bluuebunny/crossref_metadata_2025 huggingface dataset:
Accessible Game Console Interface for Upper Limbs and Mild Cognitive Impaired People
Authors: Fanucci L.  , Iacopetti F.  , Roncella R.  , Giusti D.  , Scebba A.
Published: February 2025

In this paper a hardware interface device allowing people with upper limbs disabilities and mild cognitive disabilities to play with videogame consoles is presented. Modern console controllers are provided with several, small sized pushbuttons and joysticks often to be operated at the same time; playing turns out to be very difficult or impossible for people with upper limb disabilities and mild cognitive disabilities. Especially in the world of children and teenagers, the impossibility to experience videogames may also represent another barrier to social inclusion. Some existing do-it-yourself solutions for game accessibility are based on the adaptations of commercial controllers to special needs. With such solutions, the game control is totally left to the user with disabilities, who very often is still not able to control the game with his residual functionalities. Such solutions, being non-certified modifications of a commercial device, are not even marketable. The interface presented in this paper is a new device to be connected between the original controller and the console; and allowing the connection of the most suitable switch sensors for the specific disability. Thanks to this device the specific interfaces allow the control of the same functions of pushbuttons and/or joysticks of the original controller. The mapping of external sensors to the functions of the original controller may be carried out by means of a very easy procedure. The number of external switch sensors used may be decided on the basis of the user potential. The presented device allows the collaborative playing between one or more disabled persons and another player.
How Many Positive Results on Inclusion Do We Need to Make Changes?
Authors: Brodin Jane  , Renblad Karin
Published: February 2025

The expectations of Information and Communication Technologies (ICT) as a tool for participation and equal opportunities for all have been highly valued within the European community. For children and young persons with disabilities the expectations have been of special importance as they have found their opportunities for inclusion on the agenda. Inclusion is not only a placement. Inclusion means to be part of, to share, to communicate and to be someone to count with. However, inclusion is not a matter of self and the risk is that the already started backlash will continue if we do not react in a powerful way. The aim of this paper is to stress research on inclusion of children and young persons and highlight how ICT has been and still is used in the schools to enhance participation and equal opportunities for all. We talk about a school for all, a society for all and the slogan in 2000 is “Nothing about us without us”, i.e. a concept concerning empowerment. Our intention is to stress challenging research results, and we ask “how many positive results on inclusion do we need to make changes?”, and “where are the progressive decision-makers who will implement the research results?”
Knowledge Translation for Technology Transfer: Making R&D Matter to Stakeholders
Authors: Lane Joseph P.
Published: February 2025

The paper encompasses both Research and Development by addressing how the Knowledge Translation process works to convey discoveries from concept to application, along with how the Technology Transfer process facilitates the transition from application to marketplace. The thesis is that both processes need to be explicitly linked to ensure beneficial impacts for the stakeholders involved in transforming outputs into outcomes, and for the target beneficiary stakeholders who will experience the impact of innovative devices and services. The field of Assistive Technology (AT) continues efforts to move technology-related prototypes resulting from development in the academic sector, to product commercialization within the business sector. The article describes how technology transfer can be linked to knowledge translation. This linkage is designed to increase the relevance of technology-oriented knowledge from upstream academic research, through downstream industrial development and production, and out to persons with disabilities. The linkage also provides the government sector with opportunities to conduct evidence-based project tracking and program evaluation. The relevant models, methods and measures can be applied to other fields involving technology-based innovations.
Participation of Users with Disabilities in Standardization
Authors: Soede Mathijs  , Blijham Nienke  , Verdonschot Manon
Published: February 2025

This paper is about improving participation of people with disabilities in our society by means of indirect supportive measures, i.e. the inclusion of people with disabilities in standardization work, and especially training them for this job. As standardization is a way to influence the development of products and environments according to a best working and effective solution, the standardization itself is a design process. A part of the solution is to improve public procured products in a way that they are better for use by persons with disabilities (i.e. the aim of the Mandate 376 efforts at EU-level). Thus attention will be given to inclusion of end-users in general in design processes, and what this means for end-users with disabilities. The development of a special course for getting end-users with disabilities better educated and trained for this work is the main subject of this paper.
Design for All @ eInclusion: Best Practice in Education and Training
Authors: Keith Suzette  , Whitney Gill  , Wilson Judy
Published: February 2025

