation clinical trials, which include outcomes related to symptoms and function, and outcomes related to disease modification. The guidelines for rehabilitation clinical trials provided in this report encompass these main categories. The report provides guidelines for conducting and reporting on randomized clinical trials. The topics include considerations for entering patients into trials, issues related to conducting trials, considerations for selecting outcome measures, and recommendations for statistical analyses and reporting of results. The focus of the report is on rehabilitation trials for hip, knee and hand OA, however, we believe the content is broad enough that it could be applied to rehabilitation trials for other regions as well. Copyright © 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Multidisciplinary team care in rehabilitation

DEFF Research Database (Denmark)

Momsen, A.-M.; Nielsen, C.V.; Rasmussen, J.O.

2012-01-01

Objectives: To systematically investigate current scientific evidence about the effectiveness of multidisciplinary team rehabilitation for different health problems. Data sources: A comprehensive literature search was conducted in Cochrane, Medline, DARE, Embase, and Cinahl databases, and research...... for adults, without restrictions in terms of study population or outcomes. The most recent reviews examining a study population were selected. Data extraction: Two reviewers independently extracted information about study populations, sample sizes, study designs, rehabilitation settings, the team...

Rehabilitation of uranium tailings impoundments

International Nuclear Information System (INIS)

Crawley, A.H.

1983-01-01

Under Australian environmental controls relating to the management of uranium tailings, it is no longer acceptable practice to search for a rehabilitation strategy at the end of production when the generation of tailings has ceased. The uranium projects currently in production and those being proposed are tightly regulated by the authorities. The waste management plans must consider site specific factors and must include selection of appropriate disposal sites and design for long term containment. The final encapsulation in engineered facilities must take into account the probable routes to the environment of the tailings. Rehabilitation shoud be undertaken by the mining and milling operators to standards approved by appropriate authorities. Appropriate administrative arrangements are required, by way of technical committees and financial bonds to ensure that agreed standards of rehabilitation may be achieved. Past and present experience with the rehabilitation of uranium tailings impoundments in Australia is discussed

Toward an evidence-based patient-provider communication in rehabilitation: linking communication elements to better rehabilitation outcomes.

Science.gov (United States)

Jesus, Tiago Silva; Silva, Isabel Lopes

2016-04-01

There is a growing interest in linking aspects of patient-provider communication to rehabilitation outcomes. However, the field lacks a conceptual understanding on: (a) 'how' rehabilitation outcomes can be improved by communication; and (b) through 'which' elements in particular. This article elaborates on the conceptual developments toward informing further practice and research. Existing models of communication in healthcare were adapted to rehabilitation, and its outcomes through a comprehensive literature review. After depicting mediating mechanisms and variables (e.g. therapeutic engagement, adjustment toward disability), this article presents the '4 Rehab Communication Elements' deemed likely to underpin rehabilitation outcomes. The four elements are: (a) knowing the person and building a supportive relationship; (b) effective information exchange and education; (c) shared goal-setting and action planning; and (d) fostering a more positive, yet realistic, cognitive and self-reframing. This article describes an unprecedented, outcomes-oriented approach toward the design of rehabilitation communication, which has resulted in the development of a new intervention model: the '4 Rehab Communication Elements'. Further trials are needed to evaluate the impact of this whole intervention model on rehabilitation outcomes. © The Author(s) 2015.

Optimal design of an alignment-free two-DOF rehabilitation robot for the shoulder complex.

Science.gov (United States)

Galinski, Daniel; Sapin, Julien; Dehez, Bruno

2013-06-01

This paper presents the optimal design of an alignment-free exoskeleton for the rehabilitation of the shoulder complex. This robot structure is constituted of two actuated joints and is linked to the arm through passive degrees of freedom (DOFs) to drive the flexion-extension and abduction-adduction movements of the upper arm. The optimal design of this structure is performed through two steps. The first step is a multi-objective optimization process aiming to find the best parameters characterizing the robot and its position relative to the patient. The second step is a comparison process aiming to select the best solution from the optimization results on the basis of several criteria related to practical considerations. The optimal design process leads to a solution outperforming an existing solution on aspects as kinematics or ergonomics while being more simple.

Guidelines for postdoctoral training in rehabilitation psychology.

Science.gov (United States)

Stiers, William; Hanson, Stephanie; Turner, Aaron P; Stucky, Kirk; Barisa, Mark; Brownsberger, Mary; Van Tubbergen, Marie; Ashman, Teresa; Kuemmel, Angela

2012-11-01

This article describes the methods and results of a national conference that was held to (1) develop consensus guidelines about the structure and process of rehabilitation psychology postdoctoral training programs and (2) create a Council of Rehabilitation Psychology Postdoctoral Training Programs to promote training programs' abilities to implement the guidelines and to formally recognize programs in compliance with the guidelines. Forty-six conference participants were chosen to include important stakeholders in rehabilitation psychology, representatives of rehabilitation psychology training and practice communities, representatives of psychology accreditation and certification bodies, and persons involved in medical education practice and research. Consensus guidelines were developed for rehabilitation psychology postdoctoral training program structure and process and for establishing the Council of Rehabilitation Psychology Postdoctoral Training Programs. The Conference developed aspirational guidelines for postdoctoral education and training programs in applied rehabilitation psychology and established a Council of Rehabilitation Psychology Postdoctoral Training Programs as a means of promoting their adoption by training programs. These efforts are designed to promote quality, consistency, and excellence in the education and training of rehabilitation psychology practitioners and to promote competence in their practice. It is hoped that these efforts will stimulate discussion, assist in the development of improved teaching and evaluation methods, lead to interesting research questions, and generally facilitate the continued systematic development of the profession of rehabilitation psychology. PsycINFO Database Record (c) 2012 APA, all rights reserved

Rehabilitation of patients with motor disabilities using computer vision based techniques

Directory of Open Access Journals (Sweden)

Alejandro Reyes-Amaro

2012-05-01

Full Text Available In this paper we present details about the implementation of computer vision based applications for the rehabilitation of patients with motor disabilities. The applications are conceived as serious games, where the computer-patient interaction during playing contributes to the development of different motor skills. The use of computer vision methods allows the automatic guidance of the patient’s movements making constant specialized supervision unnecessary. The hardware requirements are limited to low-cost devices like usual webcams and Netbooks.

Information architecture. Volume 3: Guidance

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-04-01

The purpose of this document, as presented in Volume 1, The Foundations, is to assist the Department of Energy (DOE) in developing and promulgating information architecture guidance. This guidance is aimed at increasing the development of information architecture as a Departmentwide management best practice. This document describes departmental information architecture principles and minimum design characteristics for systems and infrastructures within the DOE Information Architecture Conceptual Model, and establishes a Departmentwide standards-based architecture program. The publication of this document fulfills the commitment to address guiding principles, promote standard architectural practices, and provide technical guidance. This document guides the transition from the baseline or defacto Departmental architecture through approved information management program plans and budgets to the future vision architecture. This document also represents another major step toward establishing a well-organized, logical foundation for the DOE information architecture.

Scientific Guidance for Rehabilitation of the Chesapeake Bay Ecosystem under the Changing Climate.

Science.gov (United States)

Boesch, D. F.; Johnson, Z. P.; Li, M.

2017-12-01

While the Chesapeake Bay is an estuary and not a marginal sea on the scale of the Baltic Sea or the Gulf of Mexico, it has a complex set of environmental issues and multiple political jurisdictions such that it can serve as a test bed for science-informed management in larger marine systems. In particular, the Chesapeake Bay possesses a relatively advanced effort to ameliorate eutrophication, reduce toxic stresses, rehabilitate critical habitats, and sustainably utilized resources. Furthermore, both scientists and managers are addressing these challenges while now beginning to incorporate the effects of changes in temperature, precipitation and runoff, sea level, ocean boundary conditions, and pH. Increases in temperature and sea level are already apparent and future conditions can be estimated from global model projections, although sea level and ocean exchanges are also affected by variations in Gulf Stream flows and mesoscale climate. Changes in the volume, seasonality and variability in freshwater delivery from the multiple rivers discharging to the bay are harder to project with confidence, but may have pervasive consequences for circulation, reducing nutrient loads to ameliorate eutrophication, biogeochemical processes, and biotic distributions and dynamics. Science is now challenged to inform multiple adaptation strategies, including minimizing the vulnerability of humans and infrastructure, sustaining important tidal wetlands, managing sediment resources, sustaining living resources, redefining achievable ecosystem rehabilitation goals, and achieving shifting goals for nutrient load reductions. At the same time, science will also have to identify effective means to meet these challenges while also reducing greenhouse gas emissions.

Design and Development of a Bilateral Therapeutic Hand Device for Stroke Rehabilitation

Directory of Open Access Journals (Sweden)

Akhlaquor Rahman

2013-12-01

Full Text Available The major cause of disability is stroke. It is the second highest cause of death after coronary heart disease in Australia. In this paper, a post stroke therapeutic device has been designed and developed for hand motor function rehabilitation that a stroke survivor can use for bilateral movement practice. A prototype of the device was fabricated that can fully flex and extend metacarpophalangeal (MCP, proximal interphalangeal (PIP and distal interphalangeal (DIP joints of the fingers, and interphalangeal (IP, metacarpophalangeal (MCP and trapeziometacarpal (IM joints of the thumb of the left hand (impaired hand, based on movements of the right hand's (healthy hand fingers. Out of 21 degrees of freedom (DOFs of hand fingers, the prototype of the hand exoskeleton allowed fifteen degrees of freedom (DOFs, with three degrees of freedom (DOFs for each finger and three degrees of freedom (DOFs for the thumb. In addition, testing of the device on a healthy subject was conducted to validate the design requirements.

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.

A knowledge translation intervention designed using audit and feedback and the Theoretical Domains Framework for physical therapists working in inpatient rehabilitation: A case report.

Science.gov (United States)

Romney, Wendy; Salbach, Nancy; Parrott, James Scott; Deutsch, Judith E

2018-04-16

Little is known about the process of engaging key stakeholders to select and design a knowledge translation (KT) intervention to increase the use of an outcome measure using audit and feedback. The purpose of this case report was to describe the development of a KT intervention designed with organizational support to increase physical therapists' (PTs) use of a selected outcome measure in an inpatient sub-acute rehabilitation hospital. Eleven PTs who worked at a sub-acute rehabilitation hospital participated. After determining organizational support, a mixed methods barrier assessment including a chart audit, questionnaire, and a focus group with audit and feedback was used to select an outcome measure and design a locally tailored intervention. The intervention was mapped using the Theoretical Domains Framework (TDF). One investigator acted as knowledge broker and co-designed the intervention with clinician and supervisor support. The 4-m walk test was selected through a group discussion facilitated by the knowledge broker. Support from the facility and input from the key stakeholders guided the design of a tailored KT intervention to increase use of gait speed. The intervention design included an interactive educational meeting, with documentation and environmental changes. Input from the clinicians on the educational meeting, documentation changes and placement of tracks, and support from the supervisor were used to design and locally adapt a KT intervention to change assessment practice among PTs in an inpatient sub-acute rehabilitation hospital. Implementation and evaluation of the intervention is underway.

A Terminal Guidance Law Based on Motion Camouflage Strategy of Air-to-Ground Missiles

Directory of Open Access Journals (Sweden)

Chang-sheng Gao

2016-01-01

Full Text Available A guidance law for attacking ground target based on motion camouflage strategy is proposed in this paper. According to the relative position between missile and target, the dual second-order dynamics model is derived. The missile guidance condition is given by analyzing the characteristic of motion camouflage strategy. Then, the terminal guidance law is derived by using the relative motion of missile and target and the guidance condition. In the process of derivation, the three-dimensional guidance law could be designed in a two-dimensional plane and the difficulty of guidance law design is reduced. A two-dimensional guidance law for three-dimensional space is derived by bringing the estimation for target maneuver. Finally, simulation for the proposed guidance law is taken and compared with pure proportional navigation. The simulation results demonstrate that the proposed guidance law can be applied to air-to-ground missiles.

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.

Connected Audiological Rehabilitation: 21st Century Innovations

Science.gov (United States)

Saunders, Gabrielle H.; Chisolm, Theresa H.

2016-01-01

Background Tele-audiology provides a means to offer audiologic rehabilitation (AR) in a cost-, resource-, and time-effective manner. If designed appropriately, it also has the capability of personalizing rehabilitation to the user in terms of content, depth of detail, etc., thus permitting selection of the best content for a particular individual. Synchronous/real-time data collection, store and forward telehealth, remote monitoring and mobile health using smartphone applications have each been applied to components of audiologic rehabilitation intervention (sensory management, instruction in the use of technology and control of the listening environment, perceptual and communication strategies training, and counseling). In this article, the current state of tele-audiological rehabilitation interventions are described and discussed. Results The provision of AR via tele-audiology potentially provides a cost-effective mechanism for addressing barriers to the routine provision of AR beyond provisions of hearing technology. Furthermore, if designed appropriately, it has the capability of personalizing rehabilitation to the user in terms of content, depth of detail, etc., thus permitting selection of the best content for a particular individual. However, effective widespread implementation of tele-audiology will be dependent on good education of patients and clinician alike, and researchers must continue to examine the effectiveness of these new approaches to AR in order to ensure clinicians provide effective evidence-based rehabilitation to their patients. Conclusions While several barriers to the widespread use of tele-audiology for audiologic rehabilitation currently exist, it is concluded that through education of patients and clinicians alike, it will gain greater support from practitioners and patients over time and will become successfully and widely implemented. PMID:26415970

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.

[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.

Design of a biologically inspired lower limb exoskeleton for human gait rehabilitation.

Science.gov (United States)

Lyu, Mingxing; Chen, Weihai; Ding, Xilun; Wang, Jianhua; Bai, Shaoping; Ren, Huichao

2016-10-01

This paper proposes a novel bionic model of the human leg according to the theory of physiology. Based on this model, we present a biologically inspired 3-degree of freedom (DOF) lower limb exoskeleton for human gait rehabilitation, showing that the lower limb exoskeleton is fully compatible with the human knee joint. The exoskeleton has a hybrid serial-parallel kinematic structure consisting of a 1-DOF hip joint module and a 2-DOF knee joint module in the sagittal plane. A planar 2-DOF parallel mechanism is introduced in the design to fully accommodate the motion of the human knee joint, which features not only rotation but also relative sliding. Therefore, the design is consistent with the requirements of bionics. The forward and inverse kinematic analysis is studied and the workspace of the exoskeleton is analyzed. The structural parameters are optimized to obtain a larger workspace. The results using MATLAB-ADAMS co-simulation are shown in this paper to demonstrate the feasibility of our design. A prototype of the exoskeleton is also developed and an experiment performed to verify the kinematic analysis. Compared with existing lower limb exoskeletons, the designed mechanism has a large workspace, while allowing knee joint rotation and small amount of sliding.

Design of a biologically inspired lower limb exoskeleton for human gait rehabilitation

Science.gov (United States)

Lyu, Mingxing; Chen, Weihai; Ding, Xilun; Wang, Jianhua; Bai, Shaoping; Ren, Huichao

2016-10-01

This paper proposes a novel bionic model of the human leg according to the theory of physiology. Based on this model, we present a biologically inspired 3-degree of freedom (DOF) lower limb exoskeleton for human gait rehabilitation, showing that the lower limb exoskeleton is fully compatible with the human knee joint. The exoskeleton has a hybrid serial-parallel kinematic structure consisting of a 1-DOF hip joint module and a 2-DOF knee joint module in the sagittal plane. A planar 2-DOF parallel mechanism is introduced in the design to fully accommodate the motion of the human knee joint, which features not only rotation but also relative sliding. Therefore, the design is consistent with the requirements of bionics. The forward and inverse kinematic analysis is studied and the workspace of the exoskeleton is analyzed. The structural parameters are optimized to obtain a larger workspace. The results using MATLAB-ADAMS co-simulation are shown in this paper to demonstrate the feasibility of our design. A prototype of the exoskeleton is also developed and an experiment performed to verify the kinematic analysis. Compared with existing lower limb exoskeletons, the designed mechanism has a large workspace, while allowing knee joint rotation and small amount of sliding.

Career Guidance and Social Exclusion: A Cautionary Tale.

Science.gov (United States)

Watts, A. G.

2001-01-01

Examines the relationship of career guidance to public-policy interventions designed to address social exclusion. Analyzes the nature and origin of the concept of social exclusion and reviews the roles of career guidance in response to it, particularly in relation to young people who have dropped out of formal education or are at high risk of…

Design and implementation of a GPS guidance system for agricultural tractors using augmented reality technology.

Science.gov (United States)

Santana-Fernández, Javier; Gómez-Gil, Jaime; del-Pozo-San-Cirilo, Laura

2010-01-01

Current commercial tractor guidance systems present to the driver information to perform agricultural tasks in the best way. This information generally includes a treated zones map referenced to the tractor's position. Unlike actual guidance systems where the tractor driver must mentally associate treated zone maps and the plot layout, this paper presents a guidance system that using Augmented Reality (AR) technology, allows the tractor driver to see the real plot though eye monitor glasses with the treated zones in a different color. The paper includes a description of the system hardware and software, a real test done with image captures seen by the tractor driver, and a discussion predicting that the historical evolution of guidance systems could involve the use of AR technology in the agricultural guidance and monitoring systems.

Design and Implementation of a GPS Guidance System for Agricultural Tractors Using Augmented Reality Technology

Directory of Open Access Journals (Sweden)

Laura del-Pozo-San-Cirilo

2010-11-01

Full Text Available Current commercial tractor guidance systems present to the driver information to perform agricultural tasks in the best way. This information generally includes a treated zones map referenced to the tractor’s position. Unlike actual guidance systems where the tractor driver must mentally associate treated zone maps and the plot layout, this paper presents a guidance system that using Augmented Reality (AR technology, allows the tractor driver to see the real plot though eye monitor glasses with the treated zones in a different color. The paper includes a description of the system hardware and software, a real test done with image captures seen by the tractor driver, and a discussion predicting that the historical evolution of guidance systems could involve the use of AR technology in the agricultural guidance and monitoring systems.

From career guidance to the labor insertion of users of mental health services in solidarity economy enterprises

Directory of Open Access Journals (Sweden)

Letícia Gomes da Silva

2014-09-01

Full Text Available With the psychiatric reform movement, reflecting on the rehabilitation of users of mental health services in society has become essential. Aiming to include users of mental health services in solidarity economy enterprises and seeking ways to promote this inclusion, career guidance was taken as a potential tool. This research project aimed to investigate the potential of the process of career guidance as a strategy for the inclusion of these users in solidary economy enterprises. Semi-structured interviews were used for data collection. The participants were two users of mental health services that were members of the career orientation program held in 2010, the technician responsible for the solidarity economy enterprise, and two non-users of mental health services. We also carried out an analysis of the minutes of the career guidance meetings, and the data from this analysis were used to complement the data obtained in the interviews. Data analysis was based on the theoretical assumptions of solidarity economics and guidance for vocation and deinstitutionalization. The results converge toward career guidance as a facilitator of the insertion of users of mental health services in solidarity economy enterprises. Although some limitations have been found indicating the need to conduct new studies, results suggest that career guidance is a viable alternative to facilitate the inclusion of this population.

A qualitative study adopting a user-centered approach to design and validate a brain computer interface for cognitive rehabilitation for people with brain injury.

Science.gov (United States)

Martin, Suzanne; Armstrong, Elaine; Thomson, Eileen; Vargiu, Eloisa; Solà, Marc; Dauwalder, Stefan; Miralles, Felip; Daly Lynn, Jean

2017-07-14

Cognitive rehabilitation is established as a core intervention within rehabilitation programs following a traumatic brain injury (TBI). Digitally enabled assistive technologies offer opportunities for clinicians to increase remote access to rehabilitation supporting transition into home. Brain Computer Interface (BCI) systems can harness the residual abilities of individuals with limited function to gain control over computers through their brain waves. This paper presents an online cognitive rehabilitation application developed with therapists, to work remotely with people who have TBI, who will use BCI at home to engage in the therapy. A qualitative research study was completed with people who are community dwellers post brain injury (end users), and a cohort of therapists involved in cognitive rehabilitation. A user-centered approach over three phases in the development, design and feasibility testing of this cognitive rehabilitation application included two tasks (Find-a-Category and a Memory Card task). The therapist could remotely prescribe activity with different levels of difficulty. The service user had a home interface which would present the therapy activities. This novel work was achieved by an international consortium of academics, business partners and service users.

75 FR 5632 - Office of New Reactors; Interim Staff Guidance on the Review of Nuclear Power Plant Designs Using...

Science.gov (United States)

2010-02-03

... Management System (ADAMS) Accession No. ML092640035). This ISG provides new guidance information for applicants submitting a combined license (COL) or design certification (DC) for construction and operation of... (SRP), Section 8.3.1 and Sections 9.5.4 through 9.5.8. The NRC staff issues DC/COL-ISGs to facilitate...

Process evaluations in neurological rehabilitation: a mixed-evidence systematic review and recommendations for future research.

Science.gov (United States)

Masterson-Algar, Patricia; Burton, Christopher R; Rycroft-Malone, Jo

2016-11-08

To systematically review how process evaluations are currently designed, what methodologies are used and how are they developed alongside or within neurological rehabilitation trials. This mixed-methods systematic review had two evidence streams: stream I, studies reporting process evaluations alongside neurorehabilitation trials research and stream II, methodological guidance on process evaluation design and methodology. A search strategy was designed for each evidence stream. Data regarding process evaluation core concepts and design issues were extracted using a bespoke template. Evidence from both streams was analysed separately and then synthesised in a final overarching synthesis proposing a number of recommendations for future research. A total of 124 process evaluation studies, reporting on 106 interventions, were included in stream I evidence. 30 studies were included as stream II evidence. Synthesis 1 produced 9 themes, and synthesis 2 identified a total of 8 recommendations for process evaluation research. The overall synthesis resulted in 57 'synthesis recommendations' about process evaluation methodology grouped into 9 research areas, including the use of theory, the investigation of context, intervention staff characteristics and the delivery of the trial intervention. There remains no consensus regarding process evaluation terminology within the neurological rehabilitation field. There is a need for process evaluations to address the nature and influence of context over time. Process evaluations should clearly describe what intervention staff bring to a trial, including skills and experience prior to joining the research. Process evaluations should monitor intervention staff's learning effects and the possible impact that these may have on trial outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Design and Evaluation of a Soft and Wearable Robotic Glove for Hand Rehabilitation.

Science.gov (United States)

Biggar, Stuart; Yao, Wei

2016-10-01

In the modern world, due to an increased aging population, hand disability is becoming increasingly common. The prevalence of conditions such as stroke is placing an ever-growing burden on the limited fiscal resources of health care providers and the capacity of their physical therapy staff. As a solution, this paper presents a novel design for a wearable and adaptive glove for patients so that they can practice rehabilitative activities at home, reducing the workload for therapists and increasing the patient's independence. As an initial evaluation of the design's feasibility the prototype was subjected to motion analysis to compare its performance with the hand in an assessment of grasping patterns of a selection of blocks and spheres. The outcomes of this paper suggest that the theory of design has validity and may lead to a system that could be successful in the treatment of stroke patients to guide them through finger flexion and extension, which could enable them to gain more control and confidence in interacting with the world around them.

GUIDANCE FOR NUCLEAR POWER PLANT CONTROL ROOM AND HUMAN-SYSTEM INTERFACE MODERNIZATION

International Nuclear Information System (INIS)

Naser, J.; Morris, G.

2004-01-01

Several nuclear power plants in the United States are starting instrumentation and control (I and C) modernization programs using digital equipment to address obsolescence issues and the need to improve plant performance while maintaining high levels of safety. As an integral part of the I and C modernization program at a nuclear power plant, the control room and other human-system interfaces (HSIs) are also being modernized. To support safe and effective operation, it is critical to plan, design, implement, train for, operate, and maintain the control room and HSI changes to take advantage of human cognitive processing abilities. A project, jointly funded by the Electric Power Research Institute (EPRI) and the United States Department of Energy (DOE) under the Nuclear Energy Plant Optimization (NEPO) Program, is developing guidance for specifying and designing control rooms, remote shut-down panels, HSIs etc. The guidance is intended for application by utilities and suppliers of control room and HSI modernization. The guidance will facilitate specification, design, implementation, operations, maintenance, training, and licensing activities. This guidance will be used to reduce the likelihood of human errors and licensing risk, to gain maximum benefit of implemented technology, and to increase performance. The guidance is of five types. The first is planning guidance to help a utility develop its plant-specific control room operating concepts, its plant-specific endpoint vision for the control room, its migration path to achieve that endpoint vision, and its regulatory, licensing, and human factors program plans. The second is process guidance for general HSI design and integration, human factors engineering analyses, verification and validation, in-service monitoring processes, etc. The third is detailed human factors engineering guidance for control room and HSI technical areas. The fourth is guidance for licensing. The fifth is guidance for special topics

Providing rehabilitation online

DEFF Research Database (Denmark)

Bødker, Malene; Juul, Annegrete

2015-01-01

Purpose – Telecare promises to deliver healthcare services more efficiently while, at the same time, improving the quality of care. The purpose of this paper is to challenge these promises by analysing the implications of introducing telecare in the rehabilitation of patients suffering from chronic...... obstructive pulmonary disease. Design/methodology/approach – Empirically, the paper is based on interviews with and observations of rehabilitation therapists and patients taking part in a Danish telerehabilitation programme. Theoretically, the paper draws on Science and Technology Studies. Findings...... one ends. Practical implications – Evaluations of telecare technologies should pay more attention to workand responsibility-related effects of introducing telecare in order better to account for predicted and unpredicted as well as desirable and undesirable socio-technical changes. Originality/value...

