Letteratura scientifica selezionata sul tema "Orthèse active"
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Articoli di riviste sul tema "Orthèse active"
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Philippe, C., J. M. Collet, I. Bonafe, V. Cochen De Cock, S. Rekik, O. Roca e N. Huynh. "Comparaison de l’efficacité entre orthèse d’avancée mandibulaire active vs titrable dans le traitement du syndrome d’apnées obstructives du sommeil". Médecine du Sommeil 15, n. 1 (marzo 2018): 38–39. http://dx.doi.org/10.1016/j.msom.2018.01.100.
Testo completo
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Amat, Philippe, e Éric Tran Lu Y. "Apport de la rééducation myofonctionnelle orofaciale au traitement du syndrome d’apnées obstructives du sommeil : une revue systématique de la littérature". L'Orthodontie Française 90, n. 3-4 (settembre 2019): 343–70. http://dx.doi.org/10.1051/orthodfr/2019035.
Testo completoAbstract (sommario):
Introduction : Le syndrome d’apnées obstructives du sommeil (SAOS) est une affection très répandue et insuffisamment diagnostiquée, ce qui en fait un problème majeur de santé publique et de sécurité. La rééducation myofonctionnelle orofaciale (RMO) a été montrée efficace dans le traitement multidisciplinaire des SAOS de l’enfant, de l’adolescent et de l’adulte et elle est prescrite à plusieurs étapes de ces prises en charge. Objectifs : L’objectif principal de cette revue systématique de la littérature était d’évaluer l’efficacité de la rééducation myofonctionnelle orofaciale (RMO), active ou passive, dans le traitement du syndrome d’apnées obstructives du sommeil chez les enfants, les adolescents et les adultes. Matériel et méthodes : La revue systématique de la littérature fut entreprise à partir des trois bases de données électroniques : Medline (via PubMed),Cochrane Library, Web of Science Core Collection, et complétée par une recherche limitée de la littérature grise (Google Scholar) afin d’identifier les études évaluant l’efficacité de la RMO sur le SAOS. Le critère de jugement principal était une diminution de l’indice d’apnées/hypopnées (IHA) d’au moins cinq épisodes par heure par rapport à l’état initial. Les critères de jugement secondaires étaient une amélioration de la qualité subjective du sommeil, de la qualité du sommeil mesurée par polysomnographie nocturne et de la qualité de vie mesurée subjectivement. Résultats : Seulement dix études répondaient à tous les critères d’inclusion. Huit étaient des essais cliniques contrôlés randomisés, une était une étude de cohorte prospective et une autre était une étude de cohorte rétrospective. Six études étaient consacrées au SAOS de l’adulte et quatre au SAOS pédiatrique. Toutes les études incluses ont été évaluées à « faible risque de biais » d’après les douze critères de risque de biais du Cochrane Back Review Group. D’après les données probantes disponibles, la RMO permet une réduction significative de l’IAH, jusqu’à 90,6 % chez l’enfant et jusqu’à 92,06 % chez l’adulte. Elle permet une diminution significative de l’intensité et de la fréquence du ronflement, participe à une réduction de la somnolence diurne, limite la réapparition des symptômes d’apnée obstructive du sommeil (AOS) après adénoamygdalectomie chez l’enfant et améliore l’adhésion au traitement par ventilation en pression positive continue (PPC). La RMO passive, avec l’assistance apportée au patient par le port d’une orthèse sur mesure à bille, augmente l’observance à la rééducation, permet une réduction significative de l’intensité du ronflement, de l’IAH et un accroissement significatif des voies aérifères supérieures. Conclusions : Les données publiées montrent que la rééducation myofonctionnelle orofaciale est efficace dans les traitements multidisciplinaires des SAOS de l’enfant, de l’adolescent et de l’adulte et devrait être largement prescrite à plusieurs étapes de ces prises en charge. La RMO passive, avec l’orthèse d’avancée mandibulaire à bille conçue par Michèle Hervy-Auboiron, aide à pallier les fréquents défauts d’observance observés lors des traitements par RMO active.
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Petcu, Alin, Marius Georgescu e Daniela Tarniţă. "Actuation Systems of Active Orthoses Used for Gait Rehabilitation". Applied Mechanics and Materials 880 (marzo 2018): 118–23. http://dx.doi.org/10.4028/www.scientific.net/amm.880.118.
Testo completoAbstract (sommario):
In this paper three types of actuation systems of active orthoses used for human gait rehabilitation are presented. This paper analyzes different lower-limb active orthoses used for gait rehabilitation function of actuation system.
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Hoang, Ngoc-Tuyet-Trinh, Shuya Chen e Li-Wei Chou. "The Impact of Foot Orthoses and Exercises on Pain and Navicular Drop for Adult Flatfoot: A Network Meta-Analysis". International Journal of Environmental Research and Public Health 18, n. 15 (29 luglio 2021): 8063. http://dx.doi.org/10.3390/ijerph18158063.
