Posts Tagged Neurological

[WEB PAGE] ReWalk Robotics Expands Rehab Product Portfolio

ReWalk Robotics Expands Rehab Product Portfolio

 

ReWalk Robotics Ltd has finalized and moved to implement two separate agreements to distribute additional product lines in the United States market. These include telehealth-capable stroke rehabilitation devices as well as clinic and home use devices for persons with spinal cord injury.

Upon commencement of the effective periods of these agreements, the company will be the exclusive distributor of the MediTouch Tutor movement biofeedback systems in the United States, and will also have distribution rights for the MYOLYN MyoCycle Functional Electrical Stimulation (FES) cycles to US rehabilitation clinics and personal sales through the US Department of Veterans Affairs hospitals, the company notes in a media release.

“These impressive technologies serve similar clinician and patient profiles as our current products, which presents an opportunity to increase same-site sales, and offering a broader portfolio of solutions also potentially expands our access to new customers,” says Andy Dolan, Vice President of Marketing at ReWalk.

“The MediTouch Tutor devices will also give us an entry into the telehealth-capable products category to leverage recent COVID-19 related reimbursement changes and trends in rehabilitative care.”

The MediTouch Tutor movement biofeedback product line includes the Arm, Hand, 3D and Leg Tutor devices. These devices are used by physical and occupational therapists to evaluate functional tasks during rehabilitation of neurologic disorders, and can also be used by patients remotely at home. The system consists of sensors attached to textiles worn on the patient’s hand, arm or leg to detect motion and a web-based program which uses game play to provide instruction and motivation to the patient user. The program also captures and evaluates patient progress and provides feedback to the clinician.

“Entering the US physical rehabilitation clinic and home telehealth markets with our innovative wearable devices and web-based MediTutor app in order to provide the best clinical care and affordable cost effective treatment, while enabling social distancing specifically during this pandemic is a key goal for our company, and we believe that this partnership with ReWalk gives us the customer access we need,” states Giora Ein-ZVi, CEO of MediTouch, the release continues.

The MYOLYN MyoCycles use FES to facilitate therapeutic exercise for persons with muscle weakness or paralysis caused by disorders like spinal cord injury, multiple sclerosis, and stroke. Similar to the ReWalk exoskeleton, these devices can be used in a clinic for rehabilitation or training for an individual to eventually use their own at home. Both the MyoCycle Pro for clinic use and MyoCyle Home for patient home use have Federal Supply Schedule contracts to facilitate sales to VA hospitals and patients with VA benefits.

For more information, visit ReWalk Robotics Ltd.

[Source(s): ReWalk Robotics Ltd, GlobeNewswire]

via ReWalk Robotics Expands Rehab Product Portfolio – Rehab Managment

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[WEB SITE] Dutch ‘Walking Bike’ Helps Disabled People Gain Mobility, Sit Tall

Dutch ‘Walking Bike’ Helps Disabled People Gain Mobility, Sit Tall

photo caption: Actress Selma Blair, who has battled multiple sclerosis (MS), poses with an Alinker “walking bike,” a mobility device for people with disabilities, in an unknown location in this undated handout photo. Courtesy of BARBARA ALINK/ALINKER/Handout via REUTERS

WEYMOUTH, Mass. (Reuters) – Lindsey Main from Massachusetts was an active woman who enjoyed yoga, running and walking her dog, until she suffered a stroke in January 2018 and lost mobility.

While starting the long, slow process of exercise and rehabilitation she spotted actress Selma Blair announcing on Instagram she had the nervous system-damaging disease multiple sclerosis.

The 47-year-old star of films including “Cruel Intentions” and “The Sweetest Thing” posted images of herself using an Alinker mobility bike. The two began private messaging and Blair bought Main one of the bikes. Main says it has changed her life.

Now she can walk her dog again, go to the shops and dance on it.

“I think movement actually is the best medicine. It’s like that saying: ‘If you don’t use it, you lose it’,” Main said.

The bike was created by Dutch designer and humanitarian Barbara Alink, who made it initially as a mobility device for her ageing mother to use without the stigma attached to mobility walkers and scooters.

A successful crowdfunding campaign in 2014 brought about a launch in the Dutch market and a North America launch followed in 2016. Now the bike, which costs $1,977.00 ships worldwide.

“The Alinker is for everybody who identifies as an active person and happens to have a diagnosis,” said Alink.

“The feedback that I’m getting from people is that their life has changed, they can go out again, they have agency back,” she added.

The Alinker has three wheels and riders support themselves on a saddle and move their legs to push it forward. It has brakes and the high saddle means users can sit almost at standing height and speak to others at their eye level.

It is used by people with Parkinson’s, arthritis, cerebral palsy, spinal cord injuries, muscular dystrophy and peripheral neuropathy along with those recovering from strokes and surgery.

“Isolation is a bigger disease or a bigger burden on people than the actual symptoms of the disease itself,” said Alink.

