Amputees are using Nintendo Wii Fit equipment during training sessions as a way of improving their balance and stability.
Every Thursday patients from across the borough meet at Callaghan House in Heywood to go through a tailored exercise programme that improves their strength and stability after having an amputation.
Sharon Wright, Lead Physiotherapist for Amputee Rehabilitation, believes that using the Wii Fit has massive benefits for her patients. She said: “We work with patients for from four months to two years so it’s important that we find new ways of keeping them interested in their exercise and motivated to complete their training.
“After what has been a traumatic experience, the weekly sessions allow our patients to gain back some independence and meet others who know how they feel. Health professionals from the Manchester Disabled Services Centre (MDSC) also attend the sessions so patients don’t have to travel far for appointments, which can be difficult.”
Alan Carouthers, 71, from Rochdale, has been attending the sessions for five months. He said: “I first came with the hope of being able to walk again and started off doing lots of different exercises and physiotherapy. The Wii Fit is great. It is a challenge but using the slalom and football skills games has helped with my balance tremendously and of course it’s great fun.
“It’s really important to come to these sessions because you meet people who understand how you feel but can have a laugh at the same time. It has really built up my confidence and boosted my morale and I’ve been able to make some great friends.”
Heywood, Middleton and Rochdale Community Healthcare in conjunction with Rochdale Amputee Support Group purchased the Wii Fit equipment using a donation from charity Joining Hands for patients to use as part of their weekly exercise rehabilitation programme.
Help and support for amputees and their families can be found through the Greater Manchester Amputee Support Group, which was founded in 2004 by Malcolm Jones, from Rochdale. Malcolm founded the group after becoming an amputee himself and finding he needed more support. He said: “Having an amputation is a traumatic experience so it’s important that people have a support network once they leave hospital to help them and their families adjust.”
The group meets at Rochdale Infirmary on the second Tuesday of every month from 6:30pm in the Rochdale Infirmary outpatients waiting room.
Showing posts with label amputation. Show all posts
Showing posts with label amputation. Show all posts
26 September 2009
12 June 2009
Finding the right balance: Providence Healthcare’s new mobility clinic
By Beth Johnson
Radiation treatments for bone cancer at the age of 11 precipitated a condition that resulted in the amputation of Kevin Clancy’s right leg at age 48. Clancy remembers waking up on November 16, 2008 and noticing that his right foot was unusually cold. “Some of the toes had turned blue,” he recalls. “Ever since I had cancer, I’ve had poor circulation in that leg, but nothing like this.”
He was taken to an acute-care hospital the same day, where doctors discovered that only one artery was working. The decision was quickly made to remove the leg above the knee. The surgery was done November 23, and within 10 days, Clancy was transferred to Providence Hospital’s Amputee Rehabilitation program to begin rehab. Providence Hospital is one of the three integrated care divisions within Providence Healthcare in Toronto’s east end that also offers long-term care and community outreach services.
During his two months at Providence, Clancy was fitted with a prosthetic leg, and made a couple of trips home to determine what changes would need to be made to ensure a smooth transition home. Another step taken to ensure a smooth transition home was introducing Clancy to Providence’s newest service, the Mobility Clinic, where he met with his new physical and occupational therapists.
The new Mobility Clinic is designed for outpatients of Providence Hospital with muscular-skeletal impairments. It ‘fills the gap’ that opens once a patient returns home by continuing to support their therapy needs within a safe, professional, and compassionate environment.
There are two ultimate goals for the Clinic. The first is to provide individualized health-care services to improve functional abilities and promote independence. The second, more important goal, is re-integrating clients into their community and giving clients back their confidence and freedom to take charge and manage their own health care and new lifestyles.
“Kevin was confident while at Providence or at home, but there was a lot of fear each time he faced a new, public environment,” explains Clancy’s wife Christie. “For example, we had to go shopping for a light bulb, but Kevin was hesitant. He knew they were stocked at the back of the hardware store. But he did it – he summoned the confidence he needed to walk to the back of the store, find what he was looking for, get back to the car and return home.” A weekend trip to the hardware store is something we take for granted, but a milestone for someone learning to walk again after the sudden loss of a leg.
The Clinic helps people overcome fears by instilling a sense of independence through using innovative rehabilitation equipment and best practices. Physiotherapist Dellene Sakaguchi says, “Strengthening exercises help patients learn how to trust their balance again. We use tools such as a ‘core pole’ for total body conditioning.” The Clinics’s state-of-the-art gymnasium includes a variety of rehabilitation equipment, a mock kitchen and laundry room for training purposes, and a Sony Wii game system to strengthen muscles and enhance dynamic balance skills in a fun way.
“We take the time to learn about what each person’s day-to-day life involves then reintroduce them to these activities, and adapt them however necessary,” explains occupational therapist Lynne Mycyk. Staff introduced and adapted exercises and activities that would help Clancy get back to the things he loves doing, such as golfing, cooking and participating in the drum corps.
Staff members also help clients understand their injuries, their rehabilitation goals, and their achievements. Education fosters understanding; when clients see the ‘big picture’, they develop a belief in what they are doing, thereby increasing their chance of success. Beyond the physical rehabilitation provided, a sense of camaraderie and hope permeates the clinic. Clients of the service encourage each other’s progress and celebrate achievements.
With 347 beds, Providence Hospital is one of the largest rehabilitation hospitals in Ontario, and the Amputee Rehabilitation unit alone discharges up to 80 patients annually. The new Mobility Clinic is Providence’s solution to ensuring a smooth continuum of care on the patient’s journey to recovery.
Beth Johnson is the Director of Communications at Providence Healthcare.
Radiation treatments for bone cancer at the age of 11 precipitated a condition that resulted in the amputation of Kevin Clancy’s right leg at age 48. Clancy remembers waking up on November 16, 2008 and noticing that his right foot was unusually cold. “Some of the toes had turned blue,” he recalls. “Ever since I had cancer, I’ve had poor circulation in that leg, but nothing like this.”
He was taken to an acute-care hospital the same day, where doctors discovered that only one artery was working. The decision was quickly made to remove the leg above the knee. The surgery was done November 23, and within 10 days, Clancy was transferred to Providence Hospital’s Amputee Rehabilitation program to begin rehab. Providence Hospital is one of the three integrated care divisions within Providence Healthcare in Toronto’s east end that also offers long-term care and community outreach services.
