Rehabilitation Design Research Articles

Structural Rehabilitation using C-FRP: A Two-Decade Evaluation of Durability and Italian Guideline

This paper focuses on the analyses of a retrofit intervention carried out in 1996, using Carbon-Fiber Reinforced Polymers (C-FRP) on reinforced concrete (RC) portal frame structures. In that period, the regulatory standards (both national and international) governing this procedure lacked specific details, thereby requiring the intervention’s design to be based in accurate analysis of experimental data. Today, nearly two decades after the execution of the intervention, the C-FRP strengthened structure kept its structural integrity. This result not only validates the design procedure that was adopted but also confirms the significant durability advantages and lower maintenance costs associated with the use of C-FRP materials when compared to traditional solutions such as concrete and steel. In this context, the effectiveness of the structural rehabilitation design, based on experimental data, was then compared with current design procedures given by the Italian Guideline (CNR-DT 200 R1/2013). Through a comparative assessment of the two procedures and their respective results, it was possible to highlight the relevance of experimental studies for design purposes and to provide comprehensive data about long-term durability of FRP strengthened RC structures.

ИНСТРУМЕНТЫ ЦИФРОВИЗАЦИИ В ПРАКТИКЕ ПРОЕКТИРОВАНИЯ ПРИ РЕКОНСТРУКЦИИ ПОДЗЕМНЫХ ТРУБОПРОВОДОВ БЕСТРАНШЕЙНЫМИ МЕТОДАМИ

The article focuses on the possibilities of multi-optional design of repair and rehabilitation works on dilapidated pressure pipeline networks with the use of automated complexes in order to achieve minimum energy costs in water transportation with regard to the temperature factor. Two automated programs based on hydraulic and energy calculation operations are presented as digital tools. As a basic variant of reconstruction of dilapidated pipelines, the trenchless Swagelining technology was accepted. It is realized by pulling pre-compressed polymer pipes into old pipelines with their subsequent straightening. The paper presents information on regulatory and technical documentation and the application of advanced technology, installation and operation conditions, as well as comparative assessment of energy consumption after reconstruction of dilapidated sections of pipelines with polymer pipes with the possibility of minimizing energy consumption during water transportation under non-isothermal conditions of pipeline operation.

Patient experience, functional and quality of life outcomes in patients receiving surgical and non-surgical treatment for residual, recurrent, or new oropharyngeal cancer in a previously irradiated field: A systematic review

BACKGROUND: National guidance recommends counselling on functional (swallowing/ speech/ voice) and quality of life outcomes (QoL) for patients with recurrent, residual or new primary head and neck cancer (HNC) in a previously irradiated field (ReRuNeR). AIM: To investigate the measurement and reporting of function and QoL outcomes and patient/carer experience for ReRuNeR, focussing exclusively on oropharyngeal cancer (OPC). METHODS: Systematic narrative review of quantitative/qualitative studies. RESULTS: Seventeen articles reporting functional/ QoL outcomes following surgery were included. Gastrostomy dependence was the primary method of reporting function. Previously validated outcome measures (OMs) were used for reporting swallowing in four, speech in one and QoL in two trials. Qualitative data or non-surgical studies reporting function/QoL outcomes specific to ReRuNeR OPC were not identified. Methodological issues and heterogeneity noted across studies including absent baseline data, varying/ undefined timepoints for outcome measurement and the use of unvalidated tools. Patient-reported swallowing outcomes were mixed. Whereas instrumental assessment of swallowing showed a deterioration in safety/ efficiency. A post-surgical decline in speech was noted. Stable overall HR-QoL was reported but an increase in specific symptoms including speech, saliva and swallowing were noted. Pooled long term gastrostomy feeding rate was 23.42% (95% CI 10.2 to 36.6) (n = 108). CONCLUSION: A core dataset of patient and clinician-rated OMs is required to provide a comprehensive understanding of functional and QoL complications with ReRuNeR OPC. In combination with patient/carer experience data, these data can be used to inform pre-treatment counselling, rehabilitation and future clinical trial design.

