Browse Topic: Rehabilitation and physical therapy

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Electronic Fiber Provides Stretchable SensingTBMG-544211/1/2026
EPFL researchers have engineered a fiber-based electronic sensor that remains functional even when stretched to over 10 times its original length. The device holds promise for smart textiles, physical rehabilitation devices, and soft robotics.
Soft Robot Modules for New Haptic InteractionsTBMG-537839/1/2025
EPFL researchers have developed a customizable soft robotic system that uses compressed air to produce shape changes, vibrations, and other haptic, or tactile, feedback in a variety of configurations. The device holds significant promise for applications in virtual reality, physical therapy, and rehabilitation.
A Tabletop Robot May Revolutionize Physical Therapy DeliveryTBMG-523811/13/2025
Finger Pouch Actuator Improves Rehab GlovesTBMG-5199111/1/2024
Researchers have succeeded in adding finger straightening or extension to soft rehabilitation gloves through a novel foldable pouch actuator (FPA) without compromising the already existing functionality of finger bending or flexion.
Robotic Therapy Improves Tremor TreatmentTBMG-514869/1/2024
Researchers have developed SPINDLE, a pioneering robotic rehabilitation system. Combining virtual reality (VR) with customized resistance training, SPINDLE offers personalized therapy to enhance strength and dexterity for activities of daily living (ADLs). Its adaptability and potential for home use represent a major advancement in tremor rehabilitation, with broader healthcare implications.
Sensory Integration Balance Deficits in Complex mTBI: Can Early Initiation of Rehabilitation with Wearable Sensor Technology Improve Outcomes?TBMG-389244/1/2021
Mild traumatic brain injury (mTBI) is common both in civilian and military populations and can be debilitating if symptoms do not resolve after injury. Balance problems are one of the most common complaints after sustaining an mTBI and often prevent people from returning to their previous quality of life. However, clear guidelines are currently lacking on when to initiate physical therapy rehabilitation and it is unclear if early physical therapy is beneficial.
Sensory Integration Balance Deficits in Complex mTBI: Can Early Initiation of Rehabilitation with Wearable Sensor Technology Improve Outcomes?21AERP04_084/1/2021
Developing a novel feedback system using wearable sensors to provide physical therapists with realtime information about quality of head and trunk movement during exercise could improve patient rehabilitation practices. Army Medical Research and Materiel Command, Fort Detrick, Maryland Mild traumatic brain injury (mTBI) is common both in civilian and military populations and can be debilitating if symptoms do not resolve after injury. Balance problems are one of the most common complaints after sustaining an mTBI and often prevent people from returning to their previous quality of life. However, clear guidelines are currently lacking on when to initiate physical therapy rehabilitation and it is unclear if early physical therapy is beneficial. It is believed that the underlying problem of imbalance results from damage to parts of the brain responsible for interpreting sensory information for balance control. It is hypothesized that retraining the brain early, as opposed to months after injury, to correctly interpret sensory information will improve recovery. It is also believed this retraining is limited when rehabilitation exercises are performed incorrectly, and that performance feedback from wearable sensors, can improve balance rehabilitation.
Rugged-Duty Actuator Enhances State-of-the-Art Pool/Spa LiftTBMG-93424/1/2010
The benefits of aquatic physical therapy and rehabilitation for those who have difficulty with weightbearing activities due to arthritis or injury, or those who are overweight, have long been known. There is also a significant population of wheelchairbound and disabled persons who use pools and spas for recreation or therapeutic purposes. A dilemma for these individuals is how to get in and out of the pool or spa safely.
Effect of Head and Neck Anthropometry on the Normal Range of Motion of the Cervical Spine of Prepubescent Children2009-01-23026/9/2009
Application of cervical spine range of motion data and related anthropometric measures of the head and neck include physical therapy, product design, and computational modeling. This study utilized the Cervical Range of Motion device (CROM) to define the normal range of motion of the cervical spine for subjects five (5) through ten (10) years of age. And, the data was collected and analyzed with respect to anatomical measures such as head circumference, face height, neck length, and neck circumference. This study correlates these static anthropometric measures to the kinematic measurement of head flexion, extension, lateral extension, and rotation. An analysis using Pearson's correlation coefficient and a hypothesis test to evaluate the significance of the correlation indicated a statistically significant linear relationship between neck length and flexion r(156) = +0.16, p<0.042, neck length and lateral extension r(156) = +0.21, p<0.009, neck length and rotation r(156) = +0.17, p<0.035, neck circumference and lateral extension r(156) = −0.23, p<0.004, and head circumference and rotation r(156) = +0.21, p<0.009.