During his two months at Providence, Clancy was fitted with a prosthetic leg, and made a couple of trips home to determine what changes would need to be made to ensure a smooth transition home. Another step taken to ensure a smooth transition home was introducing Clancy to Providence’s newest service, the Mobility Clinic, where he met with his new physical and occupational therapists.
The new Mobility Clinic is designed for outpatients of Providence Hospital with muscular-skeletal impairments. It ‘fills the gap’ that opens once a patient returns home by continuing to support their therapy needs within a safe, professional, and compassionate environment.
There are two ultimate goals for the Clinic. The first is to provide individualized health-care services to improve functional abilities and promote independence. The second, more important goal, is re-integrating clients into their community and giving clients back their confidence and freedom to take charge and manage their own health care and new lifestyles.
“Kevin was confident while at Providence or at home, but there was a lot of fear each time he faced a new, public environment,” explains Clancy’s wife Christie. “For example, we had to go shopping for a light bulb, but Kevin was hesitant. He knew they were stocked at the back of the hardware store. But he did it – he summoned the confidence he needed to walk to the back of the store, find what he was looking for, get back to the car and return home.” A weekend trip to the hardware store is something we take for granted, but a milestone for someone learning to walk again after the sudden loss of a leg.
The Clinic helps people overcome fears by instilling a sense of independence through using innovative rehabilitation equipment and best practices. Physiotherapist Dellene Sakaguchi says, “Strengthening exercises help patients learn how to trust their balance again. We use tools such as a ‘core pole’ for total body conditioning.” The Clinics’s state-of-the-art gymnasium includes a variety of rehabilitation equipment, a mock kitchen and laundry room for training purposes, and a Sony Wii game system to strengthen muscles and enhance dynamic balance skills in a fun way.
“We take the time to learn about what each person’s day-to-day life involves then reintroduce them to these activities, and adapt them however necessary,” explains occupational therapist Lynne Mycyk. Staff introduced and adapted exercises and activities that would help Clancy get back to the things he loves doing, such as golfing, cooking and participating in the drum corps.
Staff members also help clients understand their injuries, their rehabilitation goals, and their achievements. Education fosters understanding; when clients see the ‘big picture’, they develop a belief in what they are doing, thereby increasing their chance of success. Beyond the physical rehabilitation provided, a sense of camaraderie and hope permeates the clinic. Clients of the service encourage each other’s progress and celebrate achievements.
With 347 beds, Providence Hospital is one of the largest rehabilitation hospitals in Ontario, and the Amputee Rehabilitation unit alone discharges up to 80 patients annually. The new Mobility Clinic is Providence’s solution to ensuring a smooth continuum of care on the patient’s journey to recovery.
Beth Johnson is the Director of Communications at Providence Healthcare.
Finding the right balance: Providence Healthcare’s new mobility clinic
By Beth Johnson
Radiation treatments for bone cancer at the age of 11 precipitated a condition that resulted in the amputation of Kevin Clancy’s right leg at age 48. Clancy remembers waking up on November 16, 2008 and noticing that his right foot was unusually cold. “Some of the toes had turned blue,” he recalls. “Ever since I had cancer, I’ve had poor circulation in that leg, but nothing like this.”
He was taken to an acute-care hospital the same day, where doctors discovered that only one artery was working. The decision was quickly made to remove the leg above the knee. The surgery was done November 23, and within 10 days, Clancy was transferred to Providence Hospital’s Amputee Rehabilitation program to begin rehab. Providence Hospital is one of the three integrated care divisions within Providence Healthcare in Toronto’s east end that also offers long-term care and community outreach services.
During his two months at Providence, Clancy was fitted with a prosthetic leg, and made a couple of trips home to determine what changes would need to be made to ensure a smooth transition home. Another step taken to ensure a smooth transition home was introducing Clancy to Providence’s newest service, the Mobility Clinic, where he met with his new physical and occupational therapists.
The new Mobility Clinic is designed for outpatients of Providence Hospital with muscular-skeletal impairments. It ‘fills the gap’ that opens once a patient returns home by continuing to support their therapy needs within a safe, professional, and compassionate environment.
There are two ultimate goals for the Clinic. The first is to provide individualized health-care services to improve functional abilities and promote independence. The second, more important goal, is re-integrating clients into their community and giving clients back their confidence and freedom to take charge and manage their own health care and new lifestyles.
“Kevin was confident while at Providence or at home, but there was a lot of fear each time he faced a new, public environment,” explains Clancy’s wife Christie. “For example, we had to go shopping for a light bulb, but Kevin was hesitant. He knew they were stocked at the back of the hardware store. But he did it – he summoned the confidence he needed to walk to the back of the store, find what he was looking for, get back to the car and return home.” A weekend trip to the hardware store is something we take for granted, but a milestone for someone learning to walk again after the sudden loss of a leg.
The Clinic helps people overcome fears by instilling a sense of independence through using innovative rehabilitation equipment and best practices. Physiotherapist Dellene Sakaguchi says, “Strengthening exercises help patients learn how to trust their balance again. We use tools such as a ‘core pole’ for total body conditioning.” The Clinics’s state-of-the-art gymnasium includes a variety of rehabilitation equipment, a mock kitchen and laundry room for training purposes, and a Sony Wii game system to strengthen muscles and enhance dynamic balance skills in a fun way.
“We take the time to learn about what each person’s day-to-day life involves then reintroduce them to these activities, and adapt them however necessary,” explains occupational therapist Lynne Mycyk. Staff introduced and adapted exercises and activities that would help Clancy get back to the things he loves doing, such as golfing, cooking and participating in the drum corps.
Staff members also help clients understand their injuries, their rehabilitation goals, and their achievements. Education fosters understanding; when clients see the ‘big picture’, they develop a belief in what they are doing, thereby increasing their chance of success. Beyond the physical rehabilitation provided, a sense of camaraderie and hope permeates the clinic. Clients of the service encourage each other’s progress and celebrate achievements.
With 347 beds, Providence Hospital is one of the largest rehabilitation hospitals in Ontario, and the Amputee Rehabilitation unit alone discharges up to 80 patients annually. The new Mobility Clinic is Providence’s solution to ensuring a smooth continuum of care on the patient’s journey to recovery.Beth Johnson is the Director of Communications at Providence Healthcare.
Radiation treatments for bone cancer at the age of 11 precipitated a condition that resulted in the amputation of Kevin Clancy’s right leg at age 48. Clancy remembers waking up on November 16, 2008 and noticing that his right foot was unusually cold. “Some of the toes had turned blue,” he recalls. “Ever since I had cancer, I’ve had poor circulation in that leg, but nothing like this.”
