Biomedical subjects

Heidi Sugarman

Publications and source records attributed to Heidi Sugarman.

4 recordsLinked to original sources

PubMed2006

The Jerusalem TeleRehabilitation System, a new low-cost, haptic rehabilitation approach.

Survivors of brain injury or stroke can improve movement ability with intensive, supervised practice. Since the hours of supervised therapy with a physical or occupational therapist are limited, telerehabilitation will enable patients to greatly expand the hours that they practice therapeutic exercises. The Jerusalem TeleRehabilitation System (JTRS) consists of patient and therapist systems plus a central server and database connected via the internet. The system can work in two modes: (1) a cooperative mode in which the therapist and patient are online at the same time, and (2) a stand-alone mode in which the patient uses the system on his own. In both cases, the system will monitor the status and progress of the patient and various parameters of his movement abilities, and prepare reports for the patient and for the therapist. From the clinic, the therapist will be able to change the screen seen by the patient and change the level and types of tasks, as needed. Compared to existing systems, our system will have the following advantages: (1) inexpensive and easy to use; (2) remote monitoring and control of the patient's computer by the therapist in the clinic; (3) more detailed analysis of patient status and progress; (4) a "smart" system which self-adapts to the patient's capabilities in real time, increasing or decreasing the difficulty of the exercise as needed; and (5) a central, international database which, by gathering data on many patients over time, will provide the basis for "smart" therapy and will also facilitate coordinated multicenter research studies.

Computer Simulation↗

PubMed2004

The scaling of postural adjustments during bimanual load-lifting in traumatic brain-injured adults.

Previous postural studies of traumatic brain injury (TBI) patients have been limited to identifying deficits in static and quasi-dynamic postural control tasks such as weight shifting. In this study, we examined whether or not patients with TBI are able to scale adequately their postural adjustments during the performance of the dynamic task of bimanual load-lifting. An age matched group of healthy adults served as controls. We used the Tetrax posturography system that calculates a stability score (ST) based on fluctuations in vertical ground reaction forces, normalized for body weight. During quiet standing, the ST scores of the TBI group were significantly higher than the control group. Forward weight shift and percentage change in the vertical ground reaction forces (lift postural adjustment (LPA) and post-lift postural adjustment (PLPA) scores) linearly increased with increasing load weight in both healthy and TBI subjects. Group differences were found in the magnitude of forward weight shift but not in the relative increase of the LPA and PLPA scores during the lifting and post-lifting phases respectively. The forward weight shift of the TBI group was lower-than-normal and asymmetrical--there was significantly less forward weight shift on the more affected than on the less affected limb. In addition, a significant amplitude coupling was found between the scaling of the weight shift of the heel and forefoot of each limb. However, no coupling was found between the weight shift amplitudes of homologous parts of both limbs in the TBI group. The results showed that scaling based on prior experience was preserved in the TBI group, though some TBI subjects demonstrated absent scaling in either the more affected or less affected heel or forefoot. The differences between the normal and TBI groups in postural adjustments are not necessarily a sign of pathology; rather they may represent a deliberate choice of the central nervous system to counteract predictable disturbances.

Adult↗

PubMed2004

Structured nursing intervention versus routine rehabilitation after stroke.

OBJECTIVE: The goal of this study was to examine the effect of a structured, comprehensive nursing intervention on the course of rehabilitation over the first 6 mos after a first-ever stroke. DESIGN: Intervention (experimental) study. The participants were 155 elderly stroke survivors who were admitted to a geriatric rehabilitation department. Stratified random sampling generated intervention and control groups. The intervention was designed to work together with the routine rehabilitation program and consisted of 12 consecutive weekly meetings. The control group received only the routine rehabilitation program. Study variables were measured at entry to study and after 3- and 6-mo intervals. RESULTS: Although there were no significant differences between the two groups at entry to study, at 3 and 6 mos after stroke, the intervention group showed better scores than the control group in functional status (FIM instrument), depression (Geriatric Depression Scale), self-perceived health, self-esteem, and dietary adherence. CONCLUSION: The nursing intervention had both short- and long-term effects on functional, psychological, and emotional variables. Serious consideration should be given to implementing comprehensive nursing interventions during rehabilitation tailored to meet the specific needs of stroke survivors and their caregivers.

Activities of Daily Living↗

PubMedDate not supplied

Movement in the ipsilesional hand is segmented following unilateral brain damage.

Unilateral stroke results in hemiplegia or hemiparesis of the contralateral side of the body. The ipsilateral side of the body, the so-called "good" side, is often assumed to have no deficit. However, there is increasing evidence that the function of the unaffected limbs, especially the upper extremities, is different from that of normal age-matched controls. In the present study, we examined the motor control of both hands of chronic stroke subjects, 6 with left hemisphere brain damage (LHBD) and 5 with right hemisphere brain damage (RHBD). The control group consisted of 5 normal age-matched subjects. The task of the subject was to move a handle by flexing his/her fingers until the target position was reached. The target position was set as 33% of the range of each subject. No time constraints were imposed. The movements of the normal subjects were basically smooth, with few hesitations. In contrast to this, the movements of both hands in the two stroke groups were segmented and characterized by multiple starts and stops. As compared to normals, the time to reach the target, the number of pauses during the movement, and the percent of time spent in pauses, were significantly greater for both hands of the LHBD group. In the RHBD group, the percent of time spent in pauses was significantly greater than the control group for the ipsilesional hand. The increased segmentation seen in the movements of the ipsilesional, as well as the contralesional. hands of the hemiplegic subjects suggests that the motor deficits in stroke patients may be due to a global inability to correctly plan and carry out movements.

Aged↗