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Burnfield J.M.,Institute for Rehabilitation science and Engineering | Eberly V.J.,Amigos y Amigos | Gronely J.K.,Amigos y Amigos | Perry J.,Amigos y Amigos | And 2 more authors.
Prosthetics and Orthotics International | Year: 2012

Background: Microprocessor controlled prosthetic knees (MPK) offer opportunities for improved walking stability and function, but some devices' swing phase features may exceed needs of users with invariable cadence. One MPK offers computerized control of only stance (C-Leg Compact).Objective: To assess Medicare Functional Classification Level K2 walkers' ramp negotiation performance, function and balance while using a non-MPK (NMPK) compared to the C-Leg Compact.Study Design: Crossover.Methods: Gait while ascending and descending a ramp (stride characteristics, kinematics, electromyography) and function were assessed in participant's existing NMPK and again in the C-Leg Compact following accommodation.Results: Ramp ascent and descent were markedly faster in the C-Leg Compact compared to the NMPK (p ≤ 0.006), owing to increases in stride length (p ≤ 0.020) and cadence (p ≤ 0.020). Residual limb peak knee flexion and ankle dorsiflexion were significantly greater (12.9° and 4.9° more, respectively) during single limb support while using the C-Leg Compact to descend ramps. Electromyography (mean, peak) did not differ significantly between prosthesis. Function improved in the C-Leg Compact as evidenced by a significantly faster Timed Up and Go and higher functional questionnaire scores.Conclusions: Transfemoral K2 walkers exhibited significantly improved function and balance while using the stance-phase only MPK compared to their traditional NMPK.Clinical relevanceInstability, reduced function and falls are common in deconditioned transfemoral amputees. Selection and use of prosthetic componentry that promotes greater stability in more challenging environments is essential to improve the safety, function, quality of life and independence of individuals functioning at the K2 walking level. © International Society for Prosthetics and Orthotics International 2012.


Fager S.K.,Institute for Rehabilitation science and Engineering | Beukelman D.R.,University of Nebraska - Lincoln | Jakobs T.,Invotek Inc. | Hosom J.-P.,Oregon Health And Science University
AAC: Augmentative and Alternative Communication | Year: 2010

This study described preliminary work with the Supplemented Speech Recognition (SSR) system for speakers with dysarthria. SSR incorporated automatic speech recognition optimized for dysarthric speech, alphabet supplementation, and word prediction. Participants included seven individuals with a range of dysarthria severity. Keystroke savings using SSR averaged 68.2% for typical sentences and 67.5% for atypical phrases. This was significantly different to using word prediction alone. The SSR correctly identified an average of 80.7% of target stimulus words for typical sentences and 82.8% for atypical phrases. Statistical significance could not be claimed for the relations between sentence intelligibility and keystroke savings or sentence intelligibility and system performance. The results suggest that individuals with dysarthria using SSR could achieve comparable keystroke savings regardless of speech severity. © 2010 International Society for Augmentative and Alternative Communication.


Ball L.J.,Massachusetts General Hospital | Fager S.,Institute for Rehabilitation science and Engineering | Fried-Oken M.,Oregon Health And Science University
Physical Medicine and Rehabilitation Clinics of North America | Year: 2012

Individuals with progressive neuromuscular disease often experience complex communication needs and consequently find that interaction using their natural speech may not sufficiently meet their daily needs. Increasingly, assistive technology advances provide accommodations for and/or access to communication. Assistive technology related to communication is referred to as augmentative and alternative communication (AAC). The nature of communication challenges in progressive neuromuscular diseases can be as varied as the AAC options currently available. AAC systems continue to be designed and implemented to provide targeted assistance based on an individual's changing needs. © 2012.


Fager S.,Institute for Rehabilitation science and Engineering | Bardach L.,Communicating Solutions LLC | Russell S.,Childrens Hospital Boston at Waltham | Higginbotham J.,State University of New York at Buffalo
Journal of Pediatric Rehabilitation Medicine | Year: 2012

Children with severe physical impairments require a variety of access options to augmentative and alternative communication (AAC) and computer technology. Access technologies have continued to develop, allowing children with severe motor control impairments greater independence and access to communication. This article will highlight new advances in access technology, including eye and head tracking, scanning, and access to mainstream technology, as well as discuss future advances. Considerations for clinical decision-making and implementation of these technologies will be presented along with case illustrations. © 2012 - IOS Press and the authors. All rights reserved.


Fager S.,Institute for Rehabilitation science and Engineering | Beukelman D.R.,Institute for Rehabilitation science and Engineering | Beukelman D.R.,University of Nebraska - Lincoln | Fried-Oken M.,Oregon Health And Science University | And 2 more authors.
Assistive Technology | Year: 2012

Individuals who rely on augmentative and alternative communication (AAC) devices to support their communication often have physical movement challenges that require alternative methods of access. Technology that supports access, particularly for those with the most severe movement deficits, have expanded substantially over the years. The purposes of this article are to review the state of the science of access technologies that interface with augmentative and alternative communication devices and to propose a future research and development agenda that will enhance access options for people with limited movement capability due to developmental and acquired conditions. © 2012 Copyright 2012 RESNA.

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