He was taken to an acute-care hospital the same day, where doctors discovered that only one artery was working. The decision was quickly made to remove the leg above the knee. The surgery was done November 23, and within 10 days, Clancy was transferred to Providence Hospital’s Amputee Rehabilitation program to begin rehab. Providence Hospital is one of the three integrated care divisions within Providence Healthcare in Toronto’s east end that also offers long-term care and community outreach services.
During his two months at Providence, Clancy was fitted with a prosthetic leg, and made a couple of trips home to determine what changes would need to be made to ensure a smooth transition home. Another step taken to ensure a smooth transition home was introducing Clancy to Providence’s newest service, the Mobility Clinic, where he met with his new physical and occupational therapists.
The new Mobility Clinic is designed for outpatients of Providence Hospital with muscular-skeletal impairments. It ‘fills the gap’ that opens once a patient returns home by continuing to support their therapy needs within a safe, professional, and compassionate environment.
There are two ultimate goals for the Clinic. The first is to provide individualized health-care services to improve functional abilities and promote independence. The second, more important goal, is re-integrating clients into their community and giving clients back their confidence and freedom to take charge and manage their own health care and new lifestyles.
“Kevin was confident while at Providence or at home, but there was a lot of fear each time he faced a new, public environment,” explains Clancy’s wife Christie. “For example, we had to go shopping for a light bulb, but Kevin was hesitant. He knew they were stocked at the back of the hardware store. But he did it – he summoned the confidence he needed to walk to the back of the store, find what he was looking for, get back to the car and return home.” A weekend trip to the hardware store is something we take for granted, but a milestone for someone learning to walk again after the sudden loss of a leg.
The Clinic helps people overcome fears by instilling a sense of independence through using innovative rehabilitation equipment and best practices. Physiotherapist Dellene Sakaguchi says, “Strengthening exercises help patients learn how to trust their balance again. We use tools such as a ‘core pole’ for total body conditioning.” The Clinics’s state-of-the-art gymnasium includes a variety of rehabilitation equipment, a mock kitchen and laundry room for training purposes, and a Sony Wii game system to strengthen muscles and enhance dynamic balance skills in a fun way.
“We take the time to learn about what each person’s day-to-day life involves then reintroduce them to these activities, and adapt them however necessary,” explains occupational therapist Lynne Mycyk. Staff introduced and adapted exercises and activities that would help Clancy get back to the things he loves doing, such as golfing, cooking and participating in the drum corps.
Staff members also help clients understand their injuries, their rehabilitation goals, and their achievements. Education fosters understanding; when clients see the ‘big picture’, they develop a belief in what they are doing, thereby increasing their chance of success. Beyond the physical rehabilitation provided, a sense of camaraderie and hope permeates the clinic. Clients of the service encourage each other’s progress and celebrate achievements.
With 347 beds, Providence Hospital is one of the largest rehabilitation hospitals in Ontario, and the Amputee Rehabilitation unit alone discharges up to 80 patients annually. The new Mobility Clinic is Providence’s solution to ensuring a smooth continuum of care on the patient’s journey to recovery.Beth Johnson is the Director of Communications at Providence Healthcare.
24 February 2009
APL Riff on Video Game Helps Prosthetic Patients
Iraq veteran Jonathan Kuniholm trains with the modified Guitar Hero system.
By Paulette Campbell Applied Physics Laboratory
Wii-habilitation" — using Nintendo's Wii video game system in rehabilitation therapy — continues to be popular with health care workers looking to help patients get through what some see as the pain and torture of physical therapy. Now two engineers in APL's National Security Technology Department have cranked that concept up a notch. Bobby Armiger and Jacob Vogelstein have rewired Nintendo's Guitar Hero III: Legends of Rock game to allow amputees to rock out and get valuable training with prosthetic prototypes at the same time.
Their gaming is part of the APL-led Revolutionizing Prosthetics 2009 effort, funded by the Defense Advanced Research Projects Agency, to develop a prosthetic arm that will be controlled and also feel, look and perform like a natural limb. So far the project has produced two prototypes and has leveraged a surgical technique, developed at the Rehabilitation Institute of Chicago by Todd Kuiken, that reroutes the nerves that once controlled an amputee's arm to remaining muscles. These "re- innervated" muscles naturally amplify the nerve signals so that electrodes placed against the skin can detect activity and control the prosthetic arm.
The surgery has enabled patients to control the first prototype arm and will eventually be used to control individual fingers of the final prosthetic design. But for the arm to operate correctly using these rerouted nerves, the system must learn to interpret the patient's muscle signals. The process is similar to training voice-recognition software where, for example, you are prompted to read the Gettysburg Address, except that instead of analyzing tones, the APL system records and classifies muscle twitches.
This training takes place in a Virtual Integration Environment, another RP 2009 innovation. "In the VIE, an animated on-screen arm mimics the patient's intended movements in real time, based on inputs from the electrodes attached to the user's residual muscles," Vogelstein explains. "For the training, a patient sits in front of a computer and an on-screen prompt tells them to 'flex your wrist,' 'extend your wrist,' 'close your fist,' etc."
Calibrating the mechanical limbs to recognize and respond properly to electrical signals in an amputee's residual muscles is an exhausting and draining process, says Armiger, who has been on the front lines of training the system to respond naturally to the patient. "There is no real interaction and no feedback," he says. "And there is no encouragement for the patient to do more or do it better."
The idea to adapt the game for amputees came to Armiger while he was playing Guitar Hero at a party. He and Vogelstein borrowed a colleague's copy of the game and modified the controller with a soldering iron to allow it to be controlled by the VIE. Then, button clicks were substituted with muscle contraction signals as picked up by the electrodes.
Last fall, Armiger and Vogelstein traveled to RP 2009 partner Duke University to test the rigged system on Iraq veteran Jonathan Kuniholm, who lost his right hand to shrapnel in 2005. With electrodes attached to what was left of his arm, Kuniholm was able to operate the frets using signals from his muscles.
The researchers found that playing a game is a far more intuitive way to speed up the tedious calibration process and make it more fun for volunteers. "It allows for large numbers of rapid, dynamic movements that are more natural and not stereotyped," Vogelstein says. "Ultimately we are going to get more input and longer training cycles out of patients — and that will translate to better and more natural limb control."
