Biomedical Engineering and Bioengineering Commons^™

The Value Of High Intensity Locomotor Training Applied To Patients With Acute-Onset Neurologic Injury, Meghan Fahey, Gabrielle Brazg, Christopher E. Henderson, Abby Plawecki, Emily H. Lucas, Darcy S. Reisman, Brian D. Schmit, T. George Hornby

Biomedical Engineering Faculty Research and Publications

The purpose of this review is to delineate some of the evidence regarding the effects of exercise intensity during locomotor training in patients with stroke and iSCI. We provide specific definitions of exercise intensity used within the literature, describe methods used to ensure appropriate levels of exertion, and discuss potential adverse events and safety concerns during its application. Further details on the effects of locomotor training intensity on clinical outcomes, and on neuromuscular and cardiovascular function will be addressed as available. Existing literature across multiple studies and meta-analyses reveals that exercise training intensity is likely a major factor that can …

Development And Application Of 3d Kinematic Methodologies For Biomechanical Modelling In Adaptive Sports And Rehabilitation, Anne Marie Severyn

All Dissertations

Biomechanical analysis is widely used to assess human movement sciences, specifically using three-dimensional motion capture modelling. There are unprecedented opportunities to increase quantitative knowledge of rehabilitation and recreation for disadvantaged population groups. Specifically, 3D models and movement profiles for human gait analysis were generated with emphasis on post-stroke patients, with direct model translation to analyze equivalent measurements while horseback riding in use of the alternative form of rehabilitation, equine assisted activities and therapies (EAAT) or hippotherapy (HPOT). Significant improvements in gait symmetry and velocity were found within an inpatient rehabilitation setting for patients following a stroke, and the developed movement …

Volitional Control Of Lower-Limb Prosthesis With Vision-Assisted Environmental Awareness, S M Shafiul Hasan

FIU Electronic Theses and Dissertations

Early and reliable prediction of user’s intention to change locomotion mode or speed is critical for a smooth and natural lower limb prosthesis. Meanwhile, incorporation of explicit environmental feedback can facilitate context aware intelligent prosthesis which allows seamless operation in a variety of gait demands. This dissertation introduces environmental awareness through computer vision and enables early and accurate prediction of intention to start, stop or change speeds while walking. Electromyography (EMG), Electroencephalography (EEG), Inertial Measurement Unit (IMU), and Ground Reaction Force (GRF) sensors were used to predict intention to start, stop or increase walking speed. Furthermore, it was investigated whether …

Quantifying And Reversing Compensatory Movements By Persons Post-Stroke In The Ambient Setting, Aaron Miller

Doctoral Dissertations

Nearly 800,000 people in the United States suffer stroke annually. Following the onset of stroke, survivors will exhibit deficits, such as hemiplegia, which will limit their function and ability to perform activities of daily living (ADLs). In order to regain independence, many stroke survivors will employ maladaptive compensatory strategies to help with the completion of tasks. Compensation is generally defined as any performance of a task that is different than the way it may have been performed before the onset of a neurodegenerative disorder. While for some severely impaired individuals, compensation may be necessary, for most these maladaptive strategies ultimately …

Development Of A Novel Haptic Feedback System For Gait Training Applications, Mohsen Alizadeh Noghani

Electronic Theses and Dissertations

Until recently, study and correction of motor or gait functions required costly sensors and measurement setups (e.g., optical motion capture systems) which were only available in laboratories or clinical environments. However, due to (1) the growing availability and affordability of inertial measurement units (IMUs) with high accuracy, and (2) progress in wireless, high bandwidth, and energy-efficient networking technologies such as Bluetooth Low Energy (BLE), it is now possible to measure and provide feedback in real-time for biomechanical parameters outside of those specialized settings. To enable gait training without an expert who can provide verbal feedback, augmented feedback, which is divided …

Intermittent Theta Burst Stimulation: Application To Spinal Cord Injury Rehabilitation And Computational Modeling, Neil Mittal

Theses and Dissertations

Loss of motor function from spinal cord injuries (SCI) results in loss of independence. Rehabilitation efforts are targeted to enhance the ability to perform activities of daily living (ADLs), but outcomes from physical therapy alone are often insufficient. Neuromodulation techniques that induce neuroplasticity may push the limits on recovery. Neuromodulation by intermittent theta burst transcranial magnetic stimulation (iTBS) induces neuroplasticity by increasing corticomotor excitability, though this has most frequently been studied with motor targets and on individuals not in need of rehabilitation. Increased corticomotor excitability is associated with motor learning. The response to iTBS, however, is highly variable and unpredictable, …

