Test and scale for the assessment of balance in stroke populations.
\r\n\t(1) Sustainable Waste Management;
\r\n\t(2) Micro(nano)plastics in the Environments;
\r\n\t(3) Electronic Waste and Circular Economy;
\r\n\t(4) Reducing, Recycling and Recovery of Agricultural and Food Waste;
\r\n\t(5) Biomass Valorization: Waste to Resources;
\r\n\t(6) Governmental Policy on Waste Management and Valorization.
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Postural control is the ability to maintain balance against gravitational forces by maintaining or returning the body mass center on its base support [1, 2]. This emerges from the interaction between subjects, tasks, and environment [2, 3]. Any task requires adequate postural control, but each task also requires an orientation and a stability component [2].
In clinical practices, there is no consensus about only conceptual definitions related to equilibrium, balance, or postural control, and their elements like posture, orientation, and stability. Therefore, it is interesting to at least define basic biomechanical concepts to better understand postural control and further definitions addressed in this chapter.
From a biomechanical point of view, posture refers to the alignment and orientation of the body with respect to its environment [3]. Postural orientation is the ability to maintain an adequate relation between body segments and environment due to performing a task, and postural stability is the ability to control the center of mass within the base support [2, 3].
Nowadays, postural control is no longer considered as only one system or reflex set for upright position and balance, it is considered a complex motor skill due to the interaction of multiple sensorimotor processes [4]. The two main goals of postural control are keeping postural orientation and postural equilibrium [2, 3, 4].
The human body in order to achieve stability and orientation requires a complex interaction between musculoskeletal components, neuromuscular synergies, individual sensory systems, sensory strategies, anticipatory and adaptive mechanisms, and internal representations [2]. The central nervous system (CNS) must organize the information coming from the different sensory receptors to determine the position of the body in space [2]. The sensory information coming from the different sensory systems (visual, somatosensory, and vestibular) allows to detect the position of the body and the movement in space in relation to the force of gravity and the environment [2, 3, 5]. Each sense provides specific information about the position and movement of the body, that is, each sense provides different references for postural control [2]. In the higher levels, the CNS sensory information is transformed into significative information, known as perception, and then it is selected the best sensorimotor strategies to achieve the goal of a specific task, to control external perturbance, and to adapt movement to the environmental requirements [2].
Also, postural orientation involves active control of alignment and tone of the body related to gravity, base support, visual information, and internal references [2, 3]. Spatial orientation requires the interpretation and integrated information of the visual, vestibular, and somatosensory systems. On the other hand, postural equilibrium involves the coordination of sensorimotor strategies to control the center of mass during internal and external disturbances [3, 4]. For a better explanation of the different sensory systems and sensory strategies to maintain postural control, see the diagram in Figure 1.
Postural control by sensory systems and strategies. Summary information collected from Shumway-Cook and Woollacott [
There are multiple causes and factors that could lead to dysfunctions in postural control and balance systems. In neurological populations, is commonly observed that this deficit affects the ability to stand and walk, increasing the risk of falling and injury [2].
Within neurological populations, we can find stroke patients. Stroke is a common disease [6] that generates great morbidity, mortality, and different degrees of disability, causing a great economic impact on families and society [1].
A stroke can lead to a wide range of impairments that predispose the subjects to falls. One of the principal impairments observed in this population is balance dysfunction [7, 8]. It has been reported that 83% of stroke patients present balance impairments, which lead to gait problems, such as low gait speed and alterations in different gait phases increasing the risk of falling [1]. The incidence of falls in this population within the first six months after a stroke is about 37 and 73%, and the rate of falls in chronic stroke patients is double than healthy subjects [8].
Falls and fear of falling contribute to a sedentary lifestyle with increased limitations in activities of daily living (ADL) and decreased quality of life. In addition, falls increase hospitalization time and generate a large emotional and economic impact for patients, families, and society [1, 9, 10].
The present chapter pretends to expose the principal deficiencies related to balance impairments, observed during the sit-to-stand transfer and gait after a stroke. Also, the main scales and tests for the assessments of balance used in clinical settings, as well as the technologies and new trends that allow for objective analysis of balance dysfunction in this population are reviewed.
As said before, postural control alterations contribute to a loss of stability with a high impact on the quality of life in neurological populations [1, 2]. Balance and postural control impairments cause a series of alterations and dysfunctions during daily life activities, mainly during sit-to-stand transfer and gait [11, 12].
In this section, the main alterations on the sit-to-stand transfer as well as in gait related to balance impairments in post-stroke populations are reviewed.
Sit-to-stand (STS) transfer is considered a fundamental prerequisite to achieve successfully daily life activities [11, 12, 13]. Also, it is considered a strong predictor factor of independence and is the main rehabilitation goal because it promotes independent locomotion, as well as upper limb and hand recovery [13]. In post-stroke populations, this transfer is commonly affected, and it is not easy to regain the ability to stand up from a chair safely [11].
The STS transfer has been widely analyzed [11, 14, 15], and has been described as the movement of the body mass center towards the vertical from a sitting position to an upright position without losing balance [11]. This transfer is a transition to the upright position, and it requires a movement of the mass center from a more stable position into a less one with both lower limbs extended [11, 15]. In order to simplify its analysis, the STS transfer has been divided into phases, depending on kinematics variables, ground action forces, and the movement of the mass center [11].
One of these classifications includes four phases for the analysis, considering trunk movement, seat-off, the achievement of an upright position, and the vertical stabilization at the end of the transfer [11]. Another classification considers two principal phases [11, 15], which basically includes three events, onset of STS, seat-off, and end of STS [15].
Associated with this transfer, there have been described different movement determinants in healthy subjects, such as angular displacements of lower limbs and trunk, as well as muscle activation pattern and weight-bearing distribution [16].
Indeed, there are differences in the performance of sit-to-stand transfer between healthy and post-stroke subjects [11, 13, 14, 15].
Normally, people with hemiparesis show a loss of coordinated movement between the trunk and knees. Therefore, it can be observed a completed knee extension at the end of the STS despite the hip it is still extending. Also, they show an increased center of pressure and move the trunks in a mediolateral direction towards the non-paretic side, as well as a decreased anterior pelvic tilt [11, 15, 16]. When observed lower limbs, it can be identified less muscle activity in the paretic limb, specifically of tibialis anterior, quadriceps, and soleus, showing problems in the correct activation muscle timing to achieve STS [11, 15].
To avoid the risk of falling, people with stroke adopt compensatory strategies, such as exaggeration of the anterior projection of the center of mass before standing up. This population also shows a decrease in knee moment on the paretic side and an increase in weight distribution asymmetry [11, 15, 16]. It has been suggested a correlation between asymmetry in weight-bearing with functional abilities in stroke. It states that those who carry less weight on their paretic limb obtain poor mobility scores in the functional independence scales. These same results have been demonstrated by Cheng et al. who consider the asymmetric distribution of weight-bearing during STS as a mediator of falls [11, 16].
All of these compensatory strategies are carried out to achieve the sit-to-stand transfer successfully and safely, but this population takes more time in the execution of this task, increasing the risk of falling. Because of the big amount of compensatory strategies used by the stroke population, this transfer is considered an indicator of the risk of falling [11, 16].
Similar to STS, independent walking or ambulation is also considered a prerequisite for the performance of activities of daily living [14]. Gait requires an adequate speed to be considered community ambulation, between 1.1 and 1.5 m/s [14]. Also, locomotion is a motor skill, in which control systems in every step must bear weight, give anterior and lateral stability, and keep the center of mass forward, as well as an antigravitatory postural control to provide support and balance to prevent falls [10, 11, 14].
Gait dysfunction represents a major problem in the stroke population and causes difficulties in daily life activities [12, 17]. Approximately 80% of stroke patients experience gait problems in the first 3 months after symptom onset. It has been reported that 18% of subjects are unable to walk, while 11% walk with assistance and the remaining 50% walk independently [12]. It is important to note that only 7% of users who walk independently achieve community walking, which means that they manage to walk 500 meters continuously at an adequate walking speed that allows them to cross the street safely [16].
On the other hand, 70% of stroke patients with community walking suffer falls in the first year, most of these falls are the result of loss in balance. Therefore, there is a high risk of falls in those subjects with stroke who walk independently [12].
Post-stroke gait disturbances and their treatment have been extensively researched [12, 18, 19, 20]. Mainly, we could find impairments associated with alterations in spatial-temporal characteristics and biomechanical alterations [12, 19].
Some of the characteristics of hemiparetic gait related to spatiotemporal variables include decreased cadence, prolonged swing duration on the paretic side, prolonged duration on the nonparetic side, and asymmetry in stride length [19]. As well as the increase of the double support phase and the decrease in gait speed [16, 19].
These characteristics contribute to an unsteady gait pattern, leading to restricted walking within the home and an increased risk of falls [21].
In general, due to a stroke, we can observe different impairments that may occur in the paretic lower extremity, such as abnormal recruitment of motor units, muscle weakness, abnormal activation of muscle synergies, spasticity, proprioceptive impairment, restriction in range of motion, which could enhance a poor gait pattern along with balance disturbances and increased risk of falls [13, 18, 22].
Figure 2 shows the main features in balance impairments related to sit-to-stand, standing balance, and gait after stroke. It is important to highlight that there are more features related to each transfer, but we aim to clarify the most common one in this population.
Balance and gait impairments after stroke. Summary information collected from Boukadida et al. [
Nowadays, it has become relevant to observe the quality of the movement patterns to discriminate between actual recovery and compensatory movement patterns in stroke rehabilitation [10]. Balance impairments are common in this population and they are determinants factor that influences independence and quality of life; therefore, balance became an important goal to be included in rehabilitation programs [21]. For this purpose, the use of accurate, reliable, and valid assessment tools to measure outcomes in stroke populations related to research and clinical practice is recommended [7].
Normally, rehabilitation professionals perform the evaluation by means of observation and the application of scales and instruments, which provide a certain level of objectivity [27]. Generally, the different methodology used for assessing balance can be divided into observational (e.g., the Romberg test), scales and tests, and testing instrumental equipment (e.g., posturography) [28].
