The sense of body ownership, that one's body belongs to oneself, is a result of the integration of dierent sensory streams. This sense however is not error-free; in 1998 Botvinick and Cohen [3] showed the rubber hand illusion (RHI), an illusion that made a subject feel a rubber hand as their own. An important factor to induce the illusion is the timing of the applied visual and tactile stimulation to the rubber hand. Temporal delays greater than 500ms eliminate the illusory ownership. This study investigates previously unexplored small delays between stimulation modalities and their eect for the perception of the RHI. Through a virtual reality setup of the RHI paradigm, it is shown that small delays can signicantly alter the strength of the illusion. The order of the sensory modality presented plays a catalytic role to whether or not the inter-modal delay will have an eect on the illusion's strength.
This paper describes a Functional Electrical Stimulation (FES) standing system for rehabilitation of bone mineral density (BMD) in people with Spinal Cord Injury (SCI). BMD recovery offers an increased quality of life for people with SCI by reducing their risk of fractures. The standing system developed comprises an instrumented frame equipped with force plates and load cells, a motion capture system, and a purpose built 16-channel FES unit. This system can simultaneously record and process a wide range of biomechanical data to produce muscle stimulation which enables users with SCI to safely stand and exercise. An exergame provides visual feedback to the user to assist with upper-body posture control during exercising. To validate the system an alternate weight-shift exercise was used; 3 participants with complete SCI exercised in the system for 1 hour twice-weekly for 6 months. We observed ground reaction forces over 70% of the full body-weight distributed to the supporting leg at each exercising cycle. Exercise performance improved for each participant by an increase of 13.88 percentage points of body-weight in the loading of the supporting leg during the six-month period. Importantly, the observed ground reaction forces are of higher magnitude than other studies which reported positive effects on BMD. This novel instrumentation aims to investigate weight bearing standing therapies aimed at determining the biomechanics of lower limb joint force actions and postural kinematics.
Study design
A training intervention study using standing dynamic load-shifting Functional Electrical Stimulation (FES) in a group of individuals with complete spinal cord injury (SCI) T2 to T10.
Objectives
Investigate the effect of FES-assisted dynamic load-shifting exercises on bone mineral density (BMD).
Setting
University Lab within the Biomedical Engineering
Methods
Twelve participants with ASIA A SCI were recruited for this study. Three participants completed side-to-side load-shifting FES-assisted exercises for 29 ± 5 weeks, 2× per week for 1 h, and FES knee extension exercises on alternate days 3× per week for 1 h. Volumetric Bone Mineral density (vBMD) at the distal femur and tibia were assessed using peripheral quantitative computed tomography (pQCT) before and after the intervention study.
Results
Participants with acute and subacute SCI showed an absolute increase of f trabecular vBMD (vBMDTRAB) in the proximal (mean of 26.9%) and distal tibia (mean of 22.35%). Loss of vBMDTRAB in the distal femur was observed.
Conclusion
Improvements in vBMDTRAB in the distal tibia were found in acute and subacute SCI participants, and in the proximal tibia of acute participants, when subjected to anti-gravity FES-assisted load-bearing exercises for 29 ± 5 weeks. No vBMD improvement in distal femur or tibial shaft were observed in any of the participants as was expected. However, improvements of vBMD in the proximal and distal tibia were observed in two participants. This study provides evidence of an improvement of vBMDTRAB, when combining high-intensity exercises with lower intensity exercises 5× per week for 1 h.
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