Dissertations / Theses: 'Quadriplegics'

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Seymour, Wendy, and mikewood@deakin edu au. "Remaking the body : Explorations in the sociology of embodiment." Deakin University, 1995. http://tux.lib.deakin.edu.au./adt-VDU/public/adt-VDU20050728.111439.

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As embodied social agents our lives are preoccupied with the production and reproduction of bodies. Making, unmaking and remaking our embodiment are ongoing activities. Eating, exercise, washing, grooming, dressing, for example, are activities in which the body engages in routine tasks of bodily management. Such activities can be seen as everyday rehabilitation. The study explores the impact of major physical impairment on embodiment, and on the processes involved in re-embodiment after catastrophic injury or disease. The experiences of the people in this study dramatically highlight the continuous, but largely taken for granted processes involved in our embodiment. Four analytical strands are interwoven throughout the study. The first strand relates to the frailty and vulnerability of the human body, characteristics which are epitomised by the bodies of the informants in this study. The second strand engages with key aspects of the context in which re-embodiment takes place, namely a context replete with crisis, danger, fear, uncertainty and risk. The third strand projects into the future in considering the ongoing project of self. The fourth strand addresses the institutional and social impediments which may confine vulnerable bodies and limit the exploration of more expansive bodies. The study is situated within the general theoretical approach of the sociology of the body. While recognizing the powerful impact of social discourse in the production of bodies, the study focuses on the critical role of embodiment in the reconstitution of self. The people in this study have experienced profound bodily change, but although this damage has disrupted, it has not annihilated their embodied selves. The people still possess and occupy their bodies. It is the obduracy of embodiment which directs the processes involved in remaking the body.

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Nock, Bonnie J. (Bonnie Jean). "Echocardiographic Assessment of the Left Ventricle in the Spinal Cord Injured Patient." Thesis, University of North Texas, 1989. https://digital.library.unt.edu/ark:/67531/metadc500420/.

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Ten caucasian male quadriplegics were compared with eight sedentary caucasian male controls in regards to left ventricular dimensions and mass obtained from echocardiograrns. The interventricular septum (IVS), left ventricular posterior wall (LVPW) and left ventricular internal diameter (LVII) were within normal limits for both groups. However, the INS in the SCI were significantly thicker than controls (p <0.05). Myocardial thickness was larger in SCI subjects (p <0.05). Absolute left ventricular mass (LVM) and total left ventricular volume was not different ( p > 0.05), but SCI subjects had significantly greater LVM to lean body mass ratios. Echocardiographically, SCI patients demonstrate concentric hypertrophy. This suggests adaptive response to chronic increase in afterload pressure secondary to their daily activities and muscle spasticity.

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DAVANZO, NICOLA. "ACCESSIBLE DIGITAL MUSICAL INSTRUMENTS FOR QUADRIPLEGIC MUSICIANS." Doctoral thesis, Università degli Studi di Milano, 2022. http://hdl.handle.net/2434/920339.

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This thesis explores a particular research topic in the field of Sound and Music Computing, dedicated to the creation of Accessible Digital Musical Instruments (ADMIs) designed for users affected by quadriplegia or similar motor impairments. With such conditions an user is completely paralyzed from the neck down. The impossibility to control the upper and lower limbs, particularly fingers, makes it impossible for such users to play conventional musical instruments, both acoustic and digital. This makes it necessary to introduce specific and non-trivial design and development solutions. A first part of the work is dedicated to the analysis of the related context. After defining the pertinent jargon, an analysis of different physical interaction channels available to people with quadriplegic disabilities is provided, with a review of the sensors suitable for their detection. Some of these channels are then evaluated through an experimental methodology. Further chapters provide an analysis of the state of the art in ADMIs for quadriplegic users, as well as design tools dedicated to ADMIs in general. A chapter is dedicated to the design of musical interfaces controlled through gaze, one of the most employed channels in this context. The second part describes the design, development and testing of new ADMIs suitable for quadriplegic users. The implementation of a software library for developing or fast-prototyping software instruments is described, as well as two Open-Source Hardware sensor peripherals developed ad-hoc for the detection of breath and head rotation. The remaining chapters describe the design, implementation and evaluation of Netytar, Netychords and Resin, three ADMIs that are played through the detection of gaze, breath, head movement, and stimulated resonances in the upper vocal tract, therefore playable hands-free.

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Maule, Luca. "Eye controlled semi-Robotic Wheelchair for quadriplegic users embedding Mixed Reality tools." Doctoral thesis, Università degli studi di Trento, 2019. https://hdl.handle.net/11572/368247.

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Mobile assistive robotics can play a key role to improve the autonomy and lifestyle of patients. In this context, RoboEye project aims to support people affected by mobility problems that range from very impairing pathologies (like ALS, amyotrophic lateral sclerosis) to old age. Any severe motor disability is a condition that limits the capability of interacting with the environment, even the domestic one, caused by the loss of the control on our own mobility. Although these pathologies are relatively rare, the number of people affected by this disease are increasing during the years. The focus of this project is the restore of personsâ€™ mobility using novel technologies based on the gaze on a power wheelchair designed to enable the user to move easily and autonomously inside his home. A novel and intuitive control system was designed to achieve such a goal, in which a non-invasive eye tracker, a monitor, and a 3D camera represent some of the core elements. The developed prototype integrates, on a standard power wheelchair, functionalities from the mobile robotics field, with the main benefit of providing to the user two driving options and comfortable navigation. The most intuitive, and direct, modality foresees the continuous control of the frontal and angular velocities of the wheelchair by gazing at different areas of the monitor. The second, semi-autonomous, enables the navigation toward a selected point in the environment by just pointing and activating the wished destination while the system autonomously plans and follows the trajectory that brings the wheelchair there. The main goal is the development of shared control, combining direct control by the user with the comfort of autonomous navigation based on augmented reality markers. A first evaluation has been performed on a real test bed where specific motion metrics are evaluated. The designs of the control structure and driving interfaces were tuned thanks to the testing of some volunteers, habitual users of standard power wheelchairs. The driving modalities, especially the semi-autonomous one, were modelled and qualified to verify their efficiency, reliability, and safety for domestic usage.

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Maule, Luca. "Eye controlled semi-Robotic Wheelchair for quadriplegic users embedding Mixed Reality tools." Doctoral thesis, University of Trento, 2019. http://eprints-phd.biblio.unitn.it/3737/1/PhD_Thesis_Maule_Luca_Final.pdf.

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Mobile assistive robotics can play a key role to improve the autonomy and lifestyle of patients. In this context, RoboEye project aims to support people affected by mobility problems that range from very impairing pathologies (like ALS, amyotrophic lateral sclerosis) to old age. Any severe motor disability is a condition that limits the capability of interacting with the environment, even the domestic one, caused by the loss of the control on our own mobility. Although these pathologies are relatively rare, the number of people affected by this disease are increasing during the years. The focus of this project is the restore of persons’ mobility using novel technologies based on the gaze on a power wheelchair designed to enable the user to move easily and autonomously inside his home. A novel and intuitive control system was designed to achieve such a goal, in which a non-invasive eye tracker, a monitor, and a 3D camera represent some of the core elements. The developed prototype integrates, on a standard power wheelchair, functionalities from the mobile robotics field, with the main benefit of providing to the user two driving options and comfortable navigation. The most intuitive, and direct, modality foresees the continuous control of the frontal and angular velocities of the wheelchair by gazing at different areas of the monitor. The second, semi-autonomous, enables the navigation toward a selected point in the environment by just pointing and activating the wished destination while the system autonomously plans and follows the trajectory that brings the wheelchair there. The main goal is the development of shared control, combining direct control by the user with the comfort of autonomous navigation based on augmented reality markers. A first evaluation has been performed on a real test bed where specific motion metrics are evaluated. The designs of the control structure and driving interfaces were tuned thanks to the testing of some volunteers, habitual users of standard power wheelchairs. The driving modalities, especially the semi-autonomous one, were modelled and qualified to verify their efficiency, reliability, and safety for domestic usage.

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Caselli, Thaisa Barboza 1990. "Parâmetros nutricionais e efeito da alimentação por gastrostomia em crianças e adolescentes com tetraparesia espástica." [s.n.], 2015. http://repositorio.unicamp.br/jspui/handle/REPOSIP/310764.

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Orientadores: Maria Angela Bellomo Brandão, Elizete Aparecida Lomazi
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: A tetraparesia espástica é um tipo de Encefalopatia crônica não progressiva ou não evolutiva (ECNE) que corresponde a uma condição neurológica associada a anormalidades motoras graves, ingestão alimentar deficiente, comprometimento da composição corporal e desnutrição frequente. A gastrostomia tem sido indicada para crianças com dificuldades em se alimentar decorrente da ECNE. O objetivo do trabalho foi avaliar o estado nutricional de crianças e adolescentes portadores de ECNE tetraespástica, por meio de curvas específicas e das dobras cutâneas, identificar a frequência das disfunções da motilidade digestiva e a comparar o estado nutricional daquelas alimentadas via gastrostomia (SGT) e via oral (VO). Também foi verificada a concordância entre curvas de crescimento utilizadas para população pediátrica no geral e as curvas específicas para pacientes com ECNE. Estudo transversal em que foram incluídos 54 pacientes. Foram obtidos os dados de: altura do joelho, estatura estimada, peso, dobras cutâneas e circunferências do braço. Os valores de dobras e circunferências foram comparados com a referência de Frisancho. As curvas de Brooks et al. foram utilizadas como padrão referencial e foram definidos como desnutridos aqueles que se encontravam abaixo do percentil 25 de peso para idade. A diferença dos parâmetros nutricionais entre o grupo SGT e grupo VO foi calculada por testes Qui-Quadrado e Exato de Fisher, enquanto que a relação entre curva de crescimento para crianças saudáveis (representada pelo Escore-Z calculado) e curva adotada como referencial foi verificada através do teste exato de Fisher. O nível de significância adotado foi de 5%. Dos 54 pacientes, 34 eram do sexo masculino e a média da idade foi de 10,2 anos. Vinte e cinco pacientes eram alimentados por SGT e 29 por VO. Observou-se que 70% (38/54) dos pacientes foram considerados eutróficos nos parâmetros de peso e Índice de Massa Corpórea (IMC) para idade, enquanto que 100% (54/54) estavam com estatura adequada para idade. A desnutrição em relação à dobra cutânea triciptal foi observada em 30% (26/54) enquanto que 52% (28/54) apresentaram depleção de massa magra através da circunferência braquial. Foi verificado que as disfunções da motilidade digestiva, como refluxo gastroesofágico, distúrbio de deglutição e constipação intestinal foram mais frequentes no grupo SGT, sendo possivelmente um dos fatores para indicação da cirurgia. O grupo VO apresentou mais indivíduos na faixa da desnutrição (24,14% ou 7/12), além de maior depleção de massa magra e adiposa quando comparado ao grupo SGT. Em relação às curvas, 14,3% dos pacientes que foram classificados como eutróficos no parâmetro peso para idade de acordo com a curva referencial, o Escore-Z os classificou como desnutridos e o mesmo ocorreu em 10% em relação ao IMC. A curva referencial classificou todos como tendo estatura adequada para idade, enquanto que o Escore-Z apontou baixa ou muito baixa estatura para idade. O estudo permitiu concluir que os parâmetros antropométricos indicam que os pacientes do grupo VO apresentam maior comprometimento do estado nutricional do que aqueles que se alimentam via SGT
Abstract: Spastic Quadriplegic cerebral palsy is a sort of a non-progressive chronic encephalopathy, which is related to a neurological condition linked to serious motor abnormalities, deficient food intake, body composition compromising and frequent malnourishment. Gastrostomy is being indicated to children who have difficulties in feeding due to the non-progressive chronic encephalopathy. The aim was to evaluate nutritional status of children and teenagers carriers of non-progressive chronic encephalopathy with spastic quadriplegic cerebral palsy (through comparison with specifics curves and skinfolds), dysfunctions frequency of digestive motility and the nutritional status comparison of those who feed via gastrostomy and via oral. It was also verified the accordance between growth curves used to pediatric people in general, and specifics curves for patients with non-progressive chronic encephalopathy. Sectional study which were included 54 patients. The following data were obtained: knee height, estimated stature, weight, skin folds and arm circumference. Skin folds and circumferences values were compared to Frisancho¿s reference values. Brooks curves at al. were used as referential standards, and were defined as malnourished those who were below the 25th percentile to the age. Nutritional parameters¿ difference between the group feed via gastrostomy and via oral was measured by Chi-square test and Fisher exact test. Significance level adopted was 5%. From 54 patients, 34 were male and the average age was 10.2 years old. Twenty five patients were feed via gastrostomy and 29 via oral. It was observed that 70% (38/54) of all patients were considered as eutrophic as weight and body mass parameters for the age, while 100% (54/54) had the ideal stature for the age. Malnourishment related to triceps skinfold was observed in 30% (26/54), while 52% (28/54) presented lean mass depletion through arm circumference. Was also verified that digestive motility, such as gastroesophageal reflux, swallowing disorders and intestinal constipation were frequent in group feed via gastrostomy, and a probable factor for surgery indication. Via oral group presented more individuals in malnourishment range (24,24%, or 7/12), besides higher levels of lean mass depletion, and also of adipose mass when compared to in group feed via gastrostomy. In 14,3% of patients who were classified as eutrophic in weight/age parameters in according to referential curve, Z-Score classified them as malnourished and the same happened in 10% on their body mass index. The reference curve has classified all patients as suitable stature to their ages. This study allowed to conclude that anthropometric parameters indicates that patients from via oral group present a higher compromising of nutritional status than patients of gastrostomy group
Mestrado
Saude da Criança e do Adolescente
Mestra em Ciências

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Tancredo, Janaina Roland 1980. "Análise clínica e funcional da espasticidade antes e após a estimulação elétrica neuromuscular e marcha em esteira com EENM em lesados medulares." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313748.