CRC Credential Attainment by State Vocational Rehabilitation Counselors

Science.gov (United States)

Harpster, Anna M.; Byers, Katherine L.; Harris, LaKeisha L.

2011-01-01

This study examines 137 state vocational rehabilitation (VR) counselors' perceptions of the value of having the Certified Rehabilitation Counselor (CRC) credential. While almost 53% of this sample included persons who were certified, the majority who were not indicated that the two major reasons for not currently having this designation were: (a)…

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

Science.gov (United States)

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.

Robust entry guidance using linear covariance-based model predictive control

Directory of Open Access Journals (Sweden)

Jianjun Luo

2017-02-01

Full Text Available For atmospheric entry vehicles, guidance design can be accomplished by solving an optimal issue using optimal control theories. However, traditional design methods generally focus on the nominal performance and do not include considerations of the robustness in the design process. This paper proposes a linear covariance-based model predictive control method for robust entry guidance design. Firstly, linear covariance analysis is employed to directly incorporate the robustness into the guidance design. The closed-loop covariance with the feedback updated control command is initially formulated to provide the expected errors of the nominal state variables in the presence of uncertainties. Then, the closed-loop covariance is innovatively used as a component of the cost function to guarantee the robustness to reduce its sensitivity to uncertainties. After that, the models predictive control is used to solve the optimal problem, and the control commands (bank angles are calculated. Finally, a series of simulations for different missions have been completed to demonstrate the high performance in precision and the robustness with respect to initial perturbations as well as uncertainties in the entry process. The 3σ confidence region results in the presence of uncertainties which show that the robustness of the guidance has been improved, and the errors of the state variables are decreased by approximately 35%.

A Three-Dimensional Cooperative Guidance Law of Multimissile System

Directory of Open Access Journals (Sweden)

Xing Wei

2015-01-01

Full Text Available In order to conduct saturation attacks on a static target, the cooperative guidance problem of multimissile system is researched. A three-dimensional guidance model is built using vector calculation and the classic proportional navigation guidance (PNG law is extended to three dimensions. Based on this guidance law, a distributed cooperative guidance strategy is proposed and a consensus protocol is designed to coordinate the time-to-go commands of all missiles. Then an expert system, which contains two extreme learning machines (ELM, is developed to regulate the local proportional coefficient of each missile according to the command. All missiles can arrive at the target simultaneously under the assumption that the multimissile network is connected. A simulation scenario is given to demonstrate the validity of the proposed method.

A Generic Guidance and Control Structure for Six-Degree-of-Freedom Conceptual Aircraft Design

Science.gov (United States)

Cotting, M. Christopher; Cox, Timothy H.

2005-01-01

A control system framework is presented for both real-time and batch six-degree-of-freedom simulation. This framework allows stabilization and control with multiple command options, from body rate control to waypoint guidance. Also, pilot commands can be used to operate the simulation in a pilot-in-the-loop environment. This control system framework is created by using direct vehicle state feedback with nonlinear dynamic inversion. A direct control allocation scheme is used to command aircraft effectors. Online B-matrix estimation is used in the control allocation algorithm for maximum algorithm flexibility. Primary uses for this framework include conceptual design and early preliminary design of aircraft, where vehicle models change rapidly and a knowledge of vehicle six-degree-of-freedom performance is required. A simulated airbreathing hypersonic vehicle and a simulated high performance fighter are controlled to demonstrate the flexibility and utility of the control system.

Trajectory reshaping based guidance with impact time and angle constraints

Directory of Open Access Journals (Sweden)

Zhao Yao

2016-08-01

Full Text Available This study presents a novel impact time and angle constrained guidance law for homing missiles. The guidance law is first developed with the prior-assumption of a stationary target, which is followed by the practical extension to a maneuvering target scenario. To derive the closed-form guidance law, the trajectory reshaping technique is utilized and it results in defining a specific polynomial function with two unknown coefficients. These coefficients are determined to satisfy the impact time and angle constraints as well as the zero miss distance. Furthermore, the proposed guidance law has three additional guidance gains as design parameters which make it possible to adjust the guided trajectory according to the operational conditions and missile’s capability. Numerical simulations are presented to validate the effectiveness of the proposed guidance law.

78 FR 26560 - Proposed Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

Science.gov (United States)

2013-05-07

... in nonrural areas (U.S. Census Bureau, 2011b), and rural vocational rehabilitation clients with... priorities, we designate the type of each priority as absolute, competitive preference, or invitational...)). Competitive preference priority: Under a competitive preference priority, we give competitive preference to an...

Publication trends of study protocols in rehabilitation.

Science.gov (United States)

Jesus, Tiago S; Colquhoun, Heather L

2017-09-04

Growing evidence points for the need to publish study protocols in the health field. To observe whether the growing interest in publishing study protocols in the broader health field has been translated into increased publications of rehabilitation study protocols. Observational study using publication data and its indexation in PubMed. Not applicable. Not applicable. PubMed was searched with appropriate combinations of Medical Subject Headings up to December 2014. The effective presence of study protocols was manually screened. Regression models analyzed the yearly growth of publications. Two-sample Z-tests analyzed whether the proportion of Systematic Reviews (SRs) and Randomized Controlled Trials (RCTs) among study protocols differed from that of the same designs for the broader rehabilitation research. Up to December 2014, 746 publications of rehabilitation study protocols were identified, with an exponential growth since 2005 (r2=0.981; p<0.001). RCT protocols were the most common among rehabilitation study protocols (83%), while RCTs were significantly more prevalent among study protocols than among the broader rehabilitation research (83% vs. 35.8%; p<0.001). For SRs, the picture was reversed: significantly less common among study protocols (2.8% vs. 9.3%; p<0.001). Funding was more often reported by rehabilitation study protocols than the broader rehabilitation research (90% vs. 53.1%; p<0.001). Rehabilitation journals published a significantly lower share of rehabilitation study protocols than they did for the broader rehabilitation research (1.8% vs.16.7%; p<0.001). Identifying the reasons for these discrepancies and reverting unwarranted disparities (e.g. low rate of publication for rehabilitation SR protocols) are likely new avenues for rehabilitation research and its publication. SRs, particularly those aggregating RCT results, are considered the best standard of evidence to guide rehabilitation clinical practice; however, that standard can be improved

Consensus standard requirements and guidance

International Nuclear Information System (INIS)

Putman, V.L.

1995-01-01

This report presents information from the ANS Criticality Alarm System Workshop relating to the consensus standard requirements and guidance. Topics presented include: definition; nomenclature; requirements and recommendations; purpose of criticality alarms; design criteria; signal characteristics; reliability, dependability and durability; tests; and emergency preparedness and planning

Rehabilitation of Onitsha-Enugu Dual Carriageway in Anambra ...

African Journals Online (AJOL)

The rehabilitation of Onitsha-Enugu dual carriageway in Anambra State, Nigeria, which started in 2009 was marred by inadequate rehabilitation design and gross shortfall in earthwork quantities. The project was awarded at a cost less than 60% of what was actually needed to execute it at the time of award. Delays in the ...

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.

Robotic devices and brain-machine interfaces for hand rehabilitation post-stroke.

Science.gov (United States)

McConnell, Alistair C; Moioli, Renan C; Brasil, Fabricio L; Vallejo, Marta; Corne, David W; Vargas, Patricia A; Stokes, Adam A

2017-06-28

To review the state of the art of robotic-aided hand physiotherapy for post-stroke rehabilitation, including the use of brain-machine interfaces. Each patient has a unique clinical history and, in response to personalized treatment needs, research into individualized and at-home treatment options has expanded rapidly in recent years. This has resulted in the development of many devices and design strategies for use in stroke rehabilitation. The development progression of robotic-aided hand physiotherapy devices and brain-machine interface systems is outlined, focussing on those with mechanisms and control strategies designed to improve recovery outcomes of the hand post-stroke. A total of 110 commercial and non-commercial hand and wrist devices, spanning the 2 major core designs: end-effector and exoskeleton are reviewed. The growing body of evidence on the efficacy and relevance of incorporating brain-machine interfaces in stroke rehabilitation is summarized. The challenges involved in integrating robotic rehabilitation into the healthcare system are discussed. This review provides novel insights into the use of robotics in physiotherapy practice, and may help system designers to develop new devices.

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

Science.gov (United States)

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.

Complex rehabilitation and the clinical condition of working rheumatoid arthritis patients: does cryotherapy always overtop traditional rehabilitation?

Science.gov (United States)

Księżopolska-Orłowska, Krystyna; Pacholec, Anna; Jędryka-Góral, Anna; Bugajska, Joanna; Sadura-Sieklucka, Teresa; Kowalik, Katarzyna; Pawłowska-Cyprysiak, Karolina; Łastowiecka-Moras, Elżbieta

2016-01-01

Rehabilitation slows the progress of rheumatoid arthritis (RA) and prevents progression of disability. This study aimed to compare the impact of two rehabilitation programmes on pain, disease activity, locomotor function, global health and work ability forecast in RA patients. Sixty-four employed women aged 24-65 years participated in the study. All patients underwent individual and instrumental kinesiotherapy. Thirty-two patients underwent cryogenic chamber therapy and local cryotherapy as well as non-weight-bearing, instrumental and individual kinesiotherapy. The remaining 32 patients received traditional rehabilitation in the form of electromagnetic and instrumental therapy, individual and pool-based non-weight-bearing kinesiotherapy. Rehabilitation lasted 3 weeks. Patients were examined three times: prior to rehabilitation, after 3 weeks of therapy and 3 months after completion of rehabilitation. The following study instruments were used: to assess disease activity: DAS-28; functional impairment: HAQ-DI; pain severity: VAS; patients' overall well-being: a scale from 0 to 100 (Global Health Index); and patients' own prognosis of fitness for work: the 6th question from Work Ability Index (WAI). Statistical analysis of data was performed using the STATISTICA 8.0 package. Mixed-design two-way analysis of variance was used for hypothesis testing. All patients improved after rehabilitation. The group of patients those who underwent cryotherapy had improved DAS-28, HAQ-DI, VAS and global health scores immediately following the 3-week rehabilitation programme (p cryotherapy resulted in greater improvement in disease activity DAS-28 [F(2,105) = 5.700; p = 0.007; η(2) = 0.084] and HAQ-DI locomotor function scores [F(2,109) = 6.771; p = 0.003; η(2) = 0.098] compared to traditional rehabilitation. The impact of both forms of rehabilitation on patients' own prognosis of work ability in the next 2 years was not significant. Results of patients who underwent

Using RFID Positioning Technology to Construct an Automatic Rehabilitation Scheduling Mechanism.

Science.gov (United States)

Wang, Ching-Sheng; Hung, Lun-Ping; Yen, Neil Y

2016-01-01

Accurately and efficiently identifying the location of patients during the course of rehabilitation is an important issue. Wireless transmission technology can reach this goal. Tracking technologies such as RFID (Radio frequency identification) can support process improvement and improve efficiencies of rehabilitation. There are few published models or methods to solve the problem of positioning and apply this technology in the rehabilitation center. We propose a mechanism to enhance the accuracy of positioning technology and provide information about turns and obstacles on the path; and user-centered services based on location-aware to enhanced quality care in rehabilitation environment. This paper outlines the requirements and the role of RFID in assisting rehabilitation environment. A prototype RFID hospital support tool is established. It is designed to provide assistance for monitoring rehabilitation patients. It can simultaneously calculate the rehabilitant's location and the duration of treatment, and automatically record the rehabilitation course of the rehabilitant, so as to improve the management efficiency of the rehabilitation program.

75 FR 33311 - Guidance for Industry on Bioequivalence Recommendations for Specific Products; Availability

Science.gov (United States)

2010-06-11

... available recommendations on how to design product-specific BE studies to support ANDAs. Under this process... thinking on a new process for making available to sponsors FDA guidance on how to design product-specific... ``Bioequivalence Recommendations for Specific Products.'' This guidance describes a new process for making...

A novel speech prosthesis for mandibular guidance therapy in hemimandibulectomy patient: A clinical report

Directory of Open Access Journals (Sweden)

Raghavendra Adaki

2016-01-01

Full Text Available Treating diverse maxillofacial patients poses a challenge to the maxillofacial prosthodontist. Rehabilitation of hemimandibulectomy patients must aim at restoring mastication and other functions such as intelligible speech, swallowing, and esthetics. Prosthetic methods such as palatal ramp and mandibular guiding flange reposition the deviated mandible. Such prosthesis can also be used to restore speech in case of patients with debilitating speech following surgical resection. This clinical report gives detail of a hemimandibulectomy patient provided with an interim removable dental speech prosthesis with composite resin flange for mandibular guidance therapy.

Evaluation of evidence within occupational therapy in stroke rehabilitation

DEFF Research Database (Denmark)

Kristensen, Hanne Kaae; Persson, Dennis; Nygren, Carita

2010-01-01

therapy intervention related to the use of everyday life occupations and client-centred practice within stroke rehabilitation. Design: Systematic searches of research studies published in English during 2000-2007 in peer-reviewed journals were undertaken. Thirty-nine articles and one Cochrane review were...... after rehabilitation. There is also considerable evidence for the use of everyday life occupations in occupational therapy. Occupational therapy was evaluated as an important aspect of stroke rehabilitation improving outcomes in everyday life occupations including activities of daily living (ADL...

Cold shock to aquatic organisms: guidance for power-plant siting, design, and operation

International Nuclear Information System (INIS)

Coutant, C.C.

1977-01-01

Problems of cold-shock damages to aquatic organisms have arisen at some condenser cooling-water discharges of thermal power stations when the warm-water releases have suddenly terminated. The basis for such damage lies in the exposure of resident organisms to a rapid decrease in temperature and a sustained exposure to low temperature that induces abnormal behavioral or physiological performance and often leads to death. Although some spectacular fish kills from cold shock have occurred, the present knowledge of the hydraulic and biological processes involved can provide guidance for the siting, design, and operation of power-plant cooling systems to minimize the likelihood of significant cold-shock effects. Preventing cold-shock damages is one consideration in minimizing overall environmental impacts of power-plant cooling and in balancing plant costs with environmental benefits

Safety of magnetic fusion facilities: Volume 2, Guidance

International Nuclear Information System (INIS)

1995-01-01

This document provides guidance for the implementation of the requirements identified in Vol. 1 of this Standard. This guidance is intended for the managers, designers, operators, and other personnel with safety responsibilities for facilities designated as magnetic fusion facilities. While Vol. 1 is generally applicable in that requirements there apply to a wide range of fusion facilities, this volume is concerned mainly with large facilities such as the International Thermonuclear Experimental Reactor (ITER). Using a risk-based prioritization, the concepts presented here may also be applied to other magnetic fusion facilities. This volume is oriented toward regulation in the Department of Energy (DOE) environment

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.

Experiences of patients and service providers with out-patient rehabilitation services in a rehabilitation centre in the Western Cape Province

Directory of Open Access Journals (Sweden)

Anne Kumurenzi

2015-12-01

Full Text Available Background: Rehabilitation is important for persons with disabilities as it contributes to their sense of autonomy, self-worth and social participation, and improves their quality of life. Improving the quality of rehabilitation services requires the dialogue of patients’ perceptions with those of service providers, in order to recommend informed reform. Objective: The objective was to explore the experiences of persons with physical disabilities and service providers, regarding the multi-disciplinary rehabilitation services provided at a community-based out-patient rehabilitation centre. Methods: A qualitative, exploratory study design was used to collect the data. A focus group was conducted with conveniently selected persons with physical disabilities. Three in-depth interviews were conducted with purposively selected key informants. All ethical considerations were adhered to during the implementation of the study. Results: Patients and service providers had different experiences regarding accessibility to rehabilitation services, and similar experiences with patient education and intensity of rehabilitation. Although the patients experienced that the service providers had sufficient knowledge and skills to manage them, services providers expressed that they lacked certain skills. Conclusions: The experiences expressed highlighted the need to improve rehabilitation services in terms of increasing the capacity of service providers and providing transport services for persons with disabilities.

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.

Robust approximate optimal guidance strategies for aeroassisted orbital transfer missions

Science.gov (United States)

Ilgen, Marc R.

This thesis presents the application of game theoretic and regular perturbation methods to the problem of determining robust approximate optimal guidance laws for aeroassisted orbital transfer missions with atmospheric density and navigated state uncertainties. The optimal guidance problem is reformulated as a differential game problem with the guidance law designer and Nature as opposing players. The resulting equations comprise the necessary conditions for the optimal closed loop guidance strategy in the presence of worst case parameter variations. While these equations are nonlinear and cannot be solved analytically, the presence of a small parameter in the equations of motion allows the method of regular perturbations to be used to solve the equations approximately. This thesis is divided into five parts. The first part introduces the class of problems to be considered and presents results of previous research. The second part then presents explicit semianalytical guidance law techniques for the aerodynamically dominated region of flight. These guidance techniques are applied to unconstrained and control constrained aeroassisted plane change missions and Mars aerocapture missions, all subject to significant atmospheric density variations. The third part presents a guidance technique for aeroassisted orbital transfer problems in the gravitationally dominated region of flight. Regular perturbations are used to design an implicit guidance technique similar to the second variation technique but that removes the need for numerically computing an optimal trajectory prior to flight. This methodology is then applied to a set of aeroassisted inclination change missions. In the fourth part, the explicit regular perturbation solution technique is extended to include the class of guidance laws with partial state information. This methodology is then applied to an aeroassisted plane change mission using inertial measurements and subject to uncertainties in the initial value

Plasticity, permanence and patient performance: study design and data analysis in the cognitive rehabilitation of acquired communication impairments

Directory of Open Access Journals (Sweden)

Patricia E Cowell

2010-11-01

Full Text Available Communication impairments such as aphasia and apraxia can follow brain injury and result in limitation of an individual's participation in social interactions, and capacity to convey needs and desires. Our research group developed a computerised treatment programme which is based on neuroscientific principles of speech production (Varley and Whiteside, 2001; Varley, 2010; Whiteside and Varley, 1998 and has been shown to improve communication in people with apraxia and aphasia (Dyson et al., 2009; Varley et al., 2009. Investigations of treatment efficacy have presented challenges in study design, effect measurement and statistical analysis which are likely to be shared by other researchers in the wider field of cognitive neurorehabilitation evaluation. Several key factors define neurocognitively based therapies, and differentiate them and their evaluation from other forms of medical intervention. These include: (1 inability to blind patients to the content of the treatment and control procedures; (2 neurocognitive changes that are more permanent than pharmacological treatments on which many medical study designs are based; and (3 the semi-permanence of therapeutic effects means that new baselines are set throughout the course of a given treatment study, against which comparative interventions or long term retention effects must be measured. This article examines key issues in study design, effect measurement and data analysis in relation to the rehabilitation of patients undergoing treatment for apraxia of speech. Results from our research support a case for the use of multiperiod, multiphase cross-over design with specific computational adjustments and statistical considerations. The paper provides researchers in the field with a methodologically feasible and statistically viable alternative to other designs used in rehabilitation sciences.

Playing to (self-)rehabilitate

DEFF Research Database (Denmark)

Knoche, Hendrik; Hald, Kasper; Richter, Dorte

2016-01-01

We designed and evaluated a whack-a-mole (WAM) style game (see Figure 1) in a clinical randomized controlled trial (RCT) with reminder-assisted but self-initiated use over the period of a month with 43 participants from a post-lesion pool. While game play did not moderate rehabilitative progress...

A Formal Investigation of the Organization of Guidance Behavior: Implications for Humans and Autonomous Guidance

Science.gov (United States)

Kong, Zhaodan

Guidance behavior generated either by artificial agents or humans has been actively studied in the fields of both robotics and cognitive science. The goals of these two fields are different. The former is the automatic generation of appropriate or even optimal behavior, while the latter is the understanding of the underlying mechanism. Their challenges, though, are closely related, the most important one being the lack of a unified, formal and grounded framework where the guidance behavior can be modeled and studied. This dissertation presents such a framework. In this framework, guidance behavior is analyzed as the closed-loop dynamics of the whole agent-environment system. The resulting dynamics give rise to interaction patterns. The central points of this dissertation are that: first of all, these patterns, which can be explained in terms of symmetries that are inherent to the guidance behavior, provide building blocks for the organization of behavior; second, the existence of these patterns and humans' organization of their guidance behavior based on these patterns are the reasons that humans can generate successful behavior in spite of all the complexities involved in the planning and control. This dissertation first gives an overview of the challenges existing in both scientific endeavors, such as human and animal spatial behavior study, and engineering endeavors, such as autonomous guidance system design. It then lays out the foundation for our formal framework, which states that guidance behavior should be interpreted as the collection of the closed-loop dynamics resulting from the agent's interaction with the environment. The following, illustrated by examples of three different UAVs, shows that the study of the closed-loop dynamics should not be done without the consideration of vehicle dynamics, as is the common practice in some of the studies in both autonomous guidance and human behavior analysis. The framework, the core concepts of which are

Design and evaluation of a modular lower limb exoskeleton for rehabilitation.

Science.gov (United States)

Dos Santos, Wilian M; Nogueira, Samuel L; de Oliveira, Gustavo C; Pena, Guido G; Siqueira, Adriano A G

2017-07-01

This paper deals with the evaluation of an exoskeleton designed for assisting individuals to rehabilitate compromised lower limb movements resulting from stroke or incomplete spinal cord injury. The exoskeleton is composed of lightweight tubular structures and six free joints that provide a modular feature to the system. This feature allows the exoskeleton to be adapted to assist the movement of one or more patient joints. The actuation of the exoskeleton is also modular, and can be performed passively, by means of springs and dampers, or actively through actuators. In addition, its telescopic tubular links, developed to adjust the size of the links in order to align the joints of the exoskeleton with patient joints, allows the exoskeleton to be adjustable to fit different patients. Experiments considering the interaction between a healthy subject and the exoskeleton are performed to evaluate the influence of the exoskeleton structure on kinematic and muscular activity profiles during walking.

Highly effective photonic cue for repulsive axonal guidance.

Directory of Open Access Journals (Sweden)

Bryan J Black

Full Text Available In vivo nerve repair requires not only the ability to regenerate damaged axons, but most importantly, the ability to guide developing or regenerating axons along paths that will result in functional connections. Furthermore, basic studies in neuroscience and neuro-electronic interface design require the ability to construct in vitro neural circuitry. Both these applications require the development of a noninvasive, highly effective tool for axonal growth-cone guidance. To date, a myriad of technologies have been introduced based on chemical, electrical, mechanical, and hybrid approaches (such as electro-chemical, optofluidic flow and photo-chemical methods. These methods are either lacking in desired spatial and temporal selectivity or require the introduction of invasive external factors. Within the last fifteen years however, several attractive guidance cues have been developed using purely light based cues to achieve axonal guidance. Here, we report a novel, purely optical repulsive guidance technique that uses low power, near infrared light, and demonstrates the guidance of primary goldfish retinal ganglion cell axons through turns of up to 120 degrees and over distances of ∼90 µm.

Analysis of concentrating PV-T systems for the commercial/industrial sector. Volume III. Technical issues and design guidance

Energy Technology Data Exchange (ETDEWEB)

Schwinkendorf, W.E.

1984-09-01

This report provide appropriate guidance for addressing the major technical issues associated with the design and installation of a photovoltaic-thermal (PV-T) system. Nomographs are presented for developing preliminary sizing and costing, and issues associated with specific components and the overall design of the electrical and mechanical system are discussed. SAND82-7157/2 presents a review of current PV-T technology and operating systems and a study of potential PV-T applications. Detailed PV-T system designs for three selected applications and the results of a trade-off study for these applications are presented in SAND82-7157/4. A summary of the major results of this entire study and conclusions concerning PV-T systems and applications is presented in SAND82-7157/1.