Design and implementation of cardiac rehabilitation in pediatric heart re-transplantation: a case report

Design and implementation of cardiac rehabilitation in pediatric heart re-transplantation: a case report

Comment on “Design and Implementation of Cardiac Rehabilitation in Pediatric Heart Retransplantation: A Case Report”

Comment on “Design and Implementation of Cardiac Rehabilitation in Pediatric Heart Retransplantation: A Case Report”

Research on the Conservation Rehabilitation Design of Old Commercial Building Complexes under Digital Interactive Technology

Research on the Conservation Rehabilitation Design of Old Commercial Building Complexes under Digital Interactive Technology

Web app for the stimulation of auditory skills in children

The existing literature identifies various situations related to hearing problems in children, such as difficulties in understanding oral language, delayed speech development, or auditory discrimination problems. In this work, we present a technological tool designed to stimulate listening skills in children from 5 to 7 years old, following the principles of Condemarin. This tool offers stimulation activities and provides immediate feedback to improve the ability to recognize, discriminate, and interpret auditory stimuli, which contributes to the development of communication skills in children. The tool we developed is a web application that is easy for therapists to install, learn, and configure. For its creation, we follow the prototype methodology, which includes the requirements, assembly, evaluation, corrections, documentation, and testing stages. We collaborate with a multidisciplinary team of experts in information technology, linguistic rehabilitation, education, and graphic design. Throughout the six phases of our process, we kept user needs in mind, resulting in a system evaluation that demonstrated high user satisfaction and good performance both in technical and interface terms. In addition, this application benefits children with language disorders and learning difficulties and children from 5 to 7 years old since it encourages the development of their communication skills.

Coral reef rehabilitation sites selection based on seasonal waves and environmental quality as ecological supporting system on Mandangin Island

The natural rehabilitation process in the coral reef ecosystem requires a genuinely suitable environment minimum disturbance marine threats. Baby coral is a fragile organism used to increase the quantity of coral reef cover during rehabilitating coral reef ecosystems— determination for coral rehabilitation sites with minimum marine threats for increasing success. The destructive fishing around Mandangin Island induces a declination of live coral coverage. On average, live coral cover around Mandangin Islands is under 10 percent. However, there is high coverage of dead coral that is still functional as a shelter for reef fish in the southeast Mandangin Islands. The dead reef structure can still prevent the coastal area from high seasonal waves hitting the southeast coast from July to September. A large-scale reef structure makes it difficult for small-scale fishers to disturb the rehabilitation area. Water quality indicated that east-to-south coastal areas are considered coral rehabilitation sites. Unique water quality affects the coral adaptation on Mandangin Island. East to Southeast coastal areas are considered coral reef rehabilitation locations based on coral reef cover, water quality, and seasonal waves. The limitation of the coral fragment from Mandangin Islands became the most concerned variable for rehabilitation and reef-structure design to anticipate the seasonal waves.

Use of Traffic Speed Deflectometer Data in Project-Level Pavement Rehabilitation Design

Current traffic speed deflectometer (TSD) analyses have focused on the application of pavement structural-condition data at the network level. Pavement management systems use the deflection data to adjust the treatment as determined from the surface deflections and ride quality, resulting in better treatment selection. However, TSD data can also be used at the project level to inform pavement design decisions, though this has yet to be well documented in the U.S. A pilot study was conducted in 2021 to develop a methodology to analyze the TSD data for the South Carolina Department of Transportation (SCDOT) based on the AASHTO 1993 overlay design methodology. The TSD analysis methodology determines the effective structural number for each TSD datapoint. The results generated from this analysis were used for an ongoing construction project to assess the structural condition of the pavement within the project limits. Grade restrictions on the project presented a challenge in determining limits of pavement reconstruction and pavement overlay. The results of the TSD analysis were used to characterize the effective structural number at a 52 ft interval, allowing for optimization of the limits of pavement reconstruction. This paper presents the TSD analysis methodology used and how SCDOT incorporated the TSD results at the project level to perform rehabilitation designs of an ongoing construction project.

Human-Centered Functional Task Design for Robotic Upper-Limb Rehabilitation.

