A user-inspired mobility experience of the future: a qualitative investigation.

Wheelchair users (WCUs) face additional challenges than non-WCU to multi-tasking (i.e. open doors, cook, use a cell-phone) while navigating their environments.

Modeling, Control, and Clinical Validation of an Upper-Limb Medical Education Task Trainer for Elbow Spasticity and Rigidity Assessment.

The goal of this study was to validate a series elastic actuator (SEA)-based robotic arm that can mimic three abnormal muscle behaviors, namely lead-pipe rigidity, cogwheel rigidity, and spasticity for medical education training purposes. Key characteristics of each muscle behavior were first modeled mathematically based on clinically-observed data across severity levels. A controller that incorporated feedback, feedforward, and disturbance observer schemes was implemented to deliver haptic target muscle resistive torques to the trainee during passive stretch assessments of the robotic arm.

Design and Validation of a Soft Robotic Simulator for Transseptal Puncture Training.

Objective: Transseptal puncture (TP) is the technique used to access the left atrium of the heart from the right atrium during cardiac catheterization procedures. Through repetition, electrophysiologists and interventional cardiologists experienced in TP develop manual skills to navigate the transseptal catheter assembly to their target on the fossa ovalis (FO). Cardiology fellows and cardiologists that are new to TP currently train on patients to develop this skill, resulting in increased risk of complications.

Review of assistive devices for the prevention of pressure ulcers: an engineering perspective.

Purpose: Pressure ulcers (PUs) are prevalent among immobile bed or wheelchair-reliant individuals who experience prolonged sedentary positions. Pressure relief and frequent repositioning of body posture help to mitigate complications associated with PUs. Adherence with regular repositioning is difficult to maintain due to nursing labour shortages or constraints of in-home caregivers.

BIOMECHANICAL EVALUATION OF PNEUMATIC SLEEVE ORTHOSIS FOR LOFSTRAND CRUTCHES.

Crutch walking, especially when using a swing-through gait pattern, is associated with high, repetitive joint forces, hyperextension/ulnar deviation of the wrist, and excessive palmar pressure that compresses the median nerve. To reduce these adverse effects, we designed a pneumatic sleeve orthosis that utilized a soft pneumatic actuator and secured to the crutch cuff for long-term Lofstrand crutch users. Eleven able-bodied young adult participants performed both swing-through and reciprocal crutch gait patterns with and without the custom orthosis for comparison.

Exploring the Intersection of Engineering and Medicine Through a Neuroscience Challenge Laboratory.

The medical curriculum is charged with training medical students who can possess both the technical and contextual abilities to adapt to the transformational world of medicine. This new objective would require incorporating engineering principles into the medical curriculum, which was formed by the University of Illinois as the Carle Illinois College of Medicine. As a fully integrated engineering based medical school, students partake in active learning modules that develop their quantitative, innovative, and entrepreneurship skills.

Hand-rim biomechanics during geared manual wheelchair propulsion over different ground conditions in individuals with spinal cord injury.

Geared manual wheelchair wheels, a recently developed alternative propulsion mechanism, have the potential to alleviate the high upper extremity demands required for wheelchair propulsion and help decrease the risk of secondary injuries in manual wheelchair users. The objective of this study was to investigate the effects of using geared manual wheelchairs on hand-rim biomechanics of wheelchair propulsion in individuals with spinal cord injury (SCI). Seven manual wheelchair users with SCI propelled their wheelchairs equipped with geared wheels over tile, carpet, and up a ramp in low gear (gear ratio 1.

Feasibility of VR Technology in Eliciting State Anxiety Changes While Walking in Older Women.

Virtual reality (VR) technology offers an exciting way to emulate real-life walking conditions that may better elicit changes in emotional state. We aimed to determine whether VR technology is a feasible way to elicit changes in state anxiety during walking. Electrocardiogram data were collected for 18 older adult women while they navigated a baseline walking task, a dual walking task, and four walking VR environments.

Can People with Parkinson's Disease Self-Trigger Gait Initiation? A Comparison of Cueing Strategies.

