Archive for June, 2018

[WEB SITE] Cannabis Oil for Epilepsy – What You Need to Know

Cannabis Oil for Epilepsy – What You Need to KnowCredit: Pixabay

via Cannabis Oil for Epilepsy – What You Need to Know | Technology Networks

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[WEB SITE] Scientists develop combined therapy for stroke victim recovery

Scientists in Switzerland have demonstrated that combining a brain-computer interface (BCI) with functional electrical stimulation (FES) can help stroke victims recover greater use of their paralysed limbs – even years after the stroke.

 

stroke-brain-computer-interface

 

Paralysis of an arm and/or leg is one of the most common results of a stroke. However, a team of scientists at the Defitech Foundation Chair in Brain-Machine Interface, in association with other members of EPFL’s Center for Neuroprosthetics, the Clinique Romande de Réadaptation in Sion, and the Geneva University Hospitals, have developed a technique aimed at enabling stroke victims to recover greater use of their paralysed limbs. The scientists’ pioneering approach utilises two existing therapies – a brain-computer interface (BCI) and functional electrical stimulation (FES).

Explaining the key to their approach, José del R. Millán, who holds the Defitech Chair at EPFL, said: “The key is to stimulate the nerves of the paralysed arm precisely when the stroke-affected part of the brain activates to move the limb, even if the patient can’t actually carry out the movement. That helps re-establish the link between the two nerve pathways where the signal comes in and goes out.”.

Combined therapy tested on stroke patients

Twenty-seven patients aged between 36 and 76 took part in the clinical trial. All had a similar lesion that resulted in moderate to severe arm paralysis following a stroke occurring at least ten months earlier. Half of the patients were treated with the scientists’ dual-therapy approach and reported clinically significant improvements. The other half were treated only with FES and served as a control group.

For the first group, the scientists used a BCI system to link the patients’ brains to computers by means of electrodes. This enabled them to pinpoint exactly where the electrical activity occurred in the brain tissue when the patients tried to reach out their hands. Each time the electrical activity was identified the system immediately stimulated the arm muscle controlling the corresponding wrist and finger movements. The patients in the second group also had their arm muscles stimulated, but at random times. This control group enabled the scientists to determine how much of the additional motor-function improvement could be attributed to the BCI system.

 

The scientists noted a significant improvement in arm mobility among patients in the first group after just ten one-hour sessions. When the full round of treatment was completed, some of the first-group patients’ scores on the Fugl-Meyer Assessment – a test used to evaluate motor recovery among patients with post-stroke hemiplegia – were over twice as high as those of the second group.

“Patients who received the BCI treatment showed more activity in the neural tissue surrounding the affected area. Due to their plasticity, they could help make up for the functioning of the damaged tissue,” says Millán.

 

Electroencephalographies (EEGs) of the patients clearly showed an increase in the number of connections among the motor cortex regions of their damaged brain hemisphere, which corresponded with the increased ease in carrying out the associated movements. In addition, the enhanced motor function didn’t seem to diminish with time. Evaluated again 6-12 months later, the patients were found to have lost none of their recovered mobility.

The study results were published in Nature Communications.

via Scientists develop combined therapy for stroke victim recovery

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[Case Report] Biomechanical Assessment of Fugl-Meyer Score: The Case of One Post Stroke Patient Who has Undergone the Rehabilitation using Hand Exoskeleton Controlled by Brain-Computer Interface

Abstract

Objective: The study is double aimed: 1) to propose a version of common protocol for an assessment of upper limb motor impairment with the use of biomechanical characteristics of Fugl-Meyer items and 2) to apply this protocol to assess an efficacy of rehabilitation using hand exoskeleton controlled by brain-computer interface during the late stage of post stroke recovery in patient with mild paresis.

