Cervical spinal cord injury (cSCI) often results in bilateral impairment of the arms, leading to difficulties in performing daily activities. However, little is known about the neuromotor alterations ...that affect the ability of individuals with cSCI to perform coordinated movements with both arms. To address this issue, we developed and tested a functional assessment that integrates clinical, kinematic, and muscle activity measures, including the evaluation of bilateral arm movements. Twelve subjects with a C5-C7 spinal lesion and six unimpaired subjects underwent an evaluation that included three tests: the Manual Muscle Test, Range Of Motion test and Arm stabilisation test, a subsection of the "Van Lieshout arm/hand function test". During the latter, we recorded kinematic and muscle activity data from the upper-body during the execution of a set of movements that required participants to stabilize both arms against gravity at different configurations. Analytical methods, including muscle synergies, spinal maps, and Principal Component Analysis, were used to analyse the data. Clinical tests detected limitations in shoulder abduction-flexion of cSCI participants and alterations in elbows-wrists motor function. The instrumented assessment provided insight into how these limitations impacted the ability of cSCI participants to perform bilateral movements. They exhibited severe difficulty in performing movements involving over-the-shoulder motion and shoulder internal rotation due to altered patterns of activity of the scapular stabilizer muscles, latissimus dorsi, pectoralis, and triceps. Our findings shed light on the bilateral neuromotor changes that occur post-cSCI addressing not only motor deficits but also the underlying abnormal, weak, or silent muscle activations.
Several exoskeletons have been developed and increasingly used in clinical settings for training and assisting locomotion. These devices allow people with severe motor deficits to regain mobility and ...sustain intense and repetitive gait training. However, three factors might affect normal muscle activations during walking: the assistive forces that are provided during walking, the crutches or walker that are always used in combination with the device, and the mechanical structure of the device itself. To investigate these effects, we evaluated eight healthy volunteers walking with the Ekso, which is a battery-powered, wearable exoskeleton. They walked supported by either crutches or a walker under five different assistance modalities: bilateral maximum assistance, no assistance, bilateral adaptive assistance, and unilateral adaptive assistance on each leg. Participants also walked overground without the exoskeleton. Surface electromyography was recorded bilaterally, and the statistical parametric mapping approach and muscle synergies analysis were used to investigate differences in muscular activity across different walking conditions. The lower limb muscle activations while walking with the Ekso were not influenced by the use of crutches or walker aids. Compared to normal walking without robotic assistance, the Ekso reduced the amplitude of activation for the distal lower limb muscles while changing the timing for the others. This depended mainly on the structure of the device, and not on the type or level of assistance. In fact, the presence of assistance did not change the timing of the muscle activations, but instead mainly had the effect of increasing the level of activation of the proximal lower limb muscles. Surprisingly, we found no significant changes in the adaptive control with respect to a maximal fixed assistance that did not account for subjects’ performance. These are important effects to take into careful considerations in clinics where these devices are used for gait rehabilitation in people with neurological diseases.
Purpose
With an increase in the number of adapted sports, the need to monitor sports performance in people with different abilities has grown. Indeed, a thorough evaluation of the sports gesture ...could prevent the occurrence of injuries, enable a continuous performance assessment, and allow to verify the compliance of the requirements for the competitions. Gesture kinematics provides an assessment of performance, while the muscle activities reveal the underlying strategies adopted by each athlete. In this context, we propose an instrumented evaluation to assess performance in Para-powerlifting. Our goal is to define and test a setup and a protocol to quantitatively assess the execution of bench press exercise in athletes with different abilities.
Methods
We recruited an unimpaired athlete and three Paralympic athletes. They were requested to execute the bench press exercise while we recorded muscle activity and kinematic data from the upper body. We investigated the sport gesture by extracting parameters describing coordination, symmetry, and synchronism between arms, and motor variability while repeating the gesture.
Results
Paralympic athletes performed the gestures with higher coordination between arms and low variability across repetitions compared to the unimpaired athlete, who was not at the Olympic level. All participants obtained similar kinematic performance by adopting different muscle strategies.
Conclusions
This study is a proof of concept that the instrumented evaluation proposed here can allow to conduct a complete assessment of the bench press exercise, in terms of kinematics, muscle activity and performance in athletes with different abilities.
This article explores the acceptance of a humanoid robot designed to engage in conversations with clinicians and individuals with spinal cord injuries. Building upon prior research, we introduce the ...concept of "diversity-aware" robots, which possess the capability to interact with people while adapting to their culture, age, gender, preferences, and physical and mental conditions. These robots are connected to a cloud system specifically designed to consider these factors, enabling them to adapt to the context and individuals they interact with. Our experiments involved the NAO robot interacting with both clinicians and individuals with spinal cord injuries in a hospital environment. Subsequent to the interaction, participants completed a questionnaire and underwent an interview. The collected data were analyzed to assess the system's acceptability and its persistence beyond the initial novelty effect. Furthermore, we investigated whether clinicians exhibited a lower predisposition towards the system and expressed greater concerns than end-users about using the robot, which could potentially hinder the adoption of the system.
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