A Novel Automated RGB-D Sensor-Based Measurement of Voluntary Items of the Fugl-Meyer Assessment for Upper Extremity: A Feasibility Study
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Motor function assessment is essential for post-stroke rehabilitation, while the requirement for professional therapists’ participation in current clinical assessment limits its availability to most patients. By means of sensors that collect the motion data and algorithms that conduct assessment based on such data, an automated system can be built to optimize the assessment process, benefiting both patients and therapists. To this end, this paper proposed an automated Fugl-Meyer Assessment (FMA) upper extremity system covering all 30 voluntary items of the scale. RGBD sensors, together with force sensing resistor sensors were used to collect the patients’ motion information. Meanwhile, both machine learning and rule-based logic classification were jointly employed for assessment scoring. Clinical validation on 20 hemiparetic stroke patients suggests that this system is able to generate reliable FMA scores. There is an extremely high correlation coefficient (r = 0.981, p < 0.01) with that yielded by an experienced therapist. This study offers guidance and feasible solutions to a complete and independent automated assessment system.The aim of the study was to investigate the efficiency, the feasibility, and the safety of a hybrid cardiovascular rehabilitation program in low-risk acute coronary syndrome (ACS) patients. Sixty low-risk patients with stable clinical status who experienced an ACS in the previous 3 months were included in a 3-week rehabilitation program. The patients were randomized either to a group performing the rehabilitation totally in a rehabilitation centre or partially (only the first 5 days) and then in sport centres equipped for supervised adapted physical activities. The sport centres were located in the vicinity of the patient’s home. Both rehabilitation programs entailed endurance and resistance training and educational therapy. Before and after rehabilitation, cardiorespiratory functions were measured. Similar and significant improvements in peak V.O2 and power output were seen in patients after both types of rehabilitation (p < 0.05). No particular complications were associated with both of our programs. We conclude that a hybrid rehabilitation program in low-risk ACS patients is feasible, safe, and as beneficial as a traditional program organised in a rehabilitation centre, at least in a short-term. A longitudinal follow-up should nevertheless be organised to examine the long-term impacts of this hybrid rehabilitation program.
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We designed a rehabilitation program for patients with post-myocardial infarction by modifying the 14-step program of Emory University into a more suitable form for a Japanese. The usefulness of this rehabilitation program was evaluated by comparing the clinical course of our patients with that of the patients in our affiliated institutions, where patients had no systematic rehabilitation therapy. The following results were obtained: 1) Most patients of the rehabilitation-completed group were living a non-restricted life 6 months after discharge. The life style of the rehabilitation group even including the rehabilitation-non-completed group, was far better than that of the non-rehabilitation group. 2) Many patients of the rehabilitation group were working at the same job as before infarction 3 years after discharge, while a substantial number of the patients of the non-rehabilitation group had changed their job or retired within 3 years after discharge. 3) The reason for changing job or retiring was primarily subjective symptoms or objective findings in the rehabilitation-completed group, while it was mostly fear in the non-rehabilitation group. 4) Patients who could not complete our program were mainly old patients of over 70 years of age, patients with extensive anterior infarction and subendocardial infarction and ones with complications such as shock and cardiac failure.
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Objective To identify the current situation of rehabilitation awareness, demand for rehabilitation of stroke patients in the communities of Chinese cities, in order to provide reference for rehabilitation education and suitable rehabilitation programs. Methods This community-based survey involving 964 stroke patients from three metropolises assesses rehabilitation awareness, the status of rehabilitation and demands for rehabilitation for stroke patients. Results Of the 964 patients, 33.7%(325) reported that they had received information on stroke rehabilitation and only 10.4%(100) patients were well informed of the topic. Seven hundred and fourteen(74.1%) had been hospitalized and 30.4%(294/964) received acute rehabilitation during hospitalization. Of them, 198(20.5%) patients only received acupuncture and massage or manipulation; 178(18.5%) received physical therapy. After discharge, 35%(250/714) received continuous rehabilitation services. Among the reasons of not receiving rehabilitation services, Don't know rehabilitation therapy was placed on the first rank of all reasons. Most stroke patients(74.3%) preferred to receiving rehabilitation services in the centers of community health service. In fact, only 80(8.3%) received community-based rehabilitation(CBR) after discharge. Conclusion The status of rehabilitation is worse than expected. The lack of awareness is an important barrier to early rehabilitation therapy. The importance of establishing an effective education and rehabilitation program to improve status of rehabilitation for stroke survivors should be emphasized.
Stroke
Rehabilitation counseling
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A close relationship exists between the severity of a stroke and the functional level that can be obtained after rehabilitation. The goal of rehabilitation, therefore, should be based on the severity of the stroke. Remission mainly takes place (more than 80 per cent) within the first three months post stroke. Remission after six months is very rare. Age and side of hemiparesis do not seem to influence the effect of rehabilitation significantly. It is not elucidated whether the severity of the stroke influence the effect of rehabilitation. Most of the controlled and the randomized studies indicate that rehabilitation of stroke patients, especially in rehabilitation units, accelerate remission, reduces length of stay and gives rise to a lasting improvement of function.