The Information Society is bringing about radical changes in the way we communicate and share information, and in the services that we use, for example: fixed and mobile systems, the internet, digital tv and the next generation of ambient intelligent systems. Digital inclusion policies are drawing attention to the ‘missing 30%’ who are currently excluded and the need to ensure the rights of all citizens to participate in and benefit from these new opportunities. This missing 30% embraces social, economic and political disadvantage as well as issues of ageing and disability. The established principles and practices of Design for All offers an opportunity to ensure that designers and developers working in ICT related fields are able to respond to the challenge of creating new systems, services and technologies that meet these broad demands of digital inclusion. As yet there are few teaching programmes within ICT related education that offer the core topics of Design for All in ICT, as either a named module or integrated within other modules. However, our recent survey was able to identify a number of instances of small elements, seminars and single modules. These examples have contributed to the development of curriculum guidelines which aim to stimulate the creation of new specialist programmes – both at Bachelor level and Masters level in order to encourage full integration within current mainstream ICT education and training.
Enhancing Accessibility in Mobile Navigational Services
Authors: Rassmus-Gröhn Kirsten  , Magnusson Charlotte
Published: February 2025

The success of the Wii and of the iPhone together with the persisting problem of displaying information on the small screens of mobile devices is currently pushing the development of non-visual interaction channels such as gestures, tactile/haptic interaction and sound. This development presents both potential and risk, since new channels of interaction may result either in improved or reduced accessibility.
Hazard Mitigation, Planning, and Disaster Resiliency: Challenges and Strategic Choices for the 21
Authors: Berke Philip  , Smith Gavin
Published: February 2025

Knowledge about the causes and consequences of hazards is increasing, but losses continue to rise dramatically. We examine the major benefits of land use planning when applied to hazard mitigation, and then discuss why vulnerable communities fail to enact effective planning programs to prevent hazard-induced losses. We then present five sets of choices that communities can make to advance planning for mitigation with the ultimate goal of disaster resiliency.
The Challenges of Planning for Post-Disaster Recovery
Authors: Olshansky Robert B.
Published: February 2025

Recovery is a long-term decision process in the face of rapid change, involving many individual actors and organizations making decisions about rebuilding, planning, and financing. Communities must make rapid decisions about physical reconstruction and economic development, while at the same time making critical decisions regarding management and financing, all under great time pressure. It is tempting to think of a disaster-affected community as a “blank slate” upon which a new, improved, disaster-resistant community can arise, under the guidance of rational planning. In fact, actual post-disaster situations are much more complex, and, although some forces facilitate the opportunity for positive change, there are at least an equal number of countervailing forces resisting such change. Significant change is difficult to achieve, because the political and administrative environments resist it, and because the historic evolution of the city reflects the deep-seated desires of its inhabitants. Still, physical changes do occur—usually in limited parts of a city—and they sometimes are able to bring about social and economic improvements. The challenge for planners is to learn how to maximize the limited opportunity for positive post-disaster change. This paper briefly summarizes some of the complexities of the post-disaster decision environment and suggests some ways to maximize positive change following disasters.
French Multiple Risk and Disaster Integral Management System within the European Union
Authors: Mancebo François
Published: February 2025

The French risk management system gives equal importance on the front end (pre-disaster) and on the back end (post-disaster). It is based on the idea that effectiveness, needs appraisal of social, economic, and environment risk acceptability. If a disaster is neither natural nor industrial from this point of view; it always is a human disaster insofar as it results from some amount of deliberate risk exposure. Therefore risk management is more a political than a technical issue, which means that citizen participation, NGOs and private initiatives are crucial to formulate risk and disaster policies.
Precaution and Science-Based Environmental Risk Management: Complementary not Contradictory
Authors: Bourg Dominique  , Whiteside Kerry H.
Published: February 2025

The precautionary principle can require regulatory action in cases of potential environmental damage, even before conclusive scientific proof of harm has become available. Critics charge that this inherently puts the principle at odds with rational risk management, which should be based on sound science and cost-benefit analysis. This chapter clarifies the significance of the precautionary principle by answering a variety of criticisms. The precautionary principle is not anti-science; it calls for more and wider scientific investigation of poorly understood environmental phenomena. It does not oppose hazard assessments done by experts, but it does make experts answerable to a broader public. Yet the deliberative turn in implementing the precautionary principle does not expose it to charges of populism. By using standards such as proportionality and revisability, the precautionary principle promotes reasoned policy-making in cases where risks are insufficiently understood. Finally, precaution is not to be equated with prohibition. Precautionary measures include anticipatory actions such as intensified monitoring, increased safety margins, systematic labeling, and spatial planning that creates protected zones for certain activities. The complexity of precautionary action is a reflection of the complexity of our societies and of the links they create with nature.
Progress in Movement Pattern Analysis
Authors: Laube Patrick
Published: February 2025

This chapter reports on progress made in the development of techniques and tools to formalize, describe, detect and understand movement patterns in spatiotemporal data. The chapter is presented as a critical review of the relevant literature in the fields of geographical information science, data mining and knowledge discovery, and computational geometry. After discussing the nature of movement patterns, several conceptual space models accommodating movement are discussed as a preliminary for the formation of movement patterns. Then typical types of movement patterns and their signature applications are portrayed. The chapter concludes with a series of limitations to movement pattern analysis, an outlook, and a research agenda for future work.
Caring of Old People: Features of Cognitive Technologies Development
Authors: Cesta Amedeo  , Cortellessa Gabriella  , Tiberio Lorenza
Published: February 2025

