Part One: The Basis of Injury Rehabilitation 1 Essential Considerations in Designing a Rehabilitation Program for the Injured Patient 2 Understanding and Managing the Healing Process through Rehabilitation 3 The Evaluation Process in Rehabilitation 4 Psychological Considerations for Rehabilitation of the Injured Patient Part Two: Achieving the Goals of Rehabilitation 5 Establishing Core Stabilization 6 Reestablishing Neuromuscular Control 7 Regaining Postural Stability and Balance 8 Restoring Range of Motion and Improving Flexibility 9 Regaining Muscular Strength, Endurance, and Power 10 Maintaining Cardiorespiratory Fitness during Rehabilitation Part Three: The Tools of Rehabilitation 11 Plyometrics in Rehabilitation 12 Open versus Closed Kinetic-Chain Exercise in Rehabilitation 13 Joint Mobilization and Traction Techniques in Rehabilitation 14 PNF Techniques in Rehabilitation 15 Aquatic Therapy in Rehabilitation 16 Functional Progressions and Functional Testing in Rehabilitation Part Four: Rehabilitation Techniques for Specific Injuries 17 Rehabilitation of Shoulder Injuries 18 Rehabilitation of Elbow Injuries 19 Rehabilitation of Wrist, Hand, and Finger Injuries 20 Rehabilitation of Groin, Hip, and Thigh Injuries 21 Rehabilitation of Knee Injuries 22 Rehabilitation of Lower-Leg Injuries 23 Rehabilitation of Ankle and Foot Injuries 24 Rehabilitation of Injuries to the Spine Glossary

Laboratory Manual to accompany Rehabilitation techniques for sports medicine and athletic training

http://pih.sagepub.com/content/215/3/333.full.pdf

Control of Movement for the Physically Disabled

Functional electrical stimulation

Diabetic foot ulcers (DFUs) are a serious complication for people with diabetes. They result in increased morbidity and pressures on health system resources. Developments in machine learning (ML) offer an opportunity for improved care of individuals at risk of DFUs, to identify and synthesise evidence about the current uses and accuracy of ML in the interventional care and management of DFUs, and, to provide a reference for areas of future research. PubMed, Google Scholar, Web of Science and Scopus were searched using the Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) guidelines for papers involving ML and DFUs. In order to be included, studies needed to mention ML, DFUs, and report relevant outcome measures regarding ML algorithm accuracy. Bias in included studies was assessed using the quality assessment tool for diagnostic accuracy (QUADAS-2). 37 out of 3769 papers were included after applying eligibility criteria. Included papers reported accuracy measures for multiple types of ML algorithms in DFU studies. Whilst varying across the ML algorithm used, all studies reported at least 90% accuracy compared to gold standards using a minimum of one reported ML algorithm for processing or recording data. Applications where ML had positive effects on DFU data analysis and outcomes include image segmentation and classification, raw data analysis and risk assessment. ML offers an effective and accurate solution to guide analysis and procurement of data from interventions which are designed for the care of DFUs in small samples and study conditions. Current research is limited, and, for the development of more applicable ML algorithms, future research should address the following: direct comparison of ML applications with current standards of care, health economic analyses and large scale data collection. There is currently no evidence to confidently suggest that ML methods in DFU diagnosis are ready for implementation and use in healthcare settings.

/pdf/machine-learning-in-the-prevention-diagnosis-and-management-205x3mhokm.pdf

Machine Learning in the Prevention, Diagnosis and Management of Diabetic Foot Ulcers: A Systematic Review

Radiofrequency ablation (RFA) is a relatively new technique to produce cell death by radiowaves (460– 480 kHz) caused by an alternating current emitted from the tip of a needle electrode and causing local ions vibration producing heat. In orthopaedic fields RFA has been proposed for the treatment of osteoid osteoma and painful metastases. Methods: 121 patients with a clinical and radiographic accerted osteoid osteoma have been treated with percutaneous radiofrequency ablation at our institutions from 1998 till December 2005. Average age of the patients was 23 years. Preoperative symptoms lasted 10 months on average. The osteoid osteoma was localized at the limbs in 111 cases, at the pelvis in 4 cases and at the spine in 6 cases. Results: At follow up we had 3 cases of recurrences and 2 fair results with a total of 5 unsuccessful cases. The fair results were due to a mistake of radiological indication and one case of ineffectively ablation. We observed 3 cases of skin burns in tibia with superficial infections: 2 cases resolved without treatment while the latter case showed initial bone infection and needed surgical revision. Conclusion: Percutaneous RFA of osteoid osteoma proved to be a successful treatment in more than 95% of the cases with a low complication rate.

