Archive for September, 2015
Researchers at the University of Pittsburgh have received two grants totaling $500,209 from the National Science Foundation to research walking exoskeletons.
Nitin Sharma, PhD, assistant professor of mechanical engineering and material science at the University of Pittsburgh’s Swanson School of Engineering, will lead the research, which aims to create a hybrid system optimizing the benefits of both functional electrical stimulation (FES) and powered exoskeletons. FES uses low-level electrical currents to activate the exoskeleton wearer’s leg muscles, while powered exoskeletons utilize electric motors mounted on an external frame to move the wearer’s joints.
“We are trying to combine electrical stimulation with robotics to design a control system for a hybrid exoskeleton,” Sharma said in a press release. “It is like a hybrid car switching between a gas engine and an electric motor depending on circumstance. The algorithms we are developing determine when to use power from FES and when to use the power from the motors on the frame.
”Sharma and colleagues will investigate control algorithms through two separate projects. “UNS: Optimal Adaptive Control Methods for a Hybrid Exoskeleton” is funded by the General and Age-Related Disabilities Engineering Division of National Science Foundation (NSF) and will focus on using adaptive control algorithms to allocate optimized control inputs to FES and electric motors during single joint movements. Meanwhile, “Coordinating Electrical Stimulation and Motor Assist in a Hybrid Neuroprosthesis Using Control Strategies Inspired by Human Motor Control” is funded by the Civil, Mechanical and Manufacturing Innovation Division of the NSF and will focus on the use of control algorithms to determine the best synergy between FES-induced multi-joint movements and movements aided by a powered exoskeleton.
Both projects also will investigate exoskeleton efficiency to aid manufacturers in developing hybrid models that use FES technology, powered frames and robotics.
“Current exoskeleton research is using devices completely powered by electric motors. They have huge battery packs and can only provide a maximum of about an hour of continuous walking. With FES, you are using a person’s own muscles to make that person walk. FES also has been shown clinically to improve cardio-vascular fitness, increase muscle strength, and prevent atrophy,” Sharma said.
The aim of this review is to discuss the basic forms of neuropsychological rehabilitation for patients with traumatic brain injury (TBI). More broadly, we discussed cognitive rehabilitation therapy (CRT) which constitutes a fundamental component in therapeutic interaction at many centres worldwide.
Equally presented is a comprehensive model of rehabilitation, the fundamental component of which is CRT. It should be noted that the principles of this approach first arose in Poland in the 1970s, in other words, several decades before their appearance in other programmemes.
Taken into consideration are four factors conditioning the effectiveness of such a process: comprehensiveness, earlier interaction, universality and its individualized character. A comprehensive programmeme of rehabilitation covers: cognitive rehabilitation, individual and group rehabilitation with the application of a therapeutic environment, specialist vocational rehabilitation, as well as family psychotherapy.
These training programmemes are conducted within the scope of the ‘Academy of Life,’ which provides support for the patients in their efforts and shows them the means by which they can overcome existing difficulties. Equally emphasized is the close cooperation of the whole team of specialists, as well as the active participation of the family as an essential condition for the effectiveness of rehabilitation and, in effect, a return of the patient to a relatively normal life. Also presented are newly developing neurothechnologies and the neuromarkers of brain injuries. This enables a correct diagnosis to be made and, as a result, the selection of appropriate methods for neuropsychological rehabilitation, including neurotherapy.
[WEB SITE] Why Has My Sister’s Personality Changed Since Her Traumatic Brain Injury? – brainline.org
QUESTION: My sister was in a car crash a couple of years ago. Since the wreck, her temperament has changed drastically. She is very snappy toward her children and blames them for everything wrong in her life. She just doesn’t seem to get any pleasure out of life and we are all worried about her lack of visible emotion. Any suggestions on how we might help her?
ANSWER: Personality changes like your sisters are not uncommon following a traumatic brain injury. After all, how we think and process the world is so much of who we are. Temperament is essentially the way our brain interprets the world around us. With a brain injury, the mechanisms we use to filter and understand information are disrupted. Personality changes can come from two sources following a brain injury:
- specific changes in how the brain experiences, understands, modulates, and expresses emotion
- emotional reactions to the changes brought about by the brain injury
Brain injury can affect connections that go from the cerebral cortex (the thinking part of the brain) to the limbic system (a series of inner brain structures that control and modulate emotion). These connections allow us to evaluate our emotional reactions, determine how important or minor events are, and decide on a response that matches the demands of the situation. When these connections are impaired, our emotional reactions are different from what they were prior to the injury, and are not always in tune with the situation at hand.
