Archive for April, 2020

[NEWS] Researchers at the UI create robotic rehabilitation device to help increase range of motion in the wrist

Assistant professors in the University of Iowa College of Engineering have developed a robotic device to help people increase their range of motion in the wrist using artificial muscles to increase flexibility.

Caterina+Lamuta+%28left%29+and+Venanzio+Cichella+%28right%29+pose+for+a+portrait+in+front+of+their+home+on+Saturday%2C+April+25%2C+2020.+Both+mechanical+engineering+professors+at+the+University+of+Iowa%2C+the+couple+is+a+part+of+the+team+working+to+create+a+new+robotic+rehabilitation+device.+

Caterina Lamuta (left) and Venanzio Cichella (right) pose for a portrait in front of their home on Saturday, April 25, 2020. Both mechanical engineering professors at the University of Iowa, the couple is a part of the team working to create a new robotic rehabilitation device.

Two mechanical-engineering assistant professors at the University of Iowa have created a robotic device to give people with limb impairment a wider range of motion. Right now, the pair is focused on the upper limbs and their first prototype increases mobility in the wrist.

The researchers, Venanzio Cichella and Caterina Lamuta, worked together to develop a flexible, lightweight device that can be powered with a small battery. Lamuta and her students are designing and developing the device itself and Cichella and his student are developing the controls of the device.

The device fits over the hand and wrist like a glove, and uses artificial muscles made from carbon fibers which are strong and flexible, Lamuta said. The muscles can lift 12,600 times their weight, and a lot of these artificial muscles can be used to reproduce the arrangement of human muscle. A small battery can be used to power the device, she said.

“So, the idea is to use this more flexible artificial muscle as an alternative for noisy and heavy traditional actuators like electrical motors or hydraulic or pneumatic actuators,” Lamuta said.

The current prototype can perform a few degrees of wrist extension and flexion, she said, but the researchers are working to increase the motion capabilities of the device.

The actuators the researchers are using are very inexpensive, Cichella said. This allows them to not only create a device that is portable and cheap, he said, but allows them to put more of the actuators in the device.

Related: UI researchers say people with spinal-cord injuries can exercise muscles by electrical stimulation

With so many actuators, the question eventually became how to move each of them in order to get the desired action or movement, he said.

Cichella is developing robust control algorithms that can be implemented in the device. He and his student are developing theoretical tools that will help find the optimal controls for the device, Cichella said, and the goal is to implement the algorithms on the side of the device.

Amid spread of the novel coronavirus, some orders for supplies to build sensors have been delayed and working from home makes it so they can’t use larger machinery in the labs, Lamuta said, so they’re going to have delays in their work.

“Part of our research takes place in the lab, which now is the living room of our house and our students’ houses, and also on paper and pen, so it (the challenge) spans both for theoretical and experimental,” Cichella said.

Two UI Ph.D. students and a visiting scholar from Italy are helping with the development of the algorithms and prototypes of the device.

Thilina Weerakkody, a Ph.D. student, and Carlo Greco, the visiting scholar, are working with Lamuta to develop the device itself.

Weerakkody, who has a background in biomedical-device development, has worked on the device, which is similar to an exoskeleton hand, to control it with external feedback. Now, he’s in the process of developing external sensors for the device, he said.

The first prototype only had a single degree of freedom for the wrist, he added.

“Now in the second prototype, we’ve developed a 3D-printed prototype, so in this phase we are trying to elicit two freedom instances,” Weerakkody said.

Greco helped design the muscle used in the glove, choosing the dimension and length of the muscles and studying the schematics of the wrist, he said. The glove was initially able to move up and down in one motion, Greco said, but now they are working to improve movement in the other direction.

“Our testing now is done on a 3D-printed hand with a forearm and we can measure the displacement of the angle of rotation,” Greco said. “…[If] a person does a motion on his own hand and our hand [should] do the same motion in the same [amount of] time.”

Calvin Kielas-Jensen, a Ph.D. student, has worked with Cichella to develop the control algorithms for the device. They’re working with a motion-capture system to give them submillimeter accuracy for the positions of the wrist.

With a background in electrical engineering, Kielas-Jensen has helped with the electronics in the device. He is providing feedback for what kind of sensors should be used and what kind of algorithms should be used to read the data, Kielas-Jensen added.