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Orientador: Alberto Cliquet Junior
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: A lesão medular tem como uma de suas conseqüências a espasticidade, que está geralmente presente em lesões acima do último nível torácico (T12) e pode ser avaliada através de indicadores quantitativos e qualitativos. Na pesquisa, foram avaliados dois grupos, o da Estimulação Elétrica Neuromuscular (EENM), com dezesseis pacientes e o grupo da Marcha em Esteira com EENM com oito pacientes; todos com diagnóstico de paraplegia e tetraplegia com algum grau de espasticidade. Foram utilizadas para esta avaliação as escalas: modificada de Ashworth, a de espasmos musculares, a subjetiva da espasticidade e o teste pendular. Para aplicação do teste pendular foi utilizado o Dispositivo de Teste Pendular (DTP) - (equipamento que foi elaborado e construído especificamente para avaliar a espasticidade, que possui um acelerômetro de transdutores de cristais de quartzo e um eletrogoniômetro de fibra óptica flexível que medem as tensões e os deslocamentos angulares, respectivamente) do Laboratório de Biomecânica e Reabilitação do Aparelho Locomotor. Os pacientes do grupo da EENM realizaram EENM nos músculos quadríceps e nervo fibular, sendo que os testes foram aplicados antes e logo após o procedimento. O mesmo foi realizado para o grupo da Marcha em Esteira com EENM. Os dados mostraram uma diminuição da espasticidade nos dois grupos, representado no grupo da EENM por variações nos parâmetros F1Ang, F1 Amp, E1 Amp, Plat Amp e ERI e no parâmetro E1 Ang no grupo da marcha. O grupo da EENM onde foi subdividido (pacientes com e sem medicação) notamos uma diferença significativa no subgrupo sem medicação na maioria dos parâmetros avaliados. Já o subgrupo com medicação apenas os parâmetros On Ang e RI foram significativos. Além disso, os dados da escala subjetiva e da escala modificada de Ashworth, após a estimulação elétrica neuromuscular também apresentaram uma redução nos valores da espasticidade, sendo que no grupo da marcha em esteira apenas a escala subjetiva foi significativa
Abstract: Spinal cord injury has as one of its consequences the spasticity, which is usually present in lesions above the last thoracic level (T12) and it can be assessed through quantitative and qualitative indicators. In the study it was evaluated two groups: Neuromuscular Electrical Stimulation (NMES) group with sixteen patients and the group of eight patients that performed treadmill gait with partial body weigth support and NMES, all of them were diagnosed with paraplegia or tetraplegia with some degree of spasticity. The following scales were used for assessment: Modified Ashworth Scale, Muscle Spasms Scale, Subjective Scale of Spasticity and the pendulum test. For application of the pendulum test it was used Pendular Test Device (PTD) was used, this equipment was designed and built specifically to evaluate spasticity, which has an accelerometer of quartz crystals transducer and a flexible fiber optic electrogoniometer to measure the acceleration and angular displacement, respectively. The patients in the NMES group performed NMES in the quadriceps muscle and fibular nerve, and the tests were applied before and after the procedure. The same was done for the treadmill gait with NMES group. The data showed a decrease in spasticity in both groups, represented in the NMES group by changes in the F1Ang, F1Amp, E1Amp, Plat Amp and ERI parameters of the PTD and the gait group also presented a change in the E1Ang. In the group NMES, which was divided (patients with and without drugs), it was noticed a significant difference in the subgroup without medication in most parameters. However, in the subgroup with medication only the OnAng and RI parameters were significant. In addition, data from the Subjective Scale of Spasticity and the Modified Ashworth Scale also showed a reduction in the values in the spasticity, and in the group of treadmill gait just a Subjective Scale of Spasticity was significant
Mestrado
Fisiopatologia Cirúrgica
Mestre em Ciências

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Norman, Holly. "Cellular and Molecular Mechanisms Underlying Acute Quadriplegic Myopathy : Studies in Experimental Animal Models and Intensive Care Unit Patients." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7133.

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Paris, Juliana Viana 1981. "Análise da função pulmonar e análise cinemática da mobilidade tóracoabdominal em sujeitos tetraplégicos praticantes de rúgbi em cadeira de rodas." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/275039.

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Orientador: Ricardo Machado Leite de Barros
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação Física
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Resumo: O trabalho teve como objetivo estudar o efeito de um ano de treinamento de rúgbi em cadeira de rodas sobre a função pulmonar e a mobilidade toracoabdominal de tetraplégicos através da espirometria e da análise cinemática, sendo dividido em três partes. Na primeira parte, sete tetraplégicos foram submetidos à espirometria antes e depois de treinamento de rúgbi em cadeira de rodas. Todos indivíduos apresentaram redução da função pulmonar em comparação com os valores previstos. Houve um aumento significativo na capacidade vital forçada (p= 0,01), volume expiratório forçado do primeiro segundo(p =0,02) e ventilação voluntária máxima(p= 0,03) , após um ano de treinamento.A análise de regressão entre tempo de treinamento total e as variáveis espirométricas demonstraram que os jogadores com maior tempo de treinamento tiveram maiores valores de função pulmonar (r² =0,93e 0,58, p =0,0004 e 0,004). Na segunda parte, foi estudada a análise cinemática da mobilidade toracoabdominal de tetraplégicos praticantes de rúgbi em cadeira de rodas e as diferenças de mobilidade nos compartimentos toracoabdominais após um ano de treinamento de rúgbi em cadeira de rodas. Participaram dezoito voluntários, nove do grupo de lesados medulares (GL) e nove sem lesão medular fazendo parte do grupo controle (GC). Do GL, sete voluntários foram acompanhados durante um ano de treinamento. Através das curvas de volume em função do tempo, calculou-se o coeficiente de variação das curvas no tórax superior (TS), tórax inferior (TI), abdome superior (AS), abdome inferior (AI), representando a mobilidade do toracoabdominal, em volume corrente (VC) e em capacidade vital (CV). As comparações e interações entre os fatores: grupos e compartimentos toracoabdominal foram testadas utilizando ANOVA two way e para comparar as diferenças entre os coeficientes de variação GL antes e depois do treinamento foi aplicado um teste t pareado, considerado nível significância de p<0.05 para todos os testes. Em VC não houve diferença significativa quando o GC foi comparado ao GL.Em CV, os valores dos compartimentos TS, TI e AS do GC foram significativamente maiores que os valores dos mesmos compartimentos do GL. No GL, os valores do coeficiente de variação do compartimento do TS foram significativamente menores que os valores do AI; No GL antes e depois de treinamento, a mobilidade do TS foi significativamente maior na condição pós treinamento comparada a pré treinamento. Na terceira parte, comparou-se a espirometria com análise cinemática da respiração. Foram analisadas de maneira descritiva as variáveis: as curvas de volume em função do tempo, os valores médios e de desvio-padrão dos ciclos respiratório, os valores máximos dos ciclos respiratórios, diferença entre os valores máximos e a correlação de Pearson entre os valores das curvas medidos pelo dois métodos. Existiu alta correlação entre as medidas de volume feita pela espirometria e cinemetria, contudo, os valores máximos de volume toracoabdominais calculados pela análise cinemática mostram uma tendência a serem inferiores aos valores de volumes obtidos pela espirometria. O treinamento de rúgbi em cadeira de rodas, pode melhorar a função pulmonar e mobilidade toracoabdominal de lesados medulares
Abstract: This work aimed to study the effect of a year of training in wheelchair rugby on pulmonary function and thoracoabdominal mobility of tetraplegics by spirometry and kinematic analysis. This study wasdivided into three parts. In the first part, seven tetraplegics underwent spirometry before and after attending a year of wheelchair rugby training. All Subjects presented reduced lung function compared with the predicted values. There was a significant increase in forced vital capacity (p= 0,01), first minute forced expiratory volume (p= 0,02), and maximal voluntary ventilation (p= 0,03. The regression analysis between total training time and spirometric variables showed that players with longer training had higher lung function values (r² =0,93e 0,58, p =0,0004 e 0,004). In the second part, we studied the kinematical analysis of thoracoabdominal mobility of wheelchair rugby practitioners and the differences in the mobility of thoracoabdominal compartments after a year of training. Nine tetraplegics participated in the training group (TG) and nine participantswithout spinal cord injury took part as the control group (CG). Seven volunteers of the TG were monitored for one year of training. From the volume curves as function of time we calculated the coefficient of variation of the curves in the superior thorax (ST), inferior thorax (IT), superior abdomen (SA) and inferior abdomen (IA), which representied the mobility of the thoracoabdominal compartment in the vidal volume (VT) and vital capacity (VC). Comparisons and interactions between the factors groups and thoracoabdominal compartments were tested using two-way ANOVA. To compare the differences between the coefficients of variation of TG before and after training, it was applied a paired t test, considering p <0.05 for all tests. in the variable VT showed no significant difference when the CG was compared to TG. In VC, the values of the compartments ST, IT, SA to GC were significantly higher than the values of the same compartments in TG. In TG, the coefficient of variation of TS was significantly lower than the values of IA. On TG before and after training, the mobility of ST was significantly higher to the post training results compared to pre training. In the third part, we compared spirometry with kinematical analysis of the chest wall. We analyzed the descriptive variables: volume curves as a function of time, the mean and standard deviation of the respiratory cycles, the maximum values of the respiratory cycles, the difference between the maximum and Pearson correlation between the values of curves measured by the two methods. There was high correlation between the volume measurements obtained by spirometry and kinematics, however, the maximum thoracoabdominal volume calculated by kinematical analysis showed a tendency to be lower than the values of the volumes obtained by spirometry. The wheelchair rugby training can improve pulmonary function and thoracoabdominal mobility of people with spinal cord injury
Mestrado
Biodinamica do Movimento Humano
Mestre em Educação Física

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Cacho, Enio Walker Azevedo. "Avaliação da extremidade superior de tetraplégicos = correlações clínicas, funcionais e cinemáticas." [s.n.], 2010. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309679.

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Orientador: Alberto Cliquet Junior
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Vários são os instrumentos de avaliação dedicados aos tetraplégicos. A compreensão de suas relações é de fundamental importância para o desenvolvimento e elaboração de abordagens terapêuticas voltadas à reabilitação da extremidade superior desses indivíduos. Assim, o objetivo deste estudo foi analisar as correlações entre as avaliações clínicas, funcionais e cinemáticas da extremidade superior durante os movimentos de alcance-preensão em tetraplégicos. Vinte tetraplégicos crônicos e vinte participantes controles foram selecionados para o estudo. Os instrumentos utilizados para a avaliação foram: o padrão de classificação da Associação Americana de Lesão Medular - ASIA, a Medida de Independência Funcional - MIF, a Mensuração de Independência da Medula espinhal - SCIM II, e a avaliação cinemática do movimento de alcance-preensão. Foram utilizadas as seguintes variáveis cinemáticas: deslocamento anterior do tronco e protração do ombro, amplitude articular do ombro, cotovelo e punho nos planos sagital e horizontal, índice de curvatura, pico de velocidade máxima, razão do pico de velocidade máxima, tempo de movimento e número de picos. O deslocamento anterior do tronco, protração do ombro e as amplitudes articulares do ombro e cotovelo não apresentaram diferenças significativas entre os tetraplégicos e os controles. Apenas a amplitude de flexoextensão do punho foi significativamente maior em tetraplégicos. Os movimentos dos tetraplégicos foram mais lentos, segmentados e menos harmoniosos, quando comparados com os controles. Foi encontrada uma correlação positiva entre o índice motor total e a MIF (r = 0.6089; p = 0.0044) e SCIM II (r = 0.5229; p = 0.018). As avaliações funcionais apresentaram correlação positiva entre si (r = 0.8283; p < 0.0001). Foi encontrada também correlação entre o índice motor direito e esquerdo, a MIF motora e o SCIM II, com várias variáveis cinemáticas estudadas (pico de velocidade máxima, tempo de movimento, índice de curvatura, número de picos e razão do pico de velocidade máxima de velocidade). Dentre as amplitudes articulares de movimento (ombro, cotovelo e punho), apenas a amplitude do punho demonstrou correlação com a variável clínica. Este estudo demonstra que a força muscular avaliada pelo índice motor da ASIA se correlaciona moderadamente com as variáveis cinemáticas relacionadas à harmonia de trajetória dos movimentos de alcance-preensão em tetraplégicos. Já as avaliações funcionais apresentaram forte correlação entre si e moderada correlação com o índice motor direito, esquerdo e total, mas não apresentaram uma correlação constante com as variáveis cinemáticas avaliadas à direita e à esquerda.
Abstract: Several assessment tools are dedicated to understanding tetraplegics. The understanding of their relationships has a fundamental importance for the development and elaboration of therapeutic approaches aiming rehabilitation of the upper extremity of these individuals. The objective of this study is to analyze the correlations between clinical, functional and kinematics assessments of upper extremity during reaching-grasping movements in tetraplegics. Twenty chronic tetraplegic patients and 20 control participants were selected for this study. The instruments used for evaluation were the standard classification of the American Association of Spinal Cord Injury - ASIA, the Functional Independence Measure - FIM, the Spinal Cord of Independence Measurement - SCIM II and the kinematics evaluation of the reach-grasp movement. The following kinematic variables were used: anterior displacement of the trunk and protraction of the shoulder, joint range of motion of shoulder, elbow and wrist in sagittal and horizontal planes, curvature index, peak speed, ratio of peak speed, movement time and peak number. The anterior displacement of the trunk, shoulder protraction and range of motion of shoulder and elbow showed no significant differences between groups of tetraplegic patients and controls. Only the flexion-extension amplitude of the wrist was significantly greater in tetraplegics. The movements in quadriplegic patients were slower, targeted and less harmonious when compared with controls. There was a positive correlation between the total motor index and functional FIM (r = 0.6089; p = 0.0044) and SCIM II (r = 0.5229; p = 0.018). Both functional scores showed positive correlation within each other (r = 0.8283; p < 0.0001). There was also correlation between the right and left motor indices, the motor FIM and the SCIM with most of the kinematics studied (peak of velocity, movement time, index of curvature, number of peaks and peak velocity ratio of the maximum velocity). On the other hand, for the joint range of motion (shoulder, elbow and wrist), only the wrist in the horizontal plane demonstrated correlation with clinical variables. This study demonstrates that muscle strength assessed by the ASIA motor index correlates moderately with the kinematic variables related to the harmony and the trajectory of the reaching-grasping movement in tetraplegics. Yet, functional assessments showed strong correlation among themselves, and moderate correlation with right, left and total motor index, but did not show a constant correlation with kinematic variables measured on the right and left.
Doutorado
Pesquisa Experimental
Doutor em Cirurgia

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11

McCloskey, John Brendan. "inGrid : a new tactile, tangible and accessible digital musical instrument for enhanced creative independence amongst musicians with quadriplegic cerebral palsy." Thesis, Ulster University, 2014. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.654103.

