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1
Rakauskienė, Eglė. "Paraplegikų gyvenimo kokybės ypatumai". Master's thesis, Lithuanian Academic Libraries Network (LABT), 2006. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2006~D_20060509_111958-31447.
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Goal of the research is to analyze and evaluate the life quality of paraplegics. Object of research is life quality of paraplegics. Tasks of research: to evaluate the life quality of paraplegics according to age and physical activity; to evaluate the life quality of paraplegics according to level of medulla injury, duration of trauma; to analyze the expression of life quality components of paraplegics in gender aspect.
There are numerous researches analyzing the quality of life, but we could not find any research analyzing the life quality of paraplegics. Research of such character would enable to better clarify factors having impact on life quality of paraplegics depending on gender, age, level of medulla injury, duration of medulla injury, physical activity. In order to evaluate life quality according to a standard, extensive scientific research is needed.
Research was carried out in summer 2005 at the therapy and rehabilitation centre “Landšaftas” in Monsiškės, and in recreation centre “Balčio Šilas“. Research was conducted among 41 paraplegic: 29 men and 12 women. Quality of Life Questionnaire, 2001 was applied, and supplemented with questions from questionnaire of research on socialization of disabled by Williams (1994).
Summarizing the obtained research results one can state that life quality of paraplegics of younger age (21-40 years) is better than that of aged paraplegics (41-60 years). After life quality evaluation according to level and duration of medulla injure... [to full text]
2
Mungovan, Sean F., i n/a. "The Effect of Elevation and Venous Occlusion Pressure on Cardiovascular Function in Physically Active Men Who Are Paraplegic". Griffith University. School of Physiotherapy and Exercise Science, 2004. http://www4.gu.edu.au:8080/adt-root/public/adt-QGU20040917.084824.
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The purpose of the present investigation was to: 1) Determine the relationship between cardiac output (estimated using the acetylene rebreathing methodology) and oxygen consumption in a homogeneous group of men who are paraplegic. 2) Investigate whether lower limb elevation increases stroke volume and decreases heart rate at rest and during submaximal arm exercise. 3) Investigate whether the application of constant circumferential pneumatic pressure applied to dependent lower limbs increases stroke volume and decreases heart rate at rest and during submaximal arm exercise.
3
Mungovan, Sean F. "The Effect of Elevation and Venous Occlusion Pressure on Cardiovascular Function in Physically Active Men Who Are Paraplegic". Thesis, Griffith University, 2004. http://hdl.handle.net/10072/365190.
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The purpose of the present investigation was to: 1) Determine the relationship between cardiac output (estimated using the acetylene rebreathing methodology) and oxygen consumption in a homogeneous group of men who are paraplegic. 2) Investigate whether lower limb elevation increases stroke volume and decreases heart rate at rest and during submaximal arm exercise. 3) Investigate whether the application of constant circumferential pneumatic pressure applied to dependent lower limbs increases stroke volume and decreases heart rate at rest and during submaximal arm exercise.Thesis (Masters)
Master of Philosophy (MPhil)
School of Physiotherapy and Exercise Science
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Zechar, Deborah Lee. "Tests for measurement of percent body fat in paraplegics /". The Ohio State University, 1988. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487598303839067.
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Berry, Helen Russell. "Characterisation of cardiorespiratory responses to electrically stimulated cycle training in paraplegia". Thesis, Connect to e-thesis. Edited version, 2008. http://theses.gla.ac.uk/386/.
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Thesis (Ph.D.) - University of Glasgow, 2008.PhD. theses submitted to the Department of Mechanical Engineering, Faculty of Engineering, University of Glasgow. Edited version of thesis available, uncleared 3rd party copyright material removed. Includes bibliographical references. Print version also available.
6
Kinzer, Scott Marshall. "THE ROLE OF LEG VASCULATURE IN THE CARDIOVASCULAR RESPONSES TO SUBMAXIMAL ARM-CRANK ERGOMETRY IN WHEELCHAIR-DEPENDENT PARAPLEGICS AND AMPUTEES". Thesis, The University of Arizona, 1985. http://hdl.handle.net/10150/275358.
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Barnett, Robert W. "Paraplegic standing and reciprocal gait using a floor reaction hybrid F.E.S. orthosis". Thesis, University of Strathclyde, 1990. http://oleg.lib.strath.ac.uk:80/R/?func=dbin-jump-full&object_id=21284.
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The work presented in this thesis has two main themes. Firstly, it follows the development and initial evaluation of a new, hybrid FES orthosis for paraplegics. Secondly, it describes investigations which were intended to optimize the stimulus parameters used with the orthosis. One of the major limitations with pure FES standing and walking systems is rapid muscle fatigue. During quiet stance, chronic stimulation of support muscles is required which induces fatigue and significantly reduces their useful contraction time. Mechanical bracing provides safety, strength and protection of delicate joints but it lacks some of the features of FES. The "hybrid" orthosis, considered in this thesis, combines these two techniques so that the disadvantages of either technique alone are reduced. In the following chapters, the development of the mechanical braces, the sensors, the electrical stimulator and the controlling software are considered. Several preliminary investigations are reported which demonstrate the feasibility of the orthosis with regard to fatigue reduction and stability. In addition, tests are described which were designed to improve the characteristics of muscle and reflex activity for use with the system. The results of these tests showed that muscle dynamics could be improved by the addition of a single pulse to a regular stimulus pattern. Improvements were also obtained in reflex activity but to a less significant degree.
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Kirtley, C. "Control of functional electrical stimulation with extended physiological proprioception". Thesis, University of Strathclyde, 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.292029.
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Menegaldo, Luciano Luporini. "Modelagem matematica, simulação e controle artificial da postura em seres humanos". [s.n.], 1997. http://repositorio.unicamp.br/jspui/handle/REPOSIP/264593.
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Orientador: Hans Ingo WeberDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Engenharia Mecanica
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Resumo: O desenvolvimento de próteses neurais para pacientes com lesões crônicas no sistema nervoso central, bem como o estudo do controle motor em pessoas normais, pode encontrar em ferramentas de simulação computacional importantes subsídios. Este trabalho, atendo-se à dinâmica e ao controle da postura em seres humanos, procurou desenvolver uma série de modelos que incorporassem: a mecânica de corpos rígidos, a dinâmica da contração muscular e da excitação neural e um modelo da geometria músculo-esquelética associado. Foi estabelecida uma metodologia para o projeto de um controlador, utilizando o método do LQR, e a matriz pseudo-inversa na distribuição, entre os atuadores músculo-tendíneos dos torques de controle, empregando um modelo inverso da dinâmica da contração. Os resultados de simulações para condições iniciais mostram alguns efeitos da variação das matrizes de ponderação do LQR. Discute-se em seguida o padrão de coordenação muscular obtido
Abstract: Neural prostheses and motor control studies may find in computational simulation studies helpful aids. This work, focusing on human postural dynamics and control, looked for developing a series of models that should include: rigid body mechanics, muscular contraction and neural excitation dynamics, and also an associated geometric musculoskeletal modeI. A methodology for controller design was established, using the LQR approach, and the pseudoinverse matrix for distribution of control torques among redundant musculotendon actuators, employing also an inverse model of muscular contraction dynamics. Results shows some effects on simulations for initial conditions, with LQR weight matrix variations. Muscular coordination pattem is dicussed.
Mestrado
Mecanica dos Sólidos e Projeto Mecanico
Mestre em Engenharia Mecânica
10
Burns, Keith J. "Exercise to Improve Blood Flow and Vascular Health in the Lower Limbs of Paraplegics". Kent State University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=kent1435874538.
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Schafer, Carol Linda. "Development of a functional neuromuscular stimulation (FNS) muscle training program to prepare paraplegics for standing". Master's thesis, University of Cape Town, 1989. http://hdl.handle.net/11427/25845.
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Wheelchair-bound paraplegics are in an unnatural, almost all-day sitting position. This is physiologically disadvantageous as it may cause increased abdominal pressure, renal dysfunction, pressure sores, muscle atrophy and osteoporosis. Thus it would be beneficial, physiologically and psychologically, for a paraplegic to be able to stand for temporary periods of time. As a result of the muscle atrophy and functional degeneration that follows a spinal cord injury, it is essential for paraplegics to undergo a muscle restrengthening program, using Functional Neuromuscular Stimulation (FNS), before standing up under FNS control can be attempted. Six healthy spinal cord injured subjects with spinal lesions between CS and T9 (two tetraplegics and four paraplegics) exercised their quadriceps muscles at home using a portable two-channel FNS muscle stimulator. The muscles were exercised against an increasing load to maximise the training effect. Inclined standing exercise, under FNS control, was performed in the Inclistand. The subjects' general state of health and fitness were assessed, namely their responses during a maximal arm ergometry exercise test, arm muscle function, lung function, blood biochemistry and their dietary habits. Subjects have shown improvement in quadriceps muscle strength, fatigue resistance and muscle bulk to varying degrees - according to their individual circumstances. The tetraplegics responded in a different manner to that of the paraplegics. The muscle strength increased significantly by a mean (+SD) of 97,8 + 59,6% and 171,2 + 118,1% for the four paraplegics, left and right leg respectively. There was a mean improvement of 16% in fatigue resistance in the left leg (p=0,08), while the mean response of the right leg varied. Quadriceps muscle bulk increased by 4,43 + 3,4% (left) and 2,7 + 2,1% (right) (0,05<p<0,l). The amount of subcutaneous fat around the mid-thigh decreased significantly by 4,73 + 1,4% (left) and 3,43 + 1,1% (right leg). The group was in a state of general well-being, with the exception of one subject whose serum cholesterol concentration fell within the high risk category. This study therefore showed that the FNS was sucessful in improving the quadriceps muscle strength, bulk and fatigue response of the SCI people in our research group. The valuable experience gained from this FNS study will be used to improve the present program.
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Seymour, Wendy, i 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.
13
Snyman, Hildegard. "Development of a regression equation for estimating the weight of male black South African adults with paraplegia using anthropometric measurements". Thesis, Stellenbosch : University of Stellenbosch, 2005. http://hdl.handle.net/10019.1/3044.