“It’s a rehabilitation device, so there are plenty of rehabilitation doctors that say that it’s really good to have people do something with their hands,” he said. “It’s one thing to give a patient a stress ball to squeeze, but it gets tired — it gets boring.”

via Researchers at the UI create robotic rehabilitation device to help increase range of motion in the wrist – The Daily Iowan

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[ARTICLE] The clinical effectiveness of Eye-Search therapy for patients with hemianopia, neglect or hemianopia and neglect

We investigated the clinical effectiveness of Eye-Search, a web-based therapy app designed to improve visual search times, in a large group of patients with either hemianopia, neglect or both hemianopia and neglect. A prospective, interventional cohort design was used. For the main, impairment-based outcome measure (average visual search time), the within-subject control was affected vs. unaffected side. Four hundred and twenty-six participants who fitted the inclusion criteria completed all 4 time points (1200 therapy trials). We found a significant three-way interaction between therapy, side and group. Eye-Search therapy improved search times to the affected visual field of patients with either hemianopia alone or neglect and hemianopia, but not those with neglect alone. Effect sizes were moderate to large and consistent with previous studies. We found a similar significant interaction between therapy and group for the patient-reported outcome measure “finding things” that most closely matched the impairment-based outcome (visual search). Eye-Search therapy improves both impairment-based and patient-reported outcome measures related to visual search in patients with hemianopia alone or hemianopia and neglect.

Introduction

Hemianopia and neglect are the two most common visual disorders complicating posterior brain injury (Corbetta et al., 2005; Rowe et al., 2019). While neglect is more likely to spontaneously improve over the first year post-injury than hemianopia, both have long-term effects on patients’ activities of daily living (Warren, 2009; Wee & Hopman, 2008). Several behavioural approaches to treating patients with persistent hemianopia have been successfully trialled. The most consistently effective therapies promote retraining of compensatory eye movements, by practising voluntary guided saccades (e.g., patients have to find a visual target amongst distractors, or find a target that has “jumped” to a new location in their blind field (Jacquin-Courtois et al., 2013; Schuett et al., 2012)). Eye-movement therapies have also been shown to be effective in treating the symptoms of neglect, although these rely on stimuli that induce smooth-pursuit eye movements (e.g., patients have to focus on targets that move towards their neglected side at a constant velocity (Hopfner et al., 2015; Kerkhoff et al., 2014)). We have previously reported on the clinical efficiency of Eye-Search (https://www.eyesearch.ucl.ac.uk/), a web-based therapy that improves visual search in patients with hemianopia, but in that study (n = 78) we left out patients with neglect (Ong et al., 2015). As hemianopia and neglect can co-occur (Muller-Oehring et al., 2003), the aim of this study was to investigate whether Eye-Search therapy works in patients with either neglect alone (“pure neglect” group) or hemianopia and neglect. We also extended the criteria for length of participation in the study from three time points (patients completed 800 therapy trials), to four (1200 therapy trials completed).

Materials and methods

Setting

All subjects’ data were collected using the Eye-Search browser-based app. This study was approved by the UCL Research Ethics Committee: 2681/001, and all participants consented to the use of their data. All data were anonymized and held securely on a UCL server. The Eye-Search app has five main data collecting components:

  1. A test to identify hemianopia

  2. A test to identify visual neglect

  3. The therapy: a ramp-step paradigm, embedded in a game, that delivers the trial-by-trial eye-movement practice

  4. An impairment-based outcome measure: a visual search task

  5. A patient-reported outcome measure (PROM): a visual analogue scale for rating difficulty performing six activities of daily life

Subjects re-tested themselves on the two visual tests and two outcome measures before they started therapy (baseline) and then every time that they completed a block of 400 trials (T1 = after 400 trials, T2 after 800 and T3 after 1200).

Study population and selection criteria

The therapy took place at the discretion of the patient and on their personal computers. Due to the nature and delivery modality of the therapy, the patients are considered to be self-enrolled, rather than traditionally recruited. The data analysed in this study were collected from participants who used the Eye-Search website between July 2012 and February 2019. In this period, 1407 participants took part, out of which 426 fitted the inclusion criteria (see consort diagram Figure 1). Of these, 302 (71%) were male. The mean participant age was 60 years [SD 14.6]. Causative diagnosis was self-reported with 6% leaving the section blank. The remaining patients were divided as follows: 84% stroke; 5% head injury; 3% surgery; and, 2% reported other causes such as an abscess, CO poisoning and encephalitis. Time between the cause of their visual impairment and starting therapy was positively skewed, median 85 days [IQR = 44–210 days]. Progress through the therapy was self-paced. The time to get from baseline to T1 and T3 was also positively skewed with subjects taking a median time of 5 days [IQR = 2–12 days] and 20 days [IQR = 9–33 days], respectively.

