Browsing by Subject "Rehabilitation"

Now showing 1 - 14 of 14
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    Constraint Induced Movement Therapy (CIMT) and Stroke Recovery
    (2009-05-04) Henry-Socha, Nancy A.
    Constraint Induced Movement Therapy (CIMT) is a therapy modality which can provide greater improvements in motor performance and functional use of affected upper limbs than traditional interventions. It is also showing efficacy in improvement up to two years post stroke.
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    Development of an ontology for rehabilitation: traumatic brain injury
    (2013-09) Grove, Michael John
    Traumatic Brain Injury (TBI) rehabilitation interventions are very heterogeneous due to injury characteristics and pathology, patient demographics, healthcare settings, caregiver variability, and individualized, multi-discipline treatment plans. Consequently, comparing and generalizing the effectiveness of interventions is limited largely due to non-interoperable domain data. Addressing domain data interoperability through standardization can help unpack the "black-box" of rehabilitation treatment research. This paper describes the development of a foundational non-surgical, non-pharmaceutical ontology for TBI rehabilitation to facilitate domain interoperability. A conceptualization of the clinical domain was developed through a triangulation of data sources in order to create context and to serve as the underlying source for an ontology. A set of classes with primitive ontological relations based on the conceptualization was assembled in the Protégé Ontology Editor. The ontology is designed to facilitate further granularity of classes, properties, and instances as a collaborative hub for domain engagement. It is proposed that the ontology will aid in identification of effective rehabilitation components through the facilitation of comparative effectiveness research (CER).
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    Effects of occupational therapy task-oriented approach in upper extremity post-stroke rehabilitation.
    (2011-08) Almhdawi, Khader
    There is a need for effective Upper Extremity (UE) post-stroke rehabilitation approaches. The Occupational Therapy Task-Oriented (TO) approach was described early in the nineties of the past century. Many of the TO principles were supported in the literature. However, the TO as a whole was only evaluated in case studies. This study aimed to evaluate the functional and the impairment effects of this approach and to refine its treatment protocol. Twenty participants with stroke of three months or more fulfilled the minimal affected UE active movements of at least 10° of shoulder flexion and abduction and elbow flexion-extension and volunteered for this study. Participants were randomized into two order groups. The immediate group got 3 hours of TO treatment per week for six weeks and then got six weeks of no treatment control while the delayed intervention group underwent the reversed order. Participants were evaluated before the first phase, at the cross over, and after the second phase by trained, blinded evaluators. The treatment change scores from both groups were compared with those of the control. The results supported the TO functional superiority as indicated by significant and clinically meaningful changes in the Canadian Occupational Performance Measure (COPM), the Motor Activity Log (MAL), and the time scale of the Wolf Motor Function Test (WMFT). The result failed to support hypothesis of the impairment effects superiority of the TO. We conclude that the TO approach is an effective UE post-stroke rehabilitation approach in improving the UE functional abilities. More studies are needed to provide more evidence for this approach and to illuminate more of its therapeutic abilities with different stroke severity and chronicity levels.
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    Enhancement of learning: Does sleep benefit motor skill memory consolidation?
    (2010-12) Borich, Michael Robert
    Purpose: It remains unclear how the brain best recovers from neurologic injury and how to optimally focus rehabilitation approaches to maximize this recovery. Recent research has indicated that sleep may augment this recovery. Sleep has been shown to benefit memory consolidation for certain motor skills, but it remains unclear if this relationship exists for explicit, continuous, goal-directed motor skills with rehabilitation applications. We aimed to determine the neurobehavioral relationship between finger-tracking skill development and sleep following skill training in young, healthy subjects. Methods: Forty subjects were recruited to receive motor skill training in the morning (n=20) or the evening (n=20). Measures of skill and cortical excitability were collected before and after training. Following training, each group had a post-training interval consisting of waking activity or an interval containing sleep. After this twelve-hour interval, skill performance and cortical excitability were reassessed. Subjects underwent another twelve-hour interval containing either waking activity or a sleep episode and came back for a second assessment, twenty-four hours after training. A subset of subjects (n=10) underwent the same procedures except the training period involved simple, repeated movement of the finger. Results: Skill performance improved after training and then continued to improve offline during the first post-training interval. Improvement was not enhanced by sleep during this interval. Cortical excitability was not substantially altered by training but was related to level of skill performance at follow-up assessment. Sleep quality was also found to be related to level of skill at follow-up assessments. The skilled training period did not lead to significantly improved performance compared to simple movement activity. Discussion: These data suggest that sleep is not required for offline memory enhancement for a continuous, visuospatial finger-tracking skill. These findings are in agreement with recent literature indicating the type of motor skill trained may determine the beneficial effect of sleep on post-training information processing. These results, combined with related studies in patient populations, provide a foundation to evaluate the relationship between sleep, changes in neural activity, and the time course of continuous visuospatial motor skill learning in individuals following neurologic insult.
