Archive for January, 2018

[Abstract+References] Evidence for Training-Dependent Structural Neuroplasticity in Brain-Injured Patients: A Critical Review

Acquired brain injury (ABI) is associated with a range of cognitive and motor deficits, and poses a significant personal, societal, and economic burden. Rehabilitation programs are available that target motor skills or cognitive functioning. In this review, we summarize the existing evidence that training may enhance structural neuroplasticity in patients with ABI, as assessed using structural magnetic resonance imaging (MRI)–based techniques that probe microstructure or morphology. Twenty-five research articles met key inclusion criteria. Most trials measured relevant outcomes and had treatment benefits that would justify the risk of potential harm. The rehabilitation program included a variety of task-oriented movement exercises (such as facilitation therapy, postural control training), neurorehabilitation techniques (such as constraint-induced movement therapy) or computer-assisted training programs (eg, Cogmed program). The reviewed studies describe regional alterations in white matter architecture and/or gray matter volume with training. Only weak-to-moderate correlations were observed between improved behavioral function and structural changes. While structural MRI is a powerful tool for detection of longitudinal structural changes, specific measures about the underlying biological mechanisms are lacking. Continued work in this field may potentially see structural MRI metrics used as biomarkers to help guide treatment at the individual patient level.

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via Evidence for Training-Dependent Structural Neuroplasticity in Brain-Injured Patients: A Critical Review – Karen Caeyenberghs, Adam Clemente, Phoebe Imms, Gary Egan, Darren R. Hocking, Alexander Leemans, Claudia Metzler-Baddeley, Derek K. Jones, Peter H. Wilson, 2018

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[Abstract] Pilot Study Combining Electrical Stimulation and a Dynamic Hand Orthosis for Functional Recovery in Chronic Stroke

Abstract

OBJECTIVE. We investigated the effect of a combined neuromuscular electrical stimulation (ES) and dynamic hand orthosis (DHO) regimen with a group of people with chronic stroke to improve performance on specific daily tasks.

METHOD. Four people with chronic stroke participated in an ES–DHO regimen using the affected upper extremity 5×/wk for 6 wk. Outcome measures included grip strength, range of motion (ROM), and analysis of muscle activation–deactivation during release of grasp through electromyography. Ability to perform specific daily living tasks was assessed using the Assessment of Motor and Process Skills (AMPS).

RESULTS. Results suggested that improvements in strength, ROM, and grasp deactivation are possible with the combined ES–DHO regimen. All participants’ AMPS motor scores improved.

CONCLUSIONS. An ES–DHO regimen may improve motor skills needed for functional task performance in people with chronic stroke. Results should be interpreted cautiously because of the pilot nature of the study and the small sample size.

via Pilot Study Combining Electrical Stimulation and a Dynamic Hand Orthosis for Functional Recovery in Chronic Stroke | American Journal of Occupational Therapy

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[ARTICLE] EEG-Based Brain–Computer Interfaces for Communication and Rehabilitation of People with Motor Impairment: A Novel Approach of the 21st Century – Full Text

People with severe neurological impairments face many challenges in sensorimotor functions and communication with the environment; therefore they have increased demand for advanced, adaptive and personalized rehabilitation. During the last several decades, numerous studies have developed brain–computer interfaces (BCIs) with the goals ranging from providing means of communication to functional rehabilitation. Here we review the research on non-invasive, electroencephalography (EEG)-based BCI systems for communication and rehabilitation. We focus on the approaches intended to help severely paralyzed and locked-in patients regain communication using three different BCI modalities: slow cortical potentials, sensorimotor rhythms and P300 potentials, as operational mechanisms. We also review BCI systems for restoration of motor function in patients with spinal cord injury and chronic stroke. We discuss the advantages and limitations of these approaches and the challenges that need to be addressed in the future.

Introduction

Vidal (1973, p. 157), in his seminal work, raised the question: “Can observable electrical brain signals be put to work as carriers of information in person–computer communication or for the purpose of controlling devices such as prostheses?”. Since then, we have come a long way investigating whether people with motor disabilities can repurpose brain activity from inner neural signals to tangible controls that attribute the user’s intent to interact with devices or adjust their environment (Shih et al., 2012Lebedev and Nicolelis, 2017). Nowadays, several advancements in the fields of clinical neurophysiology and computational neuroscience have led to the development of promising approaches based on non-invasive BCIs that pave the way for reliable communication and effective rehabilitation of people with disabilities.

