Clinician Useful Materials

Research – Health and Economic Benefits of Physical Activity for Patients with Spinal Cord Injury

Spinal cord injury (SCI) is a traumatic, life-disrupting event with an annual incidence of 17,000 cases in the US. SCI is characterized by progressive physical deconditioning due to limited mobility and lack of modalities to allow safe physical activity that may partially offset these deleterious physical changes. Approximately, 50% of patients with SCI report no leisure-time physical activity and 15% report leisure-time physical activity below the threshold where meaningful health benefits could be realized. Collectively, about 363,000 patients with SCI, or 65% of the entire spinal cord injured population in the US, engages in insufficient physical activity and represents a target population that could derive considerable health benefits from even modest physical activity levels. Currently, the annual direct costs related to SCI exceed US$45 billion in the US. Rehabilitation protocols and technologies aimed to improve functional mobility have potential to significantly reduce the risk of medical complications and cost associated with SCI. Patients who commence routine physical activity in the first post-injury year and experience typical motor function improvements would realize US$290,000 to US$435,000 in lifetime cost savings, primarily due to fewer hospitalizations and less reliance on assistive care. New assistive technologies that allow patients with SCI to safely engage in routine physical activity are desperately needed.

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Research – The Economic Impact of Caregiving

The share of American adults providing uncompensated care to friends or family members with serious medical conditions and the elderly is growing rapidly. It can be extremely difficult to get a good handle on who and where these caregivers are, making it even more difficult to answer key questions about the impact of caregiving on important facets of daily life, especially the economy.

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Research – Index of Independence in Activities of Daily Living

The Index of Independence in Activities of Daily Living (Index of ADL; Katz et al., 1963) is a measure of function which can be used in objective evaluations of chronically ill and ageing populations. This measure was developed from observations of a large number of activities performed by a group of patients with fracture of the hip. The Index permits ranking of individuals according to adequacy of performance. Adequacy is expressed as a grade (A, B, C, D, E, F, G, or Other) which summarizes overall performance in six functions, namely, bathing, dressing, going to toilet, transferring, continence, and feeding. The form that has been developed for recording ADL evaluations includes three descriptions of each function. For each function, the observer checks the one description that is appropriate to the subject. More than 2,000 evaluations of 1,001 individuals demonstrated use of the Index as a survey instrument, as an objective guide to the course of chronic illness, as a tool for studying the aging process, and as an aid in rehabilitation teaching. (APA PsycTests Database Record (c) 2019 APA, all rights reserved)

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Research — Feasibility and Effectiveness of a Novel Dynamic Arm Support in Persons with Spinal Muscular Atrophy and Duchenne Muscular Dystrophy

Neuromuscular disorders (NMD) commonly affect the upper extremity. Due to muscle weakness, performance of daily activities becomes increasingly difficult, which leads to reduced independence and quality of life. In order to support the performance of upper extremity tasks, dynamic arm supports may be used. The Yumen Arm is a novel dynamic arm support specially developed for people with NMD. The aim of this study is to evaluate the feasibility and effectiveness of the Yumen Arm in persons with Duchenne Muscular Dystrophy (DMD) and persons with Spinal Muscular Atrophy (SMA).

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Research — Rehabilitative and Assistive Wearable Mechatronic Upper-limb Devices: A Review

Recently, there has been a trend toward assistive mechatronic devices that are wearable. These devices provide the ability to assist without tethering the user to a specific location. However, there are characteristics of these devices that are limiting their ability to perform motion tasks and the adoption rate of these devices into clinical settings. The objective of this research is to perform a review of the existing wearable assistive devices that are used to assist with musculoskeletal and neurological disorders affecting the upper limb. A review of the existing literature was conducted on devices that are wearable, assistive, and mechatronic, and that provide motion assistance to the upper limb. Five areas were examined, including sensors, actuators, control techniques, computer systems, and intended applications. Fifty-three devices were reviewed that either assist with musculoskeletal disorders or suppress tremor. The general trends found in this review show a lack of requirements, device details, and standardization of reporting and evaluation. Two areas to accelerate the evolution of these devices were identified, including the standardization of research, clinical, and engineering details, and the promotion of multidisciplinary culture. Adoption of these devices into their intended application domains relies on the continued efforts of the community.

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