Sairag Saadprai, Sudarat Apibantaveesakul, Plaiwan Suttanon, Bunyong Rungroungdouyboon, "Design Development and Testing of Chair Accessory for Lower Limb Exercising for the Elderly.", August 2021, Volume 24 Number 4, p.82-95.
The elderly adults seldom engage in physical activities, especially in the COVID-19 situation because they cannot go outside for outdoor activities or participate in group exercises. This is a problem because increasing physical activities is very essential. Another problem is the fact that exercise equipment that can be used at home is limited. Most equipment is large, imported costly, and difficult to use without a caregiver. Hence, the purpose of this study was to report on the design and development of an accessory to be installed with a chair for lower limb exercise for the elderly. It works as a leg press exercise machine. It can be used with any type of chair, including wheelchairs. Resistance and leg degree can be adjusted while exercising to best suit each user. This study also tested its functions. First, the testing revealed that the design of chair accessory has a factor of safety at 2.8 that is adequate with repetitive usage with no damage to the user. Second, the stretch distance is from 0 to 10 cm. Third, the chair accessory “degree of movement” is from 90º to 180º. Also, as to the validity testing of resistance of the chair accessory, the researchers analyzed in each resistance level compared with the standard level using One Sample Test (significance at the P<0.05 level), and it does not show the significant differences from the standard level; at the 2 kg level (left side; P = 0.869, and right side; P= 0.738), at the 4 kg level (left side; P = 0.856, and right side; P = 0.763), and at the 6 kg level (left side; P = 0.059, and right side; P = 0.059). The testing shows that it can be used safely with elderly adults, thus enabling them to have better health and quality of life.
Laliphat Manamanchaiyaporn , Xiuzhen Tang, Yuanyi Zheng, and Xiaohui Yan, "Molecular Transport of A Magnetic Nanoparticle Swarm towards Thrombolytic Therapy", VOL. 6, NO. 3, JULY 2021, p.5605-5612.
Due to miniature size, controllability, navigation and versatile capability, micro/ nanorobots is appealing for minimally invasive procedures. In particular, blood clot as an unwanted biological object in vessel leads to severe diseases. Herein, we report a magnetite nanoparticle swarm (Fe3O4) that is capable of inducing hydrodynamic effect to capture tissue plasminogen activator (t-PA) in emergent vortices under the dynamic magnetic field. Once the swarm move to approach a site of a blood clot, the caged t-PA molecules are transported together with it across the interface for thrombolysis. In addition, the dynamic motion of each individual spinning nanorobot can assist the clot removal by exerting mechanical force to rub against the softened clot with loose fibrin fibers that is incompletely dissolved by chemical lysis of t-PA. Feasibility and performance of the swarm towards thrombolytic therapy are approved by in vitro experiments. The result reports that blood clot with 3-mm-diameter and 9-mm-length is completely removed in two hours, faster than the clinical procedure applying t-PAalone about 3 times. The contribution is extensible to apply for medical treatments ranged from simple tasks (e.g. detoxification) to complex tasks (e.g. tumor destroy).
K. Ngamdencharoensri, P. Kooncumchoo, B. Rungroungdouyboon, "The design of functional mechanical hand device for spasticity hand functions", Vol.9 No.1, p. 1-10
Stroke patients usually have disability on body opposite to damaged brain side. Recovery of upper limb is more difficult than lower limb. In addition, the distal parts of limbs are less recoverable and slower than the proximal parts. Moreover, in some cases, no longer recover any hand functions. They are not weakness only, but there are also spasticity that limit hand functions training after stroke. In moderate to severe spasticity, patients cannot open hand by self. So, the functional mechanical hand device is invented for assisting open spasticity hand, allowing patients to practice their hands by themselves every day. The main components of this prototype are springs separating of individual finger. The spring force acts finger extension. Individual finger spring has a unique force like the natural force proportion of any finger. That reason for each finger moves close to the natural fine movement independently while using the device. Also, the wrist of device is in suitable position for using hand. The simulation results of this prototype show that there is strength and safety in use. Especially, it is suitable for this patient type. The biomechanical test results in the healthy subject show that range of motion (ROM) of fingers are in the desired motion range. It is suitable to each task gestures of the finger.
