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quarta-feira, 28 de outubro de 2015

The Four Intrinsic Rewards that Drive Employee Engagement

http://iveybusinessjournal.com/

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Issues: November / December 2009. Tags: The Workplace. Categories: Featured and The Workplace.
Person helping another up a hill.
Motivational dynamics have changed dramatically to reflect new work requirements and changed worker expectations. One of the biggest changes has been the rise in importance of psychic, or intrinsic rewards, and the decline of material or extrinsic rewards. This author draws upon recent research to explain the popularity of intrinsic rewards and how these rewards can be used to build a high-engagement culture.
I have been researching workplace motivation for about 30 years and I’m amazed at how much has changed recently. Automation and off-shoring have eliminated most of the highly repetitive jobs in the U.S., while global competition has produced flatter, more responsive organizations that require employees to use judgment and initiative to a much greater extent. Over this same 30-year period, the proportion of American workers who say that their work is meaningful, allows them discretion, and makes use of their abilities has more than doubled—from less than one third to about two thirds.1 In addition, younger workers now come to organizations with different expectations than their parents. Raised during an era of rapid technological change and instant access to data, they respond best to work that is more meaningful, allows them to learn cutting-edge skills, and lets them find their own ways of accomplishing tasks.
Most of the motivational models used today were developed in earlier eras, when work and workers were different. That is why my colleagues and I developed models and strategies of motivation that better reflect the changes in today’s work dynamics.2 In doing so, we discovered that intrinsic rewards have become more important and more prevalent in the workplace today. This article will describe the reasons for this increase and why intrinsic rewards are so important today.

Extrinsic and intrinsic rewards

Extrinsic rewards—usually financial—are the tangible rewards given employees by managers, such as pay raises, bonuses, and benefits. They are called “extrinsic” because they are external to the work itself and other people control their size and whether or not they are granted. In contrast, intrinsic rewards are psychological rewards that employees get from doing meaningful work and performing it well.
Extrinsic rewards played a dominant role in earlier eras, when work was generally more routine and bureaucratic, and when complying with rules and procedures was paramount. This work offered workers few intrinsic rewards, so that extrinsic rewards were often the only motivational tools available to organizations.
Extrinsic rewards remain significant for workers, of course. Pay is an important consideration for most workers in accepting a job, and unfair pay can be a strong de-motivator. However, after people have taken a job and issues of unfairness have been settled, we find that extrinsic rewards are now less important, as day-to-day motivation is more strongly driven by intrinsic rewards.

The intrinsic rewards in today’s work

To identify these intrinsic rewards, we began by analyzing the nature of today’s work. Basically, most of today’s workers are asked to self-manage to a significant degree—to use their intelligence and experience to direct their work activities to accomplish important organizational purposes. This is how today’s employees add value—innovating, problem solving and improvising to meet the conditions they encounter to meet customers’ needs.
In turn, we found that the self-management process involves four key steps:3
  1. Committing to a meaningful purpose
  2. Choosing the best way of fulfilling that purpose
  3. Making sure that one is performing work activities competently, and
  4. Making sure that one is making progress to achieving the purpose.
Each of these steps requires workers to make a judgment—about the meaningfulness of their purpose, the degree of choice they have for doing things the right way, the competence of their performance, and the actual progress being made toward fulfilling the purpose. These four judgments are the key factors in workers’ assessments of the value and effectiveness of their efforts—and the contribution they are making.
When positive, each of these judgments is accompanied by a positive emotional charge. These positive charges are the intrinsic rewards that employees get from work, ranging in size from quiet satisfaction to an exuberant “Yes!” They are the reinforcements that keep employees actively self-managing and engaged in their work.
The following are descriptions of the four intrinsic rewards and how workers view them:4
  • Sense of meaningfulness. This reward involves the meaningfulness or importance of the purpose you are trying to fulfill. You feel that you have an opportunity to accomplish something of real value—something that matters in the larger scheme of things. You feel that you are on a path that is worth your time and energy, giving you a strong sense of purpose or direction.
  • Sense of choice. You feel free to choose how to accomplish your work—to use your best judgment to select those work activities that make the most sense to you and to perform them in ways that seem appropriate. You feel ownership of your work, believe in the approach you are taking, and feel responsible for making it work.
  • Sense of competence. You feel that you are handling your work activities well—that your performance of these activities meets or exceeds your personal standards, and that you are doing good, high-quality work. You feel a sense of satisfaction, pride, or even artistry in how well you handle these activities.
  • Sense of progress. You are encouraged that your efforts are really accomplishing something. You feel that your work is on track and moving in the right direction. You see convincing signs that things are working out, giving you confidence in the choices you have made and confidence in the future.

