ICARE: An Intelligently Controlled Assistive Rehabilitation Elliptical Training System to Promote Walking and Fitness in Persons with Physical Limitations and Chronic Conditions
Funding Agency: The National Institute on Disability and Rehabilitation Research (NIDRR Award No. H133G070209 - Principal Investigator: J.M. Burnfield, Ph.D., P.T.)
Project Description: Regaining walking ability and physical fitness are central goals for many individuals participating in rehabilitation programs, and this desire continues beyond discharge. Yet many face barriers to accessing optimal treatment programs in healthcare settings and community based fitness facilities. Barriers include lack of affordable and accessible equipment, and sufficient staff with appropriate expertise. This project developed ICARE, an Intelligently Controlled Assistive Rehabilitation Elliptical trainer and therapeutic program, to help physically challenged individuals and those with chronic conditions regain and/or retain their walking ability and physical fitness. To date, over 140 individuals with and without disabilities have participated in extensive biomechanical and equipment evaluations during the initial development period as well as subsequent clinical testing in physical rehabilitation environments and a fitness center. The ICARE design promotes greater elliptical trainer accessibility so that people with disabilities can engage in effective therapeutic exercise and gait programs in order to promote optimal health, quality of life, and maximum independence.
- Burnfield JM, Shu Y, Taylor AP, Buster TW, Nelson CA (2011). Improved Rehabilitation and Exercise Machine. U.S. Patent 8,007,405.
Relevant Publications and Presentations
- Burnfield JM, Shu Y, Buster TW, Taylor A, Nelson CA (2011). Impact of elliptical trainer ergonomic modifications on perceptions of safety, comfort, workout and usability by individuals with physical disabilities and chronic conditions. Physical Therapy, 91(11)1604-1617.
- Burnfield JM, Hildner GA, Buster TW, Taylor AP, Shu Y (2011). Speed’s Impact on Muscle Demands during Partial Body Weight Supported Training on a Motorized Elliptical. Archives of Physical Medicine and Rehabilitation, 92 (10): 1700.
- Nelson CA, Burnfield JM, Shu Y, Buster TW, Taylor A, Graham A (2011). Modified elliptical machine motor-drive design for assistive gait rehabilitation. Transactions of the ASME Journal of Medical Devices, 5:021001.1-021001.7.
- Burnfield JM, Taylor AP, Buster TW, Shu Y, Goldman AJ, Nelson CA (2011). Use of Intelligently Controlled Assistive Rehabilitation Elliptical Trainer to Improve Walking and Fitness during Acute Stroke Rehabilitation. Stroke, 42(3), pg. e326.
- Burnfield JM, Goulet C, Buster TW, Cassel AJ, Mills J, Seow CM (2011). Comparison of velocity, muscle demands and perceived exertion during elliptical training and treadmill walking in individuals with and without multiple sclerosis. 2011 Annual Combined Sections Meeting of the American Physical Therapy Association.
- Burnfield JM, Shu Y, Buster TW, Taylor AP, Merriman L, Nelson CA (2010). Comparison of lower extremity electromyographic (EMG) demands during ICARE training and walking. American Society of Biomechanics 2010 Annual Meeting. (PDF Download).
- Buster TW, Taylor AP, Frazier M, Burnfield JM (2010). Kinematic analysis of five cardiovascular exercises. American Society of Biomechanics 2010 Annual Meeting. (PDF Download).
- Burnfield JM (2010). ICARE: An Affordable Technology Designed to Promote Walking and Cardiovascular Fitness During Rehabilitation and Following Discharge. 8th Annual Medical Rehabilitation Providers Association Educational Conference.
- Burnfield JM, Shu Y, Buster TW, Taylor AP (2010). Similarity of joint kinematics and muscle demands between elliptical training and walking: Implications for practice. Physical Therapy, 90(2):289-305.
- Burnfield JM, Buster TW, Taylor A, Keenan S, Shu Y, Nelson CA (2010). Intelligently Controlled Assistive Rehabilitation Elliptical (ICARE) Training: An Analysis of Lower Extremity Electromyographic (EMG) Demands with Varying Levels of Motor Assistance. Online Proceedings, Rehabilitation Engineering and Assistive Technology Society of North America's 2010 Annual Conference (PDF Download).
- Shu Y, Buster TW, Taylor A, Keenan S, Nelson CA, Burnfield JM (2010). Ergonomic redesign of elliptical trainer to promote greater safety, comfort and usability. Online Proceedings, Rehabilitation Engineering and Assistive Technology Society of North America's 2010 Annual Conference (PDF Download).
- Burnfield JM, Combs S, Finley M (2010). The Role of Biomechanics in the Management of Upper- and Lower-extremity Dysfunction: Emerging Interventions for Individuals with Neurological Involvement [2 hour short course]. Program, 2010 Annual Combined Sections Meeting of the American Physical Therapy Association, pg. 46.