In this review, we focus on non-invasive BCI applications geared toward alternative communication and restoration of movement to paralyzed patients. We consider several milestone studies on EEG-based BCIs that contributed to the systems that improve everyday life and activity of people with motor disabilities in the 21st century. We review EEG-based BCI technologies for communication and control based on three different EEG signals (SCP, SMR and P300), and discuss their limitations and advantages. In addition, we examine and analyze the BCI methods for inducing brain plasticity and restoring functions in impaired patients. An overview of the study framework is presented in Figure 1.

FIGURE 1. Overview of the review framework.

The paper is structured as follows. We firstly review the advantages of the BCI approach compared to other strategies for communication in people with motor impairment. In section 3, we present BCI realizations based on different approaches for brain activity recording, and elaborate on three EEG-based modalities: SCP, SMR, and P300. Subsequently, we provide an elaborate overview of the milestone studies, published mainly during the last two decades, on the BCI systems for communication and rehabilitation in patients with motor-impairments. Finally, we discuss advantages and shortfalls of these BCIs, point out their limitations and comment on the future perspectives in this field.[…]

Continue —> Frontiers | EEG-Based Brain–Computer Interfaces for Communication and Rehabilitation of People with Motor Impairment: A Novel Approach of the 21st Century | Frontiers in Human Neuroscience

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[BOOK Chapter] The “Arm” Line of Devices for Neurological Rehabilitation: Engineering Book Chapter – Abstract

Abstract

In the modern scenario of neurological rehabilitation, which requires affordable solutions oriented toward promoting home training, the Institute of Industrial Technologies and Automation (ITIA) of the Italian National Research Council (CNR) developed a line of prototypal devices for the rehabilitation of the upper limb, called “Arm.” Arm devices were conceived to promote rehabilitation at affordable prices by capturing all the main features of the state-of-the-art devices. In fact, Arm devices focus on the main features requested by a robot therapist: mechanical adaptation to the patient, ranging from passive motion to high transparency, assist-as-needed and resistive modalities; proper use of sensors for performance monitoring; easy-to-use, modular, and adaptable design. These desirable features are combined with low-cost, additive manufacturing procedures, with the purpose of meeting the requirements coming from research on neuro-motor rehabilitation and motor control and coupling them with the recent breakthrough innovations in design and manufacturing.

The “Arm” Line of Devices for Neurological Rehabilitation

Copyright: © 2018 |Pages: 30

DOI: 10.4018/978-1-5225-2993-4.ch007

 

 

Introduction

 The use of robotic devices for upper-limb neuro-motor rehabilitation is usual practice in clinical centers. In respect to conventional therapies, robots allow to increase training intensity and help patients to promote their active contribution. Furthermore, robots can act as measurers of patients’ performances and adapt their interaction modalities to the emerging needs during the rehabilitation course. Robots like ARMin, MIT Manus, Armeo Spring, Braccio di Ferro, represent the state of the art devices for rehabilitation of the upper-limb and for promoting motor recovery. According to the available assessments and studies in the literature, their efficacy is slightly/moderately higher than the one of conventional therapies. Furthermore, robots are used in research to learn more about physiological and pathological motor control and neuromuscular diseases. Unfortunately, while being the state of the art devices for neuro-motor stimulation and training, such robots are very expensive and not compliant to user-friendly requirements that are needed for semi-autonomous home use. Consequently, they can be used only in clinical environments, under the supervision of medical personnel. Furthermore, sanitary costs related to rehabilitation are increasing and clinical centers can hardly support their burden. The possibility of delocalizing rehabilitation from clinical centers opens the chance for training performed in home environment, with time and costs savings for both the sanitary system and patients. In this scenario, which requires affordable solutions oriented toward promoting home training, the Institute of Industrial Technologies and Automation (ITIA) of the Italian National Research Council (CNR) developed a line of prototypal devices for the rehabilitation of the upper-limb, called -ArmArm devices were conceived to test the possibility of promoting rehabilitation at affordable prices but capturing all the main features of the state of the art devices. In fact, Arm devices focus on the main features requested by a robot therapist: mechanical adaptation to the patient, ranging from passive motion to high transparency, assist-as-needed and resistive modalities; proper use of sensors for performance monitoring; easy-to-use, modular and adaptable design. These desirable features are combined with low-cost, additive manufacturing procedures, with the purpose of meeting the requirements coming from research on neuro-motor rehabilitation and motor control and coupling them with the recent breakthrough innovations in design and manufacturing. Arm devices cover both clinical and home-oriented training and are designed for adaptation to patients with different motor impairment.