Testo completoAbstract (sommario):
Background: Adult flatfoot leads to injury and decreased quality of life. The most widely applied noninvasive approaches are wearing foot orthoses or exercising. Both interventions raise controversy about reducing pain and neutralizing foot posture. This study investigated the impact of foot orthoses and exercise on pain and navicular drop (present for foot posture). Methods: Four databases were used: MEDLINE, PubMed, Web of Science, and Cochrane, from the earliest records to November 2020. Randomized controlled studies focused on adult flatfoot that evaluated the effect of exercise and foot orthoses on pain and navicular drop were extracted. We used data analysis to estimate the relative effect of heterogeneity using I2 and publication bias using funnel plots. Results: Ten studies were identified through to November 2020. Active interventions (AIs) were exercise and exercise combined with foot orthoses; passive interventions (PIs) were foot orthoses and added stretching. Both AIs and PIs decreased pain significantly (SMD −0.94, 95% CI −1.35, −0.54 and SMD −1.4, 95% CI −1.87, −0.92). The AIs reduced pain level better than PIs. Controversially, no treatment was found to affect navicular drop. Conclusion: Both exercise and foot orthoses can reduce pain but not realign foot posture. Exercise alone or combined with foot orthoses showed a better effect on adult flatfoot than only wearing foot orthoses. Active intervention was shown to have better efficacy in reducing pain than passive intervention.
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Janzen, Swantje, Kent Stewart e Peter P. Pott. "Low-cost active knee orthoses – a systematic evaluation". Current Directions in Biomedical Engineering 4, n. 1 (1 settembre 2018): 649–52. http://dx.doi.org/10.1515/cdbme-2018-0156.
Testo completoAbstract (sommario):
AbstractThe aging of humans induces muscle weakness. Muscle weakness results the inability to climb stairs or stand up from a chair and thus, is one of the first steps towards elderly having a less autonomous and self-sufficient life. Therefore, an accessible active knee orthosis, which especially supports these movements would be of great assistance. Recent research projects have focused on feasibility, perfection of motion control and imitation of human movement. For active knee orthoses to be accessible it must be affordable. Hence, this paper systematically evaluates the current research projects around active knee orthosis and discuss the possibilities of implementing a lowcost active knee orthosis.
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AKIYOSHI, Norimasa, e Shinsaku FUJIMOTO. "0711 Development of Active Orthoses : Control Method for Orthoses Control Valve (On/Off Valve)". Proceedings of the Bioengineering Conference Annual Meeting of BED/JSME 2009.22 (2010): 114. http://dx.doi.org/10.1299/jsmebio.2009.22.114.
Testo completo
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Jenkins, Walter L., Dorsey Shelton Williams, Alex Durland, Brandon Adams e Kevin O’Brien. "Foot Orthotic Devices Decrease Transverse Plane Motion during Landing from a Forward Vertical Jump in Healthy Females". Journal of Applied Biomechanics 25, n. 4 (novembre 2009): 387–95. http://dx.doi.org/10.1123/jab.25.4.387.
Testo completoAbstract (sommario):
The use of foot orthoses has been evaluated during a variety of functional activities. Twelve college-aged active females wore two types of foot orthoses and performed a vertical jump to determine the biomechanical effect of the orthoses on lower extremity transverse plane movement during landing. Data collection included three-dimensional analysis of the tibia, knee, and hip. A repeated-measures ANOVA was performed to determine the differences between no orthoses, over-the-counter, and custom-made orthoses with transverse plane motion. At the hip joint, there was significantly less internal rotation (p< .05) in the over-the-counter condition as compared with the no orthoses condition. There was significantly less tibial internal rotation (p< .05) in the custom-made condition as compared with no orthoses. Over-the-counter devices decreased transverse plane motion at the hip, whereas custom-made devices decreased transverse plane motion of the tibia.
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Ali, Athar, Vigilio Fontanari, Marco Fontana e Werner Schmölz. "Spinal Deformities and Advancement in Corrective Orthoses". Bioengineering 8, n. 1 (25 dicembre 2020): 2. http://dx.doi.org/10.3390/bioengineering8010002.
Testo completoAbstract (sommario):
Spinal deformity is an abnormality in the spinal curves and can seriously affect the activities of daily life. The conventional way to treat spinal deformities, such as scoliosis, kyphosis, and spondylolisthesis, is to use spinal orthoses (braces). Braces have been used for centuries to apply corrective forces to the spine to treat spinal deformities or to stabilize the spine during postoperative rehabilitation. Braces have not modernized with advancements in technology, and very few braces are equipped with smart sensory design and active actuation. There is a need to enable the orthotists, ergonomics practitioners, and developers to incorporate new technologies into the passive field of bracing. This article presents a review of the conventional passive braces and highlights the advancements in spinal orthoses in terms of improved sensory designs, active actuation mechanisms, and new construction methods (CAD/CAM, three-dimensional (3D) printing). This review includes 26 spinal orthoses, comprised of passive rigid/soft braces, active dynamics braces, and torso training devices for the rehabilitation of the spine.