Aging has a negative effects on cognitive abilities and can often make independent living difficult. It has been shown that cognitive training programs can significantly mitigate the effects of age-related cognitive decline. Cognitive Technologies that incorporate intelligent techniques can synthesize now devices able to enhance memory functioning of older person through cognitive exercises based on neuropsychological aspects of cognitive aging. In designing new technology is very important to maintain a strict contact with the problems of the actual users. These paper presents a brief review of two research programs both concerning the synthesis of intelligent systems for old people and underscores aspect connected to evaluation criteria related to acceptability, usefulness and other cognitive features of such technology.
Robotic Furniture in a Smart Environment: The PEIS Table
Authors: Di Lello E.  , Loutfi A.  , Pecora F.  , Saffiotti A.
Published: February 2025

According to a recent trend, robotic technologies will be included into domestic environments in the form of simple, networked robotic devices able to cooperate in the performance of tasks. These devices may take the form of smart appliances, distributed sensors, or robotic furniture. In this paper, we describe the design of an autonomous robotic table and its inclusion in a smart environment, the PEIS Ecology. The design takes into account the constraints posed by the domestic environment. The robotic table can perform autonomous point-to-point navigation, and it can collaborate with the other devices in the ecology to perform complex tasks that go beyond simple navigation.
Context-Aware Sensing In Pervasive Computing Environment: Based HMDC with MAS
Authors: Alhaj Salahideen M.  , Alnaqeep Linda R.
Published: February 2025

In recent years, there have been considerable interests in Context-Aware (CA) sensing for pervasive computing (PvC). Where, the representation and sensing of context is an important but challenging area of research for location-aware mobile applications. On the other hand, Pervasive Computing has two core properties, namely context awareness and ad hoc communication. The context-aware property enables an application to acquire and reason about environmental attributes known as contexts. Based on the contextual information, the application can react impromptu to changes in the environment. The ad hoc communication property facilitates mobile interactions among components of the application with respect to the changing contexts. This paper, proposes a middleware for context-aware sensing actuation augmented in pervasive environment based hybrid-model for distributed caching (HMDC), with multi-agent service (MAS), such that, the bottleneck at the service provider can be alleviated and the response time for service requests can be decreased.
Workspace Awareness without Overload: Contextual Filtering of Social Interactions
Authors: Joly Adrien
Published: February 2025

At a time when social media revolutionize the exchange of information between users of the Web 2.0, many enterprises are still applying older collaboration paradigms. Following the explosion of blogs and social sharing services on the Internet, some companies are beginning to catch up with these trends, but not all employees are familiar with these new practices which require manual contribution, even though they became usual for Web 2.0 users. Inspired from previous works and currents trends in Social Networking and Context-Awareness, we propose the iterative development of an experimental framework for contextual sharing and filtering of social updates. The intension is to trigger more opportunities for communication in a collaborative environment, while preventing information overload. In this paper, we present some preliminary results on synthetizing contextual clouds reflecting current working activity of users, based on the extraction of descriptive tags from web documents that they are currently accessing.
Notes on Smart Workplaces
Authors: Mikulecký Peter
Published: February 2025

Ubiquitous computing applications and technologies, intensively studied in the area of ambient intelligence, are more and more matured to be able of creating an environment that can be intelligently helpful to users surrounded by such an environment. Besides other recent applications we may consider them also as being very suitable technology for intelligent workplaces development. In the paper some discussion about basic features of such intelligent workplaces for managers is presented, and a couple of remarks related to possible problems that could arise in these ubiquitous intelligent spaces are presented as well.
Adapting Information Displays Contents in Smart Spaces according User Emotions and Personality
Authors: Vinagre Eugénia  , Marreiros Goreti  , Ramos Carlos  , Figueiredo Lino
Published: February 2025

Ambient intelligence environments (AmI) are usually characterized as physical environments, dotted with several devices (sensors, actuators, controllers, etc.) and adaptive systems. These environments are able to adapt to human being in order to give them a more efficient support. For that, those environments should be able not only to forecast user needs, but also user behaviour. Research in Psychological area suggests that human behaviour is strongly influenced by the emotional factor and personality. In this paper we propose a model and a prototype to adapting information displays contents in smart spaces according to user emotions and personality.
Exercise in the Smart Workplace
Authors: O'Grady M.J.  , Wan Jie  , Tynan R.  , O'Hare G.M.P.  , Muldoon C.
Published: February 2025

Employees that engage in even moderate amounts of exercise during their working day suffer less from stress and are more tolerant in the various irritations that accompany normal working life. Though it cannot be said with certainty that such workers are more productive, tentative evidence suggest that this may well be the case. A useful service of a smart office or work environment is to contribute to the health and well-being of those that inhabit such spaces. One practical approach to this is to monitor the exercise that employees engage in during the day, and using this as a basis, motivate them to engage in further physical activity. In this paper, issues relating to monitoring employee physical activity are explored.
Using RFID information in routing and sequencing warehouse operations
Authors: Ballestín Francisco  , Lino Pilar  , Pérez Ángeles  , Quintanilla Sacramento  , Valls Vicente
Published: February 2025

