Locomotor Disabilities Research Articles

Ergonomic Wheelchair for Paraplegic Dogs with Resting Mechanism

After the development of specific wheelchairs for dogs, the quality of life of these animals with locomotor disabilities has improved considerably. However, even with the many benefits provided to dogs, canine wheelchairs can present some inconveniences to the animals that use them. An example of this is conventional wheelchairs, which do not have a resting mechanism, causing the animal to spend a long time without resting, which veterinarians consider to be very harmful to the health of the disabled animal. In light of the described problem, this project consists of the study of canine wheelchairs and the development of a wheelchair prototype with a resting mechanism so that the animal can rest without being removed from the chair, aiming to provide greater comfort to the animal and practicality to the owner. Additionally, the report presents the choice of ideal materials to be used in wheelchairs for dogs, in order to provide better ergonomics and experience for the animal during the use of the product. Finally, the use of rapid prototyping in the production of some parts made in 3D printers is also detailed in the report, along with presenting the assembly processes of the wheelchair prototype.

Comparing priority ranking of inclusive education indicators using multi-criteria decision-making methods: children with locomotor disabilities vs. physical disabilities

Comparing priority ranking of inclusive education indicators using multi-criteria decision-making methods: children with locomotor disabilities vs. physical disabilities

Prosthesis Usage and Functional Status in Upper Limb Amputees: A Prospective Cross-Sectional Study.

Introduction Amputation poses significant challenges encompassing psychological, physical, and socio-economic dimensions, impacting individuals and society at large. In India, a substantial portion of the population faces loco-motor disabilities, with amputees forming a notable segment. Prosthetic rehabilitation plays a crucial role in mitigating the consequences of limb loss, aiming to restore autonomy post-amputation. Methods A prospective cross-sectional observational study was conducted over 18 months, from November 2018 to May 2020, involving unilateral upper limb amputees (ULAs) aged over 18 years. A consecutive cohort of 33 patients, predominantly male (30 males and three females), with a mean age of 43 ± 12 years (median: 43 years; range: 20-67 years), was prospectively enrolled in the study. Participants had completed at least one month of post-prosthetic fitment and were actively attending outpatient or prosthetic checkout clinics. The study utilized the Manipal Prosthetic Rehabilitation Success (PRS) score and the Orthotics and Prosthetics User Survey Upper Extremity Functional Status (OPUS UEFS) score to assess prosthesis usage and functional status. Statistical analyses included descriptive statistics, Chi-square tests, Mann-Whitney U tests, Kruskal-Wallis tests, and multivariate logistic regression analysis. Results The study revealed insights into upper limb prosthesis usage in India, highlighting factors influencing the success and challenges faced by ULAs. Associations were found between the success of prosthesis usage and several factors: occupation type (p=0.012), the side of amputation involving non-dominant limbs (p=0.033), comfort level (p=0.002), and prosthesis weight (p=0.029). Comfort level emerged as a primary predictor of usage success. The OPUS UEFS scores indicated varying levels of satisfaction and usage patterns among participants, with some utilizing prostheses for specific tasks while others for broader activities. Comfort level demonstrated a statistically significant difference in OPUS UEFS scores, favoring comfortable prostheses (p=0.020). Additionally, the mean OPUS UEFS score for patients with satisfactory or good prosthesis use was 53 ± 11 (median: 55; range: 22-64), compared to 45 ± 13 (median: 43; range: 18 - 64) in those with poor prosthesis use, with the difference nearing statistical significance (p=0.058). Conclusion The study sheds light on the landscape of upper limb prosthesis usage in India, emphasizing the need for tailored interventions based on individual needs and cultural contexts. The findings underscore the importance of comfort, side of amputation involving non-dominant limbs, occupation type, and prosthesis weight in determining the success of prosthesis usage. Opportunities exist to enhance upper limb prosthetic care in India by addressing cultural nuances and refining assessment tools to better suit the Indian population.