The Berg balance scale (BBS) is a widely used tool in clinical settings and is considered the gold standard for assessing functional balance and fall risk in adults [2, 3, 21, 29]. It has been used extensively to measure outcomes in research involving older adults with a variety of conditions, for example, balance impairments, stroke, Parkinson’s disease, vestibular disorders, and in a variety of health care settings [30, 31, 32]. It contains 14 items related to the static and dynamic tasks of daily living [3]. The tasks on this scale progress in difficulty from sitting to bipedal, to bipedal with a narrow support base, to tandem gait and one leg support. The score is calculated on a 5-point ordinal scale for each item, where 0 refers to the inability to complete the test and 4 refers to being able to complete the test independently [3, 29]. The maximum score is 56 points that indicates adequate postural balance and no risk of falls, and a score equal to or less than 45 points indicates a risk of falls [3]. Specifically, values between 56 and 41 points indicate a low risk of falling, between 40 and 21 points a medium risk of falling, and between 20 and 0 points a high risk of falling. Its application lasts between 10 and 20 minutes [29, 30, 31, 32]. Another widely used test is the Timed up and Go (TU & Go) test, which measures dynamic balance and functional mobility in adults, as well as in the neurological population [33, 34, 35]. The TU & Go is a simple test that can be applied anywhere and consists of the subject standing up from a chair, walking three meters, turning around, walking back to the chair, and sitting down on the chair again. The controlled variable is the total time in seconds the subject takes to perform the test, which is then correlated with the risk of falling [34, 35, 36]. Score assumed to be normal if the time is ≤10 seconds, mild risk of falling between 11 and 20 seconds, and high risk >20 seconds [37]. This test has demonstrated excellent inter- and intra-rater reliability with values greater than 0.95, with adequate predictive value for falls in older adults and stroke patients [38, 39]. Some advantages of the TU & Go test are its simplicity and short duration of application. Additionally, it requires little equipment and allows subjects with functional impairment to perform the test [3]. However, one limitation is that although it provides information on the risk of falls, it is not able to determine the risk objectively in subjects with greater difficulties. Barry et al. mention that a limitation in the predictive value of the test could be explained by the fact that it is a single test that evaluates balance and equilibrium in a general way. Therefore, it could be improved by being combined with technological tools for motion analysis [40].
Commonly, in clinical practice, this test is combined with the application of other clinical tests such as the 10-meter walk test, and its results are compared with those obtained in the Berg balance scale [30]. These tests as a whole make it possible to assess the risk of falls, walking speed, and balance of the different patients, making it possible to objectively assess their functional level and to determine the relevant intervention strategies.
Gait speed has been shown to be a predictor for different clinical outcomes, such as response to rehabilitation, level of dependency, frailty, disability, falls, institutionalization, cognitive loss, hospitalization, cardiovascular events, and mortality. Its decrease has been associated with a lower quality of life, social participation, and the presence of depressive symptoms [41]. Middleton et al. define it as the sixth vital sign due to its broad predictive capacity. The 10-meter walk test has proven to be a robust, validated, reliable, and sensitive tool that can be applied in both clinical and research contexts, and in a wide range of pathologies, such as the elderly, chronic stroke, incomplete spinal cord injury, multiple sclerosis, Parkinson’s disease, among others [18, 38, 41, 42].
This test measures walking speed in meters per second (m/s) when walking a short distance of 10 meters. Then, the value obtained will be categorized into the four categories proposed by Perry et. Al, which are intra-domicile gait with speeds between 0 to 0.4 ms; dependent community gait with speeds from 0.4 to 0.8 m/s; community gait 0.8 to 1.2 m/s; and safe gait for crossing the street greater than 1.2 m/s [43].
On the other hand, there is the Functional Reach Scale. This scale was developed to assess the maximum limits of standing stability. Subjects are held in a standing position with feet shoulder-width apart and with one arm (hand grasped) elevated to 90 degrees of flexion. Without moving the feet, the patient is asked to reach as far as possible without losing balance. The distance reached is measured and compared with standardized references by age group as defined by Duncan et al. The functional reach test has satisfactory inter-rater reliability and has been reported as a predictor of falls in older adults [2, 3].
Table 1 summarizes some specific characteristics of the tests and scales listed before.
Test/scale | Aim | Area | Assessment | Description | Cost | Duration |
---|---|---|---|---|---|---|
Berg balance scale [3, 44] | Static balance and risk of falling. | Balance, functional mobility. | Performance measurement (score). | Scale that considers 14 items that include static and dynamic activities of varying difficulty. Each activity is evaluated from 0 to 4 points, determined by the patient’s ability to perform the activity in question. Maximum score 56. | Free (Paper and pencil) | 10 to 20 min. |
Timed up and go [37, 44] | Risk of falling. | Balance, functional mobility, vestibular assessment. | Observer. | Subject begins seated with his back against the back of a chair. At the beginning of the test, the patient gets up from the chair and walks 3 meters, and then turns and returns to the starting point and sits down. The time taken to complete the circuit is recorded. | Free (paper and pencil) | ≤3 min. |
10-M walk test [43, 44] | Independence level. | Mobility, gait, vestibular assessment. | Performance measurement (gait speed). | Subject walks a predetermined distance (depending on the variation applied), in which time is measured. The distance walked in meters is divided by the measured time. | Free (paper and pencil) | ≤ 5 min. |
Tinetti [44] | Balance perception and stability during daily life activities. | Daily life activities, Balance, Functional Mobility, Gait, and Vestibular Assessment. | Patients perception. | 10-item questionnaire designed to assess patient confidence in performing 10 activities of daily living without risk of falling as an indicator of how fear of falling impacts physical performance. The higher the score (100 max) the lower the patient’s confidence. | Free (paper and pencil) | 10 to 15 min. |
BESTest [44, 45, 46] | Postural stability and balance. | Balance, functional mobility, vestibular assessment. | Performance measurement (score). | Orients and identifies the six balance control systems in order to design better approaches to balance rehabilitation from 35 items in six sections, evaluated from 0 to 108 points. | Free (paper and pencil) | 10 to 20 min. |
Activities of Balance confidence (ABC) scale [44] | Self-reporting of the balance confidence measure. | Balance, functional mobility. | Patients perception. | Subjective measure of confidence to perform various ambulatory activities without falling or experiencing feelings of instability out of 16 activities scored from 0 (no confidence) to 100 (confidence). | Free (paper and pencil) | 5 to 10 min. |
Test and scale for the assessment of balance in stroke populations.
One of the most recent scales to measure balance is the Balance Evaluation Systems Test (BESTest), which is a balance assessment scale that allows identifying specific problems in postural control, such as biomechanical alterations, stability limits, postural response, anticipatory postural adjustments, sensory orientation, dynamic balance during gait, and cognitive effects. Although it is a new multitask scale, it includes 36 items to be evaluated with an estimated application time of 30 to 35 minutes [2, 3, 45, 46]. Its short version, the Mini-Balance Evaluation Systems Test (Mini-BESTest), was created in 2010, which contemplates 14 items and takes a total of 10 minutes to complete the assessment, with good inter- and intra-rater reliability in a sample of people with mixed conditions. The mini-BESTest has been shown to be a reliable and validated tool for assessing balance in chronic stroke patients [47].
As can be seen in this section, there is a wide range of scales and clinical tests that allow not only to assess balance but also to observe how the different components behave during the performance of different tasks. Some of them are not only validated in populations with stroke. Therefore, the reader is suggested to review the specific psychometric properties of each of them and their validation in other neurological populations before using it.
There are different therapeutic interventions to improve balance after stroke. According to Stein et al. [21] these interventions could be categorized into five main areas, exercise programs, biofeedback training, sensory training, cognitive training, and external devices.
Each of these areas will address different aspects of the multiple problems that can be found associated with balance impairments [21, 22]. Exercise programs are varied in form, maybe individual or group-based, and include a variety of impairment-oriented elements. Some may include functional activities such as sit-to-stand and balance tasks due to daily life activities, for example, reaching and standing on unstable surfaces [21].
Also, there are different intervention models such as constraint-induced therapy, task-oriented approach, as well as neurophysiological intervention approach such as the Bobath concept, proprioceptive neuromuscular facilitation, and other neurodevelopment models, which have been traditionally used in the treatment of post-stroke patients [5].
The incorporation of visual and sensory training has been shown to be effective in the treatment of balance, as well as the promotion of weight-bearing in seated and upright positions [21, 22, 23, 48]. On the other hand, the incorporation of therapeutic strategies that involve trunk work in the recovery of dynamic balance during sitting, sit-to-stand, and gait is relevant [49].
Since, trunk function has been associated with gait and balance ability in stroke patients and has been shown to be a useful predictor of recovery of gait, balance, and activities of daily living [49].
Recently, a meta-analysis by Hugues et al. concluded that physical therapy has various benefits on postural balance and stability after stroke. It suggests that functional task training, associated with musculoskeletal and/or cardiopulmonary interventions, as well as sensory interventions, appear to be effective in improving balance and postural stability. However, the authors ask for caution with this result, due to “the weak methodological quality of studies,” among other methodological elements [21, 42].
Even though there are several therapeutic approaches and categories of physical therapy, we believe it is important to highlight that each exercise program should be individualized according to the individual’s own capabilities and should be supervised by a therapist.
At a commercial level, a large number of technological systems allow to evaluate different aspects of gait, balance, and strength beyond the typical clinical methodologies, as seen in the previous section.
From the perspective of systems that are capable of evaluating movement and even mobility variables for clinical use, there are camera-based motion analysis laboratories whose measurement is carried out using software for motion analysis (Figure 3).
Optitrack system for human motion analysis using a camera-based system. Image obtained from Optitrack official website [
On the other hand, in the last 30 years, there has been an increase in the use of inertial sensors for motion analysis, whose reduction in size and consumption, in addition to the improvement in algorithms for motion tracking, have allowed them to be positioned as an attractive alternative for the study of movement objectively and quantitatively (Figure 4).
Inertial-based systems for a clinical movement analysis perspective. From left to right: APDM mobility lab, G-walk, and QMUV. Images obtained from the official website of G-walk [
Some other commercial alternatives are illustrated in Table 2.
System | Technology | Description | Area |
---|---|---|---|
Vicon [54] | Optic | Leading optical system in motion analysis used in both clinical and entertainment applications. It incorporates the ability to track reflective passive markers and, together with its tracking platform, it is possible to capture the movement made by people. Using its proprietary software, such as NEXUS, clinical biomechanical and sports motion analysis can be performed. It also offers the possibility of performing biomechanical analysis by incorporating other analysis software, such as Biomechanics of Bodies. | Clinical, sports, entertainment, academic |
Optitrack [50] | Optic | Optical system that incorporates a flexible system to perform biomechanical motion analysis, providing the possibility of natively incorporating other commonly used tools for motion analysis such as electromyography modules, force platforms, and analog sensors. Incorporates the ability to track passive reflective and active markers. It allows the use of other analysis software commonly used in the academic research area such as in Visual3D, The MotionMonitor, MATLAB, and Biomechanics of Bodies. | Clinical, sports, entertainment, academic |
MTw Awinda – X-SENS [55] | Inertial | System with inertial technology that incorporates the possibility of evaluating variables of acceleration, speed, and ranges of movement of some segments or the whole body including hands and phalanges. It offers the possibility of performing biomechanical analysis by incorporating other analysis software such as Biomechanics of Bodies. | Clinical, sports, entertainment, academic |
Perception Neuron – NOITOM [56] | Inertial | System with inertial technology that incorporates the possibility of evaluating variables of acceleration, speed, and ranges of movement of some segments or the whole body including hands and phalanges. It offers the possibility of performing biomechanical analysis by incorporating other analysis software such as Biomechanics of Bodies. | Entertainment, academic |
Ultium Motion – Noraxon [57] | Inertial | System with inertial technology that incorporates the possibility of evaluating variables of acceleration, speed, and ranges of movement of some segments or the whole body with a maximum of 16 sensors. | Clinical, sports, entertainment |
G-WALK [51] | Inertial | Sensorization of several clinical tests with a single inertial sensor to assess gait, balance, ranges of motion, and risk of falls. In addition to the incorporation of evaluation of aspects of sports performance such as jumping power and aerobic resistance. | Clinical, sports, academic |
MobilityLab – APDM [52] | Inertial | Matrix of six inertial sensors that measure different aspects of gait and risk of falls. | Clinical, academic |
QMUV [53] | Inertial | Sensorization of several clinical tests with a single inertial sensor to assess gait, balance, ranges of motion, and risk of falls. | Clinical, academic |
Commercial technological alternatives used to evaluate motor impairment conditions in post-stroke patients.