Levels of intrinsic rewards

Professor Walter Tymon (Villanova University) and I developed and refined a measure of the four intrinsic rewards, now available as the Work Engagement Profile.5 Together with our colleagues, we have used it for research, training, and interventions in a number of organizations in the U.S., Canada, and India.
We found it useful to break down each reward into three levels—high (the top 25% of our norm sample), middle-range (middle 50%), and low (bottom 25%).
High-range scorers experience the four intrinsic rewards most intensely. These rewards are highly energizing and engaging.
Middle-range scorers experience these same rewards to a more moderate degree—as somewhat positive but limited. For example, their work may seem reasonably meaningful when they stop to think of it; they may have a fair amount of choice but have to live with some decisions that don’t make sense to them; they may feel they do most things pretty well but not a few others; and they may feel they are making some progress but less than they would like. They experience these reward levels as moderately energizing and engaging—enough to put in a “fair day’s work,” but end up feeling less satisfied than they would like.
Low-range scorers are dissatisfied with many aspects of their work. They may feel their work is relatively meaningless or pointless, that they are unable to make or influence decisions about how to do their work, are unable to perform work activities very well, and are making little or no headway. Experiencing these feelings drains the workers of energy and they are likely to become cynical and resentful about their job over time.
Important benefits of the intrinsic rewards
Our research findings to date reveal the widespread benefits of the above intrinsic rewards for both organizations and employees.6
From the organization’s viewpoint, our data confirm the impact of the intrinsic rewards on employee self-management. For example, people with high reward levels show greater concentration and are rated as more effective by their bosses. But the benefits extend beyond self-management. The intrinsic rewards are strong predictors of retention. Note that this is the “right” kind of retention—keeping the people who are energized and self-managing rather than those who can’t afford to leave. We find that employees with high levels of intrinsic rewards also become informal recruiters and marketers for their organization. They recommend the organization to friends as a place to work and recommend its products and services to potential customers.
The intrinsic rewards are also a relatively healthy and sustainable source of motivation for employees. There is little chance of burnout with this form of motivation. Workers with high reward levels experience more positive feelings and fewer negative ones on the job. Their job satisfaction is higher, they report fewer stress symptoms, and are more likely to feel that they are developing professionally.7
Overall, the intrinsic rewards seem to create a strong, win/win form of motivation for both an organization and its employees—and one which suits the times. This type of motivation is focused on the shared desire that employees’ work makes an effective contribution to meaningful purposes, so that it is performance-driven. It embodies the kind of self-management and professional development demanded by younger workers. It does not depend on large outlays of money to generate extra effort, so that it is feasible when funds are tight. Furthermore, intrinsic rewards do not require that a boss be present, as exemplified by the growth of the virtual work and telecommute environments…
Despite these benefits, however, a number of managers underestimate the importance of intrinsic rewards, and continue to treat financial rewards as the key factor in motivating others. While some of this bias may simply come from their use and familiarity with older models, there is another explanation. Research shows that, although people are quick to recognize the role of intrinsic rewards in their own behavior, there is a general tendency to assume that other people are motivated mostly by money and self-interest.8 In our workshops, for example, managers are commonly surprised to learn that intrinsic rewards are valued as much by their employees as by themselves. So, it is important to educate the managers in your organization on this issue.