Figure 1. Consort diagram showing the identification of participants in the study.

[…]

Continue —->  Full article: The clinical effectiveness of Eye-Search therapy for patients with hemianopia, neglect or hemianopia and neglect

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[Abstract] Enhancing visual performance of hemianopia patients using overview window

Highlights

 

  • Proposal of a computational glasses for visual field defect
  • Design of a whac-a-mole task for empirical performance evaluation
  • Optimal combinations of size, position, and opacity for overlaid window

Abstract

Visual field defect (VFD) is a type of ophthalmic disease that causes the loss of part of the patient’s field of view (FoV). In this paper, we propose a method to enlarge the restricted FoV with an optical see-through head-mounted display (OST-HMD) equipped with a camera that captures an overview and overlays it on the persisting FoV. Because the overview window occludes the real background scene, it is important to create a balance between the augmented contextual information and the unscreened local information. We recruited twelve participants and conducted an experiment to seek the best size, position, and opacity for the overview window through a Whac-A-Mole task (a touchscreen game). We found that the performance was better when the overview window was of medium size (FoV of 9.148 × 5.153, nearly one third of FoV of the used OST-HMD) and placed lower in the visual field. Either too large or too small a size decreases the performance. The performance increases with increased opacity. The obtained results can legitimate the default setting for the overview window.

Graphical abstract

via Enhancing visual performance of hemianopia patients using overview window – ScienceDirect

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[WEB SITE] DigiTrainer – Video

DigiTrainer is a tool for reducing the muscle tone and increasing mobility in the fingers

DIGITRAINER

SIMPLY EFFECTIVE HAND THERAPY

“The principle of action is unique: It is based on the combination of vibration, movement and pressure. The vibration promotes perception and blood circulation to the hand and fingers. ”

DigiTrainer (formerly RehaDigit) can reduce the muscle tone and increase mobility in the fingers of the hand.
Following a stroke, brain injury or spinal cord injury, for example, the muscles and soft-tissues of the hand can become tight and the sensory pathways disrupted.
In order to recover lost tactile sense and to trigger new movement capabilities, intensive rehabilitation is needed and this should start as soon as possible following the injury.
For example, with a cervical level spinal cord injury it is important to avoid complications by early positioning, stretches and oedema management. The hand is perhaps the most important resource after the brain in these cases so the hands must be kept supple if we are to have a chance of developing functional activities. The DigiTrainer makes intensive rehab possible.
DigiTrainer provides both motor and sensory rehabilitation in a simple and effective manner. Through a series of finger-rolls the patient’s fingers are alternately bent and stretched (flexion/extension of the finger joints). The specially designed motor induces a slight vibration into the hand and this supports the relaxation of the finger muscles.

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Vibration preserves sensory pathways

Vibration preserves sensory pathways

DigiTrainer delivers the following functions

  • works for the left and the right hand

  • adjustable rotation velocity

  • adjustable vibration frequency

  • continues or periodic crescendo and decrescendo vibrations

  • ergonomic hand rest (height adjustable)

  • usage via touch screen

  • therapy time: 5-30 min

  • offer price £2,660 ex VAT and shipping

DigiTrainer-Produktbild-2019.jpg

INDICATIONS FOR USE

DigiTrainer can be used for the following indications:

  • passive bend and stretch movement of the II-V fingers in the rehabilitation of patients with hemi- and tetraparesis from moderate to strong paresis of the upper extremity

  • for example, after stroke, paraplegia, traumatic brain injury, M. Parkinson or joint injuries

  • for patients without distal activity of the wrist and finger flexors

  • incomplete and complete motoric paraplegia after spinal cord injury

  • for patients with spasticity in arms, low blood circulation and impaired hand mobility

