Rehabilitation Equipment Research Articles

A new framework for classification of multi-category hand grasps using EMG signals

Electromyogram (EMG) signals have had a great impact on many applications, including prosthetic or rehabilitation devices, human-machine interactions, clinical and biomedical areas. In recent years, EMG signals have been used as a popular tool to generate device control commands for rehabilitation equipment, such as robotic prostheses. This intention of this study was to design an EMG signal-based expert model for hand-grasp classification that could enhance prosthetic hand movements for people with disabilities. The study, thus, aimed to introduce an innovative framework for recognising hand movements using EMG signals. The proposed framework consists of logarithmic spectrogram-based graph signal (LSGS), AdaBoost k-means (AB-k-means) and an ensemble of feature selection (FS) techniques. First, the LSGS model is applied to analyse and extract the desirable features from EMG signals. Then, to assist in selecting the most influential features, an ensemble FS is added to the design. Finally, in the classification phase, a novel classification model, named AB-k-means, is developed to classify the selected EMG features into different hand grasps. The proposed hybrid model, LSGS-based scheme is evaluated with a publicly available EMG hand movement dataset from the UCI repository. Using the same dataset, the LSGS-AB-k-means design model is also benchmarked with several classifications including the state-of-the-art algorithms. The results demonstrate that the proposed model achieves a high classification rate and demonstrates superior results compared to several previous research works. This study, therefore, establishes that the proposed model can accurately classify EMG hand grasps and can be implemented as a control unit with low cost and a high classification rate.

Development of Stand-walking Simulator for Rehabilitation Training

A rehabilitation equipment is developed by mechanical and electronic engineering principle based on the need of rehabilitation training for patients with paraplegia. The device can prevent complications such as palsy bedsores and deep venous thrombosis. The device effectively reduces the labor intensity of the rehabilitation staff or family members to carry the patient's body, and promotes the physical and psychological rehabilitation progress of patients with lower limb paralysis.

Infection Control in Prosthodontics: A Review

Dentists and dental office personnel are exposed to a wide range of potential pathogens and have highchances of infection transmission not only in the clinic, but also in the laboratory. A proper sterilizationand disinfection protocol must be followed. This shall prevent cross-contamination of disease among thedental health care providers. Prosthodontics is a branch in dentistry which includes manipulation of variousmaterials, equipment, their use and instrumentation for rehabilitation of patients. Patients in the geriatricgroup are of special importance in this branch. A strict protocol for infection control is mandatory to combatany kind of transmission and cross-contamination between the dental office personnel and patient and viceversa.This article shall discuss the various modalities of sterilization and disinfection followed from aprosthodontist’s point of view, in the clinic and the laboratory also.

Prevalence of sports-related spinal injury stratified by competition level and return to play guidelines.

Spinal injury is among the most severe and feared injuries an athlete may face. We present an up-to-date review of the recent literature, stratifying recommendations based on injury location (cervical, thoracic, and lumbar spine) and type, as well as, the level of competitive play (high school, collegiate, professional). A literature search was completed to identify all publications reporting return to play guidelines for athletic injuries or injury-related surgery irrespective of the study design. Publication dates were not restricted by year. Search terms used included "return to play" and "spinal injury" on National Library of Medicine (PubMed) and Google Scholar. Selection criteria for literature included axial spine injury guidelines for athletic participation post-injury or post-surgery. Literature found from the search criteria was sorted based on level of competition and location of axial spine injury involved. It was found that professional athletes are more likely to suffer severe spinal injuries, require surgery, and necessitate a longer return to play (RTP), with high school and college athletes usually returning to play within days or weeks. Injuries occur mainly within contact sports and concordance exists between initial and subsequent spinal injuries. Adequate rest, rehabilitation, and protective equipment alongside the education of athletes and coaches are recommended. In conclusion, a multidisciplinary approach to patient management is required with consideration for the emotional, social, and perhaps financial impact that spinal injury may have upon the athlete. Consensus from the literature states that in order for an athlete to safely return to play, that athlete should not be actively suffering from pain, should have a full range of motion, and complete return of their strength in the absence of neurological deficit.

