If your doctor doesn't jump on this and try it out for spasticity you don't have a doctor at all. Do you prefer your incompetence, NOT KNOWING OR NOT DOING? Your responsibility, are you going to do anything about that incompetence? Like firing the board of directors? They set the goals and objectives for the entire organization. Is their goal 100% recovery for all survivors? WHY NOT?
Design of a lightweight passive orthosis for tremor suppression - and spasticity?
Abstract
Background
Tremor is the most common movement disorder with the highest prevalence in the upper limbs. The mechanical suppression of involuntary movements is an alternative and additional treatment to medication or surgery. Here we present a new, soft, lightweight, task asjustable and passive orthosis for tremor suppression.Methods
A new concept of a manual, textile-based, passive orthosis was designed with an integrated, task adjustable, air-filled structure, which can easily be inflated or deflated on-demand for a certain daily activity. The air-filled structure is placed on the dorsal side of the wrist and gets bent and compressed by movements when inflated. In a constant volume air-filled structure, air pressure increases while it is inflating, creating a counterforce to the compression caused by bending. We characterised the air-filled structure stiffness by measuring the reaction torque as a function of the angle of deflection on a test bench. Furthermore, we evaluated the efficacy of the developed passive soft orthosis by analysing the suppression of involuntary movements in the wrist of a tremor-affected patient during different activities of daily living (i.e. by calculating the power spectral densities of acceleration).Results
By putting special emphasis on the comfort and wearability of the orthosis, we achieved a lightweight design (33 g). The measurements of the angular deflection and resulting reaction torques show non-linear, hysteretic, behaviour, as well as linear behaviour with a coefficient of determination (R2) between 0.95 and 0.99. Furthermore, we demonstrated that the soft orthosis significantly reduces tremor power for daily living activities, such as drinking from a cup, pouring water and drawing a spiral, by 74 to 82% (p = 0.03); confirmed by subjective tremor-reducing perception by the patient.Conclusion
The orthosis we developed is a lightweight and unobtrusive assistive technology, which suppresses involuntary movements and shows high wearability properties, with the potential to be comfortable. This air-structure technology could also be applied to other movement disorders, like spasticity, or even be integrated into future exoskeletons and exosuits for the implementation of variable stiffness in the systems.Introduction
Tremor
Tremor is defined as the rhythmic and involuntary oscillatory movement of a body part [1]. It is the most common movement disorder in adults and may be a symptom of a disease or the consequence of drugs [1, 2]. For this movement disorder, Essential tremor (ET) and Parkinson’s Disease (PD) are the most common disorder and disease, respectively, and the hands are the most affected site [3,4,5,6]. Tremor can be distinguished between rest and action tremor; action tremor can be further classified into different sub groups, e.g. postural, kinetic and isometric tremor [7]. ET is the most prevalent type, with 4.6% of the population aged 65 and older affected, causing tremor in the upper limb. PD develops in 2% of people older than 65 [8, 9]. In the overall population of the USA, approximately 2.2% (7 million individuals) are affected by ET [10]. More than 65% of those suffering from tremor in the upper limb present serious difficulties in performing activities in daily life (ADL) [6, 11]. Furthermore, 34% of ET and 48% of PD patients were found to be at least mildly depressed [12].More at link.
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