Warehouses are essential components of logistics and supply chains. The performance of warehouse operations significantly affects the efficiency of the whole chain it belongs to. Radio frequency identification (RFID) is an emerging technology capable of providing real-time information about the location and properties of tagged object(s), such as people, equipment or products. The main objective of this article is to provide some insights into the practical benefits that can be drawn from the RFID technology in the context of warehouse operations management. To this end, we have developed a set of heuristic routing and sequencing procedures that take, and, alternatively, do not take into account, real time RFID information and compared their performance via simulation on a set of randomly generated although realistic warehouse scenarios.
The Cutting Edge of Cyber Network Development – A Paradigm to Translate and Predict the Network Strategies of Avant-garde Cyber Criminals
Authors: Agazzi Maurizio
Published: February 2025

Human beings are experiencing new paradigms, such as collective intelligence, that contribute to levels of knowledge enhancement and information sharing unimaginable prior to the existence of the Internet. Nevertheless, these new paradigms are equally interesting for cyber-terrorist groups and for organised crime. This work intends to analyse this new paradigm, which avant-garde cyber networks, since they gain vitality from the web's complexity, also happen to use to express their developing dimension. This work focuses on the characterising aspect of advanced cyber criminal networks: the fast and broad movements along temporary trajectories. Mutation is an implicit aspect of their development, given that the Internet itself is constantly changing, together with interconnections that are enriched by collective experience.
Crimen Ex Machina: A Legal Approach
Authors: Paparela Ivo
Published: February 2025

Appropriate laws and efficient judiciary and law enforcement agencies that are not corrupt, are the first line of defence against cyber aggression. Due to the border-less nature of the internet and activity on the internet, it is also clear that criminal laissez faire (in other words, a “crime friendly” legal system) in one country jeopardises anti-crime efforts in many others. An efficient legal system is, in and of itself, a form of “antivirus” and adds value to all of the existing technical anti-virus solutions; it is also the only anti-virus that criminals and terrorists alike are afraid of. But is the legislation of the NATO countries and other countries, particularly Eastern European Countries (hereinafter, EE), on cyber criminality, adequate and capable of supporting law enforcement agencies in their fight against cyber criminals?
A Fuzzy Approach to Security Codes: Cryptography Between Technological Evolution and Human Perception
Authors: Lisi Serena
Published: February 2025

Cryptography may be considered a science in fieri; it is constantly evolving and being updated, in order to adapt to today's fast-changing scenarios. This paper underlines the coexistence of two different approaches to the theory of codes and protection of confidential information; the first and largely diffused approach emphasises technology (i.e. a scientific approach) and the second emphasises human perception (i.e. a cultural, allegorical, non-conventional approach). The two different approaches are gradually merging together to create a new integrated and fuzzy approach, which resembles those theories of systems and political science developed by Burt Kosko during the late 1990s to present. In order to accept the aforementioned fuzzy approach, we need to accept a specific definition of the word cryptography, here intended as the theory and technique used to create secret codes, either in written form (encryption) or in visual form/jargon (steganography).
A Note on Public-key Cryptosystems and Their Underlying Mathematical Problems
Authors: Sgobbi Dario A.M.  , Morgari Guglielmo
Published: February 2025

While the classic symmetric encryption systems require a single key for both encryption and decryption, public-key systems are based on the existence of two distinct keys, one private and one public, and on the concept that, while the private key is never transmitted over any channel, and is therefore known only by its owner, the public key is made publicly known. Public-key systems are thus extremely useful in open network scenarios, where not all users are known in advance, or where it is simply impractical to establish a secure channel with any of them over which to exchange symmetric keys for the ensuing communications protection. Asymmetric systems are very interesting from a mathematical point of view, since they are based on one-way trapdoor functions, which are invertible functions that are “easy” to compute in one direction and “difficult” to compute in the opposite direction, with the additional condition of being “easy” to compute in that direction if additional information (the trap) is available.
Beyond Competing Identities and Ideologies: Building Resilience to Radicalization in a World in Transition
Authors: Mustakova-Possardt Elena
Published: February 2025

This author examines terrorism as a dysfunctional response of individuals from a communal and fundamentalist religious cultural background to the developmental crisis of the self in the context of the globalizing influences of an individualistic and highly secular Western culture. It offers a developmental framework for addressing these global tensions. The chapter suggests the need for a systemic approach to the cultivation of critical moral consciousness and the overcoming of ideologization, through opening a dialogue and collaboration among a wide range of cultural and religious groups in relieving the anxieties of the global transition, and articulating a coherent vision of social health, which integrates meaningfully collectivist values into democratic societies.
Religious metaphors in political discourse: Examples from the South African Truth and Reconciliation Commission
Authors: Kattermann Vera
Published: February 2025