Building a high-engagement culture

In our work with managers, change agents and training specialists, we have developed seven guidelines for building a culture that supports high levels of engagement and intrinsic rewards:9
1. Begin with a meaningful purpose.
Unlike financial rewards, you simply can’t task the Human Resources Department with developing an “intrinsic reward system.” Building intrinsic motivation is largely a line management responsibility, although HR can offer considerable help. That responsibility begins with spelling out a meaningful purpose for the organization. To be meaningful, this purpose usually needs to involve more than profit, tapping directly into the contribution that the organization’s work makes to its customers—the contribution that allows it to earn a profit. Again, it is largely that sense of contribution to something of value that drives the entire self-management process.
2. Build intrinsic motivation and engagement into management training and executive coaching.
As mentioned earlier, managers tend to recognize the role of intrinsic rewards in their own motivation, but often underestimate their importance for other people. To build a culture of engagement it is important to incorporate training on intrinsic motivation and employee engagement into management development programs. We also find that managers are more credible and effective in promoting the value of engagement when they first learn how to better understand and manage their own intrinsic rewards. Training typically begins by getting managers in touch with their own intrinsic rewards and then shifts to learning how to support the intrinsic rewards of their direct reports. At executive levels, the four intrinsic rewards also provide a useful framework for executive coaching. For example, the New West Institute builds its coaching on executive transitions around the four rewards, identifying what would be most meaningful for the executives in their new position, what choices they have, the new competencies they need to build, and the ways they will identify progress.10 Training and coaching, then, are an important part of embedding intrinsic motivation and engagement into the organization’s culture.
3. Focus conversations on meaningfulness, choice, competence and progress.
Leaders from the top down need to convey the same message—that the organization stands for doing work that matters and doing it well. When approaching any work project, leaders can underline the importance of contribution by focusing discussions on the basic questions in the self-management process:
  • What can we do here that is meaningful?
  • What creative choices can we think of to accomplish this?
  • How can we make sure we’re doing this work competently?
  • How can we make sure we’re actually accomplishing the purpose?
These questions bring employee contributions to the foreground and highlight the intrinsic rewards.
4. Engage the “middle.”
Pay special attention to building intrinsic motivation for people in the middle ranges—the large group that is only somewhat engaged. If you are able to move their intrinsic rewards to the high range, they will combine with the people who already highly engaged to form a large majority of highly engaged, energized people—the critical mass needed to support a culture of high engagement.
5. Measure intrinsic reward levels.
Without some way of assessing the state of intrinsic rewards in your organization, you will be flying blind. We use the Work Engagement Profile for systematic measurement, though with experience it is possible to get a rough sense of reward levels from everyday conversations with employees.11 Measuring the reward levels will show you the overall level of engagement in your organization and allow you to recognize improvement. It will also allow you to determine if any rewards are at lower levels than others. Because self-management requires all four reward levels, the lowest rewards will tend to act as a drag on overall engagement over time—so that they deserve special attention.
6. Provide missing building blocks for intrinsic rewards that you need to bolster.
Each reward has its own unique building blocks. Building a sense of competence involves actions that are different than those used in building a sense of choice, for example. The following is a list of key building blocks.12
Sense of Meaningfulness:
  • A non-cynical climate—freedom to care deeply
  • Clearly identified passions—insight into what we care about
  • An exciting vision—a vivid picture of what can be accomplished
  • Relevant task purposes—connection between our work and the vision
  • Whole tasks—responsibility for an identifiable product or service
Sense of Choice:
  • Delegated authority—the right to make decisions
  • Trust—confidence in an individual’s self-management
  • Security—no fear of punishment for honest mistakes
  • A clear purpose—understanding what we are trying to accomplish
  • Information—access to relevant facts and sources
Sense of Competence:
  • Knowledge—an adequate store of insights from education and experience
  • Positive feedback—information on what is working
  • Skill recognition—due credit for our successes
  • Challenge—demanding tasks that fit our abilities
  • High, non-comparative standards—demanding standards that don’t force rankings
Sense of Progress:
  • A collaborative climate—co-workers helping each other succeed
  • Milestones—reference points to mark stages of accomplishment
  • Celebrations—occasions to share enjoyment of milestones
  • Access to customers—interactions with those who use what we’ve produced
  • Measurement of improvement—a way to see if performance gets better
Notice that some of these building blocks involve relatively observable or “hard” elements, such as job designs, information systems, and formal authority. Others involve “softer” aspects of organizational culture and managerial style, such as a non-cynical climate, celebrations, trust, and skill recognition.
7. Adopt a change and implementation process that is itself engaging.
You could try to build intrinsic rewards using a centralized, top-down decision process. But we find that it makes more sense to use the change process itself as a means of fostering high levels of engagement. That was the genius of the Work Out process used by Jack Welch to help change the culture at GE.13 Similar processes are now used for planning and change in a number of organizations.14 In these applications, participatory processes allow teams of employees to identify meaningful work-related problems, recommend solutions that make sense, apply their diverse competencies, and experience a rapid sense of progress. When these processes address the building of intrinsic rewards and engagement, they not only yield workable solutions but also produce their own sense of excitement— which often serves as a significant turning point in the organization’s culture.15

