- Towards restoration of normal mechanics of functional hand tasks post-stroke: subject-specific approach to reinforce impaired muscle function. [Journal Article]
- ITIEEE Trans Neural Syst Rehabil Eng 2019 Jun 20
- Robotic therapy enables mass practice of complex hand movements after stroke, but current devices generally enforce patients to reproduce prescribed kinematic patterns using rigid actuators, without …
Robotic therapy enables mass practice of complex hand movements after stroke, but current devices generally enforce patients to reproduce prescribed kinematic patterns using rigid actuators, without considering individuals' unique impairment characteristics, thereby reducing their efficacy. In this early-stage study, we tested the feasibility of a novel, theory-based "biomimetic" approach to restoring mechanics of complex hand tasks with subject-specific assistance patterns. Twelve chronic stroke survivors performed two simulated functional tasks, hand open and simulated pinch task (distal pad press). Assistance was provided by non-restraining actuators (exotendons) that counteracted 'subject-specific' impairments, identified during unassisted task performance. There was no constraint of movement to predefined patterns. Assistance patterns required to complete tasks were significantly different across subjects, reflecting high variability in impairment and required assistance patterns. For hand open, range of motion and interjoint coordination were significantly improved for severely impaired patients, while movement quality was enhanced (reduction in jerk) for those less impaired. For simulated pinch, subject-specific assistance restored task mechanics before injury, as patients were able to direct fingertip force towards the direction normal to surface; angular deviation reduced from 16.8° ± 10.4° to 3.7° ± 12.6°. Notably, electromyography data confirmed that subjects maintained an effort level under assistance comparable to unassisted conditions. The proposed method could lead to a novel paradigm for hand rehabilitation that restores complex task mechanics with a subject-specific assistance reflecting individual impairment characteristics while promoting subjects' participation.
- Dietary Patterns of Caribbean/Central American and US Born Patients with Chronic Kidney Disease (CKD) in an Inner-City Setting (P04-110-19). [Journal Article]
- CDCurr Dev Nutr 2019; 3(Suppl 1)
- CONCLUSIONS: In our inner-City population: 1. CARIB had lower nutritional literacy but higher HEI score. 2. CARIB were more likely to report small ethnic grocery stores and better access to healthy food, although they were more likely to report low income. 3. There were significant differences in nutrient sources including (legumes), whole grains and dairy. 3. CARIB incorporated Caribbean staples into their diet, including fish dishes and fresh vegetables. 4. Cultural background should be considered when counseling even in long-term immigrants with CKD.
- Cumulative jerk as an outcome measure in nonambulatory Duchenne muscular dystrophy. [Journal Article]
- BDBrain Dev 2019 Jun 15
- CONCLUSIONS: Cj assessment is a useful method to evaluate motor activities in nonambulatory patients with DMD.
- Interaction between motor vehicles and bicycles at two-lane roundabouts: a driving volatility-based analysis. [Journal Article]
- IJInt J Inj Contr Saf Promot 2019 Jun 06; :1-11
- Drivers' instantaneous decisions regarding speed and acceleration/deceleration, as well as the time rate of acceleration change (jerk) can result in a volatility driving behaviour with significant im…
Drivers' instantaneous decisions regarding speed and acceleration/deceleration, as well as the time rate of acceleration change (jerk) can result in a volatility driving behaviour with significant impact on cyclist safety. The contribution of this article is the assessment of driving volatility in motor vehicle (MV)-bicycle interactions at two-lane roundabouts. Traffic flow and bicycle GPS data were collected from two two-lane roundabouts. Then, traffic, emissions and safety models were used to evaluate volatility impacts on safety, pollutant emissions and traffic performance. The findings showed jerk have an impact on driving volatility between MVs and bicycles, regardless of roundabout design with higher amplitude of variation for MVs. However, MVs had higher acceleration-deceleration variation than bicycles.
- Evaluation of Fidgety Movements of Infants Based on Gestalt Perception Reflects Differences in Limb Movement Trajectory Curvature. [Journal Article]
- PTPhys Ther 2019 Jun 01; 99(6):701-710
- CONCLUSIONS: It is difficult to generalize the present results to raters with various levels of expertise and experience in using the GMA. This issue calls for further research.The method used revealed commonality and individuality about the perceived movement features that can be associated with the rating of FMs.