The South African Truth and Reconciliation Commission have become famous for its innovative approach in dealing with past collective trauma. The article looks at the religious discourse used in the context of the public hearings. It can serve as an inspiring example for understanding the possible impact of religion in political processes. Strong points and drawbacks of the use of the reconciliation discourse during the work of the Truth and Reconciliation Commission are discussed and analyzed from a psychoanalytical point of view.
Radicalisation and deradicalisation: Dutch experiences
Authors: Jongman Albert
Published: February 2025

Since 9/11 the Netherlands has experienced a number of traumatic terrorist incidents that shocked and polarised society. The incidents triggered a wave of investigations and studies by journalists, academics, government, NGOs and think tanks, which has resulted in an extensive body of knowledge on radicalisation leading to terrorism. In 2003 the Dutch government reformed its counterterrorism structure, which resulted in the appointment of a National Coordinator for Counterterrorism tasked with the coordination of Dutch CT-policy. The Hofstad-group was a group emerging from the Moroccan community in the Netherlands and engaged in terrorist activities. Members were arrested and convicted to long prison sentences. While the current terrorist threat is still significant (one level below critical) the threat has gradually shifted from homegrown groups to the danger of groups that may come from abroad. Salafist jihadi groups use the video Fitna produced by MP Geert Wilders in their argumentation to justify attacks directed against Dutch interests. Partly as a result of an extensive awareness campaign the popular concern about terrorism has diminished and the feeling of security among the general public has improved. In general Dutch society remains peaceful with a far lower level of political violence than most other European countries. Over the last three years there have been no terrorist incidents with a Salafist jihadi background and in 2008 only four suspects were arrested.
Police and Muslim Communities in London: Countering Al-Qaida Influence and Islamophobia
Authors: Lambert Robert
Published: February 2025

The paper highlights the paradoxical position of certain Salafi and Islamist communities in London who have consistently demonstrated skill, courage and commitment in countering al-Qaida propaganda and recruitment activity while simultaneously facing ill-founded criticism from other Muslim communities and secular political lobbyists for creating the conditions that gave rise to the al-Qaida phenomena. In doing so the paper makes comparisons between Salafi and Islamist communities living in London during an ongoing terrorist campaign by al-Qaida and Jewish and Irish Catholic communities living in London during earlier terrorist campaigns against the UK's capital city. In each instance community policing is shown to have a crucial role to play in terms of reassurance for minority faith communities and the prevention of terrorism. However, the intersection between community policing and counter-terrorism is shown to produce tensions that may weaken minority community confidence in policing and thereby reduce pro-active community support for counter-terrorism measures. A London policing initiative is shown to have developed pro-active counter-terrorism partnerships with Salafi and Islamist community groups of a pioneering nature. In consequence that policing initiative has been accused of appeasing extremism by the same critics who conflate Salafis and Islamists with an urgent terrorist threat to London.
Stance-time asymmetry: comparison between C-leg users and able-body subjects
Authors: Raggi M.  , Cutti A.G.  , Lippi S.  , Davalli A.
Published: February 2025

The stance time symmetry has been assessed on a population of monolateral transfemoral amputees (all C-Leg users) and control subjects through baropodometric insoles. Subjects walked at three self-selected speeds on a daily-living environment for 80m. Results were compared by speed and population, showing both higher asymmetry and variability for the amputees. No relation was found between speed and symmetry.
Walking with above knee prosthesis
Authors: Erjavec T.  , Prešern M.  , Štrukel J.
Published: February 2025

The paper discusses metabolic and cardiovascular parameters during walking with above-knee prosthesis in patients after amputation due to vascular causes. According to the measured parameters, walking is ranged at the level of moderate physical activities. During walking, non-malignant arrhythmia, asymptomatic ECG criteria for coronary ischemia and especially highly increased blood pressure are frequently observed. Due to long periods of low physical activity before and after the surgery as well as comorbid heart diseases, the risk of proximate cardiac events during gait training and walking with above-knee prosthesis is high. Therefore, accurate evaluation of cardiovascular ability is necessary before prosthetic fitting. At the Institute for Rehabilitation, Republic of Slovenia (IRRS), submaximal stress testing on an. arm ergometer The difference between the calculated oxygen consumption during stress testing and during the 6-minute walk test is not statistically significant.
Security aspects of gait on stairs for transtibial amputees
Authors: Fradet L.  , Alimusaj M.  , Braatz F.  , Wolf S.I.
Published: February 2025