In addition to this, a brain injury can be emotionally traumatic. People respond with anxiety, frustration, anger, sadness, and depression to their changed capabilities and life circumstances. It’s normal for people to mourn the life they once had and try to find ways to cope with their new life and personality. These responses are affected by the potentially impaired connections described above, and may result in emotional extremes.
It is not unusual for the person with a brain injury and/or his or her family to need some counseling or therapy to understand this new identity, personality, and emotional reaction style. The person with TBI, like your sister, may work on learning strategies to better express emotions, avoid those situations likely to be particularly frustrating, read signs of emotional distress, and react in a calmer manner to emotionally charged situations. You can help by learning strategies to de-escalate your sister’s emotional outbursts, redirect her anger and frustration, understand the meaning behind a particular emotion (or lack thereof), and help create a calming environment for all concerned. A therapist or counselor may also recommend exploring the option of medication, depending on the nature and severity of your sister’s personality challenges.
[ARTICLE] Design and Control of a 3 DOF Hand Skeleton for Rehabilitation after Stroke – Full Text PDF
Stroke is one of the most common diseases among the elderly with high personal and societal costs. In recent years, robotic rehabilitation for stroke has become an active area of research for assistance, monitoring and qualifying the rehabilitation treatments. The key issue needed for improving rehabilitation system is that patient feedback should be taken into account by the robotic rehabilitation systems for providing rehabilitation treatment. Changes in the delivery of rehabilitation treatment are an important issue since the patient or specialist should be able to express their sense about doing things and apply the needed improvements in treatment. Therefore, in this study, a three degree-of-freedom (3-DOF) exoskeleton design of a thumb has been investigated. Then, a control structure is provided for greater security in which the patient feedback is evaluated in order to make necessary automatic changes in method of treatment (changing speed and force). In this design, a versatile framework with high performance is offered to simultaneously control thumb force and position regarding the patients’ feedback. This may help to keep the patient in the treatment process, reduce interventions and therapist caseload, effective automatic transmission of treatment and pain relief during the course of treatment. The results of the study suggest that the force and speed on the thumb can be changed during the rehabilitation period according to the patient’s needs. This advantage may be considered as an essential step for improvement of the rehabilitation efficiency.
[ARTICLE] The feasibility of a brain-computer interface functional electrical stimulation system for the restoration of overground walking after paraplegia – Full text HTML
Background: Direct brain control of overground walking in those with paraplegia due to spinal cord injury (SCI) has not been achieved. Invasive brain-computer interfaces (BCIs) may provide a permanent solution to this problem by directly linking the brain to lower extremity prostheses. To justify the pursuit of such invasive systems, the feasibility of BCI controlled overground walking should first be established in a noninvasive manner. To accomplish this goal, we developed an electroencephalogram (EEG)-based BCI to control a functional electrical stimulation (FES) system for overground walking and assessed its performance in an individual with paraplegia due to SCI.
Methods: An individual with SCI (T6 AIS B) was recruited for the study and was trained to operate an EEG-based BCI system using an attempted walking/idling control strategy. He also underwent muscle reconditioning to facilitate standing and overground walking with a commercial FES system. Subsequently, the BCI and FES systems were integrated and the participant engaged in several real-time walking tests using the BCI-FES system. This was done in both a suspended, off-the-ground condition, and an overground walking condition. BCI states, gyroscope, laser distance meter, and video recording data were used to assess the BCI performance.
Results: During the course of 19 weeks, the participant performed 30 real-time, BCI-FES controlled overground walking tests, and demonstrated the ability to purposefully operate the BCI-FES system by following verbal cues. Based on the comparison between the ground truth and decoded BCI states, he achieved information transfer rates >3 bit/s and correlations >0.9. No adverse events directly related to the study were observed.
Conclusion: This proof-of-concept study demonstrates for the first time that restoring brain-controlled overground walking after paraplegia due to SCI is feasible. Further studies are warranted to establish the generalizability of these results in a population of individuals with paraplegia due to SCI. If this noninvasive system is successfully tested in population studies, the pursuit of permanent, invasive BCI walking prostheses may be justified. In addition, a simplified version of the current system may be explored as a noninvasive neurorehabilitative therapy in those with incomplete motor SCI.
