Feasibility of motor-assisted elliptical to improve walking, fitness and balance following pediatric acquired brain injury: A case series.

Purpose: Walking, fitness, and balance deficits are common following acquired brain injury (ABI). This study assessed feasibility, acceptability, and usefulness of a modified motor-assisted elliptical (ICARE) in addressing walking, fitness, and balance deficits in children with chronic ABIs.

Methods: Three children (> 5 years post-ABI) completed 24 ICARE exercise sessions (exercise time, speed, and time overriding motor-assistance gradually increased) to promote mass repetition of gait-like movements and challenge cardiorespiratory fitness.

Influence of Side Uncertainty on Knee Kinematics of Female Handball Athletes During Sidestep Cutting Maneuvers.

Noncontact anterior cruciate ligament ruptures generally occur during unanticipated sidestep cutting maneuvers when athletes have their visual attention focused on the opponent. The authors investigated the influence of uncertainty related to the side to perform the sidestep cutting maneuver on knee kinematics of female handball athletes. A total of 31 female handball athletes performed the sidestep cutting maneuver during anticipated and uncertain conditions.

Differences between joint-space and musculoskeletal estimations of metabolic rate time profiles.

Motion capture laboratories can measure multiple variables at high frame rates, but we can only measure the average metabolic rate of a stride using respiratory measurements. Biomechanical simulations with equations for calculating metabolic rate can estimate the time profile of metabolic rate within the stride cycle. A variety of methods and metabolic equations have been proposed, including metabolic time profile estimations based on joint parameters.

Comparison of plantar pressure profile of young adults during training on elliptical devices and overground walking: A pilot study.

Background: Elliptical training may offer advantages over other cardiorespiratory exercises for those requiring podiatric care, since its constant double-limb support diminishes recurring high-impact plantar forces while allowing exercise in a functional, upright posture. Unknown is the impact of distinct elliptical models, that can alter user's body mechanics, on potential variations in plantar pressure patterns.

Purpose: To compare plantar pressure variables while exercising on four ellipticals and walking.

Effect of motor-assisted elliptical training speed and body weight support on center of pressure movement variability.

Background: A motor-assisted elliptical trainer is being used clinically to help individuals with physical disabilities regain and/or retain walking ability and cardiorespiratory fitness. Unknown is how the device's training parameters can be used to optimize movement variability and regularity. This study examined the effect of motor-assisted elliptical training speed as well as body weight support (BWS) on center of pressure (CoP) movement variability and regularity during training.

Variations in plantar pressure variables across elliptical trainers in older adults.

Background: Ellipticals are used to address walking and cardiorespiratory training goals of older adults, some of whom are at risk for foot injuries. Variations in joint kinematics and muscle demands when using different ellipticals could lead to plantar pressure differences. This study explored plantar pressure variables during gait and use of four ellipticals.

Perceived importance of AAC messages to support communication in rehabilitation settings.

Purpose: Permanent or temporary speech loss can occur due to a variety of medical conditions and often requires individuals to use augmentative and alternative communication (AAC) strategies and technologies to support communication. The use of AAC in medical and rehabilitation settings is critical to ensure the health, safety and psychological well-being of communicatively vulnerable individuals.

Method: This study surveyed the perceived importance of communication messages within five categories (Basic Needs, Patient-Provider Specific Communication, Social, Feelings, and Messages for Young Children) by individuals with disability who have undergone recent medical care as well as by rehabilitation care providers.

Test-retest reliability and minimal detectable change of the computerized dynamic posturography PROPRIO for adults with chronic traumatic brain injury.

Purpose: Balance deficits after brain injury, including reactive recovery from unexpected perturbations, can persist well after rehabilitation is concluded. While traditional clinical assessments are practical, the anticipatory nature of the tasks may mask perceptible balance control. Computerized dynamic posturography can directly quantify capacity to respond to unexpected, external perturbations.

Systematic Review and Expert Consensus on the Use of Orthoses (Splints and Casts) with Adults and Children after Burn Injury to Determine Practice Guidelines.

The objective of this review was to systematically evaluate the available literature addressing the use of orthoses (splints and casts) with adult and pediatric burn survivors and determine whether practice guidelines could be proposed. This review provides evidence-based recommendations specifically for rehabilitation professionals who are responsible for burn survivor rehabilitation. A summary recommendation was made after the literature was retrieved using a systematic review and critical appraisal by multiple authors.

Challenges and opportunities in augmentative and alternative communication: Research and technology development to enhance communication and participation for individuals with complex communication needs.

The field of augmentative and alternative communication (AAC) has witnessed significant changes since its inception. AAC services are now considered for a much greater number of individuals with complex communication needs and there are many more AAC options available as communication supports, including a proliferation of technologies. The scope and options for communication within society have increased substantially to include a wide array of digital and social media.

Designing effective AAC displays for individuals with developmental or acquired disabilities: State of the science and future research directions.

This paper reviews research on the impact of AAC display variables on visual attention and performance of children with developmental disabilities and adults with acquired conditions, and considers implications for designing effective visual scene displays (VSDs) or grids. When using VSDs with children with developmental disabilities or adults with acquired conditions, research supports the use of personalized photo VSDs that include familiar people engaged in meaningful activities, with navigation bars with thumbnail VSDs, located adjacent to the main VSD. Adults with acquired conditions seem to benefit from the inclusion of text boxes adjacent to the scene.

Psychological difficulties and parental well-being in children with musculoskeletal problems in the 2011/2012 National Survey of Children's Health.

Objective: This study compared children with and without current musculoskeletal (MSK) problems on key indices of child psychological adjustment and parental well-being.

Research Method: Prevalence estimates of psychological problems were compared for children ages 2-17 years with and without current MSK problems in the 2011/2012 National Survey of Children's Health. Multivariate logistic regression analyses examined the effects of MSK problem severity on the risk of psychological concerns.

Walking and Fitness Improvements in a Child With Diplegic Cerebral Palsy Following Motor-Assisted Elliptical Intervention.

Purpose: To quantify effects of motor-assisted elliptical (Intelligently Controlled Assistive Rehabilitation Elliptical [ICARE]) training on walking and fitness of a child with cerebral palsy (CP).

Key Points: A 12-year-old boy with walking limitations due to spastic diplegic CP (Gross Motor Function Classification System II) participated in 24 sessions of primarily moderate- to vigorous-intensity ICARE exercise. Fitness improvements were evidenced clinically across sessions by the child's capacity to train for longer periods, at faster speeds, and while overriding motor's assistance.

Kinematic and muscle demand similarities between motor-assisted elliptical training and walking: Implications for pediatric gait rehabilitation.

Many children with physical disabilities and special health care needs experience barriers to accessing effective therapeutic technologies to improve walking and fitness in healthcare and community environments. The expense of many robotic and exoskeleton technologies hinders widespread use in most clinics, school settings, and fitness facilities. A motor-assisted elliptical trainer that is being used to address walking and fitness deficits in adults was modified to enable children as young as three years of age to access the technology (Pedi-ICARE).