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    Housing and Urban Hennepin County.
    (1980) Shippee, B. Warner; Thompson, Laurie
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    Housing Rehabilitation Loan Programs in Minnesota.
    (Center for Urban and Regional Affairs, University of Minnesota., 1975) Fitzsimmons, James D; Nutter, Julia A; Gilder, Kathleen A
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    Modulating Physical Activity to Enhance Rehabilitative Outcomes
    (2022-05) Basten, Alec
    Skeletal muscle is the primary organ for human movement. In this way, muscle is highly organized by architecture, fiber type, excitation-contraction coupling, and metabolism to supply energy, contract, and transmit force. When any of these aspects is disrupted, for example resulting from injury, there can be decreased force production capacity and impaired movement. Skeletal muscle is remarkable in its ability to repair, regenerate and adapt. Therefore, most injuries are recoverable. Though, in severe cases of muscle injury (i.e., volumetric muscle loss injury; VML), there is a permanent loss of function. For recoverable muscle injuries, rehabilitation improves recovery. However, rehabilitation remains minimally effective for VML injury and lacks physiologic rationale as to why. Preclinical models for rehabilitation of VML are limited and must expand to test a broader scope of rehabilitation variables (i.e., timing, type, intensity, and duration). One variable that may impact the response to rehabilitation is physical activity. Currently, extreme methods of activity restriction (i.e., hindlimb unloading, immobilization, and denervation) dominate activity restriction studies. Chapter one of this thesis is a review of the literature relating to skeletal muscle, skeletal muscle injury, physical rehabilitation, VML injury, and physical activity. The second chapter of this thesis evaluates a combined electrical stimulation and range of motion as a rehabilitation approach, and an underutilized model of restricting activity that limits housing space instead of completely unloading skeletal muscle. Collectively the data indicate that this rehabilitation impaired muscle function. Restricting activity recovered some impairment, suggesting restricted activity might improve response to rehabilitation. However, restricting activity also resulted in whole body metabolic impairment, a side effect that should be seriously considered if restricting activity is to be used as an adjuvant to enhance rehabilitation. Finally, chapter three dives into conclusions and future directions of this work. Future studies should be aimed at expanding the repertoire of rehabilitation models used for the rehabilitation of VML injury and explore other variables, particularly when to commence rehabilitation, what mode of rehabilitation might be best and most translatable, and how restricting activity may play a role.
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    Motor imagery retraining after stroke with virtual hands: an immersive sensorimotor rhythm-based brain-computer interface
    (2013-06) Doud, Alexander James
    The burden of stroke on the health care system at large and individual patients is profound, and current techniques for rehabilitation rely on the training and dedication of the rehabilitation specialist. Here we present an immersive, virtual reality environment for presenting feedback to subjects in the form of a set of virtual hands. By just imagining the use of the left or right hands, subjects could see movement in the virtual hands and learn to modulate their thoughts to control them. Allowing subjects task relevant motor feedback early could prove an effective means of early rehabilitation. The implications of this training are presented in 6 patients who had suffered cortical or basal ganglia stroke. Using the system described below, the subject's were able to achieve control accuracies of as high as 81% in a binary classification task and showed progression of skill in as little as three, two-hour experimental sessions.
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    Multi-disciplinary Treatment for Chronic Low Back Pain
    (2012-04-10) Pietrini, Sean
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    A One-Year Recidivism Study for Hennepin County Department of Community Corrections and Rehabilitation
    (Hubert H. Humphrey School of Public Affairs, 2013-05-30) Gardenier, Cassidy; Peterson, Michael
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    Pavement Rehabilitation Selection
    (Minnesota Department of Transportation, 2008-01) Dai, Shongtao; Skok, Eugene; Westover, Thomas; Labuz, Joseph; Lukanen, Erland
    The objective of the project was to outline best practices for the selection of asphalt pavement recycling techniques from the many choices that are available. The report specifically examines cold-in-place recycling (CIR), plain full depth reclamation (FDR), and mill & overlay (M&O). Interviews, surveys, and site visits were conducted at both Mn/DOT districts and counties, where relevant rehabilitation information was supplied on over 120 projects. A database was constructed to organize the details of these projects, and the parameters in the database included (1) cracking, (2) ride, (3) rutting, (4) age, and (5) traffic volume. From studying the existing rehabilitation projects in the State, Ride Quality Index (RQI) and Surface Rating (SR) were selected as the descriptors of pavement surface condition. A decision procedure based on the analysis of all available projects was developed. The decision procedure included (1) consideration of road geometrics; (2) pavement condition survey; and (3) structural adequacy evaluation. Furthermore, a step-by-step checklist was developed to provide local engineers with a simple and useful tool to follow the decision procedures. The procedure includes selection of rehabilitation method, pavement thickness design, materials mixture design, and construction.