Methods: One patient, 62 years old man, 10 months after ischemic stroke was recruited in the rehabilitation procedure. The patient was instructed to perform one of three tasks: to relax and to imagine kinesthetically slow extension of either paretic (left) or intact (right) hand fingers. The recorded electroencephalography was analyzed and exoskeleton extended the patient’s fingers if brain-computer interface classifier recognized the imagery of their extension. The patient performed 10 daily procedures, each including three 10-minute long sessions. 14 items of Fugl-Meyer scale, describing flexor synergy (domain II), extensor synergy (domain III), movement combining synergies (domain IV) and movement out of synergy (domain V) were evaluated by standard Fugl-Meyer scores. In addition to Fugl-Meyer assessment biomechanical analysis of each item was performed. The items were recorded by electromagnetic tracking system for both paretic and intact arms. All seven degrees of freedom in each
arm were taken into account. Two types of biomechanical parameters were analyzed: 1) coordination between angular velocities and 2) maximal angular velocities corresponding to seven degrees of freedom of the arm.

Results: Fugl-Meyer assessment revealed motor improvements for two items only, whereas biomechanical analysis for all 14 items considered.

Conclusion: The use of Fugl-Meyer scale completed by biomechanical parameters of its’ items can be a version of common protocol for assessment of upper limb motor impairment, useful for obtaining a comparable data in different clinical studies.

Full Text PDF

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[Brochure] “Spasticity Treatment Dialogue Tool” for Patients/Caregivers and Healthcare Providers

Spasticity is one of the most common post-stroke conditions affecting stroke survivors. It is caused by damage to the brain that disrupts normal communication to muscles. Muscles do not receive the message to relax which can lead to severe spasms and contractions in locations such as the wrist, elbow, knee, or foot. Untreated, it can cause painful and debilitating bone and joint deformities that may lead to balance problems, loss of coordination and muscle movement, as well as a decrease in the overall quality of life.

 

Some common symptoms of spasticity include:

  • Tightness in limbs
  • Pain at affected site
  • Severe charley horse/cramps
  • Involuntary movement/spasms
  • Distortion of muscles/limbs

Finding the right treatment option for each individual patient is key to managing the difficult symptoms caused by spasticity. The “Spasticity Treatment Dialogue Tool” is designed to support an honest conversation between caregivers/patients and their healthcare providers.

Download Now

via Careliving Community Roundup- June, 2018 – onganalop@gmail.com – Gmail

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[Abstract] Development of an RBFN-based neural-fuzzy adaptive control strategy for an upper limb rehabilitation exoskeleton

Abstract

The patients of paralysis with motion impairment problems require extensive rehabilitation programs to regain motor functions. The great labor intensity and limited therapeutic effect of traditional human-based manual treatment have recently boosted the development of robot-assisted rehabilitation therapy. In the present work, a neural-fuzzy adaptive controller (NFAC) based on radial basis function network (RBFN) is developed for a rehabilitation exoskeleton to provide human arm movement assistance. A comprehensive overview is presented to describe the mechanical structure and electrical real-time control system of the therapeutic robot, which provides seven actuated degrees of freedom (DOFs) and achieves natural ranges of upper extremity movement. For the purpose of supporting the disable patients to perform repetitive passive rehabilitation training, the RBFN-based NFAC algorithm is proposed to guarantee trajectory tracking accuracy with parametric uncertainties and environmental disturbances. The stability of the proposed control scheme is demonstrated through Lyapunov stability theory. Further experimental investigation, involving the position tracking experiment and the frequency response experiment, are conducted to compare the control performance of the proposed method to those of cascaded proportional-integral-derivative controller (CPID) and fuzzy sliding mode controller (FSMC). The comparison results indicate that the proposed RBFN-based NFAC algorithm is capable of obtaining lower position tracking error and better frequency response characteristic.