Robotic rehabilitation has demonstrated slight positive effects compared to traditional care, but there is still a lack of targeted high-level control strategies in the current state-of-the-art for minimizing pathological motor behaviors. In this study, we analyzed upper-limb motion capture data from healthy subjects performing a pick-and-place task to identify task-specific variability in postural patterns. The results revealed consistent behaviors among subjects, presenting an opportunity to develop a novel extraction method for variable volume references based solely on observations from healthy individuals. These human-centered references were tested on a simulated 4 degrees-of-freedom upper-limb exoskeleton, showing its compliant adaptation to the path considering the variance in healthy subjects' motor behavior.

Strengthening of Precast Segmental Bridge built in 1960s using External Tendons

AbstractRecently more attention has been paid to ageing infrastructure under increased traffic on the roads in Slovakia. As a result, selected prestressed concrete bridges have been inspected. Evidence of their poor technical condition has been discovered including serious faults such as large permanent deflection, wide cracks, extensive prestressing degradation, and others. The original conceptual design and poor quality of prestressing steel protection are often the decisive factor. This paper provides an example of bridge rehabilitation design of the concrete precast segmental bridge in an emergency condition. The bridge in question which is located over the water reservoir Ruzin was built in 1967 as one of the first‐generation precast segmental bridges in Slovakia. Its service life was successfully extended using structural system modification and strengthened using external prestressing. The initial assumptions for the rehabilitation have been based on the detailed analysis of the defects, and assessment of existing conditions including the analytical approach of residual prestressing determination. This concept represents the potential solution for achieving enhanced service life of similar bridges.

Study on the impact of ovality defect on structural stability of CIPP liner of drainage pipeline

Cured-in-Place Pipe (CIPP) is a trenchless pipeline rehabilitation technology commonly used for repairing underground municipal pipes. It effectively, safely, and environmentally friendly resolves drainage pipe leakage and dripping issues by curing a new resin-impregnated liner inside the original pipe. However, in practical applications, ovality defects may occur in CIPP liners due to insufficient inflation, deformation of the original pipe, joint misalignment, and other problems. These defects have the potential to reduce the structural bearing capacity of the liners. To investigate the buckling mechanism of oval liner structures under external water pressure, two sets of OD 600 mm CIPP liner buckling tests were conducted. The critical buckling stress state and buckling mode characteristics exhibited similarities across liners with different initial ovalities. With an increase in the ovality defect of the liners from 0% to 5%, the critical buckling pressure decreased by 10.62%, while the maximum radial deformation displacement decreased by 62%. Existing models have shown an inability to accurately predict the buckling pressure of oval liners with an initial annular gap. Consequently, this study proposes an improved analytical solution for calculating the critical buckling pressure of liners with ovality imperfections under the influence of an annular gap, which aligns well with the experimental data. The conclusions drawn from this study provide substantial data support for ensuring the accuracy and safety of CIPP liner rehabilitation design.

Development of a Set of Indicators for Measuring and Improving Quality of Rehabilitation Care after Ischemic Stroke.

Stroke is the leading global cause of permanent disability and the second leading cause of dementia within the first year of the event. Systematic quality improvement interventions such as Audit & Feedback (A&F) can monitor and improve the performance of post-stroke care in conjunction with the use of quality indicators (QIs). The scientific literature shows limited studies on quality improvement and QIs design for poststroke rehabilitation. In Italy, the National Outcomes Evaluation Programme (PNE) annually provides several QIs concerning the acute wards. On the contrary, indicators for quality assessment of post-acute stroke rehabilitation are not available nationwide. In recent years, the Italian Ministry of Health has funded a national network project, the aim of which is to provide and evaluate the effectiveness of A&F strategies in healthcare improvement. Part of this project is the development of a set of IQs for ischemic stroke rehabilitation used to conduct an A&F. In this study, we describe the design and development process of these QIs from administrative databases and report the results of the pilot test conducted on a small sample of Sicilian rehabilitation facilities, comparing them from 2019 to 2021. Feedback from the participating centers was mainly positive, and the quality indicators were found to be comprehensible and appreciated. However, the study highlighted the need for better adherence to indicators measuring processes of rehabilitation care. The set of quality indicators presented in this study, relevant to inpatient settings, could be considered a starting point on which to base quality improvement initiatives both nationally and internationally.

