scholarly journals A Game-Based Rehabilitation System for Upper-Limb Cerebral Palsy: A Feasibility Study

Sensors ◽  
2020 ◽  
Vol 20 (8) ◽  
pp. 2416 ◽  
Author(s):  
Mohammad I. Daoud ◽  
Abdullah Alhusseini ◽  
Mostafa Z. Ali ◽  
Rami Alazrai
Keyword(s):  
Cerebral Palsy ◽  
Upper Limb ◽  
Arm Movements ◽  
Assessment Method ◽  
Game Playing ◽  
Kinect Sensor ◽  
Computerized Assessment ◽  
Physical Exercises ◽  
Rehabilitation System ◽  
The Right

Game-based rehabilitation systems provide an effective tool to engage cerebral palsy patients in physical exercises within an exciting and entertaining environment. A crucial factor to ensure the effectiveness of game-based rehabilitation systems is to assess the correctness of the movements performed by the patient during the game-playing sessions. In this study, we propose a game-based rehabilitation system for upper-limb cerebral palsy that includes three game-based exercises and a computerized assessment method. The game-based exercises aim to engage the participant in shoulder flexion, shoulder horizontal abduction/adduction, and shoulder adduction physical exercises that target the right arm. Human interaction with the game-based rehabilitation system is achieved using a Kinect sensor that tracks the skeleton joints of the participant. The computerized assessment method aims to assess the correctness of the right arm movements during each game-playing session by analyzing the tracking data acquired by the Kinect sensor. To evaluate the performance of the computerized assessment method, two groups of participants volunteered to participate in the game-based exercises. The first group included six cerebral palsy children and the second group included twenty typically developing subjects. For every participant, the computerized assessment method was employed to assess the correctness of the right arm movements in each game-playing session and these computer-based assessments were compared with matching gold standard evaluations provided by an experienced physiotherapist. The results reported in this study suggest the feasibility of employing the computerized assessment method to evaluate the correctness of the right arm movements during the game-playing sessions.

scholarly journals Upper Limb Movement Measurement Systems for Cerebral Palsy: A Systematic Literature Review

Sensors ◽  
2021 ◽  
Vol 21 (23) ◽  
pp. 7884
Author(s):  
Celia Francisco-Martínez ◽  
Juan Prado-Olivarez ◽  
José A. Padilla-Medina ◽  
Javier Díaz-Carmona ◽  
Francisco J. Pérez-Pinal ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Range Of Motion ◽  
Upper Extremity ◽  
Upper Limb ◽  
Wearable Sensors ◽  
Optoelectronic Devices ◽  
Kinect Sensor ◽  
Upper Limb Movements ◽  
Kinematic Models ◽  
Joint Assessment

Quantifying the quality of upper limb movements is fundamental to the therapeutic process of patients with cerebral palsy (CP). Several clinical methods are currently available to assess the upper limb range of motion (ROM) in children with CP. This paper focuses on identifying and describing available techniques for the quantitative assessment of the upper limb active range of motion (AROM) and kinematics in children with CP. Following the screening and exclusion of articles that did not meet the selection criteria, we analyzed 14 studies involving objective upper extremity assessments of the AROM and kinematics using optoelectronic devices, wearable sensors, and low-cost Kinect sensors in children with CP aged 4–18 years. An increase in the motor function of the upper extremity and an improvement in most of the daily tasks reviewed were reported. In the population of this study, the potential of wearable sensors and the Kinect sensor natural user interface as complementary devices for the quantitative evaluation of the upper extremity was evident. The Kinect sensor is a clinical assessment tool with a unique markerless motion capture system. Few authors had described the kinematic models and algorithms used to estimate their kinematic analysis in detail. However, the kinematic models in these studies varied from 4 to 10 segments. In addition, few authors had followed the joint assessment recommendations proposed by the International Society of Biomechanics (ISB). This review showed that three-dimensional analysis systems were used primarily for monitoring and evaluating spatiotemporal variables and kinematic parameters of upper limb movements. The results indicated that optoelectronic devices were the most commonly used systems. The joint assessment recommendations proposed by the ISB should be used because they are approved standards for human kinematic assessments. This review was registered in the PROSPERO database (CRD42021257211).

scholarly journals Development of a Tele-Rehabilitation System Using an Upper Limb Assistive Device

