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Mathematical modeling of the neuro-musculoskeletal system in healthy subjects has been pursued extensively. In post-stroke patients, however, such models are very primitive. Besides improving our general understanding of how stroke affects the limb motions, they can be used to evaluate rehabilitation strategies by computer simulations before clinical evaluations. A planar neuro-musculoskeletal arm model for post-stroke patients is developed. The main idea is to use a set of new coefficients, Muscle Significance Factors (MSF), to incorporate the effects of stroke in the muscle control performance. The model uses the optimal control theory to mimic the performance of the CNS and a two-link... 

Computational models of the central nervous system after a stroke helps to reveal the physiological mechanisms that may have strong impacts on the neuro-motor rehabilitation approaches. This paper studies the stroke subject's motor control mechanism in reaching movements by extending the previous study by incorporating the kinematics of motion as well as neural disconnection between the muscles and the CNS to further develop a planar patient specific neuro-musculoskeletal model of arm. The developed model was calibrated to eight post-stroke individuals by altering the Muscle Significance Factors (MFS) using numerical optimization to match the simulated motions with those measured... 

Robot-mediated rehabilitation is a rapidly advancing discipline that seeks to develop improved treatment procedures using new technologies, e.g., robotics, coupled with modern theories in neuroscience and rehabilitation. A robotic device was designed and developed for rehabilitation of upper limbs of post stroke patients. A novel force feedback bimanual working mode provided real-time dynamic sensation of the paretic hand. Results of the preliminary clinical tests revealed a quantitative evaluation of the patient's level of paresis and disability. ©2009 IEEE  

Background: Kinematic indices (KIs) are frequently used as objective measures to assess the upper extremities motor performance in post stroke patients. The clinimetric analysis of these indices has been mostly limited to their averaged values over different directions of reaching movements. Recent studies indicate direction dependencies of such motor performances due to neural and/or biomechanical causes. The direction dependencies of such indices and their clinimetric parameters remains to be investigated. Methods: An apparatus was built to perform and measure planar point-to-point reaching tasks in 8 directions using a virtual reality environment. 24 stroke and 18 healthy individuals... 

In this paper, an approach to physical collaboration between a patient and a therapist is proposed using a bilateral impedance control strategy developed for delayed tele-robotic systems. The patient performs a tele-rehabilitation task in a resistive virtual environment with the help of online assistive forces from the therapist being provided through teleoperation. Using this strategy, the patient's involuntary hand tremors can be filtered out and the effort of severely impaired patients can be amplified in order to facilitate their early engagement in physical tasks. The response of the first desired impedance model is tracked by the master robot (interacting with the patient), and the... 

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.... 

Background: Performance indices provide quantitative measures for the quality of motion, and therefore, assist in analyzing and monitoring patients' progress. Measurement of performance indices requires costly devices, such as motion capture systems. Recent developments of sensors for game controllers, such as Microsoft Kinect, have motivated many researchers to develop affordable systems for performance measurement applicable to home and clinical care. In this work, the capability of Kinect in finding motion performance indices was assessed by analyzing intra-session and inter-session test-retest reliability. Method: Eighteen stroke patients and twelve healthy subjects participated in this... 

Exercise therapy is considered as one of the main rehabilitation treatments for post-stroke patients, especially by utilizing modern technologies, such as virtual and/or augmented reality. However, in order to design an appropriate exercise program, which prolongs the exercise duration and maximize the patient's improvement, the fatigue status needs to be detected and used for the program adjustment. In the previous fatigue recognition works, only exercises for healthy and athlete subjects have been taken into account. In this paper, fatigue status classification has been accomplished in a rehabilitation exercise for poststroke patients. To do so, the reaching task, as a basic rehabilitation... 

Background and aim: Gait and balance disorders are common in the elderly populations, and their prevalence increases with age. This systematic review was performed to summarize the current evidence for subthreshold vibration interventions on postural control and gait in elderly. Method: A review of intervention studies including the following words in the title/abstract: insole, foot and ankle appliances, vibration, noise and elderly related to balance and gait. Databases searched included PubMed, ISI Web of Knowledge, Ovid, Scopus, and Google Scholar. Fifteen articles were selected for final evaluation. The procedure was followed using the preferred reporting items for systematic reviews...