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Thesis (MNutr (Human Nutrition))--University of Stellenbosch, 2005.Introduction: The objective of this study was to develop a regression equation to estimate weight of black male paraplegic South African subjects. Very few institutions in South Africa have wheel chair scales and very few paraplegic persons know what their weight is. People with spinal cord injury (SCI) are reported to have an increased risk to develop obesity and diseases of lifestyle. It is therefore important to monitor the nutritional status of these patients to prevent and treat the above diseases effectively. The aim was to develop an equation that incorporates variables or measurements that do not require a high level of skill and experience to be determined. The equipment needed for the determination of the measurements should also be easily accessible, for example a tape measure rather than a skin-fold caliper.
14
Yu, Chung-huang. "New method for restoring standing to paraplegics : control of leg muscle stimulation by the handle support reactions". Thesis, University College London (University of London), 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367761.
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Alonso, Karina Cristina 1982. "Avaliação cinemática da transferência de paraplégicos da cadeira de rodas". [s.n.], 2011. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309790.
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Orientador: Alberto Cliquet JúniorDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
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Resumo: A lesão medular é umas das mais graves e incapacitantes síndromes neurológicas que acomete o ser humano gerando distúrbios motores, sensitivos e neurovegetativos. A cadeira de rodas maximiza a locomoção funcional, a confiança, a independência e o conforto de seu utilizador e, portanto são utilizadas por grande parte dos deficientes físicos. Os indivíduos com lesão medular, aptos a transferir independentemente, possuem, normalmente, um lado preferencial para realizar suas transferências, o que pode gerar desequilíbrios musculares, futuras patologias e/ou lesões nos ombros. O objetivo do estudo foi avaliar a estratégia das transferências de paraplégicos da cadeira de rodas. Participaram do estudo doze sujeitos lesados medulares (T2 a T12), aptos a realizar independentemente a transferência da cadeira de rodas para um tablado com um metro quadrado de área por meio metro de altura. As imagens dos marcadores reflexivos nos pontos anatômicos foram capturadas por seis câmeras de infravermelho ProReflex e processadas através de um software específico (QTrac). Parâmetros cinemáticos do tronco, cabeça e ombros foram avaliados. A comparação das medidas entre os fatores estudados utilizou a ANOVA para medidas repetidas com transformação por postos. O nível de significância adotado para os testes estatísticos foi 5% ou ? 0,05. A pesquisa comparou três fatores: alturas da lesão (alta e baixa), lado de preferência e não para transferir e as duas primeiras fases da transferência (pré-levantamento e levantamento) para duração das fases da transferência, velocidade angular máxima e aceleração angular, índice de curvatura e deslocamento angular de cabeça, porém para deslocamento angular de ombros foi associado à comparação ombro líder e contralateral. A tarefa de transferência foi dividida em três fases: prélevantamento, levantamento e pós-levantamento. A duração das três fases e o índice de curvatura do esterno e da cabeça apresentaram significância estatística (p<0,05) na comparação das fases analisadas. O deslocamento angular dos ombros nos planos (x-y) e (y-z) mostraram significância estatística no efeito altura da lesão e lado da transferência (x-y: p=0.0470; y-z: p=0.0134) e o deslocamento angular da cabeça no plano (x-z) apresentou p=0.0274 no efeito lado da transferência. Os resultados obtidos com o estudo facilitaram a compreensão biomecânica e a descrição das características dos movimentos dos ombros, cabeça e tronco de sujeitos com lesão medular torácica, durante as transferências da cadeira de rodas. Embora, algumas variáveis não tenham atingido valores significativos, observou-se que há diferenças nas estratégias de transferências para as alturas das lesões
Abstract: Spinal Cord injury is one of the most severe and impairing neurological syndrome that causes motor, sensitive and central neural system disorders in humans. Wheelchair maximizes functional locomotion, the reliance, independence and the comfort of theirs users, so it is very used for the persons with physical deficiencies. These subjects usually perform their independent transfers using one side of their preference which may lead to a muscle unbalancing and future injuries. The objective of this study was to assess the wheelchair transfer strategies of paraplegic subjects. Twelve thoracic spinal cord injured subjects participated in this study (T2 to T12), and they were able to independently perform the transfers from a wheelchair to a table with an area of one square meter by half meter height. Images of reflexive anatomic markers were captured by six ProReflex infrared cameras and processed through a QTRac Capture software. Kinematics parameters of the trunk, head and shoulders were assessed. The comparison of the variables among the evaluated factors used ANOVA for repetitive measures with segmented factors. The significance adopted level for statistical tests was 5% or ? 0,05. This research compared three factors (injury height, preference and nonpreference side and phases) for transfer time of phases, maximum angular speed and angular acceleration, curve index and head angular displacement. And also besides the comparisons cited above, the shoulder angular displacement were compared the leading and contralateral shoulders. The transfer task was divided in three phases: pre-lift, lift and post-lift. Three phases duration and curve index had statistical significance (p<0.05). The shoulder angular displacements on x-y and yz plans showed statistical significance on injury height effect and transfer side (x-y: p=0.0470; y-z: p=0.0134) and head angular displacement on x-z plan showed p=0.0274 on transfer side effect. The obtained results with this research make easy the biomechanical understanding and the description of shoulder head and trunk movement characteristics of spinal cord injury subjects on their transfer tasks from wheelchair. Although some variables did not reach significant scores, it was observed that there are differences on transfer strategies for the heights of injuries
Mestrado
Fisiopatologia Cirúrgica
Mestre em Ciências
16
Gayle, George W. "The effects of ten and sixteen inch wheelchair handrims on metabolic and perceived exertion variables of male paraplegics /". The Ohio State University, 1988. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487588939088161.
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Cacho, Enio Walker Azevedo. "O efeito do treino de marcha com estimulação eletrica neuromuscular na atividade eletromiografica de pacientes paraplegicos". [s.n.], 2004. http://repositorio.unicamp.br/jspui/handle/REPOSIP/313756.
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Orientador: Alberto Cliquet JuniorDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: O efeito do treino de marcha através da estimulação elétrica neuromuscular (EENM) em pacientes com lesão da medula espinhal (LME) tem sido bem estabelecido. A medula espinhal humana reconhece apropriadas informações sensoriais e pode modular respostas motoras que facilitam a locomoção através do treinamento de marcha EENM assistido. Neste trabalho, dez pacientes (9 homens e uma mulher; 19 - 40 anos) com LME crônica (7 completas e 3 incompletas, nível neurológico abaixo de TI) foram avaliados no Laboratório de Biomecânica e Reabilitação do Aparelho Locomotor/Unicamp, no início e no fim de um programa de 30 sessões de treinamento de marcha assistido com EENM. Instrumentos utilizados para mensuração foram: American Spinal Injury Association (ASIA), Escala de Capacidade de Deambulação, Medida de Independência Funcional (MIF), Escala Modificada de Ashworth e o Registro Multicanais da Eletromiografia de superficie (EMG) dos músculos sóleos (SO), gastrocnêmios mediais (GA) e tibiais anteriores (TA) bilaterais. Os resultados demonstraram uma melhora do padrão EMG nos músculos GA e SO, durante a fase de apoio, e uma significante redução na fase de oscilação. A melhora no padrão EMG do TA ocorreu apenas à esquerda. Os resultados sugerem que o treino de marcha assistido com EENM pode induzir mudanças nos centros medulares espinhais
Abstract: The useful effect of locomotion training through neuromuscular electrical stimulation (NMES) in patients with spinal cord injury (SCI) has already been established. The human spinal cord recognizes the appropriate sensorial information and can modulate responses about the motor pool which facilitates walking under NMES training. In this series, ten patients (9 male and 1 female; 19 - 40 yrs-old) with chronic spinal cord injury (seven complete and three incompIete, neurologic leveI beIow T2) were evaluated at the Biomechanics & Rehabilitation Lab./University Hospital-Unicamp: first as soon as the patients joined the Programme and after 30 NMES based gait sessions. Clinical protocoIs of the American Spinal Injury Association (ASIA), Ability Ambulation Scale, Functional Independence Measure (FIM), Modified Ashworth Scale and the multichannel register surface of Electromyography (EMG) of muscIe soIeous (SO), gastrocnemious medialis (GA) and tibialis anterior (TA) were assessed. Results demonstrated an improvement in the EMG pattem of GA and TO muscles, during the stance phase and a significant decrease in the swing phase. Improvement in the EMG pattem in the TA muscle occurs just in the Ieft leg. Results suggest that gait training with NMES does induce changes in the spinal cord neural center, thus triggering the recovering of functional abilities/gait of paraplegics
Mestrado
Pesquisa Experimental
Mestre em Cirurgia
18
Bjerkefors, Anna. "Performance and trainability in paraplegics : motor function, shoulder muscle strength and sitting balance before and after kayak ergometer training /". Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-981-5/.
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Ewins, David John. "Investigation into the restoration of simple standing and walking function for mid-low thoracic paraplegics through the use of electrical stimulation". Thesis, University of Bath, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.236461.
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Scriba, E. W. (Ernst Wolfgang). "Proximal feed artery regulation of skeletal muscle blood flow during exercise : the paraplegic model". Thesis, Stellenbosch : Stellenbosch University, 2003. http://hdl.handle.net/10019.1/49783.