Percutaneous radiofrequency ablation of osteoid osteoma

According to the American Cancer Society the number of patients with bone tumors is growing up. The extremities of the long bones are the most affected by this disease. The common treatments are surgery (amputation), radio and chemotherapy. However, their high cost and side-effects show the necessity of new treatments. These should not only eradicate the tumor but also offer a major control over the treated area. In this sense, the microwave ablation plays an important role. A micro-coaxial slot antenna to generated thermal ablation in bone tumors is proposed. The antenna was modeled, constructed and evaluated in pig tissue. A parametric study to evaluate the effect of the blood perfusion in the thermal distributions was done. Values of bone blood perfusion among 30-1171 ml/min/kg were included in this study. Subsequently, temperature profiles and thermal distributions generated in pig bones were obtained and compared with those obtained in the model. This evaluation shows a high level of concordance; in the best cases, a difference between simulation and measurement of 0.13°C-3.83°C and 0.08°C-0.41°C was found. This study corroborates the efficiency of the models to predict the antenna behavior and the efficiency of the proposed antenna to generated thermal ablation in bone tissue.

Antena Micro-coaxial de un Slot para el tratamiento de Tumores Óseos con Ablación Térmica: Evaluación Teórica y Experimental

Diabetic skin manifestations, previous to ulcers and wounds, are not highly accounted as part of diagnosis even when they represent the first symptom of vascular damage and are present in up to 70% of patients with diabetes mellitus type II. Here, an application for skin macules characterization based on a three-stage segmentation and characterization algorithm used to classify vascular, petechiae, trophic changes, and trauma macules from digital photographs of the lower limbs is presented. First, in order to find the skin region, a logical multiplication is performed on two skin masks obtained from color space transformations; dynamic thresholds are stabilised to self-adjust to a variety of skin tones. Then, in order to locate the lesion region, illumination enhancement is performed using a chromatic model color space, followed by a principal component analysis gray-scale transformation. Finally, characteristics of each type of macule are considered and classified; morphologic properties (area, axes, perimeter, and solidity), intensity properties, and a set of shade indices (red, green, blue, and brown) are proposed as a measure to obviate skin color differences among subjects. The values calculated show differences between macules with a statistical significance, which agree with the physician’s diagnosis. Later, macule properties are fed to an artificial neural network classifier, which proved a 97.5% accuracy, to differentiate between them. Characterization is useful in order to track macule changes and development along time, provides meaningful information to provide early treatments, and offers support in the prevention of amputations due to diabetic feet. A graphical user interface was designed to show the properties of the macules; this application could be the background of a future Diagnosis Assistance Tool for educational (i.e., untrained physicians) and preventive assistance technology purposes.

/pdf/an-application-for-skin-macules-characterization-based-on-a-1qe62mtlcv.pdf

An Application for Skin Macules Characterization Based on a 3-Stage Image-Processing Algorithm for Patients with Diabetes

