Biomedical subjects

Jin-Shin Lai

Publications and source records attributed to Jin-Shin Lai.

At least 19 recordsLinked to original sources

PubMed2005

The M3S-based electric wheelchair for the people with disabilities in Taiwan.

PURPOSE: This study aims to establish an electronic wheelchair system in Taiwan that conforms to multiple master-multiple slave (M3S) standards. The proposed system could enhance the safety and convenience of people with disabilities. MATERIAL AND METHOD: The M3S-based head-controlled electric wheelchair consists of three parts: (A) the input device, (B) the output device, and (C) the safety device. Head movement can be used as the input control to cause the tilting device to produce a corresponding level of analog voltage (backward & forward/left & right) which is then transmitted to the analogy/digital conversion module to control the output device (wheelchair's motor). Ten subjects with C5 incompleted spinal cord injury were recruited in the clinical assessment. They were randomly assigned into groups A and B. In the group A, the subjects were assigned to operate the head-controlled wheelchair system with M3S standard before operating the head-controlled wheelchair system without M3S standard. In the group B, the subjects were assigned to operate the head-controlled wheelchair system without M3S standard before operating the head-controlled wheelchair system with M3S standard. Two subjects in the group B drop off due to their personal reasons. RESULTS: The time cost for group A in completing tasks 1, 2, and 3 with the M3S and without the M3S were insignificant (p>0.05). The time cost for completing in group B was insignificant (p>0.05). Thus, the wheelchair operating time is depended on the proficiency of the subjects, not the M3S standard added. DISCUSSIONS AND CONCLUSIONS: The time cost for subjects to operate the wheelchair was determined by their proficiency, not the M3S standard control added to the system. However, the M3S-based system did realize the safety mechanism and complex auxiliary tools with and without the plug-in and play function.

Adult↗

PubMed2004

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.

Adult↗

PubMed2004

Neuromuscular electric stimulation enhances endothelial vascular control and hemodynamic function in paretic upper extremities of patients with stroke.

OBJECTIVE: To investigate the effects of neuromuscular electric stimulation (NMES) on endothelial vascular control and hemodynamic function in patients in rehabilitation after acute stroke. DESIGN: Before-after trial. SETTING: Inpatients in a tertiary hospital. PARTICIPANTS: Sixteen stroke patients (11 women, 5 men) with a mean age of 60.6+/-19.5 years. INTERVENTIONS: All patients received NMES for paretic wrist extensor and flexor muscles 30 minutes daily, 5 days a week, for 4 weeks. The nonparetic upper extremities, which served as controls, did not receive NMES. MAIN OUTCOME MEASURES: Laser Doppler perfusion testing was conducted to measure cutaneous microcirculatory responses to transdermal iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP), as specific endothelium-dependent and -independent vasodilators, respectively. Arterial and venous hemodynamic function was also measured by impedance plethysmography. RESULTS: Before NMES treatment, the venous capacity and compliance of the paretic extremities did not differ significantly from those of the nonparetic extremities. However, hyperemic arterial inflow, ACh-induced cutaneous perfusion, and the ratio of ACh- to SNP-induced cutaneous perfusion were lower in the paretic than in the nonparetic extremities. After NMES treatment, hyperemic arterial inflow and venous outflow increased by 21.5% and 57.2%, respectively, in the paretic extremities (P<.05). ACh-induced cutaneous perfusion and the ratio of ACh- to SNP-induced cutaneous perfusion were also significantly enhanced in the paretic extremities. In contrast, hyperemic arterial inflow decreased by 39.6% in the nonparetic extremities (P<.05), and endothelium-dependent cutaneous vasodilation also decreased significantly. CONCLUSIONS: NMES therapy may enhance the hyperemic arterial response and endothelium-dependent dilation in skin vasculature in the paretic upper extremities of patients with stroke.

Acetylcholine↗

PubMed2004

The comparison of electromyographic pattern classifications with active and passive electrodes.

Electromyographic (EMG) signals are usually acquired using surface electrodes, and they commonly serve as the control sources of myoelectric prosthetic limbs. The use of passive electrodes and amplifiers with adjustable gain is very popular in laboratories for the development of new control strategies. However, active electrodes without conductive jelly are used in most clinical applications of myoelectric hand control. There remains an important question: Are there any differences between using active and passive electrodes in EMG pattern classifications? Autoregressive and cepstral coefficients were used to evaluate recognition rates via both types of electrodes. The results showed that the estimated recognition rates in the passive electrodes were comparable to those in the active ones (averaged recognition rate, 88.5 vs. 85.84% in the autoregressive coefficients, and 84.84 vs. 83.5%, in the cepstral coefficients, respectively). Aside from the lack of significant statistical differences between them, the results imply that the differences between the recognition rates via these electrodes could be negligible. This would be helpful for the myoelectric control of assistive devices.