The Arm prototypes are:

  • • LINarm: linear device, freely orientable in space, suitable for functional movements. It features a variable stiffness actuation, allowing to adapt the mechanical behavior of the device to patients’ needs. Functional Electrical Stimulation, simple Virtual Environments and a Patient Model, gathering data from integrated sensors and modulating the level of assistance, are integrated in the set-up. The LINarm++ Echord++ Project ended in October 2016 and guided the development of a second, more refined prototype, enhancing the original concept.
  • • PLANarm: planar device, freely orientable in space, suitable for planar functional movements. The state of the art planar robots used in literature for motor control and motor learning research inspired PLANarm. It features a variable stiffness actuation, allowing adapting the mechanical behavior of the device depending on patients’ needs.
  • • DUALarm: Low-Cost device for bimanual rehabilitation, exploiting the capability of the less affected limb to provide rehabilitation to the more affected limb. DUALarm is completely realized in 3D printing technology and aims at being an easy-to-use, low-cost, open-source project. Currently, reaching movements can be trained, but the device is conceived to be suitable for training of other functional gestures.
  • • LIGHTarm: Exoskeleton for the rehabilitation of the upper-limb, designed in two versions: LIGHTarm, not actuated, and conceived to support the weight of the impaired limb. The mechanical design includes high backdrivability, focusing on shoulder rhythm and elbow singular configurations.
  • • VIRTUALarm: Kinect One-based platform for motor monitoring, including body and limb tracking and a biomechanical evaluation of the performance in relation to databases of healthy subjects. Assessments include range of motion, motion dynamics, effort, motor control indexes, body segments barycenter tracking.

via The “Arm” Line of Devices for Neurological Rehabilitation: Engineering Book Chapter | IGI Global

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[DISSERTATION] Tele-Rehabilitation of Upper Limb Function in Stroke Patients using Microsoft Kinect – Full Text PDF

ENGLISH SUMMARY

Stroke is a major cause of death and disability worldwide. The damage or death of
brain cells caused by a stroke affects brain function and leads to deficits in sensory
and/or motor function. As a consequence, a stroke can have a significantly negative
impact on the patient’s ability to perform activities of daily living and therefore also
affect the patient’s quality of life. Stroke patients may regain function through
intensive physical rehabilitation, but often they do not recover their original
functional level. The incomplete recovery in some patients might be related to e.g.
stroke severity, lack of motivation for training, or insufficient and/or non-optimal
training in the initial weeks following the stroke.
A threefold increase in the number of people living past the age of 80 in 2050,
combined with the increasing number of surviving stroke patients, will very likely
lead to a significant increase in the number of stroke patients in need of
rehabilitation. This will put further pressure on healthcare systems that are already
short on resources. As a result of this, the amount of therapeutic supervision and
support per stroke patient will most likely decrease, thereby affecting negatively the
quality of rehabilitation.
Technology-based rehabilitation systems could very likely offer a way of
maintaining the current quality of rehabilitation services by supporting therapists.
Repetition of routine exercises may be performed automatically by these systems
with only limited or even no need for human supervision. The requirements to such
systems are highly dependent on the training environment and the physical and
mental abilities of the stroke patient. Therefore, the ideal rehabilitation system
should be highly versatile, but also low-cost. These systems may even be used to
support patients at remote sites, e.g. in the patient’s own home, thus serving as telerehabilitation systems.
In this Ph.D. project the low-cost and commercially available Microsoft Kinect
sensor was used as a key component in three studies performed to investigate the
feasibility of supporting and assessing upper limb function and training in stroke
patients by use of a Microsoft Kinect sensor based tele-rehabilitation system. The
outcome of the three studies showed that the Microsoft Kinect sensor can
successfully be used for closed-loop control of functional electrical stimulation for
supporting hand function training in stroke patients (Study I), delivering visual
feedback to stroke patients during upper limb training (Study II), and automatization
of a validated motor function test (Study III).
The systems described in the three studies could be developed further in many
possible ways, e.g. new studies could investigate adaptive regulation of the intensity
used by the closed-loop FES system described in Study I, different types of feedback
to target a larger group of stroke patients (Study II), and implementation of more
sensors to allow a more detailed kinematic analysis of the stroke patients (Study III).
New studies could also test a combined version of the systems described in this
thesis and test the system in the patients’ own homes as part of a clinical trial
investigating the effect of long-term training on motor function and/or non-physical
parameters, e.g. motivational level and quality of life.[…]