  • for patients with functional loss after injury or surgery

DigiTrainer_Anne-Hansi-1.jpg

WHAT IT DOES

DigiTrainer is a CE marked Class II medical device. The items included with the product are 1 DigiTrainer, 2 adapter plates for hand rest (25mm and 20°), 1 power supply and appropriate cable and 1 user manual

Check out the video below to see DigiTrainer in action. The unit accomodates left or right hands of various sizes and allows easy programming via a touch screen interface. The therapist can control the specific nature and speed of the movement as the DigiTrainer stretches and massages the fingers. Integrated vibration relaxes tight fingers in a safe and effective way. DigiTrainer has a unique operating principle – most devices focus on movement whereas DigiTrainer also targets the sensorimotor system. Studies have confirmed the effectiveness of the device.

Figure 14.jpg

CONTRAINDICATIONS

The DigiTrainer is generally a safe product but we recommend initial supervision and guidance is obtained from knowledgeable person

Contraindications for DigiTrainer include patients with:

  • fully developed shoulder-arm syndrome

  • acute arthritis in finger joints, thumb joints and/or wrist

  • severe contractures of the finger joints, thumb joints and/or wrist

  • acute disorders requiring special treatment of fingers or hand (e.g. tendinitis)

  • massively swollen hand

  • allergic exanthema of hand

  • fixed fingers.

Related Research

Stefan Hesse, H Kuhlmann, J Wilk, C Tomelleri and Stephen GB Kirker (2008) “A new electromechanical trainer for sensorimotor rehabilitation of paralysed fingers: A case series in chronic and acute stroke patients”
Journal of NeuroEngineering and Rehabilitation20085:21
DOI: 10.1186/1743-0003-5-21
https://jneuroengrehab.biomedcentral.com/articles/10.1186/1743-0003-5-21

R. Buschfort, J. Brocke, A. Heß, C. Werner, A. Waldner, and Stefan Hesse,
”Arm Studio to intensify upper limb rehabilitation after stroke: Concept, acceptance, utilisation and preliminary clinical results”
J Rehabil Med 2010; 42: 310–314

Stefan Hesse, Anke Heß, Cordula Werner, Nadine Kabbert, Rüdiger Buschfort
“Effect on arm function and cost of robot-assisted group therapy in subacute patients with stroke and a moderately to severely affected arm: a randomized controlled trial”
Clinical Rehabilitation 2014, Vol. 28(7) 637–647
DOI: 10.1177/0269215513516967

A. Waldner, C. Werner, S. Hesse
“Robot assisted therapy in neurorehabilitation”
EUR MED PHYS 2008;44(Suppl. 1 to No. 3)

Visit site —->  DigiTrainer

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[ARTICLE] A new electromechanical trainer for sensorimotor rehabilitation of paralysed fingers: A case series in chronic and acute stroke patients – Full Text

Abstract

Background

The functional outcome after stroke is improved by more intensive or sustained therapy. When the affected hand has no functional movement, therapy is mainly passive movements. A novel device for repeating controlled passive movements of paralysed fingers has been developed, which will allow therapists to concentrate on more complicated tasks. A powered cam shaft moves the four fingers in a physiological range of movement.

Methods

After refining the training protocol in 2 chronic patients, 8 sub-acute stroke patients were randomised to receive additional therapy with the Finger Trainer for 20 min every work day for four weeks, or the same duration of bimanual group therapy, in addition to their usual rehabilitation.

Results

In the chronic patients, there was a sustained reduction in finger and wrist spasticity, but there was no improvement in active movements. In the subacute patients, mean distal Fugl-Meyer score (0–30) increased in the control group from 1.25 to 2.75 (ns) and 0.75 to 6.75 in the treatment group (p < .05). Median Modified Ashworth score increased 0/5 to 2/5 in the control group, but not in the treatment group, 0 to 0. Only one patient, in the treatment group, regained function of the affected hand. No side effects occurred.

Conclusion

Treatment with the Finger Trainer was well tolerated in sub-acute & chronic stroke patients, whose abnormal muscle tone improved. In sub-acute stroke patients, the Finger Trainer group showed small improvements in active movement and avoided the increase in tone seen in the control group. This series was too small to demonstrate any effect on functional outcome however.