Sliding Mode Tracking Control of a Wire-Driven Upper-Limb Rehabilitation Robot with Nonlinear Disturbance Observer

Directory of Open Access Journals (Sweden)

Jie Niu

2017-12-01

Full Text Available Robot-aided rehabilitation has become an important technology to restore and reinforce motor functions of patients with extremity impairment, whereas it can be extremely challenging to achieve satisfactory tracking performance due to uncertainties and disturbances during rehabilitation training. In this paper, a wire-driven rehabilitation robot that can work over a three-dimensional space is designed for upper-limb rehabilitation, and sliding mode control with nonlinear disturbance observer is designed for the robot to deal with the problem of unpredictable disturbances during robot-assisted training. Then, simulation and experiments of trajectory tracking are carried out to evaluate the performance of the system, the position errors, and the output forces of the designed control scheme are compared with those of the traditional sliding mode control (SMC scheme. The results show that the designed control scheme can effectively reduce the tracking errors and chattering of the output forces as compared with the traditional SMC scheme, which indicates that the nonlinear disturbance observer can reduce the effect of unpredictable disturbances. The designed control scheme for the wire-driven rehabilitation robot has potential to assist patients with stroke in performing repetitive rehabilitation training.

77 FR 37007 - Applications for New Awards: National Institute on Disability and Rehabilitation Research...

Science.gov (United States)

2012-06-20

... advanced engineering research on and development of innovative technologies that are designed to solve particular rehabilitation problems, or to remove environmental barriers. RERCs also demonstrate and evaluate... early-career rehabilitation engineers. RERCs seek to solve rehabilitation problems and remove...

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...

Integrating design and communication in engineering education: a collaboration between Northwestern University and the Rehabilitation Institute of Chicago.

Science.gov (United States)

Hirsch, Penny L; Yarnoff, Charles

2011-01-01

The required course for freshmen in Northwestern University's engineering school - a 2-quarter sequence called Engineering Design and Communication (EDC) - is noteworthy not only for its project-based focus on user-centered design, but also for its innovative integrated approach to teaching communication, teamwork, and ethics. Thanks to the collaboration between EDC faculty and staff at the Rehabilitation Institute of Chicago, EDC students, at the beginning of their education, experience the excitement of solving problems for real clients and users. At the same time, these authentic design projects offer an ideal setting for teaching students how to communicate effectively to different audiences and perform productively as team members and future leaders in engineering.

Accelerated hydrotherapy and land-based rehabilitation in soccer ...

African Journals Online (AJOL)

Objective. To investigate the effectiveness of accelerated rehabilitation and accelerated hydrotherapy after anterior cruciate ligament (ACL) reconstruction in male athletes participating in soccer. Design. A non-concurrent single subject, multiple baseline design (ABA design) was conducted over 10 weeks. A series of three ...

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)

Attitude to rehabilitative counselling in southwestern Nigerian prisons.

Science.gov (United States)

A Alao, Kayode; F Adebowale, Olusegun

2014-01-01

The purpose of this paper was to examine the attitudes of prison inmates and warders (prison staff) to rehabilitative counselling and its relationship to their prison status on one hand and their educational attainment on the other. The study adopts a descriptive survey research design. In all 123 prison inmates and 110 warders were selected by stratified random sampling from Osogbo prison headquarters, as well as Ilesa and Ile-Ife prisons in southwestern Nigeria. Data were collected through a self-constructed questionnaire titled "inmate and prison staff attitude to rehabilitation counselling". Data collected were analysed using percentages and χ2 statistics. The results showed that the prison inmates and staff possessed positive attitude to rehabilitative counselling. No significant difference was found between the attitudes of prison inmates and staff members or on the basis of their prison statuses. However, the study found a significant relationship between the prison inmates' attitude to rehabilitative counselling and their educational attainment. Research LIMITATIONS/IMPLICATIONS: Statutory provision needs be made for professional rehabilitative counselling in Nigerian prisons in contrast to the religious instructions currently being allowed prisoners. Educational opportunities should be provided to ensure that the knowledge so obtained complements the rehabilitative counselling. Originality/value - This paper fulfils an identified need to study the attitude towards rehabilitative counselling.

Customizable Rehabilitation Lower Limb Exoskeleton System

Directory of Open Access Journals (Sweden)

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.

Orion Powered Flight Guidance Burn Options for Near Term Exploration

Science.gov (United States)

Fill, Tom; Goodman, John; Robinson, Shane

2018-01-01

NASA's Orion exploration spacecraft will fly more demanding mission profiles than previous NASA human flight spacecraft. Missions currently under development are destined for cislunar space. The EM-1 mission will fly unmanned to a Distant Retrograde Orbit (DRO) around the Moon. EM-2 will fly astronauts on a mission to the lunar vicinity. To fly these missions, Orion requires powered flight guidance that is more sophisticated than the orbital guidance flown on Apollo and the Space Shuttle. Orion's powered flight guidance software contains five burn guidance options. These five options are integrated into an architecture based on a proven shuttle heritage design, with a simple closed-loop guidance strategy. The architecture provides modularity, simplicity, versatility, and adaptability to future, yet-to-be-defined, exploration mission profiles. This paper provides a summary of the executive guidance architecture and details the five burn options to support both the nominal and abort profiles for the EM-1 and EM-2 missions.

Engineering and Design: Reliability Analysis of Navigation Lock and Dam Mechanical and Electrical Equipment

National Research Council Canada - National Science Library

Beranek, Dwight

2001-01-01

This engineer technical letter (ETL) provides guidance for assessing the reliability of mechanical and electrical systems of navigation locks and dams and for establishing an engineering basis for major rehabilitation investment decisions...

Rehabilitation centers in change: participatory methods for managing redesign and renovation.

Science.gov (United States)

Lahtinen, Marjaana; Nenonen, Suvi; Rasila, Heidi; Lehtelä, Jouni; Ruohomäki, Virpi; Reijula, Kari

2014-01-01

The aim of this article is to describe a set of participatory methods that we have either developed or modified for developing future work and service environments to better suit renewable rehabilitation processes. We discuss the methods in a larger framework of change process model and participatory design. Rehabilitation organizations are currently in transition; customer groups, financing, services, and the processes of rehabilitation centers are changing. The pressure for change challenges the centers to develop both their processes and facilities. There is a need for methods that support change management. Four participatory methods were developed: future workshop, change survey, multi-method assessment tool, and participatory design generator cards. They were tested and evaluated in three rehabilitation centers at the different phases of their change process. The developed methods were considered useful in creating a mutual understanding of the change goals between different stakeholders, providing a good picture of the work community's attitudes toward the change, forming an integrated overview of the built and perceived environment, inspiring new solutions, and supporting the management in steering the change process. The change process model described in this article serves as a practical framework that combined the viewpoints of organizational and facility development. However, participatory design continues to face challenges concerning communication between different stakeholders, and further development of the methods and processes is still needed. Intervention studies could provide data on the success factors that enhance the transformations in the rehabilitation sector. Design process, methodology, organizational transformation, planning, renovation.

Effectiveness of virtual reality rehabilitation for children and adolescents with cerebral palsy: an updated evidence-based systematic review.

Science.gov (United States)

Ravi, D K; Kumar, N; Singhi, P

2017-09-01

The use of virtual reality systems in the motor rehabilitation of children with cerebral palsy is new, and thus the scientific evidence for its effectiveness needs to be evaluated through a systematic review. To provide updated evidence-based guidance for virtual reality rehabilitation in sensory and functional motor skills of children and adolescents with cerebral palsy. PubMed, PEDro, Web of Science, OTseeker, PsycINFO and Cochrane Library were searched from their earliest records up to 1 June, 2016. Two reviewers applied the population intervention comparison outcome (PICO) question to screen the studies for this review. Information on study design, subjects, intervention, outcome measures and efficacy results were extracted into a pilot-tested form. Method quality was assessed independently by two reviewers using the Downs and Black checklist. Thirty-one studies included 369 participants in total. Best evidence synthesis was applied to summarize the outcomes, which were grouped according to International Classification of Functioning, Disability and Health. Moderate evidence was found for balance and overall motor development. The evidence is still limited for other motor skills. This review uncovered additional literature showing moderate evidence that virtual reality rehabilitation is a promising intervention to improve balance and motor skills in children and adolescents with cerebral palsy. The technique is growing, so long-term follow-up and further research are required to determine its exact place in the management of cerebral palsy. Systematic review registration number PROSPERO 2015:CRD42015026048. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

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...

Moisture Control Guidance for Commercial and Public ...

Science.gov (United States)

This document provides guidance to designers, construction mangers, and building operation/maintenance managers to improve IEQ and reduce risks of encountering IEQ problems due to insufficient moisture control. EPA will be producing a document entitled

Ecological Restoration: Guidance from Theory

Directory of Open Access Journals (Sweden)

Joy Zedler

2005-09-01

Full Text Available A review of the science and practice of ecosystem restoration led me to identify key ecological theories and concepts that are relevant to planning, implementing, and sustaining restoration efforts. From experience with actual restoration projects, I provide guidance for improving the restoration process. Despite an abundance of theory and guidance, restoration goals are not always achieved, and pathways toward targets are not highly predictable. This is understandable, since each restoration project has many constraints and unique challenges. To improve restoration progress, I advise that sites be designed as experiments to allow learning while doing. At least the larger projects can be restored in phases, each designed as experimental treatments to test alternative restoration approaches. Subsequent phases can then adopt one or more of the treatments that best achieved goals in earlier phases while applying new tests of other restoration measures. Both science and restoration can progress simultaneously. This phased, experimental approach (called “adaptive restoration” is an effective tool for improving restoration when monitoring, assessment, interpretation and research are integrated into the process.

Leadership Development of Rehabilitation Professionals in a Low-Resource Country: A Transformational Leadership, Project-Based Model

OpenAIRE

Pascal, Maureen Romanow; Mann, Monika; Dunleavy, Kim; Chevan, Julia; Kirenga, Liliane; Nuhu, Assuman

2017-01-01

Background and rationale This paper presents an overview of the activities and outcomes of the Leadership Institute (LI), a short-term leadership development professional development course offered to physiotherapists in a low-resource country. Previous studies have provided examples of the benefits of such programs in medicine and nursing, but this has yet to be documented in the rehabilitation literature. The prototype of leadership development presented may provide guidance for similar tra...

Design Issues and Application of Cable-Based Parallel Manipulators for Rehabilitation Therapy

Directory of Open Access Journals (Sweden)

E. Ottaviano

2008-01-01

Full Text Available In this study, cable-based manipulators are proposed for application in rehabilitation therapies. Cable-based manipulators show good features that are very useful when the system has to interact with humans. In particular, they can be used to aid motion or as monitoring/training systems in rehabilitation therapies. Modelling and simulation of both active and passive cable-based parallel manipulators are presented for an application to help older people, patients or disabled people in the sit-to-stand transfer and as a monitoring/training system. Experimental results are presented by using built prototypes.

Visual search guidance is best after a short delay.

Science.gov (United States)

Schmidt, Joseph; Zelinsky, Gregory J

2011-03-25

Search displays are typically presented immediately after a target cue, but in the real-world, delays often exist between target designation and search. Experiments 1 and 2 asked how search guidance changes with delay. Targets were cued using a picture or text label, each for 3000ms, followed by a delay up to 9000ms before the search display. Search stimuli were realistic objects, and guidance was quantified using multiple eye movement measures. Text-based cues showed a non-significant trend towards greater guidance following any delay relative to a no-delay condition. However, guidance from a pictorial cue increased sharply 300-600ms after preview offset. Experiment 3 replicated this guidance enhancement using shorter preview durations while equating the time from cue onset to search onset, demonstrating that the guidance benefit is linked to preview offset rather than a more complete encoding of the target. Experiment 4 showed that enhanced guidance persists even with a mask flashed at preview offset, suggesting an explanation other than visual priming. We interpret our findings as evidence for the rapid consolidation of target information into a guiding representation, which attains its maximum effectiveness shortly after preview offset. Copyright © 2011 Elsevier Ltd. All rights reserved.

Psychological benefits of virtual reality for patients in rehabilitation therapy.

Science.gov (United States)

Chen, Chih-Hung; Jeng, Ming-Chang; Fung, Chin-Ping; Doong, Ji-Liang; Chuang, Tien-Yow

2009-05-01

Whether virtual rehabilitation is beneficial has not been determined. To investigate the psychological benefits of virtual reality in rehabilitation. An experimental group underwent therapy with a virtual-reality-based exercise bike, and a control group underwent the therapy without virtual-reality equipment. Hospital laboratory. 30 patients suffering from spinal-cord injury. A designed rehabilitation therapy. Endurance, Borg's rating-of-perceived-exertion scale, the Activation-Deactivation Adjective Check List (AD-ACL), and the Simulator Sickness Questionnaire. The differences between the experimental and control groups were significant for AD-ACL calmness and tension. A virtual-reality-based rehabilitation program can ease patients' tension and induce calm.

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…

Career guidance in communities

DEFF Research Database (Denmark)

Thomsen, Rie

for the development of a critically reflexive career guidance practice. The considerations are organised around seven elements. 1. Creating opportunity, structure and access 2. Entering a community and increasing visibility 3. Providing guidance in communities 4. Exploring potentials in guidance situations 5...... in career guidance practices as well as in the lives of the people in the communities. This paper falls into two parts: The first part considers the collective as the starting point for the development of meaningful career guidance activities. Based on previous research on career guidance in communities......The aim of this paper is to inspire practitioners and professionals to leave their offices to bring career guidance into communities that might not identify with career guidance in the first instance. By making the effort to engage with communities, practitioners may bring about a critical change...

How did rehabilitation professionals act when faced with the Great East Japan earthquake and disaster? Descriptive epidemiology of disability and an interim report of the relief activities of the ten Rehabilitation-Related Organizations.

OpenAIRE

Liu, Meigen; Kohzuki, Masahiro; Hamamura, Akinori; Ishikawa, Makoto; Saitoh, Masami; Kurihara, Masaki; Handa, Kazuto; Nakamura, Haruki; Fukaura, Junichi; Kimura, Ryuji; Ito, Takao; Matsuzaka, Nobuou

2012-01-01

Objective: Inter-organizational coordination is important for rehabilitation disaster relief. The 2011 Great East Japan Earthquake and Disaster was unprecedented, being geographically widespread and multifaceted. Faced with the crisis, rehabilitation professionals established the 10 Rehabilitation- Related Organizations of Rehabilitation Support Service (10-RRO). The objectives of this paper are to provide descriptive epidemiology and assess the activities of 10- RRO. Design: Descriptive. Met...

Does clinical rehabilitation impose sufficient cardiorespiratory strain to improve aerobic fitness?

NARCIS (Netherlands)

Koopman, A.D.; Eken, M.M.; van Bezeij, T.; Valent, L.; Houdijk, J.H.P.

2013-01-01

Objective: To investigate the cardiorespiratory strain experienced by patients over a day and during different types of rehabilitation therapies during a clinical rehabilitation programme. In addition, to investigate the use of the Borg scale as an instrument to monitor exercise intensity. Design:

Concise Arm and Hand Rehabilitation Approach in Stroke (CARAS: A practical and evidence-based framework for clinical rehabilitation management

Directory of Open Access Journals (Sweden)

Johan A. Franck

2015-10-01

Full Text Available The volume of information on new treatment techniques supporting the restoration of arm-hand function (AHF and arm-hand skill performance (ASHP in stroke survivors overwhelms therapists in everyday clinical practice when choosing the appropriate therapy. The Concise Arm and Hand Rehabilitation Approach in Stroke (CARAS is designed for paramedical staff to structure and implement training of AHF and AHSP in stroke survivors. The CARAS is based on four constructs: (a stratification according to the severity of arm–hand impairment (using the Utrecht Arm/Hand -Test [UAT], (b the individual’s rehabilitation goals and concomitant potential rehabilitation outcomes, (c principles of self-efficacy, and (d possibilities to systematically incorporate (new technology and new evidence-based training elements swiftly. The framework encompasses three programs aimed at treating either the severely (UAT 0-1, moderately (UAT 2-3, or mildly (UAT 4-7 impaired arm-hand. Program themes are: taking care of the limb and prevention of complications (Program 1, task-oriented gross motor grip performance (Program 2, and functional AHSP training (Program 3. Each program is preceded and followed by an assessment. Training modularity facilitates rapid interchange/adaptation of sub-elements. Proof-of-principle in clinical rehabilitation has been established. The CARAS facilitates rapid structured design and provision of state-of-the-art AHF and ASHP treatment in stroke patients.

Building America Case Study: Design Guidance for Passive Vents in New Construction Multifamily Buildings, New York, New York

Energy Technology Data Exchange (ETDEWEB)

2016-02-01

This document addresses the use of passive vents as a source of outdoor air in multifamily buildings. The challenges associated with implementing passive vents and the factors affecting performance are outlined. A comprehensive design methodology and quantified performance metrics are provided. Two hypothetical design examples are provided to illustrate the process. This document is intended to be useful to designers, decision-makers, and contractors implementing passive ventilation strategies. It is also intended to be a resource for those responsible for setting high-performance building program requirements, especially pertaining to ventilation and outdoor air. To ensure good indoor air quality, a dedicated source of outdoor air is an integral part of high-performance buildings. Presently, there is a lack of guidance pertaining to the design and installation of passive vents, resulting in poor system performance. This report details the criteria necessary for designing, constructing, and testing passive vent systems to enable them to provide consistent and reliable levels of ventilation air from outdoors.

Guidance theory and practice : the status of career exploration

OpenAIRE

Taveira, Maria do Céu; Rodríguez Moreno, Maria Luísa

2003-01-01

Career intervention can be designed to enhance constructive attitudes, emotions and behaviours that will improve clients’ career attainment. In this sense, mobilisation of career exploration constitutes one of the most important tasks of career counsellors, particularly with emphasis in developmental career guidance models, first developed in the 1950s. The authors present a brief review of career exploration conceptualisation and empirical research lines. The implications for career guidance...

Patient perspectives on navigating the field of traumatic brain injury rehabilitation

DEFF Research Database (Denmark)

Graff, Heidi J; Christensen, Ulla; Poulsen, Ingrid

2018-01-01

PURPOSE: This study aimed to provide an understanding of the lived experience of rehabilitation in adults with traumatic brain injury (TBI) from hospital discharge up to four years post-injury. MATERIALS AND METHODS: We used a qualitative explorative design with semi-structured in-depth interview...... systematic follow-up programs    • Age-appropriate rehabilitation facilities    • Inclusion of patient and family in the planning of long-term rehabilitation....

DOE Handbook: Supplementary guidance and design experience for the fusion safety standards DOE-STD-6002-96 and DOE-STD-6003-96

International Nuclear Information System (INIS)

1999-01-01

Two standards have been developed that pertain to the safety of fusion facilities. These are DOE- STD-6002-96, Safety of Magnetic Fusion Facilities: Requirements, and DOE-STD-6003-96, Safety of Magnetic Fusion Facilities: Guidance. The first of these standards identifies requirements that subscribers to that standard must meet to achieve safety in fusion facilities. The second standard contains guidance to assist in meeting the requirements identified inthefirst This handbook provides additional documentation on good operations and design practices as well as lessons learned from the experiences of designers and operators of previous fusion facilities and related systems. It is intended to capture the experience gained in the various fields and pass it on to designers of future fusion facilities as a means of enhancing success and safeiy. The sections of this document are presented according to the physical location of the major systems of a t%sion facility, beginning with the vacuum vessel and proceeding to those systems and components outside the vacuum vessel (the ''Ex-vessel Systems''). The last section describes administrative procedures that cannot be localized to specific components. It has been tacitly assumed that the general structure of the fusion facilities addressed is that of a tokamak though the same principles would apply to other magnetic confinement options

DOE Handbook: Supplementary guidance and design experience for the fusion safety standards DOE-STD-6002-96 and DOE-STD-6003-96

Energy Technology Data Exchange (ETDEWEB)

None

1999-01-01

Two standards have been developed that pertain to the safety of fusion facilities. These are DOE- STD-6002-96, Safety of Magnetic Fusion Facilities: Requirements, and DOE-STD-6003-96, Safety of Magnetic Fusion Facilities: Guidance. The first of these standards identifies requirements that subscribers to that standard must meet to achieve safety in fusion facilities. The second standard contains guidance to assist in meeting the requirements identified in the first This handbook provides additional documentation on good operations and design practices as well as lessons learned from the experiences of designers and operators of previous fusion facilities and related systems. It is intended to capture the experience gained in the various fields and pass it on to designers of future fusion facilities as a means of enhancing success and safety. The sections of this document are presented according to the physical location of the major systems of a fusion facility, beginning with the vacuum vessel and proceeding to those systems and components outside the vacuum vessel (the "Ex-vessel Systems"). The last section describes administrative procedures that cannot be localized to specific components. It has been tacitly assumed that the general structure of the fusion facilities addressed is that of a tokamak though the same principles would apply to other magnetic confinement options.

77 FR 429 - Clarification and Further Guidance on the Fireworks Approvals Policy

Science.gov (United States)

2012-01-05

... 173 [Docket No. PHMSA-2011-0315; Notice No. 11-13] Clarification and Further Guidance on the Fireworks... fireworks approvals applications from fireworks manufacturers or their designated agents and grant approvals only to manufacturers of fireworks devices. This clarification and additional guidance follows the...

Effects of laminin blended with chitosan on axon guidance on patterned substrates

Energy Technology Data Exchange (ETDEWEB)

Zhu, N; Guan, Y J; Chen, X B [Division of Biomedical Engineering, University of Saskatchewan, Saskatoon S7N 5A9 (Canada); Li, M G [Department of Mechanical Engineering, University of Saskatchewan, Saskatoon S7N 5A9 (Canada); Schreyer, D J, E-mail: niz504@mail.usask.c [Department of Anatomy and Cell Biology, Cameco MS Neuroscience Research Center, University of Saskatchewan, Saskatoon, S7K 0M7 (Canada)

2010-12-15

Axon guidance is a crucial consideration in the design of tissue scaffolds used to promote nerve regeneration. Here we investigate the combined use of laminin (a putative axon adhesion and guidance molecule) and chitosan (a leading candidate base material for the construction of scaffolds) for promoting axon guidance in cultured adult dorsal root ganglion (DRG) neurons. Using a dispensing-based rapid prototyping (DBRP) technique, two-dimensional grid patterns were created by dispensing chitosan or laminin-blended chitosan substrate strands oriented in orthogonal directions. In vitro experiments illustrated DRG neurites on these patterns preferentially grew upon and followed the laminin-blended chitosan pathways. These results suggest that an orientation of neurite growth can be achieved in an artificially patterned substrate by creating selectively biofunctional pathways. The DBRP technique may provide improved strategies for the use of biofunctional pathways in the design of three-dimensional scaffolds for guidance of nerve repair.

Effects of laminin blended with chitosan on axon guidance on patterned substrates

International Nuclear Information System (INIS)

Zhu, N; Guan, Y J; Chen, X B; Li, M G; Schreyer, D J

2010-01-01

Axon guidance is a crucial consideration in the design of tissue scaffolds used to promote nerve regeneration. Here we investigate the combined use of laminin (a putative axon adhesion and guidance molecule) and chitosan (a leading candidate base material for the construction of scaffolds) for promoting axon guidance in cultured adult dorsal root ganglion (DRG) neurons. Using a dispensing-based rapid prototyping (DBRP) technique, two-dimensional grid patterns were created by dispensing chitosan or laminin-blended chitosan substrate strands oriented in orthogonal directions. In vitro experiments illustrated DRG neurites on these patterns preferentially grew upon and followed the laminin-blended chitosan pathways. These results suggest that an orientation of neurite growth can be achieved in an artificially patterned substrate by creating selectively biofunctional pathways. The DBRP technique may provide improved strategies for the use of biofunctional pathways in the design of three-dimensional scaffolds for guidance of nerve repair.

The Bobath concept in stroke rehabilitation: a focus group study of the experienced physiotherapists' perspective.

Science.gov (United States)

Lennon, S; Ashburn, A

2000-10-15

The Bobath concept, usually known as neuro-developmental treatment (NDT) in America, is one of the major approaches used to rehabilitate patients following stroke; however since the last publication of Bobath (1990), the concept has been taught via an oral tradition on postgraduate courses. This study therefore aimed to explore with experienced therapists firstly how the Bobath concept had changed since 1990, and secondly what they considered its main theoretical assumptions to be using a focus group research design. Eight peer-nominated expert physiotherapists agreed to participate in two focus groups organized according to specialist interest in either neurology (group A) or elderly care (group B). Therapists were asked to discuss six topics based on a review of published literature. Data analysis involved several readings of verbatim transcriptions, from which key themes and concepts were developed. All therapists agreed on the following core themes defining Bobath: analysis of normal movement, control of tone and facilitation of movement. Neuroplasticity was described as the primary rationale for treatment with therapists using afferent information to target the damaged central nervous system. In addition group A discussed motor learning, whereas group B discussed patient focused goals and relating treatment to function. This study highlighted changes in theory, terminology, and techniques. Tone remained a major problem in the rehabilitation management of the hemiplegic patient; however much attention was also directed towards the musculoskeletal system. Both facilitation of normal movement components and task specific practice using specific manual guidance were considered critical elements of the Bobath concept. For Bobath therapists, physiotherapy has an important impact on both the performance components of movement and functional outcomes. In view of the small numbers involved in this preliminary study, further studies are now needed to determine if these

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.