An approach to identify assistive technology attributes for people with locomotor disability by using a refined Kano model

This study aims to identify and evaluate the attributes of assistive products for people with locomotor disabilities using the refined Kano model. Thirty experts from various disciplines (product engineers and designers engineers, rehabilitation professionals, and users of assistive technology with locomotor disabilities) participated in the study. They were asked to complete a survey based on the Kano model questionnaire, which included functional and dysfunctional questions for each attribute. The findings reveal that performance, accessibility, functionality, and repairability are one-dimensional characteristics, while quality, modularity, intuitiveness, and aesthetics are attractive attributes. Affordability and durability are identified as must-be attributes. Subsequently, an importance scale was created on a 5-point Likert scale to further analyze the attributes based on the refined Kano model. The results indicate that functionality, quality, aesthetics, affordability, repairability, and durability are the vital attributes. Following this, a case study was conducted based on these attributes, focusing on the two most commonly used products in India: the ALIMCO basic manual wheelchair and the KARMA basic manual wheelchair. By incorporating identified attributes, manufacturers can establish marketing strategies that promote sustainable product development and enhance assistive product satisfaction among individuals with locomotor disabilities.

Profile of patients coming to the department of physical medicine and rehabilitation for locomotor disability certification: a 5-years observational study

Background: The persons with locomotor disability are eligible for various social welfare benefits from the Government under ‘The persons with disabilities (Equal opportunities, protection of rights and full participation) Act, 1995’ along with other causes of disabilities like blindness, hearing impairment etc. and recent enactment of the Rights of Persons with Disabilities (RPwD) Act, 2016. Understanding the utilization of services is crucial in enhancing assistance for individuals with certifiable disabilities. This study aimed to observe the clinico-demographic profile of patients coming to outpatient Department of Physical Medicine and Rehabilitations for locomotor disabilities certification and 5 years’ trend in the number of patients getting disability certificate. Methods: This retrospective study was based on the data taken at time of disability certification in a multispecialty tertiary care government medical college in Northern India. All persons with locomotor disability who were issued disability certificate between 2014 and 2018 were included in the study. Results: A total of 857 patients were issued disability certificates during the study period of 2014 to 2018. Among the 744 adult patients, only 149 (20%) were female. Most of them were urban residents. In locomotor disability, post-polio residual paralysis was the most common diagnosis encountered, followed by amputations and cerebral palsy. Most of the applicants were having a disability of 40-50%. Conclusions: Awareness has to be generated about the disability benefits and disability certification. Utilisation of services by females should be encouraged. Robust data and literature need to be built up for prevention and management of locomotor disability.

In vivo base editing of a pathogenic Eif2b5 variant improves vanishing white matter phenotypes in mice

Vanishing white matter (VWM) is a fatal leukodystrophy caused by recessive mutations in subunits of the eukaryotic translation initiation factor 2B. Currently, there are no effective therapies for VWM. Here, we assessed the potential of adenine base editing to correct human pathogenic VWM variants in mouse models. Using adeno-associated viral vectors, we delivered intein-split adenine base editors into the cerebral ventricles of newborn VWM mice, resulting in 45.9±5.9% correction of the Eif2b5R191H variant in the cortex. Treatment slightly increased mature astrocyte populations and partially recovered the integrated stress response (ISR) in female VWM animals. This led to notable improvements in bodyweight and grip strength in females, however, locomotor disabilities were not rescued. Further molecular analyses suggest that more precise editing (i.e. lower rates of bystander editing) as well as more efficient delivery of the base editors to deep brain regions and oligodendrocytes would have been required for a broader phenotypic rescue. Our study emphasizes the potential, but also identifies limitations, of current in vivo base editing approaches for the treatment of VWM or other leukodystrophies.

Impact of COVID-19 Pandemic on People with Locomotor Disability in North India: A Cross-Sectional Analysis.

