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The Clinical Feasibility of the Re-Link Trainer in Acute Stroke Rehabilitation: Preliminary Results

2019-07-27, Ward, Sarah H., Wiedemann, Lukas G., McDaid, Andrew

The Re-Link Trainer (RLT) is a 4-bar linkage end-effector that attaches to the paretic limb via a footplate, constraining the limb to a normal gait trajectory. This study aimed to determine the feasibility of using the RLT in a hospital setting, by measuring ease of getting into the RLT and set up time with acute or sub-acute stroke patients. This paper presents preliminary results from two stroke patients who have participated in the study so far. Both patients were set up in the RLT with assistance from two therapists, and both were able to stand and walk in the device with varying levels of assistance.

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End-User Evaluation of a Smart Knee Brace

2019-06-30, Alder, Andrew, Ward, Sarah H., McDaid, Andrew

The Digital KneeTM is a smart designed to be worn following knee injury or surgery. Wearability, perceived usability and clinical utility was explored with a 15-item survey of healthy endusers. There was good perceived clinical utility of the Digital KneeTM and users felt they would wear the device if they sustained an injury.

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Digital Technology to Monitor Rehabilitation Outcomes After Knee Injury: A Case Study

2019, McDaid, Andrew, Alder, Andrew, Ward, Sarah H.

The Digital KneeTM is a low-cost wearable integrated into an orthopedic brace capable of measuring knee movement in clinical and everyday settings. The system is designed to provide stability and therapeutic benefit, real-time goal setting and rehabilitation feedback. A case study of a Grade II Medial Collateral Ligament injury was conducted to determine if the Digital KneeTM could be used to objectively monitor recovery patterns following a knee injury.

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Associations between knee kinematics during gait and quadriceps corticomotor excitability following anterior cruciate ligament reconstruction

2019-05-31, Ward, Sarah H., Harkey, Matthew S., Luc-Harkey, Brittney, Pamukoff, Derek, Blackburn, Troy, Pietrosimone, Brian

Background: Impaired quadriceps function is associated with a more extended knee throughout the stance phase of gait in individuals with anterior cruciate ligament reconstruction (ACLR). This stiffened knee strategy may alter tibiofemoral loading and hasten joint breakdown and osteoarthritis development. Altered quadriceps corticomotor excitability may influence knee kinematic during gait; yet it is unknown if quadriceps corticomotor excitability associates with gait kinematics. Purpose: To determine associations between quadriceps corticomotor excitability and sagittal plane knee kinematics during walking for ACLR individuals. Methods: Thirty-three individuals with unilateral ACLR participated in this cross-sectional study (72% female, 22.2 ± 3.5years; 72.5 ± 17.2kg; 1.7 ± 0.1m; 49.9 ± 40.4 months postACLR). Quadriceps corticomotor excitability was assessed as active motor threshold (AMT) from the vastus medialis of the ACLR limb using transcranial magnetic stimulation. Three dimensional biomechanics were collected during over ground walking at a self-selected speed and extracted from the first 50% of stance. We evaluated sagittal plane knee kinematics for the current study including (knee flexion angle at heel strike [HS]; peak knee flexion angle; knee flexion excursion [peak angle – HS angle]). Partial Pearson product-moment correlations were used to assess associations between kinematic variables and corticomotor variables in the ACLR limb controlling for gait speed (α = 0.05). Results: AMT was not associated with sagittal plane knee kinematics in the ACLR limb during walking (angle at HS r= -0.13 P=0.47; peak knee flexion angle r= -0.22 P=0.22; knee flexion excursion r= -0.19 P=0.29). Conclusions: No associations were found between quadriceps corticomotor excitability and sagittal plane knee kinematics during gait in individuals with ACLR. Central pattern generators, and not cortical excitability, may more strongly influence gait kinematics. Further work is necessary to determine the influence of altered corticomotor excitability on other gait outcomes including kinetics and lower limb muscle activity patterns.