Posts Tagged mobility

[WEB SITE] AIRBNB NOW PROVIDES 24 ACCESSIBILITY RELATED FILTERS FOR TRAVELERS WITH DISABILITIES

An image depicting a person in a wheelchair, a person with crutches, and a person sitting on a sofa inside a house, basically highlighting people with disabilities staying at an airbnb location.

More often than not, people with disabilities have to call up hotels or other places where they are staying beforehand, asking whether the room they will be staying in has suitable accommodations for them. In many cases, travelers face difficulties because of lack of accessibility features, which leaves them with a not so satisfactory experience. In order to provide reasonable accommodations to travelers with disabilities, AirBnb has introduced a set of 24 filters that will help them find homes that will make their stay worthwhile, provide them a lot more independence, and allow them to enjoy their vacation a lot more with the least amount of frustration.

If you go to AirBnb.com now, and search for “Homes” (accessible filters don’t show up for anything besides homes, like experience, restaurant, etc.), you will be provided with a new section called “accessibility” that lists the following filters:

Entering the home

• Step-free access
• Wide doorway
• Well lit path to entrance
• Flat path to front door
Getting around
• Wide hallways clearance Hallways at least 36″ (90cm) wide.
• Elevators If needed, contact hosts about the width.

Bedroom

• Step-free access
• Wide doorway
• Accessible-height bed
• Wide clearance to bed
• Electric profiling bed

Bathroom

• Step-free access
• Wide doorway
• Roll-in shower
• Bathtub with shower chair
• Accessible-height toilet
• Wide clearance to shower, toilet
• Fixed grab bars for shower
• Handheld shower head
• Shower chair

Common areas

• Step-free access
• Wide entryway

Parking

• Disabled parking spot There is a city-approved parking spot or a parking space at least 8ft (2.4m) wide.

However, getting to these filters may be just a bit tricky. Here’s how you get to them.

In the search box, type a location you plan to visit. Make sure to search for “Homes”.

type a location in the search box and make sure to choose homes Once the search results appear, click “more filters”.

click more filters to get to all the accessibility section

 

Under more filters, look for the Accessibility section and then click “choose home features”.

under Accessibility, click choose home features.

This is where you will see a list of 24 accessibility related filters. Choose the ones you need for your stay, and click Save. Your search results will be updated now.

choose all filters you require under "accessibility needs".

 

To see what accommodations a specific listing provides, click on it and scroll to the Accessibility section.

 

And there you have it. AirBnb’s filters are very specific, and can help you find a home that will meet your exact needs in terms of accessibility. Next time you travel, give these filters a try, and let us know how they worked out for you!

Source: Fast Company

via AirBnb Now Provides 24 Accessibility Related Filters For Travelers With Disabilities – Assistive Technology Blog

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[Online Game] Mobility Mission Online Game – Stroke.org

Mobility Mission Online Game

Mobility Mission is an entertaining online game that addresses post-stroke mobility challenges. Stroke is a serious condition, and learning to deal with the effects of surviving a stroke can be challenging. This game will help you gain a better understanding of post-stroke mobility challenges such as spasticity, paralysis, foot drop, as well as management and treatment options you can discuss with your healthcare provider. As you travel through the four levels of the game you will learn how to improve your safety at home and acquire tips to lower your risk of falling. Your journey is waiting!

PLAY NOW

 

via Mobility Mission Online Game | Stroke.org

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[WEB SITE] Video Games Suggested as Mobility Aids for Stroke Patients

Published on 

http://www.dreamstime.com/royalty-free-stock-photography-video-games-hand-written-image28837617

 

Researchers propose that video games be used as a complement to physiotherapy treatments to help improve the mobility of patients who have experienced ischemic strokes.

In their study, published in the PNAS Journal, researchers from Basque Center on Cognition, Brain and Language (BCBL) in San Sebastian and the London Imperial College analyzed the architecture of brain injuries in stroke patients.

They propose a new therapeutic pathway that complements the physical treatments received by these patients with therapies to overcome attention deficit disorders, such as working with video games.

“Patients with brain injuries in attention control areas also suffer motility control problems, even when the movement required by the task is very simple,” says BCBL researcher David Soto, in a media release from FECYT – Spanish Foundation for Science and Technology.

The team explored the extent and location of brain injuries in 167 stroke patients for more than 3 years. Through a “mapping” performed with magnetic resonance, they identified the affected part and the type and size of the lesion, and analyzed the connectivity between the different areas of the brain.