To assess, analyse, and infer the impact of the coronavirus disease 2019 (COVID-19) pandemic on people living with locomotor disability in North India. Patients with locomotor disabilities who met the inclusion criteria received a questionnaire that had already undergone testing and validation. It covered topics highlighting the effect of the pandemic on general health, financial burden, psychological and mental health, social life and behaviour, disability and comorbidity management, transportation, and healthcare accessibility during the pandemic. In order to gauge the pandemic's effects on the population of people with locomotor disabilities, the answers to the questions were collected and analyzed. The COVID-19 pandemic has adversely affected people living with locomotor disability, ranging from loss of wages and financial crisis to anxiety, depression and lack of sleep. People with disabilities had limited reach to health and community services that were vital for them, including basic life and functional needs, besides risks of mistreatment and other psychological consequences. This analysis suggests that the root cause of pandemic disparities is the lack of disability-inclusive planning and, more significantly, the pre-existing socioeconomic disparities and challenges that disabled people have been experiencing for a long time. We suggest that unambiguous public health and policy responses should be incorporated, and health, social participation, and socioeconomic disparity causes for disabled people should be addressed in tandem.

Effectiveness of Gait Training Using Dynamic Bodyweight Support System on Locomotor Abilities of Ambulatory Children With Different Neural Disorders

Background: In this study, we evaluated the efficacy of dynamic bodyweight-supported training on the gait quality of children with different neural disorders. Methods: Seventeen ambulatory children, aged 3 to 11 years, experiencing gait limitations, were selected to participate in the designed gait training program. Each child participated in 10 practice sessions held three days a week, with each training session using the dynamic body weight support system, comprising three stages, and lasting 20 minutes. Clinical assessments were conducted using four functional tests: "Five Time Sit to Stand Test (FSST)", "Modified Time Up and Go (MTUG)", "Time Up and Down Stairs (TUDS)", and "Pediatric Berg Balance Scale" (BBS). Results: Statistical tests demonstrated a significant increase in the post-values of the BBS after gait training. Notably, children with higher relative cognitive abilities showed more improvement. Additionally, there was a significant enhancement in the assigned score for the level of independence. As all participants had received conventional physical therapies for more than three years, reaching their maximum obtainable improvements with conventional training methods, the observed improvements could be attributed to the designed training protocol even without a control group. Conclusion: Designed gait training protocol using a dynamic weight support system proved effective in enhancing balance, improving gait quality, and increasing the level of independence during performing functional tests in ambulatory children suffering from different locomotor disabilities.

Financial Autonomy and Gender Equality in Globalized World: A Study on Older Adult Population of India

We aim to analyse economic empowerment and gender equality among the older adult people in India using financial autonomy and gender inequality indices and compare different states of India for these indices across time and space. We used data from the 42nd and 52nd rounds of the National Sample Surveys for the present study. We propose two indicators namely the management of owned property and owned assets to evaluate financial autonomy. Gender inequality was estimated using the gender inequality index proposed by the UNDP. Financial autonomy has increased while the gender inequality index has decreased with time across most of the states of India. Living arrangements of the older adult population are changing. Old-aged people suffering from locomotor and cognitive disabilities are less likely to manage properties and assets. Promoting healthy aging by investing more in physical and mental health and encouraging gender equality can minimize the looming demographic crisis.

A New Exoskeleton Prototype for Lower Limb Rehabilitation

This paper presents a new solution for an exoskeleton robotic system that is used for locomotor assistance in people with locomotor disabilities. As novel features of the present research, a novel structural solution of a plane-parallel kinematic chain, intended to be used as the leg of an exoskeleton robot, is proposed. A virtual prototype is made, on the basis of which kinematic and dynamic studies are carried out using ADAMS software for the dynamic analysis of multibody systems. The dynamic simulation of the exoskeleton is performed in two simulation situations: walking on a horizontal plane, as well as the simulation of motion assistance when climbing stairs. Following this analysis, it is noted that the robotic system achieves angular variations in the hip and knee joints similar to that of a human subject. As a result, the constructive solution is feasible, and the next stage of the study is to realize an experimental prototype by the rapid prototyping technique. The kinematic elements of the exoskeleton are designed to provide structural strength, to be easily manufactured by 3D printing and to be easy to assemble. For this purpose, the structural optimization is performed with the finite element method to eliminate stress concentrators. Finally, an experimental prototype of the exoskeleton robot is manufactured and assembled, whose motion is analyzed using ultrafast-camera-based video analysis.

