Lower Limb Rehabilitation

My research addresses rehabilitation post-stroke, primarily improving lower extremity function. I study factors contributing to compensation, which involves greater than normal use of the non-impaired limb compared to the impaired limb. Compensation can be detrimental to rehabilitation as the impaired limb is underutilized and function cannot be restored. This may lead to weakness and impaired mobility/gait.

People often relate the loss of arm mobility to stroke patients because it is so noticeable when a person cannot use one of their arms properly. Statistics show, “motor deficits are common following stroke. Approximately 43% to 69% of people suffering from a stroke have upper-extremity impairment, 1, 2 and 4 years after a stroke, 67% still experience non-use of the affected arm as a major problem” (Siebers et al., 389). In these cases, CIMT can be more beneficial than less invasive therapies. CIMT looks to force movement and use of the affected side of the body after a stroke in order to promote rehabilitation while limiting the unaffected limb. However, this type of therapy does not come easily as CIMT is a very rigorous therapy. In the article, Stroke patients ' and therapists ' opinions of constraint-induced movement therapy, it was stated this therapy is intense because the unaffected arm is restrained while the patient participates in about 6 hours

Sports Therapy and Rehabilitation Services (STARS) at its location in East Meadow, New York, is addressing the problem of spinal cord injuries. These injuries are not as well known as one may think. Warren, Hamilton, and Roden-Foreman state that the “incidence of traumatic spinal cord injury (SCI) is estimated to occur in the United States at a rate of 40 cases per million” (pp. 303, 2013). This is a low incidence, especially in a country of approximately one-third of a billion of people. The prevalence of Americans in 2014 that are alive and have an SCI is approximately 276,000 persons (National Spinal Cord Injury Statistical Center, 2014).

Prognosis for lower limb amputation rehabilitation program, Summary Research by Judith Treby and Eleanor Main, (2007) Children who get a chance to be treated by physical therapy program including bed exercises, transfer practice, mobility (of any form, including wheelchair), upper limb exercises, and stretching, show improvements in their functions and increasing their chances toward a better adult life. Improvement in younger children upper limb amputation with prosthesis more than lower. The PT prognosis for a child with traumatic amputation depends on the age and the severity of amputation. Prognosis in younger children with PFFD shows improvement in the development of a higher level of gross motor skills after 6 months of physical therapy

The goal of rehabilitation after hip fracture surgery is to help the patients begin moving as quickly as possible to avoid the serious complications that can happen with being immobilized in bed. In addition, it helps the patients regain hip range of motion, maximize the strength, walk without a limp, and resume the activities.

During the course of rehabilitation the patient is often seen by multiple therapists to help maximize the recovery process. “Occupational therapists and physical therapist who work with patients with spinal cord damages work closely together in order to prioritize the goals and treatment plans they have for the patient (Emerich,Lyn 2012)”. Assessing and documenting sensory and motor function is vital when working with spinal cord injury patients. “The assessment should include the patient’s voluntary and involuntary motor activity for all the muscle groups throughout their entire body (Emerich,Lyn 2012)”.when the therapist completes this assessment it allows them to identify appropriate and functional compensatory strategies and whether the

Based on the literature the use of indwelling electrical stimulation after injury and surgical repair is supported as a modality to promote axonal regeneration of both sensory and motor neurons in animals and humans. The stimulation protocol that is seen as being the most beneficial for axonal regeneration and functional recovery is brief, low frequency (20Hz) continuous electrical stimulation with short phase duration and between 3-5 volts. Asensio-Pinilla et al. looked that the effects of electrical stimulation combined with exercise to increase axonal regeneration. Treadmill training when combined with acute electrical stimulation was seen to enhance regeneration and increase motor nerve conduction velocity. Asensio-Pinilla et al. was able to provided

The first pt we observed was Brent Lawerance a 29 yr old male who suffered a C4-C5 incomplete spinal cord injury. The pt presented to the clinic with his mother and father who were supportive which is important to note about the pt’s family life. The pt became quadriplegic following a motocross accident in 2005. The accident left the pt paralyzed from C3 and below. He was referred to therapy 4 years following the accident. During the treatment session, Dr. Morgan first decided to work on locomotor training utilizing a harness to help with unloading the pt’s body weight while walking on the treadmill. According to a study done on mice, there is evidence of benefits of exercising paralyzed limbs after SCI1. The article stated you can increase

