DTIC ADA286323: Rehabilitation R@D Progress Reports, 1992-1993. Volume 30-31

505 Pages·83 MB·English

by  Defense Technical Information Center

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Progress Reports
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Vol 30-31, December 1994
Veterans Health Administration
Rehabilitation Research and Development Service
TO THE READERSHIP
Traditionally, each issue of the Rehabilitation R&D Progress Reports
covers work accomplished during the year prior to its publication.
Therefore, Vol. 29, published in 1992, covered work done in 1991. Due to
reorganization and the installation of additional computerized equipment
for further refinement of the publication, there was no Progress Reports
published in 1993.
In order to keep our readers informed of progress being made in the
field of rehabilitation research and development, the current issue (Vol.
30-31) covers both 1992 and 1993.
The next issue (Vol. 32) will be published in 1995 and will cover
reports of work accomplished in 1994.
Thank you for your patience. We regret the delay, and any
inconvenience it may have caused, and we look forward to receiving your
input for the 1994 issue.
PUBLIC A TIONS MANAGEMENT
ON THE COVER
This striking and imposing eagle guards the entrance to the Depart-
ment of Veterans Affairs, Rehabilitation Research and Development
Service in Baltimore, Maryland.
Historically, this magnificent federal building, which has been
declared a national historic monument, was dedicated in 1933 by order of
the then Secretary of the Treasury of the Federal Government in
Washington, DC. Geographically, it is located on South Gay Street just off
Pratt Street, the main thoroughfare of Baltimore's beautiful Inner Harbor.
In 1987, the Washington, VA Central Office, Rehabilitation Research
and Development Service expanded into the field to house the operations
of a number of its Service's functions: publications, evaluation of research
and development prototypes, evaluation of non-VA commercial devices
and wheelchair compliance testing, and the support group for peer review
of rehabilitation research and development proposals submitted for
funding support. (A detailed description of each of these Sections may be
found in Section II of this issue.) Progress reports of funded projects are
reported in this publication along with non-VA reports.
It is indeed an honor for the Rehabilitation Research and Develop-
ment Service, directed by John W. Goldschmidt, M.D., to be housed in
this historic building.
THE EDITOR
Cover design by Frank Vanni; photograph by Nick Lancaster,
Scientific and Technical Publications Section, Rehabilitation Research and
Development Service, Department of Veterans Affairs.
Department of
SZ>
Veterans Affairs
J3
Rehabilitation
R&D Progress Reports
1992-93
Rehabilitation R&D Progress Reports
is a publication of
The Department of Veterans Affairs
Veterans Health Services and Research Administration
VA Rehabiliation Research and Development Service
Scientific and Technical Publications Section (1 1 7A)
103 South Gay Street
Baltimore, MD 21202-4051
GUIDELINES FOR SUBMITTING PROGRESS REPORTS
FOR THE YEAR 1994 to be published in 1995.
PUBLICATION
The Rehabilitation R&D Progress Reports is published annually.
SUMMARY OF REQUIREMENTS
GENERAL INFORMATION
Each report must include the following information:
1. Full names, titles, and addresses of the principal investigator and co-authors and location of
the research activity, including zip or postal codes.
2. Telephone number of the principal investigator.
3. Full name and address of the sponsoring organization(s), as well as the specific funded
program. Include name of organization's director, if applicable (not necessary for VA
facilities).
4. Complete and accurate recent publications resulting from this research (i.e., exact title,
author(s), publication title, volume, issue number, date, and page numbers). Incomplete
citations will be deleted.
5. A list of key words.
6. A suggested category listing (based on categories included in this book).
TEXT
Text of reports may not exceed 600 words. The Progress Reports are published solely as statements of
investigators on the current status of their work, and not as short research papers. Reports must be
typed, double-spaced format, with clearly marked page numbers. Two hard copies are required. A
copy of the same material on diskette (nonreturnable) must be included. We use files saved in pure
ASCII format under MS-DOS, either 5 1/4-inch or 3 1/2-inch diskettes.
1. ORGANIZATION: The text should contain a brief summary of the Purpose, Methodology,
Progress, Results (Preliminary or Final) over the past year, and may contain a brief statement
of Future Plans/Implications, if appropriate. Recent Publications Resulting from This
Research may include citations from the previous year only (i.e., 1994), and must be published
or accepted for publication. Information on Patents and Awards may also be included.