Hemiparesis
Stroke
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The purpose of this study is to investigate about constant effect about the plan of pioneer rehabilitation ward of large-scale rehabilitation room is not installed. It is the recovery period rehabilitation-ward adopted unit-construction in the space fixed a sickroom mainly on a private room. The following knowledge were obtained: 1. The way to spend times "out of Rehabilitation" and a design method of the space around the sickroom which is spent the time of about 2/3 at the daytime in particular in conjunction with it were important. 2. The number of steps to be generated in a time zone of "out of Rehabilitation" to occupy a time of about 80% between from 7:00 to 19:00 should be added at rehabilitation time. 3. It is important to adopt a mechanism and the idea urging by movement and going up and down, attitudinal variation at the near position in the sickroom of the patient to capture the hospitalization life whole for rehabilitation. As well as rehabilitation, designing to be able to use them as the space which patient can use routinely is important.
Position (finance)
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Rehabilitation is the significant way that helps stroke patients to regain their normal living by restoring the lost functionality to return to its normal functionality. Currently, there are many ways of rehabilitation. In this paper, the rehabilitation by using Electromyography signal (EMG) from patient to control rehabilitation device is proposed. The type of rehabilitation can be chosen either active assistive rehabilitation or passive rehabilitation. In addition, part of body for the rehabilitation can be chosen either upper limb, lower limb or four limbs simultaneously. The proposed system is easy for the patient to understand and execute. The rehabilitation follows normal physiology of human i.e. starts by developing sensory motor, motor neuron, muscle fiber and muscle respectively. Therefore, the proposed rehabilitation in this paper has advantage to the development of stroke patient.
Stroke
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老年者急性心筋梗塞例についてリハビリテーション (以下リハビリと略す) の効果, 影響を検討するため, 対照としてリハビリを施行していなかった期間の心筋梗塞群 (リハビリ(-)群) 53人平均77.1歳と, リハビリを組織的に開始後に入院した心筋梗塞群 (リハビリ(+)群) 84人平均76.1歳とに分け, 予後との関連を検討した. リハビリ(+)群を到達リハビリレベルにより分類すると, リハビリ不能群20人, 軽度リハビリ群15人, 歩行訓練群27人, リハビリ終了群22人であった. リハビリレベル別の合併症の頻度の比較では, リハビリ到達レベル高度の群に梗塞後狭心症が多かった. 心不全の有無, 梗塞再発に関しては各群間に有意差はなかった. 退院時運動レベルと梗塞後の合併症との関連を見ると, 狭心症を有する群に於いて有意に運動レベルが高かった. リハビリ(-), (+)の各群の平均3.5年の観察期間中に於いて, 心臓死は各々51%, 41%にのぼった. リハビリ(-)群の平均7.5年の観察期間中, 心臓死は62%であった. リハビリ(+)群の心臓死例26人について, リハビリレベルと生存年数の間にr=0.53 (p<0.01) の正相関が見られた. 梗塞後狭心症を両群で比較するとリハビリ (-) で13%, リハビリ(+)群で42%と, リハビリ(+)群で多かった. 退院時運動能力は, リハビリ (+) 群で高かった. 生命予後の検討では, リハビリ(+)群で生存率が高い傾向があり, 心死率は低い傾向があったが, 有意差は見られなかった.
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The article reviews a ten-year experience with rehabilitation of post-stroke patients accumulated at specialized in- and out-patient rehabilitation centers. The authors present the principles of structuring the recovery process, as well as the main components of rehabilitation programmes, individual methods, and their combination. The ultimate results of rehabilitation treatment are considerably better than those observed following the traditional chemo- and physiotherapy.
Stroke
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Trauma Center
Affect
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According to 5 Sect. 3 of the Act on the Standardisation of Rehabilitation Services (Rehabilitations-Angleichungsgesetz) an individual rehabilitation plan must be set up if several rehabilitation measures, e.g., medical, vocational and social measures are necessary, or, if different rehabilitation agencies are financially responsible for these procedures. This applies, as a rule, to the rehabilitation efforts for the severely brain-injured. The case history of a young brain-injured patient is used to demonstrate that an overal improvement can be achieved if a close co-operation between the hospital, rehabilitation centre, attending doctor, rehabilitation agencies and employers is ensured. The different measures must be adapted to the individual degree of work tolerance of the patient. Out-patient measures should be carried out -- and this not only because of the lower costs involved. The so-called "Anschlussheilverfahren" which means a treatment programme following the acute phase, initiated by the responsible agencies for the pension insurance scheme, does not seen to be the appropriate routine treatment to be carried out in the rehabilitation of the brain-injured, as they require more comprehensive and long-term therapy.
Pension insurance
Social insurance
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