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Assignment (MPhil)--University of Stellenbosch, 2003.ENGLISH ABSTRACT: The mechanisms of blood flow (BF) control to skeletal muscle during dynamic exercise are still not clearly understood. The paraplegic subject (P) has reduced sympathetic innervation to the lower limbs. The current study was designed to focus on the contribution of neural control, specifically the sympathetic nervous system (SNS), as part of the central vascular mechanism to skeletal muscle BF during dynamic exercise. Aims: We studied BF parameters in P vs. able-bodied subjects (AB) to determine whether the paraplegic can serve as a model for assessing the contribution of the SNS to changes in active vs. inactive muscle BF during exercise. Further questions addressed include: the influence of level of fitness on resting and exercise BF, how lesion level affects BF control in the paraplegic, the 'muscle pump' theory and its hypothesized role in exercise hyperemia and whether blood pooling occurs in the legs of paraplegics. Method: Noninvasive duplex Doppler studies of the large conduit arteries (brachial and common femoral) were performed on 10 elite paraplegic athletes (EP), 10 sedentary paraplegics (SP) en 10 sedentary able-bodied subjects (AB). The paraplegic groups were further subdivided by lesion level with T6 being the critical level. Tests were carried out at rest and after 2 bouts of arm ergometer exercise: a maximal incremental test and 3 minutes at 75% of maximal. Diameter, mean velocity, pulsatile index and blood flow were measured/calculated. Results: Resting heart rate was significantly higher in the paraplegic groups (EP = 80 bpm ± 10, SP = 83 bpm ± 12) vs. the AB group (69 bpm ± 7), p < 0.05. Resting diameter in the common femoral artery (CFA) was similar in EP (5.93 mm ± 1.54) and SP (6.52 mm ± 0.95), but significantly lower than in AB (7.87 mm ± 1.38), p < 0.05. Similar resting pulsatile index (PI) in the CFA were contrary to that previously reported, casting doubt on venous blood pooling theories. Post-exercise values need to be interpreted with caution in view of the large resting differences in CFA diameter. Percentage change values are therefore more appropriate. These differences were not statistically significant, but may suggest interesting trends. Large variability existed for most resting and post-exercise values. Conclusion: The paraplegic subject is an ideal model for the study of the influence of the SNS on blood supply to exercising skeletal muscle. The difference in CFA diameter at rest in the paraplegic vs. the AB group confirms previous results and is probably due to structural/non-physiological changes. Our observation that the BA and CFA diameters in EP and SP subjects do not differ significantly at rest, suggests that training does not have a spillover vasomotor effect on lower limb conduit arteries in paraplegia. Similar BF and PI values post-exercise in the SP and AB groups challenge the muscle pump theory. The SNS has an important role in the control of skeletal muscle blood flow - both at rest (vascular tone) and during exercise (redistribution). Suggestions for future research are made.
AFRIKAANSE OPSOMMING: Die meganismes betrokke by die beheer van bloedvloei (BV) gedurende dinamiese oefening is nog onduidelik. Die parapleeg (P) het verminderde simpatiese innervasie na die onderste ledemate. Die huidige studie fokus op die bydrae van die simpatiese senuwee sisteem (SSS), as deel van die sentrale vaskulêre meganisme, tot skeletale spier BV tydens dinamiese oefening. Doelstellings: Ons het BV parameters in P vs. nie-gestremde proefpersone (kontrole) bestudeer om vas te stelof die parapleeg as model gebruik kan word om die bydrae van die SSS tot veranderings in die BV in aktiewe- en onaktiewe spiere gedurende oefening, te ondersoek. Verdere aspekte wat ondersoek is, sluit in: die invloed van tiksheidvlak ten opsigte van rustende en oefenings BV, of die verlammingsvlak by die parapleeg BV kontrole beïnvloed, die 'spierpomp-teorie' en sy hipotetiese rol in oefeninghiperremie, asook die vraag of bloedsaamstorting in die bene van parapleë plaasvind. Metode: Nie-indringende duplex Doppler studies van die groot geleidingsarteries (bragiaal [BA] en gemene femoral [CFA]) is by 10 elite paraplegiese atlete (EP), 10 sedentêre parapleë (SP) en 10 sedentêre nie-gestremde proefpersone (AB) uitgevoer. Die paraplegiese proefpersone is verder onderverdeel deur die vlak van T6 as kritiese verlammingsvlak te gebruik. Toetse is tydens rus en na 2 arm-ergometer oefeningsessies uitgevoer: een maksimale inkrementeie toets en een van 75% van maksimum intensiteit. Deursnit, gemiddelde vloeispoed, pulsatiewe indeks en bloedvloei is gemeet en/of bereken. Resultate: Rustende hartspoed was beduidend hoër in die paraplegiese groepe (EP = 80 slaelminuut ± 10 en SP = 83 slm ± 12) vs. die AB groep (69 slm ± 7), p < 0.05. Rustende deursnit in die gemene femorale arterie (CFA) was dieselfde in EP (5.93 mm ± 1.54) en SP (6.52 mm ± 0.95), maar beduidend laer as in AB (7.87 mm ± 1.38), p < 0.05. Die feit dat rustende pulsatiewe indeks (PI) in die CFA dieselfde in albei groepe was, laat twyfelontstaan oor die veneuse bloedopdammings teorieë soos weergegee in die literatuur. Na-oefeningswaardes moet omsigtig evalueer word met inagneming van die groot rustende verskille in CFA deursnit. Persentasieverskilwaardes is dus meer toepaslik. Hierdie veskille was nie statisties beduidend nie, maar suggereer interessante tendense. Groot variasie het voorgekom vir beide rustende en na-oefenings waardes. Gevolgtrekking: Die parapleeg is 'n ideale model vir studies om die invloed van die SSS op bloedvloei aan aktiewe skeletale spier te bestudeer. Die verskil in rustende CFA deursnit in die parapleeg vs. die AB groep bevestig vorige resultate en is waarskynlik te wyte aan strukturele, nie-funksionele veranderinge. Ons bevindinge dat die BA en CFA deursneë nie beduidend verskil in die SP en EP groep gedurende rus nie, dui daarop dat gereëlde oefening nie 'n oorloop vasomotor effek op die onderste ledemate in die parapleeg het nie. Die feit dat daar geen verskil aangetoon kon word tussen BV en PI waardes na-oefening in die SP en AB groepe, betwis die spierpomp teorie. Die studie toon dat die SSS 'n belangrike rol in die beheer van skeletale spier bloedvloei speel - beide met rus (vaskulêre tonus) en gedurende oefening (herdistribusie). Voorstelle vir toekomstige navorsing word gemaak.
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Nogueira, Neto Guilherme Nunes 1978. "Viabilidade do emprego de mecanomiografia no controle motor artificial em lesados medulares empregando estimulação elétrica neuromuscular". [s.n.], 2013. http://repositorio.unicamp.br/jspui/handle/REPOSIP/260582.
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Orientadores Vera Lúcia da Silveira Nantes Button, Percy NohamaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia Elétrica e de Computação
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Resumo: A lesão medular afeta a condução dos sinais motores e sensoriais na medula. Com isso, a realização de movimentos voluntários por pessoas com lesão medular é prejudicada quando não impossível. A estimulação elétrica neuromuscular (EENM) é uma técnica que pode auxiliá-los a contornar essas dificuldades, pois possibilita ativar a musculatura de um membro paralisado. Embora a EENM em malha aberta seja capaz de produzir movimentos em um membro paralisado, ele não é capaz de compensar automaticamente desvios angulares devidos a distúrbios. Fenômenos supressores de desempenho muscular como a fadiga muscular e a adaptação neuronal podem comprometer a qualidade de um movimento funcional evocado artificialmente. Por isso, sistemas de controle são incorporados a estimuladores elétricos. A mecanomiografia (MMG) pode fornecer informações sobre a condição de um músculo em contração. Este trabalho investiga a viabilidade do emprego de sinais de MMG no controle da aplicação de EENM visando a sua incorporação em estratégias de controle de membros inferiores (MMII) em lesados medulares sem treinamento. Para isso, foi desenvolvido um sistema integrado de monitoração multiparamétrica e EENM com capacidade de incorporação do sinal de MMG na estratégia de controle. Um ensaio com voluntários hígidos e contrações isométricas de membros superiores (MMSS) apontou variações em parâmetros de MMG no início e final da contração. Outro ensaio analisou o sinal de MMG e de ângulo com controle de EENM em malha e cadeia abertas para indivíduos hígidos e lesados medulares. Sinais de MMG e EENM em contrações dinâmicas de MMII foram registrados. Com o sistema integrado, aplicou-se EENM com controle de ângulo de joelho em malha fechada obtendo- se estabilidade angular do joelho de um lesado medular. Finalmente, o sistema integrado aplicou controle para estabilizar o ângulo de joelho e monitorar sinais de MMG. Os resultados de ensaios experimentais mostraram que parâmetros espectrais, como a frequência média de potência, apresentaram variações entre o início e o fim da contração quando a amplitude de EENM apresentou taxas de incremento mais elevadas. Conclui-se que existe viabilidade no emprego de MMG em estratégias de controle de EENM para MMII de lesados medulares em estabilidade angular, observando-se a taxa de incremento/decremento da saída do estimulador
Abstract: Spinal cord injury affects conduction of motor and sensory signals that flow through the spinal cord. Therefore, the performance of voluntary movements by spinal cord injured (SCI) persons is impaired, if not impossible. Neuromuscular electrical stimulation (NMES) is a technique that aids SCI individuals to overcome these difficulties, because it allows activation of paralyzed limb muscles. Though NMES in open loop and in open chain tasks is able to generate movements in paralyzed limbs, it is not capable to automatically compensate for angle deviations due to disturbances. Suppressive phenomena of muscle performance, such as muscle fatigue and motor neuron adaptation, can compromise the quality of an artificially elicited functional moment. Thus, closed-loop control systems are merged with electrical stimulators. Mechanomyography (MMG) can provide information about a contracting muscle condition. This work proposes to investigate the feasibility of using MMG signals in the control of NMES application aiming its incorporation in lower limb control strategies of untrained spinal cord injured persons. An integrated system was built, comprising a multiparametric acquisition system and a closed-loop controlled neuromuscular electrical stimulator. The integrated system is able to incorporate MMG signals in the control strategy. A test with healthy volunteers performing upper limb isometric contractions indicated variations in MMG parameters between the beginning and end of contraction. Another test investigated MMG signals and joint angles with NMES in open loop and in open chain to healthy and SCI individuals. NMES and MMG signals during lower limb dynamic contractions were registered. Using the integrated system, NMES was applied to the control of knee angle in closed loop configuration ensuring angular stability of both knees on a single SCI volunteer. Finally, the integrated system applied closed loop control to stabilize the knee angle, and monitored MMG signals. Experimental results revealed that spectral parameters such as mean power frequency presented variations between the beginning and end of contraction when NMES amplitude showed higher amplitude increase rates. In conclusion, there is feasibility of using MMG signals in control strategies of NMES for lower limbs of SCI persons in reasonable angle stability. However, one must observe the stimulator output increase/decrease rate
Doutorado
Engenharia Biomedica
Doutor em Engenharia Elétrica
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Souza, Lúcia Inês Macedo de. "Investigação genética de duas novas doenças neurodegenerativas: síndrome de Spoan (Spastic Paraglegia with Optic Atrophy and Neuropathy) e SPG34". Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/41/41131/tde-06112008-164924/.
