ABSTRACT
Body machine interfaces (BMIs) are used by people with severe motor disabilities to control external devices, but they also offer the opportunity to focus on rehabilitative goals. In this study we introduced in a clinical setting a BMI that was integrated by the therapists in the rehabilitative treatments of 2 spinal cord injured (SCI) subjects for 5 weeks. The BMI mapped the user's residual upper body mobility onto the two coordinates of a cursor on a screen. By controlling the cursor, the user engaged in playing computer games. The BMI allowed the mapping between body and cursor spaces to be modified, gradually challenging the user to exercise more impaired movements. With this approach, we were able to change our subjects' behavior, who initially used almost exclusively their proximal upper body-shoulders and arms - for using the BMI. By the end of training, cursor control was shifted toward more distal body regions - forearms instead of upper arms - with an increase of mobility and strength of all the degrees of freedom involved in the control. The clinical tests and the electromyographic signals from the main muscles of the upper body confirmed the positive effect of the training. Encouraging the subjects to explore different and sometimes unusual movement combinations was beneficial for recovering distal arm functions and for increasing their overall mobility.
Subject(s)
Man-Machine Systems , Movement/physiology , Spinal Cord Injuries/rehabilitation , User-Computer Interface , Adult , Arm/physiopathology , Biomechanical Phenomena , Electrodes , Electromyography , Exercise Therapy , Female , Humans , Male , Signal Processing, Computer-Assisted , Video Games , Wireless Technology , Young AdultABSTRACT
STUDY DESIGN: Original article. OBJECTIVE: To test the use of bornaprine in the hyperhidrosis treatment in the acute phase of spinal cord-injured patients. SETTING: Patients with acute spinal cord lesions in the Spinal Unit of Pietra Ligure, Savona, Italy. METHOD: In 4 years, 12 patients have been treated, for a maximum period of 75 days, with dosages ranging from 2 to 4 mg day(-1). RESULTS: All of them reported long-lasting subjective benefits, without side effects, even after the interruption of the therapy. CONCLUSION: The bornaprine treatment, at 2 or 4 mg day(-1) dosage, has been effective and safe to contrast hyperhidrosis, in the acute phase of spinal cord-injured patients. This positive experience would require additional trials and a larger number of cases to gain a more solid support.
Subject(s)
Bridged-Ring Compounds/therapeutic use , Hyperhidrosis/drug therapy , Hyperhidrosis/etiology , Spinal Cord Injuries/complications , Adolescent , Adult , Aged , Dose-Response Relationship, Drug , Female , Humans , Longitudinal Studies , Male , Middle Aged , Spinal Cord Injuries/drug therapyABSTRACT
A group of 29 clinically stable post-traumatic brain injury patients were studied for postural disturbances utilizing both a balance force platform and the Tinetti equilibrium test. The stabilometric exam included 6 different aspects of balance, with the goal of evaluating the importance of the sensory afferents on postural control. Posturographic data revealed a global reduction of postural control. TBI patients tended to rely more on visual feedback in postural control than did age-matched controls, and exhibited problems with sensory integration as the complexity of the balance tasks was increased. The site of lesion correlated positively with postural control problems, with brainstem and subcortical gray matter lesions most frequently being involved.
Subject(s)
Brain Injuries/complications , Postural Balance , Posture , Sensation Disorders/etiology , Adolescent , Adult , Brain Stem/injuries , Data Interpretation, Statistical , Feedback/physiology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Sensation Disorders/diagnosis , Time FactorsABSTRACT
A bilateral evaluation of the trapezius muscle was carried out, clinically and by surface electromyography, in 11 stroke patients, in order to compare the activation amplitude of the upper trapezius muscle in different movements of upper limb, using the healthy side as comparison parameter. At our request of analytical activation of the trapezius (consisting in raising their shoulders), we noted in all of them a contraction, both clinically and by EMG valuable. On the contrary at our request of the fixation activity of the shoulder girdle by the trapezius (humeral flexion) we couldn't notice a considerable activation in 4 patients. These data suggest that the trapezius is more active during voluntary movements than in postural fixation, and suggest the use of rehabilitation techniques focusing on the voluntary control.
Subject(s)
Cerebrovascular Disorders/physiopathology , Muscle, Skeletal/physiopathology , Adult , Aged , Arm/physiopathology , Back , Electromyography , Female , Humans , Male , Middle Aged , Movement , Muscle Contraction/physiologyABSTRACT
The Authors report their experience in a patient with Multiple Sclerosis. The planning and the follow up of rehabilitative treatment were based on clinical, functional, electrophysiological and posturographic evaluation. The impairment degree was evaluated by Kurtzke's Expanded Disability Status Scale. The electrophysiological evaluation showed an abnormal recruitment flexor pattern at exteroceptive stimulus and posturography confirmed postural control disorder. The treatment was based on PNF techniques and postural feedback on standing balance platform. After rehabilitative treatment the clinical and functional improvement has been confirmed by normal exteroceptive flexion reflex and better stabilometric parameters.