Biomechanics of knee rehabilitation with cycling.

Science.gov (United States)

McLeod, W D; Blackburn, T A

1980-01-01

The bicycle provides quadriceps rehabilitation while controlling the stresses to the knee ligaments. With pedaling on the bicycle, forces are applied to the anterior cruciate ligament, the capsular ligaments, and the posterior structures of the knee joint as the tibial plateau is posteriorly tilted. The knee muscles can modify their forces. Therefore, by controlling the mode of cycling with varying seat heights and pedal positions, the ligaments can be relieved from these forces during the initial stages of the rehabilitative process. An exercise program can then be designed to apply controlled stress to these structures to enhance the healing and recovery processes.

Predictors for living at home after geriatric inpatient rehabilitation: A prospective cohort study.

OpenAIRE

Kool, Jan; Oesch, Peter; Bachmann, Stefan

2017-01-01

OBJECTIVE To evaluate patient characteristics predicting living at home after geriatric rehabilitation. DESIGN Prospective cohort study. PATIENTS A total of 210 patients aged 65 years or older receiving inpatient rehabilitation. METHODS Candidate predictors evaluated during rehabilitation were: age, vulnerability (Vulnerable Elders Survey), multimorbidity (Cumulative Illness Rating Scale), cognition (Mini-Mental State Examination), depression (Hospital Anxiety and ...

What Do Stroke Patients Look for in Game-Based Rehabilitation

Science.gov (United States)

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

Using the Tuning Methodology to design the founding benchmark competences for a new academic professional field: the case of Advanced Rehabilitation Technologies

Directory of Open Access Journals (Sweden)

Ann-Marie Hughes

2016-05-01

Full Text Available    Designing innovative high quality educational programmes to meet the workforce needs in emerging interdisciplinary areas of practice can present challenges to academics, students, employers and industrial partners. This paper demonstrates how the Tuning Process successfully helped to construct benchmark learning outcomes and competences in the area of healthcare practice where advanced technologies are used to improve movement namely Rehabilitation Technologies (RTs. The paper also discusses the engagement of patients, carers and carer organisations within the development of competences.    Due to changing demographics, limited resources and the availability of technology, rehabilitation technologies are starting to be used for the assessment and treatment of patients. However there are currently no European transnational Bachelor or Master programmes targeted at educating people for the design, development, use and evaluation of these technologies. The contemporary field is predominantly staffed and resourced by engineering scientists and clinicians who were primarily educated in their primary discipline. The first generations of rehabilitation technologists have established this specialist field through invention, perseverance, and collaborative working. However, there is now a recognition that new and complementary skill sets are required by future graduates, whether engineering scientists or clinicians, so as to better meet the needs of clients and the employment market whether in the domains of industry, research, academia or clinical practice.   This project demonstrates how a group of European specialist rehabilitation technologists, supported by educationalists, collaborated to identify and develop the core competences and learning outcomes required by future Master’s (second cycle graduates in this new discipline. Building on the work of the Tuning Process and applying the principles embedded in the Bologna Process, future

An Evaluation of Unemployment Reduction in Akwa Ibom State using Career Guidance and Counselling

OpenAIRE

Nsikak-Abasi Udofia; Eno Daniel Inyang

2013-01-01

This study was carried out to examine the possibility of reducing unemployment in Akwa Ibom State using career guidance and counselling interventions. To guide the study, four research questions and four null hypotheses were formulated. Variables such as educational guidance, vocational, personality trait guidance and sociological guidance were used in the investigation. A survey design was used in studying a population of 6509 senior secondary two students in 58 public secondary schools that...

Cancer survivors' perspectives and experience on western medicine and traditional Chinese medicine treatment and rehabilitation: a qualitative study.

Science.gov (United States)

Wang, Ji-Wei; Yang, Zhi-Qi; Liu, Cong; Chen, Si-Jia; Shen, Qian; Zhang, Tian-Rui; Partike, Nancy S; Yuan, Zheng-Ping; Yu, Jin-Ming

2015-01-01

In the People's Republic of China, both western medicine (WM) and traditional Chinese medicine (TCM) are the main treatment and rehabilitation options for cancer patients. This study aimed to explore cancer survivors' perspectives and experience of treatment and rehabilitation, in order to promote patient-centered activities of treatment and rehabilitation. Using a qualitative research approach, 68 cancer survivors were recruited from eight community cancer rehabilitation organizations in Shanghai, People's Republic of China. Eight focus group interviews were conducted. All these interviews were transcribed verbatim, and the data were analyzed by theme analysis. WM was the main choice in treatment phase though study participants noted more side effects. TCM was primarily used in the recovery phase. The lack of communication between doctors and cancer patients appears to affect treatment adherence and impair the doctor-patient relationship. WM was expensive for diagnostic procedures and treatment, while the cumulative costs of frequent use of TCM in the long rehabilitation period were also high. Both treatment options created significant perceived economic burden on patients. Conflicting information about dietary supplements tended to make cancer survivors confused. Improving the communication between doctors and cancer patients helps to ameliorate cancer patient adherence and the effect of treatments. It is essential to educate cancer patients about the effect and cost of both WM and traditional TCM. Meanwhile, marketing management and guidance to consumers regarding use of dietary supplements in the cancer rehabilitation field are also necessary.

Comparison between two models of elbow rehabilitation equipment

Directory of Open Access Journals (Sweden)

Vetrice Georgiana

2017-01-01

Full Text Available International studies have revealed that using continuous passive motion (CPM equipment as part of a rehabilitation program improves the recovery period and also diminishes the rehabilitation costs by about 50%. This explains the need for conceiving elbow joint rehabilitation equipment to help persons suffering from posttraumatic disabilities. In order to create the best model to meet the patients’ requirements this paper presents two constructive solutions of such equipment and a comparison between their designs. Both achieve the desired movements of the elbow joint: flexion-extension and pronation-supination and are actuated by pneumatic muscles, due to the multiple advantages of pneumatic actuation: low cost, compliance and favorable response to commands.

Psychological rehabilitation after myocardial infarction: multicentre randomised controlled trial.

OpenAIRE

Jones, D. A.; West, R. R.

1996-01-01

OBJECTIVE: To evaluate rehabilitation after myocardial infarction. DESIGN: Randomised controlled trial of rehabilitation in unselected myocardial infarction patients in six centres, baseline data being collected on admission and by structured interview (of patients and spouses) shortly after discharge and outcome being assessed by structured interview at six months and clinical examination at 12 months. SETTING: Six district general hospitals. SUBJECTS: All 2328 eligible patients admitted ove...

Orion's Powered Flight Guidance Burn Options for Near Term Exploration Missions

Science.gov (United States)

Fill, Thomas; Goodman, John; Robinson, Shane

2018-01-01

NASA's Orion exploration spacecraft will fly more demanding mission profiles than previous NASA human flight spacecraft. Missions currently under development are destined for cislunar space. The EM-1 mission will fly unmanned to a Distant Retrograde Orbit (DRO) around the Moon. EM-2 will fly astronauts on a mission to the lunar vicinity. To fly these missions, Orion requires powered flight guidance that is more sophisticated than the orbital guidance flown on Apollo and the Space Shuttle. Orion's powered flight guidance software contains five burn guidance options. These five options are integrated into an architecture based on a proven shuttle heritage design, with a simple closed-loop guidance strategy. The architecture provides modularity, simplicity, versatility, and adaptability to future, yet-to-be-defined, exploration mission profiles. This paper provides a summary of the executive guidance architecture and details the five burn options to support both the nominal and abort profiles for the EM-1 and EM-2 missions.

An interactive game-based shoulder wheel system for rehabilitation

Directory of Open Access Journals (Sweden)

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

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.

Dalayed referral of lower limb amputees for rehabilitation; an audit study

International Nuclear Information System (INIS)

Raza, M.A.; Fahim, M.; Gill, Z.A.; Waheed, A.

2014-01-01

determine the causes of delayed referral of lower limb amputees for rehabilitation. Study Design: Descriptive study. Place and Duration of Study: Armed Forces Institute of Rehabilitation Medicine Rawalpindi, from April 2012 to July 2012. Patient and Methods: Thirty two patient cases of lower limb amputation were included. They were referred cases to AFIRM from operational areas and CMHs all over Pakistan for provision of prosthesis and rehabilitation. Results: A total of 32 lower limbamputees' male patients with mean age 29 years were included in the study. Transtibial level was the most common amputation 19(57.6 %). Improvised Explosive Device (IED) was the most common mode of injury 19(57.6 %). 34.37 % patients were delayed due to leave granted to them at local set ups before referral to AFIRM for rehabilitation. Conclusion: Delayed referral for rehabilitation has poor impact on rehabilitation of an amputee. (author)

Nuclear and Radiological Emergency Management and Rehabilitation Strategies: Towards a EU approach for decision support tools

International Nuclear Information System (INIS)

Raskob, W.; Gering, F.; Lochard, J.; Nisbet, A.; Starostova, V.; Tomic, B.

2011-01-01

Highlights: → European emergency management and rehabilitation was strengthened. → Development of generic European handbooks for urban and agricultural areas. → Decision support systems became more operational. → Harmonisation of tools in Europe has been promoted. - Abstract: The 5-year multi-national project EURANOS (European Approach to Nuclear and Radiological Emergency Management and Rehabilitation Strategies), funded by the European Commission and 23 European Member States, started in April 2004. Integrating 17 national emergency management organisations with 33 research institutes, it brings together best practices, knowledge and technology to enhance the preparedness for Europe's response to any radiation emergency and long term contamination. Key objectives of the project are to collate information on the likely effectiveness and consequences of a wide range of countermeasures, to provide guidance to emergency management organisations and decision makers on the establishment of an appropriate response strategy and to further enhance advanced decision support systems (DSS), in particular, RODOS (Real-time On-line Decisions Support) decision support system), through feedback from their operational use. Further, the project aims to create regional initiatives leading to information exchange based on state-of-the-art information technologies, to develop guidance which assists Member States in developing a framework for the sustainable rehabilitation of living conditions in contaminated areas and to maintain and enhance knowledge and competence through emergency exercises, training and education, thus fostering best practice in emergency response. The project is divided into three major research activities and a set of demonstration projects which are split in two phases lasting over two and three years, respectively. The research activities address specific issues previously identified by the users or by previous research in the area. They are focused

Technologic advances in aural rehabilitation: applications and innovative methods of service delivery.

Science.gov (United States)

Sweetow, Robert W; Sabes, Jennifer Henderson

2007-06-01

The level of interest in aural rehabilitation has increased recently, both in clinical use and in research presentations and publications. Advances in aural rehabilitation have seen previous techniques such as speech tracking and analytic auditory training reappear in computerized forms. These new delivery methods allow for a consistent, cost-effective, and convenient training program. Several computerized aural rehabilitation programs for hearing aid wearers and cochlear implant recipients have recently been developed and were reported on at the 2006 State of the Science Conference of the Rehabilitation Engineering Research Center on Hearing Enhancement at Gallaudet University. This article reviews these programs and outlines the similarities and differences in their design. Another promising area of aural rehabilitation research is the use of pharmaceuticals in the rehabilitation process. The results from a study of the effect of d-amphetamine in conjunction with intensive aural rehabilitation with cochlear implant patients are also described.

The Design of a Modified PSO Guidance Law Using Predictor and LOS Rate Evaluation

OpenAIRE

Lee Yung-Lung; Chen Kuei-Yi; Chen Yi-Wei; Chen Yen-Bin; Liao Sheng-Ju

2016-01-01

This paper proposes a modified particle swarm optimization guidance (MPSOG) for the pursuit-evasion optimization problem. If the line-of-sight (LOS) rate equals zero, the curvature of the missile’s trajectory would be smaller and the probability of intercept greater. Thus, we propose using a MPSOG to improve the guidance performance. The MPSOG uses a Kalman filter to predict a target’s dynamic. The lateral acceleration commands of the y- and z-axis are optimized by the particle swarm optimiza...

The Role of Guidance, Navigation, and Control in Hypersonic Vehicle Multidisciplinary Design and Optimization

Science.gov (United States)

Ouzts, Peter J.; Soloway, Donald I.; Moerder, Daniel D.; Wolpert, David H.; Benavides, Jose Victor

2009-01-01

Airbreathing hypersonic systems offer distinct performance advantages over rocket-based systems for space access vehicles. However, these performance advantages are dependent upon advances in current state-of-the-art technologies in many areas such as ram/scramjet propulsion integration, high temperature materials, aero-elastic structures, thermal protection systems, transition to hypersonics and hypersonic control elements within the framework of complex physics and new design methods. The complex interactions between elements of an airbreathing hypersonic vehicle represent a new paradigm in vehicle design to achieve the optimal performance necessary to meet space access mission objectives. In the past, guidance, navigation, and control (GNC) analysis often follows completion of the vehicle conceptual design process. Individual component groups design subsystems which are then integrated into a vehicle configuration. GNC is presented the task of developing control approaches to meet vehicle performance objectives given that configuration. This approach may be sufficient for vehicles where significant performance margins exist. However, for higher performance vehicles engaging the GNC discipline too late in the design cycle has been costly. For example, the X-29 experimental flight vehicle was built as a technology demonstrator. One of the many technologies to be demonstrated was the use of light-weight material composites for structural components. The use of light-weight materials increased the flexibility of the X- 29 beyond that of conventional metal alloy constructed aircraft. This effect was not considered when the vehicle control system was designed and built. The impact of this is that the control system did not have enough control authority to compensate for the effects of the first fundamental structural mode of the vehicle. As a result, the resulting pitch rate response of the vehicle was below specification and no post-design changes could recover the

Smart rehabilitation garment for posture monitoring

NARCIS (Netherlands)

Wang, Q.; Chen, W.; Timmermans, A.A.A.; Karachristos, C.; Martens, J.B.O.S.; Markopoulos, P.

Posture monitoring and correction technologies can support prevention and treatment of spinal pain or can help detect and avoid compensatory movements during the neurological rehabilitation of upper extremities, which can be very important to ensure their effectiveness. We describe the design and

The screening and management of pituitary dysfunction following traumatic brain injury in adults: British Neurotrauma Group guidance

Science.gov (United States)

Tan, Chin Lik; Alavi, Seyed Alireza; Baldeweg, Stephanie E; Belli, Antonio; Carson, Alan; Feeney, Claire; Goldstone, Anthony P; Greenwood, Richard; Menon, David K; Simpson, Helen L; Toogood, Andrew A; Gurnell, Mark; Hutchinson, Peter J

2017-01-01

Pituitary dysfunction is a recognised, but potentially underdiagnosed complication of traumatic brain injury (TBI). Post-traumatic hypopituitarism (PTHP) can have major consequences for patients physically, psychologically, emotionally and socially, leading to reduced quality of life, depression and poor rehabilitation outcome. However, studies on the incidence of PTHP have yielded highly variable findings. The risk factors and pathophysiology of this condition are also not yet fully understood. There is currently no national consensus for the screening and detection of PTHP in patients with TBI, with practice likely varying significantly between centres. In view of this, a guidance development group consisting of expert clinicians involved in the care of patients with TBI, including neurosurgeons, neurologists, neurointensivists and endocrinologists, was convened to formulate national guidance with the aim of facilitating consistency and uniformity in the care of patients with TBI, and ensuring timely detection or exclusion of PTHP where appropriate. This article summarises the current literature on PTHP, and sets out guidance for the screening and management of pituitary dysfunction in adult patients with TBI. It is hoped that future research will lead to more definitive recommendations in the form of guidelines. PMID:28860331

A hybrid optical system for broadband imaging in guidance and control

Science.gov (United States)

Wu, Xiaofang; Jiang, Yuesong; Shen, Chunyan; Zhao, Yiming

2006-11-01

A binary optics method has been adopted to improve upon a conventional optical system in guidance and control, and a hybrid broadband imaging system that includes a binary surface is analyzed and evaluated by optical design software ZEMAX. The practical design shows that the introduction of binary optics can simplify the structure of the imaging system and reduce the size and weight of the broadband guidance and control system. Moreover, it can help to acquire images of radiation of different wavelengths from targets; hence it will result in improved overall performance of missiles in wars.

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...

Efficacy of memory rehabilitation therapy: a meta-analysis of TBI and stroke cognitive rehabilitation literature.

Science.gov (United States)

Elliott, Madison; Parente, Frederick

2014-01-01

To examine the efficacy of cognitive rehabilitation strategies specifically designed to improve memory after traumatic brain injury (TBI) and stroke vs. memory improvement with the passage of time. A meta-analysis was performed on 26 studies of memory retraining and recovery that were published between the years of 1985 and 2013. Effect sizes (ESs) from each study were calculated and converted to Pearson's r and then analysed to assess the overall effect size and the relationship among the ESs, patient demographics and treatment interventions. RESULTS indicated a significant average ES (r = 0.51) in the treatment intervention conditions, as well as a significant average ES (r = 0.31) in the control conditions, in which participants did not receive any treatment. The largest ESs occurred in studies of stroke patients and studies concerning working memory rehabilitation. RESULTS showed that memory rehabilitation was an effective therapeutic intervention, especially for stroke patients and for working memory as a treatment domain. However, the results also indicated that significant memory improvement occurred spontaneously over time.

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

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

Individual plant examination: Submittal guidance

International Nuclear Information System (INIS)

1989-08-01

Based on a Policy Statement on Severe Accidents Regarding Future Designs and Existing Plants, the performance of a plant examination is requested from the licensee of each nuclear power plant. The plant examination looks for vulnerabilities to severe accidents and cost-effective safety improvements that reduce or eliminate the important vulnerabilities. This document delineates guidance for reporting the results of that plant examination. 38 refs., 2 tabs

A Novel Guidance Law with Line-of-Sight Acceleration Feedback for Missiles against Maneuvering Targets

Directory of Open Access Journals (Sweden)

Kemao Ma

2014-01-01

Full Text Available Terminal guidance law design and its implementation are considered for homing missiles against maneuvering targets. The lateral acceleration dynamics are taken into account in the design. In the guidance law design, the line-of-sight acceleration signals are incorporated into the acceleration reference signals to compensate for the targets’ maneuvers. Then the commanded accelerations are designed and the convergent tracking of the lateral accelerations to these signals is proven theoretically. In the guidance implementation, a linear high-gain differentiator is used to estimate the line-of-sight rates and the line-of-sight acceleration signals. To avoid the magnifying effects of higher order differentiation, a practical design of commanded accelerations is given to realize approximate tracking of the lateral accelerations to the given reference signals. Simulation is conducted for both cases with and without measurement noises. The simulation results justify the feasibility of the design and the implementation.

Rehabilitation that incorporates virtual reality is more effective than standard rehabilitation for improving walking speed, balance and mobility after stroke: a systematic review

Directory of Open Access Journals (Sweden)

Davide Corbetta

2015-07-01

Full Text Available Question: In people after stroke, does virtual reality based rehabilitation (VRBR improve walking speed, balance and mobility more than the same duration of standard rehabilitation? In people after stroke, does adding extra VRBR to standard rehabilitation improve the effects on gait, balance and mobility? Design: Systematic review with meta-analysis of randomised trials. Participants: Adults with a clinical diagnosis of stroke. Intervention: Eligible trials had to include one these comparisons: VRBR replacing some or all of standard rehabilitation or VRBR used as extra rehabilitation time added to a standard rehabilitation regimen. Outcome measures: Walking speed, balance, mobility and adverse events. Results: In total, 15 trials involving 341 participants were included. When VRBR replaced some or all of the standard rehabilitation, there were statistically significant benefits in walking speed (MD 0.15 m/s, 95% CI 0.10 to 0.19, balance (MD 2.1 points on the Berg Balance Scale, 95% CI 1.8 to 2.5 and mobility (MD 2.3 seconds on the Timed Up and Go test, 95% CI 1.2 to 3.4. When VRBR was added to standard rehabilitation, mobility showed a significant benefit (0.7 seconds on the Timed Up and Go test, 95% CI 0.4 to 1.1, but insufficient evidence was found to comment about walking speed (one trial and balance (high heterogeneity. Conclusion: Substituting some or all of a standard rehabilitation regimen with VRBR elicits greater benefits in walking speed, balance and mobility in people with stroke. Although the benefits are small, the extra cost of applying virtual reality to standard rehabilitation is also small, especially when spread over many patients in a clinic. Adding extra VRBR time to standard rehabilitation also has some benefits; further research is needed to determine if these benefits are clinically worthwhile. [Corbetta D, Imeri F, Gatti R (2015 Rehabilitation that incorporates virtual reality is more effective than standard

Guidance Law and Neural Control for Hypersonic Missile to Track Targets

Directory of Open Access Journals (Sweden)

Wenxing Fu

2016-01-01

Full Text Available Hypersonic technology plays an important role in prompt global strike. Because the flight dynamics of a hypersonic vehicle is nonlinear, uncertain, and highly coupled, the controller design is challenging, especially to design its guidance and control law during the attack of a maneuvering target. In this paper, the sliding mode control (SMC method is used to develop the guidance law from which the desired flight path angle is derived. With the desired information as control command, the adaptive neural control in discrete time is investigated ingeniously for the longitudinal dynamics of the hypersonic missile. The proposed guidance and control laws are validated by simulation of a hypersonic missile against a maneuvering target. It is demonstrated that the scheme has good robustness and high accuracy to attack a maneuvering target in the presence of external disturbance and missile model uncertainty.

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.

Efficient rehabilitation care for joint replacement patients: skilled nursing facility or inpatient rehabilitation facility?

Science.gov (United States)

Tian, Wenqiang; DeJong, Gerben; Horn, Susan D; Putman, Koen; Hsieh, Ching-Hui; DaVanzo, Joan E

2012-01-01

There has been lengthy debate as to which setting, skilled nursing facility (SNF) or inpatient rehabilitation facility (IRF), is more efficient in treating joint replacement patients. This study aims to determine the efficiency of rehabilitation care provided by SNF and IRF to joint replacement patients with respect to both payment and length of stay (LOS). This study used a prospective multisite observational cohort design. Tobit models were used to examine the association between setting of care and efficiency. The study enrolled 948 knee replacement patients and 618 hip replacement patients from 11 IRFs and 7 SNFs between February 2006 and February 2007. Output was measured by motor functional independence measure (FIM) score at discharge. Efficiency was measured in 3 ways: payment efficiency, LOS efficiency, and stochastic frontier analysis efficiency. IRF patients incurred higher expenditures per case but also achieved larger motor FIM gains in shorter LOS than did SNF patients. Setting of care was not a strong predictor of overall efficiency of rehabilitation care. Great variation in characteristics existed within IRFs or SNFs and severity groups. Medium-volume facilities among both SNFs and IRFs were most efficient. Early rehabilitation was consistently predictive of efficient treatment. The advantage of either setting is not clear-cut. Definition of efficiency depends in part on preference between cost and time. SNFs are more payment efficient; IRFs are more LOS efficient. Variation within SNFs and IRFs blurred setting differences; a simple comparison between SNF and IRF may not be appropriate.

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.

Virtual Ultrasound Guidance for Inexperienced Operators

Science.gov (United States)

Caine, Timothy; Martin, David

2012-01-01

Medical ultrasound or echocardiographic studies are highly operator-dependent and generally require lengthy training and internship to perfect. To obtain quality echocardiographic images in remote environments, such as on-orbit, remote guidance of studies has been employed. This technique involves minimal training for the user, coupled with remote guidance from an expert. When real-time communication or expert guidance is not available, a more autonomous system of guiding an inexperienced operator through an ultrasound study is needed. One example would be missions beyond low Earth orbit in which the time delay inherent with communication will make remote guidance impractical. The Virtual Ultrasound Guidance system is a combination of hardware and software. The hardware portion includes, but is not limited to, video glasses that allow hands-free, full-screen viewing. The glasses also allow the operator a substantial field of view below the glasses to view and operate the ultrasound system. The software is a comprehensive video program designed to guide an inexperienced operator through a detailed ultrasound or echocardiographic study without extensive training or guidance from the ground. The program contains a detailed description using video and audio to demonstrate equipment controls, ergonomics of scanning, study protocol, and scanning guidance, including recovery from sub-optimal images. The components used in the initial validation of the system include an Apple iPod Classic third-generation as the video source, and Myvue video glasses. Initially, the program prompts the operator to power-up the ultrasound and position the patient. The operator would put on the video glasses and attach them to the video source. After turning on both devices and the ultrasound system, the audio-video guidance would then instruct on patient positioning and scanning techniques. A detailed scanning protocol follows with descriptions and reference video of each view along with

Experiments and kinematics analysis of a hand rehabilitation exoskeleton with circuitous joints.

