<strong>Aim: </strong>We devised a self-care supporting program targeting patients with early stages of secondary lower-limb lymphedema. The program incorporates “Simple exercises to replace lymphatic dra...<strong>Aim: </strong>We devised a self-care supporting program targeting patients with early stages of secondary lower-limb lymphedema. The program incorporates “Simple exercises to replace lymphatic drainage” based on lymphatic flow. The purpose of this study was to consider the feasibility of continuing this program. <strong>Methods:</strong> The participants were patients in the early stages of secondary lower-limb lymphedema after gynecological cancer surgery and lymphedema therapists with more than five years of experience. Patients continued self-care at home after being briefed on the program, and they were analyzed on their self-care continuity status one month later based on a self-administered questionnaire survey and self-care notes. We interviewed the lymphedema therapists about this program to discuss the feasibility of continuing it and obtain feedback. <strong>Results:</strong> The patients who participated in the study were six women who underwent surgery with lymph node dissection for gynecological cancer. The therapists were five nurses and one occupational therapist. The patient understood the importance of all items in the self-care. “Observation,” “Touching,” and “Skin care” were relatively easy to continue. “Lymph drainage” and “Exercise” were continued with “Simple exercises to replace lymphatic drainage”. “Other exercises” were able to continue by adding distance and time to daily activities. Furthermore, “Measurement” and “Recording” became a burden and were difficult to continue. Nonetheless, this program was generally approved by the lymphedema therapists. They also pointed out the content and format of the self-care notes as improvements. <strong>Conclusions: </strong>We found that the self-care supporting program that incorporated “Simple exercises to replace lymphatic drainage” might be feasible to continue self-care for patients with early stages of secondary lower-limb lymphedema. Furthermore, we found that we needed to improve the “Measurement” and “Recording” sections of this program.展开更多
Unilateral motor impairment can disrupt the coordination between the joints,impeding the patient’s normal gait.To assist such patients to walk normally and naturally,an adaptive control algorithm based on inter-joint...Unilateral motor impairment can disrupt the coordination between the joints,impeding the patient’s normal gait.To assist such patients to walk normally and naturally,an adaptive control algorithm based on inter-joint coordination was proposed in this work for lower-limb exoskeletons.The control strategy can generate the reference trajectory of the affected leg in real time based on a motion coordination model between the joints,and adopt an adaptive controller with virtual windows to track the reference trajectory.Long Short-Term Memory(LSTM)network was also adopted to establish the coordination model between the joints of both lower limbs,which was optimized by preprocessing angle information and adding gait phase information.In the adaptive controller,the virtual windows were symmetrically distributed around the reference trajectory,and its width was adjusted according to the gait phase of the auxiliary leg.In addition,the impedance parameters of the controller were updated online to match the motion capacity of the affected leg based on the spatiotemporal symmetry factors between the bilateral gaits.The LSTM coordination model demonstrated good accuracy and generality in the gait database of seven individuals,with an average root mean square error of 3.5 and 4.1 for the hip and knee joint angle estimation,respectively.To further evaluate the control algorithm,four healthy subjects walked wearing the exoskeleton while additional weights were added around the ankle joint to simulate an asymmetric gait.From the experimental results,it was shown that the algorithm improved the gait symmetry of the subjects to a normal level while exhibiting great adaptability to different subjects.展开更多
文摘<strong>Aim: </strong>We devised a self-care supporting program targeting patients with early stages of secondary lower-limb lymphedema. The program incorporates “Simple exercises to replace lymphatic drainage” based on lymphatic flow. The purpose of this study was to consider the feasibility of continuing this program. <strong>Methods:</strong> The participants were patients in the early stages of secondary lower-limb lymphedema after gynecological cancer surgery and lymphedema therapists with more than five years of experience. Patients continued self-care at home after being briefed on the program, and they were analyzed on their self-care continuity status one month later based on a self-administered questionnaire survey and self-care notes. We interviewed the lymphedema therapists about this program to discuss the feasibility of continuing it and obtain feedback. <strong>Results:</strong> The patients who participated in the study were six women who underwent surgery with lymph node dissection for gynecological cancer. The therapists were five nurses and one occupational therapist. The patient understood the importance of all items in the self-care. “Observation,” “Touching,” and “Skin care” were relatively easy to continue. “Lymph drainage” and “Exercise” were continued with “Simple exercises to replace lymphatic drainage”. “Other exercises” were able to continue by adding distance and time to daily activities. Furthermore, “Measurement” and “Recording” became a burden and were difficult to continue. Nonetheless, this program was generally approved by the lymphedema therapists. They also pointed out the content and format of the self-care notes as improvements. <strong>Conclusions: </strong>We found that the self-care supporting program that incorporated “Simple exercises to replace lymphatic drainage” might be feasible to continue self-care for patients with early stages of secondary lower-limb lymphedema. Furthermore, we found that we needed to improve the “Measurement” and “Recording” sections of this program.
基金supported by the Graduate Scientific Research and Innovation Foundation of Chongqing,China(CYB19062)the China Scholarship Council(CSC202206050121).
文摘Unilateral motor impairment can disrupt the coordination between the joints,impeding the patient’s normal gait.To assist such patients to walk normally and naturally,an adaptive control algorithm based on inter-joint coordination was proposed in this work for lower-limb exoskeletons.The control strategy can generate the reference trajectory of the affected leg in real time based on a motion coordination model between the joints,and adopt an adaptive controller with virtual windows to track the reference trajectory.Long Short-Term Memory(LSTM)network was also adopted to establish the coordination model between the joints of both lower limbs,which was optimized by preprocessing angle information and adding gait phase information.In the adaptive controller,the virtual windows were symmetrically distributed around the reference trajectory,and its width was adjusted according to the gait phase of the auxiliary leg.In addition,the impedance parameters of the controller were updated online to match the motion capacity of the affected leg based on the spatiotemporal symmetry factors between the bilateral gaits.The LSTM coordination model demonstrated good accuracy and generality in the gait database of seven individuals,with an average root mean square error of 3.5 and 4.1 for the hip and knee joint angle estimation,respectively.To further evaluate the control algorithm,four healthy subjects walked wearing the exoskeleton while additional weights were added around the ankle joint to simulate an asymmetric gait.From the experimental results,it was shown that the algorithm improved the gait symmetry of the subjects to a normal level while exhibiting great adaptability to different subjects.