Task-Specific Versus Impairment-Based Training On Locomotor Performance In Individuals With Chronic Spinal Cord Injury: A Randomized Crossover Study, Jennifer K. Lotter, Christopher E. Henderson, Abby Plawecki, Molly E. Holthus, Emily H. Lucas, Marzieh M. Ardestani, Brian Schmit, George Hornby

Biomedical Engineering Faculty Research and Publications

Background. Many research studies attempting to improve locomotor function following motor incomplete spinal cord injury (iSCI) focus on providing stepping practice. However, observational studies of physical therapy strategies suggest the amount of stepping practice during clinical rehabilitation is limited; rather, many interventions focus on mitigating impairments underlying walking dysfunction. Objective. The purpose of this blinded-assessor randomized trial was to evaluate the effects of task-specific versus impairment-based interventions on walking outcomes in individuals with iSCI. Methods. Using a crossover design, ambulatory participants with iSCI >1-year duration performed either task-specific (upright stepping) or impairment-based training for up to 20 sessions over ≤6 …

Development And Control Of A 3-Dof Exoskeleton Robot For Forearm And Wrist Rehabilitation, Tanvir Ahmed

Theses and Dissertations

The research conducted under this project directly contributes to the development of a forearm and wrist rehabilitation robot (UWM-FWRR). Upper extremity impairment following stroke, trauma, sports injuries, occupational injuries, spinal cord injuries, and orthopaedic injuries results in significant deficits in hand manipulation and the performance of everyday tasks. Strokes affect nearly 800,000 people in the United States each year. Rehabilitation programs are the main method of promoting functional recovery in individuals with finger impairment. The conventional therapeutic approach requiring a long commitment by both the clinician and the patient. Robotic devices (RDs) are novel and rapidly expanding technologies in hand …

Walking Kinematics In Young Children With Limb Loss Using Early Versus Traditional Prosthetic Knee Prescription Protocols, Mark Daniel Geil, Zahra Safaeepour, Brian Giavedoni, Colleen Coulter

Faculty and Research Publications

The traditional treatment protocol for young children with congenital or acquired amputations at or proximal to the knee prescribes a prosthesis without a working knee joint, based in part on the assumption that a child learning to walk cannot properly utilize a passively flexing prosthetic knee component. An alternative to this Traditional Knee (TK) protocol is an “Early Knee” (EK) protocol, which prescribes an articulating prosthetic knee in the child’s first prosthesis, during development of crawling and transitioning into and out of upright positions. To date, no study has compared samples of children with limb loss at or proximal to …

A Series-Elastic Robot For Back-Pain Rehabilitation, Elhussein Shata

Electronic Theses and Dissertations

Robotics research has been broadly expanding into various fields during the past decades. It is widely spread and best known for solving many technical necessities in different fields. With the rise of the industrial revolution, it upgraded many factories to use industrial robots to prevent the human operator from dangerous and hazardous tasks. The rapid development of application fields and their complexity have inspired researchers in the robotics community to find innovative solutions to meet the new desired requirements of the field. Currently, the creation of new needs outside the traditional industrial robots are demanding robots to attend to the …

The Effect Of Intermittent Theta Burst Stimulation On Biceps Corticomotor Excitability In Non-Impaired Individuals And Individuals With Tetraplegia, Blaize Majdic

Theses and Dissertations

Neuromodulation of the primary motor cortex (M1) in pair with physical therapy may be a promising method for improving motor outcomes after spinal cord injury (SCI). Increased excitability of the corticospinal motor pathways (i.e. corticomotor excitability) has shown to be associated with improved motor learning and skill acquisition. Intermittent theta burst stimulation (iTBS) is a form of non-invasive brain stimulation which can increase corticomotor excitability, as measured by an increase in the amplitude of motor evoked potentials (MEPs). However, the ability for iTBS to increase the corticomotor excitability of proximal muscles such as the biceps, and muscles affected by spinal …

Quantifying The Outcomes Of A Virtual Reality (Vr)-Based Gamified Neck Rehabilitation, Shahan Salim

Electronic Thesis and Dissertation Repository

Neck pain is a major global public health concern and adds a significant financial burden to both the healthcare system as well as people suffering from it. Additionally, it presents measurement and evaluation challenges for clinicians as well as adherence challenges and treatment barriers for the patients. We have developed a virtual reality (VR)-based video game that can be used to capture outcomes that may aid in the assessment and treatment of neck pain. We investigated: (i) performance metrics of overall accuracy, accuracy based on movement difficulty, duration, and total envelope of movement; (ii) stability across sessions; (iii) accuracy across …

A Biomechanical And Physiological Signal Monitoring System For Four Degrees Of Upper Limb Movement, Allison R. Goldman

Electronic Thesis and Dissertation Repository

A lack of adherence to prescribed physical therapy regimens in improper healing results in poor outcomes for those affected by musculoskeletal disorders (MSDs) of the upper limb. Societal and psychological barriers to proper adherence can be addressed through the system presented in this work consisting of the following components: an ambulatory biosignal acquisition sleeve, an electromyography (EMG) based motion repetition detection algorithm, and the design of a compatible capacitive EMG acquisition module.