“So with the Alinker, being engaged in life again because you can go out… your radius expands again,” she added.

Alinker is not classed as a medical device, so many insurance companies do not fund its purchase, leaving people to rely on crowdfunding or using the company’s rent-to-own scheme.

At its factory in Taipei in Taiwan, the company is working on prototypes for smaller Alinkers for children.

[Source: Reuters]

 

via Dutch ‘Walking Bike’ Helps Disabled People Gain Mobility, Sit Tall – Physical Therapy Products

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[BOOK] The Comorbidities of Epilepsy – Google Books

The Comorbidities of Epilepsy

Front Cover
Marco Mula
Academic PressApr 20, 2019 – Medical – 413 pages

Epilepsy is one of most frequent neurological disorders affecting about 50 million people worldwide and 50% of them have at least another medical problem in comorbidity; sometimes this is a the cause of the epilepsy itself or it is due to shared neurobiological links between epilepsy and other medical conditions; other times it is a long-term consequence of the antiepileptic drug treatment.

The Comorbidities of Epilepsy offers an up-to-date, comprehensive overview of all comorbidities of epilepsy (somatic, neurological and behavioral), by international authorities in the field of clinical epileptology, with an emphasis on epidemiology, pathophysiology, diagnosis and management. This book includes also a critical appraisal of the methodological aspects and limitations of current research on this field. Pharmacological issues in the management of comorbidities are discussed, providing information on drug dosages, side effects and interactions, in order to enable the reader to manage these patients safely.

The Comorbidities of Epilepsy is aimed at all health professionals dealing with people with epilepsy including neurologists, epileptologists, psychiatrists, clinical psychologists, epilepsy specialist nurses and clinical researchers.

  • Provides a comprehensive overview of somatic, neurological and behavioral co-morbidities of epilepsy
  • Discusses up-to-date management of comorbidities of epilepsy
  • Written by a group of international experts in the field

 

via The Comorbidities of Epilepsy – Google Books

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[WEB SITE] tDCS application for motor rehabilitation

Neuer Inhalt

An increasing number of studies highlight the potential application of transcranial direct current stimulation (tDCS) for motor rehabilitation in neurological diseases as well as in healthy aging. tDCS is a technique where a constant weak electric current is passed through scalp electrodes and has been shown to modulate excitability in both cortical and subcortical brain areas. Although the results of tDCS interventions for motor rehabilitation are still preliminary, they encourage further research to better understand its therapeutic potential and to inform optimal clinical use.

This collection of articles aims to present the most recent advances in tDCS for motor rehabilitation, addressing topics such as theoretical, methodological, and practical approaches to be considered when designing tDCS-based rehabilitation. Submissions of both experimental and review studies is encouraged.

This collection of articles has not been sponsored and articles have undergone the journal’s standard peer-review process overseen by the Editor-in-Chief and Associate Editors. The Editor-in-Chief and Associate Editors declare no competing interests.

  1. Content Type:Review

    Transcranial direct current stimulation for the treatment of motor impairment following traumatic brain injury

    After traumatic brain injury (TBI), motor impairment is less common than neurocognitive or behavioral problems. However, about 30% of TBI survivors have reported motor deficits limiting the activities of daily…

    Authors:Won-Seok Kim, Kiwon Lee, Seonghoon Kim, Sungmin Cho and Nam-Jong Paik

    Citation:Journal of NeuroEngineering and Rehabilitation 2019 16:14

    Published on: 25 January 2019

  2. Content Type:Review

    Transcranial direct current stimulation for promoting motor function in cerebral palsy: a review

    Transcranial direct current stimulation (tDCS) has the potential to improve motor function in a range of neurological conditions, including Cerebral Palsy (CP). Although there have been many studies assessing …

    Authors:Melanie K. Fleming, Tim Theologis, Rachel Buckingham and Heidi Johansen-Berg

    Citation:Journal of NeuroEngineering and Rehabilitation 2018 15:121

    Published on: 20 December 2018

  3. Content Type:Commentary

    Transcranial direct current stimulation (tDCS) for upper limb rehabilitation after stroke: future directions.

    Transcranial Direct Current Stimulation (tDCS) is a potentially useful tool to improve upper limb rehabilitation outcomes after stroke, although its effects in this regard have shown to be limited so far. Addi…

    Authors:Bernhard Elsner, Joachim Kugler and Jan Mehrholz

    Citation:Journal of NeuroEngineering and Rehabilitation 2018 15:106

    Published on: 15 November 2018

  4. Content Type:Research

    Home-based transcranial direct current stimulation plus tracking training therapy in people with stroke: an open-label feasibility study

    Transcranial direct current stimulation (tDCS) is an effective neuromodulation adjunct to repetitive motor training in promoting motor recovery post-stroke. Finger tracking training is motor training whereby p…