Puagprakong P., Earde P., Kooncumchoo P.,"Lumbo-Pelvic-Hip Angle Changes During Upright and Free Style Sitting in Office Workers with Lower Crossed Syndrome.", Apr. 2021, p. 532-538.
Lower crossed syndrome (LCS) is an imbalance of muscles in the lower body segment. Muscle imbalance with prolonged sitting may increase the risk of low back pain. The objective of this study was to study the lumbo-pelvic-hip angle in upright and freestyle sitting in healthy and LCS individuals. Thirty office workers (normal = 10, LCS type A = 10, and LCS type B = 10) who worked 6–8 h./d in a sitting posture were recruited. Lumbo-pelvic-hip angle was recorded while participants typed a text for 30 min in upright and freestyle sitting. Two-ways mixed model ANOVA and post-hoc Turkey test were used to analyze data. Decreased lumbar lordosis was found among the three groups. However the LCS type A group maintained their lumbar lordosis and anterior pelvic tilt, while lumbar kyphosis and posterior pelvic tilt were found in LCS type B in both sittings.
Mamom, J., Rungreungduayboon,B, "A Multidisciplinary Integrative Innovative Mattress Design to Prevent Pressure Injury for Palliative Care in the Community in Thailand", Vol. 48(4), Apr 2021, P 76-81.
A pressure injury is a severe complication that causes excessive interface pressure on a bony prominence and usually occurs in palliative patients in the community. The article describes a new healthcare innovation, A lateral tilting mattress (LTM), based on the pressure injury pathophysiology principle. This modern nursing innovation, created by a multidisciplinary team that could adjust a patient's head and knee and rotate to the left and right, may decrease interface pressure over bony prominences in palliative patients. This experimental research design of 70 palliative home-based patients examined the effectiveness of LTM on pressure injury healing scores and family caregiver's quality of life levels over time from September 2019 to May 2020. We examined differences in patients' pressure injury healing scores and family caregivers' quality of life levels between the different groups: LTM versus no-LTM. Significant time by group interactions was found on patients' pressure injury healing (F = 235.123, p <.01) and family caregivers' quality of life (p <.05) in the LTM versus no LTM group. The results provide evidence for the effectiveness of LTM in improving pressure injury healing scores that may decrease interface pressure over bony prominences in palliative patients and the overall quality of life levels in family caregivers. The findings also suggest the need for further healthcare innovation to improve the quality of care for palliative patients, increase the quality of life (or decrease stress level) among family caregivers, and reduce workloads and danger for caregivers.
Sairag Saadprai, Supachai Vorapojpisut, Chaipat Srikajohnlap, Bunyong Rungroungdouyboon, "Design and Development of a Low-Cost Force Plate with Software Application for Analyzing Balance and Coordination Training for the Elderly", April 2021, Volume 24 Number 2, p.52-66.
The physical fitness of the elderly is more likely to deteriorate by aging. Balance and coordination exercise are important to maintain the strength of the musculoskeletal system, joints, and bones as well as to reduce the risk of falling. This study presents the development of a low-cost force plate with software application (Stand Balance) for analyzing balance and coordination training for the elderly. The structure of the force plate consists of load cell circuits connected with Node32s board as part of a signal measurement that sends wireless data via Bluetooth to analyze with LabView. The software application records real-time and displays data such as the patient’s weight and training information that could be sent to the healthcare provider who can analyze the patient’s information. The software has been designed in 4 operating modes (Balance Screening, Exercise, Games, and CoP Modes). The purpose of this study was to test whether the Stand Balance could detect Center of Pressure (CoP) and Ground Reaction Forces (GRFs) and display the results regarding its accuracy and repeatability. This research found that the error of static weight measurement is 4.84%, which is assumed to be an acceptable measure of the GRFs (especially when the human body is contact to the developed force plate). Moreover, the absolute error of CoP-accuracy of (Top Middle, Top Right, Middle Left, Center, Middle Right, Bottom Left, Bottom Middle, and Bottom Right) study areas are 5.14, 4.08, 5.44, 5.02, 5.88, 7.25, 4.49, 5.28, and 6.47 mm, respectively and the error of CoP-repeatability of study areas are 0.82, 0.74, 1.21, 0.95, 1.34, 0.89, 0.74, 1.13, and 1.18%, respectively. The absolute errors of CoP-accuracy are very close to 0 mm and the error of CoP-repeatability are less than 1.5%, which show high accuracy and precision that adequate for Stand Balance to assess balance and train coordination. It could ensure that the Stand Balance could detect CoP and GRFs effectively and, therefore, can be used as a device for further clinical implementation with human.