This study proposed to investigate security aspects of gait on stairs for transtibial amputees (TTAs) and proposed to assess the effects of a new adaptive prosthetic ankle on these specific aspects. 11 TTAs and 12 controls underwent a traditional 3D gait analysis on an instrumented staircase. TTAs walked with the prosthetic ankle set in: a) the adapted mode that provides dorsiflexion during stair walking; b) a neutral position. The position of the CoP and of the foot relative to the stairs, the toe-clearance, and the coefficients of friction were computed. During stair ascent, data imply an equivalent or safer gait strategy for TTAs than for controls, especially on the involved side. No modifications were noticed between adapted and neutral modes. During stair descent, TTAs placed their prosthetic foot closer to the stair edge. The coefficient of friction was also higher during loading response on TTAs' sound side compared to controls. Both phenomena were reduced in adapted mode. For TTAs, stair descent was then less safe than stair ascent but safety was improved when walking in adapted mode.
Prospective study on physical activity levels after spinal cord injury during inpatient rehabilitation and the year after discharge
Authors: van den Berg-Emons R.J.  , Bussmann J.B.  , Haisma J.A.  , Sluis T.A.  , van der Woude L.H.V.  , Bergen M.P.  , Stam H.J.
Published: February 2025

Purpose: To assess change over time in physical activity level (PAL) after spinal cord injury (SCI), to explore its determinants, and to compare PAL 1 year after discharge from the rehabilitation center with able-bodied level. Methods: PAL, as indicated by duration of dynamic activities per day and intensity of everyday activity, was measured in 40 persons with SCI with an accelerometry-based activity monitor during 2 consecutive weekdays. Measurements were obtained at start of active rehabilitation, 3 months later, at discharge, 2 months after discharge, and 1 year after discharge. Results: Random coefficient analyses demonstrated that duration of dynamic activities and intensity of everyday activity increased during inpatient rehabilitation at rates of 41% and 19%, respectively (P<.01). Shortly after discharge, there was a strong decline (33%; P<.001) in duration of dynamic activities. One year after discharge, this decline was restored to discharge level, but was low in comparison with able-bodied level. Level and completeness of lesion were determinants of change in PAL after discharge. Conclusion: PAL increased during inpatient rehabilitation, but this increase did not continue after discharge and level 1 year after discharge was distinctly lower than able-bodied level. Subpopulations had a different change over time in PAL after discharge.
Stride time fluctuations during the six minute walk test in COPD patients
Authors: Annegarn J.  , Spruit M.A.  , Savelberg H.H.C.M.  , Willems P.J.B.  , Wouters E.F.M.  , Schols A.M.W.J.  , Meijer K.
Published: February 2025

Introduction. Detrended fluctuation analyses (DFA) method provides insight in long-range correlations in gait by the scaling exponent α. Changes in α have been associated with central neurological diseases and gait unsteadiness in the elderly. It is not conclusively known if α can also reflect dysfunction of other physiological systems. We evaluated the fractal dynamics of gait in chronic obstructive pulmonary disease (COPD) patients; a population suffering from reduced muscle function and pulmonary dysfunction. Methods Healthy subjects (n=12) and COPD patients (n=15) walked continuously for six minutes as fast as possible. Stride intervals, derived with a tri-axial accelerometer, were processed with the DFA method to derive α. Results The COPD patients differed significantly (p<0.01) from healthy subjects in age (COPD 63.7 yrs±3.9; healthy 33.3 yrs±2.3), distance walked (COPD 499m±23; healthy 662m±27) stride intervals (COPD=1.08 sec.±0.08; healthy=0.95 sec.±0.08) and α (COPD 0.89±0.12; healthy 0.72±0.14). Conclusion In contrary to central neurological diseases, COPD patients show higher α compared to healthy subjects. This indicates that also muscle dysfunction or pulmonary dysfunction can influence α.
Muscle properties and functional recovery until one year after stroke
Authors: Horstman A.M.H.  , Gerrits H.L.  , Janssen T.W.J.  , de Haan A.
Published: February 2025

Purpose: to investigate functional performance in relation to muscle function during first year after stroke. Methods: Maximal voluntary isometric torques of knee extensors (MVTe) and flexors (MVTf) were obtained in 14 patients with subacute stroke (bilaterally) 3.5±2 months after stroke and 3 (n=8), 6 (n=5) and 12 months (n=3) thereafter and in 12 age-matched able-bodied subjects. Maximal triplet response (intrinsic muscle strength), maximal rate of torque development (MRTD) and degree of voluntary activation of knee extensors were estimated. Patients performed 7 tests of functional performance. Results: In the paretic lower limb (PL), all parameters significantly (0.494<|r|<0.909) improved during all follow-ups. In the non-paretic lower limb (NL) most improvement occurred within the first 3 months. For NL and PL, MVTe improved 5 and 16%, respectively MVTf 3 and 20%, triplet 0 and 13%, activation 8 and 9%, MRTD 16 and 61%. Significant correlations (0.460<|r|<0.906) were found between all tests of functional performance and all muscle parameters of PL and all parameters (0.454<|r|<0.873) but triplet and MRTD of NL. Conclusion: All strength parameters correlated significantly with functional performance. Therefore, it is recommended to investigate the role of strength training of both legs during at least the first year of stroke.
Energy expenditure of stroke patients during upright standing
Authors: ter Hoeve N.  , Nooijen C.F.J.  , Lamoth C.J.C.  , Rijntjes D.  , Tolsma M.  , Houdijk J.H.P.
Published: February 2025