 

via Development of an RBFN-based neural-fuzzy adaptive control strategy for an upper limb rehabilitation exoskeleton

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[Abstract] A Portable Passive Rehabilitation Robot for Upper-Extremity Functional Resistance Training

Abstract:

Objective: Loss of arm function is common in individuals with neurological damage, such as stroke or cerebral palsy. Robotic devices that address muscle strength deficits in a task-specific manner can assist in the recovery of arm function; however, current devices are typically large, bulky, and expensive to be routinely used in the clinic or at home. This study sought to address this issue by developing a portable planar passive rehabilitation robot, PaRRo. Methods: We designed PaRRo with a mechanical layout that incorporated kinematic redundancies to generate forces that directly oppose the user’s movement. Cost-efficient eddy current brakes were used to provide scalable resistances. The lengths of the robot’s linkages were optimized to have a reasonably large workspace for human planar reaching. We then performed theoretical analysis of the robot’s resistive force generating capacity and steerable workspace using MATLAB simulations. We also validated the device by having a subject move the end-effector along different paths at a set velocity using a metronome while simultaneously collecting surface electromyography (EMG) and end-effector forces felt by the user. Results: Results from simulation experiments indicated that the robot was capable of producing sufficient end-effector forces for functional resistance training. We also found the endpoint forces from the user were similar to the theoretical forces expected at any direction of motion. EMG results indicated that the device was capable of providing adjustable resistances based on subjects’ ability levels, as the muscle activation levels scaled with increasing magnet exposures. Conclusion: These results indicate that PaRRo is a feasible approach to provide functional resistance training to the muscles along the upper extremity. Significance: The proposed robotic device could provide a technological breakthrough that will make rehabilitation robots accessible for small outpatient rehabilitation centers and in-home therapy.

via A Portable Passive Rehabilitation Robot for Upper-Extremity Functional Resistance Training – IEEE Journals & Magazine

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[WEB SITE] Rehab Managements’ APTA NEXT Conference and Exposition Pre-Show

More than 2,000 physical therapists from across the nation will soon gather for the APTA NEXT Conference and Exposition June 27-30 in Orlando, Fla. To help plan your conference itinerary, Rehab Management, the magazine devoted to comprehensive coverage about technologies and services for the physical therapy market, offers this exclusive preview of products you’ll want to take a closer look at. Don’t miss this opportunity to speak with manufacturer’s representatives on the exhibit hall floor and learn how these select offerings can benefit your practice; including gait and balance equipment, practice management software, and coordination training products and beyond.

BIODEX-Vibrotactile-System-Balance-SD_175

Biodex Medical Systems, Inc

The Biodex Balance System ™ SD can expand your programs to the community. Widely used for Fall Risk programs serving older adults as well as athletes with concussion management, the system establishes baseline, determines risk. Select tests and training modes improve balance and agility, such as limits of stability, and percentage of weight shift.

Incorporate sensory feedback using the VibroTactile™ System to help detect changes in postural sway, especially suited for vestibular disorders.

Visit us at the APTA NEXT Booth #803
www.biodex.com/balance

 

CrawlAhead

CrawlAhead™ by mobility research

Lightweight, portable crawler helps develop gross motor skills and left-right brain coordination. CrawlAhead properly positions infants during normal development of crawling and assists delayed infants to work on quadruped tasks. Therapeutic for clinic use – assistive for home use – cost-effective for both. Easy to don harness, rolls effortlessly, for children up to 35 lbs. or 35 inches. Turn little function to big advantage! Rentals available.

Visit us at the APTA NEXT Booth #606
litegait.com/products/CrawlAhead

 

Gaitkeeper

GaitKeeper™ by mobility research

Designed with both therapists and patients in mind. They perform with great consistency & power at very low speeds of ambulation for patients of all functional levels. Our models feature high torque, accurate speed, adjustable inclines, MoveAble control panels or remote, a true zero Start and new AdjustaBars™ for ease of use. GaitKeeper treadmills are designed for rehabilitation and can be used effectively with or without LiteGait®.

Visit us at the APTA NEXT Booth #606
www.litegait.com/products/treadmills

Gaitsens

LiteGait® by mobility research

A gait training device that simultaneously controls weight bearing, posture, and balance over treadmill or ground, creating an ideal treatment environment for patients with a wide range of impairments and functional levels. Its unique harness permits unilateral and bilateral support allowing progression of weight bearing from non to full, while allowing access to lower extremities and pelvis to facilitate proper gait patterns. A safe, fall-free environment for patients and hands-free for the therapists.