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AKIYOSHI, Norimasa, e Shinsaku FUJIMOTO. "308 Development of Active Orthoses- Control System Design for Orthoses Control Valve(On/Off Valve)-". Proceedings of Conference of Chugoku-Shikoku Branch 2011.49 (2011): 83–84. http://dx.doi.org/10.1299/jsmecs.2011.49.83.
Testo completo
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Grün, Markus, e Ulrich Konigorski. "Observer Based Method for Joint Torque Estimation in Active Orthoses". IFAC Proceedings Volumes 45, n. 2 (2012): 199–204. http://dx.doi.org/10.3182/20120215-3-at-3016.00035.
Testo completoTesi sul tema "Orthèse active"
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Mefoued, Saber. "Commande robuste référencée intention d'une orthèse active pour l'assistance fonctionnelle aux mouvements du genou". Phd thesis, Université Paris-Est, 2012. http://tel.archives-ouvertes.fr/tel-00794512.
Testo completoAbstract (sommario):
Le nombre croissant de personnes âgées dans le monde exige de relever de nouveaux défis sociétaux, notamment en termes de services d'aide et de soins de santé. Avec les récents progrès technologiques, la robotique apparaît comme une solution prometteuse pour développer des systèmes visant à faciliter et améliorer les conditions de vie de cette population. Cette thèse vise la proposition et la validation d'une approche de commande robuste et référencée intention d'une orthèse active, destinée à assister des mouvements de flexion/extension du genou pour des personnes souffrant de pathologies de cette articulation. La commande par modes glissants d'ordre 2 que nous proposons permet de prendre en compte les non-linéarités ainsi que les incertitudes paramétriques résultant de la dynamique du système équivalent orthèse-membre inférieur. Elle permet également de garantir d'une part, un bon suivi de la trajectoire désirée imposée par le thérapeute ou par le sujet lui-même, et d'autre part, une bonne robustesse vis-à-vis des perturbations externes pouvant se produire lors des mouvements de flexion/extension. Dans cette thèse, nous proposons également un modèle neuronal de type Perceptron Multi-Couches pour l'estimation de l'intention du sujet à partir de la mesure des signaux EMG caractérisant les activités musculaires volontaires du groupe musculaire quadriceps. Cette approche permet de s'affranchir d'un modèle d'activation et de contraction musculaire complexe. L'ensemble des travaux a été validé expérimentalement avec la participation volontaire de plusieurs sujets valides
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Guiraud, David. "Système de contrôle du mouvement du membre inférieur à base de réseaux de neurones artificiels : restauration de la marche chez le paraplégique". Châtenay-Malabry, Ecole centrale de Paris, 1993. http://www.theses.fr/1993ECAP0318.
Testo completoAbstract (sommario):
Une lésion totale ou partielle de la moelle épinière a un niveau t4 et t11 provoque une paralysie plus ou moins importante des membres inférieurs. Dans le cas du paraplégique complet, plusieurs solutions sont envisageables pour restaurer la fonction de marche. La stimulation électrique fonctionnelle semble être l'une des plus prometteuses. Pour obtenir un bon mouvement avec un système biomécanique aussi complexe que le nôtre, il faut des méthodes de contrôle aptes à gérer: la spécificité des paramètres d'un patient à l'autre, la forte non-linéarité du système et l'évolution dans le temps des caractéristiques de l'activateur musculaire (sous l'effet de la fatigue par exemple). Les méthodes classiques d'asservissement ne donnent pas de solution réellement satisfaisante. Les réseaux de neurones offrent, quant à eux, la possibilité de résoudre un certain nombre de ces problèmes et ce travail de thèse propose une évaluation de leurs capacités d'adaptation et d'apprentissage sur cette application particulière. Apres une analyse détaillée de chaque élément intervenant dans le mouvement du membre inferieur, nous proposons l'élaboration d'un réseau de neurones et d'une méthode d'apprentissage associée originale, tenant compte des contraintes exhibées par l'analyse précédente. Les résultats obtenus sur un outil de simulation - la machine a marcher - sont encourageants et valident, sur un cas réel, le principe développe. En effet, le réseau apprend à piloter la machine sans connaitre a priori la dynamique du système. On obtient un contrôle aussi bon qu'avec une méthode classique telle que le PID. De plus, l'intégration de connaissances liées à la structure de la trajectoire permet au réseau de fonctionner en mode dégradé où certains capteurs sont déconnectés. Ces caractéristiques en font un outil performant pour le contrôle du mouvement du membre inferieur, dont la dynamique est méconnue, avec un nombre restreint de capteurs, si l'on envisage une utilisation quotidienne du système par un patient
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Tian, Jie. "The orthos logos in Aristotle’s ethics". Doctoral thesis, Humboldt-Universität zu Berlin, Philosophische Fakultät I, 2017. http://dx.doi.org/10.18452/17712.