Brelin-Fornari, Janet, Majeske, Karl, Lynch-Caris, Terri
Guidelines for vehicle development based on principles of universal design2008-36-025710/7/2008
In order to fulfill the users' needs, many innovations are included in vehicles. However, not all of these vehicles can be used by People with Special Needs (PSN), due to their technical characteristics and/or adaptation cost, even with the financial incentives offered by Brazilian Government. In this context, the Universal Design (UD) is inserted, where PSN and people without physical deficiencies can use the same vehicle, with little or no adaptation. In order to identify the needs of PSN, interviews were carried out with PSN and exhibiters of automotive products for PSN, in the VII Reatech 2008 (International Fair of Technologies of Rehabilitation, Inclusion and Accessibility), where can be highlighted: to lower the car floor; to improve the door access (increasing width, height and opening angle); to improve the internal space of vehicles; to reduce the cost of adaptation kits; and others. Inclusion programs of the main Brazilian automotive manufacturers were also identified, focusing on kits for automotive adaptation, where some of them were preliminarily evaluated. Finally, general guidelines for vehicle development are proposed, based on principles of UD, results of interviews and a literature review.
Montanha, Ivo Rodrigues, Matiello, Joseph Pedro, Roqueiro, Nestor, da Rosa, Edison, Nicolazzi, Lauro Cesar, Ogliari, André, de Souza Vieira, Rodrigo
Dynamics of an Articulated Towboat2004-01-336411/16/2004
It is considerable the number of research around the subject of motorization of conventional manual wheechairs, however the found models don't take care of the real necessities of the wheelchair users. In the manufacture the necessity of an independent vehicle for the load transport exists. With the increasing necessity in Brazil to develop the knowledge in the area of independent vehicles and not being still available a towboat of tests adjusted to approach such problems. The articulated towboat is an intelligent independent vehicle to tow loads. The users of conventional manual wheelchairs will go to use this vehicle when to need motorization, that is in ascent cases, descending of ramps, or long distances. This vehicle possesss practical applications that they can assist systems of support to the rehabilitation of physical and motor deficiencies and also systems automatized of manufacture. The purpose of this paper is to develop some important contribution in the area of independent vehicles in the aid for the people with special needs.
Alvarenga, Flávia Bonilha, Dedini, Franco Giuseppe
Towards Understanding the Workspace of the Upper Extremities2001-01-20956/26/2001
Significant attention in recent years has been given towards obtaining a better understanding of human joint ranges, measurement, and functionality, especially in conjunction with commands issued by the central nervous system. Studies of those commands often include computer algorithms to describe path trajectories. These are typically in “open-form” with specific descriptions of motions, but not “closed form” mathematical solutions of the full range of possibilities. This paper proposes a rigorous “closed form” kinematic formulation to model human limbs, understand their workspace (also called the reach envelope), and delineate barriers therein where a path becomes difficult or impossible owing to physical constraints. The novel ability to visualize barriers in the workspace emphasizes the power of these closed form equations. Moreover, this formulation takes into account joint limits in terms of ranges of motion and identifies barriers therein where a person is required to attain a different posture. Examples include the workspaces of a typical forearm, a typical finger, and is used to illustrate the visualization of the progress in the functionality of a wrist undergoing rehabilitation.