Background: An external cue can markedly improve gait initiation in people with Parkinson's disease (PD) and is often used to overcome freezing of gait (FOG). It is unknown if the effects of external cueing are comparable if the imperative stimulus is triggered by the person receiving the cue (self-triggered) or an external source.

Objective: Two experiments were conducted to compare the effects of self- versus externally triggered cueing on anticipatory postural adjustments (APAs) during gait initiation in people with PD.

Scaling of linear anthropometric dimensions in living humans.

Objectives: Some previous studies suggest that humans do not conform to geometric similarity (isometry) in anthropometric dimensions of the upper and lower limbs. Researchers often rely on a single statistical approach to the study of scaling patterns, and it is unclear whether these methods produce similar results and are equally robust. This study used one bivariate and one multivariate method to examine how linear anthropometric dimensions scale in a sample of adult humans.

A comparison of glenohumeral joint kinematics and muscle activation during standard and geared manual wheelchair mobility.

The high prevalence of upper extremity joint injuries among manual wheelchair users is largely attributed to the high repetitive loading during propulsion. The purpose of this study was to evaluate the effects of using geared wheels for manual wheelchair mobility on shoulder joint biomechanics. Fourteen able-bodied participants performed overground propulsion and ramp ascension using standard and geared manual wheelchair wheels.

Modulation of anticipatory postural adjustments using a powered ankle orthosis in people with Parkinson's disease and freezing of gait.

Background: Freezing of gait (FOG) during gait initiation in people with Parkinson's disease (PD) may be related to a diminished ability to generate anticipatory postural adjustments (APAs). Externally applied perturbations that mimic the desired motion of the body during an APA have been demonstrated to shorten and amplify APAs; however, no portable device has been tested. In this study, a portable powered ankle-foot orthosis (PPAFO) testbed was utilized to investigate the effect of mechanical assistance, provided at the ankle joint, on the APAs during gait initiation.

Glenohumeral joint dynamics and shoulder muscle activity during geared manual wheelchair propulsion on carpeted floor in individuals with spinal cord injury.

This study investigated the effects of using geared wheels on glenohumeral joint dynamics and shoulder muscle activity during manual wheelchair propulsion. Seven veterans with spinal cord injury propelled their wheelchairs equipped with geared wheels over a carpeted floor in low gear (1.5:1) and standard gear (1:1) conditions.

A Neuromechanical Model of Reduced Dorsiflexor Torque During the Anticipatory Postural Adjustments of Gait Initiation.

Anticipatory postural adjustments (APAs) precede gait initiation and function to accelerate the center of mass forward and towards the initial stance leg. Impairments in APA generation, such as those seen in people with Parkinson's disease (PD), can impact the quality of the first step. An initial burst of activity in the dorsiflexor muscle (tibialis anterior) of the stepping leg is an important contributor to the posterior excursion of the center of pressure that accelerates the center of mass forward during an APA.

Effects of simulated firefighting and asymmetric load carriage on firefighter obstacle crossing performance.

Slips, trips, and falls (STF) of firefighters may occur while traversing stationary obstacles. STF risk may be amplified by fatigue from firefighting and carrying an asymmetric load. Vertical and horizontal clearances of the lead (VCL, HCL) and trailing (VCT, HCT) foot and contact with a 30 cm obstacle were examined in 24 firefighters.

Assessing gait changes in firefighters after firefighting activities and while carrying asymmetric loads.

One of the most common causes of injuries among firefighters is slips, trips, and falls on the fireground. Acute fatigue from firefighting activities and/or carrying asymmetric loads might impact gait characteristics increasing slip, trip, and fall risk. The purpose of this study was to examine the effects of fatigue from simulated firefighting activities and carrying asymmetric loads (fire hose over one shoulder) on firefighters' gait behavior.

Impact of SCBA size and fatigue from different firefighting work cycles on firefighter gait.