Position Tracking of a Pneumatic-Muscle-Driven Rehabilitation Robot by a Single Neuron Tuned PID Controller

Pneumatic muscle actuators (PMAs) own compliant characteristics and are suitable for use in rehabilitation equipment. This paper introduces a rehabilitation robot driven by PMAs devised in the Rehabilitation and Medical Robot Laboratory. Considering high nonlinearities inside PMAs, a single neuron tuned PID controller is carefully designed. Experimental setup is built up and trials are performed. Results demonstrate the proposed advanced PID algorithm can achieve better capacity in position tracking than the conventional PID controller.

Rehabilitation equipment

Technical means of rehabilitation (TMR) include special devices and mechanisms are intended to compensate or completely eliminate persistent disabilities in individuals with limited physical and mental capabilities and aimed at normalizing physical and work activity. They include special means for self-care and care, means for orientation in space, devices for communication and information exchange, materials for training and education, as well as devices for engaging in work activities. Rehabilitation equipment also includes all types of prostheses, orthopedic shoes and special clothing, eye prostheses and hearing aids, special sports equipment and sport outfit, as well as mobility aids (wheelchairs). They all have a single purpose, which is to facilitate the daily life of handicapped people and people with disabilities. Provision of this category of persons with technical means of rehabilitation is carriedout on the basis of individual programs. Federal Law of November 24, 1995 No. 181-FZ “On the Social Protection of Persons with Disabilities in the Russian Federation” guarantees free provision of technical rehabilitation means at the expense of the federal budget to the disabled people [6] in the Russian Federation.

Community-based rehabilitation service in Chengdu, Southwest China: a cross-sectional general survey

BackgroundWorld Health Organization initiated community-based rehabilitation (CBR) in 1978, and by now, it has been an essential process of medical services worldwide. China had strengthened primary health care on building more than 35,000 community health centers (CHCs) in cities, and more than 34,000 township health centers (THCs) in the rural area. Nevertheless, it remains unclear that if these primary health centers could provide optional rehabilitation services for disabilities. And this study aims at evaluating the supply capacity of rehabilitation service in primary health centers of Chengdu, a regional center city of southwest China.MethodWe conducted a general investigation of primary health centers in Chengdu, a city located in southwest China with more than 15 million population. Our investigation covered all of Chengdu’s 390 primary health centers from October to November 2016. We researched these primary health centers on basic rehabilitation services, diseases, and rehabilitation equipment quantity and quality, and traditional Chinese medicine (TCM) physiotherapy.ResultRehabilitation therapy is available in 88.9% (337 of 379) of all primary health centers. Meanwhile, CHCs slightly surpass THCs with an available rate of 92.2% (106 of 115) and 87.5% (231 of 264), respectively. Traditional Chinese Medicine (TCM) physiotherapy is available in 97.1% (368 of 379) of all primary health centers, 97.3% (112 of 115) of CHCs and 97.0% (256 of 264) of THCs. Quantitative analysis showed that substantial factors which could make an impact on the number of patients per year contain: categories of rehabilitation disease (P < 0.001, 95% confidence interval (CI) [− 1.571, − 0.702]),number of rehabilitation bed (P < 0.001, 95%CI [− 1.249, − 0.290]).ConclusionCBR and TCM physiotherapy has become accessible for disabilities in most basic health centers of Chengdu City, whereas, available rate of CBR in THCs is lesser than in CHCs, which suggests an imbalance in primary health service development between rural and urban area. Categories of rehabilitation diseases, and the number of rehabilitation beds constitute co-factors that make an impact on the CBR capacity of basic health centers.

