BackgroundPowered exoskeleton can improve the mobility for people with movement deficits by providing mechanical support and facilitate the gait training. This pilot study evaluated the effect of gait training using a newly developed powered lower limb exoskeleton robot for individuals with complete spinal cord injury (SCI).MethodsTwo participants with a complete SCI were recruited for this clinical study. The powered exoskeleton gait training was 8 weeks, 1 h per session, and 2 sessions per week. The evaluation was performed before and after the training for (1) the time taken by the user to don and doff the powered exoskeleton independently, (2) the level of exertion perceived by participants while using the powered exoskeleton, and (3) the mobility performance included the timed up-and-go test, 10-m walk test, and 6-min walk test with the powered exoskeleton. The safety of the powered exoskeleton was evaluated on the basis of injury reports and the incidence of falls or imbalance while using the device.ResultsThe results indicated that the participants were donning and doffing the powered lower limb exoskeleton robot independently with a lower level of exertion and walked faster and farther without any injury or fall incidence when using the powered exoskeleton than when using a knee–ankle–foot orthosis. Bone mineral densities was also increased after the gait training. No adverse effects, such as skin abrasions, or discomfort were reported while using the powered exoskeleton.ConclusionsThe findings demonstrated that individuals with complete SCI used the powered lower limb exoskeleton robot independently without any assistance after 8 weeks of powered exoskeleton gait training.Trial registrationTrial registration: National Taiwan University Hospital.Trial registration number: 201210051RIB.Name of registry: Hui-Fen Mao.URL of registry: Not available.Date of registration: December 12th, 2012.Date of enrolment of the first participant to the trial: January 3rd, 2013.Electronic supplementary materialThe online version of this article (10.1186/s12984-018-0355-1) contains supplementary material, which is available to authorized users.

A nationwide yearly cycle of indoor residual spraying (IRS) with a pyrethroid, alphacypermethrin, at a dosage of 50 mg/m(2) was instituted in 2004 in the Democratic Republic of São Tomé and Príncipe. Rates of IRS acceptance were high, varying from 82% to 95% for dwellings and outhouses. Epidemiologic surveys of the children < 9 years of age before and after the first IRS cycle revealed a rapid reduction in malaria. Overall prevalence of malaria parasitemia for all districts was lowered from 20.1% to 2.8% at 12 months after the first IRS and reached 0.7% at 8 months after the second IRS. Longer insecticidal persistence was found on wood than on cement with alphacypermethrin.

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Downhill walking places greater demands on the lower limb joints with a greater risk of falling when compared with level walking. The current study aimed to quantify the 3D joint kinematics and kinetics of the locomotor system, and their interactions with the trunk during downhill walking. Fifteen young adults walked at a self-selected pace on a 3-m walkway with slopes of 0°, 5°, 10°, and 15° while their kinematic and kinetic data were measured. A complete 3D biomechanical analysis of the locomotor system was performed on these data. The results showed that with increasing downhill angles young healthy adults increased the posterior tilt of the pelvis and lateral trunk bending towards the stance limb, as well as the peak dorsiflexor and extensor moments at the ankle and knee, respectively, during the first half of the stance phase (SP), and increased the peak moments at the hip during the second half of the SP. The associated joint forces also varied with increasing slopes over the SP. When the overall mechanical demands were considered over the SP, the angular extensor and plantarflexor impulses at the knee and ankle were found to increase linearly with increasing slopes. The current results may serve as baseline data for future studies on downhill walking, and for clinical applications in various patient groups.