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In digital music-making activities musicians with physical disabilities employ both accessible and generic control interfaces; accessible controllers capture broad input gestures and map them onto discrete output events, whereas consumer digital musical instruments (DMI's) offer extended control only through artefact multiplication (more buttons, sliders and dials). The interaction paradigm common to both consumer and specialised controllers reveals limited dimensions: click-and-drag or select-and-move. It is common practice in inclusive music activities for an able-bodied facilitator to expose access to low-level parameters via sequential and non-real-time processes, on behalf of the musician with a physical disability; these factors constrain real-time independent creative self-expression. The current research details the explicit needs and capabilities of a small group of digital musicians with quadriplegic cerebral palsy, garnered through participatory design and mixed methods. The project methodology draws on tools and models from the fields of assistive technologies and from mainstream DMI design. Project participants contribute data pertaining to preferences and capabilities, and evaluate key iterations of the evolving prototype. The practice-led and participatory design ethos relies on demonstrably repeatable and preferred gestural capabilities, without seeking to maximise physical ability in a rehabilitative context. The underlying mapping strategy exposes, in real time, a transparent hierarchy of dynamic sound parameters commonly accessed through facilitated, offline and sequential processes.

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Ferreira, Vanessa Maria de Vargas 1986. "Avaliação clínica e cinemática da função manual de pessoas com tetraplegia com a utilização de EENM e sistema híbrido = Clinical and kinematic analysis of the hand function of persons with tetraplegic using NMES and hybrid system." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309568.

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Orientador: Alberto Cliquet Junior
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: Pacientes com lesão medular cervical apresentam disfunção dos membros superiores com grande perda de funcionalidade. A eletroestimulação neuromuscular (EENM) é considerada uma ferramenta importante para a reabilitação desses pacientes. O presente estudo tem como objetivo avaliar a função de pacientes tetraplégicos na tarefa mimética de beber e comparar com a utilização de EENM e um sistema híbrido (órtese dinâmica e EENM) para membros superiores, por meio de análise clínica e cinemática. Participaram desta pesquisa 14 pacientes com tetraplegia com nível motor entre C4 a C7 e 5 voluntários saudáveis. Foram aplicadas escalas clínicas para definir o nível de acometimento neurológico e funcional do paciente (AIS e MIF) e foi realizada avaliação cinemática da tarefa mimética de beber, sendo que os pacientes realizaram a atividade em 3 situações: movimento livre, com EENM e com o sistema híbrido. As variáveis cinemáticas utilizadas foram: tempo do movimento, razão do pico de velocidade máxima, índice de curvatura, trajetória do esterno, distância punho-esterno e abertura da mão. Também foi computado o número de acertos para a realização da tarefa. Os resultados indicam que pacientes que realizam a preensão por tenodese possuem maior independência funcional pela MIF (p=0,0008). Na tarefa mimética de beber houve 60% de acertos no movimento livre, 72,8% com EENM e apenas 47,6% com o sistema híbrido. Pela análise cinemática o uso da EENM não foi diferente do movimento livre, no entanto, os pacientes apresentaram maior tempo e menor suavidade no movimento e realizaram maior trajetória do punho e esterno durante a atividade quando comparado com o controle. O uso do sistema híbrido alterou o padrão de movimento dos pacientes, apresentando um aumento na trajetória do esterno e diminuição da suavidade do movimento. Em suma, a EENM promoveu uma melhor atividade funcional para os pacientes com nível C5, no entanto, o uso do sistema híbrido não parece facilitar a manipulação de objetos por pessoas com tetraplegia
Abstract: Patients with cervical spinal cord injury have dysfunction of the upper limbs with great loss of motor function. Neuromuscular electrical stimulation (NMES) is considered an important tool in rehabilitation. The aim of the present study is to evaluate the function of patients with tetraplegia in the mimetic task of drinking and compare with the use of NMES and a hybrid system (NMES and dynamic orthosis) through clinical evaluation and kinematic analysis. Fourteen patients with tetraplegia level C4 to C7 and 5 able-bodied volunteers participated in the study. Clinical tests were applied to verify the neurological and functional impairment (AIS and FIM) and the mimetic task of drinking was assessed with kinematic during three situations: free movement, with NMES and with the hybrid system. The kinematic variables used were: movement time, peak velocity ratio, index of curvature, sternum trajectory, wrist-sternum distance and hand opening. We also computed the number of successes to perform the task. The results indicate that patients that are able to perform tenodesis grip have greater functional independence through FIM (p=0.0008). The rate of success of the free movement was 60%, 72.8% with NMES and only 47.6% with the hybrid system. In the kinematic analysis the NMES was not different from the free movement, however, patients performed the task in a longer time, the movement was less smooth and the sternum and wrist trajectories were greater than the control group. The use of the hybrid system modified the pattern of movement of the patients, with an increase of the sternum trajectory and decrease of the smoothness. In conclusion, NMES improved the functional activity of patients with C5 level; on the other hand, the use of the hybrid system does not appear to facilitate the prehension of persons with tetraplegia
Mestrado
Fisiopatologia Cirúrgica
Mestre em Ciências

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13

McBride, Seth William. "Ghosts of a Life Long Past." PDXScholar, 2013. https://pdxscholar.library.pdx.edu/open_access_etds/1104.

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"Ghost of a Life Long Past" is a memoir about the necessity of movement and physicality. It chronicles the author's life, both before and after a skiing accident that left him with quadriplegia. The memoir is split into two alternating narratives. One follows the author's post-accident journey to regain physicality and the ability to move through the world and function in his environment. The other is a series of flashbacks, looking[at] the author's pre-accident childhood in Juneau, Alaska. Themes include independence, travel, sports, disability, and the need to test the limits of ones body.

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14

Corpeno, Rebeca. "Development of method for myosin- and actin-measurements in musclefibers." Thesis, Uppsala University, Department of Medical Biochemistry and Microbiology, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-9172.

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The purpose of this study was to gain more knowledge about the deleterious effects of decreased muscle protein concentration on skeletal muscle function, by measuring the concentrations of myosin and actin in single pig muscle fibres. The pigs were earlier used in an experimental animal model to study the early stages of acute quadriplegic myopathy (AQM), a disease that is found in mechanically ventilated intensive care unit patients. Percutaneous biopsies were taken from these pigs and where now used in this study.

Even though the method used was accurately tested and theoretically working, certain problems arose. These problems were unexpected and caused problems to the study. The method used to measure the concentration of myosin and actin, an ELISA, gave no logical results. The reason could not be found and because of the time limit of this project no results from the AQM-pigs were gained. The efforts to make the method work is described and discussed.

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Medina, Giovanna Ignácio Subirá 1981. "Avaliação clínica e radiográfica do ombro de pacientes lesados medulares em programa de reabilitação." [s.n.], 2011. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313750.

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Orientador: Alberto Cliquet Junior
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: A lesão da medula espinhal é uma afecção incapacitante e que é acompanhada de inúmeras complicações diretas e indiretas. No Brasil, ocorrem cerca de 6 a 8 mil novos casos por ano de LME e, desde o momento do trauma, os pacientes lesados medulares necessitam de cuidados direcionados que devem persistir mesmo após passados anos da lesão. A dor no ombro é o processo doloroso mais comum entre os pacientes com lesão medular que se queixam de dor nos membros superiores perfazendo 71% do total. Este é um estudo clínico e radiográfico que avaliou o ombro de pacientes tetraplégicos e paraplégicos que estavam em programa de reabilitação no Laboratório de Biomecânica e Reabilitação do Aparelho locomotor do Hospital das Clínicas da Faculdade de Ciências Médicas da Universidade Estadual de Campinas (UNICAMP). Os objetivos foram estabelecer a utilidade da radiografia como exame de triagem para dor no ombro de pacientes lesados medulares. Trinta e dois ombros de 16 pacientes foram avaliados clinica e radiograficamente. Os pacientes foram divididos em 2 grupos: paraplégicos e tetraplégicos. Um grupo controle de 16 indivíduos normais, voluntários, foi selecionado. Dor no ombro foi encontrada em 89% dos tetraplégicos e em 43% dos paraplégicos. O tempo desde a lesão variou de 1.5-22 anos (média 7.88 anos); a média de idade dos pacientes foi de 35 anos (variou de 21-57 anos). A medida da articulação acromioclavicular variou de 0.03-0.7cm para o lado direito e 0.15-0.7cm para o lado esquerdo, com média de 0.37cm e 0.41cm respectivamente. Não foi encontrada correlação alguma entre dor no ombro e sexo, idade ou tempo da lesão. Houve uma tendência a correlação entre dor no ombro e tipo de lesão, com tendência dos tetraplégicos em apresentar sintomas dolorosos. Na média, os tetraplégicos apresentaram menores medidas da articulação acromioclavicular. Com os dados deste estudo, não houve confirmação da hipótese de que achados radiográficos pudessem indicar risco de desenvolver dor no ombro em pacientes lesados medulares
Abstract: Spinal Cord injury is a very disabling condition that has many direct and indirect complications. In Brazil, there are around 6 to 8 thousand new cases each year and the patients need specific care from the moment of the lesion even through years after the SCI. Shoulder pain is the most common painful process among SCI patients that complaint of pain in the upper extremities, representing 71% of the total. This was a clinical and radiographic study which evaluated the shoulders of tetraplegic and paraplegic patients who attend the rehabilitation program of the Biomechanics and Locomotor-System Rehabilitation Laboratory of the University Hospital of the Faculty of Medical Sciences of the State University of Campinas (UNICAMP). The objective was to establish the usefulness of radiography as a screening exam for shoulder pain in spinal cord injured patients. Thirty two shoulders of sixteen patients were evaluated by clinical exam and radiography. Patients were divided into two groups: paraplegic and tetraplegic. A control group of 16 normal volunteer subjects was selected. Shoulder pain was reported in 89% of tetraplegic and 43% of paraplegic. The time of injury ranged from 1.5 - 22 years (mean 7.88 years); patients had a mean age of 35 years (range, 21-57 years). The acromioclavicular joint space ranged from 0.03-0.7cm on the right side and 0.15-0.7cm on the left side, with a mean of 0.37 and 0.41cm respectively. No correlation was found between shoulder pain and gender, age or time since injury. There was a trend to correlation between shoulder pain and type of injury with tetraplegic having a tendency to pain symptoms. On average, tetraplegic had smaller acromioclavicular joint. With this study we were not able to confirm the hypothesis that radiography could be used to predict risk factor for developing shoulder pain among SCI patients
Mestrado
Fisiopatologia Cirúrgica
Mestre em Ciências

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16

Wilsmore, Bradley R. "Thermoregulation in people with spinal cord injury." School of Health Sciences - Faculty of Health and Behavioural Sciences, 2007. http://ro.uow.edu.au/theses/85.