The biosignal acquisition sleeve was untethered, unobtrusive to motion, contained only modular components, and collected biomechanical and physiological sensor data to form full motion profiles of the following …

Promoting Global Clinical Care And Research For Children With Orthopaedic Disabilities Through Motion Analysis Technology, Jacob R. Rammer, Joycie Eulah Abiera, Monica Arroyo, Luis Fernando Caicedo, Karl Canseco, Christopher Constantino, Filipe Haces Garcia, Jorge Gomez, Nikhil T. Kurapati, Mariano Gonzalez Lugo, Terence Miller, Wilfredo Agredo Rodriguez, Carlo Emmanuel Sumpaico, Gerald F. Harris

Biomedical Engineering Faculty Research and Publications

Human motion analysis is a tool used to understand orthopaedic disabilities in children and to plan and monitor treatment strategies. It enables clinicians to quantitatively describe rehabilitative progress, plan surgeries, and conduct research. While this technology is prevalent in major academic medical centers, access is lacking in many regions throughout the world. This paper presents a novel approach to offer more accessible technology at greatly reduced cost. Current applications are underway in the Philippines, Mexico, and Colombia. Through international partnerships, improvements in clinical care, medical education, and research have been observed.

The Kinematic And Biomechanical Effects Of Bracing On The Rehabilitation Of The Lcl Injured Elbow, Sara M. Banayan

Electronic Thesis and Dissertation Repository

Lateral collateral ligament (LCL) injuries are often treated non-operatively or with surgical repair. If instability persists, hinged elbow orthoses (HEOs) are often recommended. However, these orthoses are designed as a straight hinge, which does not account for the native carrying angle of the elbow. A custom HEO was designed to adjust the orthosis valgus angulation to measure in vitro elbow kinematics and biomechanics. An in vitro study investigated the effect of HEO valgus angulation during simulated active and passive flexion, in the vertical dependent and varus positions, with the forearm pronated and supinated. In the vertical dependent position, the orthosis …

Predictive Simulations Of Gait And Their Application In Prosthesis Design, Anne D. Koelewijin

ETD Archive

Predictive simulations predict human gait by solving a trajectory optimization problem by minimizing energy expenditure. These simulations could predict the effect of a prosthesis on gait before its use. This dissertation has four aims, to show the application of predictive simulations in prosthesis design and to improve the quality of predictive simulations. Aim 1 was to explain joint moment asymmetry in the knee and hip in gait of persons with a transtibial amputation (TTA gait). Predictive simulations showed that an asymmetric gait required less effort. However, a small effort increase yielded a gait with increased joint moment symmetry and reduced …

Design And Analysis Of A 3d-Printed, Thermoplastic Elastomer (Tpe) Spring Element For Use In Corrective Hand Orthotics, Kevin Thomas Richardson

Theses and Dissertations--Mechanical Engineering

This thesis proposes an algorithm that determine the geometry of 3D-printed, custom-designed spring element bands made of thermoplastic elastomer (TPE) for use in a wearable orthotic device to aid in the physical therapy of a human hand exhibiting spasticity after stroke. Each finger of the hand is modeled as a mechanical system consisting of a triple-rod pendulum with nonlinear stiffness at each joint and forces applied at the attachment point of each flexor muscle. The system is assumed quasi-static, which leads to a torque balance between the flexor tendons in the hand, joint stiffness and the design force applied to …

Robotic Resistance Treadmill Training Improves Locomotor Function In Children With Cerebral Palsy: A Randomized Controlled Pilot Study, Ming Wu, Janis Kim, Deborah J. Gaebler-Spira, Brian D. Schmit, Pooja Arora

Biomedical Engineering Faculty Research and Publications

Objective

To determine whether applying controlled resistance forces to the legs during the swing phase of gait may improve the efficacy of treadmill training as compared with applying controlled assistance forces in children with cerebral palsy (CP).

Design

Randomized controlled study.

Setting

Research unit of a rehabilitation hospital.

Participants

Children with spastic CP (N=23; mean age, 10.6y; range, 6–14y; Gross Motor Function Classification System levels, I–IV).