Effect of Purposeful Activities Using Rehabilitation Equipments on Upper Limb Function and Strength in Patients With Acute Stroke: A Pilot Study

목적: 본 예비연구는 재활도구를 이용한 목적있는 활동이뇌졸중 환자의 상지기능과 근력에 미치는 효과를 탐색하고자하였다. 방법: 14명의 뇌졸중 환자가 본 연구에 참여하였다. 모든 대상자는 실험군 7명과 대조군 7명으로 할당되었다. 실험군은 재활도구를 이용한 목적있는 활동을 수행하였으며, 대조군은 보편적인 작업치료를 받았다. 두 군은 6주 동안, 주4-5회, 하루 30분의 중재를 받았다. 결과측정은 상지기능과근력을 측정하기 위하여 Jebsen-Tylor 손 기능 검사와 도구근력검사가 측정되었다. 결과: 두 군은 중재 전과 후로 상지기능과 근력에서 향상을나타냈다. 실험군은 대조군보다 어깨의 굴곡과 외전, 팔꿈치신전에서 유의하게 더 높은 향상을 보였다. 상지기능은 두군 사이에 유의한 차이를 보이지 않았다. 결론: 본 연구의 결과는 재활도구를 이용한 목적있는 활동이 뇌졸중 환자의 어깨와 팔꿈치 근력 향상에 긍정적인 중재방법이 될 수 있음을 시사한다.

Recent Advances on Ankle Rehabilitation Device

Background: Ankle joint, as one of the important joints supporting the weight of human body, is vulnerable to injury in daily physical exercise and sports because of its special growth location and anatomical composition. The rehabilitation period of traumatic ankle is relatively long, especially in the later period of recovery. In order to relieve the clinical symptoms such as swelling and pain caused by ankle trauma, the rehabilitation of the ankle should be actively carried out by means of rehabilitation equipment. Thus, the ankle rehabilitation cycle can be minimized largely and the rehabilitation efficiency can be improved greatly. Objective: Through the summary of the latest literature on ankle rehabilitation devices, readers will be familiar with the research progress and difficulties in this field, and the reference for the followup study in this direction is provided. Methods: The structural characteristics and applications of the ankle rehabilitation devices are introduced in the paper. The latest patents and articles related to ankle rehabilitation device are compared and analyzed. Results: The ankle rehabilitation devices are classified according to the structure characteristics, driving mode and training function. The advantages and disadvantages of various devices are pointed out, and the future development direction of this research field is predicted. Conclusion: Studies show that remarkable improvements have been achieved on the ankle rehabilitation equipment. In the future, the structural optimization, new materials, control strategy, new type actuators, and rehabilitation evaluation of ankle rehabilitation devices should be further studied.

Wide-range linear viscoelastic hydrogels with high mechanical properties and their applications in quantifiable stress-strain sensors

Wide-range linear viscoelastic materials with high mechanical properties have not been reported yet, despite their bright prospect in diverse applications. Herein, we fabricate a class of physical hydrogels manifesting linear stress-strain relationship up to a strain of 1700%, high tensile stress up to 12.0 MPa and fracture toughness up to 82.1 MJ/m3, yet the materials are quite soft with Young’s modulus from 0.2 to 1.1 MPa. Such physical hydrogels are formed by designing a homogeneous network with multiple coordination interactions of different bonding strength. Under small deformation, the homogeneous network enables affine deformation featured by entropic elasticity with negligible energy dissipation. Further increasing the deformation, the elongated network chains progressively break the weak to strong coordination interactions, which not only leads to a linear increase in stress, but also generates constant growth in energy dissipation. Moreover, the hydrogels show linear relative resistance change-strain-stress behavior, and thus can be used as quantifiable stress-strain sensors to simultaneously monitor deformation and force of soft robotics, wearable devices, flexible electronics, rehabilitation and sport equipments.

