Long-term monitoring of stimulated lower leg skeletal muscle forces compared with voluntary contractions in myopathy patients - A five-year follow-up report on 5 adults.

Objective: Long-term assessments of lower leg muscle forces in ambulant patients with distal myopathies.

Methods And Materials: Over a five-year period, we measured involuntary, nerve-stimulated, isometric torques of the ankle dorsiflexors in a group of ambulant patients with myopathies and compared results with voluntary Manual Muscle Tests (MMT).

Results: From ten recruited patients, five could finish the five-year protocol.

Face anthropometry for filtering facepiece respirators: analysis of the association between facial dimensions and respirator fit.

Objective: Ensuring proper respirator fit for individuals remains a persistent challenge in occupational environments, yet there is limited knowledge about how respirators interact with the face to "'fit." Previous studies have attempted to understand the association between face dimensions and respirator fit using traditional head/face anthropometry not specifically tailored for respirators. The purpose of this study was to assess and compare the ability of filtering facepiece respirator (FFR)-specific face anthropometry with traditional head/face anthropometry in exploring the relationship between facial dimensions and the fit of FFR.

Cardiac patient-specific three-dimensional models as surgical planning tools.

Background: Three-dimensional printing is an additive manufacturing method that builds objects from digitally generated computational models. Core technologies behind three-dimensional printing are evolving rapidly with major advances in materials, resolution, and speed that enable greater realism and higher accuracy. These improvements have led to novel applications of these processes in the medical field.

Home-based transcranial direct current stimulation plus tracking training therapy in people with stroke: an open-label feasibility study.

Background: Transcranial direct current stimulation (tDCS) is an effective neuromodulation adjunct to repetitive motor training in promoting motor recovery post-stroke. Finger tracking training is motor training whereby people with stroke use the impaired index finger to trace waveform-shaped lines on a monitor. Our aims were to assess the feasibility and safety of a telerehabilitation program consisting of tDCS and finger tracking training through questionnaires on ease of use, adverse symptoms, and quantitative assessments of motor function and cognition.

Isometric skeletal muscle force measurement in primary myopathies.

Introduction: In myopathy patients, it is useful to measure skeletal muscle forces. Conventional methods require voluntary muscle activation, which can be unreliable. We evaluated a device for nonvoluntary force assessment.

Ipsilesional motor-evoked potential absence in pediatric hemiparesis impacts tracking accuracy of the less affected hand.

This study analyzed the relationship between electrophysiological responses to transcranial magnetic stimulation (TMS), finger tracking accuracy, and volume of neural substrate in children with congenital hemiparesis. Nineteen participants demonstrating an ipsilesional motor-evoked potential (MEP) were compared with eleven participants showing an absent ipsilesional MEP response. Comparisons of finger tracking accuracy from the affected and less affected hands and ipsilesional/contralesional (I/C) volume ratio for the primary motor cortex (M1) and posterior limb of internal capsule (PLIC) were done using two-sample t-tests.

Preliminary design of an energy storing orthosis for providing gait to people with spinal cord injury.

A new design is proposed for an energy storing orthosis (ESO) that restores walking to people with spinal cord injury by combining functional electrical stimulation of the quadriceps muscle with a mechanical brace that uses elastic elements to store and transfer energy between hip and knee joints. The new ESO is a variation of a previous design and uses constant force springs for energy storage. Based on the detailed design and on dynamic simulations, the concept has demonstrated preliminary technical feasibility.

Design of a portable hydraulic ankle-foot orthosis.

Small-scale hydraulics is ideal for powered human assistive devices including powered ankle foot orthoses because a large torque can be generated with an actuator that is small and light. A portable hydraulic ankle foot orthosis has been designed and is undergoing preliminary prototyping and engineering bench test evaluation. The device provides 90 Nm of ankle torque and has an operating pressure of 138 bar (2,000 psi).

Inter-electrode tissue resistance is not affected by tissue oedema when electrically stimulating the lower limb of sepsis patients.

ICU patients typically are given large amounts of fluid and often develop oedema. The purpose of this study was to evaluate whether the oedema would change inter-electrode resistance and, thus, require a different approach to using non-invasive electrical stimulation of nerves to assess muscle force. Inter-electrode tissue resistance in the lower leg was measured by applying a 300 µs constant current pulse and measuring the current through and voltage across the stimulating electrodes.

Combined statistical analysis method assessing fast versus slow movement training in a patient with cerebellar stroke: a single-case study.

Background: Gold standards of data analysis for single-case research do not currently exist.

Objective: The purpose of this study was to determine whether a combined statistical analysis method is more effective in assessing movement training effects in a patient with cerebellar stroke.

Design: A crossover single-case research design was conducted.

Optimizing the effectiveness of a mechanical suture-based anulus fibrosus repair construct in an acute failure laboratory simulation.

Study Design: In vitro comparative, laboratory experiments.

Objective: This study developed a laboratory apparatus that measured resistance to failure using pressures similar to intradiscal pressure of a lumbar spinal disk. Various combinations of an anular repair device were compared.