Notes and References
  1. These data are from James O’Toole and Edward Lawler, III, The New American Workplace, Palgrave Macmillan, 2006.
  2. This article is based on research findings and experience collected with the following colleagues: Walter Tymon, Jr., Villanova University; Erik Jansen, Naval Postgraduate School; Bruce Vincent and Steve deBree, New West Institute; and Betty Velthouse, University of Michigan, Flint.
  3. The self-management process is described in more detail in Kenneth Thomas, Intrinsic Motivation at Work, Berrett-Koehler, 2009.
  4. These descriptions are adapted from Kenneth Thomas and Walter Tymon, Jr., Work Engagement Profile, CPP, Inc., 2009.
  5. The Work Engagement Profile, with interpretive materials, is available in print form through CPP, Inc., atwww.cpp.com/WEP. An online version will be available in 2010. Information on the reliability and validity of the Profile is provided in the Work Engagement Profile Technical Brief, available online atwww.cpp.com/WEPtechbrief.
  6. These findings are summarized in the Work Engagement Profile Technical Brief.
  7. These finding are also summarized in the Work Engagement Profile Technical Brief. I am particularly indebted to Professor Jacques Forest of the Universite du Quebec a Montreal for permission to summarize his work. See also the findings on professional development in the article by Walter Tymon, Jr., Stephen Stumpf and Jonathan Doh, “Exploring talent management in India: The neglected role of intrinsic rewards,” Journal of World Business, 2010 in press.
  8. This finding was reported by Chip Heath, “On the social psychology of agency relationships: Lay theories of motivation overemphasize extrinsic incentives,” Organizational Behavior and Human Decision Processes, 1999, pp. 25-62.
  9. I am particularly indebted to Bruce Vincent and Steve deBree of the New West Institute, an early adopter of the Work Engagement Profile and my book, Intrinsic Motivation at Work (Berrett-Koehler, 2000 and 2009). They have contributed a number of lessons learned from their applications to organizational change and executive transition coaching.
  10. Information on New West’s approach to executive transition coaching is available atwww.newwestinstitute.com.
  11. For more specific advice on recognizing and increasing intrinsic reward levels, see Intrinsic Motivation at Work, 2009.
  12. This list is adapted from the Work Engagement Profile. A more detailed discussion of the building blocks and related management actions is contained in Intrinsic Motivation at Work.
  13. The Work-Out process has been described in a number of books, including Jack: Straight From the Gut, by Jack Welch with John Byrne, Warner Business Books, 2001.
  14. See for example the participative planning process described by Marvin Weisbord and Sandra Janoff inFuture Search, Second Edition, Berrett-Koehler, 2000.
  15. This observation is based on the change work of the New West Institute, which is built around the concepts in this article. Information on the New West Institute’s participative approach to change is available at www.newwestinstitute.com.

sexta-feira, 23 de outubro de 2015

The DACHOR Project: Multibody Dynamics and Control of Hybrid Active Orthoses

O engenheiro biomédico Paulo de Melo, de 29 anos, venceu o concurso Fraunhofer Portugal Challenge 2014 na categoria de doutoramento com um dispositivo para ajudar pessoas com problemas motores. A ideia foi premiada com 3000 euros e destina-se a ajudar doentes que sofrem com o chamado “pé pendente”.