Next, they subjected the patients to various motor tasks, some very simple, such as grabbing an object with force. After the tests, the researchers found that these tasks were “impaired” in those patients who had injuries in the area of the brain “involved” in attention, the release explains.

Soto notes that before this study was conducted it was thought that the control of movement and the attention control aspect were “different systems” with little relation to each other, and that the treatments enabled for the patients with cognitive injuries could not serve for those who had mobility problems. However, their research appears to suggest otherwise.

“We have to know first how our brain controls and moves to design effective therapeutic tools for stroke patients and specific therapies for each individual depending on where the injury has occurred,” he concludes.

To confirm these results, the next step will be to establish a clinical trial with patients suffering motor skills disorders due to a stroke and divide them into two groups: one of them undergoing physiotherapy treatment and the other with complementary cognitive training, per the release.

[Source(s): FECYT – Spanish Foundation for Science and Technology, Science Daily]

 

via Video Games Suggested as Mobility Aids for Stroke Patients – Rehab Managment

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[Review] Technical Developments for Rehabilitation of Mobility – Full Text

Abstract

Technically assisted rehabilitation of mobility after stroke has been well established for several years. There is good evidence for the use of end-effector devices, exoskeletons and treadmill training with and without body weight support. New developments provide the possibility for functional training during mobilization, even in intensive care units. Mobile exoskeleton devices have been developed, but their clinical effects need still to be evaluated. All devices should not only focus on increasing the number of repetitions, but also include motivational aspects such as virtual reality environments. Hygienic aspects impose a special challenge. All devices should be integrated into a rational and clearly-defined therapy concept.

Introduction

Technicallyassisted rehabilitation of mobility after stroke has been well established for several years [1]. The premise “if you want to learn to walk, you have to walk” is of primary importance. In 1995, the working group led by Stefan Hesse showed that repetitive training of walking movements using a treadmill leads to greater improvement of walking ability in stroke patients compared to conventional physiotherapy [2].

Since using a treadmill for severely affected patients is not an optimal approach, alternative solutions have been sought [3]. Almost simultaneously two technical solutions were developed. By developing the electromechanical Gangtrainer GT1®, the Berlin group created a so-called end-effector device in which the trajectory of the gait cycle is predefined and the body’s center of gravity is controlled by a belt system in the vertical and horizontal direction. An alternative technical solution, the Lokomat®, was developed by a Zürich working group as an exoskeleton which uses motors to control the knee and hip joints, so that the patient can perform gait exercises even in the case of complete paraplegia.

These approaches can now be classified as clearly evidence-based. Within the framework of the guideline initiative of the German Society for Neurorehabilitation, the guideline “Rehabilitation of Motor Function after Stroke” (ReMos) was published in 2015. Based on a systematic literature search, a total of 188 randomized clinical trials and 11 systematic reviews were identified that met stipulated quality criteria [4]. This literature was grouped not only according to interventions, but also according to the target criteria and thus the severity of the patients’ disability. Based on available evidence, different recommendations were made for gaining and improving mobility, improving walking speed, walking distance and balance [5].

However, during the last few years the rehabilitation landscape in Germany has been particularly characterized by earlier admissions of patients who are still quite disabled when leaving the primary care hospitals. This is demonstrated by massive increases in early rehabilitation treatment capacity, including those with possibilities of mechanical ventilation [6]. For patients, this development offers the advantage of being transferred early in structured rehabilitative environments where new solutions are being developed. The current state of the art as well as new developments will be discussed below. […]

Continue —> Thieme E-Journals – Neurology International Open / Full Text

Fig. 1 Verticalization in conjunction with initiation of walking movements (Erigo®, image rights: Hocoma, Zürich, Switzerland).

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[ARTICLE] How a diverse research ecosystem has generated new rehabilitation technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers – Full Text

Abstract

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program.

Background

Disabilities cause complex problems in society often unique to each person. A physical disability can limit a person’s ability to access buildings and other facilities, drive, use public transportation, or obtain the health benefits of regular exercise. Blindness can limit a person’s ability to interpret images or navigate the environment. Disabilities in speaking or writing ability may limit the effectiveness of communication. Cognitive disabilities can alter a person’s employment opportunities. In total, a substantial fraction of the world’s population – at least 1 in 6 people – face these individualized problems that combine to create major societal impacts, including limited participation. Further, the average person in the United States can expect to live 20% of his or her life with disability, with the rate of disability increasing seven-fold by age 65 [1].

