Biomedical subjects

Shih-Ching Chen

Publications and source records attributed to Shih-Ching Chen.

11 recordsLinked to original sources

PubMed2006

Correlations between subjective treatment responses and plantar pressure parameters of metatarsal pad treatment in metatarsalgia patients: a prospective study.

BACKGROUND: Metatarsalgia is related to repetitive high-pressure loading under the metatarsal head (MH) that causes pain. The high pressure under the MH can be reduced by adequately applying metatarsal pads (MPs). Plantar pressure measurements may provide a method to objectively evaluate pressure loading under the MH. However, it is still unclear if the decrease in plantar pressure under the MH after MP treatment is associated with subjective improvement. This study aims to explore the correlations between subjective pain improvement and outcome rating, and the plantar pressure parameters in metatarsalgia patients treated using MPs. METHODS: Thirteen patients (a total of 18 feet) with secondary metatarsalgia were included in this study. Teardrop-shaped MPs made of polyurethane foam were applied just proximal to the second MH by an experienced physiatrist. Insole plantar pressure was measured under the second MH before and after MP application. Visual analog scale (VAS) scores of pain were obtained from all subjects before and after 2 weeks of MP treatment. The subjects rated using four-point subjective outcome scales. The Wilcoxon signed-rank test was used to analyze the difference between the plantar pressure parameters and VAS scores before and after treatment. The Kruskal-Wallis test was applied to compare the plantar pressure parameters in each outcome group. Pearson's correlation was applied to analyze the correlation between the changes in plantar pressure parameters and VAS scores. Statistical significance was set as p < 0.05. RESULTS: MP application decreased the maximal peak pressure (MPP) and pressure-time integral (PTI) under the second MH and also statistically improved subjective pain scores. However, neither the pre-treatment values of the MPP and PTI shift in the position of the MPP after treatment, nor the age, gender and body mass index (BMI) of the subjects were statistically correlated with subjective improvement. Declines in the PTI and MPP values after MP application were statistically correlated with the improvement in VAS scores (r = 0.77, R2 = 0.59, p < 0.001; r = 0.60, R2 = 0.36, p = 0.009). CONCLUSION: We found that the successful decline in the PTI and MPP under the second MH after MP application was correlated to subjective pain improvement. This study provides a strategy for the further design and application of MPs for metatarsalgia treatment.

Adult↗

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↗

PubMed2005

Increases in bone mineral density after functional electrical stimulation cycling exercises in spinal cord injured patients.

PURPOSE: To assess the change in bone mineral density (BMD) after spinal cord injury (SCI) and to evaluate whether BMD loss can be reversed with the intervention of functional electric stimulation cycling exercises (FESCE). METHODS: Fifteen males with SCI were included. Fifteen able-bodied males were also tested to compare BMD. In the SCI group, the FESCE was performed for six months, and then was discontinued in the subsequent six months. BMD was performed before the FESCE, immediately after six months of the FESCE, and at the end of the subsequent six months. RESULTS: Before the FESCE, the BMD of the SCI subjects in every site, except the lumbar spine, was lower than that of the able-bodied subjects. After six months of FESCE, BMD of the distal femur (DF) and proximal tibia (PT) increased significantly, and BMD of the calcaneus (heel) showed a trend of increase. However, the BMD in the DF, PT, and heel decreased significantly after the subsequent six months without FESCE. The BMD of the femoral neck (FN) decreased progressively throughout the programme. CONCLUSIONS: Our study showed site-specific BMD changes after FESCE. The BMD loss in the DF and PT was partially reversed after six months of FESCE, but the effect faded once the exercise was discontinued.

Absorptiometry, Photon↗

PubMed2005

Kinesiological and kinematical analysis for stroke subjects with asymmetrical cycling movement patterns.

This aim of this study is to provide quantitative analyses of asymmetrical movements between affected and unaffected limbs for hemiparetic subjects in a cycling ergometer. To acquire kinesiological and kinematical data, electromyography (EMG) of quadriceps muscles in the both legs as well as crank positions under three cycling workloads were recorded. The symmetry index (SI) was designed to measure the similarity between muscle activities recorded from affected and unaffected limbs. Using kinematical information of the crank position, the cycling unsmoothness (denoted as roughness index, RI) can be derived from the curvature of the instantaneous cycling speed. Thirteen hemiparetic subjects following a cerebrovascular accident (CVA) and eight able-bodied subjects participated in this study. With total symmetry at SI=1, the average SIs of hemiparetic subjects (0.66+/-0.18) were significantly lower (p<0.01) than those of normal subjects (0.91+/-0.08) but no significant difference found among three workloads. From the average RI, subjects with hemiparesis exhibited less smooth cycling movements compared to normal group (p<0.01). Non-parametric Friedman and Wilcoxon tests of RIs further indicated that the workload factors are significantly different only for hemiparetic group (p<0.01). No significant difference between lower workloads in RIs showed that the CVA subjects' sound side alone can execute most of the cycling load with minimal involvement of the affected side under lower workload condition. When cycling at a heavier load, however, it is essential to force the affected limb to assist in the pedaling, thus accomplishing an effective cycling exercise. By combining these two quantitative indices, we can observe the kinesiological measurement of the symmetry of EMG phasic activities from SI and the kinematical cycling smoothness in a coordinated movement from RI, which could provide a clinical guideline for cycling exercises for hemiparetic subjects.

Biomechanical Phenomena↗

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

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

Complementary and alternative medicine education in the United States, China, and Taiwan.