La rehabilitacion neurologica surgio en los 60, como metodo formal para el tratamiento de pacientes con enfermedad vascular cerebral, trauma craneoencefalico y raquimedular que desarrollan secuelas severas que afectan su capacidad motora y sensorial. Aunque el sistema nervioso central tiene mecanismos de plasticidad que favorecen la recuperacion espontanea, un alto porcentaje de pacientes deben recibir terapias especializadas para recobrar la funcion motora, como la terapia de movimiento inducido por restriccion del miembro sano o la terapia de postura erguida. La neurorrehabilitacion ha sufrido cambios drasticos en las ultimas dos decadas debido a la incorporacion de dispositivos electronicos computarizados y robotizados, cuyo fin es estimular los procesos de neuroplasticidad. Entre los equipos podemos mencionar aque- llos destinados a la electroterapia, los aparatos para estimulacion electrica o estimulacion magnetica transcraneal, las ortesis roboticas de miembros superiores, los robots para el entrenamiento de los miembros inferiores, los sistemas para estimulacion electrica funcional, las neuroprotesis y los sistemas de interfaz cerebro-computadora, que han provocado controversia tanto por su aplicacion como por los beneficios que se han reportado en la literatura. Las tecnologias de neurorrehabilitacion tienen la finalidad de aprovechar las estructuras neuro-musculares funcionales conservadas, y que estas compensen o re-aprendan las funciones que antes hacian las zonas danadas y asi mejorar la funcion sensorio-motora. El proposito de este articulo es mencionar algunas aplicaciones clinicas y las ventajas que estas tecnologias ofrecen a los pacientes con lesion neuronal

/pdf/avances-tecnologicos-en-neurorrehabilitacion-13nwh8aboj.pdf

Avances tecnológicos en neurorrehabilitación

According to the International Diabetes Federation, approximately four million people die from diabetes each year, and ten million more suffer disabling or potentially terminal complications, such as diabetic foot disease. Therefore, the proposal is the early detection by detecting non-homogeneous temperature regions with radiometric data and image processing by IR thermography. The samples were taken from 12 patients diagnosed with diabetes mellitus without a history of diabetic foot or visible anatomical alterations, by a cooled IR sensor programmed exclusively to measure human skin temperature. The radiometric data was processed to eliminate interferences and segment the lower limb since the acquisition was carried out in a non-controlled environment; where lies the relevance of this paper. The results were presented as binary images with a defined segmented region against a contrasting background, reviling areas corresponded to higher temperatures regard the rest of the sole fo the foot as a consequence of non-homogeneous temperature pattern. A total of 6 cases showed a normal homogeneous temperature, 2 cases had fault origins and 4 cases presented spotted regions that are prospective to prone lesions. This procedure set a precedent for the analysis of early detection of the diabetic foot with radiometric data processing instead of using IR images as input; which could be used to retrieve the coordinates and carry out an exhaustive numerical analysis or pattern recognition (i.e. thermal fingerprint) to support the anticipated diagnosis based on support systems such as medical thermography as perspective.

Detection of Sore-risk Regions on the Foot Sole with Digital Image Processing and Passive Thermography in Diabetic Patients

The high thermal sensitivity of the cancerigenic cells has lead to use hyperthermia to sensitive and eradicate them with efficiency and ef- fectiveness. The traditional procedure for malignant bone tumors is mainly amputation, affecting the life quality of children and adoles- cents. Hydro hyperthermia has been chosen to improve the prog- noses in the extirpation and eradication of the malignant tumors in the Departamento de Tumores Oseos at Instituto Nacional de Reha- bilitacion. In this paper, it is showed the design, manufacture and operation of a system to generate, control and deliver heat energy into tumor: "Controlled Hydro Hyperthermia". As well as, Bone Temper- ature Distribution. The system is cheap, easy, affordable and secure system that represents a chance to preserve the extremity without to use any surgical appliance. The system has three parts: The first is the electromechanical device that provides temperature above 80 °C, last 30 min minimum. Second, the direct steam applicator. And finally the thermal mapping. At the moment, 19 patients, with bone tumor

/pdf/sistema-de-hipertermia-hidrica-controlada-con-mapeo-para-2klybyj0en.pdf

Josefina Gutierrez Martinez

Papers

Antena Micro-coaxial de un Slot para el tratamiento de Tumores Óseos con Ablación Térmica: Evaluación Teórica y Experimental

An Application for Skin Macules Characterization Based on a 3-Stage Image-Processing Algorithm for Patients with Diabetes

Avances tecnológicos en neurorrehabilitación

Detection of Sore-risk Regions on the Foot Sole with Digital Image Processing and Passive Thermography in Diabetic Patients

Sistema de hipertermia hídrica controlada con mapeo para oncología ósea