Abdel-Malek, Karim, Yang, Jingzhou, Brand, Richard, Tanbour, Emad
A Low Cost PC Based Driving Simulator for Prototyping and Hardware-In-The-Loop Applications9802222/23/1998
This paper describes a low cost, PC based driving simulation that includes a complete vehicle dynamics model (VDM), photo realistic visual display, torque feedback for steering feel and realistic sound generation. The VDM runs in real-time on Intel based PCs. The model, referred to as VDANL (Vehicle Dynamics Analysis, Non-Linear) has been developed and validated for a range of vehicles over the last decade and has been previously used for computer simulation analysis. The model's lateral and longitudinal dynamics have 17 degrees of freedom for a single unit vehicle and 33 degrees of freedom for an articulated vehicle. The model also includes a complete drive train including engine, transmission and front and rear drive differentials, and complete, power assisted braking and steering systems. A comprehensive tire model (STIREMOD) generates lateral and longitudinal forces and aligning torque based on normal load, camber angle and horizontal (lateral and longitudinal) slip. The tire model correctly simulates saturation and can represent off-road behavior including plowing in soft soil at high sideslip angles. The articulated vehicle can simulate tractor/trailer rigs, articulated buses and recreational/utility trailer setups. The visual system image generator (IG) is composed of a high speed graphics accelerator and Intel Pentium processor. The IG is capable of 800x600-pixel resolution, and three screens can be combined to give up to a 135-degree field of view. A head-mounted display can also be used to give an unlimited field of view. The visual scene rendering includes full texturing, Goraud shading, and dynamic lighting effects. The update rate is 30-60 Hz depending on scene complexity, and the IG can render at a rate of 1 million polygons/second. The time delay for display presentation is less than 100 msec., which presents minimal interference with driver closed loop control. Tire model aligning torque and a steering system model are used to compute steering torque commands which are then displayed to the driver with a torque motor applied to the simulator steering column The simulator VDM provides all outputs needed for driver cueing, including inertial outputs for commanding the IG, steering torque commands, various instrument commands, and auditory feedback. This paper summarizes the basic IG and VDM, means for generating and presenting cueing feedback to the driver, and a unique approach for easily creating and presenting driving scenarios. Several PC based driving simulation applications are also described, including a hardware-in-the-loop steering simulation, and desk top and cab simulations for use in research, rehabilitation, training and prototyping.
Allen, R. Wade, Rosenthal, Theodore J., Aponso, Bimal L., Klyde, David H., Anderson, Fritz G., Hogue, Jeffrey R., Chrstos, Jeffrey P.
Improvement of Numerical Ankle/Foot Model: Modeling of Deformable Bone97333111/12/1997
Since many years, the vehicle industry is interested in occupant safety. The dummy use in crash tests allowed to create protective means like the belt and the airbag that diminished the injuries of the head and the thorax, which are often lethal for the car occupant. An other objective appears now: to improve the car safety to avoid the injuries which are not fatal but which can cause disability and which cause great cost in hospitalization and rehabilitation. The lower extremity protection, in particular the one of the ankle and the foot region, has become the subject of diverse research efforts by its high percentage of injuries in car crashes. But the dummy mechanics cannot reproduce the accurate ankle and the foot kinematics during an impact loading like in vehicle crash. Therefore, ankle/foot complex numerical models are an essential tool for the car safety improvement. In previous papers ([1], [2]), the response of a numerical ankle/foot model with rigid bones during impact loading was validated. The tests used for these validations correspond to the principal movements in car crashes: dorsiflexion, inversion and eversion. The influence of a few parameters of the biological component modeling was studied in another paper ([3]). The present paper describes a new modeling approach of the principal bones of the ankle/foot model. The most often injured ankle/foot bones in vehicle accidents are the tarsal bones (particularly the calcaneum, the talus, the navicular and the cuboid) and the fibular and tibial malleoli. These bones are therefore modeled as deformable bodies. The cortical bone is modeled by shell elements while the trabecular bone is modeled independently by solid elements. Both meshes are connected via a tied contact interface that permits to tie arbitrarily meshed solid to shell surfaces, including finite normal gaps. Both types of elements use linear elastic materials. Nonlinear materials, including damage, have been provided for in the used material models but are not used in this study for lack of calibration data. This new deformable bone finite element modeling technique is validated for the dorsiflexion impact loading as was done previously for the model with rigid bones. The influence of the modeling with deformable bones is studied, in particular, concerning the kinetic response. The interest of using a deformable model is, for instance, the possibility to simulate the bone and soft tissue injuries. The deformability of the bone model ultimately permits to assess the damage behavior of the main parts of the ankle/foot complex during an impact loading. The localization of the maximum stress allows to identify the regions where injury can occur. In future work, nonlinear bone material behavior and explicit fracture and damage criteria will be applied for the bone fracture and for the ligament tear. The behavior of the ankle/foot model with rigid and some deformable bones, respectively, will be studied for other impact and static loading cases. Equally important is the addition of the influence of the soft tissues in future models. Some first order effects, such as soft contact padding and attenuation through energy dissipation have been identified in this study and modeled via equivalent springs, as well as internal material and external relative motion damping.