Another type of element is highly used in the clinical field for the evaluation of gait and static and dynamic balance correspond to systems that measure plantar pressures for the estimation of mobility variables. Technological alternatives range from highly accurate mats for gait and balance evaluation, to systems that embed pressure sensors within insoles to evaluate uncontrolled environments (Figure 5).
Pressure-based systems to analyze gait and posture. From left to right: GAITRite and Xsensor. Images obtained from the official website of Xsensor [
Some other examples are illustrated in Table 3.
System | Description | Area |
---|---|---|
Xsensor [58] | Insoles with plantar pressure points to measure gait variables in sports and clinical applications. | Clinical, sports |
Moticon [60] | Insole for gait analysis in rehabilitation and sports training. | Clinical, sports |
Feetme–Health [61] | Insole with inertial sensor analysis and plantar pressure point for clinical-grade measurement of spatiotemporal variables of gait. | Clinical |
GAITRite [59] | Gait analysis mat, leader in analysis for spatiotemporal variables of the gait cycle. | Clinical, academic |
P-Walk [62] | Mat that measures static balance variables through the acquisition of postures and control of the center of mass and spatiotemporal variables of the gait cycle. | Clinical, academic |
Technological systems to assess motor impairments using plantar pressures in post-stroke patients.
As mentioned at the beginning of this section, the technological tools for the treatment of post-stroke subjects seek to reduce the impact of the disabling condition to improve the quality of life of the patient through rehabilitation therapies to train or adapt the lost function.
From this perspective, the development of serious games for rehabilitation has taken on great importance in the treatment since, they make patients hooked on their treatment, avoiding problems associated with early abandonment from their therapies. Systems that use interactive platforms such as the famous Kinect (camera system) [63] and Nintendo Wii (multisensory system with inertial control and pressure platform) [64] started a massive adoption in the field of game development to support the rehabilitation. However, although they continue to be used in clinical settings for interactive treatment, these technologies are no longer commercially available and are obsolete.
Because of the great technological advance in animation and graphic processing systems, serious games for immersive or semi-immersive rehabilitation using virtual reality helmets (HTC-vive, Oculus, among others) have allowed to establish an environment that mimics in controlled conditions in the daily life of people in order to train typical activities such as brushing teeth, cooking and eating in a safe environment [65]. Also, semi-immersive elements have made it possible to instrumentalize the highly used mirror movement test to increase patients’ perception of movement. All these systems that support the mobility of the upper and lower extremities allow the development of augmented reality environments or interactive systems that enrich the experience of the patient and provide more information about the patient’s condition [66]. Some commercial rehabilitation options include Tyromotion’s PABLO (interactive upper extremity therapy), TYMO (interactive system for balance and coordination training), and DIEGO (interactive arm and shoulder rehabilitation) systems (Figure 6) [67].
Interactive rehabilitation systems developed from Tyromotion. From left to right: PABLO, TYMO, and DIEGO. Images obtained from the official website of Tyromotion [
Leaving aside the treatment systems and focusing on systems that have the potential to be used in everyday life, functional electrical stimulation tools (FES) appear, which correspond to systems that, through the injection of controlled electrical pulses, allow to recover the mobility of limbs, improving grip in upper limb cases and improving gait in case of foot drop stimulators. Although upper limb stimulators have not yet become widespread, in the literature, there is great evidence of efforts by researchers to generate alternatives to train or regain mobility of the arms and hands. Alternatively, and more commonly, there are electronic orthoses for droop foot, where by means of a system that allows the generation of controlled pulses from the detection of gait cycle events, the control of dorsiflexion can be recovered in post-stroke patients [68]. Commercial examples are SmartFES, XFT-2001, ODFS Pace, among others (Figure 7) [68, 69, 70].
Functional electrical stimulation systems commercially available. From left to right: ODFS pace, SmartFES, and XFT-2001. Images obtained from the official website of SmartFES [
On the other hand, health professionals and the scientific community have developed alternatives to treat post-stroke who, due to different factors such as economical, geographical, physical, and/or environmental, are unable to attend rehabilitation centers. The need for the above has increased as a result of the recent COVID-19 pandemic that incorporates post-stroke people as a population at risk [71]. Regarding this, different types of treatment that use technology to rehabilitate communication skills [72], upper limb rehabilitation, and/or remote activities of daily living have been evaluated, proving to be almost as effective as face-to-face treatments. Although there is a lack of information on the cost-effectiveness relationship with respect to traditional treatments, it is evident that the role of telerehabilitation is of vital importance in rural areas or in health emergencies where patients do not have access to opportune care or monitoring of their condition [73, 74].
In this section, some tools typically used for the evaluation and treatment of post-stroke patients are mentioned. However, the intention is to provide a general overview of the systems most used internationally, existing alternatives that improve their proposal in terms of accessibility and costs.
Stroke generates primary and secondary impairments that reduce the functional capacity of these patients, leading to less functional independence and quality of life. One of the main impairments associated with this population is impaired balance, both static and dynamic. This impairment in particular generates a great impact on the dysfunction of activities of daily living and main transfers such as bipedal sedentary transfer and gait. Moreover, in this pathology, 14–65% of individuals fall at least once in the hospital, and between 37 and 73% suffer falls in the next 6 months after discharge [75].
Specifically, people with stroke are at increased risk of fall-related fractures. Other adverse consequences may include fear of falling with subsequent reduction in activity, de-conditioning, and increased risk of falls. Bower et al. state that it has recently been shown that the identification of movement and balance variables, for example by measuring walking speed, application of the timed up and go test, and the Berg Balance Scale, have been shown to be strong predictors of fall risk following stroke [8].
However, as mentioned above, there are some deficiencies in the clinical tests and scales, since they fail to fully determine the variables and problems associated with balance impairment. The use of clinical scales and tests, associated with the use of technologies, could allow the adequate assessment of each of the limitations in static and dynamic balance during the different transfers performed by people with sequelae of stroke.
In this chapter, we have presented a list of alternatives to treat and evaluate the stroke patient in all phases of treatment, providing plenty of evidence of systems for movement analysis and treatment, especially useful for the treating professional, and of highly technological elements to improve adherence to rehabilitation therapies.
Finally, it is important to highlight that a specific assessment of the impairments that contribute to an unfavorable balance in subjects with stroke is necessary for each rehabilitation process, as well as the early incorporation of functional therapeutic activities aimed at their recovery and the prevention of the risk of falls.
This work was supported by the Vice-rectory for research and development (VRID) of the Universidad de Concepción: “Clinical validation of a human motion analysis system based on inertial measurement sensors in a Chilean population at risk of falls” [Cod.- 220.092.003-M].
Pablo Aqueveque, Britam Gómez and Francisco Saavedra were developers of SmartFES and QMUV devices. The remaining authors have no conflicts of interest to declare.
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The CC BY 3.0 and CC BY 4.0 license permits Works to be freely shared in any medium or format, as well as the reuse and adaptation of the original contents of Works (e.g. figures and tables created by the Authors), as long as the source Work is cited and its Authors are acknowledged in the following manner:
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\\n\\nThe same principles apply to Works published under the CC BY-NC-SA 3.0 license, with the caveats that (1) the content may not be used for commercial purposes, and (2) derivative works building on this content must be distributed under the same license. The restrictions contained in these license terms may, however, be waived by the copyright holder(s). Users wishing to circumvent any of the license terms are required to obtain explicit permission to do so from the copyright holder(s).
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\\n"}]'},components:[{type:"htmlEditorComponent",content:'Copyright is the term used to describe the rights related to the publication and distribution of original Works. Most importantly from a publisher's perspective, copyright governs how Authors, publishers and the general public can use, publish, and distribute publications.
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\n\nTERMS
\n\nAll Works published on the IntechOpen platform and in print are licensed under a Creative Commons Attribution 3.0 Unported and Creative Commons 4.0 International License, a license which allows for the broadest possible reuse of published material.
\n\nCopyright on the individual Works belongs to the specific Author, subject to an agreement with IntechOpen. The Creative Common license is granted to all others to:
\n\nAnd for any purpose, provided the following conditions are met:
\n\nAll Works are published under the CC BY 3.0 and CC BY 4.0 license. However, please note that book Chapters may fall under a different CC license, depending on their publication date as indicated in the table below:
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LICENSE | \n\t\t\tUSED FROM - | \n\t\t\tUP TO - | \n\t\t
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The CC BY 3.0 and CC BY 4.0 license permits Works to be freely shared in any medium or format, as well as the reuse and adaptation of the original contents of Works (e.g. figures and tables created by the Authors), as long as the source Work is cited and its Authors are acknowledged in the following manner:
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\n\nDISCLAIMER: Neither the CC BY 3.0 license, CC BY 4.0, nor any other license IntechOpen currently uses or has used before, applies to figures and tables reproduced from other works, as they may be subject to different terms of reuse. In such cases, if the copyright holder is not noted in the source of a figure or table, it is the responsibility of the User to investigate and determine the exact copyright status of any information utilised. Users requiring assistance in that regard are welcome to send an inquiry to permissions@intechopen.com.
\n\nAll rights to Books and Journals and all other compilations published on the IntechOpen platform and in print are reserved by IntechOpen.
\n\nThe copyright to Books, Journals and other compilations is subject to separate copyright from those that exist in the included Works.
\n\nAll Long Form Monographs/Compacts are licensed under the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) license granted to all others.
\n\nCopyright to the individual Works (Chapters) belongs to their specific Authors, subject to an agreement with IntechOpen and the Creative Common license granted to all others to:
\n\nUnder the following terms:
\n\nThere must be an Attribution, giving appropriate credit, provision of a link to the license, and indication if any changes were made.
\n\nNonCommercial - The use of the material for commercial purposes is prohibited. Commercial rights are reserved to IntechOpen or its licensees.
\n\nNo additional restrictions that apply legal terms or technological measures that restrict others from doing anything the license permits are allowed.
\n\nThe CC BY-NC 4.0 license permits Works to be freely shared in any medium or format, as well as reuse and adaptation of the original contents of Works (e.g. figures and tables created by the Authors), as long as it is not used for commercial purposes. The source Work must be cited and its Authors acknowledged in the following manner:
\n\nContent reuse:
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\n\nAll Book cover design elements, as well as Video image graphics are subject to copyright by IntechOpen.
