Volume 50 Number 5, 2013
Pages xi — xiii
This article discusses the mechanical design
characteristics of anthropomorphic prosthetic hands.
The mechanical design of the hand determines the
functions (grasping, pushing, pointing, etc) the hand
can perform and therefore the ability the user will
gain. The many tradeoffs when engineering a complex,
multifunctional electromechanical device are
discussed. Hopefully, engineers, prosthetists, and users
of prosthetic limbs will gain insight from this article.
The likely benefits of this work include a broader
understanding of the mechanical design of prosthetic
hands, a resource to use when making rehabilitation
decisions, and a review of the current state-of-the-art
anthropomorphic prosthetic hands.
This study explored the potential of portable kinetic
recording systems to determine the effect of
prostheses on the load applied on the residuum. In
this case, this load was measured during several activities
of daily living performed by an individual
with unilateral transfemoral amputation fitted with
a bone-anchored prosthesis. This work confirmed
that the proposed apparatus can reveal how changes
in prosthetic components (e.g., mechanical vs
microprocessor-controlled knee) are translated into
inner-prosthetic loading. This indicates that such an
apparatus might have the ability to support evidencebased
fitting, and therefore, to address issues related
to under- or over-prescription of components.
Persons with spinal cord injury (SCI) have increased
prevalence of abnormalities in carbohydrate
and lipid metabolism. The objective of this study was
to determine the prevalence of cardiometabolic risk
factors in people with SCI based on injury-related
variables. Waist circumference, level of injury, cholesterol
intake, and polyunsaturated fatty acid intake
were positive predictor factors. Conventional risk
factors for coronary heart disease should be identified
and treated in individuals with SCI.
This study aimed to determine the accuracy and
reliability of performing physical assessments of
people with Parkinson disease (PD) via the Internet.
People with PD who live in areas where traditional
rehabilitation services are not readily accessible
could benefit from this technology through increased
access to healthcare. Balance and mobility outcome
measures were investigated in 12 subjects via the
Internet using the eHAB telerehabilitation system.
Results showed that telerehabilitation assessments
are accurate and reliable. This study indicates that
it is possible to assess the physical ability of people
with PD via telerehabilitation systems and provides
support for further development of telerehabilitation
People with spinal cord injury usually rely on
their ability to propel a manual wheelchair for independent
mobility. Achieving the highest degree of
independence in a manual wheelchair often depends
on the user's ability to negotiate a range of environments
and overcome indoor and outdoor obstacles.
Ramps of varying degrees are frequent both outdoors
and indoors. Wheelchair users adopt different postures
and employ different stroke techniques to suit
different locomotion tasks. We developed a method
for identifying shoulder muscle coordination patterns
during level-ground versus incline wheelchair propulsion.
This approach allows for patterns and trends
in electromyography characteristics to effectively and
consistently map out patterns of physical activity.
By studying Veterans Health Administration appointments
in 75,607 Operation Iraqi Freedom/Operation
Enduring Freedom (OIF/OEF) Veterans with
posttraumatic stress disorder, depression, substance
use disorders, or traumatic brain injury (TBI)-related
problems in fiscal years 2008 and 2009, we found that
only 8.4 percent accessed vocational services. Most
Veterans who did so attended only one or two appointments.
Veterans with TBI and with more mental health
conditions overall were more likely to access vocational
services. Only 2.2 percent of Veterans received
evidence-based supported employment. However,
supported employment was effective, with 243 out
of 479 Veterans who received it obtaining competitive
work, with an average hourly wage of $11.60 and
longer-lasting jobs. More supported employment specialists are needed to serve OIF/OEF Veterans.
Typical walking measures average multiple steps
together to get a single representative step. This,
however, removes the effect that one step has on the
next. The small changes from step-to-step are considered
to be an important part of how the neuromuscular
system controls walking. While previous walking
measures have not related to an amputee's prosthesis
preference, it is possible that this is because the typical
walking measures failed to consider this other aspect
of how walking is controlled. We found a strong
relationship between the small changes that occur
from step-to-step at the prosthetic ankle and how
strongly the amputee preferred the prosthesis.
We studied subjects with lower-limb amputation
and nondisabled subjects while they used their muscle
electrical activity to control a virtual object on a
computer screen. The subjects changed the acceleration
of the virtual object based on the relative amplitude
of their muscle activity. We wanted to know
whether the subjects with amputation could learn to
change the activity level of their residual-limb muscles.
We found that the subjects with amputation only
needed a very short amount of practice to quickly
improve their residual-limb muscle control and even
match the level of the nondisabled subjects. These
results suggest that a similar control strategy could
be used for robotic lower-limb ankle prostheses.
As the U.S. population ages, more Veterans may
develop Parkinson disease. Unfortunately, those Veterans
diagnosed with Parkinson disease may develop
problems walking, particularly walking while doing another
task (talking, for example). In addition to difficulty
walking while talking, our study showed that patients
with Parkinson disease have trouble initiating walking
from a standing position while doing another task. On
the basis of these results, Veterans with Parkinson disease
should participate in interventions (exercise and
cognitive stimulation) that could improve their ability
to perform more than one task at the same time.
We aimed to develop a strong porous pylon that
could integrate with the surrounding skin and create
a natural barrier against the infection associated with
direct skeletal attachment of limb prostheses. This
article presents the results on the effectiveness of a
new version of the titanium porous composite skin
and bone integrated pylon with side fins (SBIP-3).
The side fins are designed to improve the bond between
the bone and pylon. We found that the space
between the fins and the bone into which they were fit
was filled with fibrovascular tissue and woven bone.
No substantial inflammation was found. We suggest
that the proposed method may become an alternative
to the established technique of implanting prostheses
into the medullary canal of the hosting bone.
Although polyvinylchloride (PVC) and silicone
cosmetic gloves have been used in upper-limb prosthetics
for decades, almost nothing is known about
their mechanical properties. In this study, two types of
cosmetic gloves of the same hand size were objectively
measured and compared (three PVC and three silicone).
The amount of required energy, energy loss, and
the stiffness of the different finger joints of each glove
were measured. The outcomes showed that the silicone
glove was much more flexible than the PVC glove, required
less energy when flexing the finger joints, and
dissipated less energy. These outcomes, considered
with other significant features, may help when comparing
the optimal materials for a cosmetic glove that is to
be fitted to an active hand. The mechanical properties
of these materials and the detailed design and structure
of the glove are of increasing importance as more
joints are included in the hand's motion.
Fatigue is an extreme sense of tiredness that
people with multiple sclerosis often feel. Healthcare
providers such as doctors, physiotherapists/physical
therapists, and occupational therapists do not fully
understand what causes fatigue but they do know
that regular exercise is good for everybody, including
people with multiple sclerosis. This research
will help people with multiple sclerosis talk to their
healthcare providers more confidently about what
form of exercise might be best for them. It will help
guide healthcare providers to give exercise programs
or advice that is suitable, enjoyable, and sustainable
for each person with multiple sclerosis.
Table of Contents Volume 50, Number 5
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Last Reviewed or Updated Friday, August 16, 2013 11:08 AM