Mobility disorder caused by SCI or related illnesses in people have been on the increase in recent years (\citet*{chen2016recent}). To help alleviate the difficulties these people go through in other to carry out their day to day activities requires certain robotic devices. Wearable robotic systems such as lower limb exoskeletons do not only provide effective and repetitive gait training but also reduce the burden of physiotherapists. This is because it allows the integration of the human intelligence with that of the mechanical power of the robot. Among other applications these devices may be required for, gait rehabilitation and human locomotion assistance via exoskeleton is of great importance to people with lower limb disorders. For any

A 22 year-old graphic designer name Alex A. got into a car accident that led to spinal cord injuries. The spinal cord controls body functions and feelings through ascending and descending impulses to the brain (Groves 1995). This accident prevented the patient’s spinal cord from delivering sensory or motor function below C2. A ventilator was needed for him to breath and he was fed intravenously. For this reason, a surgery was required to stabilize his condition. After five months of rehabilitation at spinal cord injury center, his motor and sensory function improved by being able to move his hands adequately. However, his lower extremities are concerned since he still had problems with mobility and defecation.

An individual’s capacity to move is critical to carry out basic activities of daily living (ADL). Motion illnesses considerably minimize a patient’s quality of living. This can be caused by two ways- a) injuries in upper or lower extremities and b) problems in Central Nervous System (CNS-brain or spinal cord). Thanks to the improvements in technology so that new ways of treatments are available for the treatment of the seriously injured survivors especially from war. In addition and due to economic reasons, the period of primary therapy is getting shorter and shorter. These issues will probably intensity later on as longevity continues to increase coupled with the prevalence of both moderate and intense motor disabilities in the elderly population and consequently increasing their need of physical assistance. To prevent these problems, current research studies display a wide variety of products specifically assisting physical rehabilitation. Robotic devices with the capacity to perform repetitive tasks on patients are among these technically innovative devices. In fact, robotic devices are already applied in clinical practice as well as clinical evaluation for rehabilitation from TBI, injured upper or lower extremities and stroke survivors. However, considering the number of devices described in the literature, so far only a few of these have succeeded to affect the subject group [1].

I enjoyed reading your posting, you mentioned numerous points pertaining to the justice model, probation and parole, and war on drugs. In my opinion, rehabilitation has been practiced with no effect on offenders as you notated. Today, I think, there are more evidence-based practices that are effective to offenders that have the desire to change and successfully reintegrate back into society such as Cognitive Based Therapy and re-entry rehabilitation. Today, more time and funding are utilized to turn the tables on recidivism.

Abstract—Lower extremity amputation constitute high percentage of limb amputation which significantly reduce the motion ability and quality of life of the amputees. Therefore the most important goal in the design of prosthesis is to restore function of the lost limb. Most of the commercially available ankle-foot prostheses are passive and thus cause many gait pathologies for below knee amputees, such as high metabolic demand, poor shock tolerance and asymmetric gait patterns.

The aim of this study was to investigate whether repetitive transcranial magnetic stimulation (rTMS) can improve motor recovery in lower extremities of the patients with subacute stage spinal cord injury (SCI). This study was conducted with 19 subjects diagnosed with paraplegia because of SCI. The experimental group included 10 subjects who underwent active rTMS, and the control group included 9 subjects who underwent sham rTMS. The SCI patients in the experimental group underwent conventional rehabilitation therapy, and active rTMS was applied daily to the hotspot of the lesional hemisphere. The SCI patients in the control group underwent sham rTMS and conventional rehabilitation therapy. The participants in both the groups received therapy five days per week for six weeks. Latency, amplitude, and velocity were assessed before and after the six-week therapy period. A significant difference in post-treatment gains for the latency and velocity was observed between the experimental and control groups (p 0.05). We conclude that rTMS may be beneficial in improving motor recovery in lower extremities of subacute stage SCI patients.

Many works deal with robotic lower-extremity rehabilitation, \cite{diaz2011}. In \cite{girone1999} a six-degree-of-freedom Steward platform for sprained ankle rehabilitation was developed. More recently, in \cite{rastegarpanah2016} a six degrees of freedom parallel manipulator was proposed for lower limb rehabilitation exercises. Considering that the cost of the robotic system is one of the critical factors, lower mobility mechanisms have been proposed. Ref. \cite{dai2004} proposed two different parallel manipulators for ankle rehabilitation, the first one with three degrees of freedom was composed by three SPS legs and a central strut which is fixed on the base platform, and joined with the moving