In light of these complex, pervasive issues, the field of rehabilitation engineering asks, “How can technology help?” Answering this question is also complex, as it often requires the convergence of multiple engineering and design fields (mechanical, electrical, materials, and civil engineering, architecture and industrial design, information and computer science) with clinical fields (rehabilitation medicine, orthopedic surgery, neurology, prosthetics and orthotics, physical, occupational, and speech therapy, rehabilitation psychology) and scientific fields (neuroscience, neuropsychology, biomechanics, motor control, physiology, biology). Shaping of policy, generation of new standards, and education of consumers play important roles as well.

In the US, a unique research center structure was developed to try to facilitate this convergence of fields. In the 1970’s the conceptual model of a Rehabilitation Engineering Center (REC), focusing engineering and clinical expertise on particular problems associated with disability, was first tested. The first objective of the nascent REC’s, defined at a meeting held by the Committee on Prosthetic Research and Development of the National Academy of Sciences, was “to improve the quality of life of the physically handicapped through a total approach to rehabilitation, combining medicine, engineering, and related science” [2]. This objective became a working definition of Rehabilitation Engineering [2].

The first five centers focused on topics including functional electrical stimulation, powered orthoses, neuromuscular control, the effects of pressure on tissue, prosthetics, sensory feedback, quantification of human performance, total joint replacement, and control systems for powered wheelchairs and the environment [2]. The first two RECs were funded by the Department of Health, Education, and Welfare in 1971 at Rancho Los Amigos Medical Center in Downey, CA, and Moss Rehabilitation Hospital in Philadelphia. Three more were added the following year at the Texas Institute for Rehabilitation and Research in Houston, Northwestern University/the Rehabilitation Institute of Chicago, and the Children’s Hospital Center in Boston, involving researchers from Harvard and the Massachusetts Institute of Technology [3]. The Rehabilitation Act of 1973 formally defined REC’s and mandated that 25 percent of research funding under the Act go to them [2]. The establishment of these centers was stimulated by “the polio epidemic, thalidomide tragedy and the Vietnam War, as well as the disability movement of the early 70s with its demands for independence, integration and employment opportunities” [3].

After the initial establishment of these RECs, the governmental funding agency evolved into the National Institute on Disability and Rehabilitation Research (NIDRR, a part of the U.S. Department of Education), and now is the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR, a part of the U.S. Department of Health and Human Services. Today, as we describe below, the RERC’s study a diverse set of technologies and their use by people with a disability, including human-computer interaction, mobile computing, wearable sensors and actuators, robotics, computer gaming, motion capture, wheeled mobility, exoskeletons, lightweight materials, building and transportation technology, biomechanical modeling, and implantable technologies. For this review, we invited all RERCs that were actively reporting to NIDILRR at the onset of this review project in 2015, and had not begun in the last two years, to participate. These were centers that were funded (new or renewal) in the period 2008-2013, except the RERC Wheelchair Transportation Safety, which was funded from 2001-2011. Two of the RERCs did not respond (see Table 1). For each center, we asked it to describe the user needs it targets, summarize key advances that it had made, and identify emerging innovations and opportunities. By reviewing the scope of rehabilitation engineering research through the lens of the RERCs, our goal was to better understand the evolving nature and demands of rehabilitation technology development, as well as the influence of a multidisciplinary structure, like the RERCs, in shaping the producing of such technology. We also performed an analysis of how multidisciplinary the current RERCs actually are (see Table 3), and asked the directors to critique and suggest future directions for the RERC program.[…]

Continue —>  How a diverse research ecosystem has generated new rehabilitation technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers | Journal of NeuroEngineering and Rehabilitation | Full Text

Fig. 14 Some MARS RERC projects. a) The KineAssist MX® Gait and Balance Device b) The Armeo Spring® reaching assistance device c) The March Hare virtual reality therapy game d) The Lokomat® gait assistance robot e) Robotic Error Augmentation between the therapist and patient f) lever drive wheelchair g) Ekso® exoskeleton h) Body-machine interface for device control

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[BOOK] Therapeutic Exercise: Foundations and Techniques – Chapter 4: Streching for Improved Mobility – Google Books

F.A. DavisOct 18, 2017
Here is all the guidance you need to customize interventions for individuals with movement dysfunction. YouÕll find the perfect balance of theory and clinical techniqueÑin-depth discussions of the principles of therapeutic exercise and manual therapy and the most up-to-date exercise and management guidelines.