\n\nEvery reproduction of a front cover image must be accompanied by an appropriate Copyright Notice displayed adjacent to the image. The exact Copyright Notice depends on who the Author of a particular cover image is. Users wishing to reproduce cover images should contact permissions@intechopen.com.
\n\nAll Video Lectures under IntechOpen's production are subject to copyright and are property of IntechOpen, unless defined otherwise, and are licensed under the Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) license. This grants all others the right to:
\n\nShare — copy and redistribute the material in any medium or format
\n\nUnder the following terms:
\n\nUsers wishing to repost and share the Video Lectures are welcome to do so as long as they acknowledge the source in the following manner:
\n\n© {year} IntechOpen. Published under CC BY-NC-ND 4.0 license. Available from: {DOI}
\n\nUsers wishing to reuse, modify, or adapt the Video Lectures in a way not permitted by the license are welcome to contact us at permissions@intechopen.com to discuss waiving particular license terms.
\n\nAll software used on the IntechOpen platform, any used during the publishing process, and the copyright in the code constituting such software, is the property of IntechOpen or its software suppliers. As such, it may not be downloaded or copied without permission.
\n\nUnless otherwise indicated, all IntechOpen websites are the property of IntechOpen.
\n\nAll content included on IntechOpen Websites not forming part of contributed materials (such as text, images, logos, graphics, design elements, videos, sounds, pictures, trademarks, etc.), are subject to copyright and are property of, or licensed to, IntechOpen. Any other use, including the reproduction, modification, distribution, transmission, republication, display, or performance of the content on this site is strictly prohibited.
\n\nPolicy last updated: 2016-06-08
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by"}},{type:"book",id:"5711",title:"Occupational Therapy",subtitle:"Occupation Focused Holistic Practice in Rehabilitation",isOpenForSubmission:!1,hash:"38180e287b6cb09b8002b7ab485de2c2",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",bookSignature:"Meral Huri",coverURL:"https://cdn.intechopen.com/books/images_new/5711.jpg",editedByType:"Edited by",editors:[{id:"171525",title:"Dr.",name:"Meral",middleName:null,surname:"Huri",slug:"meral-huri",fullName:"Meral Huri"}],equalEditorOne:null,equalEditorTwo:null,equalEditorThree:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}],booksByTopicTotal:3,seriesByTopicCollection:[],seriesByTopicTotal:0,mostCitedChapters:[{id:"55163",doi:"10.5772/intechopen.68799",title:"Virtual Reality and Occupational Therapy",slug:"virtual-reality-and-occupational-therapy",totalDownloads:2642,totalCrossrefCites:4,totalDimensionsCites:6,abstract:"Virtual reality is three dimensional, interactive and fun way in rehabilitation. Its first known use in rehabilitation published by Max North named as “Virtual Environments and Psychological Disorders” (1994). Virtual reality uses special programmed computers, visual devices and artificial environments for the clients’ rehabilitation. Throughout technological improvements, virtual reality devices changed from therapeutic gloves to augmented reality environments. Virtual reality was being used in different rehabilitation professions such as occupational therapy, physical therapy, psychology and so on. In spite of common virtual reality approach of different professions, each profession aims different outcomes in rehabilitation. Virtual reality in occupational therapy generally focuses on hand and upper extremity functioning, cognitive rehabilitation, mental disorders, etc. Positive effects of virtual reality were mentioned in different studies, which are higher motivation than non‐simulated environments, active participation of the participants, supporting motor learning, fun environment and risk‐free environment. Additionally, virtual reality was told to be used as assessment. This chapter will focus on usage of virtual reality in occupational therapy, history and recent developments, types of virtual reality technologic equipment, pros and cons, usage for pediatric, adult and geriatric people and recent research and articles.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Orkun Tahir Aran, Sedef Şahin, Berkan Torpil, Tarık Demirok and\nHülya Kayıhan",authors:[{id:"172938",title:"Prof.",name:"Hulya",middleName:null,surname:"Kayihan",slug:"hulya-kayihan",fullName:"Hulya Kayihan"},{id:"183079",title:"Ph.D.",name:"Sedef",middleName:null,surname:"Şahin",slug:"sedef-sahin",fullName:"Sedef Şahin"},{id:"196848",title:"M.Sc.",name:"Orkun Tahir",middleName:null,surname:"Aran",slug:"orkun-tahir-aran",fullName:"Orkun Tahir Aran"},{id:"197159",title:"Mr.",name:"Tarık",middleName:null,surname:"Demirok",slug:"tarik-demirok",fullName:"Tarık Demirok"},{id:"197312",title:"M.Sc.",name:"Berkan",middleName:null,surname:"Torpil",slug:"berkan-torpil",fullName:"Berkan Torpil"}]},{id:"61806",doi:"10.5772/intechopen.78312",title:"Executive Functions and Neurology in Children and Adolescents",slug:"executive-functions-and-neurology-in-children-and-adolescents",totalDownloads:1756,totalCrossrefCites:3,totalDimensionsCites:5,abstract:"This chapter discusses the theoretical and methodological issues of creating a developmental perspective on executive function (EF) in childhood and adolescence. Focusing on school periods, this section outlines the development of the basic components of EF—inhibition, working memory, and attention. Cognitive and neurophysiological evaluations show that despite the emergence of EF in the first few years of life, it continues to grow significantly in childhood and adolescence. The components vary slightly according to their developmental sequence. The chapter links findings to long-standing developmental issues (i.e. developmental sequences and processes) and suggests the necessary research to establish a developmental framework covering early childhood throughout adolescence.",book:{id:"6772",slug:"occupational-therapy-therapeutic-and-creative-use-of-activity",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Therapeutic and Creative Use of Activity"},signatures:"Gokcen Akyurek",authors:[{id:"197265",title:"Dr.",name:"Gokcen",middleName:null,surname:"Akyurek",slug:"gokcen-akyurek",fullName:"Gokcen Akyurek"}]},{id:"56049",doi:"10.5772/intechopen.69101",title:"Measurement of Participation: The Role Checklist Version 3: Satisfaction and Performance",slug:"measurement-of-participation-the-role-checklist-version-3-satisfaction-and-performance",totalDownloads:2820,totalCrossrefCites:3,totalDimensionsCites:4,abstract:"Participation in society is an area of interest to both clinicians and population researchers. Measurement of participation is therefore important, yet differences in definition, in terms of both content and scope, have made general agreement on one instrument tool elusive. What is recognized is the need for a theoretically based tool that captures both the insider and the outsider perspective. The outsider perspective, inclusive of the generally held views of a society, supports the utility for aggregating population data, whereas the insider perspective provides the internally held views of an individual needed for client-centered treatment planning. The Role Checklist Version 3 modifies one of the most commonly used assessment tools in occupational therapy practice, has good preliminary psychometric properties, and is theoretically consistent with both the ICF and the Model of Human Occupation. The Model of Human Occupation is the most widely used theoretical model in occupational therapy. This chapter provides an overview of the theoretical development, empirical testing, and implications for use of this participation measure by occupational therapists along with implications for population researchers.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Patricia J. Scott, Kelsey McKinney, Jeff Perron, Emily Ruff and Jessica\nSmiley",authors:[{id:"195495",title:"Dr.",name:"Patricia J",middleName:null,surname:"Scott",slug:"patricia-j-scott",fullName:"Patricia J Scott"},{id:"208801",title:"Dr.",name:"Kelsey G.",middleName:null,surname:"McKinney",slug:"kelsey-g.-mckinney",fullName:"Kelsey G. McKinney"},{id:"208802",title:"Mr.",name:"Jeffrey M.",middleName:null,surname:"Perron",slug:"jeffrey-m.-perron",fullName:"Jeffrey M. Perron"},{id:"208803",title:"Dr.",name:"Emily G.",middleName:null,surname:"Ruff",slug:"emily-g.-ruff",fullName:"Emily G. Ruff"},{id:"208804",title:"Dr.",name:"Jessica L.",middleName:null,surname:"Smiley",slug:"jessica-l.-smiley",fullName:"Jessica L. Smiley"}]},{id:"55024",doi:"10.5772/intechopen.68463",title:"Occupational Therapy in Oncology and Palliative Care",slug:"occupational-therapy-in-oncology-and-palliative-care",totalDownloads:2694,totalCrossrefCites:1,totalDimensionsCites:4,abstract:"Cancer is a chronic disease that may occur in both children and adults. Occupational therapy focuses on the activity limitations and participation problems in their life. Oncology rehabilitation involves in helping an individual with cancer to regain maximum physical, psychological, cognitive, social, and vocational functioning with the limits up to disease and its treatments in an interdisciplinary team concept. These treatment options are associated with the risk of some side effects, including fatigue, pain, cognitive problems, decrease in bone density and muscle endurance, weight loss, and stress- or anxiety-related psychosocial problems. Occupational therapy approaches are a holistic view in a client center and use training in activities of daily living, assistive technology, education of energy conservation techniques, and management of treatment-related problems, such as pain, fatigue, and nausea. In palliative and hospice care, occupational therapists support clients with cancer by minimizing the secondary symptoms related to cancer and its treatments. At the end of life, occupational therapy offers to identify the roles and activities that are meaningful and purposeful to the client with cancer and try to determine the barriers that limit their performance. Clients with cancer who have childhood cancer or adult cancer can face problems about body structure and functions, activity, and participation, which may limit their participation to their daily life.