Testo completoAbstract (sommario):
Der Begriff von Orthos Logos ist zentral für die ethische Lehre Aristoteles’. In der Literatur ist jedoch umstritten, was der Inhalt von OL ist. Das genaue Wesen von OL liegt immer noch im Dunkel. Ziel meiner Dissertation ist es, den Beitrag von OL für Aristoteles’ Ethik zu erforschen. Dabei soll vor allem erläutert werden, was OL ist bzw. was OL leisten kann. Auf dieser Untersuchung basierend versuche ich, eine ausführliche bzw. in sich konsistente Interpretation der wichtigen Bestandteile der Nicomachischen Ethik zu liefern. Ich werde dafür argumentieren, dass OL als der praktische Syllogismus selbst aufzufassen ist, der die moralischen Subjekte darüber informiert, was sie tun sollen bzw. weswegen sie gerade dies und nicht etwas anderes tun sollen. Sofern ein hinsichtlich der Moralität noch lernender Mensch den Syllogismus nicht vollständig begreift, ist es allerdings möglich, dass OL diesem Menschen etwas anderes zu sein scheint.The notion of the orthos logos (abbr. OL) is vital and decisive for Aristotle’s ethical project. The question of what OL really means is a vigorously debated issue. But what the OL exactly is still remains ambiguous and obscure. The purpose of my dissertation is to inquire into the philosophical contribution of the OL in Aristotle’s Ethics. To fulfil this goal, it is essentially to determine what the OL is and what the OL can do. Through this inquiry I seek to present a comprehensive and consistent reading of important parts of Aristotle’s Nicomachean Ethics. I will argue that the OL is the practical syllogism per se, which could tell moral people what should they do and why should they do this or that. But it could also appear to be something else for moral learners, since they are not capable of fully understanding the syllogism yet.
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Robinson, Ian. "Biomechanical investigation of subtalar joint action in normal and pathological gait and the modifications induced by functional orthoses". Thesis, University of Chichester, 2003. http://eprints.chi.ac.uk/855/.
Testo completoAbstract (sommario):
Current techniques of rearfoot alignment measurement have been reviewed and a new clinical technique of rearfoot measurement in weight bearing stance has been developed. This technique was validated by radiographic and cadaveric anthropometric studies. The relationship between a central heel bisection line and the underlying bone structure was investigated, and showed that the heel bisection line was coincident with the centre of the x-ray image of the calcaneus at its upper margin, but appeared to be skewed to the lateral side of the image of calcaneus (to 40% of its width) at its lower margin. A cadaveric study confirmed that this appearance arose as a result of a calcaneal tubercle that is larger medially than it is laterally. Reliability of rearfoot measurement was investigated and showed good repeatability (within the 0.5" resolution of the instrument) when made by an experienced podiatrist, with intratester repeatability of 0.93 and 0.95.
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Jarassé, Nathanaël. "Contributions à l'exploitation d'exosquelettes actifs pour la rééducation neuromotrice". Phd thesis, Université Pierre et Marie Curie - Paris VI, 2010. http://tel.archives-ouvertes.fr/tel-00641079.
Testo completoAbstract (sommario):
La rééducation neuromotrice est un des nouveaux champs d'application de la robotique en interaction physique. Dans ce domaine, on cherche à concevoir des machines pouvant assister les mouvements de patients atteints de troubles neuromoteurs dans la réalisation d'exercices physiques. Un des enjeux importants est de pouvoir proposer des machines capables de maîtriser des efforts mécaniques distribués le long des membres du patient durant les mouvements. Ceci a conduit la communauté à travailler au développement de structure exosquelettiques. L'essentiel des recherches en cours est focalisé sur les aspects cinématiques plus que sur le problème des transmissions d'efforts. C'est au contraire à ces aspects cruciaux qu'est consacrée la présente thèse. Pour améliorer la qualité du contrôle des efforts dans la mise en oeuvre des exosquelettes robotiques, les principales contributions se situent dans les domaines de la conception et de la commande. S'agissant de la conception, nous avons exploité des résultats existants dans la littérature pour la structure mécanique et la mécatronique d'actionnement, en utilisant l'exosquelette réversible ABLE conçu au CEA LIST. Partant de ce modèle, représentatif de l'existant, nous avons travaillé sur le problème du couplage mécanique entre le robot et le bras. Ce travail a permis de proposer une méthode générale pour synthétiser des mécanismes de fixation articulés passifs entre un exosquelette et un membre humain. Les fixations ainsi conçues garantissent l'isostaticité globale de l'ensemble. L'étude théorique générale est appliquée à ABLE, montrant une amélioration nette de la qualité de l'interaction. S'agissant de la commande, nous avons déployé une commande en efforts multi-contacts, ce qui constitue en soit une originalité, puis proposé de faciliter l'accompagnement des mouvements du sujet en exploitant une anticipation de trajectoire, grâce à un contrôleur mixte force/position. Là encore, l'apport expérimental évalué sur l'exosquelette ABLE est probant. Un dernier résultat important de la thèse concerne l'évaluation de la qualité de l'interaction homme-exosquelette dans des tâches de comanipulation. En effet, pour pouvoir quantifier l'apport des différentes propositions dans le domaine de la conception et de la commande, nous avons dû établir une méthode permettant d'étudier de manière reproductible l'interaction physique homme-robot, en analysant simultanément les efforts et la cinématique des gestes.