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via Link to publication from Aalborg University

 

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[ARTICLE] A Gamified Approach for Hand Rehabilitation Device – Full Text PDF

Abstract

This work details developments made in a system for hand rehabilitation,
that aims to improve recovery of fine motor control, mostly for those
recovering from stroke. The system consists of an instrumented device that is
used to interact with a variety of games designed to improve fine motor control,
enhancing rehabilitation practices. These games were tested with actual disabled
individuals and therapists, having received overall positive feedback.

Introduction

Stroke remains one of the leading causes of disability throughout the world. In
2013, it was the third greatest cause of disability, having been responsible for 113
million disability-adjusted life-years [1]. Most stroke patients suffer from some kind
of upper limb impairment [2], which can often be overcome through motor rehabilitation. This rehabilitation is of critical importance, as good control over the hands is fundamental for insuring one’s independence and quality of life. Specifically, grip force control plays a major role on daily tasks, mostly on manipulating everyday
objects. Training of grip force control is also important in other scenarios, such as the
case of individuals with newly implanted myoelectric prosthetics [3]. The use of
augmented feedback has been shown to enhance rehabilitation for the two aforementioned cases [4, 5]. Furthermore, the use of devices that enable automatic recording and objective measurement of the patients’ capabilities has been of growing interest, as most current rehabilitation practices are based on subjective progress evaluation [6,7].
The use of an instrumented device for training and accessing hand dexterity and
grip force control of a patient enables both the use of augmented feedback and progress
recording, besides allowing the incorporation of games in the rehabilitation
sessions. The use of games in rehabilitation is also increasing, as they have been
shown to increase patient engagement and therapy effectiveness [8-10]. There are a
number of devices under development that provide some of these features [11-13], but
to the best of the authors knowledge  there are no commercially available devices that
provide grip force control training.

This paper further details developments made in a hand rehabilitation system previously developed by the authors [14], with a focus on the development of a set of
therapeutic games.[…]

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via http://online-journals.org/index.php/i-joe/article/view/7793

 

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[WEB SITE] Deep Learning Device Can Predict Epileptic Seizures

Vanessa Geneva Ahern
JANUARY 29, 2018
predict seizure,signs seizure,epilepsy prediction,hca news

Imagine going about your daily life, working, shopping, and driving, knowing that you might have a seizure at any moment. But relief is on the horizon, as researchers from the University of Melbourne in Victoria, Australia have developed a potentially life-saving deep learning tool that can predict when an epileptic seizure is about to happen.

Their study was published in the journal eBioMedicine last month. The deep learning-based prediction system “achieved mean sensitivity of 69% and mean time warning of 27%, significantly surpassing an equivalent random predictor for all patients by 42%,” according to the findings.

Dean Freestone, PhD, senior research fellow at the department of medicine at St. Vincent’s Hospital at the University of Melbourne, says the tech could be contained in a chip inside a wearable device such as a wristband or bracelet, “incorporating a person’s behavior, environment, and physiology.” He and fellow co-author Mark J. Cook, MD, chair of medicine at St. Vincent’s Hospital, have launched a company named Seer Medical to pursue this technology. They hope to implant patients with the technology later this year.

“The technology is now proven. We have shown seizure prediction is possible in our previous paper published in Brain and in a Kaggle contest. This new study is just further backup,” Freestone says.

The advance could change the lives of many people with epilepsy, who worry about looming seizures while they are doing everyday activities. Patients who have tested the technology reported that they felt more in control when they used the wearable device and were more confident doing novel activities. They also claimed to have benefited from improved sleep and decision making.

The new forecasting technology would be best suited for someone having seizures once per week, according to the architects. If someone has seizures every hour, or if the seizures are too infrequent, it is difficult to train the algorithms, Freestone notes.

The way the predictive technology works is similar to Facebook’s facial recognition software. Instead of people in photos, the researchers have trained the algorithms to recognize patterns in the electrical activity of the brain that preempt seizures. “It is software that learns from example. The electrical patterns are very subtle and are invisible to the human eye, but the computer algorithms can identify them. The circadian patterns then help to boost the algorithms performance,” Freestone says.