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Estudamos duas grandes famílias com manifestações de doenças neurodegenerativas. Uma delas é originária do alto oeste do estado do Rio Grande do Norte e a outra, da região de São José do Rio Preto, SP. A primeira, uma extensa família com tradição de casamentos consangüíneos, apresenta 68 indivíduos afetados pela síndrome a qual nomeamos Spoan (Spastic Paraplegia, Optic Atrophy, Neuropathy). A mesma é uma doença neurodegenerativa de herança autossômica recessiva, caracterizada por atrofia óptica congênita, espasticidade, polineuropatia periférica axonal sensitivo-motora, sobressaltos à estimulação sonora, deformidades articulares e da coluna e disartria. Estes resultados foram publicados em 2005 no Ann Neurol. 57(5):730-7. Dando continuidade ao estudo, selecionamos 23 genes que tiveram todos os exons seqüenciados. Nenhuma mutação foi observada. Amostras de 65 afetados e seus parentes foram estudados para seis marcadores de microsatélite, totalizando 149 indivíduos genotipados. Cinqüenta SNPs foram investigados, o que nos permitiu reduzir a região candidata de 4.8 para 2.3Mb em 11q13, entre o SNP rs1939212 e o microssatélite D11S987. Para o marcador D11S1889, com alelos em homozigose para todo os pacientes, foi obtido um lod score máximo de 27 em .=0.0. Os resultados deste estudo se encontram em fase de submissão. A segunda família foi estudada pela equipe da Dra. Mayana Zatz há alguns anos. Nela, investigamos 12 indivíduos afetados e 12 normais. Dentre estes, sete, com idades entre 30 e 60 anos, foram clinicamente avaliados. A idade de início foi a partir da terceira década de vida, sendo a paraplegia espástica o único sintoma. Para o marcador DXS8057 localizado em Xq25 foi obtido um lod score máximo de 4.13 em .=0.0. Com o estudo de marcadores moleculares, delimitamos uma região candidata entre os marcadores DXS1001 e DXS8033, de cerca de 14Mb, e demonstramos a existência de um novo loco gênico no cromossomo X, por nós denominado SPG34. Os resultados deste estudo estão publicados no Neurogenet on line em 08/05/200We studied two large families with expressions of neurodegenerative diseases. One is from the high west of the state of Rio Grande do Norte and the other from São José do Rio Preto region, in São Paulo. The first, an extended family with a tradition of consanguineous marriages, has 68 individuals affected by the syndrome named by us Spoan (Spastic Paraplegia, Optic Atrophy, Neuropathy). The Spoan syndrome is a neurodegenerative disease, autosomal recessive, characterized by congenital Optic Atrophy, spasticity, axonal polyNeuropathy peripheral sensory-motor, shocks to the sound stimuli, joint and spine deformities, and dysarthria. These results were published in 2005 in Ann Neurol. 57 (5):730-7. Latter we analyzed 23 genes that were entirely sequenced. No mutation was observed. Samples of 65 affected and their relatives were studied for six microsatellite markers, totaling 149 individuals genotiped. Fifty single nucleotide polymorphisms (SNPs), located in the critical region, were also investigated, which allowed us to reduce the region for the SPOAN gene from 4.8 to 2.3 Mb, between the SNP rs1939212 and microsatellite D11S987 in 11q13. All patients are homozygous only at D11S1889, which two-point lod score with a Zmax of 27 at .=0.0 was obtained. The results of this study are being submitted. The second family was studied by Dr. Mayana Zatz group a few years ago. We investigated 12 affected and 12 normal relatives. Among these, seven patients, aged between 30 and 60 years, were clinically evaluated. The age of onset was from the third decade of life and disease showed behaviour very uniform, all affected showed Spastic Paraplegia as the only symptom. For the marker DXS8057, in Xq25, was obtained a maximum lod score of 4.13 at .=0.0. The candidate region was maped between the markers DXS1001 and DXS8033, about 14Mb and demonstrate the existence of a new gene locus on chromosome X, named by us SPG34. The results of this study were published in Neurogenet on line on may.08.2008.
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Yao, Fei. "Measurement and modeling of wheelchair propulsion ability for people with spinal cord injury". Thesis, University of Canterbury. Mechanical Engineering, 2007. http://hdl.handle.net/10092/1218.
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Wheelchair propulsion is an important part of daily living for many people with spinal cord injuries (SCI's). The aim of this project was to establish the validity of using a new approach for measuring wheelchair propulsion ability. The variation in methods observed by subject's hands in contacting and propelling their wheelchair, namely, using the push rims only; wedging the hands between push rims and tyre and grasping both push rims and tyres, highlighted that earlier studies using instrumented push rims (including the SMART ) for people with tetraplegia would not provide a true indication of propulsion ability for the participants in this study. As a result, a new inertia dynamometer was built and calibrated for measuring wheelchair propulsion ability. Kinetic and kinematic models were developed to calculate wheelchair propulsion parameters such as power output, wheelchair velocity and arm motion patterns. After testing 22 subjects with different SCI levels, the results indicated that arm function was a more important factor in wheelchair propulsion, in terms of power output, than trunk stability and strength. More importantly, people with C5/C6 tetraplegia had a significantly reduced capability in terms of wheelchair propulsion compared with other subjects with a lower lesion (T1-T8, T9-T12 and L1-S5). A further study for quantifying the contribution of triceps function on improving wheelchair propulsion for people with tetraplegia was performed by comparing kinetic and kinematics parameters in C5/C6 tetraplegia subjects. Depending on the control of elbow extension, the subjects were divided into groups with: no active elbow extension, deltoid to triceps transfer surgery (TROIDS) to provide elbow extension, and incomplete C5/C6 tetraplegia with retained active triceps function providing elbow extension. The results demonstrated that the restoration of triceps following TROIDS surgery not only allows active elbow extension, but also increased the amplitude and strength as well as the speed of arm movement. Finally, the results also point to TROIDS allowing a more pronounced and natural push phase and an improved arm movement pattern during both propulsion and recovery phase under normal and extreme conditions.
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Pierret, Benoît. "Le fauteuil roulant chez le blessé médullaire, facteur déterminant de l'insertion sociale. État des lieux et effets de la locomotion en dévers sur les astreintes physiologiques". Thesis, Université de Lorraine, 2012. http://www.theses.fr/2012LORR0216/document.
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Introduction. Les capacités et les possibilités de déplacement en fauteuil roulant manuel (FRM) sont déterminantes pour l'intégration sociale et professionnelle des usagers. Objectifs. Approfondir la connaissance des contraintes de déplacement en FRM à travers 2 études. La 1ère pour identifier les habitudes et préciser les difficultés des usagers ; la 2nde, induite par les résultats de la 1ère, pour évaluer les effets du dévers, encore méconnus, sur les astreintes cardiaques, énergétiques, musculaires et subjectives. Méthodes. La 1ère étude a été menée par questionnaire complété par 118 sujets paraplégiques en FRM. La 2nde étude, en laboratoire avec 25 hommes paraplégiques, comporte 2 tests : un test d?effort sur ergocycle à bras et un test de propulsion de 300 m et 8 conditions combinant 4 dévers (0, 2, 8 et 12 %) et 2 vitesses (0,97 m.s-1 et une vitesse choisie "de confort"). Résultats. La 1ère étude révèle un environnement peu adapté, avec des moyens de transport et des bâtiments souvent inaccessibles sans aide, et des gènes limitant les sorties des usagers parmi lesquelles figure le dévers. La 2nde étude indique des astreintes cardiaques, énergétiques et musculaires significativement modifiées par le dévers et par la vitesse (p < 0,01). L'astreinte subjective n'est pas modifiée par la vitesse. Des différences entre 0 et 2 % sont faibles mais existent. Un dévers de 12 % est difficilement réalisable. Les équilibres des activités musculaires changent dès 2 % de dévers. Le niveau lésionnel modifie de façon très importante les stratégies de déplacements et les niveaux d'astreintes mesurées ou perçues. Discussion-Conclusion. Les effets du dévers sont perceptibles dès 2 % et sont nets et délétères à 8 %. Ce travail permet de proposer de façon plus argumentée un modèle d'astreintes qui conforte le seuil de dévers fixé réglementairement à 2 % permettant à la grande majorité des usagers de FRM de se déplacer de façon autonome et de rester actifsIntroduction. Displacement capacities and possibilities in manual wheelchair (MWC) are strong determinants of social and occupational integration of MWC users. Objectives. Improve the knowledge of the strains involved by displacement in MWC through 2 studies; the first one to identify habits and difficulties of MWC users. The second one, induced by the results of the first one, has assessed the poorly known cardiac, energetic, muscular and subjective strains of the displacement of MWC users on a cross slope. Methods. The first study was a survey answered by 118 paraplegics habitual MWC users. The second one, a laboratory study conducted with 25 paraplegic men, includes 2 tests: a sub maximal arm-cranking test and a 300 m propulsion test with 8 conditions combining 4 cross slopes (0, 2, 8 et 12%) and 2 velocities (0,97 m.s-1 and a "comfortable" chosen one). Results. The first study shows an adverse environment, with many places unreachable without help and disturbances, like cross slope, which hinders users' displacements. The second study demonstrates the increases of cardiac, energetic, muscular and subjective strains with cross slope. Differencies between 0 and 2% cross slopes are low but quantified. Displacement on a 12% cross slope is very difficult. The balance of muscles activities is changing at 2% cross slope. The injury level makes deep changes in the displacements strategies and in as well perceived as measured strain levels. Discussion-Conclusion. Effects of cross slope are perceived for as low as 2% and onwards values. They are high and deleterious at 8%. This work allows to construct a model of cross slope strains which confirms that the regulatory 2% cross slope limit is well chosen because it allows most MWC users to move without help and remain active
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Oteyza, Andrés de [Verfasser], i Ludger [Akademischer Betreuer] Schöls. "Gene identification in Hereditary Spastic Paraplegias and characterization of Spastic Paraplegia type 58 (SPG58) / Andrés de Oteyza ; Betreuer: Ludger Schöls". Tübingen : Universitätsbibliothek Tübingen, 2016. http://d-nb.info/1165236532/34.