Electrodes↗

PubMed2004

Response of Taiwanese obese binge eaters to a hospital-based weight reduction program.

OBJECTIVE: To investigate the characteristics and prevalence of binge eating among overweight Taiwanese and to determine the effect of binge eating on outcome of weight loss treatment. METHODS: One hundred and eighty-nine participants in a 12-week traditional weight-reduction program were classified on the basis of the Bulimic Investigation Test, Edinburgh (BITE) scores into binge eaters (>/=20), subthreshold binge eaters (10-19), and nonbinge eaters (0-9). RESULTS: This study found a 15.9% prevalence of binge eating. The binge-eating groups (binge eaters and subthreshold binge eaters) were younger, had an earlier onset of obesity, and more psychological distress than nonbinge eaters. Differences in obesity treatment weight loss among binge eaters, subthreshold binge eaters, or nonbingers by last observation carried forward (LOCF) method were not significant. At the end of treatment, the subthreshold binge eaters had the greatest weight loss. Although their binge eating and mood significantly improved, binge eaters and subthreshold binge eaters still had significant pathology in eating behaviors at completion of the program. CONCLUSION: Alternative treatment strategies focusing on disordered eating behaviors are needed to supplement standard dietary management of overweight treatment-seeking binge eaters.

Adolescent↗

PubMed2004

Evaluation of rocker sole by pressure-time curves in insensate forefoot during gait.

OBJECTIVE: The rocker sole reduces plantar pressure in the insensate forefoot during gait, but the reasons have remained unclear. This study aimed to derive new variables descriptive of the effects of the rocker sole. DESIGN: We measured plantar pressures in eight forefoot areas in the insensate feet of ten diabetic subjects and performed stepwise regression of pressures as cubic functions of time in patients wearing shoes without and with prefabricated rocker soles. RESULTS: Pressure-time curves were all sigmoid in shape, but inflected at different time points, and were regressed by different variables in different forefoot areas in shoes without rocker soles. The rocker sole reduced peak pressures and pressure-time integrals and made pressure-time curves more concave. Inflections occurred at 15% or 16% of the gait cycle time and reached peak pressure later with the rocker. The more anterior the forefoot areas, the more concave their curves and the greater their regression parameters became. CONCLUSIONS: To evaluate the effectiveness of a rocker sole, physiatrists may regress sigmoid pressure-time curves as cubic functions of time in the insensate forefoot, check simultaneous inflections of the curves in areas rotated by the rocker sole, and compare their concavity and regression parameters in areas rotated at different distances from the axis of rotation. By doing so, physiatrists may be better able to improve the design of rocker sole and other forms of forefoot orthoses.

Aged↗

PubMed2004

The aerobic capacity and ventilatory efficiency during exercise in Qigong and Tai Chi Chuan practitioners.

The objective of this study was to compare cardiorespiratory responses to exercise among older Qigong participants, Tai Chi Chuan (TCC) practitioners and normal sedentary controls during cycle ergometry. Thirty-six community-dwelling men with a mean age of 59.1 +/- 6.6 years participated in this study. Each group (Qigong, TCC and control) included 12 subjects with matched age and body size. The Qigong group practiced Qigong regularly for 2.3 +/- 1.5 years; the TCC group practiced Yang TCC for 4.7 +/- 2.3 years. Heart rate (HR) responses were measured during the practice of Qigong and TCC. Additionally, breath-by-breath measurement of cardiorespiratory function was performed during the incremental exercise of leg cycling. The mean HR during Qigong and TCC practice was 91 +/- 5 bpm and 129 +/- 7 bpm, respectively. At the peak exercise and the ventilatory threshold (VeT), TCC group displayed highest oxygen uptake (VO2), O2 pulse and work rate among the three groups. The Qigong group also showed higher oxygen uptake and O2 pulse than the control group. At the same relative exercise intensity, the Qigong group had the highest tidal volume among the three groups. In conclusion, Qigong and TCC show a beneficial effect to aerobic capacity in older individuals, but TCC displays a better training effect than Qigong due to its higher exercise intensity. However, Qigong can enhance breathing efficiency during exercise due to the training effect of diaphragmatic breathing.

