Sharif Digital Repository

PURPOSE: This study evaluated the effects of an instrumented balance board on the balance parameters in children with spastic cerebral palsy by carrying out a pilot single-group pre-post clinical trial. METHODS: Five children aged 5 to 15 years with spastic diplegia and a Gross Motor Function Classification System level of I or II were included. All participants attended 20 sessions with an instrumented balance board, 45 minutes per session, 3 times a week for 7 weeks. The main outcome measures included the center of pressure excursion, velocity, and overshoot during quiet standing with open and closed eyes. The assessments were performed in the mediolateral and anteroposterior directions at... 

The robotic rehabilitation devices can undertake the difficult physical therapy tasks and provide improved treatment procedures for post stroke patients. During passive working mode, the speed of the exercise needs to be controlled continuously by the robot to avoid excessive injurious torques. We designed a fuzzy controller for a hand rehabilitation robot to adjust the exercise speed by considering the wrist angle and joint resistive torque, measured continuously, and the patient's general condition, determined by the therapist. With a set of rules based on an expert therapist experience, the fuzzy system could adapt effectively to the neuromuscular conditions of the patient's paretic hand.... 

Background and aim: Most currently-available stance control knee ankle foot orthoses (SCKAFOs) still need full knee extension to lock the knee joint, and they are still noisy, bulky, and heavy. Therefore, the aim of this study was to design, construct, and evaluate an original electromechanical SCKAFO knee joint that could feasibly solve these problems, and thus address the problems of current stance control knee joints with regards to their structure, function, cosmesis, and cost. Method: Ten able-bodied (AB) participants and two (knee ankle foot orthosis) KAFO users were recruited to participate in the study. A custom SCKAFO with the same set of components was constructed for each... 

Background and aim: Most currently-available stance control knee ankle foot orthoses (SCKAFOs) still need full knee extension to lock the knee joint, and they are still noisy, bulky, and heavy. Therefore, the aim of this study was to design, construct, and evaluate an original electromechanical SCKAFO knee joint that could feasibly solve these problems, and thus address the problems of current stance control knee joints with regards to their structure, function, cosmesis, and cost. Method: Ten able-bodied (AB) participants and two (knee ankle foot orthosis) KAFO users were recruited to participate in the study. A custom SCKAFO with the same set of components was constructed for each... 

This article, introduces a new haptic robot, wrist-RoboHab, for upper limb rehabilitation of post stroke, orthopedic and Parkinson patients., The robot is designed for hand movement therapy and could be used for both treatment and evaluation purposes in three operational states; forearm supination/pronation, wrist flexion/extension and ulnar/radial deviation. At first the mechanical design and control system are described. Then the results of a case study are demonstrated. Clinical results, showed an improvement in Fugle-Meyer, AROM, power and the biomechanical assessment of the spasticity in a chronic patient. Furthermore, it was approved that the robot can have a good interaction with... 

Individuals with spinal cord injury (SCI) at lower thoracic levels might walk independently with the aid of mechanical orthoses and walker by using their unimpaired trunk and upper extremity muscles (TUEM). The required motor skills and the associated subtasks of the paraplegic locomotion, however, have not been well understood yet. The purpose of this study was to investigate the coordination of the TUEM activities throughout the paraplegic gait cycle using synergy analysis. For eight paraplegic individuals (30.6 ± 11.6 years; SCI level: T12), the kinematics data and the surface electromyography (EMG) signals of TUEM were recorded during 15 gait cycles. Non-negative matrix factorization... 

Background and Purpose: Understanding the role and significance of trunk and upper extremity muscles in paraplegic gait can help in designing more effective assistive devices for these patients and also provides valuable information for improving muscle strengthening programs. Methods: In a patient with a spinal cord injury (SCI) who could walk independently (rating scale of ambulatory capacity, 9) with the aid of bilateral ankle-foot orthosis and a walker, the kinematics, kinetics and electromyographic (EMG) activities of 16 muscles from the trunk and upper and lower extremities were recorded during gait. The onset, cessation, and duration of the EMG signal were associated with the 4 phases... 