Because of space limitations we will print only up to a total of 6 citations for any one Progress
Report.
2. ILLUSTRATIONS: Do not include figures, tables or photographs.
3. EDITORIAL CHANGES: Since galley proofs are not sent on Progress Reports submissions,
any editorial changes made to meet publication requirements will be final, and not subject to
author review.
CORRESPONDENCE
Non-VA Investigators Address mail to:
Managing Editor
Rehabilitation R&D Progress Reports, 1995
Scientific and Technical Publications Section (117A)
VA Rehabilitation Research and Development Service
103 South Gay Street
Baltimore, MD 21202-4051 USA
VA Investigators Address mail to:
Program Analysis and Review Section (117A)
Rehabilitation R&D Progress Reports, Issue, 1995
Project Monitor (PA, SCI, Sensory, Geriatric [as appropriate])
VA Rehabilitation Research and Development Service
103 South Gay Street
Baltimore, MD 21202-4051 USA
CONTACTS
FTS 8(700)922-1800, FAX [phone], Commercial [phone]
Department of
Veterans Affairs
ra
Rehabilitation
R&D Progress Reports
1992-93
John W. Goldschmidt, M.D.
Director, Rehabilitation Research and Development Service
Veterans Health Administration
Department of Veterans Affairs
Tamara T. Sowell, Editor
Neil McAleer, Co-Editor
SCIENTIFIC AND TECHNICAL
PUBLICATIONS SECTION MANAGEMENT
Jon S. Peters, Acting Program Manager
Renee Bulluck, Secretary
Marcia Nealey, Program Clerk
PRODUCTION STAFF
Neil McAleer, Managing Editor
Barbara G. Sambol, Senior Technical Publications Editor
Donald L. Martin, Technical Publications Editor
June R. Terry, Program Assistant
Celeste Anderson, Secretary
INFORMATION RESOURCE UNIT
Frank L. Vanni, Visual Information Specialist
Nick Lancaster, Scientific and Technical Photographer
The opinions expressed in contributed material are those of the authors and those responsible for supplying the
material, and are not necessarily those of the Department of Veterans Affairs.
Contents of Rehabilitation R&D Progress Reports are within the public domain, with the exception of material
which was already under copyright when received and appears here with the permission of the copyright owner.
Such copyrighted material is clearly identified as such on the page where it appears, and all such material in an
issue is listed at or near this position in that issue.
Copyrighted material in this issue: NONE.
DISTRIBUTION/CIRCULATION POLICY
Rehabilitation R&D Progress Reports is distributed annually. The mailing list is intended to cover all professionals
in the rehabilitation field who are either actively involved in research, contemplate such involvement, or need to
remain familiar with the direction and methods of the current research and the clinical application of its results.
At present, the Rehabilitation R&D Progress Reports annual publication is distributed free of chartje, both in the
United States and in foreign countries. Additions will be made to the mailing list upon request.
iii
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Clinical Publications:
1984)
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Clinical Supplement No. 2 (Choosing A
. Vol. 24 1987)**Microstomia, Hip Replacement
No. 3
Wheelchair System)
. Annual
Supplie ment (PR 1988)
Clinical Guide (Physical Fitness/Lower Limb
. Vol. 26
No. 2 1989)
. Vol. 26 Loss)
No. 3 1989)
. Annual Supplement (PR 1989)
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No. 1 1990)
. Vol. 27
1990)
No. 2
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No. 3
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No. 4 1990)
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No. 3 1991)
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No. 4
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No. 1
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No. 2 1992)
. Vol. 29 1992)
No. 3
. Vol. 29 1992)
No. 4
. Vol. 29 Annua
Supplement (PR 1991)
. Vol. 30 1993)
No. 1
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No. 3 1993)
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No. 1
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No. 2
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No. 3
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Rehabilitation R&D Progress Reports 1992-93
Contents
Section I. PROJECT PROGRESS REPORTS
Progress reports are arranged in appropriate subject categories. Reports
are numbered in brackets preceding the title. VA-sponsored reports are
presented first and are followed by those of other sponsoring
organizations in alphabetical order. (See next page for a topical listing
with project numbers.)