“Patients can take action to actually prevent seizures. This could be in the form of a medication or even just a change in behavioral. We have also learnt a lot about the mechanisms of seizure, such as the strong influence of circadian cycles,” he adds.

Although significant cost and risk comes with new trials of medical devices, researchers are excited about the changes they can make. “We are working toward a system that will constantly provide a person with a risk level of seizure susceptibility,” Freestone says. “It will be a gauge that outputs a probability. We will incorporate as many aspects of a person’s behavior, environment and physiology as we can acquire from wearable technologies and other sensors.”

The findings came about, in part, thanks to the University of Melbourne’s large, long-term data set, which is unique and apt for exploring deep learning for seizure forecasting.

via Deep Learning Device Can Predict Epileptic Seizures | Healthcare Analytics News

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[WEB SITE] 8 ways augmented and virtual reality are changing medicine

Israeli companies are using futuristic technologies to simplify complex surgery, manage rehab, relieve pain, soothe autistic kids and much more.

The Realview HOLOSCOPE-i augmented reality system for cardiac surgery. Photo courtesy of Business Wire

Spine and heart surgeons will use augmented reality (AR) to simplify complex procedures. Autistic children will get relief from sensory overload with a calming virtual reality (VR) system.

These and other scenarios are made possible by Israeli innovations tapping into the tremendous potential of AR and VR for healing and wellbeing.

The methods are similar: AR superimposes static and moving images to enhance an actual environment, while VR immerses the viewer in a simulated three-dimensional environment.

“Israel is on the frontlines in some areas of this technology,” says Orit Elion, a professor of physical therapy at Israel’s Ariel University, which hosted a conference last year to strengthen cooperation between AR and VR developers and researchers for health applications.

Elion helped develop a VR-based tele-rehab service at the Gertner Institute of Chaim Sheba Medical Center in Tel Hashomer, now used across Israel to enable monitored home physical or occupational therapy sessions for patients living far from healthcare centers.

“There aren’t so many programs in the world like this — a service that has no geographic boundaries,” Elion tells ISRAEL21c.

Currently, she is investigating how VR training can help with balance and fall prevention in the elderly. “VR is a dream for that, because you can manipulate the environment with all kinds of visual input,” she says.

Here are other examples of Israeli AR and VR in the health sector.

Neurosurgery

Surgical Theater makes a portfolio of VR products based on the notion that surgeons could train for complex procedures much like the Israeli founders of the company trained for Israel Air Force missions. Neurosurgeons at major medical centers and academic institutions in the United States and elsewhere are utilizing Surgical Theater’s VR medical visualization platforms for surgical planning and navigation, patient education and engagement, and training surgical residents.

Heart surgery

In the first quarter of 2018, RealView Imaging will release its long-awaited HOLOSCOPE-i, designed to deliver live, in-air 3D holographic visualizations during interventional cardiology procedures.

Powered by the Intel RealSense SR300-Series camera based on RealView’s proprietary digital light shaping technology, HOLOSCOPE-i is the first commercial system allowing clinicians full and direct control of 3D images in real time. Surgeons can rotate, zoom, slice, mark and measure within the floating holograms.

Coming next from RealView Imaging are HOLOSCOPE-x for visualization of holograms inside the patient during interventional oncology procedures, and a holographic headset for non-medical professional applications.

Spine surgery

Augmedics develops xvision, an AR head-mounted display for spine surgery that allows surgeons to see the patient’s anatomy through skin and tissue, as if they had “x-ray vision.” The system can project the patient’s anatomy, in real time, directly onto the surgeon’s retina, with the aim of increasing safety in surgery, reducing x-ray radiation and facilitating minimally invasive procedures.

Using xvision, surgeons will be able to visually and accurately track all their surgical instruments well within their field of vision as they work. A combination of proprietary tracking algorithms, hardware, software, an image data merging unit, and specialized instruments guide the surgeon through the operating site during major and minor procedures.

The xvision system will also utilize sensors to collect surgical information, which, when connected to a big data system, will analyze and process the data, using profound learning algorithms to provide alerts and suggestions to assist the surgeon during the procedure.

Augmedics has already performed pre-clinical cadaver trials in the US and EU. The company will start clinical studies in Q2 2018 in Israel, and later this year at the Johns Hopkins Hospital in Baltimore, Maryland.

Sensory modulation

Using VR goggles, the Calma system immerses an autistic child in a simulated underwater scene filled with corals, colorful fish, bubbles and divers.