Armiger and Vogelstein next want to adapt a tennis game to train people with more radical amputations. "Eventually we want to make our software open source so that people can repurpose other games for rehabilitation," Armiger says.
28 December 2008
With Wii bit of help, rehabbers doing fine
MANSFIELD -- He's 67 and recovering from a stroke, but Joe Lakes bowls, boxes and plays golf.
Since the Nintendo Wii was introduced into the occupational therapy program at MedCentral/ Mansfield Hospital, manager Trey Counts said patients have benefited in a variety of ways while enjoying familiar sports all year long.
"The Wii is being used more and more in the rehab setting," Counts said. "We have a lot of patients who have a history of playing sports and being active, so it's nice to be able to offer this to them," Nintendo says on its Website.
The Wii is an interactive videogame system.
"A distinguishing feature of the console is its wireless controller, the Wii Remote, which can be used as a handheld pointing device and detect movement in three dimensions."
Medical News Today reported Wii is being used for rehabilitation in hospitals around the country.
"You have to do the majority of the movements involved in the real-life activity," Counts said. "There are buttons involved, so it's not exactly the same as in real life, but it can become very engaging."
The occupational therapy department, which treats those with head injuries, multiple sclerosis, Parkinson's, amputations, etc., currently offers 10 different games. Counts said they plan to offer the Wii Fit as soon as one becomes available for purchase.
"Everyone seems to be sold out of them," he said. "These games help the patients work on endurance, balance and range of motion. Some games involved cognitive skills, like sequencing, memory and keeping score."
Lakes said he had a stoke on Nov. 1, which impaired the left side of his body.
"I'm just starting to get feeling back in there, but I had to learn how to balance myself all over again," the Mansfield man said. "The Wii has been great for that. I've tried the bowling and the boxing. With bowling, if you lunge forward too much that can throw off your balance."
Lakes said using the Wii was not difficult.
"Plus, it adds a little bit of fun," he said.
Counts said he believes those as young as 3 and as old as 90 would easily be able to pick up the skills.
"We use these in the rehab stage and have gotten a lot of positive feedback," he said. "We can choose the games based on their goals, but also to get them back into their old habits. If they like to play golf, we can have them play the Wii golf game to get some of those skills back. It's fun, and they don't even realize they're working on balance and endurance. I mean they'll really get fatigued playing some of these."
Occupational therapist Charles Prinz said the Wii doesn't take away from other activities.
"This is just an addition here," he said. "It just makes things a little easier on us. A bowling simulation makes it easier because in the gym, we'd have to have one of our staff members there to set back up the pins and retrieve the ball. Now this frees up someone to do something else."
Prinz added the Wii is not forced on anyone.
"If someone doesn't like sports, then we wouldn't offer this to them," he said. "They'll spend anywhere from 15 minutes to an hour on here. Everyone really seems to enjoy it."
Since the Nintendo Wii was introduced into the occupational therapy program at MedCentral/ Mansfield Hospital, manager Trey Counts said patients have benefited in a variety of ways while enjoying familiar sports all year long.
"The Wii is being used more and more in the rehab setting," Counts said. "We have a lot of patients who have a history of playing sports and being active, so it's nice to be able to offer this to them," Nintendo says on its Website.
The Wii is an interactive videogame system.
"A distinguishing feature of the console is its wireless controller, the Wii Remote, which can be used as a handheld pointing device and detect movement in three dimensions."
Medical News Today reported Wii is being used for rehabilitation in hospitals around the country.
"You have to do the majority of the movements involved in the real-life activity," Counts said. "There are buttons involved, so it's not exactly the same as in real life, but it can become very engaging."
The occupational therapy department, which treats those with head injuries, multiple sclerosis, Parkinson's, amputations, etc., currently offers 10 different games. Counts said they plan to offer the Wii Fit as soon as one becomes available for purchase.
"Everyone seems to be sold out of them," he said. "These games help the patients work on endurance, balance and range of motion. Some games involved cognitive skills, like sequencing, memory and keeping score."
Lakes said he had a stoke on Nov. 1, which impaired the left side of his body.
"I'm just starting to get feeling back in there, but I had to learn how to balance myself all over again," the Mansfield man said. "The Wii has been great for that. I've tried the bowling and the boxing. With bowling, if you lunge forward too much that can throw off your balance."
Lakes said using the Wii was not difficult.
"Plus, it adds a little bit of fun," he said.
Counts said he believes those as young as 3 and as old as 90 would easily be able to pick up the skills.
"We use these in the rehab stage and have gotten a lot of positive feedback," he said. "We can choose the games based on their goals, but also to get them back into their old habits. If they like to play golf, we can have them play the Wii golf game to get some of those skills back. It's fun, and they don't even realize they're working on balance and endurance. I mean they'll really get fatigued playing some of these."
Occupational therapist Charles Prinz said the Wii doesn't take away from other activities.
"This is just an addition here," he said. "It just makes things a little easier on us. A bowling simulation makes it easier because in the gym, we'd have to have one of our staff members there to set back up the pins and retrieve the ball. Now this frees up someone to do something else."
Prinz added the Wii is not forced on anyone.
"If someone doesn't like sports, then we wouldn't offer this to them," he said. "They'll spend anywhere from 15 minutes to an hour on here. Everyone really seems to enjoy it."
29 November 2008
For those without hands, there's Air Guitar Hero
20 November 2008—Rehabilitation specialists have taken to Nintendo’s Wii game console as a way to help motivate patients during physical therapy and rehabilitation. The latest addition to the Wii-hab phenomenon is perhaps its coolest—Air Guitar Hero. Researchers at Johns Hopkins University have made the popular Guitar Hero game into a tool for amputees who are being fitted with the next generation of artificial arms. With a few electrodes and some very powerful algorithms, amputees can hit all the notes of Pat Benatar’s “Hit Me With Your Best Shot” using only the electrical signals from their residual muscles.
The new research, which will be presented this Friday at the IEEE Biomedical Circuits and Systems Conference, in Baltimore, is one component of a program sponsored by the U.S. Defense Advanced Research Projects Agency (DARPA). The Revolutionizing Prosthetics (RP) 2009 project, spread over 30 research institutions worldwide and led by the Johns Hopkins University Applied Physics Laboratory (APL), in Laurel, Md., is developing a mechanical arm that closely mimics the properties of a real limb.