Characterization of fatigue damage accumulation and prediction of modulus deterioration for cement stabilized base

ABSTRACT Cement stabilized materials (CSM) are widely used in the pavement base and subbase of highway structures which are susceptible to fatigue cracking and modulus deterioration under traffic loads. The residual modulus is a key indicator for the performance of CSM, and is an important factor for the rehabilitation design of the pavement with cement stabilized base. This study focuses on the damage accumulation and modulus decay of CSM. Firstly, the strength and fatigue performance of the CSM were tested. Then, fatigue transfer functions and their reliability models for the different types of CSM were established. Eight fatigue transfer equations with different reliability of the base CSM (6% cement) and subbase CSM (4% cement) were developed. It is found damage accumulation of CSM shows typical three phases: initial change in phase I (10%−15% of fatigue life), stable decay in phase II (60%−80% of fatigue life), and rapid damage in phase III (10%−25% of fatigue life). The range of parameters for the three phases of CSM fatigue damage is presented. Finally, three prediction models for modulus decay are established, including the incremental-recursive deterioration model, three-phase deterioration model, and the MEPDG’s CSB fatigue model. These findings can be used for predicting the residual performance of the CSM base, which are useful for enhancing the rationality of pavement maintenance and rehabilitation (M&R) and ensuring the durability and reliability of highway structures.

Rational design method for bituminous pavements reinforced by geogrid

Geosynthetics have been a reinforced solution for pavement structures for more than 80 years and could be effective in extending its service life. There is a lack of consolidated design methods for pavement with this reinforcement. Therefore, this work aims at proposing a new rational design approach for reinforced structures based on the French design method. In this approach, the geogrid contribution was included by improving the fatigue and rutting properties of some layers, using coefficients named kmaj and kmaj_Z. Three hypotheses were considered concerning the condition of an old bituminous layer remaining from rehabilitation works. The first one considered this layer in healthy condition to simulate a new reinforced structure. The second one considered it as cracked and the third one as disintegrated to simulate the design for rehabilitation. Two placement positions and two geogrid-interface conditions (bonded and not bonded) were analyzed. The results indicated that the geogrid was most effective in a completely deteriorated structure and it should be placed in the lowest possible position in the bound layers. This method can be used for any geogrid position within the structure. Lastly, the reinforcement by geogrid allows a reduction of the thickness of the layer above it.

Railway Arc Bridge Analysis Through Dynamic Tests

This paper presents the dynamic monitoring carried out on a 458 m long railway Papagaios Bridge in Brazil. This is a concrete arch bridge built over 60 years ago, which needed repairs. The dynamic monitoring was designed to carry out a structural integrity assessment and to calibrate a numerical model to be used for the structural rehabilitation design. Vibration measurements were carried out on the bridge in selected locations. This paper addresses data analysis, the impact measurements when a train enters the bridge and modal analysis.

Evaluation of pavement service life using AASHTO 1972 and mechanistic-empirical pavement design guides

• Predicted service life (SL) using AASHTO 1972 is generally lower than M-E method. • Variation of service life is lower in M-E method than AASHTO 1972 design method. • Predicted service life using M-E method affected by location (rural vs. urban). • Predicted SL using AASHTO 1972 is affected by SN values (design and required SN). Service life is often used by state transportation agencies to evaluate alternative flexible pavement designs. The design that keeps the pavement in acceptable condition longest before it needs another maintenance treatment is the preferred design. For a given rehabilitation design, this study evaluates the pavement service life using AASHTO 1972 pavement design guide and mechanistic-empirical (M-E) pavement design guide. The service life here is referred as the duration from last completed rehabilitation to the next maintenance treatment. The goal is not to determine which method is better, but rather, it is to understand how their estimated service lives differ and what factors contribute to their differences. To perform the evaluation, rehabilitation designs developed by the SCDOT for a research project are used. These designs take into account existing pavement distresses obtained through field investigation of 28 actual rehabilitation projects on primary routes. Service life is determined using MAP-21 criteria for good and fair pavements. Analysis results indicated that (1) the predicted service life using the M-E method has lower variation than the AASHTO 1972 method and is affected by the location (rural vs. urban) of the routes, (2) the predicted service life using the AASHTO 1972 method is generally lower than that of the M-E method and is affected by the difference between the design structural number (SN) and required SN, (3) the M-E service life for good pavement is generally longer for routes that include CMRB design and the percentage of trucks lower than 10%, and (4) the AASHTO 1972 service life is higher if the existing SN is already exceeding the required SN from the previous maintenance.