O novo produto chama-se ISTim Modular Stimulation System e baseia-se na investigação de doutoramento de Paulo de Melo, realizada Instituto Superior Técnico (IST) e intitulada “A Novel Functional Electrical Stimulation System and Strategies for Motor Rehabilitation”.

Arrastar o pé ou caminhar tocando no chão primeiro com a parte da frente do pé (em vez do calcanhar) são algumas das características do pé pendente. Esta patologia consiste na perda de controlo de um grupo de músculos da parte de baixo da perna que controla o movimento do pé. “Quando balançamos a perna para ir de um passo para o outro e levantá-la do chão, esses músculos funcionam e puxam para cima o pé para não batermos com o pé no chão. A falta de activação desses músculos faz com que o pé arraste ou bata no chão”, explicou Paulo ao P3.

É aqui que entra este dispositivo, um sistema modular de estimulação eléctrica para reabilitação motora, que promete ajudar o doente a ter uma mobilidade mais próxima do normal, actuando ao longo das diversas fases da marcha. Como? O dispositivo, colocado na própria perna do doente (debaixo do joelho), baseia-se na estimulação eléctrica funcional dos músculos associados à perda de função, actuando em certas fases da marcha através de pequenos choques eléctricos em determinadas localizações da perna e que fazem o pé mexer-se normalmente.

Para o efeito, é necessário um estimulador eléctrico funcional, mas também uma rede de sensores para saber o que se passa no pé, se está em contacto com o chão ou o qual o ângulo que está a fazer enquanto a pessoa anda. Para quê? Para conseguir adequar-se correctamente e corrigir com um estímulo diferente.

Dispositivo “portátil” e “adaptável”
Eis aqui uma das características que Paulo de Melo acredita ser distintiva face a outros dispositivos que já existem no mercado. “É bastante flexível em termos de adaptação às necessidades concretas da patologia. Modelamos matematicamente a perna do doente e o pé e como reagem face aos estímulos eléctricos e, por isso, podemos dar estimulações dos músculos muito mais fisiológicas do que os [dispositivos] que estão no mercado, que são simplesmente cegos a este princípio. [Estes] dão o mesmo tipo de estímulo independentemente do que se passa no pé ou no meio que o envolve, se há perturbações, [por exemplo, ou] se alguma coisa bate no pé ou há uma pedra”, garante.

Para além de “adaptativo”, o dispositivo é também “portátil”, “leve”, “confortável” e “flexível”, pois pode utilizado para outras patologias, garante o vencedor do prémio. “Esse sistema, agora, está a funcionar para o pé pendente, mas sendo modular e flexível, através destas unidades modulares de estimulação, conseguimos escalá-lo para outras patologias até mais complicadas, a nível do tornozelo e joelho ou mesmo para a ambulação de paraplégicos. O sistema actual já está preparado para isso. Desenvolvemos esta plataforma de estimulação e fizemo-la o suficientemente genérica para termos agora a liberdade de integrá-la a problemas mais complexos”, esclarece.

Antes de chegar ao mercado, o dispositivo médico necessita ainda de ser certificado, um processo que ainda pode demorar alguns anos. Já as unidades modulares de estimulação — uma das componentes do dispositivo — “estão mais próximas do mercado”. Paulo afirma que uma parte do prémio será investida no desenvolvimento dos protótipos (já existentes) destas unidades modulares e na sua comercialização.

Este trabalho é o resultado de uma tese de doutoramento, à qual Paulo se dedicou durante quatro anos. Integra-se, ainda, no projecto DACHOR(Multibody Dynamics and Control of Hybrid Active Orthoses), do programa MIT Portugal. Doutorado em Bioengenharia pelo MIT Portugal/IST, Paulo pretende que o seu futuro continue a passar pelas áreas da biomecânica e da performance humana.