Thai Journal of Physical Therapy
Pramodhyakul N, Luangpon N, Muengtaweepongsa S, Kaewsawang S, Kooncumchoo P., "Classification of walking ability in patients with stroke by walking distance from 6-minute walk test", 2020; 42(3) Sep-Dec: p.163-173.
ที่มาและความสำคัญ: ความสามารถการเดินโดยเฉพาะการเดินในชุมชนเป็นสิ่งสำคัญที่ส่งเสริมให้ผู้ป่วยโรคหลอดเลือดสมองมีส่วนร่วมทางสังคมเพิ่มมากขึ้น ดังนั้นการประเมินเพื่อบ่งชี้ระดับความสามารถการเดินสำหรับผู้ป่วยโรคหลอดเลือดสมองจึงเป็นสิ่งที่สำคัญ ซึ่งระยะทางการเดินที่ได้จากการประเมิน 6-minute walk test เป็นตัวแปรหนึ่งที่น่าสนใจสำหรับการแบ่งระดับความสามารถการเดินในผู้ป่วยโรคหลอดเลือดสมอง
วัตถุประสงค์: เพื่อหาค่าตัดแบ่งของ 6-minute walk test ที่เหมาะสมสำหรับจำแนกระดับความสามารถการเดินในผู้ป่วยโรคหลอดเลือดสมอง
วิธีการวิจัย: ผู้ป่วยโรคหลอดเลือดสมองระยะเรื้อรัง จำนวน 174 คน ได้รับการคัดเลือกเข้าสู่การศึกษา อาสาสมัครได้รับการประเมินความสามารถการเดินด้วยแบบประเมิน Functional walking category และ 6-minute walk test การศึกษานี้ใช้ สถิติ Receiver-operating characteristic (ROC) curve เพื่อหาค่าตัดแบ่งของ 6-minute walk test
ผลการวิจัย: ผลการศึกษาพบว่าค่าตัดแบ่งของระยะทางการเดินในกลุ่มผู้ป่วยโรคหลอดเลือดสมองที่มีความสามารถการเดินในชุมชนมีค่าเท่ากับ 193.50 เมตร (ค่าความไว = 70.00 % และ ค่าความจำเพาะ = 94.35 %)
สรุปผล: การศึกษานี้พบว่า ผู้ป่วยโรคหลอดเลือดสมองที่สามารถเดินได้อย่างน้อย 193.50 เมตร ใน 6 นาที จะมีความสามารถที่จะเดินในชุมชนได้
Science & Technology Asia
Aris Kanjanasilanont, Sirima Mongkolsomlit, Poramet Earde, Patcharee Kooncumchoo., "Differences in Grip Strength among Wheelchair Basketball Athletes: Variations by Hand Size and Handrim-Tire Diameter", Vol. 25 No.3 July - September 2020, Published 2020-11-03.