Ankle-foot orthoses (AFOs) have been described to have positive effects on the gait biomechanics in stroke patients. The plantarflexion resistance of an AFO is considered important for hemiplegic patients, but the evidence is still limited. The purpose of this case series was to design and evaluate the immediate effect of an articulated AFO on kinematics and kinetics of lower-limb joints in stroke patients. The articulated AFO with the adjustment of plantarflexion resistance was designed. The spring generates a plantarflexion resistance of the ankle joint at initial stance phase. The efficacy of orthosis was evaluated on two stroke patients in 2 conditions: without an AFO and with the AFO.... 

In spite of the extensive literature on the analysis of the muscle synergies during gait, the functionality of these synergies has not been studied in detail. This study explored the relationship between the motor modules and the kinematic maneuvers involved in human walking. Motion and surface electromyography data (of 28 trunk and lower extremity muscles) were acquired from ten healthy subjects during ten trials of self-selected speed gait each. The joint angle trajectories were half-wave rectified and divided into two independent positive directional degrees-of-freedom. The muscle and kinematic synergies were both extracted using the non-negative matrix factorization (NNMF) technique and... 

The high prevalence of shoulder pain in using walkers in patients who have spinal cord injury (SCI). Also, the limited options available to economically measure grip forces in walkers, which drove the need to create one. This article describes a method to obtain upper-extremities’ forces and moments in a person with SCI by designing an appropriate instrumented walker. First, since the commercial multidirectional loadcells are too expensive, custom loadcells are fabricated. Ultimately, a complete gait analysis by means of VICON motion analysis and using inverse dynamic method has been held to measure upper-extremities’ efforts. The results for a person with SCI using a two-wheel walker in low... 

Background: Using foot orthoses for managing medial knee osteoarthritis (MKOA) is common, although its effectiveness is in debate. Most orthoses are placed inside the shoe as a lateral wedged insole. Thus, most studies in this area have focused on the effect of insoles used with shoes. This study compared the effects of a lateral wedge with subtalar strap (combined insole) used while barefoot and lateral wedged insole fitted within sandal on pain, function and external knee adduction moment (EKAM) in patients with MKOA to consider which orthotic treatment is better. Methods: In this quasi-experimental pretest–posttest study, 29 participants with medial knee osteoarthritis were divided into... 

Background: Using foot orthoses for managing medial knee osteoarthritis (MKOA) is common, although its effectiveness is in debate. Most orthoses are placed inside the shoe as a lateral wedged insole. Thus, most studies in this area have focused on the effect of insoles used with shoes. This study compared the effects of a lateral wedge with subtalar strap (combined insole) used while barefoot and lateral wedged insole fitted within sandal on pain, function and external knee adduction moment (EKAM) in patients with MKOA to consider which orthotic treatment is better. Methods: In this quasi-experimental pretest–posttest study, 29 participants with medial knee osteoarthritis were divided into... 

In this work we introduce Heterogeneous Interconnect for Low Resolution Cache Access (Helia). Helia improves energy efficiency in snoop-based chip multiprocessors as it eliminates unnecessary activities in both interconnect and cache. This is achieved by using innovative snoop filtering mechanisms coupled with wire management techniques. Our optimizations rely on the observation that a high percentage of cache mismatches could be detected by utilizing a small subset but highly informative portion of the tag bits. Helia relies on the snoop controller to detect possible remote tag mismatches prior to tag array lookup. Power is reduced as a) our wire management techniques permit slow... 

Patella is the latest addition to the animal's skeleton. It's role in normal walking has not been clearly defined. A 9-year-old girl with congenital absence of the patella was assessed using instrumented gait analysis. The results show a tendency for the limb for external rotation, which is more pronounced during swing. We suggest that the role of the patella is mainly to redirect the force of the quadriceps tendon medially. The classically described role, which is to increase the lever arm of the quadriceps tendon, was not confirmed in this study. © 2018 Elsevier B.V  

Background: Muscle synergy is the leading hypothesis on how the central nervous system coordinates limb functions. Cerebral palsy (CP) patients utilize fewer synergies, and are believed to have a simpler neuromuscular control. This study was undertaken to determine whether consistent muscle synergies are recruited during ambulation in cerebral palsy crouch gait and how the muscles contribute to such synergies. Methods: Ten ambulatory CP patients were recruited. All walked with crouch gait. sEMG data were collected from 14 lower limb muscles during gait analysis. Non-negative matrix factorization method was utilized to extract muscle synergies. Results and significance: A total of five...