- Effect of body configuration at step contact on balance recovery from sideways perturbations. [Journal Article]
- HMHum Mov Sci 2019 May 29; 66:383-389
- Compensatory stepping is an important protective mechanism to prevent falling. To recover from sideways perturbations side steps are generally more advantageous than cross-over steps. However, there …
Compensatory stepping is an important protective mechanism to prevent falling. To recover from sideways perturbations side steps are generally more advantageous than cross-over steps. However, there is lack of understanding of the characteristics of compensatory side steps following sideways perturbations that separate successful recoveries (i.e., no falls) from falls, the most clinically relevant outcome following a balance perturbation. We aimed to identify the critical determinants for successful side stepping after large sideways balance perturbations. Twelve healthy young adults were subjected to large leftward perturbations at varying intensities on a translating sheet. For recovery attempts started with a side step, we determined body configuration variables (frontal-plane leg and trunk angle) at first step contact, as well as spatiotemporal step variables (onset, length, duration, velocity). A logistic regression analysis was conducted to determine the predictive ability of body configuration and spatiotemporal variables on the probability of success (no fall vs. fall); perturbation intensity (peak jerk of translating sheet) and a random effect for individual were also included in the model. In the final model, leg angle and peak jerk were retained as predictors of successful balance recovery and these variables correctly classified the recovery outcome in 86% of the trials. This final 'body configuration' model yielded a -2 log likelihood of -36.3, whereas the best fitting model with only spatiotemporal variables yielded a -2 log likelihood of -45.8 (indicating a poorer fit). The leg angle at a given perturbation intensity appears to be a valid measure of reactive side step quality. The relative ease of measuring this leg angle at step contact makes it a candidate outcome for reactive stepping assessments in clinical practice.
- Tremor after long term lithium treatment; is it cortical myoclonus? [Case Reports]
- CACerebellum Ataxias 2019; 6:5
- CONCLUSIONS: A synergistic effect of different factors appears to be contributing to the development of cortical myoclonus after chronic exposure to lithium. We hypothesise that the cerebellum is involved in the generation of cortical myoclonus in these cases and factors aetiologically linked to cerebellar pathology like gluten sensitivity and alcohol abuse may play a role in the development of myoclonus. Despite the very limited evidence in the literature, lithium induced cortical myoclonus may not be so rare.
- Ossification of the yellow ligament in the cervical spine - an unusual location. [Journal Article]
- BBiomedicine (Taipei) 2019; 9(2):14
- Ossification of the yellow ligament (OYL) or ligamentum flavum, usually occurs in the thoracic spine. Focal OYL occurring in the cervical spine is considered rare and is sparsely reported in the lite…
Ossification of the yellow ligament (OYL) or ligamentum flavum, usually occurs in the thoracic spine. Focal OYL occurring in the cervical spine is considered rare and is sparsely reported in the literature. We came across a 30-year-old male patient with progressive left upper limb and bilateral lower limb weakness over a period of 3 months, associated with an unsteady gait. Clinical examination revealed bilateral generalized hyper-reflexia in both upper and lower limbs, inverted supinator jerk, Hoffman's sign and clonus. Myelopathy due to cord compression was suspected and further investigations were done. MRI and CT scans revealed a bony mass in relation to the C6 spinous process projecting anterosuperiorly and narrowing the cervical spinal canal causing cord signal changes from C4 to C6 levels. In view of the deteriorating neurological status, immediate surgery in the form of decompression and posterior stabilization from C4-C6 was performed. Patient gradually recovered after surgery and attained full functional status. We report this case considering the unusual location of OYL and its successful management.
- Reliability of upper limb movement quality metrics during everyday tasks. [Journal Article]
- GPGait Posture 2019; 71:253-260
- CONCLUSIONS: Unconstrained ADLs can reliably be used to assess movement quality in functional settings that mimic real-world challenges. However, the specific movement quality metrics used in the assessment should be chosen carefully since some metrics perform dissimilarly when applied to the same data. In particular, it may be advisable to use the number of submovements in combination with other metrics, if it is to be used at all.
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- Barber's neck manipulation causing bilateral diaphragmatic paralysis and type-2 respiratory failure. [Case Reports]
- LILung India 2019 May-Jun; 36(3):226-228
- This is a case report of an unusual cause of bilateral diaphragmatic palsy. A 54-year-old gentleman, presented to us with exertional dyspnea and chest heaviness for the past 6 months which had increa…
This is a case report of an unusual cause of bilateral diaphragmatic palsy. A 54-year-old gentleman, presented to us with exertional dyspnea and chest heaviness for the past 6 months which had increased in the last 6 days. Dyspnea increased on lying down. He was diagnosed as pneumonia on the basis of X-ray and chest CT scan, received treatment for the same and responded to the therapy. However, breathlessness and hypercapnia persisted. He had unexplained hypercapnia for which extensive investigations were carried out. Neurological and cardiac assessments were essentially normal. On revisit clinical examination, he was found to have paradoxical diaphragmatic movement with respiration. Ultrasound of chest detected no diaphragmatic movement. Detailed history elicited that patient was fond of neck massage and neck cracking wherein his barber would bend his neck with jerk to either side after a haircut.After considering all possible etiologies; we concluded that it was a case of diaphragm palsy induced by barber neck manipulation, leading to Type-2 respiratory failure. The fact that the vital clues to the diagnosis were elicited by detailed history and thorough examination reinforces that history and clinical examination for doctors shall remain a very important tool for clinical diagnosis.