National Hospital for Spinal Cord Injury SESCAM

Toledo, Spain

National Hospital for Spinal Cord Injury SESCAM

Toledo, Spain
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de Los Reyes-Guzman A.,National Hospital for Spinal Cord Injury SESCAM | Dimbwadyo-Terrer I.,National Hospital for Spinal Cord Injury SESCAM | Perez-Nombela S.,National Hospital for Spinal Cord Injury SESCAM | Trincado F.,National Hospital for Spinal Cord Injury SESCAM | Gil-Agudo A.,National Hospital for Spinal Cord Injury SESCAM
IFMBE Proceedings | Year: 2014

Three-dimensional kinematic analysis provides quantitative assessment of upper limb motion and is used as an outcome measure to evaluate movement disorders. The aim of the present study is to present a set of kinematic metrics for quantifying characteristics of movement performance and the functional status of the subject during the execution of the activity of daily living (ADL) of drinking from a glass. Then, the objective is to apply these metrics in healthy people and a population with cervical spinal cord injury (SCI), and to analyze the metrics ability to discriminate between healthy and pathologic people. 19 people participated in the study: 7 subjects with metameric level C6 tetraplegia, 4 subjects with metameric level C7 tetraplegia and 8 healthy subjects. The movement was recorded with a photogrammetry system. The ADL of drinking was divided into a series of clearly identifiable phases to facilitate analysis. Metrics describing the time of the reaching phase, the range of motion of the joints analyzed, and characteristics of movement performance such as the efficiency, accuracy and smoothness of the distal segment and inter-joint coordination were obtained. The performance of the drinking task was more variable in people with SCI compared to the control group in relation to the metrics measured. Reaching time was longer in SCI groups. The proposed metrics showed capability to discriminate between healthy and pathologic people. Relative deficits in efficiency were larger in SCI people than in controls. These metrics can provide useful information in a clinical setting about the quality of the movement performed by healthy and SCI people during functional activities. © Springer International Publishing Switzerland 2014.


Gil-Agudo A.,National Hospital For Spinal Cord Injury Sescam | Perez-Nombela S.,National Hospital For Spinal Cord Injury Sescam | Forner-Cordero A.,University of Sao Paulo | Perez-Rizo E.,National Hospital For Spinal Cord Injury Sescam | And 2 more authors.
Journal of NeuroEngineering and Rehabilitation | Year: 2011

Background: Central cord syndrome (CCS) is considered the most common incomplete spinal cord injury (SCI). Independent ambulation was achieved in 87-97% in young patients with CCS but no gait analysis studies have been reported before in such pathology. The aim of this study was to analyze the gait characteristics of subjects with CCS and to compare the findings with a healthy age, sex and anthropomorphically matched control group (CG), walking both at a self-selected speed and at the same speed. Methods. Twelve CCS patients and a CG of twenty subjects were analyzed. Kinematic data were obtained using a three-dimensional motion analysis system with two scanner units. The CG were asked to walk at two different speeds, at a self-selected speed and at a slower one, similar to the mean gait speed previously registered in the CCS patient group. Temporal, spatial variables and kinematic variables (maximum and minimum lower limb joint angles throughout the gait cycle in each plane, along with the gait cycle instants of occurrence and the joint range of motion - ROM) were compared between the two groups walking at similar speeds. Results: The kinematic parameters were compared when both groups walked at a similar speed, given that there was a significant difference in the self-selected speeds (p < 0.05). Hip abduction and knee flexion at initial contact, as well as minimal knee flexion at stance, were larger in the CCS group (p < 0.05). However, the range of knee and ankle motion in the sagittal plane was greater in the CG group (p < 0.05). The maximal ankle plantar-flexion values in stance phase and at toe off were larger in the CG (p < 0.05). Conclusions: The gait pattern of CCS patients showed a decrease of knee and ankle sagittal ROM during level walking and an increase in hip abduction to increase base of support. The findings of this study help to improve the understanding how CCS affects gait changes in the lower limbs. © 2011 Gil-Agudo et al; licensee BioMed Central Ltd.


De Los Reyes-Guzman A.,National Hospital for Spinal Cord Injury SESCAM | Dimbwadyo-Terrer I.,Occupational Thinks Research Group | Perez-Nombela S.,National Hospital for Spinal Cord Injury SESCAM | Monasterio-Huelin F.,Technical University of Madrid | And 3 more authors.
NeuroRehabilitation | Year: 2016

BACKGROUND:After cervical Spinal Cord Injury (SCI), upper limbmovements made by patients have a lack of smoothness and a hand velocity profile characterized by a high number of velocity peaks. OBJECTIVE: The aim of the present paper is to propose three novel kinematic indices for quantifying movement agility and smoothness, and to analyze their discriminative capability between healthy and pathological people. METHODS: 18 people, healthy and two groups of patients with cervical SCI, participated in the study. Kinematic indices in relation to movement agility and smoothness were computed from hand trajectories and velocity profiles during the performance of the ADL of drinking from a glass. RESULTS: The proposed indices discriminated between healthy and SCI people. The results are greater in healthy than SCI people. Both smoothness indices detected significant differences between healthy and both SCI groups. Moreover, the Agility index showed capacity for discriminating between both patients groups. CONCLUSIONS: The main contribution of this research consists on the proposal of kinematic indices from experimental data, whose results are dimensionless and relative to a pattern of healthy subjects. We hope that kinematic indices proposed are a step toward the standardization of the quantitative assessment of movement characteristics and functional impairments. © 2016 - IOS Press and the authors.