Fraunhofer Portugal Challenge é um concurso que, desde 2010, premeia “as melhores ideias científicas desenvolvidas em Portugal”, em duas categorias (mestrado e doutoramento). Na categoria de doutoramento foram ainda distinguidos, nesta edição, dois investigadores da Universidade do Porto: em segundo lugar, Gilberto Bernardes, com um “software” que auxilia músicos na manipulação de sinais áudio em contextos criativos e Pydi Ganga, em terceiro, com uma plataforma para desenvolver circuitos integrados com tecnologias a-GIZO TFT. Os prémios foram de 1500 e 1000 euros, respectivamente.

http://www.mitportugal.org/
MONDAY, 30 AUGUST 2010
In recent years, Portugal has developed strong biological sciences and emerging bioengineering activities that serve as the foundation for knowledge-based innovation in the medical devices field.  Similarly, advances in new materials, micro/nanosensors, and microactuators technologies are leading to a new class of promising products, normally referred to as smart devices, able to monitor their environment and perform accordingly. Among other possibilities, such types of behavior can be obtained by the use of novel materials whose physical properties can change significantly with the surrounding environment or by active biological agents.
The opportunities in the field of medical devices are vast, both at the research, innovation and product development levels. The development of the particular skill set required to take advantage of these opportunities is a core goal of the MIT Portugal Program, more specifically in the MDIP (Material & Design-Inspired Products) Targeted Research Application Area.
Within MDIP the MIT Portugal Program has been developing a number of projects in collaboration with industrial partners, using an integrated approach to build innovative products. Within the medical devices field, one of MIT Portugal research projects consists in building an Ankle-Foot Orthosis, aimed at enhancing mobility of cystic fibrosis patients and some amputees, which applies both muscle stimulation and mechanical actuators to improve the mobility and usability of available prostheses that will allow patients to walk with greater comfort and mobility than ever before.
“Advances in robotics technology, computer technology, and materials science are enabling the development of hybrid human-machine technologies that allow humans to perform at higher levels, to function in extreme environments, and to recover from or compensate for injury better.” – Prof. Dava Newman (Professor of Aeronautics and Astronautics and Engineering Systems, Director of Technology and Policy Program, MIT)
The DACHOR project is an inter-institutional venture that joins together two MIT Portugal participating institutions (Instituto Superior Técnico-Technical University of Lisbon and the University of Minho), MIT and a Portuguese company focused in creating innovative solutions in the fields of Research, Sports and Health Care (PLUX).
Prof. Miguel Tavares da Silva (Biomechatronics Research Group/IDMEC, Instituto Superior Técnico) has led the DACHOR Project team of researchers since January 2009. Prof. Jorge Martins (IST), Prof. Paulo Flores (University of Minho), Prof. Dava Newman and Prof. Hugh Herr from MIT are also part of the team.
OttoBock Portugal, a company specializing in the development of technologies for prostheses, orthoses, rehabilitation, wheel chairs and neuro-stimulation, also collaborates with the DACHOR Project. In addition, the Biomechanics Laboratory at IST has been a key resource for the analysis of pathological and non-pathological human movement.
“What we can achieve with this type of technologies is that one can really maximize the performance of ortho-prosthetic products and the quality of life of people with reduced mobility. And that’s what really matters to us.” - Dr. Ricardo Marcelino (Prosthetist/Orthotist, Otto Bock Portugal)
This Project began with the need to respond to different pathologies.  For that reason, medical teams from the Medical School of University of Lisbon, Santa Maria and D. Estefânia Hospitals initiated contact with MIT Portugal researchers in order to work to find solutions together.
The DACHOR project proposes the development of an innovative powered Ankle-Foot Orthosis (AFO) to aid individuals with reduced mobility and neuromuscular disabilities of the locomotion apparatus, providing not only the support for general gait disabilities but also the rehabilitation of the musculoskeletal apparatus. The hybrid nature of this powered orthosis is due to an external mechanical actuation that is complemented by Functional Electrical Stimulation (FES).
DACHOR_fig1
Development of a Hybrid Active AFO