Beaugonin, Muriel, Haug, Eberhard, Cesari, Dominique
A Numerical Model of the Human Ankle/Foot under Impact Loading in Inversion and Eversion96242811/1/1996
Since numerous years, the vehicle industry is interested in occupant safety. The dummy use in crash tests allowed to create protective means like the belt and the airbag that diminished the injuries of the head and the thorax, which are often lethal for the car occupant. An other objective appears now: to improve the car safety to avoid the injuries which are not fatal but which can cause disability and which cause great cost in hospitalization and rehabilitation. The lower extremity protection, in particular the one of the ankle and the foot region, has become the subject of diverse research efforts by its high percentage of injuries in car crashes. But the dummy mechanics cannot reproduce the accurate ankle and the foot kinematics during an impact loading like in vehicle crash. Therefore, ankle/foot complex numerical models are an essential tool for the car safety improvement. The simulation of the ankle dorsiflexion response during an impact loading was presented in a first paper ([1]). The influence of a few parameters of the biological components modeling was studied in a second paper ([2]). The present paper presents the simulation of the other principal movements in car crash: the inversion and the eversion. In order to validate the ankle/foot model, the experimental tests of Professor Begeman presented in [6] are chosen. At first, the ankle/foot model with rigid bones is validated at different levels of energy. The gross kinematics of the model is correlated with the experimental tests. At a local level, the main relative motions of the bones during the inversion and the eversion were found in the simulation. For inversion, the paper also compares the calculated forces and moments at the point of fixation at mid-length of the leg with test results, the quality of which indicates future directions of improvements of the model. The future work will validate the model with deformable bones in the case of inversion and eversion. Both models will be validated also in static cases.
Beaugonin, Muriel, Haug, Eberhard, Cesari, Dominique
Postflight Crew Health Support for U.S. Astronauts Participating in the Shuttle/Mir Program9613497/1/1996
A unique rehabilitation team was formed by NASA's Medical Operations Branch (MOB) at Johnson Space Center (JSC) to support the Mir-18 crew, which included the first U.S. astronaut to fly aboard the Mir Space Station. The goal of the rehabilitation team was to safely assist the crew's return to their preflight physical condition by developing and directing a specific rehabilitation program. This paper describes the development and lessons learned regarding rehabilitation of the U.S. astronaut. Since NASA plans a continuous U.S. presence in space through the construction of an International Space Station, lessons learned from this program will be used for improving the program for future returning long-duration crewmembers.
Mathes, Karen L., Shepherd, Beth Stringham
Seat and Airbag Design to Mitigate Frontal Crash Lower Limb Injuries9605032/1/1996
Although lower extremity injuries are not life threatening (AIS less than 4), they are very debilitating and require long periods of rehabilitation. A possible cause of the ankle/foot injury in frontal crashes is the foot dorsiflexion resulting from intrusion of the toeboard. Ankle injury on the driver side in the same type of crashes may also be caused by the foot eversion or inversion as it slides off the pedals. In both cases, it is believed that bracing the leg is a major contributor to the injury mechanism. Another contributor to lower extremity injuries is leg interaction with the instrument panel (IP). This paper describes an activated seat design that acts to eliminate the interaction between the lower extremities and the vehicle interior. It also reduces the interaction between the legs and the IP by limiting the forward travel of the lower torso. Three different design approaches are presented in the paper. These approaches use either an airbag, pyrotechnic, or mechanical device, which acts in the seat cushion to then free the leg and foot from the intruding or reactive structure, and to minimize the travel of the lower torso into the IP.