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Sedef Şahin, Semin Akel and Meral Zarif",authors:[{id:"183079",title:"Ph.D.",name:"Sedef",middleName:null,surname:"Şahin",slug:"sedef-sahin",fullName:"Sedef Şahin"},{id:"183078",title:"Dr.",name:"Burcu Semin",middleName:null,surname:"Akel",slug:"burcu-semin-akel",fullName:"Burcu Semin Akel"},{id:"198859",title:"Dr.",name:"Meral",middleName:null,surname:"Zarif",slug:"meral-zarif",fullName:"Meral Zarif"}]},{id:"70122",doi:"10.5772/intechopen.89360",title:"Parkinson’s Disease Rehabilitation: Effectiveness Approaches and New Perspectives",slug:"parkinson-s-disease-rehabilitation-effectiveness-approaches-and-new-perspectives",totalDownloads:2077,totalCrossrefCites:2,totalDimensionsCites:3,abstract:"Parkinson’s disease has been considered one of the most important and common neurodegenerative diseases in the world. Its motor and nonmotor signs determine a huge functional loss, leading the individuals to lose their independence. Although the treatment requires a pharmacological approach, physical therapy has confirmed its importance in this process. Today, neurorehabilitation is indispensable to increase many of the cardinal signs of the disease. Using traditional or technological approaches, physical therapy has reached good results in improving motor and nonmotor functions, as well as the quality of life of Parkinsonians. However, it is important to develop and to fortify the physical therapy approach so that we can provide stronger evidence about our practice.",book:{id:"7543",slug:"physical-therapy-effectiveness",title:"Physical Therapy Effectiveness",fullTitle:"Physical Therapy Effectiveness"},signatures:"Luciana Auxiliadora de Paula Vasconcelos",authors:[{id:"98546",title:"Dr.",name:"Luciana Auxiliadora",middleName:null,surname:"De Paula Vasconcelos",slug:"luciana-auxiliadora-de-paula-vasconcelos",fullName:"Luciana Auxiliadora De Paula Vasconcelos"}]}],mostDownloadedChaptersLast30Days:[{id:"55080",title:"Life Skills in Occupational Therapy",slug:"life-skills-in-occupational-therapy",totalDownloads:6067,totalCrossrefCites:3,totalDimensionsCites:0,abstract:"Occupational therapy is a health profession that uses the purposeful activities to achieve multiple and complex rehabilitation aims. The main goals of the occupational therapy are to support the reintegration of individuals in daily living skills as well as to increase their independence and autonomy. Interventions of occupational therapists have primarily focused on self-care, productivity, and leisure time activities. Since the life skills includes a wide range of abilities that enable a person to perform personal care and more complicated tasks such as traveling, shopping, community participation etc., occupational therapists provide life skills training programs to meet the needs of the clients. This chapter aims to contribute to the current understanding and practices of life skills from an occupational therapy perspective. The chapter starts with a brief discussion of the importance of life skills in occupational therapy. After this introduction, the first part takes a look at the definition of life skills and identifies core components of life skills. The second part describes assessment and interventions of life skills. The third one gives an overview about school life skills programs for children and adolescents. Finally, the last part explains some life skills programs in people with disadvantages.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Hatice Abaoğlu, Özge Buket Cesim, Sinem Kars and Zeynep Çelik",authors:[{id:"197551",title:"Dr.",name:"Hatice",middleName:null,surname:"Abaoğlu",slug:"hatice-abaoglu",fullName:"Hatice Abaoğlu"},{id:"205199",title:"Dr.",name:"Sinem",middleName:null,surname:"Kars",slug:"sinem-kars",fullName:"Sinem Kars"},{id:"205200",title:"Dr.",name:"Zeynep",middleName:null,surname:"Celik",slug:"zeynep-celik",fullName:"Zeynep Celik"},{id:"205203",title:"Ms.",name:"Özge Buket",middleName:null,surname:"Cesim",slug:"ozge-buket-cesim",fullName:"Özge Buket Cesim"}]},{id:"62493",title:"Occupational Therapy in Forensic Settings",slug:"occupational-therapy-in-forensic-settings",totalDownloads:2536,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"It is necessary for a person to comply with the expectations of society and the rules of law to which these expectations are secured. Offenders turn back to the community after the penalty was executed by isolating from society and some occupations. An occupational imbalance is seen in the individuals, during this penalty period and afterward, because of limited occupational participation. As an occupational being, this affects their physical, mental and psychological well-being. Imprisonment is an important practice in criminal law to punish criminals. This may be necessary for the protection of society from criminals, but successful integration into a community after exiting the prison is the most important factor in preventing recidivism. Occupational therapy focuses on health and well-being by using meaningful and purposeful occupations. Occupation involves any activity that people perform or participate in, such as giving care to themselves or others, working, learning, playing games, and interacting with others. From this perspective, the role of occupational therapists in forensic settings is to determine the abilities of these individuals to congregate their deprived freedoms and use them to train them for an independent and autonomous life; to provide a professional orientation, career counseling, and self-esteem; to gain some habits for physical, spiritual and moral life and to reinforce.",book:{id:"6772",slug:"occupational-therapy-therapeutic-and-creative-use-of-activity",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Therapeutic and Creative Use of Activity"},signatures:"Esma Ozkan, Sümeyye Belhan, Mahmut Yaran and Meral Zarif",authors:null},{id:"70122",title:"Parkinson’s Disease Rehabilitation: Effectiveness Approaches and New Perspectives",slug:"parkinson-s-disease-rehabilitation-effectiveness-approaches-and-new-perspectives",totalDownloads:2070,totalCrossrefCites:2,totalDimensionsCites:3,abstract:"Parkinson’s disease has been considered one of the most important and common neurodegenerative diseases in the world. Its motor and nonmotor signs determine a huge functional loss, leading the individuals to lose their independence. Although the treatment requires a pharmacological approach, physical therapy has confirmed its importance in this process. Today, neurorehabilitation is indispensable to increase many of the cardinal signs of the disease. Using traditional or technological approaches, physical therapy has reached good results in improving motor and nonmotor functions, as well as the quality of life of Parkinsonians. However, it is important to develop and to fortify the physical therapy approach so that we can provide stronger evidence about our practice.",book:{id:"7543",slug:"physical-therapy-effectiveness",title:"Physical Therapy Effectiveness",fullTitle:"Physical Therapy Effectiveness"},signatures:"Luciana Auxiliadora de Paula Vasconcelos",authors:[{id:"98546",title:"Dr.",name:"Luciana Auxiliadora",middleName:null,surname:"De Paula Vasconcelos",slug:"luciana-auxiliadora-de-paula-vasconcelos",fullName:"Luciana Auxiliadora De Paula Vasconcelos"}]},{id:"62210",title:"Occupational Therapy’s Role in the Treatment of Children with Autism Spectrum Disorders",slug:"occupational-therapy-s-role-in-the-treatment-of-children-with-autism-spectrum-disorders",totalDownloads:2748,totalCrossrefCites:0,totalDimensionsCites:0,abstract:"Occupational therapists (OT) offer a wide range of therapies for individuals with ASD on the basis of specific deficits and difficulties. This chapter explores the role that OT plays, and the expertise, in relation to the interdisciplinary team. In addition, it discusses and presents empirical support for several therapeutic approaches commonly used by OTs working with individuals with ASD.",book:{id:"6772",slug:"occupational-therapy-therapeutic-and-creative-use-of-activity",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Therapeutic and Creative Use of Activity"},signatures:"Bryan M. Gee, Amy Nwora and Theodore W. Peterson",authors:null},{id:"55049",title:"Community Participation in People with Disabilities",slug:"community-participation-in-people-with-disabilities",totalDownloads:2429,totalCrossrefCites:2,totalDimensionsCites:2,abstract:"Despite the fact that participation is an important building and a valuable target, the conceptualization, identification and measurement methods vary widely. This chapter tried to gain an insider’s perspective from the obstacles that summarize what meaning participation means, how to characterize it, and what prevents and supports participation. Participation is seen as a right and a responsibility attributed to and attributed to both the person and the community. Participation does not take place in a vacuum; the environment dynamically influences participation. The effects of this conceptual framework are discussed for change at the level of evaluation, research and systems to support the participation of the people with disability.",book:{id:"5711",slug:"occupational-therapy-occupation-focused-holistic-practice-in-rehabilitation",title:"Occupational Therapy",fullTitle:"Occupational Therapy - Occupation Focused Holistic Practice in Rehabilitation"},signatures:"Gokcen Akyurek and Gonca Bumin",authors:[{id:"32431",title:"Prof.",name:"Gonca",middleName:null,surname:"Bumin",slug:"gonca-bumin",fullName:"Gonca Bumin"},{id:"197265",title:"Dr.",name:"Gokcen",middleName:null,surname:"Akyurek",slug:"gokcen-akyurek",fullName:"Gokcen Akyurek"}]}],onlineFirstChaptersFilter:{topicId:"198",limit:6,offset:0},onlineFirstChaptersCollection:[],onlineFirstChaptersTotal:0},preDownload:{success:null,errors:{}},subscriptionForm:{success:null,errors:{}},aboutIntechopen:{},privacyPolicy:{},peerReviewing:{},howOpenAccessPublishingWithIntechopenWorks:{},sponsorshipBooks:{sponsorshipBooks:[],offset:8,limit:8,total:0},allSeries:{pteSeriesList:[{id:"14",title:"Artificial Intelligence",numberOfPublishedBooks:9,numberOfPublishedChapters:90,numberOfOpenTopics:6,numberOfUpcomingTopics:0,issn:"2633-1403",doi:"10.5772/intechopen.79920",isOpenForSubmission:!0},{id:"7",title:"Biomedical Engineering",numberOfPublishedBooks:12,numberOfPublishedChapters:107,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2631-5343",doi:"10.5772/intechopen.71985",isOpenForSubmission:!0}],lsSeriesList:[{id:"11",title:"Biochemistry",numberOfPublishedBooks:33,numberOfPublishedChapters:330,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2632-0983",doi:"10.5772/intechopen.72877",isOpenForSubmission:!0},{id:"25",title:"Environmental Sciences",numberOfPublishedBooks:1,numberOfPublishedChapters:18,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2754-6713",doi:"10.5772/intechopen.100362",isOpenForSubmission:!0},{id:"10",title:"Physiology",numberOfPublishedBooks:14,numberOfPublishedChapters:145,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-8261",doi:"10.5772/intechopen.72796",isOpenForSubmission:!0}],hsSeriesList:[{id:"3",title:"Dentistry",numberOfPublishedBooks:9,numberOfPublishedChapters:139,numberOfOpenTopics:2,numberOfUpcomingTopics:0,issn:"2631-6218",doi:"10.5772/intechopen.71199",isOpenForSubmission:!0},{id:"6",title:"Infectious Diseases",numberOfPublishedBooks:13,numberOfPublishedChapters:122,numberOfOpenTopics:4,numberOfUpcomingTopics:0,issn:"2631-6188",doi:"10.5772/intechopen.71852",isOpenForSubmission:!0},{id:"13",title:"Veterinary Medicine and Science",numberOfPublishedBooks:11,numberOfPublishedChapters:112,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2632-0517",doi:"10.5772/intechopen.73681",isOpenForSubmission:!0}],sshSeriesList:[{id:"22",title:"Business, Management and Economics",numberOfPublishedBooks:1,numberOfPublishedChapters:21,numberOfOpenTopics:3,numberOfUpcomingTopics:0,issn:"2753-894X",doi:"10.5772/intechopen.100359",isOpenForSubmission:!0},{id:"23",title:"Education and Human Development",numberOfPublishedBooks:0,numberOfPublishedChapters:10,numberOfOpenTopics:1,numberOfUpcomingTopics:1,issn:null,doi:"10.5772/intechopen.100360",isOpenForSubmission:!0},{id:"24",title:"Sustainable Development",numberOfPublishedBooks:1,numberOfPublishedChapters:19,numberOfOpenTopics:5,numberOfUpcomingTopics:0,issn:"2753-6580",doi:"10.5772/intechopen.100361",isOpenForSubmission:!0}],testimonialsList:[{id:"6",text:"It is great to work with the IntechOpen to produce a worthwhile collection of research that also becomes a great educational resource and guide for future research endeavors.",author:{id:"259298",name:"Edward",surname:"Narayan",institutionString:null,profilePictureURL:"https://mts.intechopen.com/storage/users/259298/images/system/259298.jpeg",slug:"edward-narayan",institution:{id:"3",name:"University of Queensland",country:{id:null,name:"Australia"}}}},{id:"13",text:"The collaboration with and support of the technical staff of IntechOpen is fantastic. 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His present research includes organic synthesis, drug discovery and development, biochemistry, nanoscience, and nanotechnology.",institutionString:"Visiting Scientist at Lipid Nanostructures Laboratory, Centre for Smart Materials, School of Natural Sciences, University of Central Lancashire",institution:null},{id:"428125",title:"Dr.",name:"Vinayak",middleName:null,surname:"Adimule",slug:"vinayak-adimule",fullName:"Vinayak Adimule",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/428125/images/system/428125.jpg",biography:"Dr. Vinayak Adimule, MSc, Ph.D., is a professor and dean of R&D, Angadi Institute of Technology and Management, India. He has 15 years of research experience as a senior research scientist and associate research scientist in R&D organizations. He has published more than fifty research articles as well as several book chapters. He has two Indian patents and two international patents to his credit. 