Science.gov (United States)

Zhang, Fuhai; Fu, Yili; Zhang, Qinchao; Wang, Shuguo

2015-01-01

Aiming at the hand rehabilitation of stroke patients, a wearable hand exoskeleton with circuitous joint is proposed. The circuitous joint adopts the symmetric pinion and rack mechanism (SPRM) with the parallel mechanism. The exoskeleton finger is a serial mechanism composed of three closed-chain SPRM joints in series. The kinematic equations of the open chain of the finger and the closed chains of the SPRM joints were built to analyze the kinematics of the hand rehabilitation exoskeleton. The experimental setup of the hand rehabilitation exoskeleton was built and the continuous passive motion (CPM) rehabilitation experiment and the test of human-robot interaction force measurement were conducted. Experiment results show that the mechanical design of the hand rehabilitation robot is reasonable and that the kinematic analysis is correct, thus the exoskeleton can be used for the hand rehabilitation of stroke patients.

Effects of physical guidance on short-term learning of walking on a narrow beam

Science.gov (United States)

Domingo, Antoinette; Ferris, Daniel P.

2009-01-01

Physical guidance is often used in rehabilitation when teaching patients to re-learn movements. However, the effects of guidance on motor learning of complex skills, such as walking balance, are not clear. We tested four groups of healthy subjects that practiced walking on a narrow (1.27 cm) or wide (2.5 cm) treadmill-mounted balance beam, with or without physical guidance. Assistance was given by springs attached to a hip belt that applied restoring forces towards beam center. Subjects were evaluated while walking unassisted before and after training by calculating the number of times subjects stepped off of the beam per minute of successful walking on the beam (Failures per Minute). Subjects in Unassisted groups had greater performance improvements in walking balance from pre to post compared to subjects in Assisted groups. During training, Unassisted groups had more Failures per Minute than Assisted groups. Performance improvements were smaller in Narrow Beam groups than in Wide Beam groups. The Unassisted-Wide and Assisted-Narrow groups had similar Failures per Minute during training, but the Unassisted-Wide group had much greater performance gains after training. These results suggest that physical assistance can hinder motor learning of walking balance, assistance appears less detrimental for more difficult tasks, and task-specific dynamics are important to learning independent of error experience. PMID:19674900

Effects of physical guidance on short-term learning of walking on a narrow beam.

Science.gov (United States)

Domingo, Antoinette; Ferris, Daniel P

2009-11-01

Physical guidance is often used in rehabilitation when teaching patients to re-learn movements. However, the effects of guidance on motor learning of complex skills, such as walking balance, are not clear. We tested four groups of healthy subjects that practiced walking on a narrow (1.27 cm) or wide (2.5 cm) treadmill-mounted balance beam, with or without physical guidance. Assistance was given by springs attached to a hip belt that applied restoring forces towards beam center. Subjects were evaluated while walking unassisted before and after training by calculating the number of times subjects stepped off of the beam per minute of successful walking on the beam (Failures per Minute). Subjects in Unassisted groups had greater performance improvements in walking balance from pre to post compared to subjects in Assisted groups. During training, Unassisted groups had more Failures per Minute than Assisted groups. Performance improvements were smaller in Narrow Beam groups than in Wide Beam groups. The Unassisted-Wide and Assisted-Narrow groups had similar Failures per Minute during training, but the Unassisted-Wide group had much greater performance gains after training. These results suggest that physical assistance can hinder motor learning of walking balance, assistance appears less detrimental for more difficult tasks, and task-specific dynamics are important to learning independent of error experience.

Advanced entry guidance algorithm with landing footprint computation

Science.gov (United States)

Leavitt, James Aaron

The design and performance evaluation of an entry guidance algorithm for future space transportation vehicles is presented. The algorithm performs two functions: on-board trajectory planning and trajectory tracking. The planned longitudinal path is followed by tracking drag acceleration, as is done by the Space Shuttle entry guidance. Unlike the Shuttle entry guidance, lateral path curvature is also planned and followed. A new trajectory planning function for the guidance algorithm is developed that is suitable for suborbital entry and that significantly enhances the overall performance of the algorithm for both orbital and suborbital entry. In comparison with the previous trajectory planner, the new planner produces trajectories that are easier to track, especially near the upper and lower drag boundaries and for suborbital entry. The new planner accomplishes this by matching the vehicle's initial flight path angle and bank angle, and by enforcing the full three-degree-of-freedom equations of motion with control derivative limits. Insights gained from trajectory optimization results contribute to the design of the new planner, giving it near-optimal downrange and crossrange capabilities. Planned trajectories and guidance simulation results are presented that demonstrate the improved performance. Based on the new planner, a method is developed for approximating the landing footprint for entry vehicles in near real-time, as would be needed for an on-board flight management system. The boundary of the footprint is constructed from the endpoints of extreme downrange and crossrange trajectories generated by the new trajectory planner. The footprint algorithm inherently possesses many of the qualities of the new planner, including quick execution, the ability to accurately approximate the vehicle's glide capabilities, and applicability to a wide range of entry conditions. Footprints can be generated for orbital and suborbital entry conditions using a pre

Visual search guidance is best after a short delay

OpenAIRE

Schmidt, Joseph; Zelinsky, Gregory J.

2011-01-01

Search displays are typically presented immediately after a target cue, but in the real-world, delays often exist between target designation and search. Experiments 1 and 2 asked how search guidance changes with delay. Targets were cued using a picture or text label, each for 3000ms, followed by a delay up to 9000ms before the search display. Search stimuli were realistic objects, and guidance was quantified using multiple eye movement measures. Text-based cues showed a non-significant trend ...

[Evaluation of the relapse prevention guidance for drug-dependent inmates: the intervention using self-teach workbook and group therapy in a "private finance initiative" prison--the first report].

Science.gov (United States)

Matsumoto, Toshihiko; Imamura, Fumie; Kobayashi, Ohji; Wada, Kiyoshi; Ozaki, Shiro; Takeuchi, Yoshio; Hasegawa, Masahiko; Imamura, Yoko; Tania, Yuko; Adachi, Yasumori

2011-04-01

In Japan, methamphetamine (MAP) abuse has been a serious problem for 60 years, and many of MAP abusers have been incarcerated in prisons as a violator of the Stimulant Control Law in Japan. The purpose of the present study is to evaluate effectiveness of the relapse prevention guidance for drug-dependent inmates using a self-teaching workbook for drug-abusing adolescents and group therapy, conducted in the Harima Rehabilitation Program Center, one of the new prisons which the Ministry of Justice founded cooperating private enterprises as a "Private Finance Initiative" project. We provided for 89 male drug-dependent inmates, incarcerated in the Harima Rehabilitation Program Center, with the relapse prevention guidance consisting of a self-teaching workbook and group therapy, and implement pre-and post-evaluations by the Self-efficacy Scale for Drug Dependence (SES) and the Stages of Change Readiness and Treatment Eagerness Scale, 8th version for Drug Dependence (SOCRATES-8D). After a waiting term, the participants were provided with a self-teaching program, subsequently with a group program. At the point of completing the waiting term, no significant changes were observed in the SES and SOCRATES-8D scores. However, at the point of completing the self-teaching program, the SES scores significantly fell, while the total SOCRATES-8D score and the scores of the two subscales, the "Recognition" and "Ambivalence," significantly rose. Further, at the point of completing the group program, the total scores of the SES and SOCRATES-8D, and the score of the two SOCRATES-8D subscales, the "Recognition" and "Taking Steps," significantly rose. The relapse prevention guidance consisting of a self-teaching workbook and group therapy, conducted in the Harima Rehabilitation Program Center, were supposed to bring same internal changes as the "Stage of Changes" model, proposed by Prochaska and DiClemente, to drug-dependent inmates.

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...

Designing Teaching--Teaching Designing: Teacher's Guidance in a Virtual Design Studio

Science.gov (United States)

Lahti, Henna; Seitamaa-Hakkarainen, Pirita

2014-01-01

This study examined pedagogical aspects of virtual designing. It focused on how an industrial design teacher organised a university course in plastic product design and how the teacher guided student teams' design processes in a virtual design studio. The model of Learning by Collaborative Design was used as a pedagogical and analytical framework.…

Recommendations for the Design of Serious Games in Neurodegenerative Diseases.

Science.gov (United States)

Ben-Sadoun, Grégory; Manera, Valeria; Alvarez, Julian; Sacco, Guillaume; Robert, Philippe

2018-01-01

The use of Serious Games (SG) in the health domain is expanding. In the field of Neurodegenerative Diseases (ND) such as Alzheimer's Disease, SG are currently employed to provide alternative solutions for patients' treatment, stimulation, and rehabilitation. The design of SG for people with ND implies collaborations between professionals in ND and professionals in SG design. As the field is quite young, professionals specialized in both ND and SG are still rare, and recommendations for the design of SG for people with ND are still missing. This perspective paper aims to provide recommendations in terms of ergonomic choices for the design of SG aiming at stimulating people with ND, starting from the existing SG already tested in this population: "MINWii", "Kitchen and Cooking", and "X-Torp". We propose to rely on nine ergonomic criteria: eight ergonomic criteria inspired by works in the domain of office automation: Compatibility, Guidance, Workload, Adaptability, Consistency, Significance of codes, Explicit control and Error management; and one ergonomic criterion related to videogame: the game rules. Perspectives derived from this proposal are also discussed.

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...

75 FR 27544 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and...

Science.gov (United States)

2010-05-17

..., vocational rehabilitation (VR) practitioners, individuals with disabilities, and other stakeholders need to... vocational rehabilitation (VR) practitioners. The Center must work in partnership with organizations... or more priorities, we designate the type of each priority as absolute, competitive preference, or...

Chinese Human Rights Guidance on Minerals Sourcing

DEFF Research Database (Denmark)

Buhmann, Karin

2017-01-01

in the minerals sector and due diligence to ensure socially responsible sourcing of minerals with a particular focus on human rights, the guidelines refer to international human rights standards and are designed to be consistent with guidance issued by the OECD. The article discusses the Chinese guidelines...

Design of a study evaluating the effects, health economics, and stakeholder perspectives of a multi-component occupational rehabilitation program with an added workplace intervention - a  study protocol.

Science.gov (United States)

Rise, Marit B; Skagseth, Martin; Klevanger, Nina E; Aasdahl, Lene; Borchgrevink, Petter; Jensen, Chris; Tenggren, Hanne; Halsteinli, Vidar; Jacobsen, Trym N; Løland, Svein B; Johnsen, Roar; Fimland, Marius S

2018-02-05

Recent research has suggested that interventions at the workplace might be the most potent ingredient in return to work interventions, but few studies have investigated the different effects of workplace interventions as part of occupational rehabilitation programs. The comprehensive design described in this article includes effect (on return to work and health outcomes), and health economic evaluations of a workplace intervention added to a multicomponent rehabilitation program. Qualitative and mixed method studies will investigate sick-listed persons', rehabilitation therapists' and employers' perspectives on the usability and outcomes of the rehabilitation program and the workplace intervention. The program and intervention are provided to patients with musculoskeletal, psychological or general and unspecified diagnoses. The program is multi-component and includes Acceptance and Commitment Therapy, physical exercise, patient education and creating a plan for increased work participation. Persons who are employed, aged from 18 to 60 years, with a current sick leave status of 50% or more and a diagnosis within the musculoskeletal, psychological or general and unspecified chapters of International Classification of Primary Care-2 (ICPC-2) will be recruited to a researcher-blinded parallel-group randomized controlled trial. All participants take part in an in-patient occupational rehabilitation program, while the intervention group also takes part in an intervention at the workplace. The effect and economic evaluation will investigate the effect of the added workplace intervention. The primary outcome measures will be time until full sustainable return to work and total number of sickness absence days in the 12 months after inclusion. Health economic evaluations will investigate the cost-effectiveness and cost-utility. Qualitative studies will investigate rehabilitation therapists' experiences with working towards return to work within an ACT-approach and

Exploring in-hospital rehabilitation exercises for stroke patients : Informing interaction design

NARCIS (Netherlands)

Pickrell, Michelle; Van Den Hoven, Elise; Bongers, Bert

2017-01-01

Rehabilitation 1 exercises following stroke are by necessity repetitive and consequently can be tedious for patients. Hospitals are set up with equipment such as clothes pegs, wooden blocks and mechanical hand counters, which patients use to re-learn how to manipulate objects. The aim of this study

75 FR 21278 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and...

Science.gov (United States)

2010-04-23

... vocational rehabilitation agencies. In addition, this RRTC must collaborate with relevant Rehabilitation... designate the type of each priority as absolute, competitive preference, or invitational through a notice in... preference priority: Under a competitive preference priority, we give competitive preference to an...

Guidance for package approvals in the United Kingdom

International Nuclear Information System (INIS)

Morgan-Warren, E.J.

2004-01-01

Approval is required under the transport regulations for a wide range of package designs and operations, and applications for competent authority approval and validation are received from many sources, both in the UK and overseas. To assist package designers and applicants for approval, and to promote consistency in applications and their assessment, the UK Department for Transport issues guidance on the interpretation of the transport regulations and the requirements of an application for approval and its supporting safety case. The general guidance document, known as the Guide to an Application for UK Competent Authority Approval of Radioactive Material in Transport, has been issued for many years and updated to encompass the provisions of each successive edition of the IAEA transport regulations. The guide has been referred to in a number of international fora, including PATRAM, and was cited as a 'good practice' in the report of the IAEA TRANSAS appraisal of the UK in 2002. Specialist guides include the Guide to the Suitability of Elastomeric Seal Materials, which is the subject of a separate paper in this conference, and the Guide to the Approval of Freight Containers as Types IP-2 and IP-3 Packages. This paper discusses the guidance material and summarises the administrative and technical information required in support of applications for approval of package designs, special form and low-dispersible radioactive materials, shipments, special arrangements, modifications and validations. (author)

A systematic review of active video games on rehabilitative outcomes among older patients

Directory of Open Access Journals (Sweden)

Nan Zeng

2017-03-01

Conclusion: Findings indicate AVGs have potential in rehabilitation for older patients, with several randomized clinical trials reporting positive effects on rehabilitative outcomes. However, existing evidence is insufficient to support the advantages of AVGs over standard therapy. Given the limited number of studies and concerns with study design quality, more research is warranted to make more definitive conclusions regarding the ability of AVGs to improve rehabilitative outcomes in older patients.

Technical Guidance from the International Safety Framework for Nuclear Power Source Applications in Outer Space for Design and Development Phases

Science.gov (United States)

Summerer, Leopold

2014-08-01

In 2009, the International Safety Framework for Nuclear Power Source Applications in Outer Space [1] has been adopted, following a multi-year process that involved all major space faring nations in the frame of the International Atomic Energy Agency and the UN Committee on the Peaceful Uses of Outer Space. The safety framework reflects an international consensus on best practices. After the older 1992 Principles Relevant to the Use of Nuclear Power Sources in Outer Space, it is the second document at UN level dedicated entirely to space nuclear power sources.This paper analyses aspects of the safety framework relevant for the design and development phases of space nuclear power sources. While early publications have started analysing the legal aspects of the safety framework, its technical guidance has not yet been subject to scholarly articles. The present paper therefore focuses on the technical guidance provided in the safety framework, in an attempt to assist engineers and practitioners to benefit from these.

Modelling Ecological Cognitive Rehabilitation Therapies for Building Virtual Environments in Brain Injury.

Science.gov (United States)

Martínez-Moreno, J M; Sánchez-González, P; Luna, M; Roig, T; Tormos, J M; Gómez, E J

2016-01-01

Brain Injury (BI) has become one of the most common causes of neurological disability in developed countries. Cognitive disorders result in a loss of independence and patients' quality of life. Cognitive rehabilitation aims to promote patients' skills to achieve their highest degree of personal autonomy. New technologies such as virtual reality or interactive video allow developing rehabilitation therapies based on reproducible Activities of Daily Living (ADLs), increasing the ecological validity of the therapy. However, the lack of frameworks to formalize and represent the definition of this kind of therapies can be a barrier for widespread use of interactive virtual environments in clinical routine. To provide neuropsychologists with a methodology and an instrument to design and evaluate cognitive rehabilitation therapeutic interventions strategies based on ADLs performed in interactive virtual environments. The proposed methodology is used to model therapeutic interventions during virtual ADLs considering cognitive deficit, expected abnormal interactions and therapeutic hypotheses. It allows identifying abnormal behavioural patterns and designing interventions strategies in order to achieve errorless-based rehabilitation. An ADL case study ('buying bread') is defined according to the guidelines established by the ADL intervention model. This case study is developed, as a proof of principle, using interactive video technology and is used to assess the feasibility of the proposed methodology in the definition of therapeutic intervention procedures. The proposed methodology provides neuropsychologists with an instrument to design and evaluate ADL-based therapeutic intervention strategies, attending to solve actual limitation of virtual scenarios, to be use for ecological rehabilitation of cognitive deficit in daily clinical practice. The developed case study proves the potential of the methodology to design therapeutic interventions strategies; however our current

Graphic Turbulence Guidance

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Forecast turbulence hazards identified by the Graphical Turbulence Guidance algorithm. The Graphical Turbulence Guidance product depicts mid-level and upper-level...

Design and control of a bio-inspired soft wearable robotic device for ankle–foot rehabilitation

International Nuclear Information System (INIS)

Park, Yong-Lae; Chen, Bor-rong; Pérez-Arancibia, Néstor O; Young, Diana; Wood, Robert J; Nagpal, Radhika; Stirling, Leia; Goldfield, Eugene C

2014-01-01

We describe the design and control of a wearable robotic device powered by pneumatic artificial muscle actuators for use in ankle–foot rehabilitation. The design is inspired by the biological musculoskeletal system of the human foot and lower leg, mimicking the morphology and the functionality of the biological muscle–tendon–ligament structure. A key feature of the device is its soft structure that provides active assistance without restricting natural degrees of freedom at the ankle joint. Four pneumatic artificial muscles assist dorsiflexion and plantarflexion as well as inversion and eversion. The prototype is also equipped with various embedded sensors for gait pattern analysis. For the subject tested, the prototype is capable of generating an ankle range of motion of 27° (14° dorsiflexion and 13° plantarflexion). The controllability of the system is experimentally demonstrated using a linear time-invariant (LTI) controller. The controller is found using an identified LTI model of the system, resulting from the interaction of the soft orthotic device with a human leg, and model-based classical control design techniques. The suitability of the proposed control strategy is demonstrated with several angle-reference following experiments. (paper)

Employing the International Classification of Functioning, Disability and Health framework to capture user feedback in the design and testing stage of development of home-based arm rehabilitation technology.

Science.gov (United States)

Sivan, Manoj; Gallagher, Justin; Holt, Ray; Weightman, Andrew; O'Connor, Rory; Levesley, Martin

2016-01-01

The purpose of this study was to evaluate the International Classification of Functioning, Disability and Health (ICF) as a framework to ensure that key aspects of user feedback are identified in the design and testing stages of development of a home-based upper limb rehabilitation system. Seventeen stroke survivors with residual upper limb weakness, and seven healthcare professionals with expertise in stroke rehabilitation, were enrolled in the user-centered design process. Through semi-structured interviews, they provided feedback on the hardware, software and impact of a home-based rehabilitation device to facilitate self-managed arm exercise. Members of the multidisciplinary clinical and engineering research team, based on previous experience and existing literature in user-centred design, developed the topic list for the interviews. Meaningful concepts were extracted from participants' interviews based on existing ICF linking rules and matched to categories within the ICF Comprehensive Core Set for stroke. Most of the interview concepts (except personal factors) matched the existing ICF Comprehensive Core Set categories. Personal factors that emerged from interviews e.g. gender, age, interest, compliance, motivation, choice and convenience that might determine device usability are yet to be categorised within the ICF framework and hence could not be matched to a specific Core Set category.

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. 

A discussion of higher order software concepts as they apply to functional requirements and specifications. [space shuttles and guidance

Science.gov (United States)

Hamilton, M.

1973-01-01

The entry guidance software functional requirements (requirements design phase), its architectural requirements (specifications design phase), and the entry guidance software verified code are discussed. It was found that the proper integration of designs at both the requirements and specifications levels are of high priority consideration.

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.

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

A Two-Dimensional Solar Tracking Stationary Guidance Method Based on Feature-Based Time Series

Directory of Open Access Journals (Sweden)

Keke Zhang

2018-01-01

Full Text Available The amount of satellite energy acquired has a direct impact on operational capacities of the satellite. As for practical high functional density microsatellites, solar tracking guidance design of solar panels plays an extremely important role. Targeted at stationary tracking problems incurred in a new system that utilizes panels mounted in the two-dimensional turntable to acquire energies to the greatest extent, a two-dimensional solar tracking stationary guidance method based on feature-based time series was proposed under the constraint of limited satellite attitude coupling control capability. By analyzing solar vector variation characteristics within an orbit period and solar vector changes within the whole life cycle, such a method could be adopted to establish a two-dimensional solar tracking guidance model based on the feature-based time series to realize automatic switching of feature-based time series and stationary guidance under the circumstance of different β angles and the maximum angular velocity control, which was applicable to near-earth orbits of all orbital inclination. It was employed to design a two-dimensional solar tracking stationary guidance system, and a mathematical simulation for guidance performance was carried out in diverse conditions under the background of in-orbit application. The simulation results show that the solar tracking accuracy of two-dimensional stationary guidance reaches 10∘ and below under the integrated constraints, which meet engineering application requirements.

A feminist perspective on Stroke Rehabilitation

DEFF Research Database (Denmark)

Kvigne, Kari; Kirkevold, M.

2002-01-01

and female sufferers may in part be explained by the fact that rehabilitation services are designed primarily to meet the needs of men. de Beauvoir's feminist theory maintains that one's body is fundamental in creating the person, which is a lifelong process. Traditionally, the female body has been exposed...

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...

An Approach for a National eHealth Implementation – the Case of Modular Interactive Tiles for Rehabilitation

DEFF Research Database (Denmark)

Lund, Henrik Hautop; Jensen, Line Steiness Dejnbjerg; Ssessanga, Yusuf

2015-01-01

By the development of a mHealth tablet app together with modular interactive tiles for rehabilitation, we intend to facilitate the co-design, adaptation, demonstration and validation of modular ICT solutions for rehabilitation in deep rural sub-Saharan Africa. This results in highly mobile, modular...... community-based rehabilitation. Thereby, we investigate the adaptation, contextualisation and implementation in different rehabilitation methods and centres, including hospitals both in a city centres and in a rural area, NGO’s performing community based rehabilitation, and rehabilitation centres. Together...

Soft robotic devices for hand rehabilitation and assistance: a narrative review.

Science.gov (United States)

Chu, Chia-Ye; Patterson, Rita M

2018-02-17

The debilitating effects on hand function from a number of a neurologic disorders has given rise to the development of rehabilitative robotic devices aimed at restoring hand function in these patients. To combat the shortcomings of previous traditional robotics, soft robotics are rapidly emerging as an alternative due to their inherent safety, less complex designs, and increased potential for portability and efficacy. While several groups have begun designing devices, there are few devices that have progressed enough to provide clinical evidence of their design's therapeutic abilities. Therefore, a global review of devices that have been previously attempted could facilitate the development of new and improved devices in the next step towards obtaining clinical proof of the rehabilitative effects of soft robotics in hand dysfunction. A literature search was performed in SportDiscus, Pubmed, Scopus, and Web of Science for articles related to the design of soft robotic devices for hand rehabilitation. A framework of the key design elements of the devices was developed to ease the comparison of the various approaches to building them. This framework includes an analysis of the trends in portability, safety features, user intent detection methods, actuation systems, total DOF, number of independent actuators, device weight, evaluation metrics, and modes of rehabilitation. In this study, a total of 62 articles representing 44 unique devices were identified and summarized according to the framework we developed to compare different design aspects. By far, the most common type of device was that which used a pneumatic actuator to guide finger flexion/extension. However, the remainder of our framework elements yielded more heterogeneous results. Consequently, those results are summarized and the advantages and disadvantages of many design choices as well as their rationales were highlighted. The past 3 years has seen a rapid increase in the development of soft robotic

Quality assurance guidance for low-level radioactive waste disposal facility: Final report

International Nuclear Information System (INIS)

Pittiglio, C.L. Jr.