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Purdy, Allison Renee. "The Effects of Yoga Therapy on the Quality of Life for a Paraplegic Individual". PDXScholar, 2012. https://pdxscholar.library.pdx.edu/open_access_etds/342.
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The purpose of this study was to document the effects that a regular yoga therapy practice has on the quality of life for a paraplegic individual. Due to the unique nature of spinal cord injury (SCI), this was a case study with one participant. For 5 weeks the subject practiced a standardized yoga routine three times a week with a yoga teacher, receiving private instruction. Interview questions were asked before and after the intervention to document the participant's quality of life. Each week, the subject completed a modified SF-36 questionnaire as well as Cohen's Perceived Stress Survey. Perceived pain and perceived stress were the two primary variables monitored in the study. The results of this study demonstrated a slight reduction in perceived stress, a reduction in perceived pain, and an improvement in overall quality of life. Additionally, the subject increased her strength significantly from the beginning to the end of the study. Based on the findings in this study, it appears that a regular adapted yoga routine is beneficial for paraplegic individuals.
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Santos, Leila Conceição Rosa dos. "Re dimensionando limitações e possibilidades: a trajetória da pessoa com lesão medular traumática". Universidade de São Paulo, 2000. http://www.teses.usp.br/teses/disponiveis/7/7136/tde-02082007-112821/.
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O estudo foi realizado com pessoas do sexo masculino e que viveram a experiência de sofrer um trauma que acarretou a lesão da medula espinal. Teve como objetivos: - compreender os significados que a pessoa atribui a sua experiência de ser lesado medular; - compreender a maneira como a dimensão atribuída ao significado de ser lesado medular se manifesta nas ações da pessoa; - desenvolver um modelo teórico representativo da experiência da pessoa que sofreu uma lesão traumática na medula espinal. Utilizou-se como referencial teórico o Interacionismo Simbólico e como referencial metodológico, a Teoria Fundamentada nos Dados. A estratégia para a obtenção dos dados foi a entrevista. Dos resultados emergiram dois fenômenos - Sobrevivendo ao Acidente e Vivendo uma Nova Realidade. Destes, identificou-se a categoria central - Re dimensionando limitações e possibilidades. A compreensão da experiência da pessoa que adquire uma lesão da medula espinal possibilitou reconhecer como as vivências, que ocorrem após a constatação da deficiência física, são percebidas por esses indivíduos, e como redimensionam os significados que vão atribuindo às situações diferentes que passam a vivenciar. O modelo teórico mostra que a experiência de ter se tornado um paraplégico ou um tetraplégico, é permeada pela vivência de limitações, e dependências, sentimentos e reações que vão sendo dimensionados e redimensionados à medida que vai re elaborando significados e valores, e desenvolvendo ações que lhe apontam possibilidades, as quais toma posse mediante as escolhas que faz para dar continuidade ou sentido à vida preservada, porém modificadaA study conducted with adult males who had undergone the experience of suffering trauma causing spinal cord injury (SCI). The aim was to: - understand the meaning patients gave to their experience of being an SCI bearer; - understand how the dimensions attributed to being a SCI bearer manifested itself in the person\'s behavior; - develop a theoretical model representative of the experience of the person who suffered SCI. The study used as a theoretical reference Symbolic Interactionism and used the Grounded Theory methodology. Data was collected through interviews. Two phenomena emerged from the findings: \"Surviving the Accident\" and \"Living a New Reality\". Of these the central category was identified as Re defining limits and possibilities. Understanding of the experience of SCI bearers made it possible to recognize how the events that occurred after the diagnosis of the physical deficiency is perceived by the persons and how they redefine the meaning attributed to the different situations they came to experience after suffering the acquired physical deficiency. The theoretical model reveals that the experience of having become a paraplegic or tetraplegic involved a lot of coping with limitations and dependency, emotions and reactions that go on being defined and redefined as the individual restructured values and developed actions that led to possibilities of overcoming, which were adopted through the choices made, so as to give continuity of meaning to the life that remained, although in its modified state
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Gaino, Ruberlei [UNESP]. "Controle de movimentos de pacientes paraplégicos utilizando modelos fuzzy T-S". Universidade Estadual Paulista (UNESP), 2009. http://hdl.handle.net/11449/100279.
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Foram realizados estudos, projetos e simulações do controle não-linear da posição da perna de um paraplégico, com eletroestimulação, utilizando modelos fuzzy Takagi- Sugeno (T-S). Nessa pesquisa, foi adotado um modelo matemático que utiliza uma relação empírica do torque do músculo com a largura de pulso, representada por uma função de transferência de primeira ordem. A modelagem da dinâmica do modelo do paciente paraplégico foi realizada com variáveis de estado. Projetou-se um regulador fuzzy (T-S), inicialmente no ponto de operação com a posição da perna em 30o, utilizando-se a teoria de Lyapunov para o estudo da estabilidade dos sistemas dinâmicos e o projeto do controlador baseado em desigualdades matriciais lineares (Linear Matrix Inequalities, LMI). As especificações consideradas neste projeto foram a estabilidade, a taxa de decaimento e restrições nos sinais de entrada e saída. Foi também projetado um observador de estado e regulador com observador de estado, todos não-lineares e contínuos no tempo, para o paciente paraplégico, também baseado em LMI, no ponto de operação com a posição da perna em 60o. Devido a necessidade de implementação em hardware, um modelo discretizado foi proposto, para a obtenção de modelos fuzzy Takagi-Sugeno discretos no tempo, a partir de modelos fuzzy Takagi-Sugeno contínuos no tempo, considerando períodos de amostragem suficientemente pequenos. Análises te´oricas e simulações digitais comprovaram a sua eficácia. Reguladores com observadores contínuos no tempo, considerando o rastreamento da posição da perna de um paraplégico e uso de variáveis virtuais foram também propostos. Neste projeto, pôde-se variar a posição angular desejada sem a necessidade do cálculo do novo ponto de operação e do projeto de um novo controlador para cada ponto de operação. Um método de identificação de modelos locais...
This thesis presents studies, designs and simulations about the use of functional electrical stimulation, to control the leg position of a paraplegic patient. The plant is described by a nonlinear system using Takagi-Sugeno fuzzy models and a closed-loop control is presented. A transfer function represents the mathematical model related to the muscle torque and the pulse width. Considering the operation point at 30◦ and all state variables available, then a fuzzy regulator was designed. This design was based on the Lyapunov stability, Linear Matrix Inequalities (LMI), and considered the following specifications: decay rate, and input and output constraints. Moreover, the design of a state observer, also based on LMIs, to obtain a continuous-time regulator with an observer in the operation at 60◦ was presented. Due to the necessity of implementation in hardware, a new method to obtain a discrete-time T-S model of plants described by continuous-time nonlinear T-S models, considering small sampling periods was proposed. Another new methodology was proposed to design continuous-time regulators and observers, through the signal tracking (leg position of paraplegics) and the use of virtual variables. This procedure allows the tracking of the angular position, without the design of a new controller for each operation point. A new method for the identification of T-S local models, where the input is a step and the system operates around the operation point of the wanted local model was proposed. This procedure is based on LMI. Other new method, using state-derivative feedback, was proposed for the control of the leg position of a paraplegic patient, described by a T-S model, using only accelerometers as sensors. All the simulated results in this thesis show that the proposed procedures are efficient and offer good results to this control problem class.
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STRAPPAVECCIA, Silvia. "IMPIANTO AUTOLOGO DI CELLULE STAMINALI NOM (NASAL OLFACTORY MUCOSA) IN CANI PARAPLEGICI CRONICI [AUTOLOGOUS IMPLANT OF NASAL OLFACTORY MUCOSA (NOM) STEM CELLS IN CHRONIC PARAPLEGIC DOGS]". Doctoral thesis, Università degli Studi di Camerino, 2007. http://hdl.handle.net/11581/401897.