Source: Therapeutic Exercise: Foundations and Techniques – Carolyn Kisner, Lynn Allen Colby, John Borstad – Google Books

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[REVIEW] Technical Developments for Rehabilitation of Mobility – Full Text

Abstract

Technically assisted rehabilitation of mobility after stroke has been well established for several years. There is good evidence for the use of end-effector devices, exoskeletons and treadmill training with and without body weight support. New developments provide the possibility for functional training during mobilization, even in intensive care units. Mobile exoskeleton devices have been developed, but their clinical effects need still to be evaluated. All devices should not only focus on increasing the number of repetitions, but also include motivational aspects such as virtual reality environments. Hygienic aspects impose a special challenge. All devices should be integrated into a rational and clearly-defined therapy concept.

Introduction

Technicallyassisted rehabilitation of mobility after stroke has been well established for several years [1]. The premise “if you want to learn to walk, you have to walk” is of primary importance. In 1995, the working group led by Stefan Hesse showed that repetitive training of walking movements using a treadmill leads to greater improvement of walking ability in stroke patients compared to conventional physiotherapy [2].

Since using a treadmill for severely affected patients is not an optimal approach, alternative solutions have been sought [3]. Almost simultaneously two technical solutions were developed. By developing the electromechanical Gangtrainer GT1®, the Berlin group created a so-called end-effector device in which the trajectory of the gait cycle is predefined and the body’s center of gravity is controlled by a belt system in the vertical and horizontal direction. An alternative technical solution, the Lokomat®, was developed by a Zürich working group as an exoskeleton which uses motors to control the knee and hip joints, so that the patient can perform gait exercises even in the case of complete paraplegia.

These approaches can now be classified as clearly evidence-based. Within the framework of the guideline initiative of the German Society for Neurorehabilitation, the guideline “Rehabilitation of Motor Function after Stroke” (ReMos) was published in 2015. Based on a systematic literature search, a total of 188 randomized clinical trials and 11 systematic reviews were identified that met stipulated quality criteria [4]. This literature was grouped not only according to interventions, but also according to the target criteria and thus the severity of the patients’ disability. Based on available evidence, different recommendations were made for gaining and improving mobility, improving walking speed, walking distance and balance [5].

However, during the last few years the rehabilitation landscape in Germany has been particularly characterized by earlier admissions of patients who are still quite disabled when leaving the primary care hospitals. This is demonstrated by massive increases in early rehabilitation treatment capacity, including those with possibilities of mechanical ventilation [6]. For patients, this development offers the advantage of being transferred early in structured rehabilitative environments where new solutions are being developed. The current state of the art as well as new developments will be discussed below. […]

Continue —>  Thieme E-Journals – Neurology International Open / Full Text

Fig. 1 Verticalization in conjunction with initiation of walking movements (Erigo®, image rights: Hocoma, Zürich, Switzerland).

 

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[Abstract+References] Interventions to improve real-world walking after stroke: a systematic review and meta-analysis

This study aimed to determine the effectiveness of current interventions to improve real-world walking for people with stroke and specifically whether benefits are sustained.

EBSCO Megafile, AMED, Cochrane, Scopus, PEDRO, OTSeeker and Psychbite databases were searched to identify relevant studies.

Proximity searching with keywords such as ambulat*, walk*, gait, mobility*, activit* was used. Randomized controlled trials that used measures of real-world walking were included. Two reviewers independently assessed methodological quality using the Cochrane Risk of Bias Tool and extracted the data.

Nine studies fitting the inclusion criteria were identified, most of high quality. A positive effect overall was found indicating a small effect of interventions on real-world walking (SMD 0.29 (0.17, 0.41)). Five studies provided follow-up data at >3–6 months, which demonstrated sustained benefits (SMD 0.32 (0.16, 0.48)). Subgroup analysis revealed studies using exercise alone were not effective (SMD 0.19 (–0.11, 0.49)), but those incorporating behavioural change techniques (SMD 0.27 (0.12, 0.41)) were.

A small but significant effect was found for current interventions and benefits can be sustained. Interventions that include behaviour change techniques appear more effective at improving real-world walking habits than exercise alone.

