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- All Subjects: Rehabilitation
- Creators: Abbas, James
Description
Olecranon fractures account for approximately 10% of upper extremity fractures and 95% of them require surgical fixation. Most of the clinical, retrospective and biomechanical studies have supported plate fixation over other surgical fixation techniques since plates have demonstrated low incidence of reoperation, high fixation stability and resumption of activities of daily living (ADL) earlier. Thus far, biomechanical studies have been helpful in evaluating and comparing different plate fixation constructs based on fracture stability. However, they have not provided information that can be used to design rehabilitation protocols such as information that relates load at the hand with tendon tension or load at the interface between the plate and the bone. The set-ups used in biomechanical studies have included simple mechanical testing machines that either measured construct stiffness by cyclic loading the specimens or construct strength by performing ramp load until failure. Some biomechanical studies attempted to simulate tendon tension but the in-vivo tension applied to the tendon remains unknown. In this study, a novel procedure to test the olecranon fracture fixation using modern olecranon plates was developed to improve the biomechanical understanding of failures and to help determine the weights that can be safely lifted and the range of motion (ROM) that should be performed during rehabilitation procedures.
Design objectives were defined based on surgeon's feedback and analysis of unmet needs in the area of biomechanical testing. Four pilot cadaveric specimens were prepared to run on an upper extremity feedback controller and the set-up was validated based on the design objectives. Cadaveric specimen preparation included a series of steps such as dissection, suturing and potting that were standardized and improved iteratively after pilot testing. Additionally, a fracture and plating protocol was developed and fixture lengths were standardized based on anthropometric data. Results from the early pilot studies indicated shortcomings in the design, which was then iteratively refined for the subsequent studies. The final pilot study demonstrated that all of the design objectives were met. This system is planned for use in future studies that will assess olecranon fracture fixation and that will investigate the safety of rehabilitation protocols.
Design objectives were defined based on surgeon's feedback and analysis of unmet needs in the area of biomechanical testing. Four pilot cadaveric specimens were prepared to run on an upper extremity feedback controller and the set-up was validated based on the design objectives. Cadaveric specimen preparation included a series of steps such as dissection, suturing and potting that were standardized and improved iteratively after pilot testing. Additionally, a fracture and plating protocol was developed and fixture lengths were standardized based on anthropometric data. Results from the early pilot studies indicated shortcomings in the design, which was then iteratively refined for the subsequent studies. The final pilot study demonstrated that all of the design objectives were met. This system is planned for use in future studies that will assess olecranon fracture fixation and that will investigate the safety of rehabilitation protocols.
ContributorsJain, Saaransh (Author) / Abbas, James (Thesis advisor) / LaBelle, Jeffrey (Thesis advisor) / Jacofsky, Marc (Committee member) / Arizona State University (Publisher)
Created2015
Description
Progressive gait disorder in Parkinson's disease (PD) is usually exhibited as reduced step/stride length and gait speed. People with PD also exhibit stooped posture, which can contribute to reduced step length and arm swing. Since gait and posture deficits in people with PD do not respond well to pharmaceutical and surgical treatments, novel rehabilitative therapies to alleviate these impairments are necessary. Many studies have confirmed that people with PD can improve their walking patterns when external cues are presented. Only a few studies have provided explicit real-time feedback on performance, but they did not report how well people with PD can follow the cues on a step-by-step basis. In a single-session study using a novel-treadmill based paradigm, our group had previously demonstrated that people with PD could follow step-length and back angle feedback and improve their gait and posture during treadmill walking. This study investigated whether a long-term (6-week, 3 sessions/week) real-time feedback training (RTFT) program can improve overground gait, upright posture, balance, and quality of life. Three subjects (mean age 70 ± 2 years) with mild to moderate PD (Hoehn and Yahr stage III or below) were enrolled and participated in the program. The RTFT sessions involved walking on a treadmill while following visual feedback of step length and posture (one at any given time) displayed on a monitor placed in front of the subject at eye-level. The target step length was set between 110-120% of the step length obtained during a baseline non-feedback walking trial and the target back angle was set at the maximum upright posture exhibited during a quiet standing task. Two subjects were found to significantly improve their posture and overground walking at post-training and these changes were retained six weeks after RTFT (follow-up) and the third subject improved his upright posture and gait rhythmicity. Furthermore, the magnitude of the improvements observed in these subjects was greater than the improvements observed in reports on other neuromotor interventions. These results provide preliminary evidence that real-time feedback training can be used as an effective rehabilitative strategy to improve gait and upright posture in people with PD.
ContributorsBaskaran, Deepika (Author) / Krishnamurthi, Narayanan (Thesis advisor) / Abbas, James (Thesis advisor) / Honeycutt, Claire (Committee member) / Arizona State University (Publisher)
Created2017
Description
Robotic rehabilitation for upper limb post-stroke recovery is a developing technology. However, there are major issues in the implementation of this type of rehabilitation, issues which decrease efficacy. Two of the major solutions currently being explored to the upper limb post-stroke rehabilitation problem are the use of socially assistive rehabilitative robots, robots which directly interact with patients, and the use of exoskeleton-based systems of rehabilitation. While there is great promise in both of these techniques, they currently lack sufficient efficacy to objectively justify their costs. The overall efficacy to both of these techniques is about the same as conventional therapy, yet each has higher overhead costs that conventional therapy does. However there are associated long-term cost savings in each case, meaning that the actual current viability of either of these techniques is somewhat nebulous. In both cases, the problems which decrease technique viability are largely related to joint action, the interaction between robot and human in completing specific tasks, and issues in robot adaptability that make joint action difficult. As such, the largest part of current research into rehabilitative robotics aims to make robots behave in more "human-like" manners or to bypass the joint action problem entirely.
ContributorsRamakrishna, Vijay Kambhampati (Author) / Helms Tillery, Stephen (Thesis director) / Buneo, Christopher (Committee member) / Barrett, The Honors College (Contributor) / Economics Program in CLAS (Contributor) / W. P. Carey School of Business (Contributor) / School of Life Sciences (Contributor)
Created2015-05
Description
Skin and muscle receptors in the leg and foot provide able-bodied humans with force and position information that is crucial for balance and movement control. In lower-limb amputees however, this vital information is either missing or incomplete. Amputees typically compensate for the loss of sensory information by relying on haptic feedback from the stump-socket interface. Unfortunately, this is not an adequate substitute. Areas of the stump that directly interface with the socket are also prone to painful irritation, which further degrades haptic feedback. The lack of somatosensory feedback from prosthetic legs causes several problems for lower-limb amputees. Previous studies have established that the lack of adequate sensory feedback from prosthetic limbs contributes to poor balance and abnormal gait kinematics. These improper gait kinematics can, in turn, lead to the development of musculoskeletal diseases. Finally, the absence of sensory information has been shown to lead to steeper learning curves and increased rehabilitation times, which hampers amputees from recovering from the trauma. In this study, a novel haptic feedback system for lower-limb amputees was develped, and studies were performed to verify that information presented was sufficiently accurate and precise in comparison to a Bertec 4060-NC force plate. The prototype device consisted of a sensorized insole, a belt-mounted microcontroller, and a linear array of four vibrotactile motors worn on the thigh. The prototype worked by calculating the center of pressure in the anteroposterior plane, and applying a time-discrete vibrotactile stimulus based on the location of the center of pressure.
ContributorsKaplan, Gabriel Benjamin (Author) / Abbas, James (Thesis director) / McDaniel, Troy (Committee member) / School of Life Sciences (Contributor) / Barrett, The Honors College (Contributor)
Created2018-05