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    Predictors for participation in a cardiac rehabilitation program feasibility study.
    (2009-12) Krisko-Hagel, Kathryn Ann
    OBJECTIVE: Feasibility study, to explore whether stage of readiness, level of selfefficacy, or perceived benefits/barriers to begin a cardiac rehabilitation (CR) program post cardiac event are associated with the length of time individuals will participate in a Phase II CR program. BACKGROUND: “Stages of Behavior Change” from the Transtheoretical Model (TTM) of Health Behavior. Self-efficacy is one of the constructs of the TTM. Perceived benefits and barriers apply to an individual’s belief system regarding a needed course of action. AIMS: To generate an effect size for: (1) possible association between stage of readiness; (2) level of self-efficacy; and (3) perceived benefits or barriers related to CR post cardiac event and their possible association with meeting CR goals and/or length of time in the program. DESIGN AND METHOD: Prospective correlational design using a convenience sample of men and women having experienced a cardiac event who have received a physician’s order to attend a Phase II CR program. PROCEDURE: The sample was taken from one CR center located in one tertiary care center. Data were collected over a two-month period of time. FINDINGS: A significant association was found between the level of self-efficacy to begin CR and the percentage of CR goals met and a moderate association noted between the level of self-efficacy to begin CR and length of time in the program. CONCLUSIONS: The higher the self-efficacy, the more likely individuals were to remain in CR. Other variables discovered to be of interest were perceived health before the cardiac event, perceived health "now," and perceived health in six months time. IMPLICATIONS: Accurate nursing assessments could help change adverse outcomes by identifying those at risk of not completing CR. Interventions by the nurse through encouragement (to help raise level of self-efficacy of the individual and through family teaching) could help improve completion outcomes.
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    Sustainable Slum Rehabilitation in India - Dwarka Nagar, Madhya Pradesh
    (2022-11) Varghese, Alvin
    The thesis examines the slum rehabilitation and upgradation schemes in India to 1. Explore a better method – Slum Redevelopment or Rehabilitation 2. Explore the role sustainability plays in the process of Rehabilitation 3. Understand the socio-economic factors that influence and affect the im-plementation of the sustainable slum upgradation schemes The approach of a government towards urbanization is an essential factor. The government often fails to recognize the rights of the poor and incorporate this into their policies; because of this, a significant portion of the population in India's slums fails to get suitable housing and essential services. Existing government schemes spend funds on multistoried buildings and large-scale resettlement communities on the city's outskirts without considering housing and community satisfaction. Slum: A slum, according to UN-Habitat, is one that does not have any of the fol-lowing indicators: a durable house structure, easy access to improved sanitation, adequate dwelling space, and tenure security. The last is the hardest to quantify and is not presently utilized in slum assessment; the previous four rely on tradi-tional criteria (UN-Habitat, 2003). Slum Dwellers: According to UN-Habitat, a person living in a home without ac-cess to better water sources, proper sanitation, sufficient living space, sturdy shelter, and security of tenure is referred to as a slum dweller(UN-Habitat, 2003). The focus of this research is to determine if slums in Dwarka Nagar, Bhopal, can be rehabilitated to encourage sustainable urban growth and understand how the slum dwellers perceive the constraints on the slum upgradation. It will also focus on their early involvement in community participation in different stages of the project, like the restoration of Bawdi (Stepwell), creating of different activity zones and recreational areas near the Patra River which will help in continuous monitoring and evaluation. The researcher worked with architects, engineers, and community members to improve current shelter conditions by using proper construction materials and locally available materials like brick, concrete, etc. The views and experiences of slum dwellers in Dwarka Nagar as well as resi-dents around the slums were used. This research is an attempt to create sustainability as a lifestyle framework that will help people to be efficient in creating a better environment for living, by using local resources, skills, and knowledge relevant to the local community.