Besides developing two prototype mechanical arms, the project has also pioneered a nerve surgery for controlling the limbs. The nerves that once controlled an amputee’s arm are still intact even after the limb is lost. By rerouting these nerves into the chest muscles and affixing electrodes to pick up the electromyographic (EMG) signals, the RP 2009 researchers were able to use those signals to control a mechanical arm. As a result, the user feels as if he were controlling his own arm.
Though the surgery has worked so far to move an arm with six degrees of freedom, that arm still cannot enable individual finger movement—the ultimate goal of the project.
Dexterous motion of individual fingers poses a tricky software problem. To establish a clear link between mind and machine, the software that translates between EMG signals and the mechanical arm must be trained to understand what the different muscle signals mean. Pattern-recognition algorithms have to be trained by correlating input signal patterns (from muscle contractions) with the intended outputs (opening the mechanical index finger).
The amputee does this training with the help of what’s called a Virtual Integration Environment (VIE)—a virtual-reality training tool in which an onscreen animated arm mimics the user’s intended movements in real time, based on inputs from multiple electrodes attached to the user’s residual arm.
For the training, you sit in front of a screen and obey repeated commands to “close ring finger,” “open index finger,” “close middle finger,” and so on, to get the machine to create an accurate map of your singular myoelectric control mechanisms. What the algorithms and training programs are there to do is to map the subjective experience of the amputee flexing a ring finger to the movements of the virtual arm in the VIE.
That’s a lot harder than it might seem. The trouble comes when the myoelectric impulses of one finger need to be separated from the others. Press your thumb against your middle finger, and you’ll see the problem. If you can’t even easily actuate separate fingers with your native hand, how exactly is an algorithm supposed to figure out an amputee’s intentions from muscles in the chest or upper arm? And, because a movement might be slightly different every time you do it, it needs to be repeated countless times during training for the control algorithm to latch onto the essential signal.
That calibration and training process is as tedious as it is discouraging. “By 3 p.m.,” says APL engineer Robert Armiger, “[DARPA volunteer and double amputee] Jesse [Sullivan] has had lunch, and he’s tired, just like you and I are tired after working all day. It’s hard for him to keep his concentration up.” Further motivation was needed.
The researchers had experimented with games before, notably a variation on Pong. You could move the Pong paddle by “opening and closing” your virtual hand, but that movement is not relevant to opening and closing individual fingers. Though playing the game worked better than simply obeying repetitive commands, Armiger says it was useless for calibrating fine motor control. He also wanted a game with metrics that were a bit more real-world compatible. In the context of prosthetics, that would mean activating muscles to open and close “fingers” in real time, reacting quickly to a stimulus.
Inspired by Wii-hab, Armiger and colleague Jacob Vogelstein borrowed a colleague’s copy of Guitar Hero and attacked the controller with a soldering iron. They rewired the standard guitar-shaped controller to take instructions from the VIE.
Next they substituted muscle contractions for button presses. In particular, they had to rejigger the inputs. Two-handed gamers normally play by using one hand to press colored “fret” buttons to correspond to the correct notes while using the other hand to push a “strum” button in time with the note. Onscreen, these same five colored buttons scroll down the display in time with the notes the players are supposed to hit. To correctly play a note, the player must press the right color fret button and the strum button with the opposite hand.
But Vogelstein and Armiger wanted to use the game to train an amputee. So first they needed to make the game’s controls one-handed. They did that by wiring the two controls together so that an input from a muscle contraction would be read by the VIE as a simultaneous “fret” and “strum.”
For the research reported this week, Armiger and Vogelstein used three normally limbed volunteers, and only three of the five fret keys were used: red, green, and yellow. Once the skin on the subjects’ upper arms was wired up with about 10 electrodes, the subjects could control the keys by moving their fingers: for the red key, they pressed the tip of their index finger to the tip of their thumb; for the green key, the middle finger; and for the yellow key, the ring finger. After five trials, the three research subjects scored between 50 and 70 percent on the game’s “easy” setting.
In mid-October, Armiger and Vogelstein traveled to RP 2009 partner Duke University, in Durham, N.C., to test the system on its target demographic, in this case Iraq veteran Jon Kuniholm. Kuniholm’s right hand was lost to shrapnel three years ago. About to finish his Ph.D. at Duke’s Center for Biologically Inspired Materials and Material Systems, Kuniholm has been a volunteer for the DARPA program for the past two years and is the outspoken founder of the Open Prosthetics Project, an open-source Web site, independent of DARPA, that aims to make prosthetic-arm technology as open source and collaborative as Linux and Firefox.
With electrodes attached to his residual arm, Kuniholm was able to operate the frets using signals from the muscles there. “It’s fun,” says Kuniholm, who achieved the highest score reported by the experimental subjects: 70 percent. Kuniholm says that while Air Guitar Hero is the only game so far that requires individual finger movement to train an amputee to deal with those muscles again, the real success is in striving for a realistic goal. “You’re doing something simple,” he says. “It’s not rocket science. But you have to do it fast and you have to time it right.”
Kuniholm has big plans for Air Guitar Hero. He and Armiger want to use it to train people who use less advanced commercially available artificial arms. Kuniholm’s goal with the Open Prosthetics Project is to create tools that will prime the pump of prosthetics innovation but “won’t consist of several thousand dollars of computing equipment.” In fact, DARPA is in the process of making the APL-created video-game interface software open source, Kuniholm says, “so that we can all begin hacking away.” He hopes to have the source code available for prosthetics control beginning in January. “We’re in the process of getting some more data and experience with it,” he says. The next step is finding lead users at Walter Reed Army Medical Center. “But Air Guitar Hero is just a demo,” he insists. “We want to get this platform out there so people can start downloading it and start modifying other games.”
For their next game-interface modification, the APL team is eyeing Wii Tennis so that people with more radical amputations can also benefit from the motivating powers of the Wii. “We want Jesse to be able to play, too,” says Vogelstein.
The real goal is to get the software into as many hands as possible, Kuniholm says. And in that sense, the story of Air Guitar Hero mirrors the larger Revolutionizing Prosthetics project. In the end, DARPA and Johns Hopkins want to make both the arm’s hardware and the interface software, including the VIE, open source so that prosthetic-arm research innovation can evolve organically.
The new research, which will be presented this Friday at the IEEE Biomedical Circuits and Systems Conference, in Baltimore, is one component of a program sponsored by the U.S. Defense Advanced Research Projects Agency (DARPA). The Revolutionizing Prosthetics (RP) 2009 project, spread over 30 research institutions worldwide and led by the Johns Hopkins University Applied Physics Laboratory (APL), in Laurel, Md., is developing a mechanical arm that closely mimics the properties of a real limb.