1989-01-01

This document provides guidance to an applicant on meeting the quality control (QC) requirements for a low-level waste (LLW) disposal facility. The QC requirements are the basis for developing of a quality assurance (QA) program and for the guidance provided herein. The criteria are basic to any QA program. The document specifically establishes QA guidance for the design, construction, and operation of those structures, systems, components, as well as, for site characterization activities necessary to meet the performance objectives and to limit exposure to our release of radioactivity. 7 refs

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

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.

Criteria for design of the Yucca Mountain structures, systems and components for fault displacement

International Nuclear Information System (INIS)

Stepp, C.; Hossain, Q.; Nesbit, S.; Pezzopane, S.; Hardy, M.

1995-01-01

The DOE intends to design the Yucca Mountain high-level waste facility structures, systems and components (SSCs) for fault displacements to provide reasonable assurance that they will meet the preclosure safety performance objectives established by 10 CFR Part 60. To the extent achievable, fault displacement design of the facility will follow guidance provided in the NRC Staff Technical Position. Fault avoidance will be the primary design criterion, especially for spatially compact or clustered SSCs. When fault avoidance is not reasonably achievable, expected to be the case for most spatially extended SSCs, engineering design procedures and criteria or repair and rehabilitation actions, depending on the SSC's importance to safety, are provided. SSCs that have radiological safety importance will be designed for fault displacements that correspond to the hazard exceedance frequency equal to their established seismic safety performance goals. Fault displacement loads are generally localized and may cause local inelastic response of SSCs. For this reason, the DOE intends to use strain-based design acceptance criteria similar to the strain-based criteria used to design nuclear plant SSCs for impact and impulsive loads

Apply an Augmented Reality in a Mobile Guidance to Increase Sense of Place for Heritage Places

Science.gov (United States)

Chang, Yu-Lien; Hou, Huei-Tse; Pan, Chao-Yang; Sung, Yao-Ting; Chang, Kuo-En

2015-01-01

Based on the sense of place theory and the design principles of guidance and interpretation, this study developed an augmented reality mobile guidance system that used a historical geo-context-embedded visiting strategy. This tool for heritage guidance and educational activities enhanced visitor sense of place. This study consisted of 3 visitor…

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...

Psychosocial Rehabilitation: Some Lessons Learned From Natural Disaster in Iran

Directory of Open Access Journals (Sweden)

Fardin Alipour

2016-01-01

Full Text Available Background: Disasters have adverse impacts on different aspects of human life. Psychosocial Rehabilitation is one of the fields which is usually overshadowed and ignored by physical rehabilitation or its importance does not receive proper attention. This research attempts to study some lessons learned from Psychosocial Rehabilitation based on disaster experiences in Iran. Materials and Methods: This study has a conventional qualitative content analysis design. The participants of study were 15 people with direct experience of earthquake and 12 experts in this field. The study sample was selected by purposeful sampling method and the data were collected by semi-structured interviews. Results: Lack of a suitable system to deliver Psychosocial Rehabilitation, challenge in establishing balance between short-term and long-term social and mental needs, lack of mental and social experts, inefficiency in using social capital and capacities are the most important lessons learned in this field. Conclusion: Lack of awareness of mental and social problems of affected people after disaster is one of the most important barriers in successful and stable rehabilitation. Psychosocial Rehabilitation requires a suitable structure and planning for all stages of disaster management.

Structure to self-structuring: infrastructures and processes in neurobehavioural rehabilitation.

Science.gov (United States)

Jackson, Howard F; Hague, Gemma; Daniels, Leanne; Aguilar, Ralph; Carr, Darren; Kenyon, William

2014-01-01

The importance of structure in post-acute brain injury rehabilitation is repeatedly mentioned in clinical practice. However, there has been little exploration of the key elements of structure that promote greater levels of functioning and emotional/behavioural stability and how these elements are optimally integrated within the infrastructure of a rehabilitation service. The nature of structure and why it is helpful is explored initially. Thereafter, the processes involved in transition from externally supported structure to the client 'self-structuring' are described. The infrastructure for facilitating these transitional processes are considered in terms of the design of services for systemic neurorehabilitation encompassing environmental factors (e.g. living environments, vocational and recreational options, step-up services and social milieus), therapeutic alliances (rehabilitation professionals, family, friends), organisational structures (service delivery, rehabilitation coaching, transdisciplinary teams) and rehabilitation philosophies and practice. It is concluded that the process of supporting individuals to transition from the 'structure' of the environment and other people towards self-structuring skills is a critical process in rehabilitation. This is reliant upon a comprehensive and robust organisational infrastructure that can successfully and flexibly integrate the core elements of structure across a transitional pathway towards increased independence and self-structuring.

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...

The Intensive Dysphagia Rehabilitation Approach Applied to Patients With Neurogenic Dysphagia: A Case Series Design Study.

Science.gov (United States)

Malandraki, Georgia A; Rajappa, Akila; Kantarcigil, Cagla; Wagner, Elise; Ivey, Chandra; Youse, Kathleen

2016-04-01

To examine the effects of the Intensive Dysphagia Rehabilitation approach on physiological and functional swallowing outcomes in adults with neurogenic dysphagia. Intervention study; before-after trial with 4-week follow-up through an online survey. Outpatient university clinics. A consecutive sample of subjects (N=10) recruited from outpatient university clinics. All subjects were diagnosed with adult-onset neurologic injury or disease. Dysphagia diagnosis was confirmed through clinical and endoscopic swallowing evaluations. No subjects withdrew from the study. Participants completed the 4-week Intensive Dysphagia Rehabilitation protocol, including 2 oropharyngeal exercise regimens, a targeted swallowing routine using salient stimuli, and caregiver participation. Treatment included hourly sessions twice per week and home practice for approximately 45 min/d. Outcome measures assessed pre- and posttreatment included airway safety using an 8-point Penetration Aspiration Scale, lingual isometric pressures, self-reported swallowing-related quality of life (QOL), and level of oral intake. Also, patients were monitored for adverse dysphagia-related effects. QOL and adverse effects were also assessed at the 4-week follow-up (online survey). The Intensive Dysphagia Rehabilitation approach was effective in improving maximum and mean Penetration Aspiration Scale scores (PDysphagia Rehabilitation approach was safe and improved physiological and some functional swallowing outcomes in our sample; however, further investigation is needed before it can be widely applied. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Nature-assisted rehabilitation for reactions to severe stress and/or depression in a rehabilitation garden: long-term follow-up including comparisons with a matched population-based reference cohort.

Science.gov (United States)

Währborg, Peter; Petersson, Ingemar F; Grahn, Patrik

2014-03-01

To determine the effect of a nature-assisted rehabilitation programme in a group of patients with reactions to severe stress and/or mild to moderate depression. Changes in sick-leave status and healthcare consumption in these patients were compared with those in a matched population-based reference cohort (treatment as usual). Retrospective cohort study with a matched reference group from the general population. A total of 118 participants referred to a nature-assisted rehabilitation programme, and 678 controls recruited from the Skåne Health Care Register. For both groups, information on sick leave was extracted from the National Social Insurance Register and on healthcare consumption data from the Skåne Health Care Register. The interventional rehabilitation programme was designed as a multimodal programme involving professionals from horticulture and medicine. The programme was conducted in a rehabilitation garden, designed especially for this purpose. A significant reduction in healthcare consumption was noted among participants in the programme compared with the reference population. The main changes were a reduction in outpatient visits to primary healthcare and a reduction in inpatient psychiatric care. No significant difference in sick-leave status was found. A structured, nature-based rehabilitation programme for patients with reactions to severe stress and/or depression could be beneficial, as reflected in reduced healthcare consumption.

Design Considerations | Efficient Windows Collaborative

Science.gov (United States)

Foundry Foundry New Construction Windows Window Selection Tool Selection Process Design Guidance Installation Replacement Windows Window Selection Tool Assessing Options Selection Process Design Guidance Installation Understanding Windows Benefits Design Considerations Measuring Performance Performance Standards

Measuring outcomes in children's rehabilitation: a decision protocol.

Science.gov (United States)

Law, M; King, G; Russell, D; MacKinnon, E; Hurley, P; Murphy, C

1999-06-01

To develop and test the feasibility and clinical utility of a computerized self-directed software program designed to enable service providers in children's rehabilitation to make decisions about the most appropriate outcome measures to use in client and program evaluation. A before-and-after design was used to test the feasibility and initial impact of the decision-making outcome software in improving knowledge and use of clinical outcome measures. A children's rehabilitation center in a city of 50,000. All service providers in the children's rehabilitation center. Disciplines represented included early childhood education, occupational therapy, physical therapy, speech and language pathology, audiology, social work, and psychology. Using a conceptual framework based on the International Classification of Impairment, Disability, and Handicap (ICIDH), an outcome measurement decision-making protocol was developed. The decision-making protocol was computerized in an educational software program with an attached database of critically appraised measures. Participants learned about outcome measures through the program and selected outcome measures that met their specifications. The computer software was tested for feasibility in the children's rehabilitation center for 6 months. Knowledge and use of clinical outcome measures were determined before and after the feasibility testing using a survey of all service providers currently at the centre and audits of 30 randomly selected rehabilitation records (at pretest, posttest, and follow-up). Service providers indicated that the outcomes software was easy to follow and believed that the use of the ICIDH framework helped them in making decisions about selecting outcome measures. Results of the survey indicated that there were significant changes in the service providers' level of comfort with selecting measures and knowing what measures were available. Use of outcome measures as identified through the audit did not change

Design and Qualitative Evaluation of Tactile Devices for Stroke Rehabilitation

OpenAIRE

Merrett, Geoff V; Metcalf, Cheryl D; Zheng, Deyi; Cunningham, Sarah; Barrow, Stuart; Demain, Sara H

2011-01-01

Rehabilitation environments combining virtual reality with everyday motor tasks can promote recovery from neurological illness, such as stroke. Tactile devices, providing physical stimulation to the skin, may improve motor retraining. While many tactile devices have been reported, there is a distinct paucity of studies evaluating how they are perceived. This multidisciplinary research has investigated three tactile devices (vibration motors, a motor-driven ‘squeezer’, and shape memory alloys)...

Design and analysis of a gravity balanced low-cost hybrid arm support for stroke rehabilitation

OpenAIRE

Cannella, Giuseppe

2015-01-01

Worldwide 12.6 million people live with moderate to severe disability following a stroke, and the number is increasing. Associated personal and societal care costs strongly motivate the development of effective low-cost technology for upper limb stroke rehabilitation. In order to be therapeutically effective, rehabilitation devices must assist repeated performance of a range of functional tasks whilst promoting voluntary effort, thereby enabling motor re-learning. This specification encourage...

Human-system Interfaces to Automatic Systems: Review Guidance and Technical Basis

International Nuclear Information System (INIS)

O'Hara, J.M.; Higgins, J.C.

2010-01-01

Automation has become ubiquitous in modern complex systems and commercial nuclear power plants are no exception. Beyond the control of plant functions and systems, automation is applied to a wide range of additional functions including monitoring and detection, situation assessment, response planning, response implementation, and interface management. Automation has become a 'team player' supporting plant personnel in nearly all aspects of plant operation. In light of the increasing use and importance of automation in new and future plants, guidance is needed to enable the NRC staff to conduct safety reviews of the human factors engineering (HFE) aspects of modern automation. The objective of the research described in this report was to develop guidance for reviewing the operator's interface with automation. We first developed a characterization of the important HFE aspects of automation based on how it is implemented in current systems. The characterization included five dimensions: Level of automation, function of automation, modes of automation, flexibility of allocation, and reliability of automation. Next, we reviewed literature pertaining to the effects of these aspects of automation on human performance and the design of human-system interfaces (HSIs) for automation. Then, we used the technical basis established by the literature to develop design review guidance. The guidance is divided into the following seven topics: Automation displays, interaction and control, automation modes, automation levels, adaptive automation, error tolerance and failure management, and HSI integration. In addition, we identified insights into the automaton design process, operator training, and operations.

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

Science.gov (United States)

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

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.

SU-E-J-185: A Systematic Review of Breathing Guidance in Radiation Oncology and Radiology

International Nuclear Information System (INIS)

Pollock, S; Keall, P; Keall, R

2015-01-01

Purpose: The advent of image-guided radiation therapy (IGRT) has led to dramatic improvements in the accuracy of treatment delivery in radiotherapy. Such advancements have highlighted the deleterious impact tumor motion can have on both image quality and radiation treatment delivery. One approach to reducing tumor motion is the use of breathing guidance systems during imaging and treatment. A review of such research had not yet been performed, it was therefore our aim to perform a systematic review of breathing guidance interventions within the fields of radiation oncology and radiology. Methods: Results of online database searches were filtered in accordance to a set of eligibility criteria. The search, filtration, and analysis of articles were conducted in accordance with the PRISMAStatement reporting standard (Preferred Reporting Items for Systematic reviews and Meta-Analyses) utilizing the PICOS approach (Participants, Intervention, Comparison, Outcome, Study design). Participants: Cancer patients, healthy volunteers. Intervention: Biofeedback breathing guidance systems. Comparison: No breathing guidance of the same breathing type. Outcome: Regularity of breathing signal and anatomic/tumor motion, medical image quality, radiation treatment margins and coverage, medical imaging and radiation treatment times. Study design: Quantitative and controlled prospective or retrospective trials. Results: The systematic search yielded a total of 479 articles, which were filtered down to 27 relevant articles in accordance to the eligibility criteria. The vast majority of investigated outcomes were significantly positively impacted by the use of breathing guidance; however, this was dependent upon the nature of the breathing guidance system and study design. In 25/27 studies significant improvements from the use of breathing guidance were observed. Conclusion: The results found here indicate that further clinical studies are warranted which quantify more comprehensively the

SU-E-J-185: A Systematic Review of Breathing Guidance in Radiation Oncology and Radiology

Energy Technology Data Exchange (ETDEWEB)

Pollock, S; Keall, P [University of Sydney, Sydney (Australia); Keall, R [Hammond Care Palliative and Supportive Care Service, Sydney, NSW (Australia)

2015-06-15

Purpose: The advent of image-guided radiation therapy (IGRT) has led to dramatic improvements in the accuracy of treatment delivery in radiotherapy. Such advancements have highlighted the deleterious impact tumor motion can have on both image quality and radiation treatment delivery. One approach to reducing tumor motion is the use of breathing guidance systems during imaging and treatment. A review of such research had not yet been performed, it was therefore our aim to perform a systematic review of breathing guidance interventions within the fields of radiation oncology and radiology. Methods: Results of online database searches were filtered in accordance to a set of eligibility criteria. The search, filtration, and analysis of articles were conducted in accordance with the PRISMAStatement reporting standard (Preferred Reporting Items for Systematic reviews and Meta-Analyses) utilizing the PICOS approach (Participants, Intervention, Comparison, Outcome, Study design). Participants: Cancer patients, healthy volunteers. Intervention: Biofeedback breathing guidance systems. Comparison: No breathing guidance of the same breathing type. Outcome: Regularity of breathing signal and anatomic/tumor motion, medical image quality, radiation treatment margins and coverage, medical imaging and radiation treatment times. Study design: Quantitative and controlled prospective or retrospective trials. Results: The systematic search yielded a total of 479 articles, which were filtered down to 27 relevant articles in accordance to the eligibility criteria. The vast majority of investigated outcomes were significantly positively impacted by the use of breathing guidance; however, this was dependent upon the nature of the breathing guidance system and study design. In 25/27 studies significant improvements from the use of breathing guidance were observed. Conclusion: The results found here indicate that further clinical studies are warranted which quantify more comprehensively the

Advanced robotics for medical rehabilitation current state of the art and recent advances

CERN Document Server

Xie, Shane

2016-01-01

Focussing on the key technologies in developing robots for a wide range of medical rehabilitation activities – which will include robotics basics, modelling and control, biomechanics modelling, rehabilitation strategies, robot assistance, clinical setup/implementation as well as neural and muscular interfaces for rehabilitation robot control – this book is split into two parts; a review of the current state of the art, and recent advances in robotics for medical rehabilitation. Both parts will include five sections for the five key areas in rehabilitation robotics: (i) the upper limb; (ii) lower limb for gait rehabilitation (iii) hand, finger and wrist; (iv) ankle for strains and sprains; and (v) the use of EEG and EMG to create interfaces between the neurological and muscular functions of the patients and the rehabilitation robots. Each chapter provides a description of the design of the device, the control system used, and the implementation and testing to show how it fulfils the needs of that specific ...

Properties and outcomes of spinal rehabilitation units in four countries

DEFF Research Database (Denmark)

Fromovich-Amit, Y; Biering-Sørensen, F; Baskov, V

2009-01-01

OBJECTIVE: Compare rehabilitation after spinal cord lesions (SCL) in different countries. DESIGN: Multicenter comparative study. SETTING: Four spinal rehabilitation units, in Denmark, Russia, Lithuania and Israel. SUBJECTS: 199 SCL patients. INTERVENTIONS: Information was collected about unit...... properties, rehabilitation objectives, American Spinal Injury Association (ASIA) scale and spinal cord independence measure (SCIM) assessments, and patient data. chi (2)-test, t-test, ANOVA and ANCOVA were used for statistical analysis. MAIN OUTCOME MEASURES: Time from lesion onset to admission...... for rehabilitation. Staff/bed ratio was 1.7 in Lithuania and Denmark, 1.1 in Israel and 0.9 in Russia. Russian patients were the youngest and had the most severe lesions among participating units. Admission SCIM and SCI-ARMI were the lowest in Israel: 25.1+/-17.2 and 34.3+/-17.3. TAR was highest in Russia (12...

Functional outcomes of community-based brain injury rehabilitation clients.

Science.gov (United States)

Curran, Christine; Dorstyn, Diana; Polychronis, Con; Denson, Linley

2015-01-01

Community-based rehabilitation can help to maximize function following acquired brain injury (ABI); however, data on treatment outcome is limited in quantity. To describe and evaluate client outcomes of an outpatient programme for adults with moderate-to-severe traumatic and non-traumatic ABI. Two phase design involving retrospective and longitudinal study of programme completers with ABI (n = 47). Changes in functioning were measured with the Mayo-Portland Inventory (MPAI-4), administered pre- and immediately post-rehabilitation and at 3 years follow-up. Self-ratings were supplemented with MPAI-4 data from significant others (n = 32) and staff (n = 32). Injured individuals and informants reported improved physical and psychosocial functioning immediately following the completion of community rehabilitation, with medium-to-large and significant treatment gains noted on the MPAI-4 ability, adjustment and participation sub-scales (Cohen's d range = 0.31-1.10). A deterioration in individuals' adjustment was further reported at follow-up, although this was based on limited data. Issues with longer-term rehabilitation service provision were additionally noted. The data support the need for continuity of care, including ongoing emotional support, to cater to the complex and dynamic needs of the ABI population. However, these results need to be considered in the context of a small sample size and quasi-experimental design.

Effectiveness of Virtual Reality Exercises in STroke Rehabilitation (EVREST): rationale, design, and protocol of a pilot randomized clinical trial assessing the Wii gaming system.

Science.gov (United States)

Saposnik, G; Mamdani, M; Bayley, M; Thorpe, K E; Hall, J; Cohen, L G; Teasell, R

2010-02-01

Evidence suggests that increasing intensity of rehabilitation results in better motor recovery. Limited evidence is available on the effectiveness of an interactive virtual reality gaming system for stroke rehabilitation. EVREST was designed to evaluate feasibility, safety and efficacy of using the Nintendo Wii gaming virtual reality (VRWii) technology to improve arm recovery in stroke patients. Pilot randomized study comparing, VRWii versus recreational therapy (RT) in patients receiving standard rehabilitation within six months of stroke with a motor deficit of > or =3 on the Chedoke-McMaster Scale (arm). In this study we expect to randomize 20 patients. All participants (age 18-85) will receive customary rehabilitative treatment consistent of a standardized protocol (eight sessions, 60 min each, over a two-week period). The primary feasibility outcome is the total time receiving the intervention. The primary safety outcome is the proportion of patients experiencing intervention-related adverse events during the study period. Efficacy, a secondary outcome measure, will be measured by the Wolf Motor Function Test, Box and Block Test, and Stroke Impact Scale at the four-week follow-up visit. From November, 2008 to September, 2009 21 patients were randomized to VRWii or RT. Mean age, 61 (range 41-83) years. Mean time from stroke onset 25 (range 10-56) days. EVREST is the first randomized parallel controlled trial assessing the feasibility, safety, and efficacy of virtual reality using Wii gaming technology in stroke rehabilitation. The results of this study will serve as the basis for a larger multicentre trial. ClinicalTrials.gov registration# NTC692523.

Educational content related to postcolonialism and indigenous health inequities recommended for all rehabilitation students in Canada: a qualitative study.

Science.gov (United States)

Hojjati, Ala; Beavis, Allana S W; Kassam, Aly; Choudhury, Daniel; Fraser, Michelle; Masching, Renée; Nixon, Stephanie A

2017-10-02

Postcolonial analysis can help rehabilitation providers understand how colonization and racialization create and sustain health inequities faced by indigenous peoples. However, there is little guidance in the literature regarding inclusion of postcolonialism within rehabilitation educational curricula. Therefore, this study explored perspectives regarding educational content related to postcolonialism and indigenous health that rehabilitation students in Canada should learn to increase health equity. This qualitative study involved in-depth, semi-structured interviews with 19 individuals with insight into postcolonialism and health in Canada. Data were analyzed collaboratively to identify, code, and translate themes according to a structured six-phase method. Four themes emerged regarding educational content for rehabilitation students: (1) the historic trauma of colonization and its ongoing impacts on rehabilitation for indigenous peoples; (2) disproportionate health burden and inequitable access to health services; (3) how rehabilitation is related to Indigenous ways of knowing; and (4) why rehabilitation is well-positioned to address health inequities with Indigenous Peoples. Results call for reflection on assumptions underpinning the rehabilitation professions that may unintentionally reinforce health inequities. A postcolonial lens can help rehabilitation educators promote culturally safe services for people whose ill health and disability are linked to the effects of colonization. Implications for Rehabilitation Given the powerful, ongoing effects of colonization and racialization on health and disability, recommendation #24 from the Truth and Reconciliation Commission of Canada calls for the education of health professionals related to Indigenous history, rights, and anti-racism. However, there is little curricula on these areas in the education of rehabilitation professional students or in continuing education programs for practicing clinicians. This is the

Occurrence and predictors of pressure ulcers during primary in-patient spinal cord injury rehabilitation

NARCIS (Netherlands)

Verschueren, J. H. M.; Post, M. W. M.; de Groot, S.; van der Woude, L. H. V.; van Asbeck, F. W. A.; Rol, M.

Study design: Multicenter prospective cohort study. Objectives: To determine the occurrence and predictors for pressure ulcers in patients with spinal cord injury (SCI) during primary in-patient rehabilitation. Setting: Eight Dutch rehabilitation centres with specialized SCI units. Methods: The

Implementing a novel dance intervention in rehabilitation: perceived barriers and facilitators.

Science.gov (United States)

Demers, Marika; Thomas, Aliki; Wittich, Walter; McKinley, Patricia

2015-01-01

To identify clinicians' perceptions regarding the facilitators and barriers to the use of dance in rehabilitation. This study used a qualitative descriptive design. Three focus groups were conducted with clinicians across three purposively selected rehabilitation centers. Data were analyzed using thematic content analysis. Fourteen allied health-care professionals (six occupational therapists, six physical therapists, and two social workers) with previous dance experience participated in this study. Four main themes emerged from the analysis representing the personal and organizational factors influencing on the implementation of dance interventions: (1) Clinician's dance experience and training, (2) Interest and personal beliefs towards using dance as a potential intervention, (3) Support from the organization of the institution, and (4) Available resources. Although each site was different, the main factors acting as barriers and facilitators were similar for all three sites. The identification of the barriers and facilitators to implementing dance in rehabilitation is the first step to support the translation of knowledge about dance. A tailored approach designed for clinicians and managers should address the main barriers to knowledge use about dance, as a potential rehabilitation modality for individuals with disabilities. Personal and organizational factors can act simultaneously as barriers and facilitators to the implementation of a dance intervention. Lack of time for professional development and lack of support from the organization are the main barriers to the uptake of knowledge about dance in rehabilitation. A knowledge translation strategy addressing the barriers to knowledge use is helpful for clinicians and managers facilitating the implementation of dance in rehabilitation settings.

[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.

A Finger Exoskeleton Robot for Finger Movement Rehabilitation

Directory of Open Access Journals (Sweden)

Tzu-Heng Hsu

2017-07-01

Full Text Available In this study, a finger exoskeleton robot has been designed and presented. The prototype device was designed to be worn on the dorsal side of the hand to assist in the movement and rehabilitation of the fingers. The finger exoskeleton is 3D-printed to be low-cost and has a transmission mechanism consisting of rigid serial links which is actuated by a stepper motor. The actuation of the robotic finger is by a sliding motion and mimics the movement of the human finger. To make it possible for the patient to use the rehabilitation device anywhere and anytime, an Arduino™ control board and a speech recognition board were used to allow voice control. As the robotic finger follows the patients voice commands the actual motion is analyzed by Tracker image analysis software. The finger exoskeleton is designed to flex and extend the fingers, and has a rotation range of motion (ROM of 44.2°.