Introduction

The annual stroke incidence is approximately 180 patients per 100,000 inhabitants in the industrialized world. About 30% of the surviving patients suffer from a severe upper limb paresis with a non functional hand. The prognosis for regaining meaningful hand activity six months after stroke onset is poor [1]: this may partly be because current rehabilitation practice puts more emphasis on the compensatory use of the non-affected upper extremity [2].

Powered machines which can allow prolonged repetition of a controlled movement are a promising way of increasing the intensity of rehabilitation after stroke. Several devices, to treat wrist, elbow & shoulder movements, have been developed since the pioneering MIT-Manus in the early 1990s [3]. Randomized controlled trials show a convincing beneficial effect of robot-assisted upper limb treatment on the impairment of severely affected stroke patients [49].

There are fewer clinical reports of machine-assisted movement of paralysed fingers. The Rutgers Hand Masters I and II use pistons mounted inside the palm to move the fingers, with virtual reality to improve motivation. Chronic stroke patients improved range of motion, motor control and speed of the paretic fingers over several weeks of training, and the benefits were retained at follow-up [1011].

With the Howard Hand Robot, pistons assist with patient initiated grasping and releasing movements around virtual or real objects. In moderately affected chronic stroke subjects, upper limb motor functions improved, and functional MRI revealed increased sensorimotor cortex activation during the grasping task which was not seen during a non-practiced task, supination/pronation [12].

Fischer et al assisted the finger extension of mildly affected stroke patients with the help of a powered orthosis. Following six weeks of training in reach-to-grasp of virtual and actual objects, patients’ active motor performance had shown a moderate improvement [13].

The treatment of the plegic fingers after stroke is pertinent given their large cortical representation, the presumed competition between proximal and distal limb segments for plastic brain territory [14], and recent results from the MIT-group promoting earlier active treatment of distal limb [15]. Further, paresis-related immobilization seems to contribute to the development of long-term disabling finger flexor spasticity [16].

We have designed an electromechanical Finger Trainer to move individual fingers in a physiological range of movement. This article describes the device and reports its use in a small number of chronic and acute stroke patients with completely paralysed hands.

Device

The Finger Trainer, Reha-Digit, (figure 1) consists of four, mutually independent plastic rolls, each fixed eccentrically to the powered axle of the device, forming a cam-shaft. Each finger-roll can be repositioned & secured by turning a knob on the main axle, on the other end from the motor, to fit the size & range of movement of each individual finger.

Figure 1
figure1

The Finger Trainer, “Reha-Digit”, without a patient (left), and a left-hemiparetic patient practicing with the device (right).

The surface of each finger roll is concave, forming a gutter to maximise the contact area between finger & roll. Two smaller locking rollers, also concave, hold each finger against the larger finger roll. Each pair of locking rollers moves orthogonally to the axis of the finger roll, and an elastic spring pulls each pair of locking rollers towards the finger roller. These can be lifted out of the way when first positioning the hand & fingers in the device.

A spacing bar, parallel to the drive axle, holds the hand in the optimal position: a thumb stop may be used to provide additional stability. This can be moved to either side, to accommodate either the left or right hand. There are emergency-stop switches at each end of the spacing bar. The forearm can be stabilised at the correct angle & height on a gutter support.

A 24 V DC motor rotates the drive axle up to 30 times a minute through a clutch mechanism, which allows the axle to stop rotating if the hand goes into a powerful spasm. A vibration engine, situated under the base plate, provides small amplitude (2 mm) stimulation at a frequency which can be set between 0 to 30 Hz, by turning a knob. The device’s weight is 7 kg, and its dimensions are 35 cm × 24 cm × 22 cm.[…]

Continue —->  A new electromechanical trainer for sensorimotor rehabilitation of paralysed fingers: A case series in chronic and acute stroke patients | Journal of NeuroEngineering and Rehabilitation | Full Text

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[Abstract] Composite active range of motion (CXA) and relationship with active function in upper and lower limb spastic paresis

The aim of this study is to evaluate a novel composite measure of active range of motion (XA) and determine whether this measure correlates with active function.

Post hoc analysis of two randomized, placebo-controlled, double-blind studies with open-label extensions exploring changes in active function with abobotulinumtoxinA.

Tertiary rehabilitation centers in Australia, Europe, and the United States.

Adults with upper (n = 254) or lower (n = 345) limb spastic paresis following stroke or brain trauma.

AbobotulinumtoxinA (⩽5 treatment cycles) in the upper or lower limb.