Besides developing two prototype mechanical arms, the project has also pioneered a nerve surgery for controlling the limbs. The nerves that once controlled an amputee’s arm are still intact even after the limb is lost. By rerouting these nerves into the chest muscles and affixing electrodes to pick up the electromyographic (EMG) signals, the RP 2009 researchers were able to use those signals to control a mechanical arm. As a result, the user feels as if he were controlling his own arm.
Though the surgery has worked so far to move an arm with six degrees of freedom, that arm still cannot enable individual finger movement—the ultimate goal of the project.
Dexterous motion of individual fingers poses a tricky software problem. To establish a clear link between mind and machine, the software that translates between EMG signals and the mechanical arm must be trained to understand what the different muscle signals mean. Pattern-recognition algorithms have to be trained by correlating input signal patterns (from muscle contractions) with the intended outputs (opening the mechanical index finger).
The amputee does this training with the help of what’s called a Virtual Integration Environment (VIE)—a virtual-reality training tool in which an onscreen animated arm mimics the user’s intended movements in real time, based on inputs from multiple electrodes attached to the user’s residual arm.
For the training, you sit in front of a screen and obey repeated commands to “close ring finger,” “open index finger,” “close middle finger,” and so on, to get the machine to create an accurate map of your singular myoelectric control mechanisms. What the algorithms and training programs are there to do is to map the subjective experience of the amputee flexing a ring finger to the movements of the virtual arm in the VIE.
That’s a lot harder than it might seem. The trouble comes when the myoelectric impulses of one finger need to be separated from the others. Press your thumb against your middle finger, and you’ll see the problem. If you can’t even easily actuate separate fingers with your native hand, how exactly is an algorithm supposed to figure out an amputee’s intentions from muscles in the chest or upper arm? And, because a movement might be slightly different every time you do it, it needs to be repeated countless times during training for the control algorithm to latch onto the essential signal.
That calibration and training process is as tedious as it is discouraging. “By 3 p.m.,” says APL engineer Robert Armiger, “[DARPA volunteer and double amputee] Jesse [Sullivan] has had lunch, and he’s tired, just like you and I are tired after working all day. It’s hard for him to keep his concentration up.” Further motivation was needed.
The researchers had experimented with games before, notably a variation on Pong. You could move the Pong paddle by “opening and closing” your virtual hand, but that movement is not relevant to opening and closing individual fingers. Though playing the game worked better than simply obeying repetitive commands, Armiger says it was useless for calibrating fine motor control. He also wanted a game with metrics that were a bit more real-world compatible. In the context of prosthetics, that would mean activating muscles to open and close “fingers” in real time, reacting quickly to a stimulus.
Inspired by Wii-hab, Armiger and colleague Jacob Vogelstein borrowed a colleague’s copy of Guitar Hero and attacked the controller with a soldering iron. They rewired the standard guitar-shaped controller to take instructions from the VIE.
Next they substituted muscle contractions for button presses. In particular, they had to rejigger the inputs. Two-handed gamers normally play by using one hand to press colored “fret” buttons to correspond to the correct notes while using the other hand to push a “strum” button in time with the note. Onscreen, these same five colored buttons scroll down the display in time with the notes the players are supposed to hit. To correctly play a note, the player must press the right color fret button and the strum button with the opposite hand.
But Vogelstein and Armiger wanted to use the game to train an amputee. So first they needed to make the game’s controls one-handed. They did that by wiring the two controls together so that an input from a muscle contraction would be read by the VIE as a simultaneous “fret” and “strum.”
For the research reported this week, Armiger and Vogelstein used three normally limbed volunteers, and only three of the five fret keys were used: red, green, and yellow. Once the skin on the subjects’ upper arms was wired up with about 10 electrodes, the subjects could control the keys by moving their fingers: for the red key, they pressed the tip of their index finger to the tip of their thumb; for the green key, the middle finger; and for the yellow key, the ring finger. After five trials, the three research subjects scored between 50 and 70 percent on the game’s “easy” setting.
In mid-October, Armiger and Vogelstein traveled to RP 2009 partner Duke University, in Durham, N.C., to test the system on its target demographic, in this case Iraq veteran Jon Kuniholm. Kuniholm’s right hand was lost to shrapnel three years ago. About to finish his Ph.D. at Duke’s Center for Biologically Inspired Materials and Material Systems, Kuniholm has been a volunteer for the DARPA program for the past two years and is the outspoken founder of the Open Prosthetics Project, an open-source Web site, independent of DARPA, that aims to make prosthetic-arm technology as open source and collaborative as Linux and Firefox.
With electrodes attached to his residual arm, Kuniholm was able to operate the frets using signals from the muscles there. “It’s fun,” says Kuniholm, who achieved the highest score reported by the experimental subjects: 70 percent. Kuniholm says that while Air Guitar Hero is the only game so far that requires individual finger movement to train an amputee to deal with those muscles again, the real success is in striving for a realistic goal. “You’re doing something simple,” he says. “It’s not rocket science. But you have to do it fast and you have to time it right.”
Kuniholm has big plans for Air Guitar Hero. He and Armiger want to use it to train people who use less advanced commercially available artificial arms. Kuniholm’s goal with the Open Prosthetics Project is to create tools that will prime the pump of prosthetics innovation but “won’t consist of several thousand dollars of computing equipment.” In fact, DARPA is in the process of making the APL-created video-game interface software open source, Kuniholm says, “so that we can all begin hacking away.” He hopes to have the source code available for prosthetics control beginning in January. “We’re in the process of getting some more data and experience with it,” he says. The next step is finding lead users at Walter Reed Army Medical Center. “But Air Guitar Hero is just a demo,” he insists. “We want to get this platform out there so people can start downloading it and start modifying other games.”
For their next game-interface modification, the APL team is eyeing Wii Tennis so that people with more radical amputations can also benefit from the motivating powers of the Wii. “We want Jesse to be able to play, too,” says Vogelstein.
The real goal is to get the software into as many hands as possible, Kuniholm says. And in that sense, the story of Air Guitar Hero mirrors the larger Revolutionizing Prosthetics project. In the end, DARPA and Johns Hopkins want to make both the arm’s hardware and the interface software, including the VIE, open source so that prosthetic-arm research innovation can evolve organically.