Action research in rehabilitation with chronic stroke recovery

DEFF Research Database (Denmark)

Pedersen, Malene; Bundgaard, Tina H; Zeeman, Peter

2016-01-01

BACKGROUND: Chronic stroke patients are primarily referred to general rehabilitation, rather than to specific neurorehabilitation. Currently, there are no Danish clinical guidelines for chronic stroke, but recent research in neuroplasticity has contributed to possible rehabilitation interventions....... CONCLUSIONS: This report indicates that a specific neuroplastic focus in combination with action research has an impact on the participants with chronic stroke. However, there is still no clarity regarding what type of rehabilitation methods can be considered the most efficacious in promoting neuroplasticity...... for these patients. OBJECTIVE: The purpose of this project is to describe the use of a specialized neuroplastic approach in combination with an already existing training program. METHODS: The project is designed as an action research project concerning four participants with chronic stroke. Through ten intervention...

Access to rehabilitation: patient perceptions of inequalities in access to specialty pain rehabilitation from a gender and intersectional perspective

Directory of Open Access Journals (Sweden)

Maria Wiklund

2016-08-01

Full Text Available Background: Long-term musculoskeletal pain is common, particularly among women. Pain conditions are a concern in primary health care, and people with severe and complex pain are referred to specialty health care. There is gender bias in access, counselling, assessment, and treatment of long-term pain. Objective: This study explores patient accounts and perceptions about important (social factors for accessing specialised pain rehabilitation from gender and intersectional equality perspectives. We aimed to identify potential biases and inequalities in accessing rehabilitation resources at a specialised rehabilitation clinic. Design: Individual semi-structured interviews were conducted with 10 adults after an assessment or completion of a specialised rehabilitation programme in northern Sweden. Qualitative content analysis was used to explore patients’ perceptions of important factors for accessing rehabilitation. Results: One main theme was formulated as Access to rehab – not a given. Three categories of perceived inequality were demonstrated: power of gender, power of social status, and power of diagnosis. Participants perceived rehabilitation as a resource that is not equally available, but dependent on factors such as gender, socio-economic status, ability to work, ethnicity, or age, and more subtle aspects of social status and habitus (e.g. appearance, fitness, and weight. The character of diagnosis received (medical versus psychiatric or social was also noted. Conclusions: It is crucial that professionals are aware of how potential inequalities related to gender, social status, and diagnosis, and their intersections, can be created, perceived, and have influence on the processes of assessment and treatment. Reduction of social determinants of health and biases remain important within global, national, and local contexts.

ADM guidance-Ceramics: guidance to the use of fractography in failure analysis of brittle materials.

Science.gov (United States)

Scherrer, Susanne S; Lohbauer, Ulrich; Della Bona, Alvaro; Vichi, Alessandro; Tholey, Michael J; Kelly, J Robert; van Noort, Richard; Cesar, Paulo Francisco

2017-06-01

To provide background information and guidance as to how to use fractography accurately, a powerful tool for failure analysis of dental ceramic structures. An extended palette of qualitative and quantitative fractography is provided, both for in vivo and in vitro fracture surface analyses. As visual support, this guidance document will provide micrographs of typical critical ceramic processing flaws, differentiating between pre- versus post sintering cracks, grinding damage related failures and occlusal contact wear origins and of failures due to surface degradation. The documentation emphasizes good labeling of crack features, precise indication of the direction of crack propagation (dcp), identification of the fracture origin, the use of fractographic photomontage of critical flaws or flaw labeling on strength data graphics. A compilation of recommendations for specific applications of fractography in Dentistry is also provided. This guidance document will contribute to a more accurate use of fractography and help researchers to better identify, describe and understand the causes of failure, for both clinical and laboratory-scale situations. If adequately performed at a large scale, fractography will assist in optimizing the methods of processing and designing of restorative materials and components. Clinical failures may be better understood and consequently reduced by sending out the correct message regarding the fracture origin in clinical trials. Copyright © 2017 The Academy of Dental Materials. All rights reserved.

Group guidance services to improved creativity for teachers

Directory of Open Access Journals (Sweden)

Solihatun Solihatun

2017-11-01

Full Text Available Creativity in the learning process by teachers is very important in order to support the task at school. Teacher creativity allows teachers to apply various learning methods that encourage students' interest to learn from the classroom. Besides, creativity for teachers is needed to support student development. This study aims to determine the level of creativity of teachers through group guidance services. Subjects in this study involved 10 teachers at Gemma Insani Indonesia Depok. Data analysis used a quantitative approach with pre-test and post-test control group of one design. The results show effective group guidance to improve teacher creativity at Gemma Insani Indonesia Depok.

Environmental guidance for public participation in environmental restoration activities

Energy Technology Data Exchange (ETDEWEB)

1991-11-01

The US Department of Energy (DOE) is issuing this document, entitled Guidance on Public Participation for US Department of Energy Environmental Restoration Activities, to summarize policy and provide guidance for public participation in environmental restoration activities at DOE Headquarters, Field Offices, facilities, and laboratories. While the Office of Environmental Restoration and Waste Management (EM) has environmental restoration responsibility for the majority of DOE sites and facilities, other DOE Project Offices have similar responsibilities at their sites and facilities. This guidance is applicable to all environment restoration activities conducted by or for DOE under the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) as amended by the Superfund Amendments and Reauthorization Act of 1986 (SARA); the Resource Conservation and Recovery Act of 1976 (RCRA) as amended by the Hazardous and Solid Waste Amendments of 1984 (HSWA) (corrective actions only); and the National Environmental Policy Act of 1969 (NEPA). This guidance also is applicable to CERCLA remedial action programs under the Uranium Mill Tailings Radiation Control Act of 1978 and the Formerly Utilized Sites Remedial Action Program, where DOE is the designated lead. The primary objectives of this guidance document are as follows: acclimate DOE staff to a changing culture that emphasizes the importance of public participation activities; provide direction on implementing these public participation activities; and, provide consistent guidance for all DOE Field Offices and facilities. The purpose of this document is to provide guidance on conducting effective public participation activities for environmental restoration activities under CERCLA; RCRA corrective actions under sections 3004(u), 3004(v), and 3008(h); and NEPA public participation activities.

Position controlled Knee Rehabilitation Orthotic Device for Patients after Total Knee Replacement Arthroplasty

Science.gov (United States)

Wannaphan, Patsiri; Chanthasopeephan, Teeranoot

2016-11-01

Knee rehabilitation after total knee replacement arthroplasty is essential for patients during their post-surgery recovery period. This study is about designing one degree of freedom knee rehabilitation equipment to assist patients for their post-surgery exercise. The equipment is designed to be used in sitting position with flexion/extension of knee in sagittal plane. The range of knee joint motion is starting from 0 to 90 degrees angle for knee rehabilitation motion. The feature includes adjustable link for different human proportions and the torque feedback control at knee joint during rehabilitation and the control of flexion/extension speed. The motion of the rehabilitation equipment was set to move at low speed (18 degrees/sec) for knee rehabilitation. The rehabilitation link without additional load took one second to move from vertical hanging up to 90° while the corresponding torque increased from 0 Nm to 2 Nm at 90°. When extra load is added, the link took 1.5 seconds to move to 90° The torque is then increased from 0 Nm to 4 Nm. After a period of time, the speed of the motion can be varied. User can adjust the motion to 40 degrees/sec during recovery activity of the knee and users can increase the level of exercise or motion up to 60 degrees/sec to strengthen the muscles during throughout their rehabilitation program depends on each patient. Torque control is included to prevent injury. Patients can use the equipment for home exercise to help reduce the number of hospital visit while the patients can receive an appropriate therapy for their knee recovery program.

Initial Efficacy of a Cardiac Rehabilitation Transition Program: Cardiac TRUST

Science.gov (United States)

Zullo, Melissa; Boxer, Rebecca; Moore, Shirley M.

2012-01-01

Patients recovering from cardiac events are increasingly using postacute care, such as home health care and skilled nursing facility services. The purpose of this pilot study was to test the initial efficacy, feasibility, and safety of a specially designed postacute care transitional rehabilitation intervention for cardiac patients. Cardiac Transitional Rehabilitation Using Self- Management Techniques (Cardiac TRUST) is a family-focused intervention that includes progressive low-intensity walking and education in self-management skills to facilitate recovery following a cardiac event. Using a randomized two-group design, exercise self-efficacy, steps walked, and participation in an outpatient cardiac rehabilitation program were compared in a sample of 38 older adults; 17 who received the Cardiac TRUST program and 21 who received usual care only. At discharge from postacute care, the intervention group had a trend for higher levels of self-efficacy for exercise outcomes (X=39.1, SD=7.4) than the usual care group (X=34.5; SD=7.0) (t-test 1.9, p=.06). During the 6 weeks following discharge, compared with the usual care group, the intervention group had more attendance in out-patient cardiac rehabilitation (33% compared to 11.8%, F=7.1, p=.03) and a trend toward more steps walked during the first week (X=1,307, SD=652 compared to X=782, SD=544, t-test 1.8, p=.07). The feasibility of the intervention was better for the home health participants than for those in the skilled nursing facility and there were no safety concerns. The provision of cardiac-focused rehabilitation during postacute care has the potential to bridge the gap in transitional services from hospitalization to outpatient cardiac rehabilitation for these patients at high risk for future cardiac events. Further evidence of the efficacy of Cardiac TRUST is warranted. PMID:22084960

The International Safety Framework for nuclear power source applications in outer space-Useful and substantial guidance

Science.gov (United States)

Summerer, L.; Wilcox, R. E.; Bechtel, R.; Harbison, S.

2015-06-01

In 2009, the International Safety Framework for Nuclear Power Source Applications in Outer Space was adopted, following a multi-year process that involved all major space faring nations under the auspices of a partnership between the UN Committee on the Peaceful Uses of Outer Space and the International Atomic Energy Agency. The Safety Framework reflects an international consensus on best practices to achieve safety. Following the 1992 UN Principles Relevant to the Use of Nuclear Power Sources in Outer Space, it is the second attempt by the international community to draft guidance promoting the safety of applications of nuclear power sources in space missions. NPS applications in space have unique safety considerations compared with terrestrial applications. Mission launch and outer space operational requirements impose size, mass and other space environment limitations not present for many terrestrial nuclear facilities. Potential accident conditions could expose nuclear power sources to extreme physical conditions. The Safety Framework is structured to provide guidance for both the programmatic and technical aspects of safety. In addition to sections containing specific guidance for governments and for management, it contains technical guidance pertinent to the design, development and all mission phases of space NPS applications. All sections of the Safety Framework contain elements directly relevant to engineers and space mission designers for missions involving space nuclear power sources. The challenge for organisations and engineers involved in the design and development processes of space nuclear power sources and applications is to implement the guidance provided in the Safety Framework by integrating it into the existing standard space mission infrastructure of design, development and operational requirements, practices and processes. This adds complexity to the standard space mission and launch approval processes. The Safety Framework is deliberately

77 FR 66959 - Request for Information on the Future Direction of the Rehabilitation Training Program

Science.gov (United States)

2012-11-08

... Individuals 10 1 0 10 3 with Mental Illnesses (H129H).. Rehabilitation Psychology 2 1 0 1 1 (H129J... State VR agencies and in community rehabilitation programs. The following questions are designed to...

Design guidance for elastic followup

International Nuclear Information System (INIS)

Naugle, F.V.

1983-01-01

The basic mechanism of elastic followup is discussed in relation to piping design. It is shown how mechanistic insight gained from solutions for a two-bar problem can be used to identify dominant design parameters and to determine appropriate modifications where elastic followup is a potential problem. It is generally recognized that quantitative criteria are needed for elastic followup in the creep range where badly unbalanced lines can pose potential problems. Approaches for criteria development are discussed

Stroke rehabilitation.

Science.gov (United States)

Langhorne, Peter; Bernhardt, Julie; Kwakkel, Gert

2011-05-14

Stroke is a common, serious, and disabling global health-care problem, and rehabilitation is a major part of patient care. There is evidence to support rehabilitation in well coordinated multidisciplinary stroke units or through provision of early supported provision of discharge teams. Potentially beneficial treatment options for motor recovery of the arm include constraint-induced movement therapy and robotics. Promising interventions that could be beneficial to improve aspects of gait include fitness training, high-intensity therapy, and repetitive-task training. Repetitive-task training might also improve transfer functions. Occupational therapy can improve activities of daily living; however, information about the clinical effect of various strategies of cognitive rehabilitation and strategies for aphasia and dysarthria is scarce. Several large trials of rehabilitation practice and of novel therapies (eg, stem-cell therapy, repetitive transcranial magnetic stimulation, virtual reality, robotic therapies, and drug augmentation) are underway to inform future practice. Copyright © 2011 Elsevier Ltd. All rights reserved.

Geriatric Rehabilitation ('Alters-Rehabilitation'): The New Challenge for Social Medicine and Science.

Science.gov (United States)

Barolin, G. S.

1996-01-01

This discussion of geriatric rehabilitation stresses the importance of holistic and permanent rehabilitation with a fluent transition from the acute phase to the rehabilitation phase under one specialist's care and in one institution. Recommendations include mixed age groups in one ward; systematic education of relatives; follow-up rehabilitation…

The Knowledge of Rehabilitation Professionals Concerning Fetal Alcohol Spectrum Disorders.

Science.gov (United States)

Birch, Stephanie M; Carpenter, Heidi A; Marsh, Anna M; McClung, Kimberly A; Doll, Joy D

2016-01-01

The purpose of this study was to explore rehabilitation professionals' knowledge regarding signs and symptoms, prevention, and intervention of fetal alcohol spectrum disorders (FASD). Participants were 111 rehabilitation practitioners (e.g., occupational therapy, physical therapy, and speech-language pathology practitioners) recruited through email using a quantitative online survey design with purposive, snowball sampling. Results showed the majority of participants' demonstrated accurate knowledge of the signs and symptoms of FASD. Since professionals who received formal education on FASD reported significantly higher feelings of preparedness to identify children with FASD and manage/coordinate intervention plans, this study suggests rehabilitation professionals may be better prepared to treat individuals with FASD if they participate in formal training.

Design of an Automatic Path Finding Wheelchair with Intelligent Guidance System

Directory of Open Access Journals (Sweden)

Apratim MAJUMDER

2011-03-01

Full Text Available A conventional motorized wheelchair has been fitted with sensors and programmed with an intelligent guidance system to efficiently maneuver itself automatically from one point to another in a facility equipped with a grid of sensors that provide the wheelchair with the basic map of its course. The device described in this paper has been conceptualized such that once the wheelchair is given information regarding the starting and stopping point in a controlled facility, the wheelchair with this pre programmed information can efficiently construct a path towards its destination and automatically drive to that point from its present position while avoiding obstacles in its path and negotiating any turns and bends that it encounters in its course. This is achieved by means of sensors (IR and sonic located at strategic points on the chair, circuits that control the speed of the motors, and a set of microcontrollers programmed to execute the different functions of the wheelchair. The facility in which the wheelchair works has been fitted with a set of sensors that form the basis of the network which is used by the program governing the wheelchair’s automated movement to provide guidance to it by means of a course map.

Attitude of secondary school students towards guidance and ...

African Journals Online (AJOL)

The Study investigated the attitude of secondary students towards guidance and counselling services. Descriptive research design of the survey type was used. Three hypotheses were formulated to guide the study. A total of 400 secondary school students were selected from ten (10) schools through stratified random ...

A qualitative study analyzing access to physical rehabilitation for traffic accident victims with severe disability in Brazil.

Science.gov (United States)

Sousa, Kelienny de Meneses; Oliveira, Wagner Ivan Fonsêca de; Melo, Laiza Oliveira Mendes de; Alves, Emanuel Augusto; Piuvezam, Grasiela; Gama, Zenewton André da Silva

2017-03-01

Purpose To identify access barriers to physical rehabilitation for traffic accident (TA) victims with severe disability and build a theoretical model to provide guidance towards the improvement of these services. Methods Qualitative research carried out in the city of Natal (Northeast Brazil), with semi-structured interviews with 120 subjects (19 key informer health professionals and 101 TA victims) identified in a database made available by the emergency hospital. The interviews were analyzed using Alceste software, version 4.9. Results The main barriers present in the interviews were: (1) related to services: bureaucratic administrative practises, low offer of rehabilitation services, insufficient information on rehabilitation, lack of guidelines that integrate hospital and ambulatory care and (2) related to patients: financial difficulties, functional limitations, geographic distance, little information on health, association with low education levels and disbelief in the system and in rehabilitation. Conclusion The numerous access barriers were presented in a theoretical model with causes related to organizational structure, processes of care, professionals and patients. This model must be tested by health policy-makers and managers to improve the quality of physical rehabilitation and avoid unnecessary prolongation of the suffering and disability experienced by TA survivors. Implications for rehabilitation Traffic accidents (TAs) are a global health dilemma that demands integrality of preventive actions, pre-hospital and hospital care and physical rehabilitation (PR). This study lays the foundation for improving access to PR for TA survivors, an issue of quality of care that results in preventable disabilities. The words of the patients interviewed reveal the suffering of victims, which is often invisible to society and given low priority by health policies that relegate PR to a second plan ahead of prevention and urgent care. A theoretical model of the

Observability-Based Guidance and Sensor Placement

Science.gov (United States)

Hinson, Brian T.

Control system performance is highly dependent on the quality of sensor information available. In a growing number of applications, however, the control task must be accomplished with limited sensing capabilities. This thesis addresses these types of problems from a control-theoretic point-of-view, leveraging system nonlinearities to improve sensing performance. Using measures of observability as an information quality metric, guidance trajectories and sensor distributions are designed to improve the quality of sensor information. An observability-based sensor placement algorithm is developed to compute optimal sensor configurations for a general nonlinear system. The algorithm utilizes a simulation of the nonlinear system as the source of input data, and convex optimization provides a scalable solution method. The sensor placement algorithm is applied to a study of gyroscopic sensing in insect wings. The sensor placement algorithm reveals information-rich areas on flexible insect wings, and a comparison to biological data suggests that insect wings are capable of acting as gyroscopic sensors. An observability-based guidance framework is developed for robotic navigation with limited inertial sensing. Guidance trajectories and algorithms are developed for range-only and bearing-only navigation that improve navigation accuracy. Simulations and experiments with an underwater vehicle demonstrate that the observability measure allows tuning of the navigation uncertainty.

Fuel-Conservation Guidance System for Powered-Lift Aircraft

Science.gov (United States)

Erzberger, Heinz; McLean, John D.

1981-01-01

A technique is described for the design of fuel-conservative guidance systems and is applied to a system that was flight tested on board NASA's sugmentor wing jet STOL research aircraft. An important operational feature of the system is its ability to rapidly synthesize fuel-efficient trajectories for a large set of initial aircraft positions, altitudes, and headings. This feature allows the aircraft to be flown efficiently under conditions of changing winds and air traffic control vectors. Rapid synthesis of fuel-efficient trajectories is accomplished in the airborne computer by fast-time trajectory integration using a simplified dynamic performance model of the aircraft. This technique also ensures optimum flap deployment and, for powered-lift STOL aircraft, optimum transition to low-speed flight. Also included in the design is accurate prediction of touchdown time for use in four-dimensional guidance applications. Flight test results have demonstrated that the automatically synthesized trajectories produce significant fuel savings relative to manually flown conventional approaches.

Active instrumental guidance in interventional magnetic resonance imaging

International Nuclear Information System (INIS)

Wildermuth, S.; Erhart, P.; Leung, D.A.; Goehde, S.; Schoenenberger, A.; Debatin, J.F.

1998-01-01

Purpose: An active MR-based guidance system for visualisation of invasive instruments is described. Methods: The principle of MR tracking is based on the integration of a miniaturised coil into the tip of the instrument itself. A phantom experiment was designed to demonstrate the localising accuracy of this technique. In [dition, bicompatibility and warming effects were evaluated. Preliminary intravascular applications that were performed in animal experiments under MR guidance included embolisation, vascular occlusion as well as transjugular intrahepatic punctures. Percutaneous biopsies, cholecystostomies and laparoscopic applications were also evaluated with MR tracking. Results: Phantom experiments confirmed an excellent localisation accuracy of MR tracking compared to conventional r[iography. At a field strength of 0.5 T, the temperature increase remained below 2 C. Results of phantom experiments revealed a potential of significant heating dependent on the sequence parameters employed. MR tracking allowed a robust, simultaneously biplanar visualisation of the instrument tips in real time. Based on MR 'ro[ map' images, various intravascular and percutaneous interventions were successfully performed in vivo under MR guidance. Conclusions: MR tracking is a flexible concept permitting monitoring in the guidance of instruments in an MR environment. Various preliminary in vitro and in vivo experiments demonstrate safety, localisation accuracy and feasibility of this biplanar localisation technique in real time. (orig.) [de

Enhancing inpatient rehabilitation through the engagement of patients and nurses.

Science.gov (United States)

Pryor, Julie; Buzio, Amanda

2010-05-01

This paper is a report of a study conducted to describe nurses' knowledge, experiences and perceptions of a rehabilitation nursing practice development project conducted in their workplace. Several studies over the past two decades have led to increasing clarity about the nursing role in rehabilitation. Practice development is a useful vehicle for using the findings of such studies to enhance person-centred practice in rehabilitation settings. This qualitative study, in which grounded theory informed data collection and analysis, involved interviews with 21 nurses working in an inpatient rehabilitation unit in Australia about their knowledge, experiences and perceptions of a rehabilitation nursing practice development project conducted in their workplace. The three rounds of interviews were conducted as follows: 1) December 2005-January 2006; 2) June-July 2006; and 3) October 2006. Practice development was an effective vehicle for developing rehabilitation nursing practice. While collaboration and leadership were critical to the effectiveness of the project, the use of a clinically credible practice development facilitator and a focus on the development of collective nursing practice also seem to have been important. Through the introduction of new activities, both patient and nurse engagement in rehabilitation was enhanced and, as a consequence, the nurses developed a deeper appreciation of their role in rehabilitation. Carefully and collaboratively designed and sensitively implemented work-based practice development initiatives can change the context and culture of inpatient care. The use of a facilitator with relevant clinical nursing expertise to engage staff individually and collectively with research findings and to reflect on their practice and skill development is worth exploring in similar initiatives.

Human-system Interfaces to Automatic Systems: Review Guidance and Technical Basis

Energy Technology Data Exchange (ETDEWEB)

OHara, J.M.; Higgins, J.C.

2010-01-31

Automation has become ubiquitous in modern complex systems and commercial nuclear power plants are no exception. Beyond the control of plant functions and systems, automation is applied to a wide range of additional functions including monitoring and detection, situation assessment, response planning, response implementation, and interface management. Automation has become a 'team player' supporting plant personnel in nearly all aspects of plant operation. In light of the increasing use and importance of automation in new and future plants, guidance is needed to enable the NRC staff to conduct safety reviews of the human factors engineering (HFE) aspects of modern automation. The objective of the research described in this report was to develop guidance for reviewing the operator's interface with automation. We first developed a characterization of the important HFE aspects of automation based on how it is implemented in current systems. The characterization included five dimensions: Level of automation, function of automation, modes of automation, flexibility of allocation, and reliability of automation. Next, we reviewed literature pertaining to the effects of these aspects of automation on human performance and the design of human-system interfaces (HSIs) for automation. Then, we used the technical basis established by the literature to develop design review guidance. The guidance is divided into the following seven topics: Automation displays, interaction and control, automation modes, automation levels, adaptive automation, error tolerance and failure management, and HSI integration. In addition, we identified insights into the automaton design process, operator training, and operations.

75 FR 21606 - Office of Special Education and Rehabilitative Services; Overview Information; Rehabilitation...

Science.gov (United States)

2010-04-26

... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview.... Alexa Posny, Assistant Secretary for Special Education and Rehabilitative Services. [FR Doc. 2010-9626... education and training for rehabilitation personnel; (3) Disseminate, in a cost-effective manner...

Assessment of functional vision and its rehabilitation.