Aging↗

PubMed2004

Relative exercise intensity of Tai Chi Chuan is similar in different ages and gender.

This study aims to determine the relative exercise intensity of classical Yang Tai Chi Chuan (TCC) in different ages and gender. One hundred TCC practitioners (54 men and 46 women) aged 25 to 80 years participated in this investigation. Men and women were separated into three groups: young (25-44 y/o), middle-aged (45-64 y/o) and elderly (65-80 y/o). Heart rate (HR) responses during TCC practice were measured by using electrocardiographic telemetry. An exercise test with breath-by-breath measurements of cardiorespiratory function was also performed for each subject during the incremental exercise of leg cycling. Measurements obtained during the TCC practice and exercise testing were compared to determine the exercise intensity of TCC. While performing TCC, the mean HR of men was 141 +/- 12 bpm, 132 +/- 9 bpm and 120 +/- 10 bpm in the young, middle-aged and elderly groups, respectively. Men practiced TCC with mean HR corresponding to 57.8 +/- 3.7%, 56.6 +/- 3.4% and 55.1 +/- 3.1% of heart rate reserve (HRR) in the three groups. Meanwhile, the mean HR of women was 136 +/- 10 bpm, 126 +/- 11 bpm and 115 +/- 12 bpm in the young, middle-aged and elderly groups, respectively. Women practiced TCC with mean HR corresponding to 52.7 +/- 2.8%, 51.5 +/- 2.6% and 50.3 +/- 2.9% of HRR in the three age groups. The results demonstrate that classical Yang TCC is an exercise with moderate intensity, and its exercise intensity is similar across different ages in each gender. In conclusion, TCC is an aerobic exercise and suitable for participants of different ages and gender to improve their functional capacity.

Adult↗

PubMed2004

Distribution of plantar pressure on the second metatarsal head during walking.

BACKGROUND AND PURPOSE: Although high pressure occurs on the second metatarsal head during waking, the distribution of this plantar pressure has not been reported. The purpose of the study was to analyze the distribution of plantar pressure on the second to the fourth metatarsal heads during walking in healthy adults. METHODS: Plantar pressure was measured at the second and adjacent metatarsal heads by 2.54 mm x 2.54 mm transducers during walking in 72 healthy adults (32 women and 40 men). Data at the instant of peak pressure were analyzed using spatial statistics. The length and width of 90% predicted peak pressure (PPP), and anterior and posterior extents to 80, 70, 60, and 50% PPP were regressed by peak pressure, body height, body weight, gender, and foot length of the subjects. RESULTS: The distribution parameters of plantar pressure decreased proportionally from the second to the fourth metatarsal heads, and were different from the first metatarsal head. The distribution parameters were inversely correlated to peak pressure. Besides peak pressure, the length and width of 90% PPP, and anterior extent to 80% PPP could be predicted by body weight. The anterior extent to 70% PPP could be predicted by foot length. The posterior extent to 80, 70, 60, and 50% PPP could be predicted by body height of the subjects. CONCLUSIONS: Besides peak pressure, the distribution of plantar pressure was correlated with body weight, body height, and foot length at different areas on the second metatarsal head in normal adults.

Adult↗

PubMed2003

A head movement image (HMI)-controlled computer mouse for people with disabilities.

PURPOSE: This study proposes image processing and microprocessor technology for use in developing a head movement image (HMI)-controlled computer mouse system for the spinal cord injured (SCI). METHOD: The system controls the movement and direction of the mouse cursor by capturing head movement images using a marker installed on the user's headset. In the clinical trial, this new mouse system was compared with an infrared-controlled mouse system on various tasks with nine subjects with SCI. RESULTS: The results were favourable to the new mouse system. The differences between the new mouse system and the infrared-controlled mouse were reaching statistical significance in each of the test situations (p<0.05). CONCLUSIONS: The HMI-controlled computer mouse improves the input speed. People with disabilities need only wear the headset and move their heads to freely control the movement of the mouse cursor.

Communication Devices for People with Disabilities↗

PubMed2003

Poor functional recovery may indicate restenosis in patients after coronary angioplasty.

