Abbas Orand

How effective is the early fast treadmill gait speed training for stroke patients at the 2nd week after admission: comparison with comfortable gait speed at the 6th week.

[Purpose] The purpose of this study was to find whether a fast treadmill gait training speed is effective for the gait training of stroke patients in the early rehabilitation stage. [Subjects and Methods] Thirty-nine stroke patients were the subjects of our investigation. They walked on a treadmill with handrail supports at a fast speed (130% of their comfortable gait speed in the 2nd week). The treadmill gaits of the patients were recorded using a 3-dimensional analysis system at two and six weeks after their admissions. Intraclass Correlation Coefficients (ICC) of the temporal and spatial parameters of the two periods were statistically analyzed. [Results] For all of the patients, the ICCs of the measured parameters were greater than 0.58. In the case of patients whose gait speeds of the two periods were close, the ICC units were greater than 0.7. [Conclusion] The fast gait speed training allowed us to expose the patients to a gait speed that they were expected to acquire at a later stage of their rehabilitation. This training method was found to be beneficial for the mildly paralyzed patients.

The comparison of motor learning performance with and without feedback

Ten individuals were divided into two feedback and no-feedback groups. The effect of abstract visual feedback was investigated in these two groups. Using eight electroencephalography (EEG) electrodes, the induced event-related desynchronization/synchronization of the EEG of three motor imagery tasks (left hand, right hand, and right foot) was analyzed by wavelet and spatial filtering methods. Linear discriminant analysis was used to classify the three imagery tasks. Each imagery tasks total length was set to 3 s and 1 s of it was used for the classification. The classification result was shown to the subjects of the feedback group in a real-time manner as an abstract visual feedback. While the paired t-test of the first and third sessions of the training days confirmed the improvement of the motor imagery learning in the feedback group (p < 0.01), the motor imagery learning of the no-feedback group was not significant.

Development of an ankle torque measurement device for measuring ankle torque during walking

[Purpose] To develop a device for measuring the torque of an ankle joint during walking in order to quantify the characteristics of spasticity of the ankle and to verify the functionality of the device by testing it on the gait of an able-bodied individual and an equinovarus patient. [Subjects and Methods] An adjustable posterior strut (APS) ankle-foot orthosis (AFO) was used in which two torque sensors were mounted on the aluminum strut for measuring the anterior-posterior (AP) and medial-lateral (ML) directions. Two switches were also mounted at the heel and toe in order to detect the gait phase. An able-bodied individual and a left hemiplegic patient with equinovarus participated. They wore the device and walked on a treadmill to investigate the device’s functionality. [Results] Linear relationships between the torques and the corresponding output of the torque sensors were observed. Upon the analyses of gait of an able-body subject and a hemiplegic patient, we observed toque matrices in both AP and ML directions during the gait of the both subjects. [Conclusion] We developed a device capable of measuring the torque in the AP and ML directions of ankle joints during gait.

Ability of electrical stimulation therapy to improve the effectiveness of robotic training for paretic upper limbs in patients with stroke

We investigated whether untriggered neuromuscular electrical stimulation (NMES) can increase the effectiveness of shoulder and elbow robotic training in patients with hemiparesis. Thirty subacute stroke patients were randomly equally allocated to robot only (RO) and robot and electrical stimulation (RE) groups. During training, shoulder and elbow movements were trained by operating the robotic arm with the paretic arm, and the robotic device helped to move the arm. In the RE group, the anterior deltoid and triceps brachii muscles were electrically stimulated at sub-motor threshold intensity. Training was performed (approximately 1h/day, 5 days/week for 2 weeks) in addition to regular rehabilitation. Active range of motion (ROM) values of shoulder flexion and abduction, and Fugl-Meyer assessment (FMA) scores were measured before and after training. Active shoulder ROM was significantly better after than before training in the RE group; however, no such improvement was noted in the RO group. FMA scores were significantly better in both groups, and there was no significant difference between the groups. Untriggered NMES might increase the effectiveness of shoulder and elbow robotic training in patients with hemiparesis. Additionally, NMES at a sub-motor threshold during robotic training might facilitate activation of paretic muscles, resulting in paralysis improvement.

Pelvic axis-based gait analysis for ataxic mice

BACKGROUND Although different gait analysis methods such as Walking Track Analysis exist, they cannot be used to demonstrate the physical condition of mice with specific gait disorder characteristic. Therefore, we developed a new method for the gait analysis of such mice to accurately assess hind limb angle based on the pelvic axis. NEW METHOD We established and verified a gait analysis method capable of pelvic axis-based limb angle measurement by video-recording the gait of a control mice group (C57BL/6J(B6)) and three ataxic mice (ataxic B6-wob/t, Parkinsons disease model (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine treated (MPTP)), and cerebellum hypoplasia (cytosine-β-d-arabinofuranoside treated)) from the ventral side. RESULTS The assessed hind limb angles of B6-wob/t and MPTP-treated mice were significantly wider than B6 mice (p<0.01). Moreover, we could draw separating lines with slopes of minus one that could separate the data of each group in the scatter plot of the normalized hind limb step width and angle. COMPARISON WITH EXISTING METHODS We found no significance when we applied the already existing nose-tail method for the analysis of the hind limb angles of B6 and B6-wob/t mice. In the nose-tail method, since the whole body axis of the trunk varies while the trunk of the mouse is laterally bent changing the hind limb angle, B6 and B6-wob/t mice could not be differentiated. However, the two mice groups could be differentiated by the pelvic axis-based gait analysis method. CONCLUSION The pelvic axis-based gait analysis method is promising and valid for mice with gait disorder.

Energy analysis reveals the negative effect of delays in passive movement mirror therapy

Abstract Wavelet transform energy analyses of the mean and standard error of the electromyogram (EMG) and electroencephalogram (EEG) of eight subjects were investigated in passive movement mirror therapies with no delay (in-phase) and with delay (out-of-phase) situations in two frequency bands of 7.81–15.62 and 15.62–31.25 Hz. It was found that the energy levels of EEG at electrode C4 in the in-phase situation were lower than those in out-of-phase situations, while the energy levels of flexor and extensor forearm muscle groups were larger. With two exceptions, this pattern could be seen in all other subjects. The difference between the in-phase (D0) and out-of-phase situations (D025 and D05) for the frequency range of 15.62–31.25 Hz was found to be significant at a significance level of 0.05 (paired t-test analysis). The respective elevation and decline of EEG and EGM with regard to the increase of the delay may indicate the necessity for synchronization of passive movement and mirror therapy.

Multi-input/output alarming system for patients with inattention caused by higher cortical function disorder.

BackgroundTo apply advanced methods of communication, sensing, and instrumentation technologies to make a system that can help patients suffering from hemispatial neglect caused by higher cortical function disorder.MethodBy using several sensors and actuators, the objective was to construct a tailor-made system for each patient. The input part of the system consists of sensors, an interface and transmitters. The output part consists of a receiver, logical arithmetic, an output interface and actuators. The information from the input part is sent to the output part in a wireless manner allowing the mobility of the input and output parts.ResultsThe system and its functionality were realized. Voice alarming and neck muscle stimuli were applied to two patients. We could verify the applicability of the system to remind the patients to put on their wheelchair’s brake and raise its footrest before attempting to stand for transferring to their beds.ConclusionThe designed and constructed multi-input/output system can be used effectively to alarm the patients.