Science.gov (United States)

Colenbrander, August

2010-03-01

This article, based on a report prepared for the International Council of Ophthalmology (ICO) and the International Society for Low Vision Research and Rehabilitation (ISLRR), explores the assessment of various aspects of visual functioning as needed to document the outcomes of vision rehabilitation. Documenting patient abilities and functional vision (how the person functions) is distinct from the measurement of visual functions (how the eye functions) and also from the assessment of quality of life. All three areas are important, but their assessment should not be mixed. Observation of task performance offers the most objective measure of functional vision, but it is time-consuming and not feasible for many tasks. Where possible, timing and error rates provide an easy score. Patient response questionnaires provide an alternative. They may save time and can cover a wider area, but the responses are subjective and proper scoring presents problems. Simple Likert scoring still predominates but Rasch analysis, needed to provide better result scales, is gaining ground. Selection of questions is another problem. If the range of difficulties does not match the range of patient abilities, and if the difficulties are not distributed evenly, the results are not optimal. This may be an argument to use different outcome questions for different conditions. Generic questionnaires are appropriate for the assessment of generic quality of life, but not for specific rehabilitation outcomes. Different questionnaires are also needed for screening, intake and outcomes. Intake questions must be relevant to actual needs to allow prioritization of rehabilitation goals; the activity inventory presents a prototype. Outcome questions should be targeted at predefined rehabilitation goals. The Appendix cites some promising examples. The Low Vision Intervention Trial (LOVIT) is an example of a properly designed randomized control study, and has demonstrated the remarkable effectiveness of

A novel biased proportional navigation guidance law for close approach phase

Directory of Open Access Journals (Sweden)

Su Wenshan

2016-02-01

Full Text Available A novel biased proportional navigation guidance (BPNG law is proposed for the close approach phase, which aims to make the spacecraft rendezvous with the target in specific relative range and direction. Firstly, in order to describe the special guidance requirements, the concept of zero effort miss vector is proposed and the dangerous area where there exists collision risk for safety consideration is defined. Secondly, the BPNG, which decouples the range control and direction control, is designed in the line-of-sight (LOS rotation coordinate system. The theoretical analysis proves that BPNG meets guidance requirements quite well. Thirdly, for the consideration of fuel consumption, the optimal biased proportional navigation guidance (OBPNG law is derived by solving the Schwartz inequality. Finally, simulation results show that BPNG is effective for the close approach with the ability of evading the dangerous area and OBPNG consumes less fuel compared with BPNG.

Impact of a multidisciplinary rehabilitation nutrition team on evaluating sarcopenia, cachexia and practice of rehabilitation nutrition.

Science.gov (United States)

Kokura, Yoji; Wakabayashi, Hidetaka; Maeda, Keisuke; Nishioka, Shinta; Nakahara, Saori

2017-01-01

To determine whether the presence of a multidisciplinary rehabilitation nutrition team affects sarcopenia and cachexia evaluation and practice of rehabilitation nutrition. A cross-sectional study using online questionnaire among members of the Japanese Association of Rehabilitation Nutrition (JARN) was conducted. Questions were related to sarcopenia and cachexia evaluation and practice of rehabilitation nutrition. 677 (14.7%) questionnaires were analysed. 44.5% reported that their institution employed a rehabilitation nutrition team, 20.2% conducted rehabilitation nutrition rounds and 26.1% conducted rehabilitation nutrition meetings. A total of 51.7%, 69.7%, 69.0% and 17.8% measured muscle mass, muscle strength, physical function and cachexia, respectively. For those with a rehabilitation nutrition team, 63.5%, 80.7%, 82.4% and 22.9% measured muscle mass, muscle strength, physical function and cachexia, respectively, whereas 46.7%, 78.0% and 78.1% of the respondents reported implementation of nutrition planning strategies in consideration of energy accumulation, rehabilitation training in consideration of nutritional status and use of dietary supplements, respectively. Multivariate logistic regression analysis showed that the use of a rehabilitation nutrition team independently affected sarcopenia evaluation and practice of rehabilitation nutrition but not cachexia evaluation. The presence of a multidisciplinary rehabilitation nutrition team increased the frequency of sarcopenia evaluation and practice of rehabilitation nutrition. J. Med. Invest. 64: 140-145, February, 2017.

Rehabilitation of disturbed land

Energy Technology Data Exchange (ETDEWEB)

Bell, L.C. [Australian Centre for Minesite Rehabilitation Research, Kenmore, Qld. (Australia)

1996-12-31

This chapter discusses the objectives of rehabilitation of lands in Australian disturbed by mining. It gives advice on rehabilitation planning and outlines the factors influencing post-mining land use and rehabilitation strategies, including climate, topography, hydrology, properties of soils, overburden and mineral processing wastes, flora and fauna and social considerations. Finally, the key elements of a rehabilitation plan are discussed, namely: landscape reconstruction; selective handling of overburden; and establishment and maintenance of a vegetative cover. 12 figs., 1 tab.

75 FR 21617 - Office of Special Education and Rehabilitative Services; Overview Information; Rehabilitation...

Science.gov (United States)

2010-04-26

... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview.... The Assistant Secretary for Special Education and Rehabilitative Services may change the maximum..., Assistant Secretary for Special Education and Rehabilitative Services. [FR Doc. 2010-9635 Filed 4-23-10; 8...

The Rehabilitation Act of 1973--its impact on employee selection practices.

Science.gov (United States)

Guy, J H

1978-01-01

The employee selection practices of private and public enterprises that contract with the federal government or receive federal financial assistance have been subjected to extensive regulation by the agencies administering sections 503 and 504 of the 1973 Rehabilitation Act, which provide protection to qualified handicapped individuals. The author discusses the nature and significance of these restrictions and gives practical guidance on compliance. She cautions that the enforcement powers of the agencies administering the Act--the power to cut off federal funds, debar from future contracts, award back pay, and provide equitable relief--make it necessary for employers to show good faith and proper justification when a decision is made to reject a handicapped person for a job or a promotion.

Design and Evaluation of the LOPES Exoskeleton Robot for Interactive Gait Rehabilitation

NARCIS (Netherlands)

Veneman, J.F.; Kruidhof, R.; Hekman, Edsko E.G.; Ekkelenkamp, R.; van Asseldonk, Edwin H.F.; van der Kooij, Herman

2007-01-01

This paper introduces a newly developed gait rehabilitation device. The device, called LOPES, combines a freely translatable and 2-D-actuated pelvis segment with a leg exoskeleton containing three actuated rotational joints: two at the hip and one at the knee. The joints are impedance controlled to

Motivational Rehabilitation using Serious Games

OpenAIRE

Antoni Jaume i Capó; Javier Varona Gómez; Gabriel Moyà; Francisco Perales

2013-01-01

Research studies show that serious games help to motivate users in rehabilitation processes, and rehabilitation results are better when users are motivated. In long term rehabilitation for maintaining capacities, the demotivation of chronic patients is common. In this work, we have implemented balance rehabilitation video game for cerebral palsy patients. The video game was developed using the prototype development paradigm and following desirable features for rehabilitation serious games pre...

Potential role of a cognitive rehabilitation program following left temporal lobe epilepsy surgery

Directory of Open Access Journals (Sweden)

Camila de Vasconcelos Geraldi

Full Text Available ABSTRACT Research into memory and epilepsy has focused on measuring problems and exploring causes with limited attention directed at the role of neuropsychological rehabilitation in alleviating post-operative memory difficulties. Objectives To assess the effects of a memory rehabilitation program in patients with left temporal lobe epilepsy following surgery. Methods Twenty-four patients agreed to participate and 18 completed the study; nine received memory rehabilitation while nine had no input and were designated as controls. Verbal learning efficiency, naming abilities, memory subjective ratings, ecological activity measures and a language fMRI paradigm were used as outcome measures. Results Improved verbal learning and naming test performance, increase in memory strategy use and improved self-perception were observed following the rehabilitation. Changes in fMRI activation patterns were seen in the rehabilitation group over the long term. Conclusion The findings support the potential role of a cognitive rehabilitation program following left temporal lobe surgery.

Rehabilitation nutrition for sarcopenia with disability: a combination of both rehabilitation and nutrition care management

OpenAIRE

Wakabayashi, Hidetaka; Sakuma, Kunihiro

2014-01-01

Malnutrition and sarcopenia often occur in rehabilitation settings. The prevalence of malnutrition and sarcopenia in older patients undergoing rehabilitation is 49–67 % and 40–46.5 %, respectively. Malnutrition and sarcopenia are associated with poorer rehabilitation outcome and physical function. Therefore, a combination of both rehabilitation and nutrition care management may improve outcome in disabled elderly with malnutrition and sarcopenia. The concept of rehabilitation nutrition as a c...

Rehabilitation time before disability pension.

Science.gov (United States)

Støver, Morten; Pape, Kristine; Johnsen, Roar; Fleten, Nils; Sund, Erik R; Claussen, Bjørgulf; Ose, Solveig Osborg; Bjørngaard, Johan Håkon

2012-10-30

The decision to grant a disability pension is usually the end of a long process of medical examinations, treatment and rehabilitation attempts. This study investigates to what extent the time spent on rehabilitation time prior to disability pension is associated with characteristics of the individual or the local employment and welfare office, measured as municipality variance. A study of 2,533 40 to 42 year olds who received disability pension over a period of 18 years. The logarithm of the rehabilitation time before granting a disability pension was analysed with multilevel regression. The rehabilitation time before a disability pension was granted ranged from 30 to 5,508 days. Baseline health characteristics were only moderately associated with rehabilitation time. Younger people and people with unemployment periods had longer rehabilitation time before a disability pension was granted. There were only minor differences in rehabilitation time between men and women and between different levels of education. Approximately 2% of the total variance in rehabilitation time could be attributed to the municipality of residence. There is a higher threshold for granting a disability pension to younger persons and those who are expecting periods of unemployment, which is reflected in the extended rehabilitation requirements for these groups. The longer rehabilitation period for persons with psychiatric disorders might reflect a lack of common knowledge on the working capacity of and the fitted rehabilitation programs for people with psychiatric disorders.

Rehabilitation time before disability pension

Directory of Open Access Journals (Sweden)

Støver Morten

2012-10-01

Full Text Available Abstract Background The decision to grant a disability pension is usually the end of a long process of medical examinations, treatment and rehabilitation attempts. This study investigates to what extent the time spent on rehabilitation time prior to disability pension is associated with characteristics of the individual or the local employment and welfare office, measured as municipality variance. Methods A study of 2,533 40 to 42 year olds who received disability pension over a period of 18 years. The logarithm of the rehabilitation time before granting a disability pension was analysed with multilevel regression. Results The rehabilitation time before a disability pension was granted ranged from 30 to 5,508 days. Baseline health characteristics were only moderately associated with rehabilitation time. Younger people and people with unemployment periods had longer rehabilitation time before a disability pension was granted. There were only minor differences in rehabilitation time between men and women and between different levels of education. Approximately 2% of the total variance in rehabilitation time could be attributed to the municipality of residence. Conclusions There is a higher threshold for granting a disability pension to younger persons and those who are expecting periods of unemployment, which is reflected in the extended rehabilitation requirements for these groups. The longer rehabilitation period for persons with psychiatric disorders might reflect a lack of common knowledge on the working capacity of and the fitted rehabilitation programs for people with psychiatric disorders.

Guidance and Control Software Project Data - Volume 2: Development Documents

Science.gov (United States)

Hayhurst, Kelly J. (Editor)

2008-01-01

The Guidance and Control Software (GCS) project was the last in a series of software reliability studies conducted at Langley Research Center between 1977 and 1994. The technical results of the GCS project were recorded after the experiment was completed. Some of the support documentation produced as part of the experiment, however, is serving an unexpected role far beyond its original project context. Some of the software used as part of the GCS project was developed to conform to the RTCA/DO-178B software standard, "Software Considerations in Airborne Systems and Equipment Certification," used in the civil aviation industry. That standard requires extensive documentation throughout the software development life cycle, including plans, software requirements, design and source code, verification cases and results, and configuration management and quality control data. The project documentation that includes this information is open for public scrutiny without the legal or safety implications associated with comparable data from an avionics manufacturer. This public availability has afforded an opportunity to use the GCS project documents for DO-178B training. This report provides a brief overview of the GCS project, describes the 4-volume set of documents and the role they are playing in training, and includes the development documents from the GCS project. Volume 2 contains three appendices: A. Guidance and Control Software Development Specification; B. Design Description for the Pluto Implementation of the Guidance and Control Software; and C. Source Code for the Pluto Implementation of the Guidance and Control Software

77 FR 34363 - Disability and Rehabilitation Research Projects and Centers Program; Traumatic Brain Injury Model...

Science.gov (United States)

2012-06-11

... outcomes in the vocational rehabilitation process. Section 21 of the Rehabilitation Act specifically... priorities, we designate the type of each priority as absolute, competitive preference, or invitational...)). Competitive preference priority: Under a competitive preference priority, we give competitive preference to an...

Regulatory Guidance for Lightning Protection in Nuclear Power Plants

International Nuclear Information System (INIS)

Kisner, Roger A.; Wilgen, John B.; Ewing, Paul D.; Korsah, Kofi; Antonescu, Christina E.

2006-01-01

Oak Ridge National Laboratory (ORNL) was engaged by the U.S. Nuclear Regulatory Commission (NRC) Office of Nuclear Regulatory Research (RES) to develop the technical basis for regulatory guidance to address design and implementation practices for lightning protection systems in nuclear power plants (NPPs). Lightning protection is becoming increasingly important with the advent of digital and low-voltage analog systems in NPPs. These systems have the potential to be more vulnerable than older analog systems to the resulting power surges and electromagnetic interference (EMI) when lightning strikes facilities or power lines. This paper discusses the technical basis for guidance to licensees and applicants covered in Regulatory Guide (RG) 1.204, Guidelines for Lightning Protection of Nuclear Power Plants, issued August 2005. RG 1.204 describes guidance for practices that are acceptable to the NRC staff for protecting nuclear power structures and systems from direct lightning strikes and the resulting secondary effects.

Commercially available interactive video games in burn rehabilitation: therapeutic potential.

Science.gov (United States)

Parry, Ingrid S; Bagley, Anita; Kawada, Jason; Sen, Soman; Greenhalgh, David G; Palmieri, Tina L

2012-06-01

Commercially available interactive video games (IVG) like the Nintendo Wii™ (NW) and PlayStation™II Eye Toy (PE) are increasingly used in the rehabilitation of patients with burn. Such games have gained popularity in burn rehabilitation because they encourage range of motion (ROM) while distracting from pain. However, IVGs were not originally designed for rehabilitation purposes but rather for entertainment and may lack specificity for achieving rehabilitative goals. Objectively evaluating the specific demands of IVGs in relation to common burn therapy goals will determine their true therapeutic benefit and guide their use in burn rehabilitation. Upper extremity (UE) motion of 24 normal children was measured using 3D motion analysis during play with the two types of IVGs most commonly described for use after burn: NW and PE. Data was analyzed using t-tests and One-way Analysis of Variance. Active range of motion for shoulder flexion and abduction during play with both PE and NW was within functional range, thus supporting the idea that IVGs offer activities with therapeutic potential to improve ROM. PE resulted in higher demands and longer duration of UE motion than NW, and therefore may be the preferred tool when UE ROM or muscular endurance are the goals of rehabilitation. When choosing a suitable IVG for application in rehabilitation, the user's impairment together with the therapeutic attributes of the IVG should be considered to optimize outcome. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

Raising the Profile of Career Guidance: Educational and Vocational Guidance Practitioner

Science.gov (United States)

Hiebert, Bryan

2009-01-01

In 2007 the International Association for Educational and Vocational Guidance (IAEVG) launched the Educational and Vocational Guidance Practitioner credential (EVGP) as one means of formally acknowledging the knowledge, skills, and personal attributes that practitioners need in order to provide quality career development services to clients. This…

Riparian rehabilitation planning in an urban-rural gradient: Integrating social needs and ecological conditions.

Science.gov (United States)

Guida-Johnson, Bárbara; Zuleta, Gustavo A

2017-09-01

In the present context of global change and search for sustainability, we detected a gap between restoration and society: local communities are usually only considered as threats or disturbances when planning for restoration. To bridge this gap, we propose a landscape design framework for planning riparian rehabilitation in an urban-rural gradient. A spatial multi-criteria analysis was used to assess the priority of riversides by considering two rehabilitation objectives simultaneously-socio-environmental and ecological-and two sets of criteria were designed according to these objectives. The assessment made it possible to identify 17 priority sites for riparian rehabilitation that were associated with different conditions along the gradient. The double goal setting enabled a dual consideration of citizens, both as beneficiaries and potential impacts to rehabilitation, and the criteria selected incorporated the multi-dimensional nature of the environment. This approach can potentially be adapted and implemented in any other anthropic-natural interface throughout the world.

Soil Vapor Extraction System Optimization, Transition, and Closure Guidance

Energy Technology Data Exchange (ETDEWEB)

Truex, Michael J.; Becker, Dave; Simon, Michelle A.; Oostrom, Martinus; Rice, Amy K.; Johnson, Christian D.

2013-02-08

Soil vapor extraction (SVE) is a prevalent remediation approach for volatile contaminants in the vadose zone. A diminishing rate of contaminant extraction over time is typically observed due to 1) diminishing contaminant mass, and/or 2) slow rates of removal for contamination in low-permeability zones. After a SVE system begins to show indications of diminishing contaminant removal rate, SVE performance needs to be evaluated to determine whether the system should be optimized, terminated, or transitioned to another technology to replace or augment SVE. This guidance specifically addresses the elements of this type of performance assessment. While not specifically presented, the approach and analyses in this guidance could also be applied at the onset of remediation selection for a site as a way to evaluate current or future impacts to groundwater from vadose zone contamination. The guidance presented here builds from existing guidance for SVE design, operation, optimization, and closure from the U.S. Environmental Protection Agency, U.S. Army Corps of Engineers, and the Air Force Center for Engineering and the Environment. The purpose of the material herein is to clarify and focus on the specific actions and decisions related to SVE optimization, transition, and/or closure.

38 CFR 21.283 - Rehabilitated.

Science.gov (United States)

2010-07-01

.... (Authority: 38 U.S.C. 3100) (c) Rehabilitation to the point of employability has been achieved. The veteran who has been found rehabilitated to the point of employability shall be declared rehabilitated if he... professional knowledge and skills obtained under the rehabilitation plan; or (3) Pursues additional education...

Internet-based self-help group with and without online-moderation as post-rehabilitation support

OpenAIRE

Pirsich, Carolin (geb. Ubben)

2011-01-01

After having received an in-patient-treatment in a psychosomatic rehabilitation, chronic mentally ill patients need to cope with their diseases on a long term base. They are confronted with the task to sustain and develop the acquired coping strategies as well as to integrate them into their everyday life. To support these efforts, rehabilitation clinics recommend follow-up care (e.g. through self-help groups). The project “Online discussion group Seehof” was designed for the rehabilitation c...

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

Feasibility of incorporating functionally relevant virtual rehabilitation in sub-acute stroke care: perception of patients and clinicians.

Science.gov (United States)

Demers, Marika; Chan Chun Kong, Daniel; Levin, Mindy F

2018-03-11

To determine user satisfaction and safety of incorporating a low-cost virtual rehabilitation intervention as an adjunctive therapeutic option for cognitive-motor upper limb rehabilitation in individuals with sub-acute stroke. A low-cost upper limb virtual rehabilitation application incorporating realistic functionally-relevant unimanual and bimanual tasks, specifically designed for cognitive-motor rehabilitation was developed for patients with sub-acute stroke. Clinicians and individuals with stroke interacted with the intervention for 15-20 or 20-45 minutes, respectively. The study had a mixed-methods convergent parallel design that included a focus group interview with clinicians working in a stroke program and semi-structured interviews and standardized assessments (Borg Perceived Exertion Scale, Short Feedback Questionnaire) for participants with sub-acute stroke undergoing rehabilitation. The occurrence of adverse events was also noted. Three main themes emerged from the clinician focus group and patient interviews: Perceived usefulness in rehabilitation, satisfaction with the virtual reality intervention and aspects to improve. All clinicians and the majority of participants with stroke were highly satisfied with the intervention and perceived its usefulness to decrease arm motor impairment during functional tasks. No participants experienced major adverse events. Incorporation of this type of functional activity game-based virtual reality intervention in the sub-acute phase of rehabilitation represents a way to transfer skills learned early in the clinical setting to real world situations. This type of intervention may lead to better integration of the upper limb into everyday activities. Implications for Rehabilitation • Use of a cognitive-motor low-cost virtual reality intervention designed to remediate arm motor impairments in sub-acute stroke is feasible, safe and perceived as useful by therapists and patients for stroke rehabilitation. �

Current state of craniofacial prosthetic rehabilitation.

Science.gov (United States)

Ariani, Nina; Visser, Anita; van Oort, Robert P; Kusdhany, Lindawati; Rahardjo, Tri Budi W; Krom, Bastiaan P; van der Mei, Henry C; Vissink, Arjan

2013-01-01

This study aimed to review the current state of the techniques and materials used to rehabilitate maxillofacial defects. The MEDLINE and EMBASE databases were searched for articles pertinent to maxillofacial prostheses published from January 1990 to July 2011. The main clinical stages were the subject of analysis. A multidisciplinary approach is preferred when rehabilitating maxillofacial defects. Surgical reconstruction can be used for smaller defects, but larger defects require a prosthesis to achieve an esthetic rehabilitation. Implant retained prostheses are preferred over adhesive prostheses. Silicone elastomer is currently the best material available for maxillofacial prostheses; however, longevity and discoloration, which are greatly influenced by ultraviolet radiation, microorganisms, and environmental factors, remain significant problems. In the near future, the widespread availability and cost effectiveness of digital systems may improve the workflow and outcomes of facial prostheses. Patients report high satisfaction with their prostheses despite some areas that still need improvement. Maxillofacial prostheses are a reliable treatment option to restore maxillofacial defects and improve quality of life. Significant progress has been made in the application of implants for retention and digital technology for designing surgical guides, suprastructures, and craniofacial prostheses. Further improvements are necessary to enhance longevity of prostheses.

Stigmatizing Attributions and Vocational Rehabilitation Outcomes of People with Disabilities

Science.gov (United States)

Chan, Jacob Yui-Chung; Keegan, John P.; Ditchman, Nicole; Gonzalez, Rene; Zheng, Lisa Xi; Chan, Fong

2011-01-01

Objective: To determine whether employment outcomes of people with disabilities can be predicted by the social-cognitive/attribution theory of stigmatization. Design: Ex post facto design using data mining technique and logistic regression analysis. Participants: Data from 40,585 vocational rehabilitation (VR) consumers were extracted from the…

Continuing pollution from the Rum Jungle U-Cu project: A critical evaluation of environmental monitoring and rehabilitation

Energy Technology Data Exchange (ETDEWEB)

Mudd, Gavin M., E-mail: Gavin.Mudd@eng.monash.edu.a [Environmental Engineering, Dept of Civil Engineering, Monash University, Clayton, VIC 3800 (Australia); Patterson, James [Environmental Engineering Consultant, Sydney, NSW (Australia)

2010-05-15

The former Rum Jungle uranium-copper project, Australia, is an internationally important case study on environmental pollution from and rehabilitation of mining. The Rum Jungle mining project is briefly reviewed, followed by a critical evaluation of monitoring data and pollution loads prior to and after rehabilitation - leading to the conclusion that rehabilitation has clearly failed the test of time after just two decades. The most critical findings are the need to understand pollution cycles holistically, and designing monitoring regimes to match, explicit inclusion of radiological criteria (lacking in original planning), and finally the need to set targets based on environmental criteria. Two examples include polluted groundwater which was excluded from rehabilitation and the poor design, construction and/or performance of engineered soil covers - both leading to increasing acid drainage impacts on the Finniss River. The critical review therefore presents a valuable case study of the environmental performance of uranium mine site rehabilitation. - The Rum Jungle U-Cu project underwent extensive rehabilitation in the 1980's, however, it remains a major cause of pollution to the Finniss River.

Recommendations for the Design of Serious Games in Neurodegenerative Diseases

Directory of Open Access Journals (Sweden)

Grégory Ben-Sadoun

2018-02-01

Full Text Available The use of Serious Games (SG in the health domain is expanding. In the field of Neurodegenerative Diseases (ND such as Alzheimer’s Disease, SG are currently employed to provide alternative solutions for patients’ treatment, stimulation, and rehabilitation. The design of SG for people with ND implies collaborations between professionals in ND and professionals in SG design. As the field is quite young, professionals specialized in both ND and SG are still rare, and recommendations for the design of SG for people with ND are still missing. This perspective paper aims to provide recommendations in terms of ergonomic choices for the design of SG aiming at stimulating people with ND, starting from the existing SG already tested in this population: “MINWii”, “Kitchen and Cooking”, and “X-Torp”. We propose to rely on nine ergonomic criteria: eight ergonomic criteria inspired by works in the domain of office automation: Compatibility, Guidance, Workload, Adaptability, Consistency, Significance of codes, Explicit control and Error management; and one ergonomic criterion related to videogame: the game rules. Perspectives derived from this proposal are also discussed.