Risk of slips, trips and falls in firefighters maybe influenced by the firefighter's equipment and duration of firefighting. This study examined the impact of a four self-contained breathing apparatus (SCBA) three SCBA of increasing size and a prototype design and three work cycles one bout (1B), two bouts with a five-minute break (2B) and two bouts back-to-back (BB) on gait in 30 firefighters. Five gait parameters (double support time, single support time, stride length, step width and stride velocity) were examined pre- and post-firefighting activity.

Impact of SCBA size and firefighting work cycle on firefighter functional balance.

Slips, trips and falls are leading causes of fireground injuries. A functional balance test (FBT) was used to investigate the effects of self-contained breathing apparatus (SCBA) size and design, plus firefighting work cycle. During the FBT, subjects walked along a narrow platform and turned in defined spaces, with and without an overhead obstacle.

Design and analysis of coiled fiber reinforced soft pneumatic actuator.

Fiber reinforced elastomeric enclosures (FREEs) are soft pneumatic actuators that can contract and generate forces upon pressurization. Typical engineering applications utilize FREEs in their straight cylindrical configuration and derive actuation displacement and forces from their ends. However, there are several instances in nature, such as an elephant trunk, snakes and grapevine tendrils, where a spiral configuration of muscle systems is used for gripping, thereby establishing a mechanical connection with uniform force distribution.

Six-Minute Walk Test Performance in Persons With Multiple Sclerosis While Using Passive or Powered Ankle-Foot Orthoses.

Objective: To determine whether a powered ankle-foot orthosis (AFO) that provides dorsiflexor and plantar flexor assistance at the ankle can improve walking endurance of persons with multiple sclerosis (MS).

Design: Short-term intervention.

Setting: University research laboratory.

Physiological response to firefighting activities of various work cycles using extended duration and prototype SCBA.

Firefighters' self-contained breathing apparatus (SCBA) protects the respiratory system during firefighting but increases the physiological burden. Extended duration SCBA (>30 min) have increased air supply, potentially increasing the duration of firefighting work cycles. To examine the effects of SCBA configuration and work cycle (length and rest), 30 firefighters completed seven trials using different SCBA and one or two bouts of simulated firefighting following work cycles common in the United States.

Evaluation of a wrist orthosis on lofstrand crutch-assisted gait.

Lofstrand, or forearm, crutches are a common assistive mobility device for those with functional impairments. However, repeated loading of the wrist and palmar region and continual hyperextension of the wrist during Lofstrand crutch usage may cause wrist strain, pain, and secondary injuries such as carpal tunnel syndrome. In order to reduce risk of injury, a novel wrist orthosis was developed with the intent of improving wrist posture and reducing/redirecting palmar loads from the carpal tunnel region to the adductor pollicis area.

Detection of Gait Modes Using an Artificial Neural Network during Walking with a Powered Ankle-Foot Orthosis.

This paper presents an algorithm, for use with a Portable Powered Ankle-Foot Orthosis (i.e., PPAFO) that can automatically detect changes in gait modes (level ground, ascent and descent of stairs or ramps), thus allowing for appropriate ankle actuation control during swing phase.

Smoothing spline analysis of variance models: A new tool for the analysis of cyclic biomechanical data.

Cyclic biomechanical data are commonplace in orthopedic, rehabilitation, and sports research, where the goal is to understand and compare biomechanical differences between experimental conditions and/or subject populations. A common approach to analyzing cyclic biomechanical data involves averaging the biomechanical signals across cycle replications, and then comparing mean differences at specific points of the cycle. This pointwise analysis approach ignores the functional nature of the data, which can hinder one׳s ability to find subtle differences between experimental conditions and/or subject populations.

Quantifying Dynamic Changes in Plantar Pressure Gradient in Diabetics with Peripheral Neuropathy.

Diabetic foot ulcers remain one of the most serious complications of diabetes. Peak plantar pressure (PPP) and peak pressure gradient (PPG) during walking have been shown to be associated with the development of diabetic foot ulcers. To gain further insight into the mechanical etiology of diabetic foot ulcers, examination of the pressure gradient angle (PGA) has been recently proposed.