2021 ◽  
Vol 33 (4) ◽  
pp. 877-886
Author(s):  
Eiichiro Tanaka ◽  
Wei-Liang Lian ◽  
Yun-Ting Liao ◽  
Hao Yang ◽  
Li-Ning Li ◽  
...  
Keyword(s):  
Upper Limb ◽  
Time Delays ◽  
Physical Therapist ◽  
Assistive Device ◽  
The Internet ◽  
Kinect Sensor ◽  
Upper Limb Function ◽  
Rehabilitation System ◽  
Remote Interaction ◽  
Rehabilitation Exercises

A tele-rehabilitation system that can achieve remote interaction between a physical therapist (PT) and a patient was developed. Patients need to execute rehabilitation exercises to maintain upper limb function. However, it is difficult for them to travel to hospitals without aid. This system is equipped with a PC and a Kinect sensor at the hospital side (i.e., the PT), and a PC and an upper limb assistive device in the patient’s home. The PT displays the motion in front of a Kinect sensor, which identifies the motion. In addition, the device on the home side assists the motion of the patient using the Internet. When the device receives a force higher than the safety value from the patient at any particular point on it, vibrators at the corresponding point on the PT’s arm start to vibrate. Thereby, the PT can identify the patient’s condition and limitations. The time delays in the transmission of data of device motion and the vibrators were measured and compared. As a result, the PT could identify the patient’s condition faster than the motion of the device.

scholarly journals Induced Contention Therapy and functional bandage in children with cerebral palsy: Case report

2020 ◽  
Vol 18 ◽  
pp. 1-9
Author(s):  
Priscila Oliveira Bortoli ◽  
Letícia Ramos Dutra ◽  
Rodrigo José Knabben ◽  
Claudia Mirian de Godoy Marques ◽  
Micheli Martinello
Keyword(s):  
Cerebral Palsy ◽  
Motor Skills ◽  
Upper Limb ◽  
Handgrip Strength ◽  
Hemiplegic Cerebral Palsy ◽  
Motor Activities ◽  
The Right ◽  
Positive Effect ◽  
Manual Activity

Background: The decrease in the manual activity of hemiparetic children, affects their functionality and independence. Among the therapies used to improve manual function, there is Induced Contention Therapy (ICT) and functional bandaging (FB). Such approaches aim to improve the use and decrease the disuse learned from the upper limb in subjects with hemiparesis. Objective: Identify the effect of ICT, associated with the application of functional bandaging on the affected upper limb, in the function of the upper limb and on the handgrip of a child with spastic hemiplegic cerebral palsy. Methods: A 5-year-old child received ICT for three hours daily for three consecutive weeks associated with FB in the right upper limb. The use of the upper limb was evaluated using the Pediatric Upper Extremity Motor Activity Log (PMAL) scale, the acquisition of new motor standards using the Inventory of New Motor Activities and Program (INMAP) scale, the motor skill by the Pediatric Arm Functional Test (PAFT) and the handgrip strength by the dynamometer. Results: There was an improvement in the quantity and quality of use of the paretic upper limb after the application of ICT, which remained after one month of therapy. In addition, it was observed the acquisition of new motor skills and improvement in handgrip strength. Conclusion: This study had a potential positive effect on handgrip strength, functionality and quality of use of the paretic upper limb of a child with spastic CP after the application of ICT associated with functional bandaging.

scholarly journals Modeling the assessment of the upper limb motor function impairment in children with cerebral palsy using sEMG and IMU sensors

2019 ◽  
Author(s):  
S. Raouafi ◽  
M. Raison ◽  
A. Sofiane
Keyword(s):  
Cerebral Palsy ◽  
Motor Function ◽  
Upper Limb ◽  
Assessment Method ◽  
Measurement Unit ◽  
Support Vector ◽  
Healthy Children ◽  
Linear Discriminant ◽  
Function Impairment ◽  
Children With Cerebral Palsy

AbstractSeveral rehabilitation approaches have shown that robot-assisted therapy (robot-AT) can improve the quality of upper limb movements in children with cerebral palsy (CP). However, there is still no method for assessing upper limb motor function impairment using a combination of surface electromyography (sEMG) and inertial measurement unit (IMU) sensors. The aim of this study was to develop a functional ability model to assess the effectiveness of robot-AT on improving upper limb function in children with CP. Fifteen healthy children and fifteen children with CP were included in this study. Children with CP performed eighteen robot-AT sessions and were evaluated twice, using EMG and three-axis IMU readings from accelerometer (IMU-ACC). Principal component analysis and the RELIEFF algorithm were used for dimensionality reduction of the feature space. The classification was performed by using support vector machines, linear discriminant analysis, and random forest. The proposed assessment method was evaluated by using leave-one-out cross validation. With this approach, it was possible to differentiate between healthy children and children with CP pre-robot-AT and post-robot-AT with an overall accuracy of 97.56%. This study suggests that there is potential for modeling the assessment of the upper limb motor function impairment in children with CP using sEMG and IMU-ACC sensors.