1. World Health Organization. Towards a common language for functioning, disability and health-ICF. Geneva: World Health Organization, 2002. Available at: http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.123.1564&rep=rep1&type=pdf (accessed 26 March 2013). Google Scholar
2. Tudor-Locke CE, Myers AM. Challenges and opportunities for measuring physical activity in sedentary adults. Sports Med 2001; 31(2): 91100. Google Scholar CrossRef, Medline
3. Ministry of Health. Guidelines on physical activity for older people (aged 65 years and over). Wellington, 2013. Google Scholar
4. Simonsick EM, Guralnik JM, Volpato S, Balfour J, Fried LP. Just get out the door! Importance of walking outside the home for maintaining mobility: Findings from the women’s health and aging study. J Am Geriatr Soc 2005; 53(2): 198203. Google Scholar CrossRef, Medline
5. Lord SE, McPherson K, McNaughton HK, Rochester L, Weatherall M. Community ambulation after stroke: How important and obtainable is it and what measures appear predictive? Arch Phys Med Rehabil 2004; 85(2): 234239. Google Scholar CrossRef, Medline
6. McKevitt C, Fudge N, Redfern J, . Self-reported long-term needs after stroke. Stroke 2011; 42(5): 13981403. Google Scholar CrossRef, Medline
7. Towfighi A, Markovic D, Ovbiagele B. Impact of a healthy lifestyle on all-cause and cardiovascular mortality after stroke in the USA. J Neurol Neurosurg Psychiatry 2012; 83(2): 146151. Google Scholar CrossRef, Medline
8. Tudor-Locke C, Washington TL, Hart TL. Expected values for steps/day in special populations. Prev Med 2009; 49(1): 311. Google Scholar CrossRef, Medline
9. English C, Manns PJ, Tucak C, Bernhardt J. Physical activity and sedentary behaviors in people with stroke living in the community: A systematic review. Phys Ther 2013; 94(2): 185196. Google Scholar CrossRef, Medline
10. Ada L, Dean CM, Lindley R. Randomized trial of treadmill training to improve walking in community-dwelling people after stroke: The AMBULATE trial: Clinical trial. Int J Stroke 2013; 8(6): 436444. Google Scholar Link
11. Duncan PW, Sullivan KJ, Behrman AL, . Body-weight–supported treadmill rehabilitation after stroke. N Engl J Med 2011; 364(21): 20262036. Google Scholar CrossRef, Medline
12. Mudge S, Barber PA, Stott NS. Circuit-based rehabilitation improves gait endurance but not usual walking activity in chronic stroke: A randomized controlled trial. Arch Phys Med Rehabil 2009; 90(12): 19891996. Google Scholar CrossRef, Medline
13. Pang MYC, Eng JJ, Dawson AS, McKay HA, Harris JE. A community-based fitness and mobility exercise program for older adults with chronic stroke: A randomized, controlled trial: Fitness and mobility exercise for stroke. J Am Geriatr Soc 2005; 53(10): 16671674. Google Scholar CrossRef, Medline
14. van de Port IGL, Wevers LEG, Lindeman E, Kwakkel G. Effects of circuit training as alternative to usual physiotherapy after stroke: Randomised controlled trial. BMJ 2012; 344: e2672e2672. Google Scholar CrossRef, Medline
15. Wade DT, Collen FM, Robb GF, Warlow CP. Physiotherapy intervention late after stroke and mobility. BMJ 1992; 304(6827): 609613. Google Scholar CrossRef, Medline
16. Green J, Young J, Forster A, Collen F, Wade D. Combined analysis of two randomized trials of community physiotherapy for patients more than one year post stroke. Clin Rehabil 2004; 18(3): 249252. Google Scholar Link
17. Michie S, Abraham C, Whittington C, McAteer J, Gupta S. Effective techniques in healthy eating and physical activity interventions: A meta-regression. Health Psychol 2009; 28(6): 690701. Google Scholar CrossRef, Medline
18. Sugavanam T, Mead G, Bulley C, Donaghy M, van Wijck F. The effects and experiences of goal setting in stroke rehabilitation – a systematic review. Disabil Rehabil 2013; 35(3): 177190. Google Scholar CrossRef, Medline
19. Barclay RE, Stevenson TJ, Poluha W, Ripat J, Nett C, Srikesavan CS. Interventions for improving community ambulation in individuals with stroke. Cochrane Database Syst Rev 2015; 3: CD010200. Google Scholar