- Burnfield JM. Development of the ICARE Trainer to Promote Gait and Cardiovascular Fitness in Individuals with Physical Disabilities (2010). Presented at Rancho Los Amigos National Rehabilitation Center. Downey, CA. May 27, 2010.
- Burnfield JM. Patient-Centered Rehabilitation Research (2010). Presented at Capital City Kiwanis. Lincoln, NE. May 18, 2010.
- Burnfield JM (2010). Ergonomics in Health Care: Biomechanical Considerations. Presented at Wisconsin Physical Therapy Association. Green Bay, WS. April 15, 2010.
- Burnfield JM (2010). Biomechanical Demands of Transfer and Gait Activities: Promoting Clinician Safety and Therapeutic Patient Outcomes. Presented at Tenth Annual Safe Patient Handling and Movement Conference. Lake Buena Vista, FL. March 31, 2010.
- Burnfield JM, Roemmich RT, Scherr T, Buster TW (2009). Comparison of Vastus Lateralis and Medial Hamstring Electromyographic Activity Across Five Cardiovascular Exercises. Supplement to Medicine and Science in Sports and Exercise, Volume 41(5), pgs. S568-569.
- Buster TW, Roemmich RT, Doher NJ, Burnfield JM (2009). Comparison of Ankle Muscle Electromyographic Activity Across Five Cardiovascular Exercises. Supplement to Medicine and Science in Sports and Exercise, Volume 41(5), pg. S569.
- Taylor AP, Buster TW, Barber BR, Burnfield JM (2009). Comparison of Forefoot and Heel Pressures Across Fast Walking and Four Elliptical Trainer Conditions. Supplement to Medicine and Science in Sports and Exercise, Volume 41(5), pg. S242.
- Corbridge LM, Goldman AJ, Shu Y, Buster TW, Burnfield JM (2009). Clinician's Muscle Effort During Partial Body Weight Support Treadmill Training: Is it Hard Work? Online Proceedings, American Physical Therapy Association's 2009 Annual Conference and Exposition.
- Burnfield JM, Barber BR, Buster TW, Taylor AP (2009). Plantar Pressures Vary Across Elliptical Trainers and Compared to Walking. Proceedings, Gait and Clinical Movement Analysis Society 14th Annual Meeting, pgs. 116-117.
- Buster TW, Goldman AJ, Corbridge LM, Shu Y, Burnfield JM (2009). Partial Body Weight Support Treadmill Training: Clinician's Upper Extremity Muscle Activation During Facilitation of Hemiparetic Limb Movement. Proceedings, Gait and Clinical Movement Analysis Society 14th Annual Meeting, pgs 258-259.
- Burnfield JM, Goldman A (2009). The Physical Therapist's Role in Community Based Wellness for Stroke Patients. Presented at Eighth Annual Nebraska Stroke Symposium-Present Challenges and Future Hopes. Omaha, NE. October 12, 2009.
- Burnfield JM, Wilkinson H (2009). Breaking Down Barriers to Wellness and Fitness in Persons Living with Chronic Conditions and Disabilities: A Proactive Approach. Presented at Osher Lifelong Learning Institute (OLLI), College of Education and Human Sciences, University of Nebraska - Lincoln. Lincoln, NE. April 15, 2009.
- Burnfield JM, Buster TR (2009). Neuroplasticity: Applying Guiding Principles to Help People Relearn to Walk Following an Injury. Presented at Osher Lifelong Learning Institute (OLLI), College of Education and Human Sciences, University of Nebraska - Lincoln. Lincoln, NE. April 8, 2009.
- Kulig K, Burnfield JM (2008). The role of biomechanics in orthopedic and neurological rehabilitation. Acta of Bioengineering and Biomechanics, 10:1-14.
- Kulig K, Burnfield JM (2008). Mechanistic and interventional aspects of movement disorders: The role of biomechanics. Proceedings of the International Congress of the Polish Society of Biomechanics 2008, pgs. 11-18.
- Burnfield JM, Buster TW, Provorse A, Takahashi S (2007). Muscular demands during elliptical training compared to overground walking. Physiotherapy, 93(Supplement 1), pg. S179.
- Takahashi S, Burnfield JM, Buster TW, Provorse AR (2007). Comparison of Gluteal Muscle Electromyographic Activity across Five Cardiovascular Exercises in Healthy Young Adults. Medicine and Science in Sports and Exercise, Volume 39(5), pg. S255.
First Hope Initiative
Funding Agency: Department of Health and Human Services, Health Resources and Services Administration (Federal Award No 1 R1CRH20680-01-00 - Principal Investigator: J.M. Burnfield, Ph.D., P.T.)