Wheelchair basketball is a popular sport for people with disabilities. Movement skills during competition require a suitable grip with the wheelchair wheels. An inappropriate handgrip may reduce performance. The objective of this study was to investigate the effect of 3 handrim-tire diameters on the handgrip strength in 3 hand sizes of wheelchair basketball athletes. Seventy-one wheelchair basketball athletes, 20-40 years old, with a Functions Determining Classification level of 1.0-4.5, and who have played wheelchair basketball for more than 1 year, were divided into 3 hand size groups; small (ฃ180 mm.), medium (190-200 mm.), and large (ณ230 mm.). Handgrip strength, local perceived discomfort, and comfort questionnaire for using hand tools were recorded for 3 handrim-tire diameters; 63 mm., 67 mm., and 71 mm. Descriptive data analysis and two-ways mixed-model ANOVA were used to analyze the data, including a posthoc analysis with Tukey's test. The highest grip strength for small, medium, and large hands was found for handrim sizes of 63, 67, and 71 mm., respectively. Grip strength for medium hand size was significantly higher when compared to small hand size in 3 handrim-tire diameters (p<0.01, p<0.001, p<0.001, respectively). Large hand size was significantly higher when compared to small hand size in handrim-tire 67 mm. (p<0.001) and 71 mm. (p<0.001). High discomfort was found for the following: small hand size with handrim-tire 67 and 71 mm., medium hand size with handrim-tire 63 mm., and large hand size with handrim-tire 63 and 67 mm. Handgrip strength and hand discomfort in each hand size were correlated to handrim-tire diameter.
Mamom, J. "Digital Technology: Innovation for Malnutrition Prevention among Bedridden Elderly Patients Receiving Home-Based Palliative Care.", Vol. 47(10), Oct, 2020, p165-169.
In this innovative development design study, we aimed at examining the effects of digital technology in its use as a mobile nutrition application on the nutritional status and calorie intake for 60 Thai bedridden elderly patients receiving home-based palliative care. The elderly bedridden patients were randomized into two groups, a control group receiving routine care and an experimental group using the anti-malnutrition application. The data from a personal information record, the assessment form for body mass index, calorie intake calculation form and the record form for blood albumin levels were analyzed using descriptive statistics and t-test. The results showed that the calorie intake, blood albumin levels, and body mass index of the experimental group were significantly higher than those of the control group (p <.05). The results suggest that this application could solve the malnutrition problem in elderly bedridden patients and significantly enhance their caregivers' satisfaction. This mobile application for appropriate nutrition and calorie intake calculations can be used as a significant practical, effective health-associated innovation that promotes patients' nutritional status. It facilitates the monitoring of patients' nutritional status. It also provides caregivers with the knowledge and understanding they need to improve the home-based palliative care of the elderly bedridden patients, especially in the health crisis of the COVID-19 era.
Vajira Medical Journal
Pansuksawat N, Earde PT, Kooncumchoo P, Rungroungdouyboon B, Pramodhyakul N., "Effects of I-Walk training on gait performances in patients with chronic stroke", Oct 2020; 64(4): p.243-254.
Objective: To determine the effects of I-Walk (Robotic-assisted gait device) training compared with over-ground walking training on motor impairments assessed by lower extremity scores, lower extremity angles during walking, and gait performances in patients with chronic stroke.
Methods: A single blinded randomized controlled trial was conducted. Twenty four chronic stroke patients were randomly assigned into two groups; experimental group (n=12) and control group (n=12). For gait performances, patients in an experimental group received I-Walk training, while those in a control group received over-ground walking training. The duration of training was 60 min per day, 3 days per week for 8 weeks. The outcome measures included motor impairments assessed by the Fugl-Meyer Assessment of Lower Extremity (FMA-LE) scores, lower extremity angles during walking (hips, knees, ankles), and gait performances (step length, cadence, walking speed, stride length, and step length symmetry ratio). All variables were measured before and after the training period.
Results: There was a statistically significant difference in motor impairments assessed by the FMA LE scores, lower extremity angles during walking on hips and knees, as well as gait performances, including step length, cadence, and walking speed, between the experimental and the control groups (p<0.05). In particular, the statistically significant changes were demonstrated in motor impairments assessed by the FMA-LE scores, lower extremity angles during walking on hips, knees, and ankles, as well as gait performances, including step length, cadence, walking speed, stride length, and step length symmetry ratio, before and after the I-Walk training in the experimental group (p<0.05).
Conclusions: The I-Walking training could yield a statistically significant improvement of motor impairments assessed by FMA-LE scores, lower extremity angles during walking, and gait performances in chronic stroke patients. Nonetheless, further studies are recommended to elucidate and ratify the effective outcomes in patients with other stages of stroke, different ranges of lower extremity, and various spatiotemporal parameters.