Clinical Relevance for the Veteran


A Wearable Tremor-suppression Orthosis
Jack Kotovsky, MS and Michael J. Rosen, PhD.

Purpose of the Work. This article describes the design and development of a wearable orthosis that reduces wrist tremor motion. Subjects/Procedures. The design and manufacturing of prototypes are described as well as their quantitative characterization. The damping and stiffness behavior of the devices is described in detail. Initial testing with subjects with tremor is also discussed. Results. A wearable orthosis has been successfully demonstrated that selectively reduces wrist tremor motion by providing passive, viscous resistance. Acting as a mechanical low-pass filter known to be effective in tremor-reduction, the viscous resistance permits purposeful, low velocity motion while resisting higher velocity motion associated with tremor. The device acts on the flexion/extension motion of the wrist; additional devices would be required to damp tremor of other joints. Relevance to the Veteran Population. The orthosis described can help restore function (i.e., eating, drinking, writing) to individuals affected by tremor. The device is designed to be unobtrusive, comfortable to wear, lightweight, and easy to use. Jack Kotovsky, MS

The Design and Development of a Gloveless Endoskeletal Prosthetic Hand
Rajiv Doshi, MS; Clement Yeh, BS; Maurice LeBlanc, CP, MSME.

Purpose of the Work. The goal of this project was to design and develop an inexpensive, body-powered, prosthetic hand that better meets the needs of upper-limb amputees. Subjects/Procedures. After identifying areas for improvement in currently available prosthetic hands, we designed a radically different prosthesis that takes advantage of recent improvements in materials technology. Results. The new prosthetic hand grasps objects of various shapes and sizes and offers an improved appearance relative to current prostheses. Relevance to the Veteran Population. The new prosthetic hand offers several advantages to the person with upper-limb amputation. The prosthesis has a realistic grasping motion, is lighter, requires less force to operate, and is soft. Also, the new mechanical hand is expected to cost significantly less than those currently available.
Rajiv Doshi, MS

Retention of Supportive Properties by Eggcrate and Foam Wheelchair Cushions
Greg Shaw, PhD.

Purpose of the Work. This study investigated the eggcrate foam wheelchair cushion's reported poor performance. Procedures. The eggcrate cushion was compared to a firmer, high-density foam cushion, similar to what most seating experts recommend. The ability of the cushions to support the weight of a wheelchair user was measured for both cushions after periods during which the cushions were compressed to simulate use. The cushions were flattened in a press for up to 6 hours. Results. Study results failed to support the common perception that the soft eggcrate cushion would lose its supportive properties more rapidly than the much firmer foam cushion. Relevance to the Veteran Population. Eggcrate foam cushions may be suitable for some wheelchair users. However, when selecting a cushion, a number of other factors must be considered. These include reducing the chance of developing a pressure sore, comfort, providing a stable sitting posture, and ease of cleaning. This study did not evaluate the eggcrate cushion's performance in these areas.
Greg Shaw, PhD

Teaching Memory Strategies to Persons with Multiple Sclerosis
Daniel N. Allen, PhD; Gerald Goldstein, PhD; Rock A. Heyman, MD; Tiziana Rondinelli, BS.

Purpose of the Work. A memory-retraining program previously effectively used with persons wit head injury was conducted with individuals who had multiple sclerosis. Subjects/Procedures. Eight subjects with multiple sclerosis participated. The memory program involved computer-assisted teaching of imagery-based memory strategies designed to help improve memory for lengthy word lists and for associating names with faces. Results. Participants learned the memory strategies quickly and did not require the lengthy training needed by persons with head injuries. Relevance to the Veteran Population. Memory training for veterans with multiple sclerosis may sometimes only require teaching of the memory strategy without extensive practice required for other individuals with memory problems.
Daniel N. Allen, PhD

Exercise and activity level in Alzheimer's disease: A potential treatment focus
Linda Teri, PhD; Susan M. McCurry, PhD; David M. Buchner, MD; Rebecca G. Logsdon, PhD; Andrea Z. LaCroix, PhD; Walter A. Kukull, PhD; William E. Barlow, PhD; Eric B. Larson, MD, MPH.

Purpose of the Work. The purpose of this study was to describe a 12-week program for improving physical function in persons with Alzheimer's disease (AD). Subjects/Procedures. Thirty community-dwelling AD patients and their family caregivers were taught an individualized program of endurance activities (primarily walking), strength training, and balance and flexibility exercises. Results. At baseline, the AD patients performed more poorly on measures of physical ability (such as walking speed) than has been reported in the literature for non-demented older adults. Nevertheless, all the AD patients were able to do some exercises, and one-third of patients completed all assigned exercises during the training period. Caregivers learned and directed patients during scheduled exercise activities. Relevance to the Veteran Population. Increasing numbers of aging veterans are at risk for developing AD. These findings indicate that it is feasible to include regular exercise as part of the routine treatment for AD.
Linda Teri, PhD

Characteristics Associated with Marginal Hearing Loss and Subjective Well-being among a Sample of Older Adults
Marcia J. Scherer, PhD, MPH and D. Robert Frisina, PhD.

Purpose of Work. Our goal was to assess perceptions of hearing loss, psychological adjustment to hearing loss, and general well-being among persons aged sixty and older with recent hearing loss. Subjects and Procedures. Forty people 61 to 81 years of age (20 with normal hearing; 20 with mild to moderate hearing loss) completed a hearing loss survey, Assistive Technology Device Predisposition Assessment (ATD PA), and Profile of Hearing Aid Performance (PHAP). Results. Data from the hearing survey, ATD PA, and PHAP revealed that people with hearing loss have less satisfaction with their independence and emotional well-being than those with normal hearing. Relevance to Veteran Population. Living with a hearing loss can be made easier by identifying and addressing personal and interpersonal concerns. When individuals are screened for predispositions to hearing aid use, the most appropriate treatment strategies can be implemented, which will reduce frustration with hearing aids and improve perceptions of general health status and well-being.
Marcia J. Scherer, PhD, MPH

Form perception with a 49-point electrotactile stimulus array on the tongue: A technical note
Paul Bach-y-Rita, MD; Kurt A. Kaczmarek, PhD; Mitchell E. Tyler, MS; Jorge Garcia-Lara, DDS.

Purpose of the Work. The aim was to develop a prototype of a tongue man-machine interface to carry patterned information to the brain from a TV camera, a microphone, or any artificial sensor. The long-term goal is to develop a practical, cosmetically acceptable, wireless system for persons with sensory loss, including for blind persons, for whom it will include a miniature TV camera, microelectronics and FM transmitter built into a pair of glasses, and microelectronics, battery and the electrotactile array in a dental orthodontic retainer. Subjects/Procedures. Five adult subjects received 10-20 minutes of training followed by four blocks of random presentation of geometric forms. Results. Tongue shape recognition performance across all sizes was 79.8%. Relevance to the Veteran Population. Applications for veterans may include sensory systems for amputees, for deaf persons and for persons with spinal cord injuries (e.g., sensory information from robotic hands, insensate hands, and limb prostheses).
Paul Bach-y-Rita, MD

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  Last Updated Friday, June 24, 2005 10:49 AM