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La terapia delle lesioni spinali croniche dell'uomo rappresenta attualmente uno dei maggiori campi di interesse della ricerca scientifica. Tra le strategie sperimentali di ultima elaborazione, il trapianto di cellule staminali sta dimostrando notevoli potenzialita' per la cura di molte patologie del SNC. I modelli animali principalmente utilizzati per gli studi sperimentali sono i ratti, ma le dimensioni del midollo spinale in questa specie sono estremamente diverse da quelle dell'uomo, e le condizioni di laboratorio in cui i protocolli sperimentali vengono applicati sono molto differenti dalle condizioni accidentali delle lesioni umane. Il trauma spinale e' un'evenienza piuttosto frequente nel cane, ma molto spesso la terapia non viene effettuata precocemente o e' inefficace, cosi' da portare ad una condizione di paraplegia cronica. In questa specie l'eziopatogenesi delle lesioni e le dimensioni del midollo sono simili a quelle dell'uomo. Per tali ragioni il cane rappresenta un buon modello per lo studio delle terapie sperimentali nelle lesioni spinali croniche. Lo scopo del presente lavoro e' quello di verificare se l'impianto autologo di cellule staminali adulte di natura olfattoria sia in grado di ripristinare la deambulazione volontaria in cani paraplegici cronici. Sono stati inclusi nello studio 6 soggetti sottoposti alla nostra attenzione tra gennaio 2004 e dicembre 2005 per l'insorgenza di un grave trauma spinale compreso tra le vertebre T4 e L3. Trascorsi almeno due mesi dall'insorgenza della paraplegia, in ciascun cane e' stato effettuato il prelievo bioptico della mucosa nasale. Il campione e' stato quindi inviato nel laboratorio di riferimento, dove le cellule staminali sono state isolate e allestite su un apposito supporto. Nei mesi successivi tutti i 6 pazienti sono stati sottoposti all'impianto delle cellule autologhe, dopo esposizione chirurgica del segmento midollare leso e asportazione del tessuto cicatriziale. La fase post-operatoria e' stata dedicata all'esecuzione di intensi protocolli fisioterapici e di indagini cliniche e strumentali, finalizzate alla valutazione del recupero neurologico. I risultati ottenuti hanno evidenziato la presenza di un parziale ripristino delle capacita' deambulatorie in 3 soggetti, mentre i tracciati elettrofisiologici relativi ai Potenziali Evocati Somato-Sensoriali (PESS) non hanno subito alcuna variazione nel periodo successivo all'impianto. In un soggetto, deceduto spontaneamente per una patologia indipendente dalla condizione neurologica, e' stato possibile sottoporre il midollo spinale a valutazioni di tipo istologico e immunoistochimico. Queste hanno evidenziato la presenza, nel tratto midollare sede dell'impianto, di gruppi di neuroni-fibre dispersi all'interno di abbondante tessuto fibroso. Pur considerando l'esiguita' del numero dei soggetti inclusi nella ricerca, e in attesa di poter sottoporre ad indagini istologiche il midollo spinale di 5 di loro, si puo' concludere che l'impianto di cellule staminali di origine olfattoria nel midollo spinale di cani paraplegici cronici puo' presentare notevoli potenzialita' terapeutiche. The treatment of chronic spinal cord injuries in humans is, today, one of the most important fields of scientific research. Among the experimental strategies recently developed, stem cell transplants are demonstrating great potentiality for the cure of many central nervous system (CNS) pathologies. The most common animal models used in experimental studies are rats but the dimensions of the spinal cord of this species are quite different from those of the human, and the laboratory conditions in which the experimental protocols are applied do not resemble the accidental conditions of human injuries. Spinal cord injuries are relatively frequent in dogs but very often the therapy is not applied promptly or is not efficacious, and the result is a condition of chronic paraplegia. The etiopathogenesis of the injuries and the dimensions of the spine of the dog are similar to those of the human. For these reasons, the dog represents a good model for studying experimental treatment of chronic spinal cord injuries. The aim of this study is to verify whether the autologous implant of adult stem cells obtained from nasal olfactory mucosa (NOM) is able to restore voluntary ambulation in dogs with chronic paraplegia. This study concerns six subjects that we cared for between January 2004 and December 2005 after the onset of a serious spinal trauma in the area between the vertebrae T4 and L3. At least two months after the onset of paraplegia, a bioptic sample was taken from the nasal mucosa of each dog. The sample was sent to the reference laboratory where the stem cells were isolated and prepared on an appropriate scaffold. During the following months all six patients were subjected to the implant of autologous cells, after the surgical exposure of the injured segment of the spinal cord and the removal of scar tissue. The post-surgical phase was dedicated to intensive physiotherapy protocols and clinical and instrumental investigations, with the aim of evaluating the neurological recovery. The results obtained demonstrated the presence of a partial restoration of the ambulatory capacity in three subjects, while the electrophysiological pathways relative to the Somatosensory Evoked Potential (SSEPs) did not undergo any variation in the period following the implant. In the case of one dog, that died spontaneously from a pathology not connected with the neurological condition, it has been possible to carry out histological and immununohistochemical evaluations of the spinal cord. These have demonstrated the presence of groups of neuron-fibres dispersed inside abundant fibrous tissue in the area of the implant. While taking into consideration the small number of subjects included in the research and in anticipation of being able to subject the spinal cords of the other five dogs to histological investigations, we can nevertheless conclude that the implant of the stem cells of olfactory origin in the spinal cord of dogs with chronic paraplegia can offer outstanding therapeutic potential.
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MANCUSO, GIUSEPPE. "Dissecting the pathogenesis of hereditary spastic paraplegia linked to SPG4 and SPG7 genes". Doctoral thesis, Università degli Studi di Milano-Bicocca, 2011. http://hdl.handle.net/10281/20207.
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The aim of this thesis is to analyze and characterize the function of two genes involved in Hereditary Spastic Paraplegia, SPG4 and SPG7, to dissect their role in the pathogenesis of the disease.
SPG4 encodes for Spastin, a microtubule severing protein involved in cytoskeletal dynamics and subcellular trafficking.
On the other hand, SPG7 encodes for Paraplegin, a subunit of the m-AAA protease complex. This protease plays a key role in inner membrane protein quality control and in specific substrate maturation.
Studying two genes with different function can shed light on common pathogenetic mechanisms in an etiologically complex disease such as Hereditary Spastic Paraplegia.
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Silva, Gelson Aguiar da. "Funcional independence of individuals With paraplegia in a rehabilitation program: results and associated factors". Universidade Federal do CearÃ, 2006. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=389.
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CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel SuperiorSpinal cord injury can convey constraints to individuals, but a rehabilitation program which evalueates the functional gain allows outpatient care during the rehabilitation process. The aim of the present research was to evaluate results obtained trough the administration of Functional Independence Measure (FIM scale) in paraplegic petients within rehabilitation programs, by connecting such results with the variables: age, gender, time, level and etiology of the lesion, classification of lesion according to the ASIA (American Spinal Injury Association) criterion, time of hosptalization, educational status and complications (pressure sores, heterotopic ossofication, spasticity and neuropathic pain). For such, a transversal quantitative retrospective descriptive study was proceeded by analyzing medical records and the scoresobtained with FIM scale. The investigations were done using spedific tests, through the SPOSS software (statistical Package for the Social Science), version 13 for Windws. Results demonstrated that among the variables there studied variables there is a direct correlation between age, time of lesion, motor level, time of hospitalization and hospitalization wich a companion and the independence gain (P< 0.05). Besides there is an inverse relation between the lession classification (AIS A, B, C, D, or E) and the functional gain (P< 0.05). Functional evaluation of people with spinal cord injury though MIF scale allows to fallow up functional gain in people within a rehabilitation program.
A lesÃo medular pode trazer limitaÃÃes ao indivÃduo, mas um programa de reabilitaÃÃo que avalie o ganho funcional permite o acompanhamento, ao longo do decurso de reabilitaÃÃo. O objetivo desta pesquisa foi avaliar os resultados obtidos com a aplicaÃÃo da Medida de IndependÃncia Funcional (MIF) em pessoas portadoras de paraplegia em programa de reabilitaÃÃo; associando tais achados com as variÃveis: idade, sexo, tempo, nÃvel e etiologia da lesÃo, classificaÃÃo da lesÃo segundo o critÃrio da ASIA (American Spinal Injury Association), tempo de hospitalizaÃÃo, escolaridade e complicaÃÃes (Ãlcera de pressÃo, ossificaÃÃo heterotÃpica, espasticidade e dor neuropÃtica). Para isso foi realizado um estudo quantitativo transversal, de natureza retrospectiva, de carÃter descritivo, com anÃlise de 228 prontuÃrios e da pontuaÃÃo obtida mediante a Escala MIF. As anÃlises foram feitas sob testes especÃficos com auxÃlio do software SPSS (Statistical Package for the Social Science), versÃo 13 para Windows. Os resultados mostraram que, dentre as variÃveis estudadas, hà uma relaÃÃo direta entre a idade, o tempo de lesÃo, nÃvel motor, tempo de internaÃÃo e a internaÃÃo com acompanhante e o ganho de independÃncia (p< 0,05). TambÃm hà uma relaÃÃo inversa entre a classificaÃÃo da lesÃo (AIS A, B, C, D ou E) e o ganho funcional (p< 0,05). A avaliaÃÃo funcional em pessoas portadoras de lesÃo medular, por meio da Escala de Medida de IndependÃncia Funcional, permite o acompanhamento do ganho funcional em pessoas submetidas a um programa de reabilitaÃÃo.
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Parodi, Livia. "Identification of genetic modifiers in Hereditary Spastic Paraplegias due to SPAST/SPG4 mutations Spastic paraplegia due to SPAST mutations is modified by the underlying mutation and sex Hereditary spastic paraplegia: More than an upper motor neuron disease". Thesis, Sorbonne université, 2019. http://www.theses.fr/2019SORUS317.
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Les Paraplégies Spastiques Héréditaires (PSHs) sont un groupe de maladies neurodégénératives rares qui surviennent suite à la dégénérescence progressive des voies corticospinales, entraînant une spasticité des membres inférieurs, signe distinctif de la pathologie. Elles se caractérisent par une extrême hétérogénéité qui concerne à la fois les facteurs génétiques et cliniques, ainsi que d’autres aspects de la maladie, tels que l’âge d’apparition et la sévérité des signes. Cette variabilité est typiquement observée chez les patients porteurs de mutations pathogènes dans SPAST, le gène le plus fréquemment muté dans les PSHs. Après avoir réuni une cohorte de 842 patients mutés dans SPAST, nous avons utilisé une combinaison de différentes approches de Séquençage de Nouvelle Génération (NGS) afin de mieux comprendre les causes de l’hétérogénéité observée chez les patients, afin d’identifier des facteurs génétiques responsables de variations de l’âge au début de la maladie. Les données résultantes du génotypage de l’ensemble du génome ont ainsi été utilisées pour effectuer des analyses d’association et de liaison qui, combinées aux données de séquençage de l’ARN, ont permis d’identifier différents variantes/gènes candidats, potentiellement impliqués comme facteurs modificateurs de l’âge de début des SPAST-PSHsHereditary Spastic Paraplegias (HSPs) are a group of rare, inherited, neurodegenerative disorders that arise following the progressive degeneration of the corticospinal tracts, leading to lower limbs spasticity, the disorder hallmark. HSPs are characterized by an extreme heterogeneity that encompasses both genetic and clinical features, extending to additional disorder’s features, such as age of onset and severity. This phenotypic variability is typically observed among HSP patients carrying pathogenic mutations in SPAST, the most frequently mutated HSP causative gene. After assembling a cohort of 842 SPAST-HSP patients, a combination of different Next Generation Sequencing approaches was used to dig deeper into the causes of the observed heterogeneity, especially focusing on the identification of age of onset genetic modifiers. Sequencing data resulting from Whole Genome Genotyping were used to perform both association and linkage analysis that, combined with RNA sequencing expression data, allowed to identify different candidate variants/genes, potentially acting as SPAST-HSP age of onset modifiers
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AITKACI, SADI. "Les paraplegies ischemiques post operatoires". Limoges, 1989. http://www.theses.fr/1989LIMO0209.
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Sullivan, Martin Joseph. "Paraplegic Bodies: Self and Society". Thesis, University of Auckland, 1996. http://hdl.handle.net/2292/1917.
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In this dissertation it is argued that humans constitute themselves as subjects in a complex of interrelationships between body, self, and society, The effects of these interrelationships are examined through the ways in which traumatic paraplegics constitute themselves as subjects following their accidents. Subsequent to paralysis there is a radical break in how paraplegics experience their bodies, in what they are physically able to do, and in the ways in which their bodies are interpreted socially, assigned meanings, and allocated space in which to do and be. Experiential accounts of paraplegia are presented as a means to exploring the implications of these changes in the ways paraplegics constitute themselves as subjects.