02 November 2008
Physical therapy: It’s all about movement
By Erik Nieuwenhuis
October is National Physical Therapy Month, and this year’s theme is “It’s All About Movement!”Physical therapists are the movement experts. We help people move forward. e help people who have had a stroke or an amputation regain their independence. We help millions of Americans manage or eliminate their neck or back pain. We educate and lead workers and companies to work smart and improve the ergonomics in their workplace and homes. We help children with cerebral palsy improve their overall function and participation in life.Movement is essential to our everyday lives at work, home and play. Movement is an essential ingredient in your daily health and quality of life! Having the ability to move safely and effectively is crucial in our lives and the lives of the people physical therapists treat. The physical therapy profession empowers people to move forward and take control of the movement that is essential in everyone’s life.
What is a physical therapist?Physical therapists are good people to know. They’’re educated in understanding the interaction of all your body parts. Their hands-on approach begins with examination, diagnosis, and then treatment of the immediate problem. Then they teach you how to take care of yourself by showing you how to do exercises and how to use and move your body properly to gain strength and mobility while preventing injury and wear and tear to your body. You’ll find them advising on proper work smart posture and body mechanics in the workplace, treating injuries, consulting on fitness/wellness and self care of the working, aging body. You’ll also find them treating patients in the hospital, clinic or home settings. Today physical therapists provide help for every part of the body and to everyone from infants to the elderly, serving more than one million people each day.Where do physical therapists practice?- Outpatient clinics or private practice n 41.5 percent- Outpatient hospitals n14.5 percent- Acute hospitals n 13.1 percent- Patient’s home (home health) n 7.9 percent- Skilled nursing, extended care, or sub-acute facilities n 5.6 percent- Academic institutions n 4.8 percent- Schools (Pre-School, Primary and Secondary) n 4.1 percent- Inpatient rehab facilities n 3.5 percent- Hospices- Industrial, workplace or occupational environments- Fitness centers, health clubs, sports training facilities- ResearchAPTA website June 2007 http://www.apta.org/Educational requirementsCurrently, nearly 200 colleges and universities nationwide offer professional physical therapy education programs.Des Moines University, the University of Iowa, the University of Nebraska Medical Center and the University of South Dakota offer physical therapy programs close to the tri-state area. Western Iowa Tech Community College also offers a physical therapy assistant program. Most physical therapy programs require a student graduate from an accredited four year college and take prerequisite classes for the physical therapy school the student is applying to.Employment outlookThe demand for physical therapists is expected to grow much faster than the average for all occupations through 2014. The demand for physical therapists should continue to grow as the number of individuals with disabilities or limited function increases. Job opportunities are expected to be particularly good in acute hospital, rehabilitation, and orthopedic settings because the elderly receive the most treatment in these settings. Plus, widespread interest in health promotion should increase demand for physical therapy services at the worksite and health clubs. A growing number of employers are using physical therapy services to evaluate worksites, develop exercise programs and teach WorkSmart and safety habits to employees to reduce injuries, claims and costs.Daily job tasksWe treat patients to: improve mobility, relieve pain, increase strength and balance, improve coordination and prevent or limit permanent physical disabilities of patients suffering from injuries or disease.Physical therapists restore, maintain, and promote overall fitness and health.Our patients include accident victims from motor vehicle accidents and slip, trip and fall injuries, individuals with disabling conditions such as lower back pain, arthritis, heart disease and stroke, diabetes or those with amputations, fractures or total knee and hip replacements among others.Physical therapists determine the patient’s ability to be independent and reintegrate into the community or workplace after an injury or illness with the goal of improving how an individual functions at work, play and home.Therapists also teach patients how to use assistive and adaptive devices to improve their safety and independence.Sources:1. American Physical Therapy Association Website at http://www.apta.org/2. US News and World Report 20063. Erik Nieuwenhuis MS, PT My Life and Career as a Physical TherapistContact Erik Nieuwenhuis at St Luke’s IMPACC WorkSmart and WELLness Services at 712-279-1842 or Nieuween@stlukes.org
October is National Physical Therapy Month, and this year’s theme is “It’s All About Movement!”Physical therapists are the movement experts. We help people move forward. e help people who have had a stroke or an amputation regain their independence. We help millions of Americans manage or eliminate their neck or back pain. We educate and lead workers and companies to work smart and improve the ergonomics in their workplace and homes. We help children with cerebral palsy improve their overall function and participation in life.Movement is essential to our everyday lives at work, home and play. Movement is an essential ingredient in your daily health and quality of life! Having the ability to move safely and effectively is crucial in our lives and the lives of the people physical therapists treat. The physical therapy profession empowers people to move forward and take control of the movement that is essential in everyone’s life.
What is a physical therapist?Physical therapists are good people to know. They’’re educated in understanding the interaction of all your body parts. Their hands-on approach begins with examination, diagnosis, and then treatment of the immediate problem. Then they teach you how to take care of yourself by showing you how to do exercises and how to use and move your body properly to gain strength and mobility while preventing injury and wear and tear to your body. You’ll find them advising on proper work smart posture and body mechanics in the workplace, treating injuries, consulting on fitness/wellness and self care of the working, aging body. You’ll also find them treating patients in the hospital, clinic or home settings. Today physical therapists provide help for every part of the body and to everyone from infants to the elderly, serving more than one million people each day.Where do physical therapists practice?- Outpatient clinics or private practice n 41.5 percent- Outpatient hospitals n14.5 percent- Acute hospitals n 13.1 percent- Patient’s home (home health) n 7.9 percent- Skilled nursing, extended care, or sub-acute facilities n 5.6 percent- Academic institutions n 4.8 percent- Schools (Pre-School, Primary and Secondary) n 4.1 percent- Inpatient rehab facilities n 3.5 percent- Hospices- Industrial, workplace or occupational environments- Fitness centers, health clubs, sports training facilities- ResearchAPTA website June 2007 http://www.apta.org/Educational requirementsCurrently, nearly 200 colleges and universities nationwide offer professional physical therapy education programs.Des Moines University, the University of Iowa, the University of Nebraska Medical Center and the University of South Dakota offer physical therapy programs close to the tri-state area. Western Iowa Tech Community College also offers a physical therapy assistant program. Most physical therapy programs require a student graduate from an accredited four year college and take prerequisite classes for the physical therapy school the student is applying to.Employment outlookThe demand for physical therapists is expected to grow much faster than the average for all occupations through 2014. The demand for physical therapists should continue to grow as the number of individuals with disabilities or limited function increases. Job opportunities are expected to be particularly good in acute hospital, rehabilitation, and orthopedic settings because the elderly receive the most treatment in these settings. Plus, widespread interest in health promotion should increase demand for physical therapy services at the worksite and health clubs. A growing number of employers are using physical therapy services to evaluate worksites, develop exercise programs and teach WorkSmart and safety habits to employees to reduce injuries, claims and costs.Daily job tasksWe treat patients to: improve mobility, relieve pain, increase strength and balance, improve coordination and prevent or limit permanent physical disabilities of patients suffering from injuries or disease.Physical therapists restore, maintain, and promote overall fitness and health.Our patients include accident victims from motor vehicle accidents and slip, trip and fall injuries, individuals with disabling conditions such as lower back pain, arthritis, heart disease and stroke, diabetes or those with amputations, fractures or total knee and hip replacements among others.Physical therapists determine the patient’s ability to be independent and reintegrate into the community or workplace after an injury or illness with the goal of improving how an individual functions at work, play and home.Therapists also teach patients how to use assistive and adaptive devices to improve their safety and independence.Sources:1. American Physical Therapy Association Website at http://www.apta.org/2. US News and World Report 20063. Erik Nieuwenhuis MS, PT My Life and Career as a Physical TherapistContact Erik Nieuwenhuis at St Luke’s IMPACC WorkSmart and WELLness Services at 712-279-1842 or Nieuween@stlukes.org
04 September 2008
China's Paralympic history
BEIJING, Sept. 2 (Xinhua) -- After watching the "truly exceptional" Summer Olympis as spectators, China's Paralympic athletes are looking to repeat their Athens glory four years ago in Beijing.