A healthy diet during the recovery from a brain injury is highly beneficial. Scientists know that deficiencies in certain nutrients and chemicals can cause disruptions in brain functioning and the ability to think clearly. The brain uses calories to function. When someone sustains a brain injury, it is necessary to eat enough nutritional calories to help the brain function efficiently.
Nutritional Tips for Head Injuries
Eat small meals every three to four hours.
Keep small baggies of healthy snacks with you during the day to boost your energy, such as nuts, trail mix, apples, cheese, hard-boiled eggs, and energy bars. Ask a member of your family or support group to make these for you and put them in a small cooler to take with you when away from home.
Balance small meals with a combination of protein, healthy fats and oils, and carbohydrates. Proteins include fish, lean meats, nuts, and eggs. Healthy fats and oils can be found in avocados, seeds, and nuts. Carbohydrates are found in vegetables, fresh fruits, and grains. Avoid eating carbohydrates by themselves if you have blood sugar concerns. Many individuals report that sugar and chocolate increase headaches, so eat sweets sparingly.
Eat moderately. Do not overeat as it can cause you to feel sleepy.
Eat by the clock. If your brain/body signals are not working well, set a timer, watch alarm or a mobile phone to alert you that it’s time to eat.
Since weight gain is common following brain injury, this is another reason to stick to a healthy diet.
Try to eat around the same time every day. The body does best when it is on a routine schedule.
It is very important to eat healthy foods to help the brain function efficiently. Feed your brain with protein snacks throughout the day.
Grocery Shopping and Menu Ideas
[ARTICLE] Anodal tDCS Combined With Radial Nerve Stimulation Promotes Hand Motor Recovery in the Acute Phase After Ischemic Stroke
Background and Objective: The question of the best therapeutic window in which noninvasive brain stimulation (NIBS) could potentiate the plastic changes for motor recovery after a stroke is still unresolved. Most of the previous NIBS studies included patients in the chronic phase of recovery and very few in the subacute or acute phase. We investigated the effect of transcranial direct current stimulation (tDCS) combined with repetitive peripheral nerve stimulation (rPNS) on the time course of motor recovery in the acute phase after a stroke.
Methods: Twenty patients enrolled within the first few days after a stroke were randomized in 2 parallel groups: one receiving 5 consecutive daily sessions of anodal tDCS over the ipsilesional motor cortex in association with rPNS and the other receiving the same rPNS combined with sham tDCS. Motor performance (primary endpoint: Jebsen and Taylor Hand Function Test [JHFT]) and transcranial magnetic stimulation cortical excitability measures were obtained at baseline (D1), at the end of the treatment (D5), and at 2 and 4 weeks’ follow-up (D15 and D30).
Results: The time course of motor recovery of the 2 groups of patients was different and positively influenced by the intervention (Group × Time interaction P = .01). The amount of improvement on the JHFT was greater at D15 and D30 in the anodal tDCS group than in the sham group.
Conclusion: These results show that early cortical neuromodulation with anodal tDCS combined with rPNS can promote motor hand recovery and that the benefit is still present 1 month after the stroke.
[ARTICLE] Wrist Rehabilitation Assisted by an Electromyography-Driven Neuromuscular Electrical Stimulation Robot After Stroke
Background: Augmented physical training with assistance from robot and neuromuscular electrical stimulation (NMES) may introduce intensive motor improvement in chronic stroke.
Objective: To compare the rehabilitation effectiveness achieved by NMES robot–assisted wrist training and that by robot-assisted training.
Methods: This study was a single-blinded randomized controlled trial with a 3-month follow-up. Twenty-six hemiplegic subjects with chronic stroke were randomly assigned to receive 20-session wrist training with an electromyography (EMG)-driven NMES robot (NMES robot group, n = 11) and with an EMG-driven robot (robot group, n = 15), completed within 7 consecutive weeks. Clinical scores, Fugl-Meyer Assessment (FMA), Modified Ashworth Score (MAS), and Action Research Arm Test (ARAT) were used to evaluate the training effects before and after the training, as well as 3 months later. An EMG parameter, muscle co-contraction index, was also applied to investigate the session-by-session variation in muscular coordination patterns during the training.
Results: The improvement in FMA (shoulder/elbow, wrist/hand) obtained in the NMES robot group was more significant than the robot group (P < .05). Significant improvement in ARAT was achieved in the NMES robot group (P < .05) but absent in the robot group. NMES robot–assisted training showed better performance in releasing muscle co-contraction than the robot-assisted across the training sessions (P < .05).