The DACHOR project relies on multibody dynamics methodologies to model and optimize altered human gait and on adaptive control architectures to distribute the control forces between both actuators. It is expected that the highlighted innovations contribute to an improved locomotion and muscular rehabilitation, to an increased autonomy and to a reduction in power, size and weight of the external actuators. The outcomes of the project span from new computational modeling tools and control methods to new mechanical designs and prototypes for hybrid human-machine systems. The results from the computational modeling provide know-how to the development of a prototype of an active ankle-foot orthosis with the devised control architecture.
In 2011 physical prototypes will be implemented and MIT Portugal researchers expect to develop prototypes for the mechanical orthosis and for the electro-stimulation orthosis by the end of this year. Also, in 2011 MIT Portugal researchers expect to produce a prototype for a hybrid orthosis, gathering the mechanical and the electro-stimulation components.
The most important result expected from the DACHOR project is a novel orthotic device that helps individuals with general gait disabilities. Patients will have access to a better orthotic device that will provide locomotion support as well as muscular rehabilitation, significantly improving their quality of life. This is possible by means of novel hybrid adaptive biorobotic technology that is in a first stage implemented computationally using advanced 3D multibody integrated models, and in a later stage materialized in a physical prototype.
DACHOR_fig2
Computational models

Another important result is reflected in the results obtained from physiotherapy programs in which a new tool will be available that can help physiatrists to devise new and more efficient treatment plans, allowing faster patient recovery with improved results.
From the scientific point of view the outcomes of this project are twofold. The most important is to provide conditions to enlarge the research community so that even more advanced orthotic devices can be envisaged in the near future. The other repercussion is to allow team researchers with teaching responsibilities to spread knowledge and motivate new students to enroll research in this important topic.
From the industry point of view, and considering the participation in the project of a startup company with experience in technology transfer, the team expects to create spinoff products, such as a new FES device, and eventually a new spin-off company.
The DACHOR Project highlights the human enhancement component by working to assist people with locomotion disabilities and improving their quality of life in the near future. This will have a major impact in peoples’ lives, enabling them to have greater mobility with less effort and fatigue. Moreover, patients will be able to manipulate and use a wide range of everyday objects that otherwise would constitute barriers to them. DACHOR’s impact on the self-esteem and integration of disabled people makes this project a potentially significant application of research and technology to contemporary challenges in society.

sexta-feira, 16 de outubro de 2015

Automated gait rehabilitation with LYRA explained

Automated Gait Therapy is backed by 20 Years of Research.

Please see a selection of notable papers and clinical studies below:

Stroke

  • Jorgensen, H. S., Nakayama, H., Raaschou, H. O. & Olsen, T. S. Recovery of walking function in stroke patients: The Copenhagen stroke study. Arch. Phys. Med. Rehabil. 76, 27–32 (1995).
  • Halder, P. et al. Electrophysiological evidence for cortical plasticity with movement repetition. Eur. J. Neurosci. 21,2271–2277 (2005).
  • Peurala, S. H. et al. Effects of intensive therapy using gait trainer or floor walking exercises early after stroke. J. Rehabil. Med. 41, 166–173 (2009).
  • Pohl, M. et al. Repetitive locomotor training and physiotherapy improve walking and basic activities of daily living after stroke: a single-blind, randomized multicentre trial (DEutsche GAngtrainerStudie, DEGAS). Clin. Rehabil. 21, 17–27 (2007).
  • Dobkin, B. H. Strategies for stroke rehabilitation. Lancet Neurol. 3, 528–536 (2004).
  • O’Dell, M. W., Lin, C.-C. D. & Harrison, V. Stroke rehabilitation: strategies to enhance motor recovery. Annu. Rev. Med.60, 55–68 (2009).
  • Kwakkel, G., Kollen, B. & Lindeman, E. Understanding the pattern of functional recovery after stroke: facts and theories. Restor. Neurol. Neurosci. 22, 281–299 (2004).
  • Mehrholz, J., Pohl, M. & Elsner, B. Treadmill training and body weight support for walking after stroke. Cochrane database Syst. Rev. 1, CD002840 (2014).
  • Mehrholz, J., Elsner, B., Werner, C., Kugler, J. & Pohl, M. Electromechanical-assisted training for walking after stroke.Cochrane database Syst. Rev. 7, CD006185 (2013).