Visit us at the APTA NEXT Booth #606
www.litegait.com

Q-Pads

Q-pads™ by mobility research

An interactive balance and coordination training system which provides visual feedback via pressure sensitive surfaces and colorful lights. Multi-functional rehabilitation system that enables therapists to design training activities for all functional levels and training needs. Use on the floor for weight shifting, balance or stepping tasks or mounted on wall for upper extremity work. Both fun and challenging. Each pad measures between 10 and 330 pounds of force, is magnetic, has auto-turn-off and cleans easily.

Visit us at the APTA NEXT Booth #606
www.litegait.com/products/Q-Pads

Raintree

Raintree Systems

Raintree Systems develops Value Based Solutions for the Health Care Industry. Our products are built with the specific purpose of providing real value to the provider, practice and patient. Fully Integrated, custom configurable certified EHR designed for Adult and Pediatric rehab (PT, OT, SP) are designed to be powerful, intuitive and easy to use so that the individuals that use our products can be more effective and efficient at their jobs. Let us show you the Raintree Difference.

Visit us at the APTA NEXT Booth #902
www.raintreeinc.com

TheraOffice

TheraOffice

TheraOffice is the only EMR and practice management software designed by physical therapists to be the most adaptable to your unique business. Our fully-integrated solution including scheduling, documentation, accounting, and reporting enables improvement in clinical workflow processes and overall business performance with a focus on striving to achieve compliance that exceeds today’s evolving billing requirements. Come visit us at booth #1006 to view a live demo of our brand-new, all-in-one application!

Visit us at the APTA NEXT Booth #1006
www.TheraOffice.com

Therapy-Mouse

Therapy Mouse™ by mobility research

A wearable sensor that allows control of computer pointer using movement of any body segment. Snap the sensor in its bracket affixed to desired body segment, plug the receiver into any PC, Mac or Android computer, and Therapy Mouse will translate user movements to precise control of the mouse pointer. No setup. No cameras. No driver to install. Therapy Mouse can be used for Computer Access, Neuro-Gaming, and Dual Tasking Therapy in the clinic or home.

Visit us at the APTA NEXT Booth #606
www.litegait.com/products/Therapy-Mouse

 

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[ARTICLE] Brain-actuated functional electrical stimulation elicits lasting arm motor recovery after stroke – Full Text

Abstract

Brain-computer interfaces (BCI) are used in stroke rehabilitation to translate brain signals into intended movements of the paralyzed limb. However, the efficacy and mechanisms of BCI-based therapies remain unclear. Here we show that BCI coupled to functional electrical stimulation (FES) elicits significant, clinically relevant, and lasting motor recovery in chronic stroke survivors more effectively than sham FES. Such recovery is associated to quantitative signatures of functional neuroplasticity. BCI patients exhibit a significant functional recovery after the intervention, which remains 6–12 months after the end of therapy. Electroencephalography analysis pinpoints significant differences in favor of the BCI group, mainly consisting in an increase in functional connectivity between motor areas in the affected hemisphere. This increase is significantly correlated with functional improvement. Results illustrate how a BCI–FES therapy can drive significant functional recovery and purposeful plasticity thanks to contingent activation of body natural efferent and afferent pathways.

Introduction

Despite considerable efforts over the last decades, the quest for novel treatments for arm functional recovery after stroke remains a priority1. Synergistic efforts in neural engineering and restoration medicine are demonstrating how neuroprosthetic approaches can control devices and ultimately restore body function2,3,4,5,6,7. In particular, non-invasive brain-computer interfaces (BCI) are reaching their technological maturity8,9 and translate neural activity into meaningful outputs that might drive activity-dependent neuroplasticity and functional motor recovery10,11,12. BCI implies learning to modify the neuronal activity through progressive practice with contingent feedback and reward —sharing its neurobiological basis with rehabilitation13.