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Thermoafferent information is integrated at multiple levels within the central nervous system. However, due to the difficulty in differentiating thermoregulatory functions of the spinal cord from those of higher centres in humans, the role of the spinal cord in certain aspects of thermoregulation remains unclear. Subjects with spinal cord injury have unique neural changes providing an opportunity to evaluate the role of the spinal cord, independently of higher thermoregulatory centres. Subjects with (N=11) and without (N=11) spinal cord injury were studied in a series of experiments, in which a wide range of local and whole-body temperature changes and postural manipulations were imposed. During these trials, various physiological (skin temperature, core temperature, local sweat rate and sweat expulsion frequency - a measure of central sympathetic drive), and psychophysical variables (thermal sensation and discomfort) were investigated. Six key observations arose from these experiments: (i) Subjects with spinal cord injury had a lower thermoafferent capacity (secondary to neural damage) and a corresponding reduction in thermoefferent drive (sudomotor sensitivity of 4.2 versus 8.8 expulsions•min-1•C-1 in able-bodied; P=0.03). (ii) Equations used to approximate thermoafferent drive in able-bodied subjects, overestimated thermal feedback in subjects with spinal cord injury. However, this could be corrected by modifying the skin area weightings to include only the sensate areas. (iii) No subjects with physiologically-confirmed thermoefferent spinal cord injury displayed sweating from insensate skin sites, indicating that a spinal cord that has been isolated from higher centres cannot induce thermal sweating. (iv) Subjects with spinal cord injury had higher forehead sweat rates (0.77 versus 0.52 mg•cm-2•min-1; P=0.03), but an equivalent sweat sensitivity (1.24 versus 1.27 mg•cm-2•min-1•°C-1; P=0.94), indicating the presence of a peripheral adaptation to sustain thermal homeostasis, and secondary to reduced thermal afferent and efferent flow. (v) Respiratory frequency increased more for a given increase in body temperature in subjects with spinal cord injury (2.4 versus 1.1 breaths•min-1•°C-1; P=0.042), but this did not provide a thermoregulatory benefit. (vi) Subjects with spinal cord injury demonstrated greater changes in behavioural thermoregulatory indicators (thermal sensation and discomfort) in response to standardised local and whole-body thermal loads. Collectively, these observations indicate the unique nature of thermoregulation in people with spinal cord injury and the adaptive ability of the human thermoregulatory system.

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17

Vesterlund, Erik. "Adaptation and Design of a Marine Vehicle for Disabilities." Thesis, Luleå tekniska universitet, Institutionen för ekonomi, teknik och samhälle, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:ltu:diva-62672.

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This report is the result of the master thesis project in Industrial Design engineering (IDE), performed at Luleå University of Technology, by Erik Vesterlund. The task was to produce a conceptual belly boat design that enables individuals paralyzed in the lower extremities to use, propel, maneuver, assemble and use a belly boat. The initial stage included a pre-study of identifying and clarifying what the most common causes of paralyzation of the lower extremities originates from as well as finding the correct terms and what challenges they may include. It was discovered that there are many different causes and effects. Paraplegic are individuals who are unable to move, control or feel their legs depending on the severity of the injury. Quadriplegic individuals are unable to move, control or feel the entire of their body below their shoulders, depending on the severity of the injury. After the causes and effects were mapped, the challenges had to be identified. This was done through tests, interviews, literature studies and participant observations with individuals that are living with these types of injuries. Different problems and needs were mapped, and the most crucial to the usage of a belly boat was identified as the propelling and maneuvering of the craft. Safety aspects were also looked into and documented in order to ensure that the concept was safe for the users. Thereafter, a variety of methods were used in order to generate multiple ideas of how the identified problems and needs could be solved. The generated ideas were formulated and composed into complete solutions in the concept generating phase. The less good solutions were filtered out with the help of an evaluation matrix, and the good solutions were framed into different over-all concepts. Those were graded in a concept scoring matrix and composed into the final concept. The final concept fulfills the overall objectives and aims of the project, and also exceeds some of them, like allowing fully functional individuals to share the craft with Para- and quadriplegics, and without looking as equipment for individuals with disabilities. This broadens the market potential and increases the realization possibilities of a production, hence making the dream of assistance free wilderness adventures for Para- and quadriplegics all over the world, a reality.
Denna rapport är resultatet av ett examensarbete i Teknisk design, utfört vid Luleå tekniska universitet av Erik Vesterlund. Uppgiften var att ta fram en konceptuell båt design, som gör det möjligt för individer som är förlamade i de nedre extremiteterna att använda, driva, manöverera och använda en båt. I inledningsskedet genomfördes en förstudie för att identifiera och tydliggöra vad de vanligaste orsakerna till förlamning i de nedre extremiteterna, samt att ta reda på vilka utmaningar det omfattar. Det upptäcktes att det finns många olika orsaker och effekter. Paraplegi är individer som inte kan röra sig, kontrollera eller känna sina ben, beroende på hur allvarlig skadan är. Tetraplegi är individer som inte kan röra sig, styra eller känna hela sin kropp under sina axlar, beroende på hur allvarlig skadan är. Efter det att orsaker och effekter kartlagts, hade utmaningarna identifierats. Detta gjordes även genom tester, intervjuer, litteraturstudier och deltagande observationer med personer som lever med dessa typer av skador. Olika problem och behov kartlades, och den mest avgörande för användningen av en båt identifierades som framdrivning och manövrering av båten. Säkerhetsaspekter undersöktes och dokumenteras i syfte att säkerställa att konceptet var säkert för användarna. Därefter användes en mängd olika metoder för att generera flera idéer om hur de identifierade problemen och behoven skulle kunna lösas. De genererade idéer gestaltades i form av olika lösningar. De mindre bra lösningarna filtrerades bort, med hjälp av en utvärderingsmatris, och de goda lösningarna gestaltades i olika helhetskoncept. De graderades sedan i en konceptmatris och resulterade i det slutliga konceptet. Det slutgiltiga konceptet uppfyller det övergripande syftet och målen för projektet, och överträffar också några av dem, som att tillåta att fungerande individer delar båten med para- och quadriplegics, samt att konceptet inte ser ut som utrustning för personer med funktionshinder. Detta vidgar den potentiella marknaden och ökar realiseringsmöjligheterna, och bidrar därför till att drömmen om ett vildmarksäventyr för Para- och quadriplegics över hela världen, kan bli verklighet.

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Aare, Sudhakar Reddy. "Intensive Care Unit Muscle Wasting : Skeletal Muscle Phenotype and Underlying Molecular Mechanisms." Doctoral thesis, Uppsala universitet, Klinisk neurofysiologi, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-180374.

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Acute quadriplegic myopathy (AQM), or critical illness myopathy, is a common debilitating acquired disorder in critically ill intensive care unit (ICU) patients characterized by generalized muscle wasting and weakness of limb and trunk muscles. A preferential loss of the thick filament protein myosin is considered pathognomonic of this disorder, but the myosin loss is observed relatively late during the disease progression. In attempt to explore the potential role of factors considered triggering AQM in sedated mechanically ventilated (MV) ICU patients, we have studied the early effects, prior to the myosin loss, of neuromuscular blockade (NMB), corticosteroids (CS) and sepsis separate or in combination in a porcine experimental ICU model. Specific interest has been focused on skeletal muscle gene/protein expression and regulation of muscle contraction at the muscle fiber level. This project aims at improving our understanding of the molecular mechanisms underlying muscle specific differences in response to the ICU intervention and the role played by the different triggering factors. The sparing of masticatory muscle fiber function was coupled to an up-regulation of heat shock protein genes and down-regulation of myostatin are suggested to be key factors in the relative sparing of masticatory muscles. Up-regulation of chemokine activity genes and down-regulation of heat shock protein genes play a significant role in the limb muscle dysfunction associated with sepsis. The effects of corticosteroids in the development of limb muscle weakness reveals up-regulation of kinase activity and transcriptional regulation genes and the down-regulation of heat shock protein, sarcomeric, cytoskeletal and oxidative stress responsive genes. In contrast to limb and craniofacial muscles, the respiratory diaphragm muscle responded differently to the different triggering factors. MV itself appears to play a major role for the diaphragm muscle dysfunction. By targeting these genes, future experiments can give an insight into the development of innovative treatments expected at protecting muscle mass and function in critically ill ICU patients.

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Llano-Diez, Monica. "Mechanisms Underlying Intensive Care Unit Muscle Wasting : Intervention Strategies in an Experimental Animal Model and in Intensive Care Unit Patients." Doctoral thesis, Uppsala universitet, Klinisk neurofysiologi, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-173466.

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Critically ill patients admitted to the intensive care unit (ICU) commonly develop severe muscle wasting and weakness and consequently impaired muscle function. This not only delays respirator weaning and ICU discharge, but has deleterious effects on morbidity, mortality, financial costs, and quality of life of survivors. Acute Quadriplegic Myopathy (AQM) is one of the most common neuromuscular disorders underlying ICU muscle wasting and paralysis, and is a consequence of modern intensive care interventions, although the exact causes remain unclear. Muscle gene/protein expression, intracellular signalling, post-translational modifications, muscle membrane excitability, and contractile properties at the single muscle fibre level were explored in order to unravel the mechanisms underlying the muscle wasting and weakness associated with AQM and how this can be counteracted by specific intervention strategies. A unique experimental rat ICU model was used to address the mechanistic and therapeutic aspects of this condition, allowing time-resolved studies for a period of two weeks. Subsequently, the findings obtained from this model were translated into a clinical study. The obtained results showed that the mechanical silencing of skeletal muscle, i.e., absence of external strain (weight bearing) and internal strain (myosin-actin activation) due to the pharmacological paralysis or sedation associated with the ICU intervention, is likely to be the primary mechanism triggering the preferential myosin loss and muscle wasting, features specifically characteristic of AQM. Moreover, mechanical silencing induces a specific gene expression pattern as well as post-translational modifications in the motor domain of myosin that may be critical for both function and for triggering proteolysis. The higher nNOS expression found in the ICU patients and its cytoplasmic dislocation are indicated as a probable mechanism underlying these highly specific modifications. This work also demonstrated that passive mechanical loading is able to attenuate the oxidative stress associated with the mechanical silencing and induces positive effects on muscle function, i.e., alleviates the loss of force-generating capacity that underlie the ICU intervention, supporting the importance of early physical therapy in immobilized, sedated, and mechanically ventilated ICU patients.

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Castro, Anita Weigand de. "Efeito da radioterapia na profilaxia da ossificação heterotópica em pacientes com lesão medular traumática." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/5/5140/tde-15062009-162618/.

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O objetivo deste trabalho foi estudar o efeito da radioterapia na profilaxia da ossificação heterotópica (OH) em pacientes com lesão medular traumática. Foram estudados 19 pacientes (15 homens e quatro mulheres), média de idade de 30,4 ± 10,8 anos (19 a 58 anos), com lesão medular traumática. A causa mais freqüente da lesão medular foi acidente de trânsito (42,1%), seguida por queda (26,3%), ferimento por projétil de arma de fogo (21%), mergulho (5,3%) e queda de objeto sobre as costas (5,3%). Dez pacientes eram tetraplégicos (52,6%) e nove (47,4%) eram paraplégicos. Apresentavam lesão medular completa (Frankel A) 14 pacientes (73,7%) e cinco pacientes (25,3%) tinham lesão incompleta (Frankel B). Todos os pacientes incluídos no estudo realizaram cintilografia óssea inicial até um mês após o traumatismo raquimedular e apresentaram diagnóstico negativo para OH. Os pacientes foram divididos em dois grupos: nove pacientes receberam radioterapia em dose única de 8 Gy nos quadris (Grupo Estudo) e 10 pacientes compuseram o Grupo Controle. Após seis meses de seguimento clínico e radiológico, um paciente do Grupo Estudo (11%) e cinco pacientes do Grupo Controle (50%) apresentaram OH. A distribuição da freqüência do desenvolvimento da OH nos dois grupos não mostrou diferença estatística significante, apesar da menor incidência de OH no grupo submetido à radioterapia (Grupo Estudo). Concluiu-se que, com o número de pacientes estudados, não foi possível comprovar a eficácia da radioterapia na prevenção da ossificação heterotópica, ainda que haja uma forte tendência para a correlação estatística
The goal of this study was to evaluate the effect of radiotherapy on the prophylaxis of heterotopic ossification (HO) after spinal cord injury (SCI). Nineteen SCI patients were studied (15 men and four women). The mean age was 30.4 ± 10.8 years (range 19 to 58 years). The most frequent causes of lesion were traffic accident (42.1%), fall (26.3%), shot gun (21%), diving (5.3%) and objects falling on the vertebral column (5.3%). Ten patients were tetraplegics (52.6%) and nine were paraplegics. Fourteen patients (73.7%) had complete lesion (Frankel A) and five had incomplete lesion (Frankel B). All patients realized initial scintigraphy until one month after SCI and showed negative results for HO. The patients were randomized in two groups: nine patients received single dose irradiation with 8 Gy on the hips (Study Group) and 10 patients were the Control Group. After six months of clinical and radiological follow up, one patient of the Study Group (11%) and five patients of Control Group (50%) showed HO. The frequency distribution of the development of HO in both groups showed no significant statistical difference, although there was lower incidence of HO in the radiotherapy group. We concluded that, with the number of patients studied, it was no possible to prove the efficacy of radiotherapy to prevent HO, although had a strong tendency for the statistical correlation

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Surdilovic, Tihomir. "Fuzzy Mouse Cursor Control System for Computer Users with Spinal Cord Injuries." Digital Archive @ GSU, 2006. http://digitalarchive.gsu.edu/cs_theses/49.

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People with severe motor-impairments due to Spinal Cord Injury (SCI) or Spinal Cord Dysfunction (SCD), often experience difficulty with accurate and efficient control of pointing devices (Keates et al., 02). Usually this leads to their limited integration to society as well as limited unassisted control over the environment. The questions “How can someone with severe motor-impairments perform mouse pointer control as accurately and efficiently as an able-bodied person?” and “How can these interactions be advanced through use of Computational Intelligence (CI)?” are the driving forces behind the research described in this paper. Through this research, a novel fuzzy mouse cursor control system (FMCCS) is developed. The goal of this system is to simplify and improve efficiency of cursor control and its interactions on the computer screen by applying fuzzy logic in its decision-making to make disabled Internet users use the networked computer conveniently and easily. The FMCCS core consists of several fuzzy control functions, which define different user interactions with the system. The development of novel cursor control system is based on utilization of motor functions that are still available to most complete paraplegics, having capability of limited vision and breathing control. One of the biggest obstacles of developing human computer interfaces for disabled people focusing primarily on eyesight and breath control is user’s limited strength, stamina, and reaction time. Within the FMCCS developed in this research, these limitations are minimized through the use of a novel pneumatic input device and intelligent control algorithms for soft data analysis, fuzzy logic and user feedback assistance during operation. The new system is developed using a reliable and cheap sensory system and available computing techniques. Initial experiments with healthy and SCI subjects have clearly demonstrated benefits and promising performance of the new system: the FMCCS is accessible for people with severe SCI; it is adaptable to user specific capabilities and wishes; it is easy to learn and operate; point-to-point movement is responsive, precise and fast. The integrated sophisticated interaction features, good movement control without strain and clinical risks, as well the fact that quadriplegics, whose breathing is assisted by a respirator machine, still possess enough control to use the new system with ease, provide a promising framework for future FMCCS applications. The most motivating leverage for further FMCCS development is however, the positive feedback from persons who tested the first system prototype.

