Ambulation study of a woman with paraplegia using a reciprocating gait orthosis with functional electrical stimulation in Taiwan: a case report.

PURPOSE: Many patients who suffer from spinal cord injuries with paraplegia cannot recover to walk independently. They need to use a special walking orthoses to support their body to walk properly. Traditionally, long leg braces (LLB) were fitted to patients for walking. Unfortunately, the results were not satisfactory as this device supplies adequate support with less than optimum mobility. This study used the latest reciprocating gait orthosis (RGO) combined with functional electrical stimulation (FES). This combination provides a greater support range while applying assistant mechanical walking structures. The FES co-ordination helps restore natural walking abilities that the paralysed patient has lost. METHOD: This study developed a walking orthosis with FES, using FES to stimulate specific muscles (quadriceps, hamstring) in the paralysed patients' lower limbs. The proposed method can achieve the benefits of physical therapeutics while paralysed patients can achieve the purpose of walking. The FES is designed with control buttons on the walking orthosis. A patient can control the left or right leg in walking and speed control via the control buttons. RESULTS: Several practical tests were conducted on the new walking orthosis. A 25-year-old female paralysed patient (L1 complete spinal cord injury) used traditional LLB, RGO and RGO with FES to proceed with walking rehabilitation and clinical assessment. Heart rate difference (HRdifference), mean blood pressure (MBPdifference), walking speed, length of steps, number of steps and oxygen consumption comparisons were made before and after walking. The results show that RGO and RGO with FES were both better than LLB. However, the differences between RGO and RGO with FES in HRdifference, MBPdifference, and walking speed were not significant. This is because the patient's right leg reaction to the electrical stimulation was relatively low. DISCUSSION AND CONCLUSIONS: In general, RGO can help the patient achieve quicker and more independent walking. The combination of RGO and FES can increase the effectiveness of RGO for more mobile aid. These two walking orthoses are better than traditional LLB. Both methods provide patients who suffer from paraplegia with better choices.

A novel home appliance control system for people with disabilities.

PURPOSE: This research proposed an eyeglass-type infrared-based home appliance control system for spinal cord injured (SCI) with tetraplegia. METHOD: This system is composed of four major components: A headset, an infrared transmitting module, an infrared receiving/signal-processing module, and a main controller, the Intel-8951 microprocessor. This design concept was based on the use of an infrared remote module fastened to the eyeglasses that could allow the convenient control of the input motion on the keys of a remote controller of a home appliance which are all modified with infrared receiving/signal-processing modules. For system evaluation, 12 subjects (4 male, 8 female, 26- 47-years-old were recruited. Six persons without disabilities were in the control group and 6 with SCI with tetraplegia formed the experimental group. RESULTS: The average accuracy of the control group and the experimental group are 88.8 +/- 10.6% and 85.9 +/- 14.3%, respectively. The average time cost of the control group and the experimental group are 57.2 +/- 8.1 sec and 66.6 +/- 12.3 sec, respectively. An independent t-test revealed that the differences in the average accuracy and the average time cost of the control group and the experimental group are not significant (p > 0.05). CONCLUSIONS: Using the novel home appliance control system not only provided the advantages of convenience, accuracy and sanitation for people with disabilities but it also helped them to live more independently.

Infrared-based communication augmentation system for people with multiple disabilities.

PURPOSE: This study describes an eyeglass-type infrared-based communication board for the nonspeaking with quadriplegia. METHOD: This system is composed of four major components: a headset, an infrared transmitting module, an infrared receiving/signal-processing module, and a main controller, the Intel-8951 microprocessor. This design concept was based on the use of an infrared remote module fastened to the eyeglasses which could allow the convenient control of the input motion on the keys of a communication board, which are all modified with infrared receiving/signal-processing modules. For system evaluation, 12 subjects (all men, 21-45 years old, six normal subjects as the control group and six nonspeaking with quadriplegia as the experimental group) were recruited. RESULTS: The average accuracy of the control group and the experimental group were 93.1 +/- 4.3% and 89.7 +/- 5.5%, respectively. The average time cost of the control group and the experimental group were 78.3 +/- 8.7 s and 89.9 +/- 10.2 s, respectively. An independent t-test revealed that the differences in the average accuracy and the average time cost of the control group and the experimental group were not significant (p>0.05). CONCLUSIONS: The increase of opportunity to communicate using the infrared-based communication board would help people with multiple disabilities to socialize actively.

Clinical evaluation of the tilt sensors feedback controlled FES for hemiplegia.

A feedback controlled functional electrical stimulation (FES) system is developed to provide the hemiplegic patients a real-time stimulation to their muscles to prevent the drop-foot and the quadriceps weakness from happening during gait training. The FES is controlled by tilt sensors (t.s.) and triggered by footswitches (f) with real-time feedback. As the FES receives the signals from these sensors, it adjusts and outputs an optimum set of stimulation parameters automatically.