Gil-Agudo A.,National Hospital For Spinal Cord Injury Sescam | Solis-Mozos M.,National Hospital For Spinal Cord Injury Sescam | Del-Ama A.J.,National Hospital For Spinal Cord Injury Sescam | Crespo-Ruiz B.,National Hospital For Spinal Cord Injury Sescam | And 2 more authors.
Disability and Rehabilitation: Assistive Technology | Year: 2013

Purpose: The aim of the present study was to describe and test the reliability of a comprehensive product-centered approach to assessing functional performance and wheelchair user perceptions on device ergonomics and satisfaction of performance. A pilot study was implemented using this approach to evaluate differences among four manual wheelchairs. Method:. Six wheelchair users with complete spinal cord injury (SCI) at the thoracic level and with no previous upper limbs impairment were recruited for this study. After finishing circuit tasks, subjects were asked to complete a questionnaire about ergonomic wheelchair characteristics (manoeuvrability, stability, comfort and ease of propulsion) and satisfaction about task performance. On the other hand, objective data were recorded during user performance as the time required to complete each test, kinetic wheelchair propulsion data obtained with two SMARTWheels® and physiological parameters (heart rate and physiological index). Results: Kuschall Champion® and Otto Bock Voyage® wheelchairs were ranked best for most ergonomic aspects specially in manoeuvrability (p < 0.05). Less time was required to execute most of the circuit tasks in both wheelchair models (p < 0.05). Conclusions: This approach proposed highlight the importance of looking both kinds of information, user perception and user functional performance when evaluating a wheelchair or comparing across devices. Implications for Rehabilitation In rehabilitation, the reliability of the clinical evaluation of the wheelchair can help to improve and adapt the wheelchair to patient, contributing significantly to the prevention of overuse injuries in the upper limbs. © 2013 Informa UK, Ltd.


De Los Reyes-Guzman A.,National Hospital for Spinal Cord Injury SESCAM | Dimbwadyo-Terrer I.,National Hospital for Spinal Cord Injury SESCAM | Trincado-Alonso F.,National Hospital for Spinal Cord Injury SESCAM | Monasterio-Huelin F.,Technical University of Madrid | And 2 more authors.
Clinical Biomechanics | Year: 2014

Background: Quantitative measures of human movement quality are important for discriminating healthy and pathological conditions and for expressing the outcomes and clinically important changes in subjects' functional state. However the most frequently used instruments for the upper extremity functional assessment are clinical scales, that previously have been standardized and validated, but have a high subjective component depending on the observerwho scores the test. But they are not enough to assess motor strategies used duringmovements, and their use in combination with other more objective measures is necessary. The objective of the present review is to provide an overviewon objective metrics found in literature with the aimof quantifying the upper extremity performance during functional tasks, regardless of the equipment or system used for registering kinematic data. Methods: A search inMedline, Google Scholar and IEEE Xplore databases was performed following a combination of a series of keywords. The full scientific papers that fulfilled the inclusion criteria were included in the review. Findings: A set of kinematicmetricswas found in literature in relation to joint displacements, analysis of hand trajectories and velocity profiles. Thesemetrics were classified into different categories according to themovement characteristic that was being measured. Interpretation: These kinematic metrics provide the starting point for a proposed objective metrics for the functional assessment of the upper extremity in people with movement disorders as a consequence of neurological injuries. Potential areas of future and further research are presented in the Discussion section. © 2014 Elsevier Ltd. All rights reserved.


PubMed | Technical University of Madrid, National Hospital for Spinal Cord Injury SESCAM and Bioengineering Group
Type: Journal Article | Journal: Clinical biomechanics (Bristol, Avon) | Year: 2014

Quantitative measures of human movement quality are important for discriminating healthy and pathological conditions and for expressing the outcomes and clinically important changes in subjects functional state. However the most frequently used instruments for the upper extremity functional assessment are clinical scales, that previously have been standardized and validated, but have a high subjective component depending on the observer who scores the test. But they are not enough to assess motor strategies used during movements, and their use in combination with other more objective measures is necessary. The objective of the present review is to provide an overview on objective metrics found in literature with the aim of quantifying the upper extremity performance during functional tasks, regardless of the equipment or system used for registering kinematic data.A search in Medline, Google Scholar and IEEE Xplore databases was performed following a combination of a series of keywords. The full scientific papers that fulfilled the inclusion criteria were included in the review.A set of kinematic metrics was found in literature in relation to joint displacements, analysis of hand trajectories and velocity profiles. These metrics were classified into different categories according to the movement characteristic that was being measured.These kinematic metrics provide the starting point for a proposed objective metrics for the functional assessment of the upper extremity in people with movement disorders as a consequence of neurological injuries. Potential areas of future and further research are presented in the Discussion section.


PubMed | National Hospital For Spinal Cord Injury Sescam
Type: Journal Article | Journal: Disability and rehabilitation. Assistive technology | Year: 2013

The aim of the present study was to describe and test the reliability of a comprehensive product-centered approach to assessing functional performance and wheelchair user perceptions on device ergonomics and satisfaction of performance. A pilot study was implemented using this approach to evaluate differences among four manual wheelchairs.Six wheelchair users with complete spinal cord injury (SCI) at the thoracic level and with no previous upper limbs impairment were recruited for this study. After finishing circuit tasks, subjects were asked to complete a questionnaire about ergonomic wheelchair characteristics (manoeuvrability, stability, comfort and ease of propulsion) and satisfaction about task performance. On the other hand, objective data were recorded during user performance as the time required to complete each test, kinetic wheelchair propulsion data obtained with two SMARTWheels and physiological parameters (heart rate and physiological index).Kuschall Champion and Otto Bock Voyage wheelchairs were ranked best for most ergonomic aspects specially in manoeuvrability (p < 0.05). Less time was required to execute most of the circuit tasks in both wheelchair models (p < 0.05).This approach proposed highlight the importance of looking both kinds of information, user perception and user functional performance when evaluating a wheelchair or comparing across devices.

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