Complex versus simple ankle movement training in stroke using telerehabilitation: a randomized controlled trial.

Background: Telerehabilitation allows rehabilitative training to continue remotely after discharge from acute care and can include complex tasks known to create rich conditions for neural change.

Objectives: The purposes of this study were: (1) to explore the feasibility of using telerehabilitation to improve ankle dorsiflexion during the swing phase of gait in people with stroke and (2) to compare complex versus simple movements of the ankle in promoting behavioral change and brain reorganization.

Design: This study was a pilot randomized controlled trial.

A portable powered ankle-foot orthosis for rehabilitation.

Innovative technological advancements in the field of orthotics, such as portable powered orthotic systems, could create new treatment modalities to improve the functional out come of rehabilitation. In this article, we present a novel portable powered ankle-foot orthosis (PPAFO) to provide untethered assistance during gait. The PPAFO provides both plantar flexor and dorsiflexor torque assistance by way of a bidirectional pneumatic rotary actuator.

Low-cost, take-home, beating heart simulator for health-care education.

Intended for medical students studying the evaluation and diagnosis of heart arrhythmias, the beating heart arrhythmia simulator combines visual, auditory, and tactile stimuli to enhance the student's retention of the subtle differences between various conditions of the heart necessary for diagnosis. Unlike existing heart arrhythmia simulators, our simulator is low cost and easily deployable in the classroom setting. A design consisting of solenoid actuators, a silicon heart model, and a graphical user interface has been developed and prototyped.

Feasibility of a hybrid-FES system for gait restoration in paraplegics.

This paper proposes a new configuration for a hybrid-FES gait restoration system, and presents a combination of simulation and experiment that support the feasibility of the proposed approach. Gait simulation results are presented that indicate the majority of load bearing and the majority of power for gait is provided by the legs (i.e.

Systematic evaluation of ureteral occlusion devices: insertion, deployment, stone migration, and extraction.

Objectives: To compare 4 ureteral occlusion devices in terms of insertion force, maneuverability, radial dilation and extraction forces, ability to prevent stone migration, and tip stiffness.

Methods: The devices tested were the PercSys Accordion, Microvasive Stone Cone (7 and 10 mm), and Cook N-Trap. Using a ureteral model with an artificial stone in place, the insertion force, number of attempts, and time to pass the impacted stone were measured.

Twitch response of intact human tibialis anterior muscle to doublet stimulation at graded strengths.

The purpose of this project was to determine if the properties of doublet force twitches change with recruitment level. Isometric, human tibialis anterior force twitches were measured in response to singlet and doublet stimulation at several recruitment levels for eight healthy subjects. All doublets showed nonlinear force summation.

Physical characteristics of next-generation ureteral access sheaths: buckling and kinking.

Objective: To evaluate physical characteristics of next-generation access sheaths that impact clinical failure.

Methods: Testing of the Cook Flexor (12/14 Fr x 35 cm, Cook), ACMI UroPass (12/14 Fr x 38 cm, ACMI), Bard Aquaguide (11/13 Fr x 35 cm Bard), and Boston Scientific Navigator (11/13 Fr x 36 cm BSCI-11, 13/15 Fr x 36 cm BSCI-13) was performed on a linear motion stage driven by a stepper motor with a resolution of 5 microm per step. Force was measured at a sampling rate of 5 Hz with a Wagner FDIX digital force gauge.

Technical feasibility of teleassessments for rehabilitation.

Background: technical feasibility was evaluated for conducting standard motor assessment instruments in a remote setting. Remote assessment was compared to co-located assessment for five clinical evaluation instruments: joint range-of-motion (ROM), manual muscle test (MMT), Berg sit-to-stand, Berg forward reach, and timed up and go (TUG).

Methods: co-located and remote rooms were in the same building connected by broadband video and audio.

Comparison of finger tracking versus simple movement training via telerehabilitation to alter hand function and cortical reorganization after stroke.

Objective: To compare 2 telerehabilitation training strategies, repetitive tracking movements versus repetitive simple movements, to promote brain reorganization and recovery of hand function.

Methods: Twenty subjects with chronic stroke and 10 degrees of voluntary finger extension were randomly assigned to receive 1800 telerehabilitation trials over 2 weeks of either computerized tracking training (track group) with the affected finger and wrist involving temporospatial processing to achieve accuracy or movement training (move group) with no attention to accuracy. Following movement training, the move group crossed over to receive an additional 2 weeks of tracking training.

Design and simulation of a pneumatic, stored-energy, hybrid orthosis for gait restoration.

Loss of mobility due to lower limb paralysis is a common result of thoracic level spinal cord injury. Functional electrical stimulation (FES) can restore primitive gait in the vicinity of a wheelchair by using electrical stimulation to generate muscle contractions. A new concept for FES-assisted gait is presented that combines electrical stimulation with an orthosis that contains a fluid power system to store and transfer energy during the gait cycle.