Interventions

Participants were randomly assigned to receive controlled assistance (n=11) or resistance (n=12) loads applied to the legs at the ankle. Participants underwent robotic treadmill training 3 times a week for 6 weeks (18 …

Assessment Of A Hand Exoskeleton On Proximal And Distal Training In Virtual Environments For Robot Mediated Upper Extremity Rehabilitation, Kevin Abbruzzese

Dissertations

Stroke is the leading cause of disability in the United States with approximately 800,000 cases per year. This cerebral vascular accident results in neurological impairments that reduce limb function and limit the daily independence of the individual. Evidence suggests that therapeutic interventions with repetitive motor training can aid in functional recovery of the paretic limb. Robotic rehabilitation may present an exercise intervention that can improve training and induce motor plasticity in individuals with stroke. An active (motorized) hand exoskeleton that provides support for wrist flexion/extension, abduction/adduction, pronation/supination, and finger pinch is integrated with a pre-existing 3-Degree of Freedom (DOF) haptic …

Elbow Patients’ Data Collection And Analysis: An Examination Of Electromyography Healing Patterns, Raneem Haddara

Electronic Thesis and Dissertation Repository

Musculoskeletal conditions are the most common cause of severe long-term pain and physical disability, accounting for the highest disability costs of about $17 billion yearly. To provide better rehabilitation tactics, the knowledge gap between injuries and their healing mechanisms needs to be addressed. The use of electromyography (EMG) is very popular in detecting neuromuscular diseases or nerve lesions; however, there is limited knowledge available for quantifying healing patterns of EMG in orthopedic patients who have injured their joints, muscles, or bones. In order to quantify the progress of orthopedic patients and assess their neuromuscular health and muscle synergy patterns, EMG …

Engineering Synthetic Feedback To Promote Recovery Of Self-Feeding Skills In People With Sensory Deficits Due To Stroke, Alexis Krueger

Master's Theses (2009 -)

Kinesthesia refers to sensations of limb position and movement, and deficits of upper limb kinesthetic feedback are common after stroke, impairing stroke survivors’ ability to perform the fundamental reaching and stabilization behaviors needed for daily functions like self-feeding. I attempt to mitigate the negative impact of post-stroke kinesthesia deficits by evaluating the utility of vibrotactile sensory substitution to restore closed-loop kinesthetic feedback of the upper limb. As a first step, this study evaluated performance in healthy individuals during fundamental reaching, stabilization, and tracking behaviors while using supplemental vibrotactile feedback encoding either limb state information or goal-aware error information. First, I …

Evaluation Of An Actuated Wrist Orthosis For Use In Assistive Upper Extremity Rehabilitation, Devon Holley

Master's Theses (2009 -)

Cerebral palsy (CP) is a neurological condition caused by damage to motor control centers of the brain. This leads to physical and cognitive deficiencies that can reduce an individual’s quality of life. Specifically, motor deficiencies of the upper extremity can make it difficult for an individual to complete everyday tasks, including eating, drinking, getting dressed, or combing their hair. Physical therapy, involving repetitive tasks, has been shown to be effective in training normal motion of the limb by invoking the neuroplasticity of the brain and its ability to adapt in order to facilitate motor learning. Creating a device for use …

The Development Of A Prosthetic Training Software For Upper Limb Amputees, Tyler Kayne Sullins

USF Tampa Graduate Theses and Dissertations

The purpose of this study was to develop an intuitive software that aids in the field of prosthetic training and rehabilitation by creating an individualized visualization of joint angles. This software is titled “the prosthetic training software (PTS) for individualized joint angle representation”, and it enables the individualized portrayal of predicted or pre-recorded joint angles. The PTS is an intuitive program for clinicians and prosthesis users that produces an animation of a virtual avatar reflecting the user’s segment lengths and amputation for rehabilitation and training purposes.

The PTS consists of a graphical user interface (GUI) and a 3D visualization of …

A Novel Approach To User Controlled Ambulation Of Lower Extremity Exoskeletons Using Admittance Control Paradigm, Kiran Kartika Karunakaran

Dissertations

The robotic lower extremity exoskeletons address the ambulatory problems confronting individuals with paraplegia. Paraplegia due to spinal cord injury (SCI) can cause motor deficit to the lower extremities leading to inability to walk. Though wheelchairs provide mobility to the user, they do not provide support to all activities of everyday living to individuals with paraplegia.