Conclusions: The NMES robot–assisted wrist training was more effective than the pure robot. The additional NMES application in the treatment could bring more improvements in the distal motor functions and faster rehabilitation progress.
What is Homonymous Hemianopia?
The ability to see is a complex process involving the eyes and the brain. Both parts must be working for us to see. A Homonymous Hemianopia is caused by damage to the visual pathway in the brain, usually in the occipital lobe on one side.
People often think that they have lost the vision in one eye. In actual fact they have lost half the vision in both eyes. Damage to the right occipital lobe will affect the left visual field and conversely damage to the left will result in a right visual field loss.
But recently, he figuratively cut the cord to his desktop and joined the mobile revolution. Morales was visiting an area Veterans Affairs blind rehabilitation center, learning how to use an iPhone’s features for people with vision impairment.
“It’s pretty amazing,” Morales said, demonstrating how he can call up a song and play it with a few taps. “Whatever I can do on the computer I can basically do it on the iPhone. It has the same capability.”
The smartphone, a gadget designed for the sighted, has turned out to be a godsend for those who are blind and visually impaired, making them more independent than ever before.
With VoiceOver, the iPhone’s built-in gesture-based app that reads text on a touch-screen aloud, or Google Android’s TalkBack, users who are blind can access anything on their phones. The user activates apps with a few gestures — single finger to explore and find buttons, one-finger touch to identify things on the screen and double-tap to push the button after it’s located.
“It’s a learning curve, but you can learn to do every single thing on an iPhone that anyone else can do,” said Lee Huffman, editor of AccessWorld, published by the American Foundation for the Blind. “These devices are opening up a whole new world.”
It didn’t look like it would turn out that way at first.
“The blind community started getting really panicky” when smartphones and later, tablets, took off following the iPhone’s debut in 2007, researcher Joshua Miele, associate director of Smith-Kettlewell Eye Research Institute in San Francisco, recalled. “Touch-screens were a real concern.
”But in 2009, Apple included VoiceOver in its mobile operating system, and followed up with the personal assistant Siri in 2011, launching a new world of mobility for the visually impaired. Google added TalkBack, a screen reader, to its Android operating system in 2009 and Google Now, a personal assistant, in 2012. Microsoft mobile has similar features.
“It’s made a huge difference, productivity-wise,” said Jennison Asuncion, accessibility leader at LinkedIn, who is blind. “I use my mobile phone probably even more than lot of people.”
Erin Lauridsen, 32, a trainer at the Independent Living Resource Center in San Francisco, has been blind since birth and grew up using expensive, clunky, single-purpose devices for doing coursework in school. “When the iPhone 3GS came out with VoiceOver built in it was a huge game-changer for me and a lot of other people,” she said.
She uses an app called BlindSquare for navigation; Money Reader to identify currency denominations; and Voice Dream Reader to assemble audio play lists of documents from many sources. She also uses Uber and a lot of other popular apps.
“I’m on an equal footing with what everyone else does — the Yelping, Facebooking and Twittering,” she said.
People who are visually impaired want to use their mobile phones like anyone else, said Astrid Weber, who researches user experience at Google, visiting people who are visually impaired in their homes to see what they need and how they use technology.
“Mobility is really important for them,” she said.
Google Now — the Android personal assistant — is popular with users with vision impairment, said Eve Andersson, manager of Google’s accessibility engineering. Her parents who are vision impaired use it all the time, she said. “They ask their phones questions, ask it to call me, ask it for directions and create reminders. They love being able to do that with their voice.
”For years there have been screen readers for desktop computers. OutSpoken, developed by Berkeley Systems in the late 1980s, was the first for the Mac, according to Smith-Kettlewell’s Miele, who worked for the company.
But while VoiceOver and TalkBack broke the tether to the desktop, third-party apps still have to be made accessible to people with disabilities.
There’s a legal issue too. The Americans with Disabilities Act requires websites and mobile applications to be accessible, said disability rights lawyer Lainey Feingold, although regulations are still being worked on by the U.S. Department of Justice.
Google announced Google Impact Challenge: Disabilities last year with a $20 million grant for technology innovators in the nonprofit community who work on technology to make people with disabilities more independent. “We’re actively looking for proposals,” said Brigitte Hoyer Gosselink of Google.org….