A rare variation in the formation of the lower trunk of the brachial plexus its embryological basis and clinical importance - a case report

2012 ◽  
Vol 6 (4) ◽  
pp. 49-52
Author(s):  
N Satyanarayana ◽  
R Guha ◽  
P Sunitha ◽  
GN Reddy ◽  
G Praveen ◽  
...  
Keyword(s):  
Case Report ◽  
Brachial Plexus ◽  
Upper Limb ◽  
Clinical Importance ◽  
Medical Sciences ◽  
Nerve Roots ◽  
Rare Variation ◽  
Lower Trunk ◽  
Male Cadaver ◽  
The Right

Brachial plexus is the plexus of nerves, that supplies the upper limb.Variations in the branches of brachial plexus are common but variations in the roots and trunks are very rare. Here, we report one of the such rare variations in the formations of the lower trunk of the brachial plexus in the right upper limb of a male cadaver. In the present case the lower trunk was formed by the union of ventral rami of C7,C8 and T1 nerve roots. The middle trunk was absent. Upper trunk formation was normal. Journal of College of Medical Sciences-Nepal,2011,Vol-6,No-4, 49-52 DOI: http://dx.doi.org/10.3126/jcmsn.v6i4.6727

Força dos Músculos Rotadores do Ombro em Indivíduos Saudáveis/ Rotator Cuff Muscle Strength in Healthy Individuals

1970 ◽  
Vol 1 (1) ◽  
pp. 78-82
Author(s):  
Paulo José Oliveira Cortez ◽  
José Elias Tomazini ◽  
Mauro Gonçalves
Keyword(s):  
Rotator Cuff ◽  
Muscle Strength ◽  
Internal Rotation ◽  
Upper Limb ◽  
Statistical Difference ◽  
External Rotation ◽  
Healthy Individuals ◽  
Average Strength ◽  
Strength Tests ◽  
The Right

Introdução: A diminuição da capacidade de exercer esforços por parte dos músculos rotadores pode criar uma variedade de problemas. O conhecimento preciso do nível de força muscular de um indivíduo é importante, tanto para a avaliação da capacidade funcional ocupacional, como para uma apropriada prescrição de exercícios atléticos e de reabilitação. Percebe-se escassez de informação sobre as articulações do ombro, bem como os fatores envolvidos na força muscular dessa região. O objetivo deste estudo foi comparar a força gerada pelos músculos do manguito rotador entre o membro superior direito e o membro superior esquerdo em indivíduos saudáveis. Métodos: Participaram do estudo 22 sujeitos do sexo masculino, com idade de 18 e 19 anos, militares, saudáveis e sem história clínica de patologia ortopédica ou qualquer tipo de lesão no sistema musculoesquelético. Foram aplicados dois testes de força: Rotação Interna e Rotação Externa. Resultado : A força média de rotação interna no membro superior direito (MSD) foi maior que a força média de rotação interna no membro superior esquerdo (MSE) (p=0,723) e a força de rotação externa no MSD foi menor que a força média de rotação externa no MSE (p=0,788). Não houve diferença estatística na comparação dos valores de força de todos os testes de força isométrica. Conclusão: Para amostra estudada e metodologia utilizada na avaliação da força muscular, não houve diferença estatística na comparação da força gerada pelos músculos do manguito rotador do membro superior direito e do membro superior esquerdo.Rotator Cuff Muscle Strength in Healthy Individuals Introduction: Decreased ability to exert efforts by the rotator muscles can create a variety of problems. The precise knowledge of the level of muscular strength of an individual is important for both the functional capacity evaluation for occupational as an appropriate exercise prescription and rehabilitation of athletic. It is perceived scarcity of information on the shoulder joints as well as factors involved in muscle strength in this region. Objective: Develop a device for measuring the strength generated by the muscles of the upper limbs and the verification of efficiency and adaptability of this device through a comparative study of muscle strength in healthy subjects. Methods: The study included 22 male subjects, aged 18 and 19 years, military personnel, body mass between 57.7 and 93 kg (71.8 ± 9.45 kg) and height between 1.67 and 1.90 m (1.75 ± 0.06 m), healthy and without a history of orthopaedic disease or any kind of damage to the musculoskeletal system. Three strength tests were applied: Internal Rotation and External Rotation. For each type of effort three maximum voluntary contractions were required for 10 seconds, with an interval of 30 seconds between each contraction.  Results: Internal rotation in the right upper limb (RUL) was higher than the average strength of internal rotation in the left upper limb (LUL) (p = 0, 723) and the external rotation strength in RUL was lower than the average strength of external rotation in the LUL (p=0,788).  No statistical difference in comparing the strength values of all isometric strength tests. Conclusion: For sample and methodology used to assess muscle strength, there was no statistical difference in comparing the force generated by the muscles of the rotator cuff of the right and left upper limb.