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Oliveira, Paulo Jorge Félix. "A real-time architecture for smart wearable orthoses system". Master's thesis, 2017. http://hdl.handle.net/1822/55265.
Testo completoAbstract (sommario):
Dissertação de mestrado integrado em Engenharia Eletrônica Industrial de ComputadoresTherapies assisted by powered Wearable Robotic Devices for treating lower limb impairments – ROBOT-AIDED gait training – have been increasingly used in addition to conventional therapeutic approaches, in the fields of rehabilitation and assistance. Particularly, powered exoskeletons and orthoses have been highlighted. These complex robotic systems require the design of bioinspired control architectures, that emphasizes modularity, determinism, portability and effective actuation. The main goal proposed in this work comprises the development of a powered knee orthosis (PKO) system, embedded with wearable gait sensors, capable of providing assistance to motion while monitoring the human gait, in terms of kinematic, kinetic and physiologic parameters. Furthermore, the overall validation of the rehabilitative tools is carried out with the development of motion control strategies for knee motion assistance, suitable for distinct types of therapies and pathologic patients. These strategies are integrated in a bioinspired hierarchical control architecture, that allows the distribution of controllers (low-, mid-, and high-level) according to the human motor functioning principles. Moreover, an adaptive real-time gait segmentation method capable of detecting six human gait events is also presented and validated, and further integrated in the PKO system. This first set-up of the system was validated with healthy subjects, on treadmill gait training, in order to prove the well-functioning of the designed components, the effectiveness of the actuation and impact of the orthosis in the users. Overall, the outcomes are promising, with a successful validation of the motion assistance strategies as well as the adaptive gait segmentation tool. Furthermore, this work also presents the conceptual design and technical description of a new bioinspired, real-time, modular, and effective architecture for smart wearable orthoses system, entitled SmartOs, capable of integrating an active ankle-foot orthosis (PAFO) and the PKO, with wearable gait sensory systems and advanced gait methods.
Terapias assistidas por sistemas robóticos ativos e vestíveis para tratamento de deficiências dos membros inferiores têm vindo a ser cada vez mais utilizadas em adição a terapias convencionais, em reabilitação e assistência. Em particular, exosqueletos e ortóteses ativas tem sido destacada. Estes sistemas complexos requerem o projeto de arquiteturas de controlo, que realçam modularidade, determinismo, portabilidade e uma atuação eficaz. O objetivo principal proposto neste trabalho inclui o desenvolvimento de um sistema para uma ortótese ativa do joelho (PKO), embebido com sensores da marcha, capaz de assistir o movimento enquanto monitoriza a marcha humana, em termos de cinemática, cinética e parâmetros fisiológicos. A validação completa desta ferramenta reabilitativa decorreu com a criação de estratégias de controlo para assistir o movimento do joelho, adequadas para diferentes terapias e pacientes patológicos. Estas estratégias foram então integradas numa arquitetura de controlo bioinspiradas, que permite a definição de controladores (baixo, médio, e alto nível) relacionadas com os princípios do funcionamento do motor humano. Além disso, um algoritmo adaptativo de segmentação em tempo-real da marcha, capaz de destacar seis eventos, é também apresentado e validado, com posterior integração no sistema PKO. Esta primeira configuração do sistema foi validada com sujeitos saudáveis, em treadmill, de forma a provar o correto funcionamento dos componentes desenhados, a eficácia da atuação, e o impacto da ortótese nos utilizadores. No geral, os resultados foram promissores, com uma validação bem-sucedida das estratégias de assistência ao movimento e também da ferramenta segmentação da marcha. Além disso, este trabalho também apresenta o desenho conceptual e descrição técnica de uma nova arquitetura em real-time, bioinspirada, modular e eficaz para sistemas ortópticos inteligentes, intitulada SmartOS, capaz de integrar uma ortótese ativo do tornozelo (PAKO) e o PKO, com sensores da marcha vestíveis e algoritmos da marcha avançados.
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Roca, Olivier. "Étude comparative à court terme d’orthèses d’avancée mandibulaire titrable vs. active dans le traitement du syndrome d’apnées obstructives du sommeil chez l’adulte". Thesis, 2019. http://hdl.handle.net/1866/23950.
Testo completoAbstract (sommario):
Introduction : Le syndrome d’apnées obstructives du sommeil (SAOS) est un problème de santé publique fréquent. La gestion par pression positive continue (TPPC) est la référence, mais de nombreuses personnes le refusent ou ne s’y adaptent jamais. Ainsi, les orthèses d’avancée mandibulaire (OAM) titrables gagnent en popularité car elles apportent des solutions concrètes et bien souvent durables. L’approche myofonctionelle, soit d’offrir des activités linguales, est une piste complémentaire qui pourrait améliorer la gestion du SAOS. C’est dans ce but que nous avons observé la combinaison de ces deux éléments par la réalisation d’une OAM active (OAMA). En effet, le repositionnement actif de la mandibule en position avancée pourrait bien atténuer certains effets indésirables de l’OAM conventionnelle.