454 Section II. SPONSOR INDEX WITH SELECTED PROGRAM SUMMARIES
A. Department of Veterans Affairs
B. Non-VA Sponsoring Organizations
This section contains the name and location of all sponsoring
organizations and an index of the titles and page numbers of the projects
sponsored by each.
Section III.
AUTHOR INDEX
476
The names of all progress report investigators and directors of
sponsoring orgnizations are listed with corresponding page numbers.
487 JRRD On-Line Information on accessing Progress Reports and JRRD electronically.
Section I
Project Progress Reports
Computerized Methods in Prosthetics and Orthotics
22
/. Amputations and Limb Prostheses
Functional Biomechanical Characterization and
23
Functional Design Specification: Lower-Extremity
A. General
Prosthetics
1 Additive Fabrication Technique for the CAM of
Dynamic Response Prosthetic Feet and Their Role in
24
Prosthetic Sockets
Human Ambulation
2 Prosthetic/Orthotic Materials
25
Dundee Limb Fitting Centre Lower Limb Amputee
3 Resource Unit for Information and Education
Survey
4 Short Range Telemetry of Surface Myoelectric
Signals
C. Lower Limb
2. Above-Knee
B. Upper Limb
26 Computer-Aided Socket Design and Computer-
1. General
Aided Manufacturing for Above-Knee Prosthetics
5 New Control Applications for Upper-Limb
27 Femoral Displacement in Above-Knee Sockets
Prostheses: Direct Muscle Attachment for
28 Modification of the Van Nes Prosthesis
Position-Servo Control
29 Pediatric Above-Knee Endoskeletal Running
6 Direct Muscle Attachment: Multifunctional Control
Prosthesis
of Hands and Arms
7 VV59 Prosthetic Hand Enhancements: Cosmetics,
Electronics, and New Larger Size
C. Lower Limb
8
Biomechanical Study to Improve Grip in Children's
3. Below Knee
Terminal Devices
30 Efficiency of Dynamic Elastic Response Feet
Prosthetic Arm Design and Simulation System:
31 Prosthetic Design for Dysvascular Below-Knee
PADSS Amputees
10
EPP-Type Position-Servo Control of Electric Elbows
32 Gait Initiation in Below-Knee Amputees: Analysis of
for Children Safe Function
II
Electromechanical Prosthetic Hands and Visual 33 New CAD/CAM Methods to Enhance Prosthesis
Feedback Design
Myoelectric Control Strategies 34 Practical Applications of New CAD and CAE
12
Improving Prosthetic Prehension Techniques to Socket Design
13
35 Comparison of CAD/CAM and Conventional
Techniques for the Fabrication of Trans-Tibial
B. Upper Limb
Sockets with Supracondylar Suspension
2. Above-Elbow
36 Comparison of Van Nes Rotationplasty and Syme's
14 Triphasic Patterns in Above-Elbow Amputees
Amputation
15 Liberty MyoSelector: An Adaptable Scheme to
Select Multiple Functions
16 New Boston Elbow: Increased Capabilities
17 MyoArray: A Diagnostic Tool to Test and Train
//. Biomechanics
Amputees to Use Myoelectric Prostheses
18 Development of a Prosthesis for Elbow
A. Bone and Joint Studies
Disarticulation Amputees
37 Maintenance and Adaptation of Bone Tissue: The
Importance of Mechanical Stimuli
B. Upper Limb
38 Determination of Bone and Joint Loads from Bone
3. Below Elbow
Density Distributions
19 EMG Pattern Recognition
39 Upright Posture: How Limb Biomechanics Limits
the Ability to Stand
40 Strength of Human Cortical Bone with Simulated
C. Lower Limb
Metastatic Lesions
1. General
20 Clinical and Laboratory Study of Amputation 41 Biomechanics of Cervical Diagnostic Maneuvers: A
Surgery and Rehabilitation Pilot Study
42 Optimum Implant Stiffness for Lumbar Fusion: A
21 Application of Ultrasound and Computer
Techniques to Lower Limb Prosthetic Socket Pilot Study
Design
Project Progress Reports
43 Correlation of Streaming Potentials with Stages of
///. Functional Assessment
Bone Repair/Remodeling
72 Effects of Sensory-Neural Deficits on Balance and
44 Study to Investigate the Benefits of Physiotherapy Posture in Individuals with Multiple Sclerosis:
and External Supports on the ACL Deficient Knee A Pilot Study
45 Skeletal Muscle Characteristics during Submaximal