With a biggest-ever 547-member delegation, China will start their seventh Paralympic tour on Sunday, competing in all the 20 events and 295 disciplines.
The past six Paralympics have witnessed the high-spirited and vigorous progress made by Chinese. Here are some facts about China's Paralympic history:
1984 Stoke Mandeville & New York
-- The 1984 Paralympic Games were held in Europe and North America. China made its Paralympic debut in the New York Games by sending 24 athletes who competed in athletics, swimming and table tennis.
China finished 23rd at the gold tally with two golds, 13 silvers and nine bronzes, including the country's first ever Paralympic gold won by Ping Yali.
The Games turned out as a success despite a short preparation period of four months. The organizers agreed that the future Games should be held at one place.
1988 Seoul
-- China's 43 athletes participated in athletics, swimming, table tennis and shooting. A total of 44 medals including 17 golds lifted China to the 14th place among 61 delegations on the gold standings.
The Seoul Paralympic Games took place at Olympic venues.
1992 Barcelona
-- China sent a 24-athlete delegation to the 9th Paralympics and was ranked 12th place on the gold tally with 11 golds, seven silvers and seven bronzes.
The organizing committee reduced the number of athletes by setting strict rules in order to enhance the credibility of the Games. Athletes with different disabilities were allowed to participate in the same events.
1996 Atlanta
-- Thirty-seven athletes over six sports clinched 16 gold medals, pushing China to the ninth place on the gold tally.
For the first time, athletes with an intellectual disability took part in this Games, along with athletes with spinal cord disabilities, cerebral palsy, amputations, les autres and visual impairments.
2000 Sydney
-- China sent 87 athletes to six sports in the Games, which included goalball, judo and power lifting for the first time. A total of 73 medals including 34 golds propelled China to the sixth place on the gold tally.
The Sydney Paralympics, which offered 550 gold medals, marked the first-time participation of female athletes in power lifting.
A total of 300 world and Paralympic records were set over 18 events in Sydney.
2004 Athens
-- China sent 200 athletes to take part in 11 events at the Athens Paralympics. With a historic 141 medals including 63 golds, China topped the medal standings for the first time.
Women's judo and volleyball (sitting) made their first appearance in Athens. China won the first gold medal in women's volleyball, beating the Netherlands 3-1.
At the closing ceremony, the new logo of the International Paralympic Committee (IPC) was unveiled as the Paralympic flag with the three "Agitos" was raised in the stadium.
With a biggest-ever 547-member delegation, China will start their seventh Paralympic tour on Sunday, competing in all the 20 events and 295 disciplines.
The past six Paralympics have witnessed the high-spirited and vigorous progress made by Chinese. Here are some facts about China's Paralympic history:
1984 Stoke Mandeville & New York
-- The 1984 Paralympic Games were held in Europe and North America. China made its Paralympic debut in the New York Games by sending 24 athletes who competed in athletics, swimming and table tennis.
China finished 23rd at the gold tally with two golds, 13 silvers and nine bronzes, including the country's first ever Paralympic gold won by Ping Yali.
The Games turned out as a success despite a short preparation period of four months. The organizers agreed that the future Games should be held at one place.
1988 Seoul
-- China's 43 athletes participated in athletics, swimming, table tennis and shooting. A total of 44 medals including 17 golds lifted China to the 14th place among 61 delegations on the gold standings.
The Seoul Paralympic Games took place at Olympic venues.
1992 Barcelona
-- China sent a 24-athlete delegation to the 9th Paralympics and was ranked 12th place on the gold tally with 11 golds, seven silvers and seven bronzes.
The organizing committee reduced the number of athletes by setting strict rules in order to enhance the credibility of the Games. Athletes with different disabilities were allowed to participate in the same events.
1996 Atlanta
-- Thirty-seven athletes over six sports clinched 16 gold medals, pushing China to the ninth place on the gold tally.
For the first time, athletes with an intellectual disability took part in this Games, along with athletes with spinal cord disabilities, cerebral palsy, amputations, les autres and visual impairments.
2000 Sydney
-- China sent 87 athletes to six sports in the Games, which included goalball, judo and power lifting for the first time. A total of 73 medals including 34 golds propelled China to the sixth place on the gold tally.
The Sydney Paralympics, which offered 550 gold medals, marked the first-time participation of female athletes in power lifting.
A total of 300 world and Paralympic records were set over 18 events in Sydney.
2004 Athens
-- China sent 200 athletes to take part in 11 events at the Athens Paralympics. With a historic 141 medals including 63 golds, China topped the medal standings for the first time.
Women's judo and volleyball (sitting) made their first appearance in Athens. China won the first gold medal in women's volleyball, beating the Netherlands 3-1.
At the closing ceremony, the new logo of the International Paralympic Committee (IPC) was unveiled as the Paralympic flag with the three "Agitos" was raised in the stadium.
Subscribe to:
Posts (Atom)