UbiquitousRehabilitation

CL Bennett, K Cen, KM Steele, DK Rosner, (2016) “An intimate laboratory? Prostheses as a tool for experimenting with identity and normalcy.” CHI Human Factors in Computing Systems, ACM

Dr. Steele Handathon, JournalArticle, Orthoses, UbiquitousRehabilitation , , , , , ,
Prostheses from the 15th century (medieval metal hand) to the 21st century (3D-printed enable hand).

Peer-review paper at CHI Human Factors in Computing Systems Annual Conference:

Prostheses are more than just a tool to enhance function – they strongly influence perceptions of identity and normalcy.

Prostheses from the 15th century (medieval metal hand) to the 21st century (3D-printed enable hand).Abstract: This paper is about the aspects of ability, selfhood, and normalcy embodied in people’s relationships with prostheses. Drawing on interviews with 14 individuals with upper-limb loss and diverse experiences with prostheses, we find people not only choose to use and not use prosthesis throughout their lives but also form close and complex relationships with them. The design of “assistive” technology often focuses on enhancing function; however, we found that prostheses played important roles in people’s development of identity and sense of normalcy. Even when a prosthesis failed functionally, such as was the case with 3D-printed prostheses created by an on-line open-source maker community (e-NABLE), we found people still praised the design and initiative because of the positive impacts on popular culture, identity, and community building. This work surfaces crucial questions about the role of design interventions in identity production, the promise of maker communities for accelerating innovation, and a broader definition of “assistive” technology.

View the video for more information on this work.

SSM Lee, D Gaebler-Spira, LQ Zhang, WZ Rymer, KM Steele, (2016) “Use of shear wave ultrasound elastography to quantify muscle properties in cerebral palsy.” Clinical Biomechanics

Dr. Steele JournalArticle, MotorControl, UbiquitousRehabilitation , ,
Sample ultrasound images from gastrocnemius and tibialis anterior showing greater shear wave velocity on more affected limb.

Journal article in Clinical Biomechanics:

Kat Steele partnered with Sabrina Lee from Northwestern University and the Rehabilitation Institute of Chicago to investigate shearwave ultrasound elastography as a new tool to quantify changes in muscle properties in cerebral palsy.

Sample ultrasound images from gastrocnemius and tibialis anterior showing greater shear wave velocity on more affected limb.Abstract: Individuals with cerebral palsy tend to have altered muscle architecture and composition, but little is known about the muscle material properties, specifically stiffness. Shear wave ultrasound elastography allows shear wave speed, which is related to stiffness, to be measured in vivo in individual muscles. Our aim was to evaluate the material properties, specifically stiffness, as measured by shear wave speed of the medial gastrocnemius and tibialis anterior muscles in children with hemiplegic cerebral palsy across a range of ankle torques and positions, and fascicle strains. Shear wave speed was measured bilaterally in the medial gastrocnemius and tibialis anterior over a range of ankle positions and torques using shear wave ultrasound elastography in eight individuals with hemiplegic cerebral palsy. B-mode ultrasound was used to measure muscle thickness and fascicle strain. Shear waves traveled faster in the medial gastrocnemius and tibialis anterior of the more-affected limb by 14% (P = 0.024) and 20% (P = 0.03), respectively, when the ankle was at 90°. Shear wave speed in the medial gastrocnemius increased as the ankle moved from plantarflexion to dorsiflexion (less affected: r2 = 0.82, P < 0.001; more-affected: r2 = 0.69, P < 0.001) and as ankle torque increased (less affected: r2 = 0.56,P < 0.001; more-affected: r2 = 0.45, P < 0.001). In addition, shear wave speed was strongly correlated with fascicle strain (less affected: r2 = 0.63, P < 0.001; more-affected: r2 = 0.53, P < 0.001). The higher shear wave speed in the more-affected limb of individuals with cerebral palsy indicates greater muscle stiffness, and demonstrates the clinical potential of shear wave elastography as a non-invasive tool for investigating mechanisms of altered muscle properties and informing diagnosis and treatment.

Two NIH R01 Grants Funded

Dr. Steele Awards, MotorControl, UbiquitousRehabilitation , , , , ,

NIH logoThe Ability & Innovation Lab is excited to announce that two of our recent grant proposals have been funded! This funding will help to accelerate our mission to improve movement for individuals with neurologic disorders.

Quantifying patient-specific changes in neuromuscular control in cerebral palsy: Funded by the National Institute of Neurological Disorders and Stroke, this research will examine how new measures of neuromuscular control can be used to better predict outcomes after multi-level orthopaedic surgery for individuals with cerebral palsy. We will be working in close partnership with Gillette Children’s Specialty Healthcare, one of the leading institutions in the management of pediatric neurological disorders. This research will address the challenge of identifying the best treatment for each individual. Cerebral palsy is caused by a brain injury and every brain injury is unique. We will be using new measures from muscle synergy analysis (see prior work here) to determine how patient-specific measures of control can be used to predict outcomes after surgery.

Ubiquitous rehabilitation to improve movement after neurologic injury: Funded by the joint NSF-NIH Smart & Connected Health Initiative, this research will work in partnership with the University of Texas at Austin to use flexible electrodes to track and train muscle activity after stroke and other neurologic injuries. We know that more practice and use after brain injury increases long-term recovery and function. This research will investigate new pathways for both motivating patients to re-learn to use their muscle and providing doctors and therapists with the data and insight needed to guide and customize therapy.