Objectifs : Comparer, dans un environnement de soins courants, l’efficacité de l’OAMA à une OAM conventionnelle titrable chez des patients adultes atteints d’un SAOS sévère qui refusent ou sont intolérants au TPPC. L’évaluation se fera notamment par le taux de réponse globale qui inclut l’évolution de l’index d’apnée-hypopnée (IAH) et l’observance.
Méthodologie : 18 participants complétèrent la totalité de l’étude, 8 dans le groupe OAM et 10 dans le groupe OAMA. Après avoir rempli des questionnaires, ils ont été invité à un examen dentaire, articulaire et à une première polysomnographie (PSG). Tous ont reçu le traitement par orthèse. Après minimum 3 mois de port, une nouvelle série de questionnaires a été remplie, un nouvel examen clinique a été réalisé ainsi qu’une seconde PSG.
Résultats : L’IAH (p<0,001), le temps passé avec une saturation pulsée en dioxygène supérieure à 90% (p=0,002), l’index de désaturation (p=0,004) et le nombre de micro-éveil (p=0,007) ont significativement diminué dans les 2 groupes, sans différence significative entre les groupes. L’ensemble des résultats des questionnaires ont mis en évidence une amélioration significative entre le début et la fin de l’étude pour les 2 groupes sans toutefois de différence significative entre les deux types d’orthèses pour les variables sur la somnolence, la fatigue et les fonctions usuelles ou la qualité du sommeil Toutefois il y a significativement plus de salivation rapportée avec l’OAMA, plus de temps en éveil lors du sommeil et une tendance vers un port moins long au cours de la nuit. Une qualité du sommeil qui se normalise moins qu’avec l’OAM conventionnelle à aussi été notée. De façon subjective de par les rapports patients, à court terme, moins de claquements aux articulations temporo-mandibulaires (ATM) (p=0,05) et moins de changements d’occlusion (p=0,05) ont été rapportés par le groupe OAMA par rapport au groupe OAM. Enfin le taux de réponse globale ne différait pas de façon significative entre les groupes (p=0,64).
Conclusion : L’OAMA est une option de traitement équipotente pour les index de sommeil lorsqu’on la compare à une OAM titrable conventionnelle. Bien que l’OAMA engendre moins de claquements au niveau des ATM et de modifications occlusales à court terme, il est essentiel, par une étude à plus grande taille, de confirmer si les tendances à moins bien dormir et à ne pas utiliser l’OAMA pour une durée semblable à l’OAM peut s’expliquer.Introduction: Obstructive sleep apnea syndrome (OSAS) is a common public health issue. Management with continuous positive airway pressure (CPAP) is the gold standard, but many people are unable to cope with it or refuse it. So, titratable mandibular advancement devices (MADs) are gaining in popularity, because they provide real long-term solutions. The myofunctional approach, which involves lingual exercises, is an additional measure that could improve OSAS management. To this end, we have observed the association of these two elements by creating an active MAD (AMAD). Indeed, actively repositioning the mandible in the advanced position may well mitigate some of the adverse effects of conventional MADs. Objectives: To compare the efficacy of AMADs in a routine care environment with conventional titratable MADs in adult patients with severe OSAS who do not want or do not tolerate CPAP therapy. The evaluation will focus on the overall response rate, which includes changes in apnea-hypopnea index (AHI) and compliance. Methodology: 18 participants completed the entire study, 8 in the MAD group and 10 in the AMAD group. After completing a series of questionnaires, they were asked to undergo a dental and temporomandibular joint (TMJ) examination, and their first polysomnography (PSG). They all received the treatment. After the patients had used it for at least 3 months, another series of questionnaires was completed, and another clinical examination and a second PSG were carried out. Results: AHI (p <0.001), time spent with SpO2>90 (p = 0.002), desaturation index (p = 0.004) and number of micro-arousals (p = 0.007) significantly decreased in both groups, with no significant difference between groups. The overall results of the questionnaires showed a significant improvement between the beginning and the end of the study for both groups with no significant difference between the groups for drowsiness, fatigue, normal activities and sleep quality variables. However, a much higher salivation rate was reported with the AMAD, as well as longer wake times during sleep periods and a tendency for the device to be worn for less time during the night. It was also observed that sleep quality does not normalize as much as with conventional MADs. Subjectively, patients in the AMAD group reported fewer TMJ clicks (p = 0.05) and fewer occlusion changes (p = 0.05) in the short term, compared to the MAD group. Finally, there were no significant differences between the groups in the overall response rate (p = 0.64). Conclusion: AMAD is an equipotent treatment option, based on sleep indexes, when compared to conventional titratable MADs. While AMADs produce subjectively less TMJ clicking and occlusal changes in the short term, it is essential to conduct a large-scale study to confirm whether the tendencies to not sleep as well and to use AMADs for shorter periods than MADs can be explained.
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Figueiredo, Joana Sofia Campos. "Smart wearable orthosis to assist impaired human walking". Doctoral thesis, 2019. http://hdl.handle.net/1822/65877.