Proteome Analysis of Thyroid Hormone Transporter Mct8/Oatp1c1-Deficient Mice Reveals Novel Dysregulated Target Molecules Involved in Locomotor Function.

Thyroid hormone (TH) transporter MCT8 deficiency causes severe locomotor disabilities likely due to insufficient TH transport across brain barriers and, consequently, compromised neural TH action. As an established animal model for this disease, Mct8/Oatp1c1 double knockout (DKO) mice exhibit strong central TH deprivation, locomotor impairments and similar histo-morphological features as seen in MCT8 patients. The pathways that cause these neuro-motor symptoms are poorly understood. In this paper, we performed proteome analysis of brain sections comprising cortical and striatal areas of 21-day-old WT and DKO mice. We detected over 2900 proteins by liquid chromatography mass spectrometry, 67 of which were significantly different between the genotypes. The comparison of the proteomic and published RNA-sequencing data showed a significant overlap between alterations in both datasets. In line with previous observations, DKO animals exhibited decreased myelin-associated protein expression and altered protein levels of well-established neuronal TH-regulated targets. As one intriguing new candidate, we unraveled and confirmed the reduced protein and mRNA expression of Pde10a, a striatal enzyme critically involved in dopamine receptor signaling, in DKO mice. As altered PDE10A activities are linked to dystonia, reduced basal ganglia PDE10A expression may represent a key pathogenic pathway underlying human MCT8 deficiency.

Prevalence, pattern and determinants of disabilities in India: Insights from NFHS-5 (2019-21).

There is a need to provide an overview of the disability burden in India as there are limited studies. The present study aimed to estimate the prevalence and assess the pattern and determinants of disability in India. We analyzed National Family Health Survey-5 data using the "svyset" command in STATA software. We assessed the correlates by multivariable regression and reported an adjusted prevalence ratio (aPR) with a 95% confidence interval (CI). QGIS 3.2.1 software was used for spatial analysis of distributions of different disabilities. The mean (SD) age of 28,43,917 respondents was 30.82 (20.62) years, with 75.83% (n = 21,56,633) and 44.44% (n = 12,63,086) of them being from a rural area and were not educated, respectively. The overall prevalence of disability was 4.52% [(95% CI: 4.48-4.55), n = 1,28,528]. Locomotor disabilities accounted for 44.70% of all disabilities (n = 51,659), followed by mental disabilities (20.28%, n = 23,436). Age 75 years and above (vs. 0-14 years) [aPR: 2.65 (2.50-2.81)], male (vs. female) [aPR: 1.02 (1.0-1.04)], no education (vs. higher education) [aPR 1.62 (1.56-1.68)], unmarried (vs married) [aPR: 1.76 (1.70-1.82)], seeking the care of non-governmental organization (NGO) (vs. other) [aPR: 1.32 (1.13-1.55)] were significant independent determinants. The highest overall prevalence of locomotor was in Lakshadweep/UTs (8.88%) and Delhi (57.03%), respectively. Out of every hundred individuals in India, four have a disability. More intervention strategies should be planned, considering factors like education, residence, health promotion and caste so that the services provided by the government can be available and accessible to everyone in need.

Synaptic alterations as a common phase in neurological and neurodevelopmental diseases: JNK is a key mediator in synaptic changes.

Synaptic alterations as a common phase in neurological and neurodevelopmental diseases: JNK is a key mediator in synaptic changes.

EYE-CONTROLLED MOUSE CURSOR

The system described here presents hand-free interface between human and computer. It uses various image processing methods such as face detection, eye extraction, interpretation of sequence of eye blinks in real time for controlling a non- intrusive, human-computer interface. It uses a typical webcam to capture an input image. Mousecursor control can be done by facial movement by moving the face towards left and right, up and down, mouse events are controlled through eye blinks. A high number of people, affected with neuron locomotor disabilities can use this technology in computers for basic tasks such as sending or receiving messages, browsing the internet, watch their favorite TV shows or movies. This algorithm is used to give the best possible outcomes of the eye position using the decision tree algorithm so that the eye movement is detected and the mouse moves accordingly. It also enables the user to open and close the applications by blinking the eye.