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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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Nunes, Willian Ricardo Bispo Murbak. "A new dynamic model applied to electrically stimulated lower limbs and switched control design subject to actuator saturation and non-ideal conditions /". Ilha Solteira, 2019. http://hdl.handle.net/11449/183168.
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Orientador: Aparecido Augusto de CarvalhoAbstract: Electrical stimulation is a promising technique for motor rehabilitation in cases of spinal cord injury. Stimulator saturation is important in the control system designs applied to electrical stimulation. The negligence of the actuator saturation in the electrical stimulation can lead to unwanted control results, which evidences the muscular fatigue effects. For the first time a switched controller subject to actuator saturation for electrically stimulated lower limb is proposed. The dynamic limb extension model is nonlinear and uncertain. The uncertain nonlinear system described by Takagi-Sugeno fuzzy models operating within an operating region in the state space is considered in this study. In addition, fault in the actuator, muscle activation uncertainty, and muscular non-idealities, such as fatigue, spasms, and tremor were considered at three three severity levels. The switched controller is compared to parallel distributed compensation technique. Simulations denote better results of the switched controller by dealing with parametric uncertainties. On the other hand, a challenge for FES control systems is to monitor torque in muscle contractions. In isotonic contraction applications, measuring torque is difficult. The novelty in this study is the proposal of a new nonlinear model, whose state variables are angular position, angular velocity and angular acceleration. In this new model the torque variable is replaced by the angular acceleration. Experimental tests list the ... (Complete abstract click electronic access below)
Resumo: A estimulação elétrica é uma técnica promissora para reabilitação motora em casos de lesão medular. A saturação do estimulador também é um requisito importante no projeto de sistemas de controle aplicados à estimulação elétrica. A negligência da saturação do atuador pode conduzir a resultados de controle indesejados, que evidencia os efeitos de fadiga muscular. Pela primeira vez é proposto um controlador chaveado sujeito à saturação para membro inferior estimulado eletricamente. O modelo dinâmico de extensão do membro inferior é não linear e incerto. O sistema descrito por modelos fuzzy Takagi-Sugeno e operando dentro de uma região de operação no espaço de estados é considerado neste trabalho. Além disto, falha do atuador, incerteza de ativação muscular, e não idealidades musculares, tais como fadiga, espasmos e tremor foram considerados em três níveis de severidade. O controle chaveado é comparado com a compensação distribuída paralela. Simulações denotam melhores resultados do controlador chaveado lidando com incertezas paramétricas da planta. Por outro lado, um desafio dos sistemas de controle para estimulação elétrica funcional é monitorar a dinâmica do torque em contrações musculares. Em aplicações de contração isotônica, medir o torque é algo difícil. A novidade neste estudo é a proposta de um novo modelo não linear, cujas variáveis de estado são posição angular, velocidade angular e aceleração angular. Neste novo modelo a variável torque é substituída adequadamente pel... (Resumo completo, clicar acesso eletrônico abaixo)
Doutor
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Courtois, Frédérique J. "Residual erectile capacity of paraplegic rats". Thesis, McGill University, 1989. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=74335.
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This series of studies was designed to investigate the residual erectile capacity of paraplegic rats. Results from human studies suggest that erectile capacity in paraplegic men may be maintained following psychogenic, but not reflexogenic, stimulation. Using an animal model to overcome methodological difficulties associated with human studies, reflexogenic stimulation was defined as local stimulation of the genitals, and psychogenic stimulation as stimulation of a key central structure. Results from higher CNS stimulation showed that electrical stimulation of the medial preoptic area of the hypothalamus reliably triggers penile responses in rats and elicits penile responses as a post-stimulation effect. Optimal stimulation parameters were identified and used to maximize the effect on spinal animals. The effect of central stimulation was then compared to that of local stimulation to examine whether truly sexual responses were elicited. Results demonstrated that central stimulation elicits primarily erectile responses with a few urine-marking responses. The two stimulation sources were then used to test the residual erectile capacity of paraplegic rats whose lesions interrupted the L6-S1 fibers. Results showed that a high proportion of animals (85%) indeed maintain erectile responses to central stimulation but lose reflex activity from the genital area. These results support the hypothesis under study and are discussed in terms of the neural substrates of erection and their implication at the human level.
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Meijer, Inge A. "Genetic analysis of the hereditary spastic paraplegias". Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=102811.
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The Hereditary Spastic Paraplegias (HSP) comprise a group of neurodegenerative diseases characterized by progressive lower limb spasticity. This disease, with a prevalence ranging from 1 to 20 in 100,000 individuals, is currently untreatable. The neuropathological hallmark is axonal degeneration of motor neurons in the corticospinal tract. However, the mechanisms of pathogenesis underlying this neurodegeneration remain poorly understood. Over the last decade, genetic studies of HSP have identified 33 loci including 14 genes. The main objective of this dissertation was to identify and characterize genes in a large North American HSP cohort. Mutation analysis of the two most common genes implicated in HSP, SPG3 and SPG4, led to the detection of nine novel mutations, including an ancestral SPG4 mutation in five French Canadian families. This screen also allowed for the molecular characterization of the p.del436N mutation in SPG3, which suggests a previously unidentified dominant-negative mechanism. Furthermore, a novel deletion in the VPS9 domain of the ALS2 gene was identified in a family with severe infantile onset HSP. In addition, linkage analysis and whole genome scan efforts resulted in the successful mapping of two novel HSP loci, SPG27 and SAX1. SAX1 represents the first locus for autosomal dominant spastic ataxia, a complicated form of HSP, with a common ancestor in Newfoundland. Finally, a positional candidate gene strategy at the SPG8 locus identified three missense mutations in a novel gene encoding strumpellin. Two mutations failed to rescue an axonal phenotype induced by morpholino knock-down of the SPG8 gene in zebrafish. Our efforts to identify and characterize HSP genes determined the underlying genetic cause in 36% of our cohort. These genetic causes include two novel loci and a novel gene. The findings are a major contribution to the characterization of the pathophysiology of HSP and significantly broaden the knowledge in the field of motor neuron disease. Analysis of the 15 known HSP genes suggests a common disease mechanism involving disrupted axonal membrane protein trafficking. Unraveling this mechanism will elucidate the functional maintenance of neurons in the corticospinal tract and will facilitate the development of therapies for HSP and related diseases.
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Bataweel, Adel Omar. "Lower limb orthotics inprovements for paraplegic mobility". Thesis, University of Salford, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.700292.
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Voll, Juliana. "Recuperação funcional em dachshunds paraplégicos sem percepção de dor profunda submetidos à hemilaminectomia". reponame:Biblioteca Digital de Teses e Dissertações da UFRGS, 2010. http://hdl.handle.net/10183/31728.
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Lesões agudas da medula espinhal são de ocorrência comum em certas raças condrodistróficas como a Dachshund. Nessa raça, um desenvolvimento anormal do disco intervertebral causa uma precoce desidratação e mineralização do núcleo pulposo. Como conseqüência da degeneração discal, esses cães são propensos à extrusão discal aguda que resulta em lesão da medula espinhal contusiva e compressiva. A cirurgia descompressiva é o método de tratamento para cães com disfunção neurológica secundária à compressão da medula espinhal e o prognóstico para recuperação funcional é determinado principalmente pela severidade da lesão na medula espinhal. A perda da sensação de dor profunda em cães com doença do disco intervertebral indica lesão grave da medula espinhal e costuma ser considerada como um mau prognóstico. Existem poucos estudos com um número significativo de casos documentando a recuperação após cirurgia descompressiva em cães com ausência de percepção de dor profunda. A cirurgia raramente é recomendada se a percepção de dor profunda está ausente por mais de 48 horas, mas não foi comprovado um período de tempo mais preciso para tal recomendação. Este trabalho teve como objetivo avaliar a recuperação funcional dos membros pélvicos de cães da raça Dachshund paraplégicos com ausência de percepção de dor profunda por um período inferior e superior a 48 horas, devido à extrusão discal, submetidos à cirurgia descompressiva. Trinta cães paraplégicos foram distribuídos em dois grupos, sendo o primeiro formado por animais com ausência da sensação de dor profunda nos membros pélvicos por um período inferior a 48 horas e o segundo por um período superior a 48 horas. Em todos os pacientes foram realizados exame mielográfico e cirurgia descompressiva (hemilaminectomia). Posteriormente, esses animais foram submetidos a exame neurológico e avaliados quanto ao grau de locomoção e percepção de dor profunda. Apenas foram considerados recuperados os animais que demonstraram grau 3, 4 ou 5 de locomoção (paresia leve, ataxia ou exame neurológico normal). Os resultados comprovaram que pacientes com ausência de dor profunda devido à extrusão do disco intervertebral devem ser considerados candidatos à cirurgia descompressiva. O argumento de um prognóstico ruim, como afirmado em alguns estudos prévios, não se justifica baseado na duração da ausência de dor profunda antes do procedimento cirúrgico. O retorno da percepção de dor profunda dentro de 4 semanas pode ser associado com prognóstico favorável para retorno da locomoção (grau 3, 4 ou 5). A nova escala estabelecida dos graus de locomoção foi útil na avaliação da recuperação funcional de cães paraplégicos.Acute lesions of spinal cord are a common occurrence in certain chondrodystrophic breeds such as Dachshund. In this race, an abnormal development of the intervertebral disc causes an early dehydration and mineralization of the pulposus core. As a result of disc degeneration, these dogs are prone to acute disc extrusion, resulting in a compressive and contusive spinal cord injury. Surgical decompression is the treatment method for dogs with neurological dysfunction secondary to spinal cord compression and the prognosis for functional recovery is mainly determined by the severity of spinal cord injury. The loss of deep pain perception in dogs with IVDD indicates severe injury of the spinal cord and is often considered as a bad prognosis. There are few studies with a good number of cases documenting the recovery after decompressive surgery in dogs with no deep pain perception (DPP). Surgery is rarely recommended if DPP is absent for more than 48 hours, but an exact period of time for such a recommendation has not been clearly established. This study aims to evaluate the functional recovery of pelvic limbs of paraplegic Dachshund breed dogs paraplegic with no deep pain perception for a period inferior and superior to 48 hours due to disc extrusion and submitted to surgical decompression. Thirty dogs were divided into two groups; the first consists of paraplegic dogs with no sense of deep pain in the pelvic limbs for less than 48 hours and the second, formed by dogs more than 48 hours. All patients underwent to myelographic examination and surgical decompression (hemilaminectomy). Thereafter, these animals were submitted to neurological examination and evaluated about their degree of movement and deep pain perception. Only were considered as recovered animals that reached locomotion grade 3, 4 or 5. The results showed that patients with absence of deep pain due to intervertebral disc extrusion should be considered candidates for decompressive surgery. The argument of a poor prognosis, as stated in some previous studies, was not justified based on duration of deep pain absence before surgery. The return of deep pain perception within 4 weeks may be associated with favorable prognosis for return of locomotion (grade 3, 4 or 5). The established grade of movement degrees was useful in evaluating the functional recovery of paraplegic dogs.
