Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia Veterans Affairs Medical Center, and University of Pittsburgh Medical Center, Philadelphia and Pittsburgh, PA, USA.
Treatment resistance is a common clinical occurrence among patients treated for major depressive disorder. Clinicians have several options when treating resistant depression, including switching antidepressants within the same class, switching outside the class, and augmenting with various agents, including atypical antipsychotics. Atypical antipsychotics have shown efficacy as adjuncts to antidepressants in the treatment of resistant depression, although long-term efficacy is undetermined. Atypical antipsychotics need to be compared for efficacy against specific target symptoms, as well as for differences in safety and tolerability.
[Show abstract][Hide abstract] ABSTRACT: Robotic lower limb exoskeletons hold significant potential for gait assistance and rehabilitation; however, we have a limited understanding of how people adapt to walking with robotic devices. The purpose of this study was to test the hypothesis that people reduce net muscle moments about their joints when robotic assistance is provided. This reduction in muscle moment results in a total joint moment (muscle plus exoskeleton) that is the same as the moment without the robotic assistance despite potential differences in joint angles. To test this hypothesis, eight healthy subjects trained with the robotic hip exoskeleton while walking on a force-measuring treadmill. The exoskeleton provided hip flexion assistance from approximately 33% to 53% of the gait cycle. We calculated the root mean squared difference (RMSD) between the average of data from the last 15 min of the powered condition and the unpowered condition. After completing three 30-min training sessions, the hip exoskeleton provided 27% of the total peak hip flexion moment during gait. Despite this substantial contribution from the exoskeleton, subjects walked with a total hip moment pattern (muscle plus exoskeleton) that was almost identical and more similar to the unpowered condition than the hip angle pattern (hip moment RMSD 0.027, angle RMSD 0.134, p<0.001). The angle and moment RMSD were not different for the knee and ankle joints. These findings support the concept that people adopt walking patterns with similar joint moment patterns despite differences in hip joint angles for a given walking speed.
Journal of Biomechanics 02/2011; 44(5):789-93. DOI:10.1016/j.jbiomech.2011.01.030 · 2.75 Impact Factor
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