Statistical and Methodological Considerations for Randomized Controlled Trial Design in Physical Medicine and Rehabilitation.

Well-designed randomized controlled clinical trials assessing treatments in the field of physical medicine and rehabilitation are essential for evidence-based patient care. However, there are challenges unique to clinical trials in physical medicine and rehabilitation due to complex health interventions in this field. We highlight routinely encountered empirical challenges and provide evidence-based recommendations on statistical and methodological approaches for the design and conduct of randomized controlled trials. Some of the issues addressed include challenges with blinding treatment groups in a rehabilitation setting, heterogeneity in treatment therapy, heterogeneity of treatment effects, uniformity in patient-reported outcome measures, and effect on power with varying scales of information. Furthermore, we discuss challenges with estimation of sample size and power, adaption to poor compliance with treatment and missing outcomes, and preferred statistical approaches for longitudinal data analysis. Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. Upon completion of this article, the reader should be able to: (1) Appraise the complexities of interventions in physical medicine and rehabilitation and how these challenges impact the conduct of clinical trials; (2) Develop an analytical strategy for poor treatment compliance and missing outcomes that can compromise the causal effect sought in a randomized clinical trial; and (3) Recognize the role of a data and safety monitoring board in a clinical trial. Advanced. The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Rebar Replacement in Severely Damaged RC Bridge Column Plastic Hinges: Design Criteria and Experimental Investigation

This paper presents a procedure for rehabilitating plastic hinges with damaged/fractured weldable longitudinal rebars in severely damaged reinforced concrete (RC) bridge columns and possible improvements regarding connection protection and plastic hinge development. Damaged/fractured longitudinal rebars are replaced with new rebar segments, and the basis of this approach involves connecting intermediate machined parts to the original longitudinal rebars by welding with an off-the-shelf steel equal angle. The proposed rehabilitation design procedure is based on capacity design principles, with equations that define the new geometries and required ductility, and it is validated experimentally on three 1∶6-scale RC circular column specimens. Compared with the original columns, the ductility capacity of the rehabilitated columns increased from 39% to 58%, and the energy dissipation (equivalent viscous damping ratio) increased from approximately 50% to 250%. The base shears of the rehabilitated columns were smaller than those of the original columns owing to the reduction in the rebar area; thus, shear failure was avoided, and the demand on the foundation was reduced. The rehabilitation procedure, by adopting a welding connection that is easily performed on site and concentrates the damage in the new rebar segments, promises to be a quick, simple, reliable, and effective means to improve the ductility and shear capacity of RC bridge columns without using mechanical couplers or changing the column dimensions.

3D scanning of Upper Limb anatomy by a depth-camera-based system

The 3D reconstruction of upper limb anatomy plays a significant role in many biomedical fields such as ergonomics, motion rehabilitation, and prosthesis design. In the last few years, the technical advancement of consumer-grade depth cameras has supported the development of portable and low-cost optical 3D body scanners for healthcare applications. The real-time scanning of human body parts, however, still represents a complex task due to the non-stationary nature of the scanning target. This issue imposes that the scanning time must be reduced as much as possible to minimize scanning artifacts. In this regard, depth cameras can capture geometrical information at video frame rates, thus guaranteeing fast acquisition times. Furthermore, the simultaneous use of multiple sensors would minimize undercut geometries, which impair the 3D reconstruction’s completeness. In this work, a portable 3D optical scanner has been developed by rigidly assembling three Intel® RealSense™ D415 depth cameras on a lightweight circular frame. The three sensors are mutually calibrated, by using a 3D printed calibration specimen, to simultaneously align acquisitions from the three different camera viewpoints for each scanner pose. The system’s effectiveness has been assessed by acquiring the geometry of both a plaster hand and a human hand and comparing the results with those obtained by a high-end stationary structured light scanner. The developed system represents a low-cost handheld alternative to existing body scanners for collecting and storing 3D anatomical data, which can be used in the design process of bespoke medical devices.