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Biomedical subjects

L Fehr

Publications and source records attributed to L Fehr.

8 recordsLinked to original sources

Follow-up assessment of standing mobility device users.

The use of standing devices by spinal cord-injured subjects was investigated through a national survey of a sample of individuals who returned their manufacturer's warranty card to two companies. We obtained a 32% response rate (99/310). The majority of respondents were male (87%) with a median age between 41 and 50 years. Seventy-seven percent were paraplegic and 21% were quadriplegic. Forty percent had between 1 and 5 years experience with their device, and 84% of those responding were currently using their standing device. Forty-one percent used their standing device one to six times a week; two-thirds stood between 30 minutes and 1 hour for each use. Less than 10% of subjects experienced any side effects, such as nausea or headaches, from standing. Twenty-one percent of subjects reported being able to empty their bladder more completely. There was also a favorable response by some individuals on the effects of the standing devices on bowel regularity, reduction of urinary tract infections, leg spasticity, and number of bed sores. Finally, 79% of subjects highly recommended use of standing devices to other people with spinal cord injury. The positive responses of individuals using standing devices is a strong recommendation for the assistive technology community to make these devices more available to individuals with spinal cord injury.

Adult

Biomechanical and reflex responses to joint perturbations during electrical stimulation of muscle: instrumentation and measurement techniques.

A test device is developed to measure ankle joint compliance and muscle activity when the ankle is subjected to perturbations in angular position (or torque) from bias positions achieved volitionally or via electrical stimulation. The ankle measurement system uses a pivoting footplate and is operable with the subject sitting or supine. A companion platform for the knee is developed that uses a rotary arm and attached leg brace and is operable with the subject's leg in the horizontal or vertical plane. The knee fixture's pivoting arm can slide to account for the cam-like movement of the knee during rotation. The devices use similar hardware and share common instrumentation and control. Precise torque or position perturbations are delivered by a computer-controlled torque motor to the ankle or knee. Angular displacement, torque, acceleration, knee fixture moment arm and electromyographic data are collected on analogue tape and simultaneously digitised and stored. A special stimulator/recording amplifier permits the recording of electromyographic signals from the stimulated muscle. Experimental data indicate that the ankle and knee devices, operated horizontally, are purely inertial systems. Sample ankle and knee joint responses to perturbations are presented.

Ankle Joint

Initial clinical evaluation of a wheelchair ergometer for diagnostic exercise testing: a technical note.

The purpose of this initial study was to evaluate a new wheelchair ergometer (WCE) and exercise test protocol for the detection of coronary artery disease in men with lower limb disabilities. Forty-nine patients (63 +/- 9 yr) completed WCE tests without complications. Peak heart rate was 84 +/- 15% (mean +/- SD) of age-predicted maximum and peak double product was 223 +/- 62 x 10(2). The specified target heart rate (> or = 80% age-predicted maximal) or a positive result was achieved in 76% of tests. Fourteen tests were rated positive, 21 as negative and 14 as nondiagnostic for exercise-induced ischemia. In 18 patients who underwent coronary angiography, the predictive value was 100% (10/10) for a positive, and 50% (2/4) for a negative WCE test result. These results suggest that WCE is a viable initial diagnostic option for some persons who cannot adequately perform treadmill or cycle ergometry exercise.

Adult

Research device to preproduction prototype: a chronology.

This paper describes the evolution of the Wheelchair Aerobic Fitness Trainer (WAFT), a wheelchair ergometer developed for determination of aerobic capacity and the diagnosis of coronary artery disease in lower limb disabled persons whose mobility depends primarily on the manual wheelchair. The device was originally developed for use in research studies to determine peak exercise capacity in persons with spinal cord injuries and other lower limb disabilities and to formulate associated graded exercise stress test protocols. In subsequent research, the device was incorporated into a specially designed testing station for the detection of coronary artery disease in persons who cannot adequately undergo treadmill or cycle ergometry testing because of lower limb disabilities. Based on the usefulness of the device for both rehabilitation and diagnostic purposes, the WAFT has been brought into the technology transfer process of the Department of Veterans Affairs Rehabilitation Research and Development Service. Under a contract with Packer Engineering, Inc., Naperville, IL, development of a preproduction version of the device and six units for field evaluation has commenced. The preproduction prototype of the WAFT has incorporated numerous improvements over the original device and promises to expand the potential for future research, rehabilitation, and diagnostic applications.

Adult

Choosing a school.

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Accreditation

Is there a win-win?

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American Nurses' Association