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Othero, Marilia Bense. "Produção do cuidado a pacientes com condições neurológicas muito graves: contribuições interdisciplinares para uma fundamentação teórica." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/5/5137/tde-04112016-145454/.

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A assistência aos pacientes com doenças neurológicas de longa duração não é reconhecida na produção científica brasileira; entende-se por doença neurológica de longa duração: doenças neurológicas de curso longo, fase final de difícil identificação, com sintomas variados e condição de dependência moderada ou grave e comprometimento cognitivo de difícil avaliação. Neste estudo, foram consideradas as seguintes condições: estado vegetativo persistente, estado mínimo de consciência e síndrome do encarceramento (ou síndrome de locked-in). Em busca bibliográfica, verificou-se que não há artigo em língua portuguesa sobre o tema. No cotidiano, a assistência é focada em higiene e observação clínica. Entretanto, na perspectiva do Cuidado, algo mais é necessário ao se pensar este tipo de prática, para a promoção da dignidade humana. Os objetivos deste estudo são: relatar uma prática junto a pessoas com doenças neurológicas de longa duração focada no seu resgate biográfico, e fundamentar a mesma de maneira interdisciplinar, a partir do Cuidado como categoria reconstrutiva. É uma pesquisa qualitativa, na qual foram utilizados primariamente registros de um diário de campo da primeira autora, sobre intervenções em Terapia Ocupacional com esta população; a partir destes, foram produzidas narrativas e reflexões sobre a metodologia de intervenção. A partir do resgate biográfico, busca-se resgatar a condição de sujeito do paciente neurológico muito grave. Na segunda etapa, tem-se a fundamentação teórica numa perspectiva interdisciplinar; o conceito de Cuidado é a referência principal, compreendido como o sentido existencial da experiência de adoecimento. Também foi utilizado o referencial da psicanálise de orientação freudiana e lacaniana para aprofundamento teórico dos achados empíricos descritos através de narrativas. A reconstrução da biografia do paciente ocorre por diversas perspectivas, mas especialmente pela estimulação sensorial - não com foco de recuperação neurológicas, mas a partir do repertório do paciente e em busca da validação de sua condição de sujeito. Junto com uma detalhada avaliação e acompanhamento, o terapeuta faz um monitoramento contínuo, propondo atividades e dando especial atenção ás reações observadas, para que possa nomeá-las ou traduzi-las, bem como discriminar os estímulos agradáveis e desagradáveis; isto também possibilita ampliação das possibilidades de encontro deste sujeito com o mundo. Os conceitos psicanalíticos: estágio do espelho, real, lalíngua e constituição do sujeito apresentam-se como fundamentais para a compreensão das experiências empíricas vividas e, posteriormente, elaboração de uma fundamentação teórica. Memória, história, identidade, dignidade e subjetividade qualificam a prática junto a pessoas com doenças neurológicas de longa duração. A despeito das reações neurológicas apresentadas, tal prática possibilita a reconstrução de um cotidiano significativo e as teorias psicanalíticas de orientação freudiana e lacaniana constituem importante marco para fundamentação da reconstrução da assistência
The care of people with Long Term Neurological Conditions (LTNC) isn´t recognized in the Brazilian Palliative Care scientific production; in daily basis, the assistance is focussed on hygiene´s care and clinical observation. However, from the perspective of palliative care, something more is needed, to promote the dignity of the human person. To describe an occupational therapy intervention for patients with LTNC based on biographical rescue. Records and field diaries of an Occupational Therapy intervention promoted by the first author were used to produce narratives and reflections about this intervention´s methodology. The concept of Comprehensive Care is the main reference, designed as care interested in the existential sense of the illness process. It was also used the framework of Freud´s and Lacan´s psychoanalysis for theoretical studies of the empirical findings reported through narratives. The beginning of the reconstruction of the patient´s biography occurs by several perspectives, especially through sensory stimuli related to prior patient´s occupational repertoire. Along with the detailed evaluation, the therapist does a careful and continuous monitoring, proposing activities, giving special attention to their reactions, being able to discriminate what pleases or not, and expanding the possibilities of encounter of people with LTNC and the environment which surround them. The psychoanalytic concepts: mirror stage, real, lalangue and subject´s constitution had major importance to understand the empirical experiences and to develop a theoretical basis. Memory, history, identity, dignity, and subjectivity qualify the practice of occupational therapist with people with LTNC. Regardless of neurological reactions presented by the patients this practice helps reconstructing the meanings of the daily life of person with so severe disability. Sensory stimuli are shown as potential tools for a reconfiguration of the assistance with someone seriously affected by a neurological disease. Psychoanalytic theories of Freudian and Lacanian orientation are also an important framework for the reconstruction assistance

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Freitas, Juliana Viana. "As redes sociais de indivíduos com tetraplegia: mudanças e permanências." Universidade Catolica de Salvador, 2014. http://ri.ucsal.br:8080/jspui/handle/123456730/206.

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O presente estudo visa analisar a composição e a recomposição das redes sociais de indivíduos tetraplégicos crônicos após lesão medular adquirida; mas também, mapear as tensões e os paradoxos que emergem da situação de completa dependência do auxílio de outras pessoas para garantir a sua sobrevivência. A pesquisa se inscreve no campo da investigação qualitativa.Os participantes foram quatro pessoas com tetraplegia atendidas em uma Clínica Escola de Fisioterapia na cidade de Salvador-BA, e, o cuidador principal de cada uma delas, totalizando oito entrevistados. Foram incluídos no estudo portadores de tetraplegia secundária a traumatismo raquimedular e classificada como ASIA A; que tivessem pelo menos um ano de lesão; com idade superior a 18 anos; do sexo masculino; e, que tivessem sido acompanhados pela pesquisadora em algum momento da sua trajetória de reabilitação. Foram excluídos da pesquisa aqueles cuja lesão medular fosse de origem congênita, perinatal ou ainda adquirida na infância. No que tange aos cuidadores, os mesmos foram eleitos com base na análise da narrativa das pessoas com tetraplegia, através da identificação daqueles que assumissem a maior parcela das atividades e responsabilidades relativas ao seu cuidado. A coleta foi orientada por uma postura etnográfica e os dados foram obtidos com base nas narrativas biográficas dos indivíduos selecionados e através de entrevistas guiadas por roteiros semiestruturados elaborados pelas pesquisadoras. A análise das mudanças e permanências das redes sociais de apoio de tetraplégicos realizada nesse estudo mostrou ser um instrumento capaz de permitir uma melhor compreensão das dinâmicas de cuidado adotas em situação de alta dependência. Principalmente por ter possibilitado a contextualização dos eventos mais marcantes, em principal a tetraplegia, no decorrer da história de vida de cada um. Da mesma forma, evidenciou que a presença de uma rede social, mesmo que esvaziada e fragilizada, é determinante na adoção de estratégias positivas de enfrentamento da tetraplegia. O que não exclui a necessidade de buscar a elaboração de estratégias voltadas a ‘normalização’ dessas redes, que, pelo aumento do tamanho e da diversidade dos laços, poderiam proporcionar menor sobrecarga aos cuidadores e maiores possibilidades de participação social para as pessoas com tetraplegia. Para tal vê-se como indiscutível uma maior presença do Estado no suporte a essas famílias, e também a sensibilização da sociedade no sentido de acolher e não derepudiar a diversidade resultante da deficiência.
The present study aims, on the one hand, to analyze the composition and recomposition of social networks of chronic quadriplegic individuals after spinal cord injury acquired and, on the other hand, mapping the tensions and paradoxes that emerge from the situation of complete dependence on the help of other people to ensure their survival. The research falls into the field of qualitative research and follows an interdisciplinary model of analysis. The research participants were four people with quadriplegia attended in a Physiotherapy Clinic-school in the city of Salvador, Bahia, and also the main caregiver of each one of them, totaling eight interviewees. The study included patients with secondary quadriplegia to spinal cord injury and classified as ASIA A; that had at least one year of injury. All the "cases" analyzed are male, aged over 18. It was excluded from the study those whose spinal cord injury would be of congenital origin, perinatal or even acquired in childhood. In regard to the caregivers, those were elected based on the analysis of the narrative of the people with quadriplegia, through the identification of those who take the biggest share of the activities and responsibilities relating to their care. The swab was guided by an ethnographic posture and the data were obtained based on the biographical narratives of the selected individuals and through interviews guided by semi-structured scripts prepared by the researchers. The analysis of the changes and continuities of social support networks of quadriplegic patients performed in this study proved to be an important methodological path and that allowed a better understanding of the dynamics of care in situations of high dependence. It was evident that the presence of a social network, even if emptied and fragile, is instrumental in the adoption of positive coping strategies of quadriplegia, which does not exclude the need to seek the development of strategies aimed at the 'normalization' of these networks, which, by increasing the size and diversity of the bonds, could provide less burdensome to caregivers and greater possibilities of social participation for people with quadriplegia. It’s undisputed the importance of a bigger presence of the State on supporting these families, as well as the sensitization of society in a way to accept and not to reject the diversity resulting from disability

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Campos, Luis Felipe Castelli Correia de 1987. "Comparação entre métodos para mensuração da potência aeróbia em atletas tetraplégicos = Comparison of methods for aerobic power assessment in athletes with tetraplegia." [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/275106.

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Orientador: José Irineu Gorla
Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação Física
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Resumo: A avaliação da Potência Aeróbia em atletas com tetraplegia, como indicador de limite máximo de tolerância ao exercício aeróbio, é uma importante área de interesse no campo da performance paradesportiva. O presente estudo teve como objetivo comparar as medições direta e indireta do Consumo Pico de Oxigênio (VO2pico) no teste de campo contínuo e incremental Octagon Multi-Stage Test (OMFT) bem como, correlacionar os valores obtidos no teste contínuo e incremental no ciclo-ergometro de braço (EB). Participaram desse estudo 8 atletas tetraplégicos praticantes de Rugby em cadeira de rodas. Os atletas inicialmente realizaram a avaliação antropométrica para o cálculo do índice de massa corporal (IMC) e percentual de gordura (%G) em seguida foram submetidos ao teste de campo incremental (OMFT) com a utilização do analisador de gás portátil K4b2 Cosmed para mensuração direta do VO2pico. Após 72 horas os mesmos atletas realizaram o teste contínuo e incremental no EB para obtenção dos valores de VO2pico. Pré e pós-testes foram mensurados os valores de Frequência Cardíaca (FC), Concentração de Lactato ([Lac]), Consumo de Oxigênio (VO2) e percepção Subjetiva de Esforço (PSE). Além disso, no teste de campo (OMFT) foram coletados os dados de distância total percorrida, estágio final e número de voltas realizadas variáveis para mensuração indireta do VO2pico. Para os valores de VO2pico, observou-se que no EB os valores de média do grupo foi de 17,8±6 ml/kg/min, enquanto que para o teste OMFT foram de 21,9±5,2ml/kg/min pela mensuração direta e 24,8±3,3ml/kg/min para a mensuração através da equação de predição pré-estabelecida, a FCmax foi de 129,1±24bpm no EB e de 127,8±26bpm no OMFT. Já a PSE foi de 8,2±1,03 no EB e de 6,5±2,2 no OMFT. Através do calculo de correlação entre as mensurações de VO2pico, observou-se alta correlação (r=0.86) entre as mensuração do OMFT direta e indireta com nível de significância de p<0.05 e através do teste de Bland-Altman foi observada a concordância entre os métodos com LIC95% variando de -2,8 a 8,5. O teste OMFT apresenta validade para mensuração da Potência Aeróbia em atletas com tetraplegia, porém, observa-se a necessidade de reajustes no protocolo para que os resultados encontrados sejam de fato mais próximos à realidade dos atletas com tetraplegia, possibilitando maior controle dos resultados obtidos e a prescrição da intensidade de exercícios, evitando assim, lesões devido à sobrecarga do treinamento
Abstract: Evaluation of Aerobic Power in Spinal Cord Injury athletes as an indicator of maximum aerobic exercise tolerance is an important area of interest of sports performance. The present study aimed to compare the direct and indirect measurements of peak oxygen consumption (VO2peak) in field testing continuous and incremental Octagon Multi-Stage Test (OMFT) and to correlate the values obtained in the test continuous incremental in cycle-arm ergometer (EA). Eight athletes of the Wheelchair Rugby participated in this study. These athletes initially underwent anthropometric measurements for calculating the Body Mass Index (BMI) and percent body fat (%BF). After were submitted to field test (OMFT) with the use of portable gas analyzer K4b2 Cosmed for measurement direct of the VO2peak. After 72 hours the same athletes performed the test continuous incremental in EA to obtain the values of VO2peak. Pre and post-test values have been measured heart rate (HR), lactate concentration ([Lac]), oxygen consumption (VO2) and perceived exertion (PE). Moreover, the field test (OMFT) data were collected from total distance traveled, stage, and number of turns. Variables to measurement indirect of VO2 peak. For the VO2peak values, it was observed that the values of the EA group mean was 17.8 ± 6ml/kg/min, whereas for the test OMFT were 21.9 ± 5.2 ml/kg/min by direct measurement and 24.8 ± 3.3 ml/kg/min for measurement prediction equation by pre-established, HRmax was 129.1 ± 24bpm in EA and 127.8 ± 26bpm in OMFT. Already the PSE was 8.2±1.03 in EA and 6.5±2.2 in OMFT. By calculating the correlation between the measurements of VO2peak, there was a high correlation (r = 0.86) between the measurement of direct and indirect OMFT with a significance level of p <0.05 and by Bland-Altman concordance was observed between methods with varying LIC95% from -2.8 to 8.5. The OMFT shows validity for measuring Aerobic Power in athletes with tetraplegia; however, there is a need for adjustments in the protocol so that the results are actually closer to the reality of athletes with tetraplegia, enabling greater control of the results and prescription of exercise intensity, thus avoiding injury due to overload training
Mestrado
Atividade Fisica Adaptada
Mestre em Educação Física

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Flores, Lucinar Jupir Forner 1980. "Avaliações autonômicas e cardiovasculares em pessoas com lesão da medula espinhal nas situações de repouso, em um teste de estresse mental e durante exercício físico." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/275029.