Purpose: To study the energy expenditure needed for balance control of stroke patients during upright standing, and to determine the relationship between energy expenditure and measures of balance control and muscle activity. Methods: Ten stroke patients and twelve healthy controls performed four upright standing tasks; one without and three with balance perturbations. Energy expenditure was assessed using a pulmonary gas measurement system. Conventional and dynamic balance measures were calculated from center of pressure time series, obtained with a force plate. Muscle activity of the ankle plantar flexors and dorsal flexors was measured using electromyography. Results: On average, energy expenditure during standing was 125% higher in stroke patients. Challenging balance caused a significant increase in energy expenditure (21-52%) for both groups, but no significant interaction (group x condition) was found. Balance control was impaired and muscle activity was higher in stroke patients in all standing conditions. Significant, though moderate to low, correlations were found between energy expenditure and measures of balance control and muscle activity. Conclusion: This study shows that the increased effort for maintaining balance can have a clinically relevant effect on energy expenditure of stroke patients. Besides balance control, other factors responsible for the increased energy expenditure during upright standing in stroke patients should be explored.
The effects of Osteopathic treatment on common femoral artery blood flow in SCI individuals and able-bodied controls
Authors: Denissen G.A.W.  , Murray D.  , Hopman M.M.T.  , MacDonald M.J.
Published: February 2025

Introduction: Pressure sores have been shown to be the major secondary health complication in spinal cord injured (SCI) individuals, and are associated with decreased blood flow and reduced healing potential. The goal of this study was to determine the effect of 3 different sessions of osteopathic treatment on mean leg blood flow (MLBF) in the left common femoral artery (CFA) of SCI individuals compared to able-bodied (AB) individuals. Methods: Six individuals (five male, one female; age 44 ± 17.5 years) with chronic SCI (C6-T12; ASIA A-B; 3.7 ± 4.6 years post-injury) and six AB individuals (five male, one female, 38.3 ± 9.7 years) participated in our study. The protocol consisted of 1 control ‘familiarization’ session of 40 minutes and 3 osteopathic treatment days, where our participants received manual therapy treatment focusing on the cranium (session 1), abdomen (session 2) and the lower extremities (session 3). Doppler ultrasound was used to determine the diameter and mean blood velocity (MBV) in the CFA before, during and after each session. Results: Two-way ANOVA statistical analysis revealed no difference in the maximal change in MLBF and leg vascular resistance (LVR) between groups or between the different treatment days. However, the maximal change in (MBV) was higher and maximal change of mean diameter was lower in SCI individuals (1.9 ± 2.0 cm/s; 0.03 ± 0.03 cm) compared to AB individuals (0.4 ± 1.3 cm/s; 0.06 ± 0.06 cm) across all treatments. There were no differences in absolute MLBF or LVR between treatments. Conclusion: Osteopathic treatment did not have an effect on CFA MLBF in either SCI or AB individuals. There was, however, a difference in the maximal change in MBV and diameter from rest to during treatment between groups. These, were however, so small that absolute flow was not observed to be different from baseline.
Effect of seat height on the propulsion effectiveness and the glenohumeral joint load in handrim wheelchair propulsion
Authors: Arnet U.  , van Drongelen S.  , Veeger H.E.J.  , van der Woude L.H.V.
Published: February 2025

The purpose of this study was to evaluate the effectiveness of force application and the load on the glenohumeral joint during handrim wheelchair propulsion at two different seat heights. In a research laboratory able-bodied male subjects propelled a wheelchair fitted with a SmartWheel on a treadmill at 3 different speeds, while power output was kept constant at 25 W by a pulley system. There was no effect of seat height on the propulsion effectiveness and the glenohumeral joint load under the current experimental conditions.
The availability of desired physical activity following spinal cord injury
Authors: Bassett R.  , Ginis K.M.  , Latimer A.E.  , Wolfe D.L.
Published: February 2025