OBJECTIVE: To investigate whether poor response to exercise training can detect restenosis in asymptomatic patients after percutaneous transluminal coronary angioplasty (PTCA). DESIGN: Case-control study. SETTING: A hospital-based outpatient cardiac rehabilitation program in Taiwan. PARTICIPANTS: Sixteen patients aged 49.7+/-7.8 years who had undergone PTCA and completed a 3-month exercise program. Patients were separated into a restenosis group (n=7; age, 46.4+/-9.8y) and a nonrestenosis group (n=9; age, 52.3+/-12.9y), according to their angiography follow-up results. The interval between PTCA and angiography ranged from 6 months to 2 years. INTERVENTION: Bicycle exercise workouts were conducted 3 times a week during rehabilitation, with exercise intensity adjusted to each patient's ventilatory threshold. MAIN OUTCOME MEASURES: A graded exercise test with gas analysis was conducted before training, at 6 weeks and at 3 months after training, to evaluate the sequential changes of cardiorespiratory function. RESULTS: After 3 months of training, the nonrestenosis group showed an increase of 30.4% in peak oxygen uptake (Vo(2)peak, P<.05), 13.7% in peak oxygen pulse (P<.05), 22.2% in peak rate-pressure product (P<.05), and 13.6% in peak work rate (P<.05). Most of the improvement occurred within the first 6 weeks of training. The restenosis group did not show significant increase in these variables. At the ventilatory threshold, the nonrestenosis group also displayed a significant increase of Vdot;o(2), oxygen pulse, and work rate. However, the restenosis group showed no improvement after training. CONCLUSION: Functional recovery appears to be a good indicator of restenosis for patients after PTCA. A poor response to exercise can be noted within 6 weeks of training in PTCA patients with restenosis.

Aged↗

PubMed2002

Spinal cord infarction caused by cardiac tamponade.

This article describes a 16-yr-old male patient who went into shock and cardiac arrest 2 wk after surgical repair of an atrial septal defect. Cardiac tamponade was diagnosed and promptly treated, and his hemodynamic status stabilized 4 hr after the initial presentation of shock; however, paraplegia was found when the patient regained consciousness. Physicians should be alert to a possible diagnosis of spinal cord infarction in patients with complications of cardiovascular surgery, particularly when a new onset of neurologic symptoms or signs occurs.

Adolescent↗

PubMed2002

Improvement of cardiorespiratory function after percutaneous transluminal coronary angioplasty or coronary artery bypass grafting.

OBJECTIVE: The objective of this study was to investigate the effect of a 3-mo training program for patients with either a percutaneous transluminal coronary angioplasty (PTCA) or a coronary artery bypass grafting (CABG). DESIGN: Forty-four patients participated in a 3-mo outpatient cardiac rehabilitation program. Graded exercise tests with gas analysis were conducted before and after training to evaluate the changes of cardiorespiratory function. RESULTS: In the pretraining examination, the PTCA group showed a higher peak oxygen uptake (VO2peak) and work rate than the CABG group. In the posttraining examination, the PTCA group increased 14.6% in VO2peak. Meanwhile, the CABG group increased 32.8% in VO2peak. At the ventilatory threshold, both groups also significantly increased in Vo2. CONCLUSIONS: A 3-mo cardiac rehabilitation program for patients with PTCA or CABG could favorably enhance their cardiorespiratory function. Although the pretraining VO2peak was lower for the patients with CABG, their training potential was greater, and hence they could achieve a similar level of aerobic capacity as the PTCA group.

Adult↗

PubMed2002

Comparison of pressure and time parameters in evaluating diabetic footwear.

OBJECTIVE: Although peak pressure has been used in the evaluation of diabetic footwear, other potential parameters have remained unstudied. This study was undertaken to compare the effects of diabetic footwear on pressure-time integral, peak pressure, and contact time in different areas of the foot. DESIGN: In-shoe pressure was measured and analyzed separately in the left and right feet of 14 diabetic patients with neuropathy by using 24 discrete sensors for each foot; pressure-time integral, peak pressure, and contact time at 48 data points were compared between patients wearing their own shoes and patients wearing diabetic footwear. RESULTS: The three parameters were symmetrically reduced in the anterior and posterior parts of bilateral feet and increased in the middle part of bilateral feet. The 34 sensors that showed significant changes in pressure-time integral included all 23 sensors that showed significant changes in peak pressure, and 15 of 18 sensors showed significant changes in contact time. The change of the pressure-time integral was correlated to walking speed at 17 sensors, sex at five, body mass index at four, and speed difference at two. CONCLUSIONS: The effect of diabetic footwear is detected at more sensors by pressure-time integral than by peak pressure and contact time. The slower a patient walks, the greater the change of the pressure-time integral by diabetic footwear. It is suggested that pressure-time integral be routinely included in the evaluation of diabetic footwear for each patient.

Aged↗

PubMed2002

The cardiorespiratory response and energy expenditure of Tai-Chi-Qui-Gong.