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Since from August 2013 working as a Associate Professor, and in 2016 promoted to Profeesor in the School of Basic Sciences: Department of Chemistry and having 20 years of teaching and research experiences.",institutionString:null,institution:{name:"Rani Channamma University, Belagavi",country:{name:"India"}}},{id:"158492",title:"Prof.",name:"Yusuf",middleName:null,surname:"Tutar",slug:"yusuf-tutar",fullName:"Yusuf Tutar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/158492/images/system/158492.jpeg",biography:"Prof. Dr. Yusuf Tutar conducts his research at the Hamidiye Faculty of Pharmacy, Department of Basic Pharmaceutical Sciences, Division of Biochemistry, University of Health Sciences, Turkey. He is also a faculty member in the Molecular Oncology Program. He obtained his MSc and Ph.D. at Oregon State University and Texas Tech University, respectively. 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His research focuses on biochemistry, biophysics, genetics, molecular biology, and molecular medicine with specialization in the fields of drug design, protein structure-function, protein folding, prions, microRNA, pseudogenes, molecular cancer, epigenetics, metabolites, proteomics, genomics, protein expression, and characterization by spectroscopic and calorimetric methods.",institutionString:"University of Health Sciences",institution:null},{id:"180528",title:"Dr.",name:"Hiroyuki",middleName:null,surname:"Kagechika",slug:"hiroyuki-kagechika",fullName:"Hiroyuki Kagechika",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/180528/images/system/180528.jpg",biography:"Hiroyuki Kagechika received his bachelor’s degree and Ph.D. in Pharmaceutical Sciences from the University of Tokyo, Japan, where he served as an associate professor until 2004. He is currently a professor at the Institute of Biomaterials and Bioengineering (IBB), Tokyo Medical and Dental University (TMDU). From 2010 to 2012, he was the dean of the Graduate School of Biomedical Science. Since 2012, he has served as the vice dean of the Graduate School of Medical and Dental Sciences. He has been the director of the IBB since 2020. Dr. Kagechika’s major research interests are the medicinal chemistry of retinoids, vitamins D/K, and nuclear receptors. He has developed various compounds including a drug for acute promyelocytic leukemia.",institutionString:"Tokyo Medical and Dental University",institution:{name:"Tokyo Medical and Dental University",country:{name:"Japan"}}},{id:"94311",title:"Prof.",name:"Martins",middleName:"Ochubiojo",surname:"Ochubiojo Emeje",slug:"martins-ochubiojo-emeje",fullName:"Martins Ochubiojo Emeje",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/94311/images/system/94311.jpeg",biography:"Martins Emeje obtained a BPharm with distinction from Ahmadu Bello University, Nigeria, and an MPharm and Ph.D. from the University of Nigeria (UNN), where he received the best Ph.D. award and was enlisted as UNN’s “Face of Research.” He established the first nanomedicine center in Nigeria and was the pioneer head of the intellectual property and technology transfer as well as the technology innovation and support center. 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He received his post-doctoral training in oncology and cancer proteomics for two years at the Cancer Research Institute of Human Medical University in China. In 2001, he went to the University of Tennessee Health Science Center (UTHSC) in USA, where he was a post-doctoral researcher and focused on mass spectrometry and cancer proteomics. Then, he was appointed as an Assistant Professor of Neurology, UTHSC in 2005. He moved to the Cleveland Clinic in USA as a Project Scientist/Staff in 2006 where he focused on the studies of eye disease proteomics and biomarkers. He returned to UTHSC as an Assistant Professor of Neurology in the end of 2007, engaging in proteomics and biomarker studies of lung diseases and brain tumors, and initiating the studies of predictive, preventive, and personalized medicine (PPPM) in cancer. In 2010, he was promoted to Associate Professor of Neurology, UTHSC. Currently, he is a Professor at Xiangya Hospital of Central South University in China, Fellow of Royal Society of Medicine (FRSM), the European EPMA National Representative in China, Regular Member of American Association for the Advancement of Science (AAAS), European Cooperation of Science and Technology (e-COST) grant evaluator, Associate Editors of BMC Genomics, BMC Medical Genomics, EPMA Journal, and Frontiers in Endocrinology, Executive Editor-in-Chief of Med One. He has\npublished 116 peer-reviewed research articles, 16 book chapters, 2 books, and 2 US patents. 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He has published several articles in peer-reviewed journals, chapters, and edited books. His area of specialization is free radical biochemistry and autoimmune diseases.",institutionString:"Imam Abdulrahman Bin Faisal University",institution:{name:"Imam Abdulrahman Bin Faisal University",country:{name:"Saudi Arabia"}}},{id:"41865",title:"Prof.",name:"Farid A.",middleName:null,surname:"Badria",slug:"farid-a.-badria",fullName:"Farid A. Badria",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/41865/images/system/41865.jpg",biography:"Farid A. Badria, Ph.D., is the recipient of several awards, including The World Academy of Sciences (TWAS) Prize for Public Understanding of Science; the World Intellectual Property Organization (WIPO) Gold Medal for best invention; Outstanding Arab Scholar, Kuwait; and the Khwarizmi International Award, Iran. He has 250 publications, 12 books, 20 patents, and several marketed pharmaceutical products to his credit. 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He also serves as a Publons Academy mentor and Bentham brand ambassador.",institutionString:"Punjab Technical University",institution:{name:"Punjab Technical University",country:{name:"India"}}},{id:"142388",title:"Dr.",name:"Thiago",middleName:"Gomes",surname:"Gomes Heck",slug:"thiago-gomes-heck",fullName:"Thiago Gomes Heck",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/142388/images/7259_n.jpg",biography:null,institutionString:null,institution:{name:"Universidade Regional do Noroeste do Estado do Rio Grande do Sul",country:{name:"Brazil"}}},{id:"336273",title:"Assistant Prof.",name:"Janja",middleName:null,surname:"Zupan",slug:"janja-zupan",fullName:"Janja Zupan",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/336273/images/14853_n.jpeg",biography:"Janja Zupan graduated in 2005 at the Department of Clinical Biochemistry (superviser prof. dr. Janja Marc) in the field of genetics of osteoporosis. Since November 2009 she is working as a Teaching Assistant at the Faculty of Pharmacy, Department of Clinical Biochemistry. In 2011 she completed part of her research and PhD work at Institute of Genetics and Molecular Medicine, University of Edinburgh. She finished her PhD entitled The influence of the proinflammatory cytokines on the RANK/RANKL/OPG in bone tissue of osteoporotic and osteoarthritic patients in 2012. From 2014-2016 she worked at the Institute of Biomedical Sciences, University of Aberdeen as a postdoctoral research fellow on UK Arthritis research project where she gained knowledge in mesenchymal stem cells and regenerative medicine. She returned back to University of Ljubljana, Faculty of Pharmacy in 2016. 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Demonstrated record of scientific achievements through consistent publication record (H index = 13, with 874 citations) in high impact journals such as Nature Communications, Oncotarget, Annals of Oncology, PNAS, and AJRCCM, etc. Strong research professional with a post-doctorate from ACTREC where I gained experimental oncology experience in clinical settings and a doctorate from IGIB where I gained expertise in asthma pathophysiology. A well-trained biotechnologist with diverse experience on the bench across different research themes ranging from asthma to cancer and other infectious diseases. An individual with a strong commitment and innovative mindset. 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He pursued post-doctoral research at College of Pharmacy, Health Science Center, Texas A & M University and was involved in another postdoctoral research at Department of Translational Neurosciences and Neurotherapeutics, John Wayne Cancer Institute, Santa Monica, California. In 2015, he worked in Harvard-MIT Health Sciences & Technology as a visiting scientist. He has substantial experience in nanotechnology-based formulation development and successfully served various Indian organizations to develop pharmaceuticals and nutraceutical products. He is an inventor in many US patents and an author in many peer-reviewed articles, book chapters and books published in various media of international repute. Dr. Mukherjee is currently serving as Principal Scientist, R&D at Esperer Onco Nutrition (EON) Pvt. Ltd. and heads the Hyderabad R&D center of the organization.",institutionString:"Esperer Onco Nutrition Pvt Ltd.",institution:null},{id:"319365",title:"Assistant Prof.",name:"Manash K.",middleName:null,surname:"Paul",slug:"manash-k.-paul",fullName:"Manash K. Paul",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/319365/images/system/319365.png",biography:"Manash K. Paul is a Principal Investigator and Scientist at the University of California Los Angeles. He has contributed significantly to the fields of stem cell biology, regenerative medicine, and lung cancer. His research focuses on various signaling processes involved in maintaining stem cell homeostasis during the injury-repair process, deciphering lung stem cell niche, pulmonary disease modeling, immuno-oncology, and drug discovery. He is currently investigating the role of extracellular vesicles in premalignant lung cell migration and detecting the metastatic phenotype of lung cancer via machine-learning-based analyses of exosomal signatures. Dr. Paul has published in more than fifty peer-reviewed international journals and is highly cited. He is the recipient of many awards, including the UCLA Vice Chancellor’s award, a senior member of the Institute of Electrical and Electronics Engineers (IEEE), and an editorial board member for several international journals.",institutionString:"University of California Los Angeles",institution:{name:"University of California Los Angeles",country:{name:"United States of America"}}},{id:"311457",title:"Dr.",name:"Júlia",middleName:null,surname:"Scherer Santos",slug:"julia-scherer-santos",fullName:"Júlia Scherer Santos",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/311457/images/system/311457.jpg",biography:"Dr. Júlia Scherer Santos works in the areas of cosmetology, nanotechnology, pharmaceutical technology, beauty, and aesthetics. Dr. Santos also has experience as a professor of graduate courses. Graduated in Pharmacy, specialization in Cosmetology and Cosmeceuticals applied to aesthetics, specialization in Aesthetic and Cosmetic Health, and a doctorate in Pharmaceutical Nanotechnology. Teaching experience in Pharmacy and Aesthetics and Cosmetics courses. She works mainly on the following subjects: nanotechnology, cosmetology, pharmaceutical technology, aesthetics.",institutionString:"Universidade Federal de Juiz de Fora",institution:{name:"Universidade Federal de Juiz de Fora",country:{name:"Brazil"}}},{id:"219081",title:"Dr.",name:"Abdulsamed",middleName:null,surname:"Kükürt",slug:"abdulsamed-kukurt",fullName:"Abdulsamed