scholarly journals The Dynamic Thumb-in-Palm Pattern in Children with Spastic Cerebral Palsy and Its Effects on Upper Limb Function

Children ◽  
2020 ◽  
Vol 8 (1) ◽  
pp. 17
Author(s):  
Ja Young Choi ◽  
Dong-Wook Rha ◽  
Seon Ah Kim ◽  
Eun Sook Park
Keyword(s):  
Cerebral Palsy ◽  
Upper Limb ◽  
Multivariable Analysis ◽  
Spastic Cerebral Palsy ◽  
Type I ◽  
Upper Arm ◽  
Limb Function ◽  
Upper Limb Function ◽  
Limb Deformities ◽  
Arm Function

The thumb-in-palm (TIP) pattern is one of the most common upper limb deformities in cerebral palsy (CP). This study was designed to investigate the effect of the dynamic TIP pattern on upper limb function in children with spastic CP. This prospective observational study included a total of 106 children with CP with dynamic TIP. The House TIP classification while grasping small or large objects, Melbourne Assessment of Unilateral Upper Limb Function (MUUL), Shriners Hospital Upper Extremity Evaluation (SHUEE), Zancolli classification for wrist–finger flexor deformity, and degree of swan neck deformity were assessed. Type I was the most common and highest functioning House TIP classification type. However, there were no significant differences in upper arm function between types II, III, and IV. The three components of the SHUEE showed stronger association with MUUL than House TIP and Zancolli classifications. After multivariable analysis, functional use of the wrist–finger and the thumb played a more significant role than the dynamic alignment of the thumb. In conclusion, the House TIP classification is useful to describe the TIP pattern. The SHUEE thumb assessment is a useful tool for reflecting upper arm function. The upper arm function was related more with the associated wrist flexor deformity than dynamic TIP.

scholarly journals Virtual Reality in Neurorehabilitation: An Umbrella Review of Meta-Analyses

2021 ◽  
Vol 10 (7) ◽  
pp. 1478
Author(s):  
Alexandra Voinescu ◽  
Jie Sui ◽  
Danaë Stanton Fraser
Keyword(s):  
Virtual Reality ◽  
Cerebral Palsy ◽  
Brain Injury ◽  
Upper Limb ◽  
Umbrella Review ◽  
High Quality ◽  
Quality Of Evidence ◽  
Upper Limb Function ◽  
Meta Analyses

Neurological disorders are a leading cause of death and disability worldwide. Can virtual reality (VR) based intervention, a novel technology-driven change of paradigm in rehabilitation, reduce impairments, activity limitations, and participation restrictions? This question is directly addressed here for the first time using an umbrella review that assessed the effectiveness and quality of evidence of VR interventions in the physical and cognitive rehabilitation of patients with stroke, traumatic brain injury and cerebral palsy, identified factors that can enhance rehabilitation outcomes and addressed safety concerns. Forty-one meta-analyses were included. The data synthesis found mostly low- or very low-quality evidence that supports the effectiveness of VR interventions. Only a limited number of comparisons were rated as having moderate and high quality of evidence, but overall, results highlight potential benefits of VR for improving the ambulation function of children with cerebral palsy, mobility, balance, upper limb function, and body structure/function and activity of people with stroke, and upper limb function of people with acquired brain injury. Customization of VR systems is one important factor linked with improved outcomes. Most studies do not address safety concerns, as only nine reviews reported adverse effects. The results provide critical recommendations for the design and implementation of future VR programs, trials and systematic reviews, including the need for high quality randomized controlled trials to test principles and mechanisms, in primary studies and in meta-analyses, in order to formulate evidence-based guidelines for designing VR-based rehabilitation interventions.

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