73 Development of a Predictive Model of Driving
Activation
Performance in Stroke Patients
46 Skeletal Muscle Reaction to Growth and 74 Functional Analysis of Feeding and Interaction
Immobilization
Disorders with Young Children Who Are
47 Quantitative Functional Anatomy of the Upper Profoundly Disabled
Extremity
48 Kinematic and Dynamic Analysis of the Shoulder
Mechanism
IV. Functional Electrical Stimulation
B. Human Locomotion and Gait Training
A. General
49 Comparative Study of Stabilogram-Diffusion
75 Selective Neural-Muscular Stimulation Using
Analysis and Traditional Posturographic Analyses
Magnetic Fields and Implantable Coils
50 Bicycle Ergometry to Improve Ambulation in
76 Rehabilitation of the Colon after Spinal Cord
Hemiplegic Stroke Patients
Injury: A Pilot Study
51 Initiation of Human Walking
77 High Charge Density, Bipolar Electrodes for
52 Computational Posturography: In Numero
Chronic FNS
Experiments on Postural Control
78 Implantable Electrodes Using Iridium Oxide Film
53 Integration of Visual Input into the Aged Postural
Technology
Control System
79 Management of Central Ventilatory Insufficiency
54 Age-Related Changes to Open-Loop and Closed-
through Abdominal and Thoracic Stimulation: A
Loop Postural Control Mechanisms
Pilot Study
55 Effects of Visual Input on Open-Loop and Closed-
80 Electrical Activation of the Diaphragm for
Loop Postural Control Mechanisms
Ventilatory Assist
56 Random Walking during Quiet Standing
81 Evaluation and Optimization of FES Techniques for
57 Integrated Assessment of Factors Affecting
Exercise
Functional Capacity for Locomotion
58 Restoration of Gait for the Stroke Patient
B. Upper Limb Applications
59 Computer-Aided Movement Analysis in a
82 Functional Neuromuscular Systems for Upper
Rehabilitation Context
Extremity Control
60 Effects of Head Injury on Open-Loop and Closed-
Loop Postural Control Mechanisms
C. Lower Limb Applications
61 Feigning Postural Instability
83 FES-Aided Paraplegic Gait Using a Controlled-
62 Postural Control Adaptability during Prolonged
Brake Orthosis
Spaceflight
84 Development of an On-Line Correction Capability
63 Development of a Direct Ultrasound Ranging
for FNS Locomotion: Computer Simulation of
System for the Quantification of Ambulation
Paraplegic Gait through Multiple Gait Cycles
64 Assessment of Variability in Human Walking
85 Development of an On-Line Correction Capability
65 Hard-Wired Central Pattern Generators for
for FNS Locomotion: Mathematical Models for
Quadrupedal Locomotion
Muscle Control
66 Effects of Noise on a Locomotor Central Pattern
86 Development of an On-Line Correction Capability
Generator Model
for FNS Locomotion: A Fuzzy Logic Rule Base
67 Group-Theoretic Approach to Rings of Coupled
for Gait Phase Detection and Correction
Biological Oscillators
87 Development of an On-Line Correction Capability
68 Coordination of Muscles in Gait
for FNS Locomotion: State Estimation of
Electrically Stimulated Muscle Using the EMG
C. Other
Surface Response
69 Effects of Head Positioning on Pressure Generation
88 Restoration of Standing Pivot Transfer for
in the Pharynx during Normal Swallowing: A
Quadriplegic Patients Using a Totally Implanted
Pilot Study
FNS System
70 Development of a Low-Dimensional Representation
89 Functional Paraplegic Walking with Electrical
of Lifting Dynamics: A Pilot Study
Stimulation
71 Contralateral vs. Ipsilateral Cane Use
90 Restoration of Muscle Activity Through FES and
Associated Technology: The Raft Project, A
Concerted Action
Rehabilitation R&D Progress Reports 1992-93
119 Attention in Early Dementia
91 Biomechanical Analysis of Paraplegic Walking with
Orthoses and FES 120 Later Life Effects of Early Life Disability:
92 Estimation of Electrical Stimulus: Torque Comparisons of Age-Matched Controls on
Relationship in Quadriceps Muscle for FES Indicators of Physical, Psychological, and Social