20. Pollock A, Baer G, Campbell P, . Physical rehabilitation approaches for the recovery of function and mobility following stroke. Cochrane Database Syst Rev 2014; 4: CD001920. Google Scholar
21. States RA, Pappas E, Salem Y. Overground physical therapy gait training for chronic stroke patients with mobility deficits. Cochrane Database Syst Rev 2009; 3: CD006075. Google Scholar
22. Duncan PW, Sullivan KJ, Behrman AL, . Protocol for the Locomotor Experience Applied Post-Stroke (LEAPS) trial: A randomized controlled trial. BMC Neurol 2007; 7(1): 39. Google Scholar CrossRef, Medline
23. Galvin R, Cusack T, Stokes E. A randomised controlled trial evaluating family mediated exercise (FAME) therapy following stroke. BMC Neurol 2008; 8(1): 22. Google Scholar CrossRef, Medline
24. Logan PA, Walker MF, Gladman JRF. Description of an occupational therapy intervention aimed at improving outdoor mobility. Br J Occup Ther 2006; 69(1): 26. Google Scholar Link
25. Mansfield A, Wong JS, Bayley M, . Using wireless technology in clinical practice: Does feedback of daily walking activity improve walking outcomes of individuals receiving rehabilitation post-stroke? Study protocol for a randomized controlled trial. BMC Neurol 2013; 13(1): 93. Google Scholar CrossRef, Medline
26. Galvin R, Cusack T, O’Grady E, Murphy TB, Stokes E. Family-Mediated Exercise Intervention (FAME): Evaluation of a novel form of exercise delivery after stroke. Stroke 2011; 42(3): 681686. Google Scholar CrossRef, Medline
27. Logan PA. Randomised controlled trial of an occupational therapy intervention to increase outdoor mobility after stroke. BMJ 2004; 329(7479): 13721375. Google Scholar CrossRef, Medline
28. Higgins JP, Green S. Handbook for systematic reviews of interventions. Cochrane Version 5.0.2 [updated September 2009]. Cochrane Collaboration, 2009. Available from: www.cochrane-handbook.org (accessed 24 June 2013). Google Scholar
29. Review Manager (RevMan). Copenhagen: The Nordic Cochrane Centre. The Cochrane Collaboration, 2012.
30. Galvin R, Stokes E, Cusack T. Family-Mediated Exercises (FAME): An exploration of participant’s involvement in a novel form of exercise delivery after stroke. Top Stroke Rehabil 2014; 21(1): 6374. Google Scholar CrossRef, Medline
31. Pohl M, Werner C, Holzgraefe M, . Repetitive locomotor training and physiotherapy improve walking and basic activities of daily living after stroke: A single-blind, randomized multicentre trial (DEutsche GAngtrainerStudie, DEGAS). Clin Rehabil 2007; 21(1): 1727. Google Scholar Link
32. Michie S, Ashford S, Sniehotta FF, Dombrowski SU, Bishop A, French DP. A refined taxonomy of behaviour change techniques to help people change their physical activity and healthy eating behaviours: The CALO-RE taxonomy. Psychol Health 2011; 26(11): 14791498. Google Scholar CrossRef, Medline
33. Dean CM, Rissel C, Sherrington C, . Exercise to enhance mobility and prevent falls after stroke: The community stroke club randomized trial. Neurorehabil Neural Repair 2012; 26(9): 10461057. Google Scholar Link
34. Nadeau SE, Wu SS, Dobkin BH, . Effects of task-specific and impairment-based training compared with usual care on functional walking ability after inpatient stroke rehabilitation: LEAPS trial. Neurorehabil Neural Repair 2013; 27(4): 370380. Google Scholar Link
35. Mansfield A, Wong JS, Bryce J, . Use of accelerometer-based feedback of walking activity for appraising progress with walking-related goals in inpatient stroke rehabilitation A randomized controlled trial. Neurorehabil Neural Repair 2015; 29(9): 847857. Google Scholar Link
36. Scott EJ, Eves FF, French DP, Hoppé R. The theory of planned behaviour predicts self-reports of walking, but does not predict step count. Br J Health Psychol 2007; 12(4): 601620. Google Scholar CrossRef, Medline
37. Kreisel SH, Hennerici MG, Bäzner H. Pathophysiology of stroke rehabilitation: The natural course of clinical recovery, use-dependent plasticity and rehabilitative outcome. Cerebrovasc Dis 2007; 23(4): 243255. Google Scholar CrossRef, Medline