The purpose of this study was to evaluate the cardiorespiratory response and energy expenditure during the practice of Tai-Chi-Qui-Gong (TCQG). Forty-seven TCQG practitioners with a mean age of 60.7 +/- 9.9 years participated in this study. The cardiorespiratory responses and energy expenditure were measured by a K4 telemetry system. TCQG has 54 motions and can be divided into 3 sets. The result indicated that the exercise intensity of each motion is about 3 metabolic equivalents (MET) and the energy expenditure of each set is about 60 Kcal. The estimated intensity of TCQG in elderly individuals approximated 50% of the maximum oxygen uptake (vO2max) for men, and 60% of the maximum oxygen uptake (vO2max) for women. The findings demonstrate that TCQG is a low intensity exercise and can be prescribed as an alternative exercise program for cardiopulmonary rehabilitation.

Adult↗

PubMed2002

Tai Chi Chuan: an ancient wisdom on exercise and health promotion.

Tai Chi Chuan (TCC) is a Chinese conditioning exercise and is well known for its slow and graceful movements. Recent investigations have found that TCC is beneficial to cardiorespiratory function, strength, balance, flexibility, microcirculation and psychological profile. The long-term practice of TCC can attenuate the age decline in physical function, and consequently it is a suitable exercise for the middle-aged and elderly individuals. TCC can be prescribed as an alternative exercise programme for selected patients with cardiovascular, orthopaedic, or neurological diseases, and can reduce the risk of falls in elderly individuals. The exercise intensity of TCC depends on training style, posture and duration. Participants can choose to perform a complete set of TCC or selected movements according to their needs. In conclusion, TCC has potential benefits in health promotion, and is appropriate for implementation in the community.

Exercise↗

PubMed2002

Psychobehavioral response and weight loss prediction in a hospital-based weight reduction program.

BACKGROUND AND PURPOSE: Depression and binge eating are common adverse psychologic responses associated with weight loss in overweight and obese adults. This study aimed to assess the effects of different degrees of weight loss on psychologic functioning and the relationship between mood change and weight reduction, and to identify predictors of short-term weight loss among subjects in a hospital-based weight reduction program. METHODS: A total of 189 obese subjects who participated in a hospital-based weight-reduction program during a 12-week interval were enrolled in this study. They ranged in age from 18 to 67 years (mean, 40.5 +/- 12.3 yr) with female predominance (87.8%). Mean body weight was 79.3 +/- 13.9 kg and mean body mass index was 31.1 +/- 3.8 kg/m2 on entry into the program. Body weight was periodically measured and subjects were asked to complete two self-administered questionnaires including the Brief Symptom Rating Scale (BSRS) and the Bulimic Investigatory Test, Edinburgh (BITE), pre- and post-treatment. RESULTS: Using the last observation carried forward method of analysis, the average weight loss for all participants was 5.6 +/- 3.7 kg. For subjects who completed the 12-week program, weight loss was 6.6 +/- 3.6 kg. Subjects who completed the program (n = 115, 60.8%) had significantly reduced BITE as well as all BSRS subscale scores at the end of the program. There was no linear relationship between mood change and weight loss by correlation analysis, but subjects with higher degrees of weight loss had improvement in more dimensions of psychologic functioning. Initial mood and binge-eating status predicted neither compliance nor weight reduction. Two biologic factors (initial weight loss, initial body weight) and one behavioral factor (attendance rate) were identified as significant predictors of short-term weight loss for all subjects. CONCLUSIONS: There was no evidence that weight loss made mood or eating pathology worse among those who completed the weight loss program. Beneficial effects on general psychologic functioning and eating pathology were demonstrated for subjects with a minimal weight loss of 5% of initial weight and who completed the program. Psychologic assessments at the start of the program did not predict weight loss at the end of participation in this hospital-based weight loss program.

Adolescent↗

PubMedDate not supplied

SEMG-controlled telephone interface for people with disabilities.

This paper proposes the development of a surface electromyographic (SEMG)-controlled telephone interface for the disabled. The system is composed of three major components: (1) a SEMG receiving/signal-processing module; (2) a row-column scanning interface for the telephone dialling pad; and (3) a main controller, the Intel-8951 microprocessor. The design concept was based on the idea of using a SEMG generated by the disabled and converting it into a trigger pulse. This could allow convenient control of the dialing motion in the row-column scanning keys of a telephone dialling pad. People with disabilities are competent for certain kinds of work such as being a telephone operator. The increase of opportunities to perform a job for the disabled would help them live independently.

Adult↗