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Orientador: José Irineu Gorla
Tese (doutorado) ¿ Faculdade de Educação Física, Universidade Estadual de Campinas
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Resumo: O objetivo do presente estudo foi avaliar as respostas autonômicas e cardiovasculares em pessoas com lesão da medula espinhal (PLME) praticantes de Rugby em Cadeira de Rodas (RCR) em diferentes situações. A amostra foi composta de dez (10) tetraplégicos do sexo masculino com média de idade de 29,6 ± 6,5 anos. As coletas foram realizadas na UNICAMP, com a aprovação do Comitê de Ética em Pesquisa sob-protocolo nº 276/2010. Foram realizadas avaliações antropométricas. A potência aeróbia (PA) foi estimada por um teste máximo de quadra com duração de 12 minutos. A Pressão arterial (PAS) verificada pelo método auscultatório e o registro da variabilidade da PAS (VPAS) através do equipamento Finometer® (Finapress©). Avaliações da VFC foram realizadas com os sujeitos sentados nas cadeiras próprias (repouso, estresse mental e exercício). O Stroop Test foi utilizado como teste de estresse mental (TEM). Para o registro de informações da VFC foi usado o frequencímetro modelo RS800CX-POLAR© e posteriormente foi utilizado o software da Polar© para análise dos dados. Os dados foram apresentados em média±desvio padrão. Para análise estatística foi utilizado o software INSTAT®. Valores de p<0,05 foram considerados significativos para diferenças entre situações de avaliação. O tempo de lesão medular foi de 7,5 ± 4,1 anos. Quanto à massa corporal e estatura dos sujeitos, foi verificada média de 64,5 ± 6,2 kg e 1,75 ± 0,09 m. O índice de massa corporal foi de 21 ± 1,4 kg/m2. Já o percentual de gordura (DXA) foi de 21± 5,4%. O valor médio da distância percorrida no teste de 12 min, para a estimativa da PA foi de 1579,5 ± 439,1 m. O valor médio para a PA estimada correspondeu a 18,03 ± 8,1 ml/kg/min-1. Valores de FC e PAS foram significativamente maiores ao final do teste de 12 min quando comparados aos valores de repouso e recuperação. Resultados de FC ao longo do teste de estresse mental revelaram-se maiores que os valores de FC iniciais do registro. A PAS não apresentou diferenças entre as avaliações de repouso e estresse mental, assim como os valores de VFC não apresentaram diferenças significativas nestas situações. Valores do balanço autonômico da VFC também não apresentaram diferenças quando comparado valores iniciais e no teste de estresse mental (BF, AF e BF/AF). Já em exercício a VFC apresentou diferenças, assim como os valores de BF, AF e BF/AF quando comparado aos valores pré e pós exercício. A VPAS apresentou-se reduzida pós exercício físico, assim como a PASist e o índice de BF quando comparados aos valores pré exercício físico. Estes resultados indicam que a amostra estudada apresenta potência aeróbia dentro da normalidade para esta população. O % de gordura foi menor do que outros estudos com tetraplégicos. Ocorreram alterações durante o exercício físico nos componentes da VFC e VPAS semelhantes aos de outros estudos com tetraplégicos - (repouso x TEM x pós exercício físico). Há indícios de menores prejuízos neste grupo estudado em relação aos danos no controle autonômico da circulação, provavelmente por esta amostra participar de programa de treinamento físico
Abstract: The purpose of this work was to evaluate the autonomic and the cardiovascular responses in people with spinal cord injury (PLME) the players of Wheelchair Rugby (RCR) in different situations. The sample was composed of ten (10) tetraplegics male. The samples were collected in Campinas, with the approval of the Committee of Ethics in the Research with the protocol 276/2010. In this work was performed anthropometric evaluation. The aerobic power (AP) was estimated by a max court test that didn't exceed 12 minutes. The blood pressure (BP) verified by auscultation and registration of the BP variability (BPV) through an equipment called Finometer® (Finapress©).The evaluation of heart rate variability (HRV) were made with the individuals sitting on their chairs (rest, mental stress test and exercise). The Stroop Test was used as a test of mental stress. For recording of information of the HRV was used frequency counter model RS800CX-POLAR© and afterward was used Polar© software for data analysis. The data were expressed as average±standard deviation. To the statistical analysis was performed using the INSTAT® software. p values<0.05 were considered statistically significant differences between the situations of evaluation. The average age of the individuals was 29.6 ± 6.5 years old and the time of spinal cord injury was 7.5± 4.1 years. As for weight and height of them, there was an average of 64.5 ± 6.2 kg and 1.75 ± 0.09 m. The body mass index was 21 ± 1.4 kg/m2. The fat percentage (DXA) was 21 ± 5.4%. Results revealed that the test for 12 min, the distance rode to the PA estimate was 1579.5 ± 439.1 m. It was verified that the estimated value of AP is 18.03 ± 8.1 ml/kg/min-1. The HR and the BP values were significantly higher at the end of the test 12 min when compared to the values of resting and recovery. The results of FC along the mental stress test, proved to be larger than the values of initial HR of the record. The BPV did not show differences between the evaluations of rest and mental stress, as well as the values of HRV were not significantly different in these situations. Values of the autonomic balance of the HRV also showed no differences when compared to initial values and mental stress test (LF, AF e LF/HF). In the exercise the HRV presented discrepancies as well as the heart rate variability showed differences as well as the values of LF, HF e LF/HF when compared to pre and post exercise. The VBP presented the reduced as well as SBP and the values of BF compared before and after exercise. These results indicate that the sample presents aerobic power within the normal range for this population. The percentage of fat was lower than other studies with tetraplegics. Changes during exercise in HRV components and BPV similar to other studies with tetraplegics - (resting x TEM x post exercise). We can still consider that exist evidence of minor damage in relation to damage to the autonomic control of circulation, probably because this sample participate in physical training program
Doutorado
Atividade Fisica, Adaptação e Saude
Doutor em Educação Física

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Monageng, Selina Nonkambule. "Tetraplegia The psychosocial problems encountered by black patients once discharged from the hospital /." Diss., Pretoria : [s.n.], 2007. http://upetd.up.ac.za/thesis/available/etd-11052007-121604.

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Varoto, Renato. "Desenvolvimento e avaliação de um protótipo de sistema híbrido para membro superior de tetraplégicos." Universidade de São Paulo, 2010. http://www.teses.usp.br/teses/disponiveis/18/18152/tde-09062010-100922/.

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Em geral, indivíduos com disfunções motoras nos membros superiores apresentam dificuldades para executar a movimentação de objetos, a qual é essencial para a execução das atividades de vida diária. Dessa forma, esses indivíduos não a executam ou a fazem de maneira ineficiente. Para que essa manipulação seja realizada de maneira satisfatória, fazem-se necessários os movimentos de alcance e preensão de objetos controlados voluntariamente pelo indivíduo, e também a aquisição sensorial da força empregada durante a preensão. Portanto, este trabalho apresenta o desenvolvimento, a aplicação e a avaliação de um protótipo de sistema híbrido visando à reabilitação parcial da capacidade sensório-motora do membro superior direito de tetraplégicos. Tal sistema engloba uma órtese dinâmica para cotovelo utilizada em conjunto com a estimulação elétrica neuromuscular, e uma luva instrumentada que possibilita a realimentação qualitativa da força de preensão. Os resultados das avaliações clínicas mostraram que o sistema auxilia os tetraplégicos em tarefas que envolvem o alcance e a preensão de objetos, bem como trazê-los para próximo do corpo. O aumento da faixa de alcance, a geração de preensão e a restauração artificial da habilidade de movimentar um objeto para próximo do corpo representam esse auxílio proporcionado pelo sistema. Assim o protótipo de sistema híbrido representa uma estratégia alternativa para a reabilitação de lesados medulares (níveis C5-C6).
Generally, individuals with motor impairments in the upper limbs have difficulties performing the movement of objects, which is essential for the execution of activities of daily living. Thus, these individuals do not perform these activities or perform them inefficiently. Toward satisfactory manipulation, reach and grasp movements of objects performed with voluntary control, and grasp force feedback are necessary. Therefore, this work presents the development, application and evaluation of a hybrid system prototype aiming at partial rehabilitation of sensory-motor ability of quadriplegic\'s right upper limb. Such system includes an elbow dynamic orthosis combined with neuromuscular electrical stimulation, and an instrumented glove that allows the qualitative grasp force feedback. The results of clinical assessment showed that the system aids quadriplegic in tasks that involve reaching and grasping of objects, as well as bringing them close to the body. The improvement of reaching range, grasping generation and artificial restoration of the ability to move an object close to the body represent this aid provided by the system. Thus, the hybrid system prototype represents an alternative strategy for the rehabilitation of individuals with spinal cord injury (C5-C6 level).

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Santos, Ana Paula Coelho Machado dos. "Análise da função diafragmática após a intervenção da estimulação elétrica transcutânea em pacientes tetraplégicos." Universidade Tecnológica Federal do Paraná, 2009. http://repositorio.utfpr.edu.br/jspui/handle/1/363.

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Capes
A tetraplegia é uma lesão na medula espinhal, que compromete o tronco, os membros superiores e inferiores e músculos respiratórios. Nas lesões completas, a função motora e sensorial abaixo do nível da lesão apresenta-se comprometida. Nas lesões incompletas ou parciais, ocorre a preservação da função motora e sensitiva, não havendo padrões definidos de recuperação. A estimulação elétrica já vem sendo utilizada para indução respiratória diafragmática. Neste trabalho, foram avaliados 10 indivíduos tetraplégicos, de ambos os sexos, na faixa etária de 18 á 48 anos, durante 10 sessões onde foram aplicados anamnese, avaliação inicial constando sinais vitais, cintometria, manovacuometria, oximetria, avaliação do nível da lesão, e a avaliação do déficit motor e respiratório. Aplicaram-se dois métodos utilizando o sistema de Eletroestimulação sincronizada: o primeiro com sincronização manual, FESSM (Estimulação Elétrica Funcional) e o segundo, usando o MD2, com sincronização automática. A função muscular do Diafragma foi avaliada antes e depois das aplicações de estimulação elétrica, cuja intenção era potencializar a ação, possibilitando um melhor recrutamento muscular e, conseqüentemente, uma melhor reeducação muscular respiratória. Quanto a análise comparativa entre os métodos, após a intervenção com equipamento I observou-se melhores resultados em relação aos parâmetros sinais vitais e manovacuômetria. Com a intervenção do equipamento II, observou-se melhores resultados nos parâmetros oximetria e grau de dispnéia. O equipamento I apresentou resultados satisfatórios em relação a função do sistema digestório, principalmente em pacientes com lesão medular incompleta.
The tetraplegia is an injury in the spinal cord that compromises the motor and sensitive systems commanded by the spinal cord below of that damage level. Respiratory muscles are compromises too. In complete injuries, motor and sensorial function completely damaged. In the incomplete or partial injuries, motor and sensitive function occurs, but no recovery pattern is known. The electric stimulation is used nowadays for respiratory induction. In this work, 10 tetraplegic patients had been evaluated, both gender, ages range from 18 to 48 years, during 10 sessions where anamneses were applied. Vital signals motor respiratory disfunction, and injury level were evaluated. The system of synchronized electrostimulation was applied using two methods: the first one with manual synchronization; FESSM; and the second one, using the MD2, with automatic synchronization. The muscular function of the Diaphragm was evaluated before and after the applications of electrostimulation. The comparative analysis between the two methods, had shown better results after the intervention with equipment I regarding the parameters and vital signs of manovacuometry. With the intervention of equipment II, it was observed better results in the pulse parameters and degree of dyspnea. The equipment I had shown satisfactory results for the function of the digestive system, especially in patients with incomplete spinal cord injury.

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Singer, Mathew Kyle. "Self powered wrist extension orthosis." Thesis, University of Canterbury. Mechanical Engineering, 2006. http://hdl.handle.net/10092/1154.

