Technology and Health Care - Volume 22, issue 2

Authors: Fang, Juan | Vuckovic, Aleksandra | Galen, Sujay | Cossar, Calum | Conway, Bernard A. | Hunt, Kenneth J.

Article Type: Research Article

Abstract: Background: Rehabilitation of walking should start early after injury to maximise the beneficial effects of gait restoration. Most current gait robotic systems are not suitable for patients who cannot maintain an upright position. Objective: This study aimed to develop a prototype to test a supine-stepping system for early rehabilitation of walking. Methods: Based on the pendulum model of walking, a supine-stepping system was designed through control of the toe and the ankle trajectories. This study implemented the pendulum concept of walking in a functional prototype including a bar-cam mechanism and a foot platform that makes …it possible to perform stepping while lying in a supine position. The kinematics of supine stepping produced by the bar-cam prototype were firstly simulated by a corresponding bar-cam model in Matlab/Simmechanics, then investigated through a preliminary test using an empty leg frame, and lastly by tests on three able-bodied subjects. The experimental results from the bar-cam prototype were compared with the computer simulation results. Furthermore, supine stepping of one subject was compared with his performance during overground walking. Results: The lower extremity kinematics produced while performing stepping using the prototype matched the corresponding simulation results as well as the performance during overground walking. Conclusions: This study demonstrated the technical feasibility of implementing the pendulum concept in a gait orthosis for early rehabilitation of walking. Show more

Keywords: Gait robotics, supine stepping, early rehabilitation of walking

DOI: 10.3233/THC-140821

Citation: Technology and Health Care, vol. 22, no. 2, pp. 273-288, 2014

Authors: Hawi, Nael | Liodakis, Emmanouil | Musolli, Daut | Suero, Eduardo M. | Stuebig, Timo | Claassen, Leif | Kleiner, Carsten | Krettek, Christian | Ahlers, Volker | Citak, Musa

Article Type: Research Article

Abstract: Background: Motion sensing input devices could provide a practical and low-cost alternative method for repeated range of motion measurements. This study aimed to assess the reliability, accuracy and time requirements of a motion sensing input device (Microsoft Kinect) for ROM measurements comparing it with goniometer based measurements and subjective estimation. Material and methods: Full ROM was measured in 14 shoulder and elbow joints using the different methods. The order was randomly selected and each movement was measured twice. The results were recorded in degrees and the time measured in seconds. Results: In general, there …was a poor to moderate agreement between the Kinect system compared to the goniometer. There was a good agreement between the goniometer-based and the subjective technique. The Kinect-based technique showed excellent test-retest reliability. Conclusion: The Kinect system showed good test-retest reliability, but lower accuracy compared to goniometer-based measurements. Improvements in patient positioning and measurement protocol standardization must be made before its implementation in clinical practice. Show more

Keywords: Motion detection, Kinect®, range of motion (ROM), goniometer

DOI: 10.3233/THC-140831

Citation: Technology and Health Care, vol. 22, no. 2, pp. 289-295, 2014

Authors: Ogawa, Yoshikazu | Nakata, Yusuke | Tominaga, Teiji

Article Type: Research Article

Abstract: Background: Modern medical management requires constant quality improvement of the various instruments used for surgical procedures. Higher quality, less complicated handling, and reduced maintenance are all desirable qualities. However, any improvements in instrumentation require that surgeons must clearly understand the application of the device by adherence to the manufacturer's instructions. The weakness of this one-way information flow depends on the low interest among medical personnel for post-purchase reassessment. Objective: Service industries have research departments to investigate the post-purchase behavior of customers, and service recovery is considered essential to retain customers after service failure. All service providers can …suffer service failures, and even the best providers may make errors in delivering service. Such an approach has been increasingly adopted in the risk management at medical institutions. Methods: We report our clinical trials of the post-purchase reassessment and product improvement of surgical instrumentation. Medical personnel reassessed the use of a newly developed endoscope holder based on the manufacturer's manual and made recommendations for possible improvements, which were examined by the manufacturer. Results: Simple but important improvement was achieved for reducing the instability and uncertainty of instrument fixation. Conclusion: This bi-directional post-purchase communication between medical personnel and manufacturers can improve risk management in medical institutions. Show more

Keywords: Improvement, medical device, physician-manufacturer communication, post-purchase, reassessment

DOI: 10.3233/THC-140781

Citation: Technology and Health Care, vol. 22, no. 2, pp. 297-301, 2014