ChatEMG: Synthetic Data Generation to Control a Robotic Hand Orthosis for Stroke.

Intent inferral on a hand orthosis for stroke patients is challenging due to the difficulty of data collection. Additionally, EMG signals exhibit significant variations across different conditions, sessions, and subjects, making it hard for classifiers to generalize. Traditional approaches require a large labeled dataset from the new condition, session, or subject to train intent classifiers; however, this data collection process is burdensome and time-consuming.

Volitional Control of the Paretic Hand Post-Stroke Increases Finger Stiffness and Resistance to Robot-Assisted Movement.

Increased effort during use of the paretic arm and hand can provoke involuntary abnormal synergy patterns and amplify stiffness effects of muscle tone for individuals after stroke, which can add difficulty for user-controlled devices to assist hand movement during functional tasks. We study how volitional effort, exerted in an attempt to open or close the hand, affects resistance to robot-assisted movement at the finger level. We perform experiments with three chronic stroke survivors to measure changes in stiffness when the user is actively exerting effort to activate ipsilateral EMG-controlled robot-assisted hand movements, compared with when the fingers are passively stretched, as well as overall effects from sustained active engagement and use.

Clinician perceptions of a novel wearable robotic hand orthosis for post-stroke hemiparesis.

Purpose: Wearable robotic devices are currently being developed to improve upper limb function for individuals with hemiparesis after stroke. Incorporating the views of clinicians during the development of new technologies can help ensure that end products meet clinical needs and can be adopted for patient care.

Methods: In this cross-sectional mixed-methods study, an anonymous online survey was used to gather clinicians' perceptions of a wearable robotic hand orthosis for post-stroke hemiparesis.

Motor Learning Following Stroke: Mechanisms of Learning and Techniques to Augment Neuroplasticity.

Sensorimotor impairments are common after stroke requiring stroke survivors to relearn lost motor skills or acquire new ones in order to engage in daily activities. Thus, motor skill learning is a cornerstone of stroke rehabilitation. This article provides an overview of motor control and learning theories that inform stroke rehabilitation interventions, discusses principles of neuroplasticity, and provides a summary of practice conditions and techniques that can be used to augment motor learning and neuroplasticity in stroke rehabilitation.

Overground Robotic Gait Trainer mTPAD Improves Gait Symmetry and Weight Bearing in Stroke Survivors.

Stroke is a leading cause of disability, impairing the ability to generate propulsive forces and causing significant lateral gait asymmetry. We aim to improve stroke survivors' gaits by promoting weight-bearing during affected limb stance. External forces can encourage this; e.

Occupational Therapy and Activities of Daily Living Interventions to Improve Performance in Activities of Daily Living for Adults With Stroke (2012-2019).

Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings for occupational therapy and activities of daily living (ADL) interventions to improve ADL outcomes for adults with stroke.

Adaptive Semi-Supervised Intent Inferral to Control a Powered Hand Orthosis for Stroke.

In order to provide therapy in a functional context, controls for wearable robotic orthoses need to be robust and intuitive. We have previously introduced an intuitive, user-driven, EMG-based method to operate a robotic hand orthosis, but the process of training a control that is robust to concept drift (changes in the input signal) places a substantial burden on the user. In this paper, we explore semi-supervised learning as a paradigm for controlling a powered hand orthosis for stroke subjects.

Exercise for Adults With Stroke to Improve ADL and/or Functional Mobility Performance (2012-2019).

Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings from the systematic review on interventions to improve activities of daily living (ADL) and functional mobility performance for people with stroke.

Task Oriented Training Interventions for Adults With Stroke to Improve ADL and Functional Mobility Performance (2012-2019).

Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings from the systematic review on interventions to improve activities of daily living (ADL) and functional mobility performance for people with stroke.

Behavioral Interventions to Improve Performance in Activities of Daily Living for Adults With Stroke (2012-2019).

Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings for behavioral interventions to improve outcomes in activities of daily living for adults with stroke, including cognitive, self-management, falls prevention, psychosocial, and creative/recreation interventions.

Technology-Related Interventions to Improve Performance in Activities of Daily Living for Adults With Stroke (2012-2019).

Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings for technology-related interventions to improve performance in activities of daily living for adults with stroke, such as virtual reality/gaming, biofeedback, robotics, electrical stimulation, and telerehabilitation.

Task-Oriented Training With Cognitive Strategies for Adults With Stroke to Improve ADL and/or Functional Mobility Performance (2012-2019).

Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings from the systematic review on interventions to improve activities of daily living and functional mobility performance for people with stroke.

Preparatory Interventions to Support ADL Performance for Adults With Stroke (2012-2019).

Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings for preparatory interventions to support performance in activities of daily living for adults with stroke, such as early mobilization, bilateral priming, passive range of motion, sensory retraining, and shoulder taping.

Content Validity of the Left Ventricular Assist Device Bathing Assessment.

Many institutions recommend modified bathing techniques for individuals with left ventricular assist devices (LVADs) due to infection risk. Although these techniques may be challenging for patients, there currently is no assessment to evaluate these skills and whether intervention programs have been successful. This article describes the development and content validation of the LVAD Bathing Assessment.

Design of Spiral-Cable Forearm Exoskeleton to Assist Supination for Hemiparetic Stroke Subjects.