Three-Fourths of ICU Physical Therapists Report Use of Assistive Equipment and Technology in Practice: Results of an International Survey

Introduction: Patients surviving critical illness develop persistent functional mobility impairments that significantly impact their quality of life. Early rehabilitation interventions in the intensive care unit (ICU) may mitigate the sequelae of critical illness. However, implementation of such interventions is very low in clinical practice. Assistive rehabilitation equipment and technology, such as tilt beds and cycle ergometers, provide physical therapists (PTs) with strategies to complement functional mobility interventions. Purpose: To determine PTs' self-reported use of assistive rehabilitation equipment and technology in their clinical practices in the ICU and to describe the rationale for their use. Methods: An online survey (Qualtrics), with closed- and open-ended questions, was distributed to PTs working in the ICU, via e-mail through the Academy of Acute Care Physical Therapy “PTinICU” e-mail listserv and the online ICU Recovery Network and Twitter. Descriptive statistics were used to assess frequency and rationale for the use of specific equipment and technology. Results: PTs (n = 206, mean age 39.6 ± 9.7 years, 82% female) completed the survey (81% in the United States and 19% from 12 countries outside of the United States). Respondents (153/206, 74%) reported using at least one type of equipment or technology. The most commonly used were hospital tilt beds and tilt tables (n = 106, 51%), mobilization chairs (n = 80, 39%), standing frames (n= 66, 32%), cycle ergometers (n = 63, 31%), and exercise platforms (n = 36, 17%). The most common rationale for use was as a bridge to functional mobility (response ranging from 17% to 44% depending on the technology). The most common reason for not using equipment or technology was limited or no access (71%, 37/53). PTs from outside the United States (vs US-based PTs) reported greater use of equipment or technology (n = 206, 92% vs 70%, P = .001). Conclusions: Approximately 75% of PTs completing this survey report use of assistive rehabilitation equipment and technology in their ICU clinical practice, emphasizing the need for further research to understand the clinical approaches for use and the efficacy of such technology.

Motivators for and Barriers to Exercise Rehabilitation in Hemodialysis Centers: A Multicenter Cross-Sectional Survey.

The aim of the study was to explore motivators for and barriers to exercise rehabilitation in hemodialysis patients and the barriers perceived by the hemodialysis center staff. A cross-sectional study was performed in five hemodialysis centers using patient questionnaires designed for this study to evaluate the motivators for and barriers to exercise rehabilitation. Questionnaires were not yet validated. Of the 471 recruited patients, 63.3% were willing to participant in exercise rehabilitation. The greatest motivators included improving quality of life (98.0%) and wanting to be healthier (98.0%). Perceived barriers included discomfort (59.0%), concerns regarding safety (36.7%), and disinterest (27.0%). Among these, unwillingness, disinterest, and having peripheral arterial disease were independent risk factors of lack of participation in exercise rehabilitation. The most common perceived barriers among the 90 employees that participated were lack of professional guidance and advice from rehabilitation therapists (93.1%), lack of exercise rehabilitation knowledge (86.2%), and lack of special exercise equipment (86.2%). Most patients were willing to exercise to improve their health and quality of life. Barriers to exercise rehabilitation included patient and staff factors. It is essential to establish a rehabilitation team within dialysis centers, including general staff and rehabilitation therapists. These centers require improved rehabilitation policies and access to specialized rehabilitation equipment.

Prerequisites for the formation of the concept. Physical therapy of children in need of palliative care

The purpose of the research is the scientific justification and development of a system of physical therapy for children who need palliative care. The methods of research in this case are empirical methods (description, comparison, measurement), the method of theoretical knowledge (axiomatic), general logical methods (analysis, synthesis), systematic approach.&#x0D; The basis of providing palliative care involves a patient-centered approach of a multidisciplinary team, the composition of which is determined by the patient's needs, his age, and the severity of his condition. If we consider the rehabilitation support of children who need non-oncological palliative care within the framework of the International Classification of Functioning, it can be stated that, having violations in the Body Structure and Functions component, they have significant limitations in the Activity-Participation component. Contextual factors – Environmental factors and Personal factors – play a significant role in the quality and effectiveness of rehabilitation. After the rehabilitation instrumental examination, the needs of the child and his family members, child-centered tasks are identified, and the goal of physical therapy is formed. The means of the rehabilitation program are therapeutic physical culture, massage, positioning, dance and movement therapy, photo therapy and art therapy using the «hand in hand» method; selection of technical means of movement, rehabilitation equipment for modification of the educational space. Therefore, the means of the physical therapy program will be directed to reducing the complication of the main disease, will help to form the household-educational-social organization of the space of children of this category, will contribute to the emotional and psychological stability of patients, their family members, and representatives of the interdisciplinary team.