Helleman, Henk, Brantman, Russ, Nakhla, Said
Trauma Center Based Crash Investigation Research: Methodologies and Applications9407093/1/1994
In recent years a new collaboration has been formed between highway safety researchers and the medical community. Both the National Highway Traffic Safety Administration and Centers for Disease Control and Prevention have sponsored crash investigation studies in which accident reconstructionists work in conjunction with Level I Trauma Center staff. For the first time, the detailed analysis of crash circumstances and injury producing mechanisms is developed in concert with a forensic analysis of injury producing forces and tissue response. Long term patient outcome and rehabilitation costs are also addressed. This paper compares the methodologies employed in this trauma based research with those of other major data systems. It describes the background and focus of each research program and addresses the data needs that can be met.
Bents, Frances D., Dischinger, Patricia C., Siegel, John H.
Anatomy of an Instrumented Generic Quadriplegic Evaluation Van93288010/1/1993
Vehicles have been modified for physically challenged individuals to gain mobility for quite sometime. The evaluation process, prescription of equipment and training of prospective candidates is conducted at specific sites, typically hospitals, with rehabilitation facilities. The evaluation process may require on road time to help access the individuals needs. The vehicle used to evaluate clients may be as simple as a passenger car with hand controls. For the more severely limited individual an elaborate high technology van with special controls for steering, throttle and braking is required. Each individual evaluated requires their own unique need for equipment which often limits a facility in offering driving assistance or requires them to have access to several vehicles. Up to this point in time, most of the evaluation vehicles lacked any type of instrumentation to help assess a persons physical capability while driving. The dynamic effect on the body produced during driving can greatly affect the physically challenged individual. This paper looks at the modification of a quadriplegic evaluation van and the installation of instrumentation to help assist with the evaluation.
Hicks, George W.
Rehabilitation of Lower Limb Injuries86193110/1/1986
The rehabilitation phase of management is concerned with complications and uncorrectable problems that have resulted from the original injury. Similar problems may be caused by injuries in several different organ systems. Problems include weakness or paralysis, pain, loss of motion, loss of a limb, or functional disability. Each problem area must be approached from the point of view of prevention, specific treatment, and functional restoration. This presentation will attempt to outline some of the general principles of rehabilitation and to review some specific problems in management of disabilities resulting from lower extremity injuries.
Joynt, R. L.
Adult Occupant Injuries of the Lower Limb86192710/1/1986
Lower limb injuries among motor vehicle occupants are relatively common and are one of the principle causes of permanent disability. The author has reviewed the current literature and his own experience as an orthopaedic surgeon and research accident investigator concerning lower limb injuries among motor vehicle occupants. An unreported series of knee, thigh, hip, pelvis injuries with indepth accident investigation is reported. Incidence rates for specific injury diagnoses are not available. Gross tabulations reveal that lower limb injury is second only to head injury in frequency among injured motor vehicle occupants. Lower limb injuries are possibly the commonest cause of permanent disability and impairment resulting from motor vehicle accidents. Accident investigation studies have identified the mechanisms of the more common lower limb injuries which are as follows: 1) Intrapelvic fracture-dislocations of the hip are caused by lateral impacts selectively loading the greater trochanter of the proximal femur. 2) Pelvic rami fractures occur with lateral impacts in which the load is distributed to the iliac wing and pelvis as well as the greater trochanter by a padded or yielding surface. 3) Posterior hip dislocations are caused by axial loading of the femur through the knee with the hip in acute flexion. Similar loading and less flexion causes fractures of the posterior wall of the acetabulum (hip socket) followed by dislocation. 4) Femoral shaft fractures are caused by axial loading of the femur through the knee and the application of a bending moment to the thigh. Penetration of the knee into the clash, slipping below the lower dash, or impaction of the thigh against the steering wheel or steering column are the usual causes of the bending moment. 5) Supracondylar and comminuted shaft fractures occur in more severe accidents with increased energy transfer to the femur through the knee and without bending moment. 6) Patellar fractures occur because of load concentration on the patella. Knee contact with dash support structures or dash mounted accessories may provide such concentration, resulting in patellar fractures. 