Source: Interventions to improve real-world walking after stroke: a systematic review and meta-analysisClinical Rehabilitation – Caroline M Stretton, Suzie Mudge, Nicola M Kayes, Kathryn M McPherson, 2017

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[BLOG POST] Get Back On Your Feet with Exercises for Foot Drop – Saebo

Foot drop (sometimes called drop foot or dropped foot) is the inability to raise the front of the foot due to weakness or paralysis of the muscles and nerves that lift the foot. Foot drop itself is not a disease, it is a symptom of a greater problem or medical condition.

You can recognize foot drop by how it affects your gait. Someone with foot drop may drag their toes along the ground when walking because they cannot lift the front of their foot with each step. In order to avoid dragging their toes or tripping they might lift their knee higher or swing their leg in a wide arc instead. This is called steppage gait, and is a coping mechanism for foot drop issues.

Causes of Foot Drop

There are three main causes of the weakened nerves or muscles that lead to foot drop:

1: Nerve Injury. The peroneal nerve is the nerve that communicates to the muscles that lift the foot. Damage to the peroneal nerve is the most common cause of foot drop. The nerve wraps from the back of the knee to the front of the shin and sits closely to the surface, making it easy to damage. Damage to the peroneal nerve can be caused by sports injuries, hip or knee replacement surgery, a leg cast, childbirth or even crossing your legs.

2: Muscle Disorders. A condition that causes the muscles to slowly weaken or deteriorate can also cause foot drop. These disorders may include muscular dystrophy, amyotrophic lateral sclerosis (Lou Gehrig’s disease) and polio.

3: Brain or Spinal Disorders. Neurological conditions can also cause foot drop. Conditions may include stroke, multiple sclerosis (MS), cerebral palsy and Charcot-Marie-Tooth disease.

How Foot Drop is Treated

Treatment for foot drop requires treating the underlying medical condition that caused it. In some cases foot drop can be permanent, but many people are able to recover. There are a number of treatments that can help with foot drop:

1: Surgery

If your foot drop is caused by a pinched nerve or herniated disc then you will likely have surgery to treat it. Surgery may also be necessary to repair muscles or tendons if they were directly damaged and are causing foot drop. In severe or long term cases, you might have surgery to fuse your ankle and foot bones and improve your gait.

2: Functional Electrical Stimulation

If your foot drop is being caused by damage to the peroneal nerve than Functional Electrical Stimulation may be an alternative to surgery. A small device can be worn or surgically implanted just below the knee that will stimulate the normal function of the nerve, causing the muscle to contract and the foot to lift while walking.

3: Braces or Ankle Foot Orthosis (AFO)

Wearing a brace or AFO that supports the foot in a normal position is a common treatment for foot drop. The device will stabilize your foot and ankle and hold the front part of the foot up when walking. While traditionally doctors have prescribed bulky stiff splints that go inside the shoe, the SaeboStep is a lightweight and cost effective option that provides support outside the shoe.

4: Physical Therapy

Therapy to strengthen the foot, ankle, and lower leg muscles is the primary treatment for foot drop and will generally be prescribed in addition to the treatment options mentioned above. Stretching and range of motion exercises will also help prevent stiffness from developing in the heel.

 

Rehabilitation Exercises for Foot Drop

Specific exercises that strengthen the muscles in the foot, ankle and lower leg can help improve the symptoms of foot drop in some cases. Exercises are important for improving range of motion, preventing injury, improving balance and gait, and preventing muscle stiffness.

When treating foot drop, you may work with a physical therapist who will help you get started strengthening your foot, leg and ankle muscles. Rehabilitation for foot drop can be a slow process, so your physical therapist will likely recommend that you continue to do strengthening exercises at home on your own.

By being consistent about your exercises at home, you can maximize your chances of making a successful recovery from foot drop. Strengthening the weakened muscles will allow you to restore normal function and hopefully start walking normally again.

Like any exercise program, please consult your healthcare professional before you begin. Please stop immediately if any of the following exercises cause pain or harm to your body. It’s best to work with a trained professional for guidance and safety.