Electromyography as a surrogate for estimating metabolic energy expenditure during locomotion.

Minimizing metabolic energy expenditure (MEE) plays an important role in increasing mobility in people with locomotor disabilities, as movements that require high energy lead to less activity. Rehabilitation programs and devices use MEE to determine how effective they are, but using indirect calorimetry is limiting due to time delays and non-real-world conditions. Electromyography (EMG) offers insight into how muscles activate; thus, the purpose of this study was to develop a real-time MEE feedback system through the utilization of EMG signals. Participants completed five walking conditions at different stride frequencies (preferred, +/- 15%, +/- 30%), while breath-by-breath gas exchange, ground reaction forces and EMG signals were collected. The live EMG signal was numerically integrated and separated into strides, then scaled by a cost of force (COF) coefficient. MEE had the expected quadratic relationship seen in previous literature (R²=0.967), along with COF data (R²=0.701). The EMG method stabilized between 75.1% - 133.1%, which is not within a close range (90% - 110%) of MEE; thus, future studies must investigate other mathematical methods. Our results indicate a qualitative association between MEE and EMG activity, which could be used to increase mobility and quality of life for populations with disability.

Resilience in Mothers having Children with Disabilities

In a developing society and community with limited rehabilitation and care services there are major challenges for mothers with disabled children and the responsibility of a child’s growth falls solely on the shoulders of the mother or caregivers. Understanding the resilience in mothers (caregivers) is becoming more important as a process in the area of disabilities, for quality development and caring of children with disabilities. The question tthat comes to mind is, what factors make some families do well in adverse conditions while others fight to keep their family life functional, when they are subjected to similar stresses? The aim of this research is to explore the role of resilience factors in mothers having children with disabilities. This study was conducted to assess the resilience of mothers who have children with disabilities. In this scientific study all 300 mothers (100 mothers with intellectual disability, 100 mothers with locomotor disability, and 100 mothers of normal children) were selected from northern India. The resilience scales were administered to assess the resilience variable; the scale has the 4-factor solution, which had 31 items: the alpha reliability coefficient was 0.95. The result of the study shows that the F-value for resilience in mothers of intellectually disabled children, children with locomotor disabilities and of normal children the F value for resilience is 198.379 which is significant at 0.001 levels of significance. This shows that there is difference within the group of mothers of intellectually disabled children, children with locomotor disabilities and normal children. Findings reveal that the level of resilience is different in mothers of intellectually disabled children, children with locomotor disablilities and normal children. The dentification of factors that promote resilience in mothers of children with intellectual disabilities is likely to advance clinical practice by providing new emphasis in clinical areas in family- centered care. Evidence supports the theory that resilience is linked to the availability and accessibility of culturally relevant resources. The results are especially important for building a group of resilient mothers who will be involved in their children’s recovery.

Designing Functional Clothing for People with Locomotor Disabilities

This article presents a study on functional clothing for people with disabilities. The clothing items which were the subject of research, i.e. polo shirt, T-shirt, shirt, trousers and jeans, were designed for people with physical disabilities, namely for daily activities for people who often sit in wheelchairs. The study used the research method of anthropometric theory, pattern design, textile materials, and an actual survey to analyse and evaluate the reality of movement ability and perception of clothes to determine the requirements for people with disabilities. The authors proposed suitable materials and provided solutions to adjust the basic pattern to become more suitable for people with locomotor disabilities. Finished sewing products were tested and evaluated experimentally by people with leg disabilities at the Center for Sponsoring - Vocational Training and Employment Introduction of Ho Chi Minh City and the Association for the support of people with Disabilities and Orphans of Ho Chi Minh City according to the Likert scale with 5 rating levels for each criterion. The results showed that the Cronbach’s Alpha index was over 0.7. The research addressed the comfort of disabled people’s clothing, indicating promising further development of other functional clothing.