Current research is addressing the issue of ambulation through the use of wearable exoskeletons that are pre-programmed. There are currently four exoskeletons in the U.S. market: Ekso, Rewalk, REX and Indego. All of the currently available exoskeletons have 2 active Degrees of Freedom (DOF) except …

Structural-Functional Brain Connectivity Underlying Integrative Sensorimotor Function After Stroke, Benjamin Thomas Kalinosky

Dissertations (1934 -)

In this dissertation research project, we demonstrated the relationship between the structural and functional connections across the brain in stroke survivors. We used this information to predict arm function in stroke survivors, suggesting that the tools developed through this research will be useful for prescribing individualized rehabilitation strategies in people after stroke. Current clinical methods for rehabilitating sensorimotor function after stroke are not based on the locus of injury in the brain. Instead, therapies are generalized, treating symptoms such as weakness and spasticity. This results in outcomes that are highly variable, with severity of impairment immediately following stroke as the …

Refining A Post-Stroke Pharmacological And Physical Treatment To Reduce Infarct Volume Or Improve Functional Recovery, Using Gene Expression Changes In The Peri-Infarct Region To Examine Potential Mechanisms In Male And Female Rats, Moner A. Ragas

Browse all Theses and Dissertations

Stroke, a life-threatening medical condition, is the fifth-leading cause of death in the United States with an estimated annual cost of treatments above $70 billion. A combination of innovative approaches was used in our lab to optimize the pre-clinical stroke research design by choosing the most appropriate animal model and methodologies to increase the translational capability of the stroke research. The first study, modeled after ongoing clinical trials using fluoxetine, refined the appropriate timing of fluoxetine and ascorbic acid delivery if a rat was on simvastatin for 7 days pre-stroke and throughout the remainder of the study. Administration of fluoxetine …

Increased Lower Limb Spasticity But Not Strength Or Function Following A Single-Dose Serotonin Reuptake Inhibitor In Chronic Stroke, Krishnaj Gourab, Brian D. Schmit, T. George Hornby

Biomedical Engineering Faculty Research and Publications

Objective: To investigate the effects of single doses of a selective serotonin reuptake inhibitor (SSRI) on lower limb voluntary and reflex function in individuals with chronic stroke.

Design: Double-blind, randomized, placebo-controlled crossover trial.

Setting: Outpatient research setting.

Participants: Individuals (N=10; 7 men; mean age ± SD, 57±10y) with poststroke hemiplegia of >1 year duration who completed all assessments.

Interventions: Patients were assessed before and 5 hours after single-dose, overencapsulated 10-mg doses of escitalopram (SSRI) or placebo, with 1 week between conditions.

Main Outcome Measures: Primary assessments included maximal ankle and knee isometric strength, and velocity-dependent (30°/s–120°/s) plantarflexor stretch reflexes under …

A Continous Rotary Actuation Mechanism For A Powered Hip Exoskeleton, Matthew C. Ryder

Masters Theses

This thesis presents a new mechanical design for an exoskeleton actuator to power the sagittal plane motion in the human hip. The device uses a DC motor to drive a Scotch yoke mechanism and series elasticity to take advantage of the cyclic nature of human gait and to reduce the maximum power and control requirements of the exoskeleton. The Scotch yoke actuator creates a position-dependent transmission that varies between 4:1 and infinity, with the peak transmission ratio aligned to the peak torque periods of the human gait cycle. Simulation results show that both the peak and average motor torque can …

Motivating Rehabilitation By Distorting Reality, James L. Patton, Yejun Wei, Chris Scharver, Robert V. Kenyon, Robert A. Scheidt

Robert Scheidt

We have found, through a series of recent experiments, encouraging evidence that the neuro-motor system is motivated to change motor patterns when exposed to visuo-motor tasks. We have also shown that the learning of these tasks can be heightened with forces and/or visual distortions that appropriately manipulate the error. This process does not require intense concentration and it is often considered a game. We describe the next generation of robotic large-workspace, three dimensional haptics/graphics systems for rehabilitation

A Novel Fmri Paradigm Suggests That Pedaling-Related Brain Activation Is Altered After Stroke, Nutta-On Promjunyakul, Brian D. Schmit, Sheila M. Schindler-Ivens

Physical Therapy Faculty Research and Publications

The purpose of this study was to examine the feasibility of using functional magnetic resonance imaging (fMRI) to measure pedaling-related brain activation in individuals with stroke and age-matched controls. We also sought to identify stroke-related changes in brain activation associated with pedaling. Fourteen stroke and 12 control subjects were asked to pedal a custom, MRI-compatible device during fMRI. Subjects also performed lower limb tapping to localize brain regions involved in lower limb movement. All stroke and control subjects were able to pedal while positioned for fMRI. Two control subjects were withdrawn due to claustrophobia, and one control data set was …