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One of the most devastating effects of tetraplegia is the inability to grasp and manipulate everyday objects necessary to living an independent life. Currently surgery is widely accepted as the solution to improve hand functionality. However, surgery becomes difficult when the user has paralysed wrists as is the case with C5 tetraplegia. The aim of this research was to develop a solution which provided controlled wrist flexion and extension which, when combined with surgery, achieves a 'key pinch' grip. This particular grip is critically important for people with C5 tetraplegia as it is used for countless grasping activities, necessary on a day-to-day basis. A systematic design process was used to evolve the solution to provide controlled wrist flexion and extension. Concept brainstorming identified four alternative solutions which were evaluated to find the preferred concept. The chosen solution was called the Self Powered Wrist Extension Orthosis, more commonly referred to as the 'orthosis'. This concept contained a shoulder harness which provided both energy and control to the wrist harness, which in turn changed the wrist position. The orthosis was developed with the use of a mathematical model which theoretically predicted the functional performance by comparing the required force needed to move the wrist harness to the achievable force supplied by the user's shoulders. Using these parameters, the orthosis was optimized using the matlab Nelder-Mead algorithm which adjusted the wrist harness geometries to maximize the functional performance. A prototype was constructed and tested with the help of two participants who when combined, achieved an average of 18.5° of wrist rotation. The theoretical model however predicted an average range of motion of 28.4°. The discrepancy found between the theoretical and experimental result can be contributed to incorrect assumptions in the theoretical model. This included unaccounted friction and inaccurate modeling of the orthosis dynamics. The feedback from potential users of the orthosis was enthusiastic and encouraging especially towards the simplicity, usability and practicality of the design.

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Bouton, Xavier. "Personne diminuée et personne à part entière : de la mise en oeuvre d'un agir distribué avec le patient atteint de déficience motrice dans un service de Médecine Physique et Réadaptation." Thesis, Lyon, 2017. http://www.theses.fr/2017LYSE2140.

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La thèse porte sur l’accompagnement de patients atteints de déficiences motrices handicapantes soumis à l’épreuve intime de soi à la suite d’une atteinte radicale du corps. Elle repose sur une enquête ethnographique, associant observations et entretiens, menée dans deux structures hospitalières du CHU de Saint-Etienne : le service de Soins de Rééducation Post Réanimation, dit SRPR et, pour une plus grande part, le service de Médecine Physique et Réadaptation, dit MPR. En présentant le travail de « recapacitation » de la personne à l’épreuve d’un nouveau corps devenu « non autonome », la thèse explore le travail relationnel entre les professionnels de santé et le patient au cours des soins et des activités de rééducation fonctionnelle, mais aussi la manière dont sont inclus les proches, afin d’infléchir la perception de la situation de handicap et de construire collectivement un projet acceptable de vie après le séjour en milieu hospitalier. Cette perspective donne à voir la manière dont, face aux fortes contraintes de l’épreuve intime de soi, la parole partagée devient ressource pour faire advenir les interactions et engager ainsi le patient dans la réappropriation intrasubjective de son corps et intersubjective de la continuité de son être. Une place importante est donnée au parcours des patients tétraplégiques, un cas extrême et à part dans la prise en charge des patients en MPR. La thèse présente une chronique du vécu de ces patients particuliers, et montre ainsi la spécificité des « étapes » passées, qui structurent l’expérience du corps « non autonome » et de la personne qui, devenue « dépendante », est incluse dans un collectif d’actants humains – les professionnels de santé, les proches  mais aussi d’objets techniques, au sein duquel son agir est distribué. Le récit rend compte des temps et des moments vécus par ces patients dans ce collectif, au cours d’une prise en charge pouvant se compter en mois, voire en années, en déclinant les activités ordinaires des chambres, celles du plateau technique, celles des réunions de professionnels et enfin celles, exceptionnelles, d’un dispositif de rencontre ad hoc qui réunit un collectif d’anciens patients venus avec leurs conjointes et un patient tétraplégique et sa compagne afin de finaliser le projet de retour de ce dernier dans l’espace social ordinaire
The doctoral thesis focuses on the assistance of functional impaired patients passing throug a personal self experience following a severe physical injury. It is based on an ethnographic inquiry, combining observations and interviews that have been conducted in two hospital services of Saint-Etienne’s UH. The first service is the functional rehabilitation recovery service and, for the major part, the other is the physical medecine and rehabilitation service. In presenting the « recapacitation » work of a person experimenting a new « non autonomous » body, the thesis explores relations between the medical professionals and patients, during the care and functional rehabilitation activities, but also the way in which relatives are included, in order to impact the perception of the handicap situation and to build collectively an acceptable life project after the hospital stay. This perspective reveals how to confront strong constraints of personal self experience by sharing words, this last become as a ressource to bring into the interactions and thus to engage the patient in an intrasubjective reappropriation of his body and an intersubjective continuity of his being. An important place is given to the hospitalization of quadriplegic patients, which is an extreme case and apart in the patient’s care in the physical medecine and rehabilitation service. The thesis presents a chronicle of a lived experience of these particular patients and thus shows the specificity of the process taken place in order to structure the experience of non autonomous body and to the one who has become dependent, and included in a collective composed of human actors  medical professionals, relatives  but also technical objects in which his act is distribued. The narrative takes into consideration the time and the moments experienced by these patients in this collective, during the care which can be counted by months and sometimes by years, by describing the ordinary activities in the rooms, those of the technical installations, those of professional’s meetings, finally and exceptionally a meeting’s structure where a group of former patients come with their spouses and a quadriplegic patient accompanied by his partner, to finalize the project of his return to an ordinary social environment

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Pereira, Cesar Augusto Martins. "Desenvolvimento e avaliação de uma interface homem-computador, com as funções de um \"mouse\", controlada pelo movimento da cabeça para uso em pessoas com deficiências físicas." Universidade de São Paulo, 2009. http://www.teses.usp.br/teses/disponiveis/5/5140/tde-28082009-131552/.

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Os objetivos deste trabalho foram desenvolver um dispositivo apontador, com as mesmas funções de um mouse, controlado pelo movimento da cabeça, e comparar a eficiência do dispositivo proposto, utilizando o controle do cursor do computador no modo absoluto e relativo (joystick), operado por dez indivíduos tetraplégicos e por dez indivíduos sem acometimento neuromuscular. A maioria dos parâmetros estudados apresentou diferença significativa, entre as situações de controle absoluto e relativo, para os indivíduos de ambos os grupos, evidenciando que os parâmetros medidos no modo absoluto foram melhores que os medidos no modo relativo. O dispositivo apontador emula adequadamente as funções de deslocamento do cursor, mostrando que o modo de controle absoluto é mais eficiente que o modo de controle relativo
The objectives of this study were to develop a head controlled pointer device with mouse functions and compare its performance when operated in absolute versus relative (joystick like) modes by ten quadriplegic subjects and ten people without neuromuscular impairment. The device was composed of a video camera, a computer program and a reflective paper target attached to a cap which was then placed on the user´s head. Most of the measured parameters revealed a significant difference between the control modes, favouring the absolute one, for both studied groups. The developed head pointer adequately emulates the computer cursor displacement, with the absolute control mode being functionally more efficient than the relative control mode in this study.

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Shay, Barbara L. "Evaluation of the role of upper limb strength to exercise performance in quadriplegics." 1993. http://hdl.handle.net/1993/9681.

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Leipoldt, E. A. "Good life in the balance a cross-national study of Dutch and Australian disability perspectives on euthanasia and physician-assisted suicide /." 2003. http://portal.ecu.edu.au/adt-public/adt-ECU2006.0010.html.

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Jansen, van Rensburg Johanna Elizabeth. "Ekologies sistemiese faktore wat bydra tot die onafhanklike funksionering van kwadrupleë." Diss., 1995. http://hdl.handle.net/10500/17005.

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Text in Afrikaans
Die ekologiese faktore wat bydra tot die onafhanklikheid van twintig Suid-Afrikaanse kwadruplee is vanuit 'n sistemiese perspektief beskou. ('n Selfontwerpte vraelys en onderhoud is benut). Die kriteria was dat: Hulle 'n betrekking beklee; finansieel selfonderhoudend is; tuis gaan in 'n eie woonplek; 'n voertuig besit wat aan hulle mobiliteitsvereistes voldoen; en van 'n rolstoel gebruik maak. Sekere demografiese faktore staan in 'n positewe vehouding tot onafhanklikheid. F aktore rakende die indiwidu het die meeste waarde vir die instandhouding en ontwikkeling van 'n onafhanklike lewenstyl. Faktore wat verband hou met die sosiale ondersteuningstelsel is van ietwat minder belang. Alhoewel die faktore wat verband hou met die gemeenskap nie heeltemal onbelangrik is nie, het dit deurgaans die minste waarde. Faktore wat verband hou met funksionele aanpassings (versorging; mobiliteit; loopbaanaangeleenthede en finansies; en dermkanaal- en blaasbeheer) was deurgaans van besondere belang. Die belangrikheid van tersiere opleiding; die hoeveelheid hulpmiddels in gebruik; en sport, oefening en ontspanning was minder as wat verwag is.
The ecological factors contributing to the independence of twenty South African quadriplegics were investigated from an systemic perspective. (A self compiled questionnaire and semi-structured interview were used). The criteria for inclusion is: Employment; financial self-support; living in a residences of their own; having a motor vehicle that satisfy their mobility requirements; and reliance on a wheelchair. Certain demographic factors are linked, positively to independence. The factors related to the individual appeared to be the most important factor in developing and maintaining an independent lifestyle. The social support system received a slightly lower value rating. Community factors, while not entirely unimportant, received the lowest ratings throughout the study. The factors regarding functional adaptations ( care; mobility; career issues and finances; and control over bowels and bladder) were in general of great significance. The value of tertiary education; the amount of special aids in use; and sport, exercise and recreation have been less than expected.
Social Work
M.A. (Sosiale Wetenskappe (Geestesgesondheid))

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Zíbarová, Tereza. "Péče o kvadruplegiky v České republice a Velké Británii, pozitiva a negativa z pohledu uživatele." Master's thesis, 2021. http://www.nusl.cz/ntk/nusl-438174.

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The diploma thesis deals with the field of the care after quadriplegics in the Czech Republic and the United Kingdom. The aim of the diploma thesis is to describe positive and negative aspects of the care provided to quadriplegics both in Great Britain and the Czech Republic from the point of view of the care users, and subsequently to propose possibilities of improvement of the care in the Czech Republic. The theoretical part explains quadriplegia and outline social and health systems for quadriplegics in the Czech Republic as well as in the United Kingdom. This part includes the description of compensatory aids available for clients, conditions of health and social insurance, rehabilitation care options and financial support in both countries. In the research part, based on data interpretation of the data collected by qualitative research technique (interviews that were implemented with quadriplegics living the Czech Republic and United Kingdom), I analyze the situation of the clients of both social and health systems. These interviews revealed several areas of positive and negative evaluation of the existing situation and highlight possibilities of potential future improvement of the care in the Czech Republic.

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Chung, Yu-Fung, and 鄭裕峰. "The effects of Seating Positioning on Attention in School Chlidren with Quadriplegic Cerebral Palsy." Thesis, 2007. http://ndltd.ncl.edu.tw/handle/07500592322861064103.

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碩士
國立陽明大學
復健科技輔具研究所
95
Abstract This thesis focuses on two questions: Whether seating positioning has an effect on the attention span of school children with quadriplegic cerebral palsy; and what factor(s) will influence the degree of attention of these school children. Due to lack of proper evaluation tools to gauge these children’s degree of attention, an evaluation form was first established. Then, using these as the dependent variables, the experiment with seating positioning as the independent variable was conducted to try to answer the first research question. To explore and answer the second question, the contents of my interviews are used. The Attention Evaluation Form for school children with quadriplegic cerebral palsy falls into 5 categories: focused, selective, sustained, divided, and alternating attention. A preliminary form items have been established and revised and its structure and contents have been reviewed and confirmed by experts in this field. The criterion-related validity of the Evaluation Form is acceptable when used on these children (Pearson r = -.505, n = 12, p ≒ .047, one-tailed). When conducting the experiment with this Form, the attention of these children with a proper seating positioning is better than those without (t = -4.834, df = 24, p≒ .000, one-tailed). The information of the interviews consists of three ifferent cases of school children with quadriplegic cerebral palsy, all critically analyzed with grounded theory procedures and techniques. The result of this research shows that the degree and length of attention of these school children is subject to various factors in the classroom, such as seating positioning, teaching styles, personal emotional reasons and teaching tools. Therefore, from the experiment and interviews of this study, two conclusions can be drawn: Proper seating positioning can improve the attention of school children with quadriplegic cerebral palsy; and certain specific factors in the classroom, including seating positioning, can influence the performance of these children. keyword：Seating Positioning、Attention、Quadriplegic Cerebral Palsy

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Leung, Brian. "Access via a Multiple Camera Tongue Switch for Children with Severe Spastic Quadriplegic Cerebral Palsy." Thesis, 2009. http://hdl.handle.net/1807/26441.

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Access technologies facilitate novel and alternative methods for individuals with disabilities to interact with their environment. Finding suitable access solutions for children with severe spastic quadriplegic cerebral palsy can be difficult because of their poor motor control and targeting abilities due to spasticity at the limbs, neck, and head. In this research a multiple camera tongue switch was developed for a 7 year-old case study participant with severe spastic quadriplegia. Remotely via video, this system reacts to tongue protrusions as cues for single-switch access. Having multiple cameras mitigates targeting problems with the head that conventional single camera systems would present. Results of a usability experiment with the participant show that good sensitivity (82%) and specificity (80%) can be achieved with a non-contact tongue protrusion access modality for a user with spastic quadriplegia. Moreover, the experiment verified that the extra cameras improve utility of video-based access technologies for the target population.

