Biomedical subjects

W D Memberg

Publications and source records attributed to W D Memberg.

6 recordsLinked to original sources

PubMed2001

A transducer to measure isometric elbow moments.

OBJECTIVE: The purpose of this study was to design and implement a transducer to measure accurately the isometric elbow moments produced by individuals with tetraplegia. DESIGN: The device needed to be insensitive to off-axis moments and proximal joint motions and be capable of being used over a wide range of elbow and shoulder positions in an outpatient clinic setting. BACKGROUND: Measurement of the smaller isometric moments produced by individuals with tetraplegia is especially sensitive to the errors that can be introduced by inaccurate lever arm determination, off-axis loads, and proximal joint motions. Devices traditionally utilized for quantifying isometric strength are difficult to implement for the spinal cord injured population. METHODS: The elbow moment transducer consists of two four-bar parallelogram linkages joined by a lockable pivot. Strain gauges mounted on one beam of the parallelogram produce an output proportional to the elbow moment. RESULTS: Calibration of the device indicates that it accurately quantifies isometric elbow moments over a range that is appropriate for evaluating elbow extension strength in individuals with tetraplegia. CONCLUSIONS: A device was developed and implemented that accurately quantifies isometric elbow moments over a range that is appropriate for evaluating elbow extension strength in individuals with tetraplegia. RELEVANCE: The ability to quantitatively evaluate elbow strength in persons with tetraplegia is useful for understanding and improving the clinical outcomes of rehabilitative interventions that involve the elbow.

Calibration↗

PubMed2001

A neuroprosthesis for high tetraplegia.

BACKGROUND: This case report describes a neuroprosthesis that restored shoulder and elbow function in a 23-year-old man with chronic C3 complete tetraplegia. Before implementation of the neuroprosthesis, electrodiagnostic testing revealed denervation from C5 to T1, with the greatest degree of denervation in the C8 and T1 myotomes. Thirteen percutaneous intramuscular electrodes were implanted into muscles acting on the shoulder and elbow of one upper limb. Before functional testing, the subject underwent a conditioning regimen to maximize the strength and endurance of the implanted muscles. RESULTS: After completion of the 8-week exercise regimen, stimulated active range of motion against gravity included 60 degrees of shoulder abduction, 45 degrees of shoulder flexion, 10 degrees of shoulder external rotation with the shoulder passively abducted to 90 degrees, and 110 degrees of elbow flexion. Stimulated elbow extension lacked 20 degrees of full extension with gravity eliminated. After system setup, the subject was able to pick up mashed potatoes on a plate with a utensil and bring them to his mouth using the neuroprosthesis and a balanced forearm orthosis. A switch mounted on the headrest of the subject's wheelchair and a position sensor mounted on the contralateral shoulder allowed the subject to control movement of his upper limb.

Activities of Daily Living↗

PubMed2000

Electrically stimulated elbow extension in persons with C5/C6 tetraplegia: a functional and physiological evaluation.

OBJECTIVE: To measure the effect of electrically stimulated triceps on elbow extension strength, range of motion, and the performance of overhead reaching tasks. SETTING: Clinical research laboratory. PARTICIPANTS: Four individuals with spinal cord injuries at the C5 or C6 motor level. INTERVENTIONS: The participants, who already had an implanted upper extremity neuroprosthesis, were provided with elbow extension through functional electrical stimulation (FES) of the triceps brachii. MAIN OUTCOME MEASURES: Comparisons of stimulated elbow extension to voluntary elbow extension: (1) evaluations of impairment such as range of motion and strength; (2) performance of a set of functional overhead reaching tasks that required elbow extension; (3) a usage survey (conducted by telephone) to examine use of triceps stimulation in the home and community. RESULTS: All participants achieved greater range of motion and strength of elbow extension with stimulated triceps versus without. Overall functional task performance improved in 100% of the tasks tested for all but one participant, who showed improvement in 60% of the tasks. Participants reported using the triceps in at least one activity for at least 90% of the days the neuroprosthesis was donned.

Adult↗

PubMed1998

An elbow extension neuroprosthesis for individuals with tetraplegia.

Functional electrical stimulation (FES) of the triceps to restore control of elbow extension was integrated into a portable hand grasp neuroprosthesis for use by people with cervical level spinal cord injury. An accelerometer mounted on the upper arm activated triceps stimulation when the arm was raised above a predetermined threshold angle. Elbow posture was controlled by the subjects voluntarily flexing to counteract the stimulated elbow extension. The elbow moments created by the stimulated triceps were at least 4 N.m, which was sufficient to extend the arm against gravity. Electrical stimulation of the triceps increased the range of locations and orientations in the workspace over which subjects could grasp and move objects. In addition, object acquisition speed was increased. Thus elbow extension enhances a person's ability to grasp and manipulate objects in an unstructured environment.

Biomechanical Phenomena↗

PubMed1997

Instrumented objects for quantitative evaluation of hand grasp.

Two instrumented objects have been developed for quantitative assessment of functional tasks performed with the hand. These objects are useful for assessing neuroprosthetic hand grasp systems, and may also be useful in evaluating a variety of other upper limb disabilities and rehabilitation techniques. One object monitors grasp forced and object orientation during palmar prehension, allowing simulation of a drinking task or of manipulating a book. The second object monitors grasp force during lateral prehension for simulating eating or writing tasks. The two objects provide tools to analyze how a subject uses a hand grasp neuroprosthesis to perform activities of daily living. The objects will also be useful in comparing different methods of controlling the neuroprosthesis and in evaluating future changes in the neuroprosthetic system. Assessment trials with these two instrumented objects were performed quickly in an outpatient clinic setting.

Activities of Daily Living↗

PubMedDate not supplied

An analysis of the input-output properties of neuroprosthetic hand grasps.

We measured the input-output properties of the hand grasps of 14 individuals with tetraplegia at the C5/C6 level who had received an implanted upper limb neuroprosthesis. The data provide a quantitative description of grasp-opening and grasp-force control with neuroprosthetic hand grasp systems. Static properties were estimated by slowly ramping the command (input) from 0 to 100%. A hand-held sensor monitored the outputs: grasp force and grasp opening. Trials were performed at different wrist positions, with two different-sized objects being held, and with both grasp modes (lateral and palmar grasps). Larger forces were produced when grasping larger objects, and greater opening was achieved with the wrist in flexion. Although active grasp force increased with wrist extension, it was not significant statistically. Lateral grasp produced larger forces than the palmar grasp. The command range can be divided into a portion that controls grasp opening and a portion that controls grasp force. The portion controlling force increased with spacer size, but did not depend significantly on grasp mode or wrist position. The force-command relationships were more linear than the position-command relationships. Grasp opening decreased significantly over a one-year period, while no significant change in grasp force was observed. These quantitative descriptions of neuroprosthetic hand grasps under varying conditions provide useful information about output capabilities that can be used to gauge the effectiveness of different control schemes and to design future control systems.

Adult↗