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Fulltext The Conceptual Development of a Multifunctional Stepladder for Older People and Caregivers

Gan KW, Ng PK, Liew KW, Ng YJ, Yeow JA

Int J Environ Res Public Health, 2022 Nov 03;19(21).
PMID: 36361278 DOI: 10.3390/ijerph192114399

Stepladders are compact, foldable ladders with flat steps and a platform. Despite all the research and design efforts, there are still limitations in terms of the multifunctionality, usability and simplicity of stepladders and related variants. By combining ideas, features and functions from patent literature, existing products and scientific journals, this study aims to conceptualise a multifunctional stepladder for improved usability. Five concepts are created, which are screened and evaluated against a set of criteria to select the best concept for improved usability, divided into three categories: simplicity, effectiveness and efficiency. The result is a versatile invention that functions as a stepladder, walker, wheelchair and Pilates chair, suitable for older people and caregivers in nursing homes. It allows medical records or supplies to be retrieved from high places without the need for inappropriate aids. The invention can replace wheelchairs and walkers and converts into a Pilates chair to provide a mobile exercise option for older people. The concept offers older people flexibility and independence in terms of mobility and healthcare, while saving space in the nursing home. Further design studies, prototyping and testing are needed before this idea can go into production.

Matched MeSH terms: Walkers
Automatic liver tumor segmentation on computed tomography for patient treatment planning and monitoring

Moghbel M, Mashohor S, Mahmud R, Saripan MI

EXCLI J, 2016;15:406-23.
PMID: 27540353 DOI: 10.17179/excli2016-402

Segmentation of liver tumors from Computed Tomography (CT) and tumor burden analysis play an important role in the choice of therapeutic strategies for liver diseases and treatment monitoring. In this paper, a new segmentation method for liver tumors from contrast-enhanced CT imaging is proposed. As manual segmentation of tumors for liver treatment planning is both labor intensive and time-consuming, a highly accurate automatic tumor segmentation is desired. The proposed framework is fully automatic requiring no user interaction. The proposed segmentation evaluated on real-world clinical data from patients is based on a hybrid method integrating cuckoo optimization and fuzzy c-means algorithm with random walkers algorithm. The accuracy of the proposed method was validated using a clinical liver dataset containing one of the highest numbers of tumors utilized for liver tumor segmentation containing 127 tumors in total with further validation of the results by a consultant radiologist. The proposed method was able to achieve one of the highest accuracies reported in the literature for liver tumor segmentation compared to other segmentation methods with a mean overlap error of 22.78 % and dice similarity coefficient of 0.75 in 3Dircadb dataset and a mean overlap error of 15.61 % and dice similarity coefficient of 0.81 in MIDAS dataset. The proposed method was able to outperform most other tumor segmentation methods reported in the literature while representing an overlap error improvement of 6 % compared to one of the best performing automatic methods in the literature. The proposed framework was able to provide consistently accurate results considering the number of tumors and the variations in tumor contrast enhancements and tumor appearances while the tumor burden was estimated with a mean error of 0.84 % in 3Dircadb dataset.

Matched MeSH terms: Walkers
Fulltext Increased Lower Limb Loading During Sit-to-Stand is Important for the Potential for Walking Progression in Ambulatory Individuals with Spinal Cord Injury

Khuna L, Mato L, Amatachaya P, Thaweewannakij T, Amatachaya S

Malays J Med Sci, 2019 Jan;26(1):99-106.
PMID: 30914897 DOI: 10.21315/mjms2019.26.1.9

Background: Decreased rehabilitation time may increase the need for walking devices at the time of discharge to promote levels of independence among ambulatory individuals with spinal cord injury (SCI). However, using walking devices could create adverse effects on patients. This study explores the proportion of walking devices used, potential for walking progression, and associated factors among ambulatory individuals with SCI.
Methods: Fifty-seven participants were assessed for their demographics and functional ability relating to the requirement for walking devices, including the Timed Up and Go Test (TUGT) and lower limb loading during sit-to-stand (LLL-STS).
Results: Thirty-five participants (61%) used a walking device, particularly a standard walker, for daily walking. More than half of them (n = 23, 66%) had potential of walking progression (i.e., safely walk with a less-support device than the usual one). The ability of walking progression was significantly associated with a mild severity of injury, increased lower-limb muscle strength, decreased time to complete the TUGT, and, in particular, increased LLL-STS.
Conclusion: A large proportion of ambulatory individuals with SCI have the potential for walking progression, which may increase their level of independence and minimise the appearance of disability. Strategies to promote LLL-STS are important for this progression.

Matched MeSH terms: Walkers

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