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Kader, Ibrahim Babul Salam. "Modelling and control of paraplegic's knee joint (FES-swinging)". Thesis, University of Sheffield, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.556679.
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The use of electrical signals to restore the function of paralyzed muscles is called functional electrical stimulation (PES). PES is a promising method to restore mobility to individuals paralyzed due to spinal cord injury (SCI). This thesis is concerned with the development of an accurate paraplegic knee joint model and control of electrically stimulated muscle. The modelling of musculoskeletal of paraplegic's lower limb is significantly challenging due to the complexity of the system. The first aim of this study is to develop a knee joint model capable of relating electrical parameters to dynamic joint torque as well as knee angle for PES application. The knee joint is divided into 3 parts; active muscle properties, passive knee joint properties and lower limb dynamics Hence the model structure comprising optimised equations of motion and fuzzy models to represent the passive viscoelasticity and active muscle properties is formulated. The model thus formulated is optimised using genetic optimization, and validated against experimental data. The results show that the model developed gives an accurate dynamic characterisation of the knee joint. The second aim of this study is to develop PES-induced swinging motion control. A crucial issue of PES is the control of motor function by artificial activation of paralyzed muscles. Major problems that limit the success of current PES control systems are nonlinearity of the musculoskeletal system and rapid change of muscle properties due to fatigue. Fuzzy logic control (FLC) with its ability to handle a complex nonlinear system without mathematical model is used. Two FLC strategies; trajectory based control and cycleto- cycle control are developed. In the trajectory based control, the controller with less energy consumption is developed to reduce muscle fatigue. The ability of this controller to minimize the fatigue is proved in the experimental work. The discretetime cycle-to-cycle control strategy is developed without predefined trajectory. This strategy is applicable for controlling PES-induced movement with the ability to reach full knee extension angle and to maintain a steady swinging of the lower limb as desired in the presence of muscle fatigue and spasticity. The performances of the controllers are assessed through simulation study and validated through experimental work.
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Hussain, Zakaria. "Intelligent Control Techniques for FES-Assisted Paraplegic Indoor Rowing Exercise". Thesis, University of Sheffield, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.521966.
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Jaime, Ralf-Peter. "On the control of paraplegic standing using functional electrical stimulation". Thesis, University of Glasgow, 2002. http://theses.gla.ac.uk/1591/.
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This thesis is concerned with the restoration of upright standing after spinal cord injury (SCI) by the means of Functional Electrical Stimulation. In particular, the work presented in this thesis is concerned with unsupported standing, i.e. standing without any support by the arms for stabilisation. Firstly, the experimental apparatus and feedback control approach is described. Secondly, the experimental work is divided into three parts. The motivation, experimental setup and procedure as well as results and conclusions are given for each of them. The feasibility of the investigated approach was usually tested on a neurologically intact subject. The results were subsequently confirmed with a paraplegic subject. First the feasibility and fundamental limitations of unsupported standing were investigated. Assuming the subject as a single-link inverted pendulum, an improved fully dynamic control approach was employed in the first step, confirming existing results. Here, the voluntary influence by the central nervous system was minimised. However, it is naturally desirable to take advantage of the residual sensory-motor abilities of the paraplegic subject to ease the task of stabilising the body. Ankle stiffness control has been proposed in the literature to accomplish this task. Hitherto, ankle stiffness was provided by artificial actuators. In the second part we investigated the feasibility and limitations of ankle stiffness control by means of FES. The same single-link approach was employed as above. Ankle stiffness control by FES was used in the third part to enable paraplegic standing. Here, the subject was required to participate actively in the task of stable standing and, while doing so, behaving like a double-link inverted pendulum. It could be shown that FES-controlled ankle stiffness contributed crucially to the subject's ability to stand. The thesis concludes with propositions for future work.
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HAJIMIRZAALIAN, HAMIDREZA. "Robotic Biomedical Device for Recovering Cardiovascular Efficiency in Paraplegic Patients". Doctoral thesis, Politecnico di Torino, 2014. http://hdl.handle.net/11583/2540888.
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This thesis is studying on the Design and development of a biomechanical robotize IPC
device to accomplish a therapeutic methodology for recovery of cardio-circulatory
functions, which may be seriously impaired in paraplegic patients. This impairment is
caused by the reduction of venous return, due to the missing muscular contraction in
zones without innervations.
Intermittent Pneumatic Compression (IPC) is a well-known technique, which can be used
for several therapeutic treatments like sports recovery, lymphoedema drainage, and deep
vein thrombosis prevention. An IPC device produces a definite massaging action on the
limb by inflating and deflating a given number of bladders according to particular time
laws.
The designed IPC device in this thesis is proposed for the lower limb to recover the
venous return and preventing the Deep Vein Thrombosis (DVT) in the patients. The
experimental tests on the volunteer persons showed the significant improvements on the
important parameters of the cardiovascular, like the stroke volume (SV), the cardiac
output (CO), and the end diastolic volume of left ventricle (LVEDV).
To understand the dynamic behaviour of the IPC device and to optimize its performances,
the device is characterized based on the mechanical and physiological aspects and its
mathematical model is simulated in Simulink-Matlab. The validation of the mathematical
model is done by comparing results with the experimental one.
In addition, to apply the desired pressure pattern on the limb, two control strategies based
on the PID algorithm and regulating inflating time are implemented on the model. The
results of the controlled model, shows about 60% improving in performances of the
device as concerns the bladder pressure control. In this case the experimental test has been
done and it verified the control results of the simulation
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TUAL, PASCAL. "Paraplegie associee au htlv1 en guyane francaise". Nantes, 1990. http://www.theses.fr/1990NANT019M.
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Kagawa, Takahiro, i Yoji Uno. "Gait pattern generation for a power-assist device of paraplegic gait". IEEE, 2009. http://hdl.handle.net/2237/13886.
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Wester, Gry. "Distributive justice and the disabled, reflections on Ronald Dworkin's paraplegic case". Thesis, University College London (University of London), 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.498493.
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Rochester, Lynn. "The influence of electrical stimulation on skeletal muscle in paraplegic subjects". Thesis, University of Newcastle Upon Tyne, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.303382.
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Jailani, Rozita. "Analysis and control of FES-assisted paraplegic walking with wheel walker". Thesis, University of Sheffield, 2011. http://etheses.whiterose.ac.uk/14989/.
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The number of people with spinal cord injury (SCI) is increasing every year and walking has been found to be the most exciting and important prospect to these patients to improve their quality of life. Many individuals with incomplete SCI have the potential to walk and everyone of them wants to try. Unfortunately up to now, there is less than one third of patients could walk again after SCI. Residual function, the orthotic support, energy expenditure, patient motivation and control technique are some of the factors that influence the walking outcome of spinal cord injured people. In this thesis, a series of studies are carried out to investigate the possibility of enhancing the performance of the functional electrical stimulation (PES) assisted paraplegic walking with wheel walker through the development and implementation of intelligent control technique and spring brake orthosis (SBO) with full utilization of the voluntary upper body effort. The main aim of this thesis is to enable individuals with complete paraplegia to walk again with maximum performance and the simplest approach as possible. Firstly, before simulation of the system can be made, it is important to select the right model to represent the actual plant. In this thesis, the development of a humanoid and wheel walker models are carried out using MSC.visualNastran4D (vN4D) software and this is integrated with Matlab Simulink® for simulation. The newly developed quadriceps and hamstrings muscle models from the series of experiments are used to represent subject muscles after comparison and validation with other two well-known muscle models are performed. Several experiments are conducted to investigate the effect of stimulation frequency and pulse-width in intermittent stimulation with isometric measurement from paraplegic subjects. The results from this work can serve as a guidance to determine the optimum stimulation parameters such as frequency and pulse-width to reduce muscle fatigue during PES application. The ability test is introduced to determine the maximum leg force that can be applied to the specific paraplegic subject during FES functional task with minimum chance of spasm and leg injury. Investigations are carried out on the control techniques implemented for FES walking with wheel walker. PID control and fuzzy logic control (FLC) are used to regulate the electrical stimulation required by the quadriceps and hamstrings muscles in order to perform the FES walking manoeuvre according to predefined walking trajectory. The body weight transfer is introduced to increase the efficiency of FES walking performance. The effectiveness of body weight transfer and control strategy to enhance the performance of FES walking and reduce stimulation pulses required is examined. Investigations are carried out on the effectiveness of spring brake orthosis (SBO) for FES assisted paraplegic walking with wheel walker. A new concept in hybrid orthotics provides solutions to the problems that affect current 'hybrid orthosis, including knee and hip flexion without relying on the withdrawal reflex or a powered actuator and foot-ground clearance without extra upper body effort. The use of SBO can also eliminate electrical stimulation pulses required by the hamstrings muscle for the same FES walking system. Further improvement of the FES walking system is achieved by introducing finite state control (FSC) to control the switching time between springs, brakes and electrical stimulation during FES assisted walking with wheel walker with the combInation of FLC to regulate the electrical stimulation required for the knee extension. The results show that FSC can be used to accurately control the switching time and improve the system robustness and stability.
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Holschbach, Jeannine Katharina [Verfasser]. "Frakturheilung bei Paraplegie im Rattenmodell / Jeannine Katharina Holschbach". Hannover : Bibliothek der Tierärztlichen Hochschule Hannover, 2014. http://d-nb.info/1065206089/34.
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