Testo completoAbstract (sommario):
Tese de Doutoramento (Programa Doutoral em Engenharia Biomédica)O acidente vascular cerebral (AVC) é a terceira principal causa de incapacidade motora adulta. A reabilitação da marcha com um treino repetitivo e orientado ao doente, possível com ortóteses ativas (OAs), potencia a recuperação da mobilidade. Contudo, é necessário ajustar a reabilitação da marcha às atuais necessidades do sujeito, bem como integrar sensores vestíveis nas OAs para avaliar objetivamente a marcha. Esta tese visa o desenvolvimento do SmartOs, um sistema ortótico ativo, modular, e vestível, com o intuito de providenciar um treino de marcha repetitivo e orientado às necessidades de doentes com AVC, e de avaliar a locomoção do doente por meio de dados cinemáticos e musculares. Esta tese inclui cinco fases de investigação. Primeiro, foi desenvolvida uma estrutura modular para integrar, de forma inovadora e eficaz, sistemas sensoriais, ferramentas de análise da marcha, e estratégias de controlo nas OAs. Segundo, foi desenvolvido um laboratório portátil de análise de marcha com quatro sistemas sensoriais, passíveis de serem utilizados em stand-alone ou combinados com sistemas externos. O benchmarking com sistemas comerciais demonstrou a potencialidade destes sistemas sensoriais para a avaliação objetiva da locomoção. Terceiro, foi desenvolvida uma máquina de estados com limites adaptativos para a deteção de eventos da marcha, a qual demonstrou ser adequada como benchmarking para avaliação de eventos humanos da marcha. Quarto, foi criada uma ferramenta de machine learning para o reconhecimento e previsão de modos de locomoção e transições. Esta ferramenta destaca-se pela classificação precisa de direções e terrenos com uso exclusivo de dados cinemáticos. Por último, foi desenvolvida uma arquitetura de controlo hierárquica com quatro estratégias de controlo. As estratégias de trajetória orientada ao sujeito e impedância adaptativa fornecem um treino de marcha repetitivo e assist- as-needed, respetivamente. As estratégias baseadas na eletromiografia e na interação homem- OA contribuem para o fortalecimento muscular. Em suma, os resultados indicam que o SmartOs está funcional para futura aplicação em ambiente clínico quer como uma solução de assistência personalizada, quer como uma ferramenta de avaliação da marcha de doentes com AVC.
Stroke is the third leading cause of adult long-term motor disability. Gait rehabilitation approaching user-oriented and repetitive gait training has the potential for long-term mobility recovery. Active orthoses (AO) can tackle these rehabilitation abilities. More research is needed to foster gait rehabilitation oriented to the current user’s needs and to integrate wearable sensors into AOs for objective gait assessment. This thesis aims the development of SmartOs, a smart, modular, wearable active lower limb orthotic system, to foster user-oriented and repetitive gait training in impaired gait due to stroke and to evaluate human motor condition using kinematic and muscular gait measures. This work includes five research stages. First, a modular framework was implemented to integrate into an innovative and effective manner, wearable sensor systems, gait analysis tools, and control strategies into AOs. Second, a wearable motion lab including four wearable sensor systems, with an open-architecture for both stand-alone or third-party systems use, was successfully developed. The benchmarking analysis with commercial systems outlined that the sensor systems are purposeful for objective evaluation of the user’s motor condition. Third, a gait event detection tool through a finite state machine with an adaptive threshold-based structure was developed for detecting gait events in daily locomotion. Results show that the tool is suitable as a benchmark for detecting human gait events. Fourth, a machine learning-based recognition and prediction tool was achieved to classify locomotion modes and transitions. This tool advances the state-of-the-art by demonstrating that the exclusive use of kinematic data successfully classifies different walking directions and terrains. The last research stage made the SmartOs a multi-functional system through a hierarchical control architecture with four assistive control strategies. The user-oriented trajectory and adaptive impedance controls foster repetitive and assist-as-needed gait training, respectively. Both the EMG-based and user-orthosis interaction based control contribute to muscle strengthening. Findings indicate that SmartOs is functionally operative for a future clinical application as a personalized assistive and gait assessment solution of stroke survivors.
Capitoli di libri sul tema "Orthèse active"
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Di Gregorio, R., e V. Parenti-Castelli. "Parallel mechanisms for knee orthoses with selective recovery action". In Advances in Robot Kinematics, 167–76. Dordrecht: Springer Netherlands, 2006. http://dx.doi.org/10.1007/978-1-4020-4941-5_18.
Testo completoAtti di convegni sul tema "Orthèse active"
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Lugrís, Urbano, Jairo Carlín, Alberto Luaces e Javier Cuadrado. "Consideration of Assistive Devices in the Gait Analysis of Spinal Cord–Injured Subjects". In ASME 2013 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/detc2013-13252.
