Volume 53 Number 4, 2016
Pages xi — xiii
This study aimed to (1) identify the prevalence
and severity of pain and psychiatric comorbidities
among Veterans who had been deployed during Operations
Enduring Freedom (OEF), Iraqi Freedom
(OIF), and New Dawn (OND) and (2) assess whether
the Department of Veterans Affairs (VA) Polytrauma
System of Care and OIF/OEF/OND registry reflect
real differences among patients. Results confirmed
the high prevalence of pain and concurrent mental
health problems among personnel returning from
military deployment, signifying the need for elaborate
mental health screening and treatment for Veterans
registering for VA healthcare.
People with spinal cord injuries are prone to developing
pressure ulcers, which can cause problems
with quality of life and medical health. Managing
these ulcers usually involves minimizing pressure
on the area with the ulcer. One option to promote
healing and allow people to continue being mobile
is use of prone carts, but traditional manual carts are
known to cause strain on the spine and shoulders.
This report describes the design of an ergonomic
motorized prone cart. Through an iterative and collaborative
process, the final motorized prone cart
successfully reached goals of motorization, maneuverability,
ergonomic fit, and utility. The consistent
attention to user needs while creating a cart that can
be easily and economically serviced has produced a
motorized, ergonomic prone cart that can help improve
user quality of life, increase compliance with pressure ulcer treatment recommendations, and offer
more independence and mobility to hospitalized users.
Users have always had high expectations for the
function of artificial upper limbs, often because of
their portrayal in the popular media and comparisons
with nondisabled people. Only a small percentage
of patients with an upper-limb amputation regularly
use a prosthesis, mainly because many patients perceive
a lack of function. Externally powered prostheses
can be controlled by muscle signals from the
residual limb, but they can still be difficult for users
to control. In this study, we investigated the use of
novel high-density force sensors that measure pressure
from muscle movements as a possible control
input for an upper-limb prosthesis, with the goal of
developing a more robust prosthetic control method.
Our high-density force sensor method showed greater
accuracy in recognizing movements of the wrist
and hand than currently available control methods.
Future work will focus on confirming these results in
subjects with amputation and refining the techniques.
This study provides evidence that the Music-
Glove, a music-based hand therapy device, is feasible
and effective for providing rehabilitation at home.
Participants that used the MusicGlove for 3 wk had significantly greater improvements in self-reported
functional use of the impaired hand than those who
performed conventional home therapy. Further, participants
significantly increased the number of exercise
repetitions they performed with the MusicGlove
over time, showing that they became increasingly
engaged as therapy progressed. The findings of this
study will benefit Veterans with hand impairment
after stroke. MusicGlove therapy could benefit individuals
after spinal cord injury and traumatic brain
injury as well.
Current prosthetic legs used by individuals with
lower-limb amputations, including Veterans, do not
effectively compensate for the loss of feeling that accompanies
limb loss. This sensory deprivation contributes
to decreased mobility and balance performance,
especially during everyday tasks requiring
multitasking. Artificial sensory feedback using vibrations
on the residual limb to communicate information
about limb position, speed, and contact may
help improve both mobility and balance in people
with amputation. This article describes work being
done to develop such a system, specifically examining
the effects of multitasking and prosthetic liners
on the reaction times to vibrations on the surface of
Although illicit drug use is lower amongst U.S.
military personnel than among civilians, it is generally
on the rise. Here, a Veteran???s drug abuse resulted in prolonged immobilization, gluteal compartment
syndrome, and several morbid sequelae. This resulted
in a prolonged hospital course requiring surgery
and several interventional procedures to save his life,
reduce debilitating pain, and facilitate rehabilitation
back to the community. This case serves to demonstrate
the course of a patient with the rare entity of
gluteal compartment syndrome from traumatic presentation
through rehabilitation back to the community.
Nocturnal disabilities are very common among
patients with Parkinson disease (PD), with up to
96.6 percent of patients reporting at least one nocturnal
symptom. These symptoms negatively affect
patients??? quality of life and increase caregiver burden.
As one of the nighttime disturbances in PD,
nocturnal hypokinesia contributes to nighttime falls.
The majority of falls happened in bedrooms when
patients attempt to get out of bed. The aim of our
study was to develop a portable ambulatory motion
recorder (the NIGHT-Recorder) that can quantify
nocturnal hypokinesia in patients with PD. As part
of the experimental verification, the device was able
to capture the problems of fewer and slower rolling
over episodes in patients with PD compared with
their spouses. In contrast, PD patients got out of bed
more often than their spouses. Therefore, the device
helps identify those patients at risk for nighttime disabilities
for early intervention that includes rehabilitation.
Our study shows that it is technically feasible
to develop a portable device to assist physicians in
identifying patients who suffer or are at risk of nocturnal
hypokinesia. Additional studies are warranted
to develop protocols for early treatment and rehabilitation,
as well as strategies to prevent nighttime falls
or accidents in PD patients.
Safe and effective medications for pain disorders
are limited. Males and females may experience pain
differently; however, little is known about the biology
of pain disorders. Evidence suggests that neurosteroids
(naturally occurring substances in the brain
and body) may play a role in the biology of pain.
Our preliminary findings show that DHEAS (neurosteroid)
is lower in women who report higher levels
of back pain. This could mean that women with
lower DHEAS levels are at greater risk of developing
pain than women with higher levels of DHEAS.
Therefore, increasing DHEAS levels may prevent or
improve pain in female Veterans.
Healthcare providers use standardized outcome
measures to determine risk for falls in older adults.
Research describing the usefulness of outcome measures
in people with mild cognitive impairment is
lacking. This research describes the usefulness of
three outcome measures in identifying risk for falling
for people with and those without mild cognitive impairment. We found that when explained in a standardized
manner in people with and without mild
cognitive impairment, the 8-Foot Up and Go is more
useful than the Timed Up and Go test for identifying
people at risk for falling.
High cervical spinal cord injury (SCI), as can occur
in combat situations, can result in the inability to
operate a computer. To address this, we evaluated
the ability of an individual with a high level SCI to
control a computer cursor using two different user
interfaces: head movements measured with a headworn
orientation sensor and electrical signals from
four head and neck muscles. Subject performance
with each user interface was evaluated and compared
with the performance of a group of nondisabled
subjects. Head orientation was more accurate
but less responsive than the electrical signals but the
electrical signals were more responsive and faster.
The impaired subject exhibited similar performance
as nondisabled subjects. Although head orientation
performed better in some performance measures,
electrical signals can be recorded less obtrusively
and more reliably and may be the more practical
choice as a user interface. The methods developed
in this work can be used to quantitatively evaluate
the performance of assistive technology used by
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Last Reviewed or Updated Tuesday, August 2, 2016 10:18 AM