A New Design Scheme for Intelligent Upper Limb Rehabilitation Training Robot.

In view of the urgent need for intelligent rehabilitation equipment for some disabled people, an intelligent, upper limb rehabilitation training robot is designed by applying the theories of artificial intelligence, information, control, human-machine engineering, and more. A new robot structure is proposed that combines the use of a flexible rope with an exoskeleton. By introducing environmentally intelligent ergonomics, combined with virtual reality, multi-channel information fusion interaction technology and big-data analysis, a collaborative, efficient, and intelligent remote rehabilitation system based on a human’s natural response and other related big-data information is constructed. For the multi-degree of the freedom robot system, optimal adaptive robust control design is introduced based on Udwdia-Kalaba theory and fuzzy set theory. The new equipment will help doctors and medical institutions to optimize both rehabilitation programs and their management, so that patients are more comfortable, safer, and more active in their rehabilitation training in order to obtain better rehabilitation results.

Design and Analysis of a Wearable Upper Limb Rehabilitation Robot with Characteristics of Tension Mechanism

Nowadays, patients with mild and moderate upper limb paralysis caused by cerebral apoplexy are uncomfortable with autonomous rehabilitation. In this paper, according to the “rope + toothed belt” generalized rope drive design scheme, we design a utility model for a wearable upper limb rehabilitation robot with a tension mechanism. Owing to study of the human upper extremity anatomy, movement mechanisms, and the ranges of motion, it can determine the range of motion angles of the human arm joints, and design the shoulder joint, elbow joint, and wrist joint separately under the principle of ensuring the minimum driving torque. Then, the kinematics, workspace and dynamics analysis of each structure are performed. Finally, the control system of the rehabilitation robot is designed. The experimental results show that the structure is convenient to wear on the human body, and the robot’s freedom of movement matches well with the freedom of movement of the human body. It can effectively support and traction the front and rear arms of the affected limb, and accurately transmit the applied traction force to the upper limb of the joints. The rationality of the wearable upper limb rehabilitation robot design is verified, which can help patients achieve rehabilitation training and provide an effective rehabilitation equipment for patients with hemiplegia caused by stroke.

A scoping review of the resources needed to deliver anterior cruciate ligament physiotherapy rehabilitation in randomised controlled trials

Background: The Anterior Cruciate Ligament (ACL) stabilises the knee and is commonly injured in sport. Surgical repair and rehabilitation are common. However, rehabilitation randomised controlled trials do not always report the resources used to deliver ACL rehabilitation. This may lead to suboptimal availability of resources for evidence based care.Objective: To identify the resources used to deliver multimodal ACL rehabilitation in randomised controlled trialsMethods: Comprehensive searches, combining ‘anterior cruciate ligament’, and ‘rehabilitation’ with the Cochrane RCT filter, were conducted of Medline, Embase, Cinahl, PeDro, Sports Discus and the Cochrane Library. Adults post ACL reconstruction were included. The intervention and comparator were physiotherapy for post-operative rehabilitation. Outcomes were the resources required to deliver rehabilitation, and study type was randomised controlled trials. Papers were screened against the criteria; data were charted and narrative synthesis applied.Results: Fourteen studies reported on 599 patients. The interventions ranged from 4 to 36 weeks. Physiotherapy was typically an hour and ranged from 1 to 5 sessions/week. Resources included a gym environment with rehabilitation equipment such as resistance machines, free weights, cardiovascular and neuromuscular control equipment, and an experienced physiotherapist.Conclusions: Implications for future studies include the need for a more detailed report of the resources used in RCTs. Accurate reporting would help healthcare decision makers to effectively manage resources when implementing evidence based care. Findings can be considered as criteria against which to audit resource provision.