Purpose: To determine the discrepancy between the types of leisure time physical activity (LTPA) people with spinal cord injury (SCI) desire and the types of LTPA available. A secondary objective was to determine the relationship between this discrepancy in desired and available LTPA and participants' thoughts and feelings towards LTPA. Methods: Questionnaires were completed during a telephone interview. People with SCI (n=259; 75% male, 63% quadriplegic) reported their current LTPA and were classified as active or inactive. The most desired LTPA and its availability was reported. Participants' thoughts and feelings toward LTPA were measured. Results: The most desired LTPA were sports and swimming. Only 54% stated their desired LTPA was available with no difference in availability between active and inactive people. This suggests it is possible to be active when ideal activities are unavailable. However, among inactive people attitudes, intentions and self-efficacy were higher among those who believed the desired LTPA was available versus those who did not (p<.05). Conclusion: Among inactive individuals, increasing LTPA availability may positively influence thoughts and feelings toward LTPA. LTPA initiatives should focus on improving the availability of desired PA such as sports and swimming. Inactive individuals with access to desired PA must be encouraged to participate.
Therapeutic activities in 3 Dutch SCI rehabilitation centers recorded with the Spinal Cord Injury – Interventions Classification System (SCI-ICS)
Authors: van Langeveld A.H.B.  , Post M.W.M.  , van Asbeck F.W.A.  , Postma K.  , Leenders J.  , ter Horst P.  , Rijken H.  , Lindeman E.
Published: February 2025

The purpose of this study was. to examine the contents of therapy directed at self-care and mobility for patients with a spinal cord injury (SCI) in inpatient rehabilitation. Therapists from 3 Dutch rehabilitation centers used the SCI-ICS to record treatment sessions of patients with a SCI over a period of 4 weeks. The SCI-ICS consists of 25 categories at 3 levels of functioning (body functions, basic activities, and complex activities) and 139 different interventions. Time spent on different levels, categories, and types of interventions, was used to describe similarities and differences between the centers. Therapists (n=53) recorded 1640 treatment sessions of 48 patients. Most time was spent on interventions to improve muscle power, walking and wheelchair propulsion. Although differences were found, over-all the findings indicate that the 3 Dutch centers provided similar therapy programs.
Benefits of virtual sports, Wii-Sport activity for children with cerebral palsy in the Pető Institute
Authors: Saringer-Szilard Z.S.
Published: February 2025

Would you have thought that a person with Cerebal Palsy (CP) – no matter how severe the injury is – can play tennis, golf, and box and can achieve the same results like their healthy fellows, can break out in sweat, develop muscle fatigue and fight to win a point? All this, despite the fact that people with cerebral palsy characteristically have little muscle on them, are overweight beyond their teenage years, have coordination problems, and can have sensory injuries, which may impede locomotory experiences as well as a lack of attention and concentration. We have used the virtual world to assist us. Using the Wii console we studied the effects of play on 10-18 year old children with CP (N=19) over a period of 30 weeks. The physical, psychological and mental tests we conducted at the outset and the end of the study has provided a good evidence of the changes we have observed. The results of the work we have performed have shown well that playful exercise tasks had a beneficial impact on the psychological status; children experienced a sense of success, which motivated them to work on, to develop while playing, and to become more active, while practice and play also resulted in muscle development. Their cognitive function was also positively influenced (attention, memory and concentration). There was development of the locomotory condition of even the very gravely injured children with CP, their injured side became more active, in the case of atetotic children there was improvement in their targeted movements, whereas the endurance of diplegic and the fine motorics of the tetraparetic children also improved.
Effect of functional electrostimulation on impaired skin vasodilator responses to local heating in spinal cord injury
Authors: Thijssen D.H.J.  , van Duijnhoven N.T.L.  , Janssen T.W.J.  , Green D.J.  , Minson C.T.  , Hopman M.T.E.
Published: February 2025

Spinal cord injury (SCI) induces vascular adaptations below the level of the lesion, such as impaired cutaneous vasodilation. However, the mechanisms underlying these differences are unclear. The aim of this study is to examine arm and leg cutaneous vascular conductance (CVC)-responses to local heating in 17 able-bodied controls (39±13 years) and 18 SCI subjects (42±8 years). SCI subjects were counterbalanced for functional electro-stimulation(FES)-cycling exercise (SCI-EX, n=9) or control (SCI-C, n=9) and re-analyzed after 8 weeks. Arm and leg SkBF was measured by laser-Doppler flowmetry during local heating (42°C), resulting in an axon-reflex mediated first peak, nadir and a primarily NO-dependent plateau-phase. Data were expressed as a percentage of maximal CVC (%CVCmax; 44°C). CVC-responses to local heating in the paralyzed leg, but also in the forearm of SCI subjects, were lower than in able-bodied controls (P<0.05 and 0.01, respectively). The 8-week intervention did not change forearm and leg CVC-responses to local heating in SCI-C and SCI-EX, but increased femoral artery diameter in SCI-EX (P<0.05). Interestingly, findings in skin microvessels contrast with conduit arteries, where physical (in)activity contributes to adaptations in SCI. The lower CVC-responses in the paralyzed legs might suggest a role for inactivity in SCI, but the presence of impaired CVC-responses in the normally active forearm suggests other mechanisms. This is supported by a lack of adaptation in skin microcirculation after FES-cycle training. This might relate to the less frequent and smaller magnitude of skin blood flow responses to heat stimuli compared with controls, than physical inactivity per se.