An Under-Actuated 5-DOF Robotic Manipulator for Ultrasound Transducer Guidance Using a Passive Four-Bar Linkage

2009 ◽  
Author(s):  
Allan R. Provorse ◽  
Carl A. Nelson ◽  
Gregory R. Bashford ◽  
Judith M. Burnfield ◽  
Kornelia Kulig
Keyword(s):  
Achilles Tendon ◽  
Medical Practice ◽  
Robotic Manipulator ◽  
Response To Treatment ◽  
Robot Kinematics ◽  
Ultrasound Transducer ◽  
Ultrasound Probe ◽  
The Subject ◽  
Robotic Devices ◽  
Four Bar Linkage

Robotic devices have made inroads in various areas of medical practice. This paper offers a design of robot kinematics for ultrasound probe manipulation to obtain reproducible Achilles tendon images for quantifying injury or response to treatment. The design includes a motor-controlled 4-DOF arm with an additional smaller, passive four-bar linkage mount for the ultrasound probe to optimize surface contact with the subject and increase the mobility to 5 DOF.

scholarly journals Mechanotendography in Achillodynia shows reduced oscillation variability of pre-loaded Achilles tendon: a pilot study

2020 ◽  
Vol 30 (2) ◽  
pp. 247-257
Author(s):  
Laura Schaefer ◽  
Frank Bittmann
Keyword(s):  
Achilles Tendon ◽  
Rank Correlation ◽  
Achilles Tendinopathy ◽  
The Body ◽  
Mechanical Pressure ◽  
Mechanical Oscillations ◽  
Pressure Impact ◽  
The Subject ◽  
The Mean ◽  
Intrapersonal Variability

The present study focuses on an innovative approach in measuring the mechanical oscillations of pre-loaded Achilles tendon by using Mechanotendography (MTG) during application of a short yet powerful mechanical pressure impact. This was applied on the forefoot from the plantar side in direction of dorsiflexion, while the subject stood on the ball of the forefoot on one leg. Participants with Achilles tendinopathy (AT; n = 10) were compared to healthy controls (Con; n = 10). Five trials were performed on each side of the body. For evaluation, two intervals after the impulse began (0-100ms; 30-100ms) were cut from the MTG and pressure raw signals. The intrapersonal variability between the five trials in both intervals were evaluated using the arithmetic mean and coefficient of variation of the mean correlation (Spearman rank correlation) and the normalized averaged mean distances, respectively. The AT-group showed a significantly reduced variability in MTG compared to the Con-group (from p = 0.006 to p = 0.028 for different parameters). The 95% confidence intervals (CI) of MTG results were disjoint, whereas the 95% CIs of the pressure signals were similar (p = 0.192 to p = 0.601). We suggest from this work that the variability of mechanical tendon oscillations could be an indicative parameter of an altered Achilles tendon functionality.

scholarly journals Controlling of a ROS-based robotic system in accordance to the assist-as-needed principle in end-effector based rehabilitation systems

2018 ◽  
Vol 4 (1) ◽  
pp. 199-202
Author(s):  
Sebastian Becker ◽  
Wiebke Hinterlang ◽  
Tim Eschert ◽  
Catherine Disselhorst-Klug
Keyword(s):  
Impedance Control ◽  
Proximal Part ◽  
The Elderly ◽  
Subjective Assessment ◽  
Robot Kinematics ◽  
Robotic Rehabilitation ◽  
End Effector ◽  
3 Dimensional ◽  
The Central Nervous System ◽  
Robotic Devices

AbstractStroke is one of the most frequent diseases among the elderly and often leads to an ongoing failure of functions in the central nervous system. Due to the plasticity of the brain affected may regain lost motor function by repetitive training. Robotic devices can be an approach to accelerate the rehabilitation process by maximizing patients’ training intensity. End-effector based robotic systems are particularly suitable for this purpose and often an advantage over exoskeletons since the proximal part of the upper limb remains under the control of the patient. Furthermore, the integration of the assistas- needed principle (AAN) into these devices enables individualized, adaptable robotic support to patients during therapy. In this study an end-effector based robotic rehabilitation device based on the Robot Operating System (ROS) framework is introduced. The system allows patients to perform 3- dimensional movements without a therapist’s assistance. With regard to the AAN, focus was based on impedance control and an additional real-time adaption of the impedance control parameters by using a feedback loop. 10 healthy subjects took part in this study to evaluate the overall concept with regard to usability and quality of the supported movement. Hence, the three most promising adaption models of AAN (without adaption, adaption according to position and time, adaption according to velocity) under three different levels of movement support (0%, 50%, 100%) were investigated by administering a self-designed questionnaire and the robot kinematics. The results showed no significant differences between the three different adaption models of AAN. However, the subjective assessment of the movements was in keeping with robot kinematics and the control approaches as well as the overall system have experienced remarkable support.