We present the development of a cable-based passive forearm exoskeleton that is designed to assist supination for hemiparetic stroke survivors. Our device uniquely provides torque sufficient for counteracting spasticity within a below-elbow apparatus. The mechanism consists of a spiral single-tendon routing embedded in a rigid forearm brace and terminated at the hand and upper-forearm.

Thumb Stabilization and Assistance in a Robotic Hand Orthosis for Post-Stroke Hemiparesis.

We propose a dual-cable method of stabilizing the thumb in the context of a hand orthosis designed for individuals with upper extremity hemiparesis after stroke. This cable network adds opposition/reposition capabilities to the thumb, and increases the likelihood of forming a hand pose that can successfully manipulate objects. In addition to a (where both cables are of fixed length), our approach also allows for a single-actuator (where the extension cable is actuated while the abductor remains passive), which allows a range of motion intended to facilitate creating and maintaining grasps.

Home Aerobic Training for Cerebellar Degenerative Diseases: a Randomized Controlled Trial.

Balance training has shown some benefits in cerebellar ataxia whereas the effects of aerobic training are relatively unknown. To determine whether a phase III trial comparing home aerobic to balance training in ambulatory patients with cerebellar ataxia is warranted, we conducted a single-center, assessor-blinded, randomized controlled trial. Nineteen subjects were randomized to aerobic training and 17 subjects to balance training.

Effectiveness of interventions to improve occupational performance of people with cognitive impairments after stroke: an evidence-based review.

This evidence-based review was conducted to determine which interventions are effective in improving occupational performance after stroke. Forty-six articles met the inclusion criteria and were examined. Interventions for the following impairments were reviewed: general cognitive deficits, executive dysfunction, apraxia, memory loss, attention deficits, visual field deficits (included because of their close relationship with neglect), and unilateral neglect.

The potential value of comprehensive geriatric assessment in evaluating older women with primary operable breast cancer undergoing surgery or non-operative treatment--a pilot study.

Objectives: Breast cancer in older women raises a number of discrete issues, including how healthcare professionals can best decide which patients are candidates for surgery. A pilot study involving women aged ≥70years newly diagnosed with early operable primary breast cancer was conducted aiming to explore the potential value of comprehensive geriatric assessment (CGA).

Materials And Methods: Decision of primary treatment followed consultation with the clinical team and was not guided by any aspect of this study.

Comprehensive geriatric assessment for older women with early breast cancer - a systematic review of literature.

Background: The Comprehensive Geriatric Assessment (CGA) is an analytical tool increasingly implemented in clinical practice. Breast cancer is primarily a disease of older people; however, most evidence-based research is aimed at younger patients.

Methods: A systematic review of literature was carried out to assess the use of CGA in older breast cancer patients for clinical decision making.

A randomised trial of primary tamoxifen versus mastectomy plus adjuvant tamoxifen in fit elderly women with invasive breast carcinoma of high oestrogen receptor content: long-term results at 20 years of follow-up.

Background: Long-term analysis of a randomised trial in Nottingham comparing tamoxifen versus surgery as initial treatment demonstrated that in oestrogen receptor (ER)-unselected cases, surgery achieved better local control, with no difference in overall survival. It was suggested that for patients with ER-rich tumours, local control and survival may be comparable. We now present long-term follow-up of a randomised trial designed to address this clinical scenario.

Long-term (37 years) clinical outcome of older women with early operable primary breast cancer managed in a dedicated clinic.

Background: A dedicated clinic for older women with early primary breast cancer, established in 1973, has recently evolved into a combined surgical/oncology facility. This study aimed to compare the clinical outcome across these periods.

Methods: From 1973 to 2010, 1758 women were managed.

Optimising the management of primary breast cancer in older women - a report of a multi-disciplinary study day.

Purpose: The objectives of the study day were to (i) develop an in-depth understanding around the biology and treatment options; (ii) explore the specific physical and psychosocial needs and consideration including patients perspective; and (iii) gain insight into the development of a dedicated, holistic and multi-disciplinary clinic service and the importance of supporting research, for older women with primary breast cancer.

Design: The format included presentations (with lectures from external and local faculty, and short research papers from Nottingham) with a number of interactive discussions, and sharing of patients' experience.

Results: Four sessions were held covering (i) pathological features, (ii) role of radiotherapy and adjuvant chemotherapy, (iii) role of surgery, geriatric assessment and quality of life issues, and (iv) challenges in running research trials.

Long-term clinical outcome of oestrogen receptor-positive operable primary breast cancer in older women: a large series from a single centre.

Introduction: A Cochrane review of seven randomised trials (N=1571) comparing surgery and primary endocrine therapy (PET) (oestrogen receptor (ER) unselected) shows no difference in overall survival (OS). We report outcome of a large series with ER-positive (ER+) early invasive primary breast cancer.

Methods: Between 1973 and 2009, 1065 older (≥ 70 years) women (median age 78 years (70-99)) had either surgery (N=449) or PET (N=616) as initial treatment.

Addressing the sociotechnical drivers of quality improvement: a case study of post-operative DVT prophylaxis computerised decision support.

Background: Quality improvement (QI) initiatives characterised by iterative cycles of quantitative data analysis do not readily explain the organisational determinants of change. However, the integration of sociotechnical theory can inform more effective strategies. Our specific aims were to (1) describe a computerised decision support intervention intended to improve adherence with deep venous thrombosis (DVT) prophylaxis recommendations; and (2) show how sociotechnical theory expressed in 'Fit between Individuals, Task and Technology' framework (FITT) can identify and clarify the facilitators and barriers to QI work.