Application on Paraplegic Patients Status
93 Novel FES System Improving Locomotion Abilities 121 Evaluation of Adaptive Device Use by Older Adults
in SCI Subjects by Enhanced Voluntary Control with Mixed Disabilities
Based on Sensory Integration and Extended 122 Use of Technology to Promote Rehabilitation of
Sensory Perception
Older Persons: Reducing the Barriers to
Independence
123 Role of Training to Enhance Utilization of In-Home
Support: A Comparison Between Older Hispanics
V. Geriatrics
and Anglos With A Disability
94 Optokinetic Testing for Diagnosis and Rehabilitation
124 Policy and Funding Alternatives to Promote
of Balance Disorders
Community and Supportive Services for Older
95 Upper Body Motion Analysis for Amelioration of
Persons with a Disability
Falls in the Elderly
125 Analysis of Policy Barriers to Accessing Technology
96 Influences on Long Bones: Development, Growth,
Services for Individuals Aging with a Disability
and Aging
126 Analysis of Policy Barriers to Accessing Technology
97 Effects of Expectation, Reward, and Activity on
Services for Individuals Aging with a Spinal Cord
Subtypes of Schizophrenia
Injury
98 Age-Related Changes in the Triceps Surae Stretch
127 Polio Disability: Personal Meaning, Well-Being, and
Reflex and Postural Control
Age
99 Knowledge-Based System for Selecting Elopement
128 Discussing CPR/DNR Choices with Geriatric
Control Devices
Inpatients: The Psychological Impact on the
100 Environmental and Behavioral Factors in Falls
Patient
among the Elderly
129 Caregiver Health
101 Evaluation of Interventions to Prevent Elopement
130 Psychosocial Factors and Health in the Elderly
among Nursing Home Patients
102 Design of New Toilet Prototypes for Elderly and
Disabled Veterans
103 Applicability of Accessibility Codes to Meet the
VI. Head Trauma and Stroke
Needs of Elderly People 131 Computer-Assisted Treatment of Hemi-lnattention
104 Balance Training in Elderly Fallers and Nonfallers
in R-CVA Patients
105 Effects of Strength Changes for Older Adults 132 Neuroactivation SPECT Imaging for Assessment of
106 Restraint of Ambulatory Nursing Home Residents Rehabilitation Potential Following Cerebral
Infarction
with Cognitive Impairments
107 Effects of Age and Resistance Training on Skeletal 133 Integrating Trauma and Rehabilitation (ITR)
Muscle 134 Orthokinetic Orthosis: Systematic Replication of a
108 Quantitative Posturography: Age-Related Changes in Clinical Efficacy Study of Orthokinetics
Treatment for a Patient with Upper Extremity
Postural Stability
109 Effect of Chair Design on Chair Rise Performance Hemiparetic Movement Dysfunction in Post-Acute
CVA
in Disabled Old Adults
135 Musical Attention Training Program
110 Effects of Muscle Strength on Balance during
Movement in the Elderly 136 Reducing Motor Disability in Hemiparetic Stroke by
111 Do Changes in Strength Improve Balance and Manipulation of Sensory Input from the Paretic
Function in Elderly Men and Women? Upper Limb: A Quantitative Evaluation
112 Synchronized Electrical Stimulation Therapy in 137 Predictive Value of Cognitive/Behavioral Measures
Elderly Incontinent Men: A Pilot Study in Patients after Stroke in Assessing Functional
113 Manipulating Joint Compliances and Outcome
138 Improving Vocational Outcomes of Individuals Who
Ground-Reaction Forces to Predict Falling
Potential: A Pilot Study Have Sustained a Stroke
114 Behavioral Treatment of Urinary Incontinence 139 Effectiveness of a Telephone Support Group for
115 Effects of Aging on the Bone Tissue of the Femoral Stroke Caregivers
Neck on Men and Women 140 Effects of Aerobic Exercise on Young Persons Post-
116 Swallowing Dysfunction in Elderly Head and Neck Stroke
141 Controlled Study of the Effects of EMG Feedback
Cancer Patients
and Electrical Stimulation on Motor Recovery in
117 Swallowing Physiology Related to Normal Aging
118 Age-Related Changes in Sensory-Motor Performance Acute Stroke Patients