Most attempts to use non-invasive BCI systems for upper limb rehabilitation after stroke have coupled them with other interventions, although not all trials reported clinical benefits. The majority of these studies are case reports of patients who operated a BCI to control either rehabilitation robots14,15,16,17,18,19 or functional electrical stimulation (FES)20,21,22,23. A few works have described changes in functional magnetic resonance imaging (fMRI) that correlate with motor improvements17,18,22.

Recent controlled trials have shown the potential benefit of BCI-based therapies24,25,26,27. Pichiorri et al.26recruited 28 subacute patients and studied the efficacy of motor imagery with or without BCI support via visual feedback, reporting a significant and clinically relevant functional recovery for the BCI group. As a step forward in the design of multimodal interventions, BCI-aided robotic therapies yielded significantly greater motor gains than robotic therapies alone24,25,27. In the first study, involving 30 chronic patients24, only the BCI group exhibited a functional improvement. In the second study, involving 14 subacute and chronic patients, both groups improved, probably reflecting the larger variance in subacute patients’ recovery and a milder disability25. The last study27 showed that in a mixed population of 74 subacute and chronic patients, the percentage of patients who achieved minimally clinical important difference in upper limb functionality was higher in the BCI group. The effect in favor of the BCI group was only evident in the sub-population of chronic patients. Moreover, the conclusions of this study are limited due to differences between experimental and control groups prior to the intervention, such as number of patients and FMA-UE scores, which were always in favor of the BCI group.

In spite of promising results achieved so far, BCI-based stroke rehabilitation is still a young field where different works report variable clinical outcomes. Furthermore, the efficacy and mechanisms of BCI-based therapies remain largely unclear. We hypothesize that, for BCI to boost beneficial functional activity-dependent plasticity able to attain clinically important outcomes, the basic premise is contingency between suitable motor-related cortical activity and rich afferent feedback. Our approach is designed to deliver associated contingent feedback that is not only functionally meaningful (e.g., via virtual reality or passive movement of the paretic limb by a robot), but also tailored to reorganize the targeted neural circuits by providing rich sensory inputs via the natural afferent pathways28, so as to activate all spare components of the central nervous system involved in motor control. FES fulfills these two properties of feedback contingent on appropriate patterns of neural activity; it elicits functional movements and conveys proprioceptive and somatosensory information, in particular via massive recruitment of Golgi tendon organs and muscle spindle feedback circuits. Moreover, several studies suggest that FES has an impact on cortical excitability29,30.

To test our hypothesis, this study assessed whether BCI-actuated FES therapy targeting the extension of the affected hand (BCI–FES) could yield stronger and clinically relevant functional recovery than sham-FES therapy for chronic stroke patients with a moderate-to-severe disability, and whether signatures of functional neuroplasticity would be associated with motor improvement. Whenever the BCI decoded a hand-extension attempt, it activated FES of the extensor digitorum communis muscle that elicited a full extension of the wrist and fingers. Patients in the sham-FES group wore identical hardware and received identical instructions as BCI–FES patients, but FES was delivered randomly and not driven by neural activity.

As hypothesized, our results confirm that only the BCI group exhibit a significant functional recovery after the intervention, which is retained 6–12 months after the end of therapy. Besides the main clinical findings, we have also attempted to shed light on possible mechanisms underlying the proposed intervention. Specifically, electroencephalography (EEG) imaging pinpoint significant differences in favor of the BCI group, mainly an increase in functional connectivity between motor areas in the affected hemisphere. This increase is significantly correlated with functional improvement. Furthermore, analysis of the therapeutic sessions substantiates that contingency between motor-related brain activity and FES occurs only in the BCI group and contingency-based metrics correlate with the functional improvement and increase in functional connectivity, suggesting that our BCI intervention might have promoted activity-dependent plasticity.[…]

Continue —> Brain-actuated functional electrical stimulation elicits lasting arm motor recovery after stroke | Nature Communications

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[WEB SITE] Cognitive Assessment: Neurocognitive Assessment Battery Online for the detection of cognitive deterioration (CAB).