“Children on the autism spectrum typically suffer from sensory moderation disorder, traditionally treated in a ‘white room’ where various objects are gradually introduced. This is costly and not always readily available. Our initiative simulates the white room with VR,” says Dan Kohen-Vacs, a senior computer science researcher at Holon Institute of Technology (HIT), where Calma was invented by students last year.

A management console allows the therapist to add, moderate or remove stimulants (including music) in response to the reaction of the child in real time. The goal is to train the child’s sensory regulation system to better handle auditory and visual stimulants and achieve emotional balance.

“We are completing the first proof-of-concept version and testing it in the Dekalim school in Jerusalem,” Kohen-Vacs tells ISRAEL21c. HIT’s tech-transfer company will work on commercializing the system.

“The plan is to expand to other locations. It may be possible to enable parents to use the system at home. You just need a smartphone and something like Google Cardboard that enables you to put the phone in it and wear it as headset,” says Kohen-Vacs.

Amit Bar-Tov, an occupational therapist at Dekalim, told Globes that the Calma pilot met with “great enthusiasm among the students for emotional regulation and sensory regulation, an improvement in learning capabilities, and a better connection with the environment.”

Burn rehab

Prof. Josef Haik, director of Sheba Medical Center’s Burn Center, has been using VR for more than a decade as a bedside tool to ease the painful process of rehabilitation from severe burns.

“It’s all about early mobilization and rehabilitation, getting back to the tasks of everyday life,” Haik tells ISRAEL21c.

In 2004, Sheba installed a large Computer Assisted Rehabilitation Environment (CAREN) system in a pioneering move toward VR in treatment and rehab. Burn patients couldn’t be moved to the CAREN room so Haik came up with an inexpensive portable alternative using EyeToy, a digital camera device for PlayStation. Today he’s using Kinect with games devised for patients with certain disabilities.

VR gaming therapy offer several advantages, says Haik: The games distract patients and thereby lessen their pain perception; allow patients to adapt to seeing and accepting the look of the scarred area of their body onscreen; and use rewards such as points to encourage continuation of therapy. Moreover, the patient does not have to wear or touch anything, eliminating any risk of cross infection.

Haik reported on the therapy in a 2006 study and has presented his approach to the American Burn Association and other associations around the world.

Stroke and traumatic brain injury  

The SeeMe VR rehab system was developed by physiotherapists at Beit Rivka Geriatric Rehabilitation Hospital in Petah Tikva in cooperation with Brontes Processing of Poland for stroke or traumatic brain injury patients.

It has been on the market since 2009, making it the first commercial VR system of its kind.

SeeMe’s technology transmits images to the patient’s computer via a Kinect controller or standard web camera and immerses the patient in a customized computer game requiring specific exercises set by the therapist.

The clinician can use the system to evaluate strength, endurance, range of motion, postural control, reaction time, proprioception, quality of movement, perception, divided attention and memory.

Parkinson’s disease and multiple sclerosis

Studies by scientists from the Technion-Israel Institute of Technology, Tel Aviv Medical Center and Tel Aviv University over the past decade have shown that incorporating VR headsets in gait training improved the walking abilities of people with multiple sclerosis and reduced fall risk in Parkinson’s patients. The latest study, published in Neurology in September, found that VR training actually modifies brain activation patterns in Parkinson’s patients.

PT and pain relief

Caesarea-based Motorika Medical’s ReoAmbulator robotic gait-training device helps adults and children improve walking, balance, coordination, posture or stamina while focusing on accomplishing VR tasks to improve motor or cognitive function including memory and selective attention. Combining these tasks in one session is meant to add a higher degree of challenge leading to better results. On the market since 2014, ReoAmbulator is used in two countries in Asia, five in Europe and in the United States — around 30 installations so far.

VRHealth of Tel Aviv and Boston is partnering with major players including Oculus, HTC and Microsoft to launch the first cross-platform-compatible VR medical application for rehab.

“We believe we are the only medical device company using an immersive headset as certified medical software,” founder Eran Orr tells ISRAEL21c. “What makes it a medical device is how you keep the data encrypted, how you can integrate electronic medical records and whether there is a billable insurance code for physicians to use. There is quality assurance and documentation for every app we are developing.”

VRHealth’s flagship VRPhysio software applications – two for neck therapy and one for shoulder therapy – got FDA clearance and are being implemented first in Spaulding Rehabilitation Hospital and Beth Israel Deaconess Medical Center in Boston. CE approval for Europe is expected soon.

