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Development and Evaluation of Rehabilitation, Physiotherapy and Assistive Technologies, Robotics, Prosthetics and Implants, Mobility and Communication Tools, Home Automation and Telerehabilitation
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Background: Robotic exoskeleton devices enable individuals with lower extremity weakness to stand up and walk over ground with a full-weight bearing and reciprocal gait. Limited information is availab...
Background: Robotic exoskeleton devices enable individuals with lower extremity weakness to stand up and walk over ground with a full-weight bearing and reciprocal gait. Limited information is available on how an exoskeleton robotic affects gait characteristics. Objective: The purpose of this study was to examine whether wearing a robotic exoskeleton affects temporospatial parameters, kinematics, and muscle activity during gait. Methods: Fifteen healthy adults (age: 26.2±8.3 years, 6 men, 9 women) completed the study. Each participant performed walking under two conditions, with and without wearing a robotic exoskeleton (EKSO). A 10-camera motion analysis system synchronized with 6 force plates and a surface electromyographic (EMG) system captured temporospatial and kinematic gait parameters and lower extremity muscle activity. Five walking trials were collected for each condition and included for data analysis. Results: Differences were observed between the two conditions in temporospatial gait parameters of speed, stride length, and double limb support time. When wearing EKSO, hip and ankle range of motion were reduced and knee range of motion increased during the stance phase. However, during swing phase, knee and ankle range of motion were reduced when wearing exoskeleton bionic suit. EMG activity decreased bilaterally in the stance phase for all muscle groups of the lower extremities, and in the swing phase for the distal muscle groups (tibialis anterior and soleus) as well as left medial hamstrings when participants were wearing EKSO. Conclusions: Wearing EKSO altered temporospatial gait parameters, lower extremity kinematics and muscle activity during gait in healthy adults. EKSO appears to promote a type of gait that is disparate from normal gait in first time users. More research is needed to determine the impact on gait training with EKSO in people with gait impairments.
Background: It is widely known that adults with mild learning disabilities (MLDs) face a plethora of inequalities when accessing effective healthcare. One aspect that significantly affects the comple...
Background: It is widely known that adults with mild learning disabilities (MLDs) face a plethora of inequalities when accessing effective healthcare. One aspect that significantly affects the complexity and outcome of primary care is communication. However, patients as well as staff often find it difficult to deliver information in a comprehensible manner, thus leading to a potential misdiagnosis or the individual’s needs remaining unknown. To date, research on how to promote communication within consultations involving adults with mild learning disabilities has largely centered on the development of communication booklets. Objective: This study assessed the potential of using mobile technologies to extract the needs of patients with MLDs and to promote communication during clinical consultations. Due to the lack of similar technologies available, we were interested in obtaining a set of design guidelines from a series of experts in order to shape the development of future technologies. Methods: The study drew on qualitative data and consisted of a 3-stage design process. Firstly, we extracted an initial set of design requirements from a purposive selection of experts in learning disabilities including 4 academics, 3 governmental advisors, 2 General Practitioners and a full-time support worker. We then designed a technology probe using these requirements and subsequently presented it to a subset (n=4) of the aforementioned experts during a round of usability studies. The feedback received was used to update the initial set of requirements extracted during stage 1. Results: A set of guidelines have been produced that may assist in the development of medical applications that target the complex needs of adults with mild learning disabilities. Factors that must be considered during the design process include: the specific health needs of the target population; consumers’ cognitive, motor, auditory and visual abilities; and literacy levels. Furthermore, such technologies should enable customizations to be made to its interface but should restrict patients in changing the content embedded within. Conclusions: The experts involved in the study were optimistic about the potential of embedding mobile technologies within the consultation process. They believe that such technologies could significantly improve communication by displaying information in a form understood by both practitioners and patients. The information provided may also be used by staff to shape the questions presented throughout thus alleviating potential time constraints. The guidelines identified throughout this paper will help to ensure more appropriate technologies are developed in the future.