Kükürt",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/219081/images/system/219081.png",biography:"Dr. Kükürt graduated from Uludağ University in Turkey. He started his academic career as a Research Assistant in the Department of Biochemistry at Kafkas University. In 2019, he completed his Ph.D. program in the Department of Biochemistry at the Institute of Health Sciences. He is currently working at the Department of Biochemistry, Kafkas University. He has 27 published research articles in academic journals, 11 book chapters, and 37 papers. He took part in 10 academic projects. He served as a reviewer for many articles. He still serves as a member of the review board in many academic journals. He is currently working on the protective activity of phenolic compounds in disorders associated with oxidative stress and inflammation.",institutionString:null,institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"178366",title:"Dr.",name:"Volkan",middleName:null,surname:"Gelen",slug:"volkan-gelen",fullName:"Volkan Gelen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/178366/images/system/178366.jpg",biography:"Volkan Gelen is a Physiology specialist who received his veterinary degree from Kafkas University in 2011. Between 2011-2015, he worked as an assistant at Atatürk University, Faculty of Veterinary Medicine, Department of Physiology. In 2016, he joined Kafkas University, Faculty of Veterinary Medicine, Department of Physiology as an assistant professor. Dr. Gelen has been engaged in various academic activities at Kafkas University since 2016. There he completed 5 projects and has 3 ongoing projects. He has 60 articles published in scientific journals and 20 poster presentations in scientific congresses. His research interests include physiology, endocrine system, cancer, diabetes, cardiovascular system diseases, and isolated organ bath system studies.",institutionString:"Kafkas University",institution:{name:"Kafkas University",country:{name:"Turkey"}}},{id:"418963",title:"Dr.",name:"Augustine Ododo",middleName:"Augustine",surname:"Osagie",slug:"augustine-ododo-osagie",fullName:"Augustine Ododo Osagie",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/418963/images/16900_n.jpg",biography:"Born into the family of Osagie, a prince of the Benin Kingdom. I am currently an academic in the Department of Medical Biochemistry, University of Benin. Part of the duties are to teach undergraduate students and conduct academic research.",institutionString:null,institution:{name:"University of Benin",country:{name:"Nigeria"}}},{id:"192992",title:"Prof.",name:"Shagufta",middleName:null,surname:"Perveen",slug:"shagufta-perveen",fullName:"Shagufta Perveen",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/192992/images/system/192992.png",biography:"Prof. Shagufta Perveen is a Distinguish Professor in the Department of Pharmacognosy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia. Dr. Perveen has acted as the principal investigator of major research projects funded by the research unit of King Saud University. She has more than ninety original research papers in peer-reviewed journals of international repute to her credit. She is a fellow member of the Royal Society of Chemistry UK and the American Chemical Society of the United States.",institutionString:"King Saud University",institution:{name:"King Saud University",country:{name:"Saudi Arabia"}}},{id:"49848",title:"Dr.",name:"Wen-Long",middleName:null,surname:"Hu",slug:"wen-long-hu",fullName:"Wen-Long Hu",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/49848/images/system/49848.jpg",biography:"Wen-Long Hu is Chief of the Division of Acupuncture, Department of Chinese Medicine at Kaohsiung Chang Gung Memorial Hospital, as well as an adjunct associate professor at Fooyin University and Kaohsiung Medical University. Wen-Long is President of Taiwan Traditional Chinese Medicine Medical Association. He has 28 years of experience in clinical practice in laser acupuncture therapy and 34 years in acupuncture. He is an invited speaker for lectures and workshops in laser acupuncture at many symposiums held by medical associations. He owns the patent for herbal preparation and producing, and for the supercritical fluid-treated needle. Dr. Hu has published three books, 12 book chapters, and more than 30 papers in reputed journals, besides serving as an editorial board member of repute.",institutionString:"Kaohsiung Chang Gung Memorial Hospital",institution:{name:"Kaohsiung Chang Gung Memorial Hospital",country:{name:"Taiwan"}}},{id:"298472",title:"Prof.",name:"Andrey V.",middleName:null,surname:"Grechko",slug:"andrey-v.-grechko",fullName:"Andrey V. Grechko",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/298472/images/system/298472.png",biography:"Andrey Vyacheslavovich Grechko, Ph.D., Professor, is a Corresponding Member of the Russian Academy of Sciences. He graduated from the Semashko Moscow Medical Institute (Semashko National Research Institute of Public Health) with a degree in Medicine (1998), the Clinical Department of Dermatovenerology (2000), and received a second higher education in Psychology (2009). Professor A.V. Grechko held the position of Сhief Physician of the Central Clinical Hospital in Moscow. He worked as a professor at the faculty and was engaged in scientific research at the Medical University. Starting in 2013, he has been the initiator of the creation of the Federal Scientific and Clinical Center for Intensive Care and Rehabilitology, Moscow, Russian Federation, where he also serves as Director since 2015. He has many years of experience in research and teaching in various fields of medicine, is an author/co-author of more than 200 scientific publications, 13 patents, 15 medical books/chapters, including Chapter in Book «Metabolomics», IntechOpen, 2020 «Metabolomic Discovery of Microbiota Dysfunction as the Cause of Pathology».",institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"199461",title:"Prof.",name:"Natalia V.",middleName:null,surname:"Beloborodova",slug:"natalia-v.-beloborodova",fullName:"Natalia V. Beloborodova",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/199461/images/system/199461.jpg",biography:'Natalia Vladimirovna Beloborodova was educated at the Pirogov Russian National Research Medical University, with a degree in pediatrics in 1980, a Ph.D. in 1987, and a specialization in Clinical Microbiology from First Moscow State Medical University in 2004. She has been a Professor since 1996. Currently, she is the Head of the Laboratory of Metabolism, a division of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russian Federation. N.V. Beloborodova has many years of clinical experience in the field of intensive care and surgery. She studies infectious complications and sepsis. She initiated a series of interdisciplinary clinical and experimental studies based on the concept of integrating human metabolism and its microbiota. Her scientific achievements are widely known: she is the recipient of the Marie E. Coates Award \\"Best lecturer-scientist\\" Gustafsson Fund, Karolinska Institutes, Stockholm, Sweden, and the International Sepsis Forum Award, Pasteur Institute, Paris, France (2014), etc. Professor N.V. Beloborodova wrote 210 papers, five books, 10 chapters and has edited four books.',institutionString:"Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology",institution:null},{id:"354260",title:"Ph.D.",name:"Tércio Elyan",middleName:"Azevedo",surname:"Azevedo Martins",slug:"tercio-elyan-azevedo-martins",fullName:"Tércio Elyan Azevedo Martins",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/354260/images/16241_n.jpg",biography:"Graduated in Pharmacy from the Federal University of Ceará with the modality in Industrial Pharmacy, Specialist in Production and Control of Medicines from the University of São Paulo (USP), Master in Pharmaceuticals and Medicines from the University of São Paulo (USP) and Doctor of Science in the program of Pharmaceuticals and Medicines by the University of São Paulo. Professor at Universidade Paulista (UNIP) in the areas of chemistry, cosmetology and trichology. Assistant Coordinator of the Higher Course in Aesthetic and Cosmetic Technology at Universidade Paulista Campus Chácara Santo Antônio. Experience in the Pharmacy area, with emphasis on Pharmacotechnics, Pharmaceutical Technology, Research and Development of Cosmetics, acting mainly on topics such as cosmetology, antioxidant activity, aesthetics, photoprotection, cyclodextrin and thermal analysis.",institutionString:null,institution:{name:"University of Sao Paulo",country:{name:"Brazil"}}},{id:"334285",title:"Ph.D. Student",name:"Sameer",middleName:"Kumar",surname:"Jagirdar",slug:"sameer-jagirdar",fullName:"Sameer Jagirdar",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/334285/images/14691_n.jpg",biography:"I\\'m a graduate student at the center for biosystems science and engineering at the Indian Institute of Science, Bangalore, India. I am interested in studying host-pathogen interactions at the biomaterial interface.",institutionString:null,institution:{name:"Indian Institute of Science Bangalore",country:{name:"India"}}},{id:"329248",title:"Dr.",name:"Md. Faheem",middleName:null,surname:"Haider",slug:"md.-faheem-haider",fullName:"Md. Faheem Haider",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329248/images/system/329248.jpg",biography:"Dr. Md. Faheem Haider completed his BPharm in 2012 at Integral University, Lucknow, India. In 2014, he completed his MPharm with specialization in Pharmaceutics at Babasaheb Bhimrao Ambedkar University, Lucknow, India. He received his Ph.D. degree from Jamia Hamdard University, New Delhi, India, in 2018. He was selected for the GPAT six times and his best All India Rank was 34. Currently, he is an assistant professor at Integral University. Previously he was an assistant professor at IIMT University, Meerut, India. He has experience teaching DPharm, Pharm.D, BPharm, and MPharm students. He has more than five publications in reputed journals to his credit. Dr. Faheem’s research area is the development and characterization of nanoformulation for the delivery of drugs to various organs.",institutionString:"Integral University",institution:{name:"Integral University",country:{name:"India"}}},{id:"329795",title:"Dr.",name:"Mohd Aftab",middleName:"Aftab",surname:"Siddiqui",slug:"mohd-aftab-siddiqui",fullName:"Mohd Aftab Siddiqui",position:null,profilePictureURL:"https://mts.intechopen.com/storage/users/329795/images/system/329795.png",biography:"Dr. Mohd Aftab Siddiqui is an assistant professor in the Faculty of Pharmacy, Integral University, Lucknow, India, where he obtained a Ph.D. in Pharmacology in 2020. He also obtained a BPharm and MPharm from the same university in 2013 and 2015, respectively. His area of research is the pharmacological screening of herbal drugs/natural products in liver cancer and cardiac diseases. He is a member of many professional bodies and has guided many MPharm and PharmD research projects. 