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Jau-YuanShiao and 蕭兆原. "Neural Network Control and Driver Assistance System of Interactive Electrical Power Wheelchair for People with Quadriplegia." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/f85q79.

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碩士
國立成功大學
電機工程學系
103
People with quadriplegia usually have less chance to go out because of the lost of mobility. Although there are a lot of commercial products providing different input methods such as joystick, brain wave, eye control and sound control to manipulate the electrical power wheelchair, none of them can fit their needs because of three main difficulties. First, in order to use the wheelchair for long time, the input device should be very comfortable. Moreover, high stability and safety of control system are absolutely required. Last, they have a huge blind spot during controlling the wheelchair because their vision is constraint by the lost of body mobility. The goal of this research is to overcome the second difficulties by applying neural network control, Lidar obstacle avoidance, multi-camera real-time blind spot image display and remote monitoring functions to the system. In this research, we made a Smart Electrical Power Wheelchair (SEPW) system with embedded systems, Android tablet. Also, Lidar, Wifi, Bluetooth and encoder modules are also equipped to the wheelchair. In order to modify the system to fit different demands, we modularize the system and separate it to two parts – the main system and additional functions. The main system part is including the electrical power wheelchair, Android tablet and STM32F4 Discovery controller. The user can use the well-developed Morse code controller to input command to the Android tablet. The command will be transmitted to the controller through Bluetooth. Then, the wheelchair executes the corresponding movement. In order to control the wheelchair, PID control method was applied to the previous research. However, due to the lack of adaptive ability, the PID parameter should be re-configured manually according to different user or environment. As a result, the neural network is applied and implement on STM32F4-Discovery to identify the system features and auto-configure the PID parameter, improving the adaptive ability of SEPW system. Additional functions are obstacle avoidance, blind spot real-time image display and remote monitoring. These functions can be added to the main system according the different demands. The XV-11 Lidar sensor is applied to do obstacle avoidance. This sensor can perform 360 degree obstacle scanning and return the distance of obstacle in each degree. However, there are some errors caused by the motion or sensor. Kalman filter is applied to cancel these errors. After cancel the error, an obstacle avoidance algorithm presented in [2] was applied to navigate the wheelchair when approaching obstacles. Moreover, the number of Lidar can be increased depend on user’s demand. In order to display real-time image of blind spot, a Rapberry Pi connected with two USB cameras is installed to the wheelchair. The USB cameras can capture the image from left and right. Through Wifi, the images can be displayed on the corresponding position in the use interface of Android tablet. Similarly, more Rapberry Pi can be installed to the wheelchair to display more blind spot image. Last, the remote monitoring function is used to send warning message and real-time image to their family when the system detects the unusual motion pattern. This function is implement on the Android tablet and PC environment through internet socket programming. The result shows that the PID parameter of the controller can approach optimal number when the neural network controller is trained after 2 commands. The wheelchair is move on the ceramic tile. The desire speed is set to 10 encoder pulses in 20ms. The input command is going for 2000 encoder pulse. The error between two wheels is lower than 20 pulse no matter the wheelchair is without load, moving on the ground or person sit on it. Real-time image of blind spot can be display with 19.8 frame per second when the image resolution is 160x120. Remote image monitor can reach 15.38 fps when Android tablet can receive adequate 3G signal and the PC with 20Mbps fiber Internet. With this SEPW project, people with severe disabilities can control the SEPW safely, stably and comfortably. The remote monitor function also help the caregiver decrease anxious and worry.

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Wu, Jia-Jhen, and 吳佳蓁. "The Use of Visual Interaction System to Facilitate Interpersonal Communication for A Person with Quadriplegia: An Action Research." Thesis, 2016. http://ndltd.ncl.edu.tw/handle/23956626413053853553.

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碩士
國立彰化師範大學
復健諮商研究所
104
Abstract The present study aimed to know how a proposed visual interaction system (VI system) facilitated interpersonal communication for a quadriplegic person as a result of suffering brain arteriovenous malformation rupture in his home environment. The study adopted an action research methodology. It was particularly interested in the evaluation, adjustment and instructional procedure after the VI system was intervened; as well we the outcome of interpersonal communication the study participant achieved based on the collaborative viewpoints of the participant and his family members. Main findings of the study are as follows: 1.The VI system adjustment procedure included the choice of screen size and image pixel, the setting of wifi acceptor, the distance and curve of VI system, the distance prediction between VI system and its surrounding obstacles; and the place of wifi acceptor. For Morse-coded communication card, attention had been given to its content, input method and allocation. 2.The provision of instructional program focused on the manipulation of VI system and the independent use of Morse-coded communication card to facilitate interaction with others. Main concern included the participant’s properly positioning base on his condition, the design of appropriate learning objectives and teaching tips, the implementation of multivariate situation assemble education and the discovery of workable problem-solving strategies through the discussion among the researcher, the participant and his family members. 3.To optimize the use of VI system, the participant t positioning, the location of the system and the setting of the Morse-coded communication time should be taken into consideration. 4.At the end of the study, the participant could effectively use the VI system to interact with his family members in several different settings at home, with an achievement rat of 70%. Based on the study, the researcher provides with comments to potential device users and their families, concerned departments and educators, as well as other researchers.

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Kalsi-Ryan, Sukhvinder. "The Quadriplegia Hand Assessment Tool (Q-HAT): The development of a clinical assessment measure of the hand for the cervical spinal cord injured individual." 2006. http://link.library.utoronto.ca/eir/EIRdetail.cfm?Resources__ID=442137&T=F.

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Gan, Liu Shi. "The stimulus router system novel neural prosthesis /." Phd thesis, 2009. http://hdl.handle.net/10048/819.

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Thesis (Ph.D.)--University of Alberta, 2009.
A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy, Medical Sciences - Biomedical Engineering. Title from pdf file main screen (viewed on November 14, 2009). Includes bibliographical references.

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Pavlikhina, Ekaterina. "Vliv zmeny postury na respiracni funkce u pacientu s postižením michy." Master's thesis, 2019. http://www.nusl.cz/ntk/nusl-396995.

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Author: Bc. Pavlikhina Ekaterina Title: Influence of the posture's change on respiratory function in spinal cord injury patients. Objectives: The purpose of this thesis is to analyze change in respiratory function on change of posture in patients with spinal cord injury (SCI). Another objective is to compare the respiratory functions in a health subjects and in a SCI patients. Last but not least is an effort to find out whether SCI patients have a pattern of restrictive pulmonary dysfunction. The findings can help understanding development of respiratory complications after spinal cord injury. It may help in choosing optimal position during respiratory examination and respiratory rehabilitation. Methods: In theoretical part, there were explored the available knowledges about respiratory complications and their effects on posture. In practical part, there were 26 subjects - 16 patients with SCI and 10 healthy subjects. Subjects with SCI were divided into two groups - one with paraplegia and other one with quadriplegia. Measurements were performed with spirometer on each subject during supine, sitting and standing postures. There were collected vital capacity (VC), forced vital capacity (FVC) and forced expiratory volume in first second (FEV1) data from all subjects. All data were processed in...

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Plecháčková, Kristýna. "Péče o ventilovaného spinálního pacienta v České republice." Master's thesis, 2010. http://www.nusl.cz/ntk/nusl-281248.

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Thesis "Care of ventilator-dependent patienl wilh spinal cord injury in Czech republic" deals with problems of high cervica\ spinal cord les ion wilh diaphragm para\ysis. Generally introduces clinical manifestation of the spinal cord injury, classifícation of spinal cord lesions and statistical data regarding the incidence, prevalence and etiology. In more detail focuses on respiratory problems. Contains survey of most conunon respiratory complications in ventilator-dependent quadriplegic patients and infonn about the possibililies of respiralory physiotherapy. The practical part provides the first description of the Czech population of pentaplegics. Truough case studies indroduces health and livíng conditíons of persons wíth high spinal cord lesion and need of mechanical ventilation. Powered by TCPDF (www.tcpdf.org)

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Pokorný, Václav. "Program BanalFatal v prevenci úrazů páteře a míchy." Master's thesis, 2020. http://www.nusl.cz/ntk/nusl-434482.

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Title: The BanalFatal program in spinal cord injury prevention Objectives: The main objective of this diploma thesis is to examine the subjective impressions of participants after the completion of this program (lesson) so that it is possible to assess the emotional impact of the program and its impact on the further behavior of children. Methods: A quantitative strategy was used for the research part of the thesis. For the purposes of the research, two original questionnaires were created. 6 primary schools were contacted, in which the BanalFatal program previously took place. The questionnaire, aimed at school prevention methodologists, was filled in by all addressed school staff, but only in 4 school facilities, it was possible to interview school pupils. Thus, 6 school prevention methodologists and 164 pupils from 4 selected primary schools (Prague 11, 4, Litoměřice, Dačice) were interviewed. The questionnaire for prevention methodologists contains closed, semi-closed, and open questions. The questionnaire for pupils was created in the form of a survey and contained only closed questions. Results: All school methodologists presume that attending the BanalFatal lecture will have a certain effect on students' change in behavior during risky activities. "Certainly yes" was stated by 1 and "rather...

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Špačková, Anežka. "Hodnocení krátkodobého vlivu fyzioterapeutických technik na spasticitu u pacientů s míšní lézí." Master's thesis, 2018. http://www.nusl.cz/ntk/nusl-382906.

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The subject of this thesis is spasticity in individuals with spinal lesions. The aim is to evaluate and compare a short-term effect of selected physio-therapeutic methods on spasticity of lower limbs in spinal patients. Two methods of comparison were chosen - passive stretching and the Vojta's reflex therapy. The work consists of two parts. The theoretical part describes the problems of spinal lesions, central motoneuron syndrome and spasticity, including its pathophysiology and investigation and therapeutic approaches. The practical part contains an attempt to verify and subsequently compare the immediate antispastic effect of the chosen methods, which is an important prerequisite for the following active exercises as an inseparable part of a physiotherapeutic exercise unit. Clinical evaluation scales are used to evaluate spasticity, namely Modified Ashworth Scale (MAS) and Muscle Excitability Scale (MES). The results are then compared with other studies and literature. Keywords spinal lesions, quadriplegia, Modified Ashworth Scale, Muscle Excitability Scale, Vojta's method, stretching

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Martin-Lemoyne, Valérie. "Effets de l’utilisation d’un chien d’assistance sur les efforts aux membres supérieurs lors de la montée d’une pente en fauteuil roulant chez les individus ayant une lésion médullaire." Thèse, 2014. http://hdl.handle.net/1866/12121.

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Problématique. L'utilisation d'un chien d'assistance à la mobilité (CAM) représente une option novatrice pour préserver l’intégrité des membres supérieurs (MSs) chez les utilisateurs de fauteuil roulant manuel (FRM). Aucune étude biomécanique n’a quantifié les effets du CAM sur les efforts aux MSs lors de la montée d’un plan incliné. Objectif. Cette étude quasi-expérimentale vise à comparer les efforts aux MSs lors de la montée d’un plan incliné avec et sans l’assistance d’un CAM. Méthodologie. Dix participants avec une lésion de la moelle épinière (LME) qui utilisent un FRM et possèdent un CAM ont monté un plan incliné à trois reprises avec et sans l’assistance du CAM. Les forces appliquées sur les cerceaux, mesurées avec des roues instrumentées, et les mouvements du FRM et des MSs, enregistrés avec un système d'analyse du mouvement, ont permis de mesurer les efforts mécaniques aux MSs. Simultanément, l'activité électromyographique (EMG) des muscles grand pectoral, deltoïde antérieur, biceps et triceps a été enregistrée et normalisée avec sa valeur maximale pour mesurer les efforts musculaires aux MSs. Résultats. En général, le CAM réduit significativement les valeurs moyennes et maximales de la force totale appliquée aux cerceaux et de sa composante tangentielle, des moments nets de flexion, de rotation interne et d’adduction aux épaules et des taux d’utilisation musculaire du deltoïde antérieur, du biceps et du triceps. Conclusion. L’assistance d’un CAM réduit les efforts aux MSs lors de la montée d’un plan incliné chez les utilisateurs d’un FRM ayant une LME.
Problematic. The use of a mobility assistance dog (ADMob) represents an innovative option to preserve upper limb (U/Ls) integrity in manual wheelchair (MWC) user population. No biomechanical studies have quantified the effects of ADMob on U/Ls efforts when climbing an incline. Objective. This quasi-experimental study compares the U/Ls efforts when climbing an incline with and without the assistance of an ADMob for MWC traction. Methodology. Ten participants with spinal cord injury (SCI) using a MWC and owning an ADMob climbed an incline 3 times with and without the use of an ADMob. The forces applied to the handrims, captured with instrumented wheel and movements of the MWC and the U/Ls, recorded with a three-dimensional motion analysis system, were used to measure the U/Ls mechanical efforts. Simultaneously, the electromyographic (EMG) activity of the pectoralis major muscle, anterior deltoid, biceps and triceps were recorded during the tasks and normalized with its maximum value to measure the U/Ls muscular efforts. Results. Typically, ADMob significantly reduces the mean and peak values of the total force applied to the rings and the tangential component, the mean and peak values of flexion, internal rotation and adduction net joint moments at the shoulder and the mean and peak values of muscular utilization ratio of anterior deltoid, pectoralis major, biceps and triceps. Conclusion. The assistance of an ADMob for MWC traction when climbing an incline reduces the effort to U/Ls among MWC users with a SCI.

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Dissertations / Theses on the topic 'Quadriplegics'

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