As public demand for complementary and alternative medicine increases,it is important for physical medicine and rehabilitation physicians to have some basic understanding of complementary and alternative medicine or at least to appreciate some of the approved indications so that appropriate referrals can be made. Because the concept of evidence-based medicine is essential for a successful physical medicine and rehabilitation practice in either academic or private facilities, well-developed research projects, such as randomized, controlled trials of large sample size, are needed to investigate the efficacy and safety of complementary and alternative medicine therapy.

China↗

PubMed2004

The relationship between parental concerns and professional assessment in developmental delay in infants and children--a hospital-based study.

BACKGROUND: Developmental delay (DD) in infants and children is one of the chief complaints of parents. It has been established that the concerns of parents are as accurate as quality screening tests. Some kinds of concerns are particularly useful in the early detection of associated developmental problems. The purpose of this study was to investigate the relationship between the main parental concerns and the final diagnosis based on professional assessment of children who are suspected to have DD. METHODS: One-hundred and 1 infants or children were recruited into this study. The major concerns of parents were elicited and categorized by various developmental domains: speech, motor, behavioral, cognitive, global, and non-specific developmental problems. All children underwent comprehensive combined assessments by professionals in the hospital, and were classified into 6 subtypes: speech, motor, behavioral, cognitive, and global DD, and normal development. RESULTS: Our results revealed that parental concerns about speech, motor, and behavioral development yielded a high sensitivity to the final diagnosis of the same developmental domain (77-89%). However, concerns about cognitive and global DD had limited sensitivity (15-36%). On the other hand, concerns about global, speech, and motor DD had relatively higher positive predictive values (55-77%). Comparatively, cognitive or behavioral concerns had lower positive predictive values (25-33%). CONCLUSIONS: Such results indicate that parents play an important role in detecting speech, motor and behavioral DD in children. Parental concerns about cognition and behavior should be questioned in terms of their association with the real problem. This information may be useful in establishing trends in understanding the discrepancy or relationship between parental concerns and professional assessments in DD.

Child↗

PubMed2003

The development of a knee locker with closed-loop functional electrical stimulation (FES) for hemiplegia in gait training.

PURPOSE: A knee locker with closed-loop functional electrical stimulation (FES) system has been developed to prevent the quadriceps weakness and the drop-foot of the hemiplegia during gait training. METHOD: The FES system is triggered by a footswitch on the heel of the disabled foot to stimulate the tibialis anterior muscle for dorsi-flexion and to turn-off the knee locker in the swing phase through the main controller. Besides, the footswitch on the heel of the affected-side can be used to stimulate the quadriceps and to turn-on the knee locker for quadriceps weakness in the stance phase. RESULTS: It is revealed that the mean velocity, cadence, stride length, active ankle motion range, and functional ambulation category (FAC) have improved significantly from 0.15 +/- 0.04 m sec( - 1), 43.3 +/- 15.4 steps min( - 1), 0.36 +/- 0.11 m, 15 degrees, level 2 to 0.43 +/- 0.21 m sec( - 1), 69.4 +/- 19.1 steps min( - 1), 0.73 +/- 0.17 m, 40 degrees, level 4 respectively for the patient. A paired t-test indicated that differences in the electromyography (EMG) of the tibialis anterior and the quadriceps muscles between patient's disabled (affected-side) foot and normal (unaffected-side) foot are not significant (p > 0.05) after 16 weeks of training. CONCLUSIONS: It is concluded that this new knee locker with closed-loop FES system is capable of providing the hemiplegia with restoration to regular walking after appropriate gait training.

Electric Stimulation Therapy↗

PubMed2002

Effects of balance training on hemiplegic stroke patients.

BACKGROUND: The purpose of this study was to evaluate the delayed effects of balance training program on hemiplegic stroke patients. METHODS: A total of 41 ambulatory hemiplegic stroke patients were recruited into this study and randomly assigned into two groups, the control group and trained group. Visual feedback balance training with the SMART Balance Master was used in the trained group. Bruunstrom staging of affected limb scores and Functional Independent Measure (FIM) scores of each patient were recorded. Quantitative balance function was evaluated using the SMART Balance Master. Data were collected before training and 6 months after completing the training program. RESULTS: Significant improvements in dynamic balance function measurements were found for patients in the trained group at 6 months after completing the training program. The ability of self-care and sphincter control also improved for patients in the trained group. On the other hand, no significant differences were found in static balance functions between the trained group and control group at 6 months of follow up. The locomotion and mobility scoring of FIM also revealed no differences between the groups. CONCLUSION: Dynamic balance function of patients in the visual feedback training group had significant improvements when compared with the control group. Activities of daily living (ADL) function in self-care also had significant improvements at 6 months of follow up in the trained group. The results showed that balance training was beneficial for patients after hemiplegic stroke.

Adult↗

PubMedDate not supplied

Neural network and fuzzy control in FES-assisted locomotion for the hemiplegic.

This study is aimed at establishing a neural network and fuzzy feedback control FES system used for adjusting the optimum electrical stimulating current to control the motion of an ankle joint. The proposed method further improves the drop-foot problem existing in hemiplegia patients. The proposed system includes both hardware and software. The hardware system determines the patient's ankle joint angle using a position sensor located in the patient's affected side. This sensor stimulates the tibialis anterior with an electrical stimulator that induces the dorsiflexion action and achieves the ideal ankle joint trace motion. The software system estimates the stimulating current using a neural network. The fuzzy controller solves the nonlinear problem by compensating the motion trace errors between the neural network control and actual system. The control qualities of various controllers for four subjects were compared in the clinical test. It was found that both the root mean square error and the mean error were minimal when using the neural network and fuzzy controller. The drop-foot problem in hemiplegic's locomotion was effectively improved by incorporating the neural network and fuzzy controller with the functional electrical simulator.

Algorithms↗