RESUMEN
Ambulatory patients with hemiparesis were given auditory feedback of weight bearing on the involved leg in order to achieve symmetrical standing. A device for augmented sensory feedback, the Limb Load Monitor, was used for the training. Patients who could correct their limb loading pattern during the first treatment session learned to achieve symmetrical standing. Results are also related to the magnitude of weight bearing on the involved limb and the side on which the lesion occurs. These findings suggest that the patients utilized the feedback signal to control an inherent activity.
Asunto(s)
Biorretroalimentación Psicológica , Hemiplejía/rehabilitación , Postura , Sonido , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Based on records of 81 patients who used the LLM, and on questionnaire answers and comments from clinicians, the following can be concluded: 1. The LLM can be operated easily after a minimum of training. It does not break down with extended clinical use when handled properly. 2. The LLM manual provides sufficient information for proper operation and clinical use of the device. 3. The number of patients in a clinic who can benefit from LLM training can be predicted, if consideration is given to the type of facility and the size of the patient population and physical therapy staff. 4. The largest diagnostic group of patients who can benefit from LLM therapy are lower-limb amputees, followed by hemiplegic and orthopedic patients. 5. The general selection criteria outlined initially proved sufficient. A patient who is selected properly can be expected to respond to the feedback signal (i.e., make a weight-bearing adjustment) within the first or second session.
Asunto(s)
Retroalimentación , Pierna/fisiología , Locomoción , Monitoreo Fisiológico/instrumentación , Adolescente , Adulto , Anciano , Miembros Artificiales , Niño , Electrónica Médica , Estudios de Evaluación como Asunto , Hemiplejía/rehabilitación , Humanos , Persona de Mediana Edad , Monitoreo Fisiológico/estadística & datos numéricos , Modalidades de Fisioterapia/educación , Postura , Sensación , Sonido , Estrés Mecánico , Encuestas y Cuestionarios , Factores de TiempoRESUMEN
These experiments describe electromyographic activity and forces developed during step-down from several heights. The external environment of the experimental subjects was varied by blindfold or Achilles' tendon vibration during descent. EMG activity of the step-down limb, vertical force of impact and knee angle were measured. The results show that the triceps surae muscle contracts prior to the time of impact of the foot with the substrate if information about the step height is supplied to the subject and if the sensory system is not disturbed by vibration. In the presence of vibration or if the step height is unknown, the triceps surae does not contract prior to foot contact. This produces a large force transient which must be absorbed by the skeletal structure, rather than being damped by a lengthening contraction of the triceps surae. The data suggest that the forces developed during ordinary step-down may be the cause of bone and injury in people with impaired vision or in patients with damaged nervous systems who exhibit large responses to vibration.