Kinematic Analysis of Spherical Four-Bar Linkages via the Inflection Cubic and Thales Ellipse

2015 ◽  
Author(s):  
Giorgio Figliolini ◽  
Jorge Angeles
Keyword(s):  
Special Interest ◽  
Kinematic Analysis ◽  
Vector Fields ◽  
Three Dimensions ◽  
Unique Point ◽  
Planar Case ◽  
Acceleration Vector ◽  
The Subject ◽  
Four Bar Linkage ◽  
Spherical Motion

The subject of this paper is the formulation of a specific algorithm for the kinematic analysis of spherical four-bar linkages via the inflection spherical cubic and spherical Thales ellipse by devoting particular attention to the crossed four-bar linkage (anti-parallelogram). Moreover, both the inflection and the elliptic cones, which represent the equivalent of the Bresse cylinders of the planar case in three-dimensions, are obtained by showing the particular properties of the spherical motion in terms of the curvature of a coupler curve and both the velocity and acceleration vector fields. Of special interest are also the cases in which the three acceleration poles coincide at one unique point or in two plus one, which depends on the intersections of two spherical curves of third and second degree.

scholarly journals Anesthesia: Its advantages and risks for human health

2019 ◽  
Vol 3 (2) ◽  
pp. 1-10
Author(s):  
Rachel Naranjo Vázquez ◽  
Dayana Margarita Palomino Caballero ◽  
Celestina Lourdes Ricoy Pérez
Keyword(s):  
Human Health ◽  
Medical Practice ◽  
Health Professionals ◽  
Local Anesthetics ◽  
Anesthetic Agents ◽  
Starting Point ◽  
The Subject ◽  
New Research ◽  
Scientific Value ◽  
Area Of Application

All the types of anesthesia that are applied, it is the local one of the most interesting, because it is most often used in medical practice. As any procedure has its risks and is that you have to take into account the area of application, as well as the adverse and toxic effects that would bring its administration in inappropriate doses. In this sense, the purpose of the research is to promote an academic reflection related to the use and proper application of local anesthetics to avoid possible complications in the health of patients. To this end, a thorough bibliographic review was carried out, where 65 bibliographic documents containing scientific articles were analyzed, as well as updated literature on the subject. It was concluded that it is necessary for the health professional to have a vast knowledge about the correct use and proper application of local anesthetics to avoid unwanted effects on human health. The scientific value of the work lies in the very nature of the subject studied, since its study is an urgent challenge for health professionals, while the results offered can be a valid starting point to undertake new research to deepen and expand the knowledge related to the use and application of anesthetic agents in medical practice.

scholarly journals The release of adhesions improves outcome following minimally invasive repair of Achilles tendon rupture

2021 ◽  
Author(s):  
Michael R. Carmont ◽  
Sara Brandt Knutsson ◽  
Annelie Brorsson ◽  
Jón Karlsson ◽  
Katarina Nilsson-Helander
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Response To Treatment ◽  
Minimally Invasive Surgical ◽  
Initial Rupture ◽  
Patient Reported ◽  
Rise Height ◽  
Endoscopic Debridement

Abstract Purpose Operative repair of Achilles tendon rupture may lead to complications, which influence outcome adversely. The aim of this study was to determine the incidence, impact and response to treatment of post-operative adhesions. Methods From February 2009 to 2021, 248 patients operated on with percutaneous or minimally invasive surgical repair have been prospectively evaluated using the Achilles tendon Total Rupture Score (ATRS) and Heel-Rise Height Index (HRHI), following acute Achilles tendon rupture. Results Fourteen (5.6%) patients were identified as having adhesions. Four patients reported superficial adhesions and ten patients reported a deeper tightness of the tendon. At a mean (SD) of 10.5 (2.3) months following repair, the overall ATRS was at a median (IQR) 65 (44.5–78) points and (HRHI) was mean (SD) 81.5 (13.5)%. Of those deemed to have deep adhesions the antero-posterior diameter of the tendon was at mean (SD) 15.6 (4.6) mm. Open release of superficial adhesions resulted in improved ATRS in all patients. Endoscopic debridement anterior to the Achilles tendon led to alleviation of symptoms of tightness and discomfort from deep adhesions and improved outcome in terms of the ATRS score. At a mean (SD) of 15.9 (3.3)-month follow-up from initial rupture and repair, the patients reported at median (IQR) ATRS scores of 85 (64.8–92.8) points, Tegner level 5 (3–9) and mean (SD) HRHI 86.2 (9.5)%. Patients significantly improved both ATRS and HRHI following release at median (IQR) of 16.5 (− 1.8–29.3) points (p = 0.041) and mean (SD) 5.6 (8.3)% (p = 0.043). Conclusions The incidence of patient-reported adhesions following minimally invasive repair of Achilles tendon rupture was estimated to be 5.6%. The occurrence of superficial adhesions was associated with a lower outcome scores as well as symptoms of anterior tendon tightness and stiffness were associated with a lower score in most patients. Surgical release of adhesions led to a significant improvement in outcome.

scholarly journals Hocken: Prince of Collectors

2015 ◽  
Author(s):  
J.E. Traue
Keyword(s):  
New Zealand ◽  
Medical Practice ◽  
Medical Practitioner ◽  
Historical Research ◽  
Primary Sources ◽  
The Subject ◽  
The University ◽  
Over Time