Project Description: This technology and research initiative will increase the functional independence, quality of life, and outcomes of patients with severe disabilities arising from such conditions as stroke, brain injury and spinal cord injury. The focus of this work is to develop affordable technology packages that maximize an individual’s ability to control their environment (lights, windows, bed, etc.), communicate their needs, and engage in therapeutically meaningful activities at bedside 24 hours a day, 7 days a week from the first day of inpatient rehabilitation. The ultimate goal is to seamlessly integrate technology across the rehabilitation environment to break down barriers in communication, environmental control and independence frequently experienced by adults and children with severe physical disabilities arising from spinal cord injuries, strokes or traumatic brain injuries. The technology will enable patients to have more independence and control from their very first days in rehabilitation, helping the individuals and their families to focus more fully on rehabilitation and maximizing progress during this critical recovery period.
Muscular Demands Associated with Walking on a Treadmill with Partial Body Weight Support
Funding Agency: Christopher and Dana Reeve Paralysis Resource Center (Principal Investigator: J.M. Burnfield, Ph.D., P.T.)
Project Description: The primary aim of this study is to systematically examine the influence of walking speed on stride characteristics, muscular demands and perceived exertion in persons participated in partial body weight support treadmill training therapy following a recent stroke (< 1 month).
Development of a Reliable Sonographic Method of Quantifying Tendon and Ligament Structure
Funding Agency: The Layman Award, University of Nebraska - Lincoln (Principal Investigator: G. Bashford, Ph.D., P.E.; Co-Principal Investigators: J.M. Burnfield, Ph.D., P.T., K. Kulig, Ph.D., P.T.)
Project Description: The goals of this research include: 1) developing a reliable sonographic method to assess tendon and ligament structure; 2) validating this method using images acquired from tendons (Achilles, Tibialis Posterior) and the Patellar Ligament in persons with varying activity levels (wheelchair bound, ambulatory and runners); and 3) differentiating between tenalgic (pain in tendon) and non-tenalgic tissues.
Comparison of Gait Kinematics and Muscle Activation during Overground Gait, Treadmill Walking, and Elliptical Training in Individuals with Multiple Sclerosis
Funding Agency: Health Future Foundation Faculty Development Grant, Creighton University (Principal Investigator: C. Goulet, Ph.D., P.T.; Madonna Site Principal Investigator: J.M. Burnfield, Ph.D., P.T.)
The specific aims of this study are 1) to identify the biomechanical and physiological demands of exercise on an elliptical trainer and 2) to compare the demands to those encountered during overground and treadmill walking for persons with multiple sclerosis. Adults with multiple sclerosis who are able to walk as well as adults without neurologic or orthopaedic conditions that would interfere with their walking ability are participating in this study.
Plantar Pressure Variations when Exercising on Commercially Available Cardiovascular Equipment in Persons with Diabetes
Funding Sources: Madonna Auxiliary and the Gifford Swenson Estate (Principal Investigator: J.M. Burnfield, Ph.D., P.T.)
Project Description: The purpose of this line of research is to better understand how pressures on the bottom of the feet vary during exercise on different types of cardiovascular exercise equipment. Special pressure mapping insoles quantify the pressures experienced between the foot and the shoe insole during exercise.
Monitoring Physical Activity using the BodyMedia Sensewear2 Device
Project Description: Identification of physical activities is important in the promotion of exercise for maintaining a healthy lifestyle. It is also valuable to the clinical profession for improving rehabilitation monitoring. The purpose of this study is to devise an algorithm that uses signals recorded from a single biaxial accelerometer in a commercially available body monitoring device to discern between three activity classes: 1) overground or treadmill running; 2) wheelchair propulsion; and 3) eight other common activities (e.g., walking overground and on a treadmill negotiating stairs, exercising on a stairclimber and reaching activities).
Establishing Levels of Upper Extremity Functional Ability for Instrumental Activities of Daily Living
Project Description: This study is exploring the recovery of arm function following a stroke with a specific emphasis on determining relationships between measures recorded on standard clinical assessment tools and the ability to use the arm in Madonna's simulated "real life" environment called Independence Square.
The Nebraska Concussion Study at Madonna Rehabilitation Hospital
Funding Agencies: U. S. Department of Education; State of Nebraska Department of Health and Human Services Regulation and Licensure Medical Services/Trauma Program; Cline, Williams Wright, Johnson & Oldfather, LLP (Principal Investigator-Lori Terryberry-Spohr, Ph.D., ABPP-CN)
Project Description: The purpose of this study is to assess the utility of neurocognitive tools in improving the prevention, detection, and monitoring of concussive events in high school athletes. Researchers work collaboratively with school professionals including athletic trainers, coaches, and school nurses as well as healthcare professionals to implement the use of baseline testing protocols and concussion monitoring utilizing neurocognitive measures. Other projects have included the development of educational tools for distribution within area school districts and working with Lincoln Public Schools on the development of a screening tool for use by school nurses and staff in the school/playground setting.