General Cognitive Assessment Battery (CAB)

Innovative online neuropsychological test. Study brain function and complete a comprehensive online screening. Precisely evaluate a wide range of abilities and detect cognitive well-being (high-moderate-low). Identify strengths and weaknesses in the areas of memory, concentration/attention, executive functions, planning, and coordination.

WHO IS IT FOR?

    • For my own evaluation
    • For a family member
    • For my patients
    • For my students
    • For a research study

TOTAL PRICE 49.95

 

Cognitive assessment battery to study brain function and cognitive performance

  • Assess current state of the user’s cognitive skills
  • For children 7 years and older and adults.
  • The complete battery lasts about 30-40 minutes.

The General Cognitive Assessment Battery (CAB) from CogniFit is a leading professional tool that makes it possible to get study the brain function of children 7 years and older and adults in depth, using online cognitive tasks. The results from this neuropsychological tool are useful for understanding the user’s cognitive state, strengths, and weaknesses. This can help determine whether or not the cognitive changes that the user may be experiencing are normal, or if they reflect some kind of neurological disorder. Any private or professional user can easily use this cognitive assessment.

This normalized cognitive test is completely online and lasts about 30-40 minutes. After completing the evaluation, a report will automatically be generated with the user’s neurocognitive profile. This report gathers useful information and presents data in an easy-to-understand format to make it possible to understand the functioning of different cognitive skills. It also provides valuable information that can help detect the risk of some disorder or problem, recognize its severity, and identify support strategies for each case.

We recommend using this neuropsychological assessment to better understand cognitive function, or cognitive, physical, psychological, or social well-being, and where there are symptoms or difficulties related o concentration/attention, memory, reasoning, planning, or coordination. We recommend using this complete cognitive test to complement a professional diagosis, and never to substitute a clinical consultation.[…]

 

Visit Site —> Cognitive Assessment: Neurocognitive Assessment Battery Online for the detection of cognitive deterioration (CAB).

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[WEB SITE] Symbitron | Symbiotic man-machine interaction in wearable exoskeletons to enhance mobility for paraplegics – CORDIS Project

Welcome to the Symbitron project website! Our main goals are:

  • To develop a safe, bio-inspired, personalized wearable exoskeleton that enables SCI patients to walk without additional assistance, by complementing their remaining motor function
  • To develop training environments and training protocols for SCI patients and their clinicians
  • To provide clinical proof of concept for safety and functionality of the system

WE2_S01720p

Video of one of the test pilots with a complete spinal cord injury, walking in WE2 (ankle, knee and hip actuation)


General information

Symbitron – Symbiotic man-machine interactions in wearable exoskeletons to enhance mobility for paraplegics

Project Coordination: University of Twente, Enschede, The Netherlands

Project Coordinator: Herman van der Kooij (University of Twente)

Project Partners: see Consortium

E-mail: info at symbitron dot eu

Funding: European Union, Seventh Framework Programme

                 FP7-ICT-2013-10, ID 661626

Start date: October 1st, 2013

Duration: 48 months

EU funding: 3.099.898

Tree-Clouds-4cm-4cm-300dpi-RVBThe Symbitron project is part of the “Future and Emerging Technologies (FET)” programme of the European Commission: http://ec.europa.eu/digital-agenda/en/future-emerging-technologies-fet.

Objectives

A)  To develop an integrated neuromuscular model that describes the physiology of healthy versus impaired human gait (WP2)

B)  To design and manufacture personalised modular exoskeletons that compensate for SCI impairments (WP3)

C)  To develop personalised human inspired neuro-muscular controllers for the wearable exoskeletons (WP4)

D)  To optimise the design & control, and bi-directional symbiotic man-machine interaction of wearable exoskeletons (WP5)

E)  To determine the safety and functionality of the personalised SYMBITRON wearable exoskeletons in a clinical study (WP6)

F) To disseminate key findings to relevant stakeholders and to secure IP protection and exploitation of valuable innovatins (WP7)

Symbitron objectivesVisit Site —>  Symbitron | Symbiotic man-machine interaction

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