Testo completoAbstract (sommario):
The gait of spinal cord–injured subjects can be improved by means of properly designed active orthoses. Since the gait pattern varies greatly among different patients, the orthoses and their corresponding controllers must be carefully customized, and the joint motor torques obtained from inverse dynamic analysis constitute a useful input for this task. Nowadays, the analysis of standard gait by using motion capture data is a mature discipline. However, the problem becomes more complex in the case of spinal cord–injured subjects wearing active orthoses: in addition to the presence of the orthoses, these patients always require the help of supplementary assistive devices, such as crutches, in order to stabilize their gait. In this work, the gait analysis of a subject walking with the aid of crutches and active knee–ankle–foot orthoses is performed, by introducing the assistive devices both at the experimental and computational levels. The required sensors and actuators are incorporated to the system, and the measurements are used to solve the inverse dynamics problem in order to calculate the joint motor torques produced by the subject during gait.
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Bagheri, Ahmad, e Mohammad J. Sadigh. "Optimal spring layout and specifications for rotary active ankle orthoses". In 2018 3rd International Conference on Control and Robotics Engineering (ICCRE). IEEE, 2018. http://dx.doi.org/10.1109/iccre.2018.8376481.
Testo completo
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Bagheri, Ahmad, e Mohammad J. Sadigh. "Optimal Spring Layout and Specifications for Linear Active Ankle Orthoses". In Modelling, Simulation and Identification / 854: Intelligent Systems and Control. Calgary,AB,Canada: ACTAPRESS, 2017. http://dx.doi.org/10.2316/p.2017.854-015.
Testo completo
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Silveira, Guilherme L. M., Marciel A. Gomes e Adriano A. G. Siqueira. "First experimental results on adaptation algorithms for lower limbs active orthoses". In Automation (MED 2010). IEEE, 2010. http://dx.doi.org/10.1109/med.2010.5547868.
Testo completo
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Gomes, Marciel A., Adriano A. G. Siqueira e Guilherme L. M. Silveira. "Neural Network-Based Gait Adaptation Algorithms for Lower Limbs Active Orthoses". In ASME 2009 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2009. http://dx.doi.org/10.1115/sbc2009-206167.
Testo completoAbstract (sommario):
This work deals with neural network-based gait-pattern adaptation algorithm for an active orthosis. The proposed device is developed for lower limbs and based on a commercially available orthosis, Figure 1. Active orthoses can be designed for helping physically weak or injured people during rehabilitation procedures [1]. The robotic orthosis Lokomat is being recently used for rehabilitation of patients with stroke or spinal cord injury individuals [2]. Gait-pattern adaptation algorithms are proposed by Riener, et. al [3], considering the human-machine interaction. The algorithms in Riener, et. al [3] were developed for a fixed base robotic system; they can not be applied directly in the proposed orthosis, since no stability of the gait pattern is considered. A trajectory generator for biped robots taking into account the ZMP (Zero Moment Point) criterion is presented in Huang, et al. [4]. This method presents suitable results with smooth and second-order differentiable curves.
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Figueiredo, Joana, Cristina P. Santos e Juan C. Moreno. "Assistance and rehabilitation of gait disorders using active lower limb orthoses". In 2015 IEEE 4th Portuguese Meeting on Bioengineering (ENBENG). IEEE, 2015. http://dx.doi.org/10.1109/enbeng.2015.7088837.
Testo completo
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Eslamy, Mahdy, e Arndt F. Schilling. "A Conceptual High Level Controller to Walk with Active Foot Prostheses/Orthoses". In 2018 7th IEEE International Conference on Biomedical Robotics and Biomechatronics (Biorob). IEEE, 2018. http://dx.doi.org/10.1109/biorob.2018.8487213.
Testo completo
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Dollar, Aaron M., e Hugh Herr. "Active Orthoses for the Lower-Limbs: Challenges and State of the Art". In 2007 IEEE 10th International Conference on Rehabilitation Robotics. IEEE, 2007. http://dx.doi.org/10.1109/icorr.2007.4428541.
Testo completo
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Gome, Marciel A., Guilherme L. M. Silveira e Adriano A. G. Siqueira. "Gait-pattern adaptation algorithms based on neural network for lower limbs active orthoses". In 2009 IEEE/RSJ International Conference on Intelligent Robots and Systems (IROS 2009). IEEE, 2009. http://dx.doi.org/10.1109/iros.2009.5354232.
Testo completo
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Philen, Michael. "On the Applicability of F2MC Variable Impedance Materials for Prosthetic Devices". In ASME 2008 Conference on Smart Materials, Adaptive Structures and Intelligent Systems. ASMEDC, 2008. http://dx.doi.org/10.1115/smasis2008-572.
Testo completoAbstract (sommario):
The applicability of variable modulus fluidic flexible matrix composites (F2MC) is investigated for development of prosthetic devices. The F2MC material is an innovative combination of high performance composite tubes containing high bulk modulus fluids. The new material system can potentially achieve several orders of magnitude change in stiffness through valve control. The F2MC material system is investigated in this research through analytical studies for active impedance control for load transfer reduction in a transtibial prosthetic sockets and impedance joint control for an ankle-foot orthoses (AFO). Preliminary analysis results indicate that the variable modulus system can reduce the load transfer between the limb and transtibial socket and can provide impedance tailoring for improving foot-slap in an AFO.