Application and Development of 3D Printing in Medical Field

Different from reduction manufacturing and equal manufacturing, 3D printing is an additive manufacturing method, which transforms 3D model into 2D cross-section data to form entity layer by layer. This makes its processing not limited by complexity of the design model and number of the manufacturing products. It is very suitable for the medical field with high customization requirements. In fact, application of 3D printing technology in the medical field is particularly noticeable. In this paper, application and development of 3D printing technology are reviewed in medical model, rehabilitation equipment, tissue engineering, medical hygiene materials, lab-on-chip. Its applications include medical education, surgical planning, prosthesis customization, tissue culture and biosensor manufacturing and so on. Its wide application is due to its digital model, which makes the whole manufacturing process easier to digitize, so it is more conductive to updating and customization of products via 3D printing.

Применение реабилитационного оборудования NUGA BEST в комплексной программе восстановительного лечения больных анкилозирующим спондилоартритом

Study objective: to evaluate the eff ectiveness of Nuga-Best rehabilitation equipment in a comprehensive rehabilitation program for the patients with a central form of ankylosing spondylitis. Material and methods: the study involved 65 (aged 28 – 48, mean age 34,6±2,9) patients with a verifi ed diagnosis of ankylosing spondylitis. The patients were divided into two groups: the control group (n=32), receiving conventional treatment and the main group (n=33), which received procedures on Nuga-Best rehabilitation equipment along with traditional methods. The rehabilitation effectiveness criteria were: visual analogue scale of pain assessment, index BASDAI (Bath Ankylosing Spondylitis Disease Activity Index), chest excursion, Schober test, Index BASMI (Bath Ankylosing Spondylitis Metrology Index), indicators of psychoemotional status according to the Feling-Activity-Mood test. Results: At the end of the rehabilitation course, the range of movements in the aff ected parts of the spine increased from 2.98±0.23 cm to 5.56±0.27 cm (p<0.05) in the main group, and from 3.12±0.16 cm up to 5.11±0.14 cm in the control group (p<0.05). A decrease of the pain during walking was reported by 98.2% of the patients of the main and 67.3% of the control group (p<0.05). The volume of excursions of the spine was restored in 67% of patients of the first group, in 42% of the second group. The average BASDAI index reflecting the disease activity before treatment in the control group was 3.45±0.89 points, and after treatment decreased to 2.09±0.63 points (p<0,05). The rehabilitation procedures on Nuga-Best led to a signifi cantly more pronounced decrease in this index – from 3.35±0.91 to 1.82±0.61 points (p<0,05). The BASMI spinal mobility index in the control group before treatment was 4.03±1.12 points, after treatment 3.93±0.82 points, and in the main group of patients after treatment it was 3.11±0.91 points compared to pretreatment values of 4.12±1.26 points. Conclusions: In patients with central AS, Nuga-Best produces a multifactor effect, leading to a decrease in spine functional overload, promotes muscle relaxation and analgesia, increased range of motion in the spine and chest excursion, prolongs clinical remission and improves the psycho-emotional status of patients.

基于空间定轴齿轮结构与链传动的健身娱乐康复器械机构设计

基于空间定轴齿轮结构与链传动的健身娱乐康复器械机构设计

Influence of modern technologies used in rehabilitation on selected functional parameters of the spine of patients with low back pain

The aim of the study was to examine influence of modern technologies used in the DBC method (Documentation Based Care) on the selected functional parameters of the spine of patients with low back pain. The research group comprised of 196 patients randomly divided into two groups. Patients in Group I were subjected to DBC treatment with modern rehabilitation equipment, while patients in Group II underwent the traditional form of therapeutic exercise. All subjects included in the study suffered from chronic low-back pain lasting for a period of at least three months. All the symptoms were non-specific. The results presented in the article unequivocally reveal that patients who underwent DBC treatment achieved better, statistically significant improvement in spinal functionality. The modern technologies introduced to the treatment had a considerable impact on the selected functional parameters of the spine of patients with low back pain. The DBC method used as a rehabilitation program for low back pain had a statistically significant influence on the functional parameters of the spine.