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He is currently appointed as the Voigt Chair in Data Science in the Department of Industrial Engineering, with a joint appointment as Professor in the Computer Science Division, Stellenbosch University. Prior to his appointment at Stellenbosch University, he has been at the University of Pretoria, Department of Computer Science (1998-2018), where he was appointed as South Africa Research Chair in Artifical Intelligence (2007-2018), the head of the Department of Computer Science (2008-2017), and Director of the Institute for Big Data and Data Science (2017-2018). In addition to a number of research articles, he has written two books, Computational Intelligence: An Introduction and Fundamentals of Computational Swarm Intelligence.",institutionString:null,institution:{name:"Stellenbosch University",institutionURL:null,country:{name:"South Africa"}}},subseries:[{id:"22",title:"Applied Intelligence",keywords:"Machine Learning, Intelligence Algorithms, Data Science, Artificial Intelligence, Applications on Applied Intelligence",scope:"This field is the key in the current industrial revolution (Industry 4.0), where the new models and developments are based on the knowledge generation on applied intelligence. The motor of the society is the industry and the research of this topic has to be empowered in order to increase and improve the quality of our lives.",annualVolume:11418,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/22.jpg",editor:{id:"27170",title:"Prof.",name:"Carlos",middleName:"M.",surname:"Travieso-Gonzalez",fullName:"Carlos Travieso-Gonzalez",profilePictureURL:"https://mts.intechopen.com/storage/users/27170/images/system/27170.jpeg",institutionString:null,institution:{name:"University of Las Palmas de Gran Canaria",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"13633",title:"Prof.",name:"Abdelhamid",middleName:null,surname:"Mellouk",fullName:"Abdelhamid Mellouk",profilePictureURL:"https://mts.intechopen.com/storage/users/13633/images/1567_n.jpg",institutionString:null,institution:{name:"Paris 12 Val de Marne University",institutionURL:null,country:{name:"France"}}},{id:"109268",title:"Dr.",name:"Ali",middleName:null,surname:"Al-Ataby",fullName:"Ali Al-Ataby",profilePictureURL:"https://mts.intechopen.com/storage/users/109268/images/7410_n.jpg",institutionString:null,institution:{name:"University of Liverpool",institutionURL:null,country:{name:"United Kingdom"}}},{id:"3807",title:"Dr.",name:"Carmelo",middleName:"Jose Albanez",surname:"Bastos-Filho",fullName:"Carmelo Bastos-Filho",profilePictureURL:"https://mts.intechopen.com/storage/users/3807/images/624_n.jpg",institutionString:null,institution:{name:"Universidade de Pernambuco",institutionURL:null,country:{name:"Brazil"}}},{id:"38850",title:"Dr.",name:"Efren",middleName:null,surname:"Gorrostieta Hurtado",fullName:"Efren Gorrostieta Hurtado",profilePictureURL:"https://mts.intechopen.com/storage/users/38850/images/system/38850.jpg",institutionString:null,institution:{name:"Autonomous University of Queretaro",institutionURL:null,country:{name:"Mexico"}}},{id:"239041",title:"Prof.",name:"Yang",middleName:null,surname:"Yi",fullName:"Yang Yi",profilePictureURL:"https://mts.intechopen.com/storage/users/239041/images/system/239041.jpeg",institutionString:"Virginia Tech",institution:{name:"Virginia Tech",institutionURL:null,country:{name:"United States of America"}}}]},{id:"23",title:"Computational Neuroscience",keywords:"Single-Neuron Modeling, Sensory Processing, Motor Control, Memory and Synaptic Pasticity, Attention, Identification, Categorization, Discrimination, Learning, Development, Axonal Patterning and Guidance, Neural Architecture, Behaviours and Dynamics of Networks, Cognition and the Neuroscientific Basis of Consciousness",scope:"Computational neuroscience focuses on biologically realistic abstractions and models validated and solved through computational simulations to understand principles for the development, structure, physiology, and ability of the nervous system. This topic is dedicated to biologically plausible descriptions and computational models - at various abstraction levels - of neurons and neural systems. This includes, but is not limited to: single-neuron modeling, sensory processing, motor control, memory, and synaptic plasticity, attention, identification, categorization, discrimination, learning, development, axonal patterning, guidance, neural architecture, behaviors, and dynamics of networks, cognition and the neuroscientific basis of consciousness. 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Novel computational algorithms for image analysis, scene understanding, biometrics, deep learning and their software or hardware implementations for natural and medical images, robotics, VR/AR, applications are some research directions relevant to this topic.",annualVolume:11420,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/24.jpg",editor:{id:"294154",title:"Prof.",name:"George",middleName:null,surname:"Papakostas",fullName:"George Papakostas",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002hYaGbQAK/Profile_Picture_1624519712088",institutionString:null,institution:{name:"International Hellenic University",institutionURL:null,country:{name:"Greece"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"1177",title:"Prof.",name:"António",middleName:"J. 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This group of bio-inspired metaheuristics solves multiple optimization problems by applying the metaphor of natural selection. It so far has solved problems such as resource allocation, routing, schedule planning, and engineering design. Moreover, in the field of machine learning, evolutionary computation has carved out a significant niche both in the generation of learning models and in the automatic design and optimization of hyperparameters in deep learning models. This collection aims to include quality volumes on various topics related to evolutionary algorithms and, alternatively, other metaheuristics of interest inspired by nature. For example, some of the issues of interest could be the following: Advances in evolutionary computation (Genetic algorithms, Genetic programming, Bio-inspired metaheuristics, Hybrid metaheuristics, Parallel ECs); Applications of evolutionary algorithms (Machine learning and Data Mining with EAs, Search-Based Software Engineering, Scheduling, and Planning Applications, Smart Transport Applications, Applications to Games, Image Analysis, Signal Processing and Pattern Recognition, Applications to Sustainability).",annualVolume:11421,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/25.jpg",editor:{id:"136112",title:"Dr.",name:"Sebastian",middleName:null,surname:"Ventura Soto",fullName:"Sebastian Ventura Soto",profilePictureURL:"https://mts.intechopen.com/storage/users/136112/images/system/136112.png",institutionString:null,institution:{name:"University of Córdoba",institutionURL:null,country:{name:"Spain"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"111683",title:"Prof.",name:"Elmer P.",middleName:"P.",surname:"Dadios",fullName:"Elmer P. 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It has become a massive part of our daily lives, making predictions based on experience, making this a fascinating area that solves problems that otherwise would not be possible or easy to solve. This topic aims to encompass algorithms that learn from experience (supervised and unsupervised), improve their performance over time and enable machines to make data-driven decisions. It is not limited to any particular applications, but contributions are encouraged from all disciplines.",annualVolume:11422,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/26.jpg",editor:{id:"24555",title:"Dr.",name:"Marco Antonio",middleName:null,surname:"Aceves Fernandez",fullName:"Marco Antonio Aceves Fernandez",profilePictureURL:"https://mts.intechopen.com/storage/users/24555/images/system/24555.jpg",institutionString:"Universidad Autonoma de Queretaro",institution:{name:"Autonomous University of Queretaro",institutionURL:null,country:{name:"Mexico"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"43680",title:"Prof.",name:"Ciza",middleName:null,surname:"Thomas",fullName:"Ciza Thomas",profilePictureURL:"https://mts.intechopen.com/storage/users/43680/images/system/43680.jpeg",institutionString:null,institution:{name:"Government of Kerala",institutionURL:null,country:{name:"India"}}},{id:"16614",title:"Prof.",name:"Juan Ignacio",middleName:null,surname:"Guerrero Alonso",fullName:"Juan Ignacio Guerrero Alonso",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002g6HB8QAM/Profile_Picture_1627901127555",institutionString:null,institution:{name:"University of Seville",institutionURL:null,country:{name:"Spain"}}},{id:"3095",title:"Prof.",name:"Kenji",middleName:null,surname:"Suzuki",fullName:"Kenji Suzuki",profilePictureURL:"https://mts.intechopen.com/storage/users/3095/images/1592_n.jpg",institutionString:null,institution:{name:"University of Chicago",institutionURL:null,country:{name:"United States of America"}}},{id:"214067",title:"Dr.",name:"W. 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David Pan",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bSEI9QAO/Profile_Picture_1623656213532",institutionString:null,institution:{name:"University of Alabama in Huntsville",institutionURL:null,country:{name:"United States of America"}}},{id:"72920",title:"Prof.",name:"Yves",middleName:"Philippe",surname:"Rybarczyk",fullName:"Yves Rybarczyk",profilePictureURL:"https://mts.intechopen.com/storage/users/72920/images/system/72920.jpeg",institutionString:"Dalarna University, Faculty of Data and Information Sciences",institution:{name:"Dalarna University",institutionURL:null,country:{name:"Sweden"}}}]},{id:"27",title:"Multi-Agent Systems",keywords:"Collaborative Intelligence, Learning, Distributed Control System, Swarm Robotics, Decision Science, Software Engineering",scope:"Multi-agent systems are recognised as a state of the art field in Artificial Intelligence studies, which is popular due to the usefulness in facilitation capabilities to handle real-world problem-solving in a distributed fashion. The area covers many techniques that offer solutions to emerging problems in robotics and enterprise-level software systems. Collaborative intelligence is highly and effectively achieved with multi-agent systems. Areas of application include swarms of robots, flocks of UAVs, collaborative software management. Given the level of technological enhancements, the popularity of machine learning in use has opened a new chapter in multi-agent studies alongside the practical challenges and long-lasting collaboration issues in the field. It has increased the urgency and the need for further studies in this field. We welcome chapters presenting research on the many applications of multi-agent studies including, but not limited to, the following key areas: machine learning for multi-agent systems; modeling swarms robots and flocks of UAVs with multi-agent systems; decision science and multi-agent systems; software engineering for and with multi-agent systems; tools and technologies of multi-agent systems.",annualVolume:11423,isOpenForSubmission:!0,coverUrl:"https://cdn.intechopen.com/series_topics/covers/27.jpg",editor:{id:"148497",title:"Dr.",name:"Mehmet",middleName:"Emin",surname:"Aydin",fullName:"Mehmet Aydin",profilePictureURL:"https://mts.intechopen.com/storage/users/148497/images/system/148497.jpg",institutionString:null,institution:{name:"University of the West of England",institutionURL:null,country:{name:"United Kingdom"}}},editorTwo:null,editorThree:null,editorialBoard:[{id:"275140",title:"Dr.",name:"Dinh Hoa",middleName:null,surname:"Nguyen",fullName:"Dinh Hoa Nguyen",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRbnKQAS/Profile_Picture_1622204093453",institutionString:null,institution:{name:"Kyushu University",institutionURL:null,country:{name:"Japan"}}},{id:"20259",title:"Dr.",name:"Hongbin",middleName:null,surname:"Ma",fullName:"Hongbin Ma",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002bRhDJQA0/Profile_Picture_2022-05-02T08:25:21.jpg",institutionString:null,institution:{name:"Beijing Institute of Technology",institutionURL:null,country:{name:"China"}}},{id:"28640",title:"Prof.",name:"Yasushi",middleName:null,surname:"Kambayashi",fullName:"Yasushi Kambayashi",profilePictureURL:"https://s3.us-east-1.amazonaws.com/intech-files/0030O00002aYOQxQAO/Profile_Picture_1625660525470",institutionString:null,institution:{name:"Nippon Institute of Technology",institutionURL:null,country:{name:"Japan"}}}]}]}},libraryRecommendation:{success:null,errors:{},institutions:[]},route:{name:"chapter.detail",path:"/chapters/24291",hash:"",query:{},params:{id:"24291"},fullPath:"/chapters/24291",meta:{},from:{name:null,path:"/",hash:"",query:{},params:{},fullPath:"/",meta:{}}}},function(){var e;(e=document.currentScript||document.scripts[document.scripts.length-1]).parentNode.removeChild(e)}()