XA was used to calculate a novel composite measure (CXA), defined as the sum of XA against elbow, wrist, and extrinsic finger flexors (upper limb) or soleus and gastrocnemius muscles (lower limb). Active function was assessed by the Modified Frenchay Scale and 10-m comfortable barefoot walking speed in the upper limb and lower limb, respectively. Correlations between CXA and active function at Weeks 4 and 12 of open-label cycles were explored.

CXA and active function were moderately correlated in the upper limb (P < 0.0001–0.0004, r = 0.476–0.636) and weakly correlated in the lower limb (P < 0.0001–0.0284, r = 0.186–0.285) at Weeks 4 and 12 of each open-label cycle. Changes in CXA and active function were weakly correlated only in the upper limb (Cycle 2 Week 12, P = 0.0160, r = 0.213; Cycle 3 Week 4, P = 0.0031, r = 0.296). Across cycles, CXA improvements peaked at Week 4, while functional improvements peaked at Week 12.

CXA is a valid measure for functional impairments in spastic paresis. CXA improvements following abobotulinumtoxinA injection correlated with and preceded active functional improvements.

via Composite active range of motion (CXA) and relationship with active function in upper and lower limb spastic paresis – Nicolas Bayle, Pascal Maisonobe, Romain Raymond, Jovita Balcaitiene, Jean-Michel Gracies,

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[ARTICLE] A New Design Scheme for Intelligent Upper Limb Rehabilitation Training Robot – Full Text PDF

Abstract: In view of the urgent need for intelligent rehabilitation equipment for some disabled people, an intelligent, upper limb rehabilitation training robot is designed by applying the theories of artificial intelligence, information, control, human-machine engineering, and more. A new robot structure is proposed that combines the use of a flexible rope with an exoskeleton. By introducing environmentally intelligent ergonomics, combined with virtual reality, multi-channel information fusion interaction technology and big-data analysis, a collaborative, efficient, and intelligent remote rehabilitation system based on a human’s natural response and other related big-data information is constructed. For the multi-degree of the freedom robot system, optimal adaptive robust control design is introduced based on Udwdia-Kalaba theory and fuzzy set theory. The new equipment will help doctors and medical institutions to optimize both rehabilitation programs and their management, so that patients are more comfortable, safer, and more active in their rehabilitation training in order to obtain better rehabilitation results.

Full Text PDF

 

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[Review] Immediate and long-term effects of BCIbased rehabilitation of the upper extremity after stroke: a systematic review and metaanalysis – Full Text PDF

Abstract

Background: A substantial number of clinical studies have demonstrated the functional recovery induced by the use of brain-computer interface (BCI) technology in patients after stroke. The objective of this review is to evaluate the effect sizes of clinical studies investigating the use of BCIs in restoring upper extremity function after stroke and
the potentiating effect of transcranial direct current stimulation (tDCS) on BCI training for motor recovery.

Methods: The databases (PubMed, Medline, EMBASE, CINAHL, CENTRAL, PsycINFO, and PEDro) were systematically searched for eligible single-group or clinical controlled studies regarding the effects of BCIs in hemiparetic upper extremity recovery after stroke. Single-group studies were qualitatively described, but only controlled-trial studies were included in the meta-analysis. The PEDro scale was used to assess the methodological quality of the controlled studies. A meta-analysis of upper extremity function was performed by pooling the standardized mean difference (SMD). Subgroup meta-analyses regarding the use of external devices in combination with the application of BCIs were also carried out. We summarized the neural mechanism of the use of BCIs on stroke.

Results: A total of 1015 records were screened. Eighteen single-group studies and 15 controlled studies were included. The studies showed that BCIs seem to be safe for patients with stroke. The single-group studies consistently showed a
trend that suggested BCIs were effective in improving upper extremity function. The meta-analysis (of 12 studies) showed a medium effect size favoring BCIs for improving upper extremity function after intervention (SMD = 0.42; 95% CI = 0.18–0.66; I2 = 48%; P < 0.001; fixed-effects model), while the long-term effect (five studies) was not significant (SMD = 0.12; 95% CI = − 0.28 – 0.52; I2 = 0%; P = 0.540; fixed-effects model). A subgroup meta-analysis indicated that using functional electrical stimulation as the external device in BCI training was more effective than using other devices (P = 0.010). Using movement attempts as the trigger task in BCI training appears to be more effective than using motor
imagery (P = 0.070). The use of tDCS (two studies) could not further facilitate the effects of BCI training to restore upper extremity motor function (SMD = − 0.30; 95% CI = − 0.96 – 0.36; I2 = 0%; P = 0.370; fixed-effects model).