EVALUATION OF THE EFFICIENCY OF REHABILITATION MATHODTS FOR CHILDREN WITH DISABILITIES AND LOCOMOTOR DISORDERS (REVIEW ARTICLE)

This review article aims at analyzing the modern medical literature on evaluating the effectiveness of current methods of rehabilitation care for children with disabilities and locomotor disabilities. According to the latest reports, in the structure and causes of children disability for 2011-2015, diseases of the nervous system (17.0% -18.9%) rank the second position. Cerebral palsy is a serious disease leading to disability. Current social and economic situation in Ukraine necessitates the strengthening of social protection of children with disabilities, the definition of priority areas in this field of care, and put the early social rehabilitation of children with disabilities among the social and medical priorities. Along with impacted psychophysical development, children can experience social maladaptation, lack of social contacts, low sociometric status that negatively impacts their mental development, the emotional and volitional spheres. Therefore, it is important to introduce wide-scale socio-psychological rehabilitation among this category of children in order to restore lost socio-psychic functions. The main goal of rehabilitation care is to improve the quality of life of patients and to promote their maximum social adaptation. For further development and improvement of the rehabilitation system, various scientific studies are being carried out. One of the important directions in this domain is the evaluation of the effectiveness of rehabilitation measures. The study of methods for evaluating complex rehabilitation programs is a promising direction for the implementation of approaches in organizing an in-depth investigation of this problem. The evaluation of the effectiveness of socio-psychological, psychological-pedagogical, physical rehabilitation care for children with disabilities, cerebral palsy and other central nervous system disorders and locomotive disorders should be carried out by multidisciplinary teams. Despite the significant number of existing methods for assessing the effectiveness of rehabilitation care, there are currently no highly effective and specific methods, and the main disadvantages of existing methods, according to the studied literature sources, are low specificity and laboriousness. Summarizing all of the above, it is important to evaluate the results of literature data in order to identify trends associated with modern methods for assessing rehabilitation measures for children with disabilities.

Access to Geriatric Disability Care in India: A Roadmap for Research.

This paper presents an ontological review of the global research on access to geriatric disability care and a roadmap for future research to address the problem in India. First, the dominant research focus is on resources (human, financial, and spatial) that affect access to disability care; there is little focus on informational and technological resources. Second, functional disabilities are the dominant focus of the research, followed by cognitive, mental, and locomotor disabilities; there is little focus on speech, hearing, and visual disabilities. Third, barriers, inhibitors, and catalysts of physical access are the dominant focus, with relatively less focus on virtual access; there is very little emphasis on the drivers to access. Fourth, the primary, although not dominant, focus is on access for urban and rural populations; there is very little focus on access for underserved and indigenous populations. Future research must address these gaps systematically to improve access. This paper adds: (a) a systemic framework for the study of an important, complex, emerging problem; (b) a systematic review of the global research on the problem; and (c) a research roadmap to address the emerging problem in India.

Evaluating the Quality of Life for People with Locomotor Disabilities by Practicing a Certain Sport

This present article describes the importance of practicing performance sport for people with disabilities, along with the benefits and changes in the quality life that the latter bring. The purpose of this paper has been to focus our attention on the way people with certain afflictions can overcome the bridge of disability by practicing a sport, taking into account relevant examples, such as participating in two European Handball Championships for athletes in wheelchairs for the Romanian National team. As a leading method of research, we have used a questionnaire which aims to understand the way in which disabled people cope with performance sports and how these activities influence their lives, generally, further analysing auxiliary aspects such as the quality of sleep, adopted diet and social life, to name a few. The questionnaire has been distributed to all players who participated in the two European Championships from 2018 to 2019, from 8 European Union countries, with a sample group of 59 disabled people. Based on this implemented method of action, we have examined the results and have had discussions regarding the significant role of performance sport in the life of people with disabilities, concluding that sport is not merely an isolated subject in their day to day routine, but a quintessential element in many aspects of their contemporaneous living. Sport represents a stable platform for shaping and sustaining certain healthy habits with recommendations that people with disabilities engage in such an endeavour thus managing their physical and mental health and also their social and community lives.