7) Knee ligament and other soft tissue and joint surface injuries are caused by knee impact with the lower dash and/or interaction between the knee, dash and foot, toepan and/or pedals. 8) Posterior cruciate ligament injury is caused by loading of the proximal tibia through the lower dash displacing the tibia posteriorly beneath the femoral condyles. 9) Tibial shaft fracture are caused by axial loading because of knee-dash fixation and upward and rearward movement of the toepan coupled with torsion and/or a bending moment. 10) Foot and ankle injuries are caused by upward and rearward displacement of the toepan after the knee has impacted and become fixed in the lower dash or by rolling off the brake pedal. Treatment of lower limb fractures is necessarily prolonged because of the necessity for bone healing and rehabilitation of injured joints. Cast immobilization of 6 weeks to as much as a year may be necessary. Certain fractures are best treated by open reduction and internal fixation with plates and screws, intramedullary nails, circumferential wires and bands. Occasionally, immobilization in traction or external fixation with the use of trans-fixation pins extending trhough the skin into the bone, is necessary. Soft tissue damage and loss must be repaired or replaced by graft or substitution with an artificial implant. Minimum healing time is seldom less than 3 months, typically requires 6-12 months, and may extend as long as several years. Permanent disability frequently results from lower extremity injuries. Fractures extending into major joints,' the hip, knee and ankle frequently cause traumatic (degenerative) arthritis. Total joint replacement of the hip and knee, and fusion of the ankle are ultimately often necessary to provide even partial relief from such disability. Ligamentous injuries of the knee may lead to long term instability and traumatic arthritis. Deformities due to bone loss, malunion and infection are also common sequelae of more severe fractures of the lower limb.
States, John D.
The Public Health Impact of Lower Extremity Trauma86193210/1/1986
Lower extremity injuries have been cited as the most frequent cause of serious disability caused by road traffic accidents. This paper presents the results of a study which examined the long-term consequences and associated costs of lower extremity trauma severe enough to require hospitalization. Results indicate that direct costs associated with lower extremity trauma are significant as evidenced by long hospitalizations and high utilization rates of inpatient and outpatient health and rehabilitative services in the year post-discharge. Furthermore, of individuals in the study who were employed prior to injury, only 56% had returned to work within one year. Implications of these findings for public health interventions are discussed.
MacKenzie, Ellen J.
Evaluation of Medical Care and Associated Costs Relative to Spinal Cord Injury8604242/24/1986
The following data have been collected from 8 Regional Spinal Injury Care Systems: 1. Cost of emergency evacuation from the site of injury to all hospitals. 2. Cost of all acute care in different hospitals. 3. Cost of hospitalization and rehabilitation in the Spinal Units. 4. The rate of useful recovery in different neurological groups. 5. Type of clinical material presenting at all Spinal Units. Early intensive and rigorous orthopedic and physical therapy reduces hospitalization length, hospitalization cost and the number of rehospitalizations. This improvement in patient care is reflected by an increased quality and length of survival.
Careme, L.
A Quantitative Approach to Driver Training for the Disabled85166810/1/1985
Standard driver education programs for the disabled, although generally successful in helping their clients to earn licenses, depend largely on classroom and on-road experience to train severely disabled and cognitively disabled clients. This can lead to hazardous situations when the client has a high anxiety level, or when he is not educationally or functionally prepared for on-road driving. The Louisiana Tech University rehabilitation Engineering Center has developed a driver training system which provides quantitative feedback to the trainer on client progress throughout the training. It uses a five-stage approach based on learning theory, which tends to improve learning time, decrease client anxiety, and thus reduce hazard.
Irwin, Edwin, Kerr, Donald, Hale, Paul N.
Design Development of Arm-Powered Bicycles for the Disabled8400232/1/1984
This paper describes the design development of two new bicycles for individuals with lower limb disability: an arm-powered bicycle and a tandem bicycle for disabled and able-bodied individuals to ride together. The tandem is a spinoff from the design of the single rider aria-powered bicycle. Both have been developed at the Palo Alto VA Rehabilitation Research and Development Center as part of a program to provide alternative recreational vehicles and equipment for people with disability. The functional features of each vehicle, and a descriptive discussion of the bicycle dynamics are presented.
Schwandt, Douglas F.
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