Spinal Cord Injury

  • Winchester, P. et al. Changes in supraspinal activation patterns following robotic locomotor therapy in motor-incomplete spinal cord injury. Neurorehabil. Neural Repair 19, 313–324 (2005).
  • Mehrholz, J. et al. Locomotor training for walking after spinal cord injury ( Review ) Locomotor training for walking after spinal cord injury. (2012). doi:10.1002/14651858.CD006676.pub3.Copyright

Parkinsons Disease

  • Picelli, A. et al. Does robotic gait training improve balance in Parkinson’s disease? A randomized controlled trial.Parkinsonism Relat. Disord. 18, 990–993 (2012).
  • Picelli, a. et al. Robot-Assisted Gait Training in Patients With Parkinson Disease: A Randomized Controlled Trial.Neurorehabil. Neural Repair 26, 353–361 (2012).
  • Picelli, A. et al. Robot-assisted gait training versus equal intensity treadmill training in patients with mild to moderate Parkinson’s disease: A randomized controlled trial. Park. Relat. Disord. 19, 605–610 (2013).
  • Sale, P. et al. Robot-assisted walking training for individuals with Parkinson’s disease: a pilot randomized controlled trial. BMC Neurol. 13, 50 (2013).

Multiple Sclerosis

  • Swinnen, E. et al. Treadmill Training in Multiple Sclerosis: Can Body Weight Support or Robot Assistance Provide Added Value? A Systematic Review. Mult. Scler. Int. 2012, 1–15 (2012).
  • Gandolfi, M. et al. Robot-assisted vs. sensory integration training in treating gait and balance dysfunctions in patients with multiple sclerosis: a randomized controlled trial. Front. Hum. Neurosci. 8, 318 (2014).
  • Vaney, C. et al. Robotic-Assisted Step Training (Lokomat) Not Superior to Equal Intensity of Over-Ground Rehabilitation in Patients With Multiple Sclerosis. Neurorehabil. Neural Repair 26, 212–221 (2012).
  • Lo, A. C. & Triche, E. W. Improving gait in multiple sclerosis using robot-assisted, body weight supported treadmill training. Neurorehabil. Neural Repair 22, 661–671 (2008).
  • Schwartz, I. et al. Robot-assisted gait training in multiple sclerosis patients: a randomized trial. Mult. Scler. 18, 881–890 (2012).
  • Beer, S. et al. Robot-assisted gait training in multiple sclerosis: a pilot randomized trial. Mult. Scler. 14, 231–236 (2008).

Cerebral Palsy

  • Druzbicki, M. et al. Functional effects of robotic-assisted locomotor treadmill therapy in children with cerebral palsy.J. Rehabil. Med. 45, 358–363 (2013).
  • Smania, N. et al. Improved gait after repetitive locomotor training in children with cerebral palsy. Am. J. Phys. Med. Rehabil. 90, 137–149 (2011).

Traumatic Brain Injury

  • Freivogel, S., Mehrholz, J., Husak-Sotomayor, T. & Schmalohr, D. Gait training with the newly developed ‘LokoHelp’-system is feasible for non-ambulatory patients after stroke, spinal cord and brain injury. A feasibility study. Brain Inj.22, 625–632 (2008).
  • We are currently looking for clinical partners to further investigate the effects of automated gait therapy with patients after traumatic brain injury! Contact us to learn more.

Other

  • Courtine, G. et al. Transformation of nonfunctional spinal circuits into functional states after the loss of brain input.Nat. Neurosci. 12, 1333–1342 (2009).
  • Shadmehr, R. & Mussa-Ivaldi, F. a. Adaptive representation of dynamics during learning of a motor task. J. Neurosci.14, 3208–3224 (1994).
  • Hömberg, V. Evidence based medicine in neurological rehabilitation–a critical review. Acta Neurochir. Suppl. 93, 3–14 (2005).
  • Freivogel, S., Schmalohr, D. & Mehrholz, J. Improved walking ability and reduced therapeutic stress with an electromechanical gait device. J. Rehabil. Med. 41, 734–739 (2009)