VRHealth plans to launch additional products within a year: VRCoordi, which will work with VRPhysio to improve coordination skills, initially of children with developmental coordination disorder and various levels of autism; VRCogni to improve cognitive function in stroke, Alzheimer’s, concussion, Parkinson’s and dementia patients; VRReliever to manages chronic and severe pain through distraction; VRPsyc to enhances treatment for diagnosable mental disorders including general stress, phobias and anxieties, eating disorders, and PTSD.

“I hope our company will make a difference in the entire healthcare sector — every hospital, nursing home and assisted living — because VR can make a huge difference in many fields,” says Orr.

“I think Israel has a lot of potential in this technology because of the quality of engineers and developers able to develop products at a rapid pace and to be first to market and expand from there. That’s why we maintain our R&D in Israel.”

via 8 ways augmented and virtual reality are changing medicine | ISRAEL21c

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[VIDEO] tDCS preparation – Sooma – YouTube

via Sooma tDCS – preparation – YouTube

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[WEB SITE] New wireless sleeve to help people recover arm use after stroke – ScienceDaily

Summary: Scientists are intending to develop and trial a new wearable technology to help people who have had a stroke recover use of their arm and hand. The team will create a wireless sleeve, which will provide automatic, intelligent information about muscle movement and strength while patients practice every-day tasks at home. The data will be available on a computer tablet to enable patients to review their progress as well as to allow therapists to tailor their rehabilitation program.

Scientists at the University of Southampton are to develop and trial a new wearable technology to help people who have had a stroke recover use of their arm and hand.

Led by Professor Jane Burridge, the team will create a wireless sleeve, which will provide automatic, intelligent information about muscle movement and strength while patients practice every-day tasks at home.

The data will be available on a computer tablet to enable patients to review their progress as well as to allow therapists to tailor their rehabilitation programme.

The two-year project has been funded with a grant of just under £1 million from the National Institute for Health Research (NIHR) through its Invention for Innovation (i4i) programme and is a collaboration between the University of Southampton and Imperial College London, two medical technology consultancies; Maddison and Tactiq and NHS Trusts in Bristol and Portsmouth.

Jane Burridge, Professor of Restorative Neuroscience at Southampton, comments: “About 150,000 people in the UK have a stroke each year and, despite improvements in acute care that results in better survival rates, about 60 per cent of people with moderate to severe strokes fail to recover useful function of their arm and hand.

“Stroke rehabilitation is increasingly home-based, as patients are often discharged from hospital after only a few days. This policy encourages independence and avoids problems associated with prolonged hospital stays. However, some patients struggle to carry out the exercises and they may question whether what they are doing is correct. Similarly therapists don’t have objective measurements about their patients’ muscle activity or ability to move. Rehabilitation technologies like our sleeve will address problems faced by both patients and therapists.”

The wearable technology is the first to incorporate mechanomyography (MMG) microphone-like sensors that detect the vibration of a muscle when it contracts, and inertial measurement units (IMU), comprising tri-axial accelerometers, gyroscopes and magnetometers that detect movement. Data from the two types of sensors will be put together and then data that is not needed, for example outside noise, will then be removed from the muscle signal.

The feedback to patients will be presented on a user-friendly computer interface as an accurate representation of their movement, showing them how much they have improved.

The same sleeve and computer tablet technology, but using different software and user-interfaces, will provide therapists with information to help them diagnose specific movement problems, and inform their clinical decision-making, monitor progress and therefore increase efficiency and effectiveness of therapy.

Professor Burridge adds: “We hope that our sleeve will help stroke patients regain the use of their arm and hand, reduce time spent with therapists and allow them to have the recommended 45 minutes daily therapy more flexibly.. It will also be used to assess patients’ problems accurately as well as more cheaply and practically than using laboratory-based technologies.”

The team, which includes members who themselves have suffered strokes, are working with medical device consultancies, Maddison and Tactiq to develop wearable prototypes and graphical user interfaces which can then be trialled with patients from two NHS sites. They will test the user interfaces, wireless connectivity and examine how easy the sleeve is to wear. The potential cost savings to the NHS will also be examined.

Story Source: Materials provided by University of SouthamptonNote: Content may be edited for style and length.

 

via New wireless sleeve to help people recover arm use after stroke — ScienceDaily

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