Towel Stretch

1-towel-stretch

Sit on the floor with both legs straight out in front of you. Loop a towel or exercise band around the affected foot and hold onto the ends with your hands. Pull the towel or band towards your body. Hold for 30 seconds. Then relax for 30 seconds. Repeat 3 times.

Toe to Heel Rocks

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Stand in front of a table, chair, wall, or another sturdy object you can hold onto for support. Rock your weight forward and rise up onto your toes. Hold this position for 5 seconds. Next, rock your weight backwards onto your heels and lift your toes off the ground. Hold for 5 seconds. Repeat the sequence 6 times.

Marble Pickup

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Sit in a chair with both feet flat on the floor. Place 20 marbles and a bowl on the floor in front of you. Using the toes of your affected foot, pick up each marble and place it in the bowl. Repeat until you have picked up all the marbles.

Ankle Dorsiflexion

4-ankle-dorsiflexion

Sit on the floor with both legs straight out in front of you. Take a resistance band and anchor it to a stable chair or table leg. Wrap the loop of the band around the top of your affected foot. Slowly pull your toes towards you then return to your starting position. Repeat 10 times.

Plantar Flexion

5-plantar-flexion

Sit on the floor with both legs straight out in front of you. Take a resistance band and wrap it around the bottom of your foot. Hold both ends in your hands. Slowly point your toes then return to your starting position. Repeat 10 times.

Ball Lift

6-ball-lift

Sit in a chair with both feet flat on the floor. Place a small round object on the floor in front of you (about the size of a tennis ball). Hold the object between your feet and slowly lift it by extending your legs. Hold for 5 seconds then slowly lower. Repeat 10 times.

Get Back On Your Feet

Don’t let foot drop affect your mobility, independence, and quality of life. With proper rehabilitation and assistive devices many people are able to overcome the underlying cause of their symptoms and get back to walking normally. If you are showing symptoms of foot drop, talk to a medical professional about your treatment options.

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All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.

Source: Get Back On Your Feet with Exercises for Foot Drop | Saebo

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[WEB SITE] Virtual reality intervention shows promise to repair mobility and motor skills in impaired limb

A combination of traditional physical therapy and technology may improve the motor skills and mobility of an impaired hand by having its partner, more mobile hand lead by example through virtual reality training, new Tel Aviv University research suggests.

“Patients suffering from hemiparesis — the weakness or paralysis of one of two paired limbs — undergo physical therapy, but this therapy is challenging, exhausting, and usually has a fairly limited effect,” said lead investigator Prof. Roy Mukamel of TAU’s School of Psychological Sciences and Sagol School of Neuroscience, who conducted the research with his student Ori Ossmy. “Our results suggest that training with a healthy hand through a virtual reality intervention provides a promising way to repair mobility and motor skills in an impaired limb.” The research was published in Cell Reports.

Does the left hand know what the right hand is doing?

53 healthy participants completed baseline tests to assess the motor skills of their hands, then strapped on virtual reality headsets that showed simulated versions of their hands. The virtual reality technology, however, presented the participants with a “mirror image” of their hands — when they moved their real right hand, their virtual left hand would move.

In the first experiment, participants completed a series of finger movements with their right hands, while the screen showed their “virtual” left hands moving instead. In the next, participants placed motorized gloves on their left hands, which moved their fingers to match the motions of their right hands. Again, the headsets presented the virtual left hands moving instead of their right hands.

The research team found that when subjects practiced finger movements with their right hands while watching their left hands on 3D virtual reality headsets, they could use their left hands more efficiently after the exercise. But the most notable improvements occurred when the virtual reality screen showed the left hand moving while in reality the motorized glove moved the hand.

Tricking the brain

“We effectively tricked the brain,” said Prof. Mukamel.

“Technologically, these experiments were a big challenge,” Prof. Mukamel continued. “We manipulated what people saw and combined it with the passive, mechanical movement of the hand to show that our left hand can learn even when it is not moving under voluntary control.”

The researchers are optimistic that this research could be applied to patients in physical therapy programs who have lost the strength or control of one hand. “We need to show a way to obtain high-performance gains relative to other, more traditional types of therapies,” said Prof. Mukamel. “If we can train one hand without voluntarily moving it and still show significant improvements in the motor skills of that hand, we’ve achieved the ideal.”

The researchers are currently examining the applicability of their novel VR training scheme to stroke patients.

Source: American Friends of Tel Aviv University

Source: Virtual reality intervention shows promise to repair mobility and motor skills in impaired limb

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