Conclusion: The use of BCIs has significant immediate effects on the improvement of hemiparetic upper extremity function in patients after stroke, but the limited number of studies does not support its long-term effects. BCIs combined with functional electrical stimulation may be a better combination for functional recovery than other kinds
of neural feedback. The mechanism for functional recovery may be attributed to the activation of the ipsilesional premotor and sensorimotor cortical network.

Full Text PDF

 

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[BLOG POST] Symptoms of Post -Traumatic Stress

After experiencing a traumatic event, a person can be inflicted with stressful reminders of that event, which can be crippling and debilitating, and seriously interrupt a person’s life. The onset of Post-Traumatic Stress (PTS) doesn’t have a specific time frame, it can take hold weeks, months, or even years after the occurrence of a traumatic event. While there aren’t yet any concrete ways to determine who will and will not experience PTS, a recent study has identified some genetic links. It’s important to understand the symptoms and warning signs of PTS because they can begin to appear at any time, even without warning.

The four hallmark symptoms of PTS involve re-experiencing, avoidance, arousal and reactivity, and mood and cognition. In some cases, a patient needs to express a symptom of at least one of each for at least a month to be diagnosed with Post-Traumatic Stress.

Re-Experiencing 
The phenomenon of re-experiencing can occur at any time of the day, and frequently disrupts a person’s daily routine. At night, bad dreams and nightmares can upend a full night’s sleep, and depending on the severity of nightmares or night terrors, cause insomnia. These flashbacks can make it feel like a person is experiencing the traumatic event for the first time. The triggers for re-experiencing are typically rooted in reminders of the event in the form of words, objects, or situations.

Avoidance
Reminders of a traumatic event can trigger avoidance symptoms in a person suffering with PTS. Those reminders can be places, things or people. A change in a close relationship with a person they experienced the traumatic event with could be a hint of avoidance. However, avoidance can also manifest in avoiding other people entirely, which can then lead to feeling isolated and alone.

Arousal and Reactivity
While many of the symptoms of PTS can be triggered by something, arousal symptoms tend to be constant. The arousal symptoms typically cause feelings of stress and anger, and can result in angry outbursts. They can also lead to feeling on edge, and being easily startled. Daily tasks such as eating, focusing, and sleeping can all be affected by these symptoms.

Mood and Cognition
While re-experiencing is a well-known symptom of PTS, it isn’t required to diagnose it. Mood swings and changes in mood, such as feelings of hopelessness, numbness, as well as guilt and shame, or even suicidal thoughts, can be an indicator of the onset of PTS. Loss of interest in activities that were previously enjoyable is also common, and these feelings can also cause a person to feel isolated and detached from family, friends, and their life.

Symptoms of PTS can vary in intensity, but they don’t operate on a standard progression from mild to intense over time. Instead, they depend on the scenario in which they are triggered. For example, if a person is dealing with a stressful situation and they are triggered, their symptoms could be more intense. For military service members, it is imperative that they have the opportunity to be diagnosed and treated if they experience or display symptoms of PTS. The Intrepid Spirit Centers that the Intrepid Fallen Heroes Fund is constructing are helping thousands of military service members address and heal from their symptoms of Post-Traumatic Stress. To learn more about these centers click here or, donate today.

via Symptoms of Post-Traumatic Stress | Intrepid Fallen Heroes Fund

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[WEB SITE] Brain Injury News – CNS

RESEARCH UPDATES, INDUSTRY NEWS, SURVIVOR STORIES

The world of advancements in brain injury knowledge and treatment is a rich composite of the progress being made by scores of dedicated people. The articles and reports below reflect current research, industry analysis, and stories of recovery. Innovations in patient care and the evolution of best practices in rehabilitation are among the subjects addressed by thought leaders, universities, and institutes noted here.

Categories:  Survivor  Stories  Traumatic Brain Injury  Concussion  Stroke  Aneurysm  Coma

NEWS & EVENTS ARCHIVES

via Brain Injury News

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