Dr Thomas Morland Hocken (1836-1910), born and trained as a medical practitioner in Britain, settled in Dunedin in 1862 and built a very successful medical practice. He soon began researching early New Zealand history and by 1880 was delivering public lectures on the subject. At a time when there were no publicly available collections of primary sources or publications relating to New Zealand in the country, and where the best resources for historical research were in London, Hocken began collecting ephemera, maps, newspapers, pamphlets and books, paintings and drawings, seeking out and copying original documents and saving the reminiscences of old colonists to support his research and publications. Over time his collecting became more comprehensive and he turned his attention to creating a full bibliographical record of New Zealand publications, culminating in the publication of A Bibliography of the Literature Relating to New Zealand in 1908. His last act was to gift his collection to the nation to be held in trust by the University of Otago and available for anyone with a definite purpose of study. 

scholarly journals Business Ethics in Medical Practice

2021 ◽  
Author(s):  
Monica Cojocaru ◽  
◽  
Ayten Güler Dermengi ◽  
Keyword(s):  
Health Services ◽  
Business Ethics ◽  
Medical Ethics ◽  
Medical Practice ◽  
Health Unit ◽  
Daily Work ◽  
The Subject

The aim of the paper is to understand in depth the notion of medical ethics and how it can be applied by medical and auxiliary staff in daily work, whether we are considering a private health unit or a public unit with the same object of activity. The importance of the subject, in the authors' view, although it is always current, comes especially in the context of the need to improve the health of an increasing number of people affected by the SARS Cov2 pandemic, people who use health services.

Physicians' Preferences in a Blind Trial of Imipramine and Amitriptyline

1969 ◽  
Vol 115 (527) ◽  
pp. 1175-1179 ◽  
Author(s):  
Evelyn Reynolds ◽  
D. F. Craggs ◽  
M. P. Joyston-Bechal ◽  
M. J. Pritchard ◽  
P. H. Tooley ◽  
...  
Keyword(s):  
Medical Practice ◽  
Response To Treatment ◽  
Measurable Effect ◽  
Double Blind ◽  
Blind Trial ◽  
Drug Of Choice ◽  
Single Blind ◽  
Alternative Drugs

Some investigations suggest that the attitude of a psychiatrist to therapy with drugs may affect his patient's response to treatment (Sheard, 1963; Reynolds, Joyce, Swift, Tooley and Weatherall, 1965), though the evidence is far from conclusive and earlier findings have not always been confirmed by further research (Hordern and Hamilton, 1963; Uhlenhuth and Park, 1964). The possibility that a particular drug may be more effective if administered by a physician who believes it to be superior to alternative drugs appears to have received little attention. Such preferences exist in medical practice. The present study was undertaken to test the hypothesis that they have a measurable effect, provided the drug is administered knowingly. The efficacy of the drug of choice of three psychiatrists was therefore compared (a) under single blind and double blind conditions, and (b) with that of alternative medication.

Can ethics be taught in a hospital?

PEDIATRICS ◽  
1977 ◽  
Vol 60 (2) ◽  
pp. 253-255 ◽  
Author(s):  
Peter Singer
Keyword(s):  
Medical Practice ◽  
Formal Training ◽  
Ethical Decisions ◽  
The Subject

No one now doubts that physicians frequently face difficult ethical questions in the course of medical practice. These questions are often of a kind that cannot simply be left to await a time when one has greater leisure. Physicians have to act and take responsibility for their decisions, whichever way they decide. Often the ethical decisions are as crucial as the medical ones. Yet most physicians have received no formal training in ethics and many of them have not thought, talked, or read much about the subject either. It is not uncommon for a physician to describe himself as purely a technician, a kind of advanced plumber who does nothing but respond to requests from people who come to have defective plumbing put right.

Settling in Paris

2019 ◽  
pp. 275-300
Author(s):  
Stanley Finger
Keyword(s):  
Medical Practice ◽  
Subject Matter ◽  
Napoleonic Wars ◽  
Great Work ◽  
Napoleon Bonaparte ◽  
Georges Cuvier ◽  
The Subject ◽  
The City

Gall and Spurzheim arrived in Paris during October 1807, while the Napoleonic Wars were still raging and where Napoleon Bonaparte was reshaping every aspect of society. Napoleon despised foreigners and considered Gall’s doctrine absurd. He urged Georges Cuvier, one of his appointed guardians of French science, to reject it. Nonetheless, Gall made inroads, giving public lectures and demonstrations on his organologie that were well received, while seeing patients to support himself. Encouraged by these ventures, he and Spurzheim wrote a Mémoire and submitted it to the Institut National in 1808. Cuvier, who headed the evaluating committee and was being guided by Napoleon, rejected it as unoriginal and unsuitable for the division for Sciences Mathématiques et Physiques, even though the subject matter was basic anatomy and not more controversial organologie. Gall was furious and sent letters expressing his disappointment to Cuvier, but to no avail. Consequently, he published a book covering the submission, the rejection, and his retorts. And rather than leaving France, he opted to continue his lecturing and medical practice in the city with many amenities, and he continued to work on a series of volumes he was already calling his “great work.”

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