    Authors:Ann Van de Winckel, James R. Carey, Teresa A. Bisson, Elsa C. Hauschildt, Christopher D. Streib and William K. Durfee

    Citation:Journal of NeuroEngineering and Rehabilitation 2018 15:83

    Published on: 18 September 2018

via tDCS application for motor rehabilitation

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[Abstract] A Preliminary Study: Mobile Device for Hand and Wrist Rehabilitation – IEEE Conference Publication

Abstract:

Task-specific rehabilitation has emerged as an influential approach to address the specific neurological problems. In particular, the recovery of hand and wrist functions of people suffering from hemiparesis and hemiplegia has appeared as a means of voluntary practices. In this study, a passive rehabilitation device has been designed to offer repetitive, low-cost, portable, easy-to-use human-machine interface for people who have limited hand-wrist mobility, also substantially decrease the therapist’s workload, and provide motivation and objective feedback to users. Therapy-based task-oriented virtual reality games are also accompanied with the proposed rehabilitation device to raise patient’s attention and motivation throught the therapy.

via A Preliminary Study: Mobile Device for Hand and Wrist Rehabilitation – IEEE Conference Publication

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[WEB SITE] Virtual reality, Smart car and putting green help patients at new Hoag center recover from traumatic injuries

Hoag Hospital in Newport Beach opened a 21,000-square-foot rehabilitation center on Monday for adults who have suffered orthopedic and neurological crises, including strokes and other traumatic injuries.

The Fudge Family Acute Rehabilitation Center includes 18 rooms, workout equipment, a garden, a putting green and a virtual reality system.

Hoag Dr. Keyvan Esmaeili said the center will serve as a transition area where patients relearn basic tasks lost to injury or illness.

 

The patients are recovering from amputations, brain, spinal cord and orthopedic injuries, strokes and pulmonary disorders, brain tumor surgery and similar challenges.

“The simplest of tasks can be tremendously overwhelming and fatiguing for these patients,” said Mark Glavinic, Hoag’s director of rehabilitation. “This is about bringing function and independence back to them.”

 

The rehab center has a variety of methods to aid patients with regaining motor function, ranging from the traditional — like using overhead harnesses — to the unique.

Mark Glavinic, director of rehabilitation for Hoag Hospital, demonstrates a lift at the Fudge Family Acute Rehabilitation Center for patients who have a hard time supporting themselves.

Mark Glavinic, director of rehabilitation for Hoag Hospital, demonstrates a lift at the Fudge Family Acute Rehabilitation Center for patients who have a hard time supporting themselves. (Scott Smeltzer / Staff Photographer)

Glavinic said the virtual reality system is a novel way for patients to sharpen hand-eye skills; they can, for example, use virtual swords to pop on-screen balloons. The system stores patients’ data so medical personnel can track their progress.

 

With an average stay of 12 to 15 days, each patient gets his or her own bedroom and bathroom.

An electronic lift is available to lead patients to the bathroom from bed if they can’t support themselves. Esmaeili said this prevents injuries that can occur when nurses lift patients.

 

The rehab team is composed of physicians, nurses and therapists from stroke centers, neurological institutes and other specialized areas.

The facility also includes a room built to mirror an apartment. It is meant to be a transition room — with associated “obstacles” to navigate — before a patient is released to go home. Patients can practice washing dishes, using a stove and opening cabinets.

When patients need a break from the indoors, recreational therapists will guide them to the garden and putting green.

 

There’s also an engine-less Smart car so patients can relearn how to get in and out of a vehicle.

Mark Glavinic, Hoag Hospital's director of rehabilitation, shows how a Smart car is used to help patients with their daily routines as part of the new Fudge Family Acute Rehabilitation Center.

Mark Glavinic, Hoag Hospital’s director of rehabilitation, shows how a Smart car is used to help patients with their daily routines as part of the new Fudge Family Acute Rehabilitation Center. (Scott Smeltzer / Staff Photographer)

The facility, in the making for about 10 years, is one of only a few acute rehabilitation centers at Orange County hospitals.

 

Heidi Pallares, Hoag’s director of corporate communications and media relations, said Hoag doesn’t publicize the full cost of its projects, though $4 million was donated for the center by Gary Fudge of Newport Beach.

 

Fudge, 74, who suffered a stroke in 2010 and underwent treatment at Hoag, said he wanted to help others who are going through the same psychologically draining rehabilitation.

 

“I came face to face with my mortality,” Fudge said. “It wasn’t pleasant.”

Fudge had to regain the ability to perform even the most basic tasks, like deleting an email. He said he has virtually no limitations now.

 

Fudge said he would have benefited from the new center had it been around when he had his stroke. In particular, he said, he shouldn’t have been going home after rehab sessions.

 

“I would have preferred staying here,” Fudge said. “This could have helped me … and it will undoubtedly help others.”

 

via Virtual reality, Smart car and putting green help patients at new Hoag center recover from traumatic injuries – Los Angeles Times

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[Abstract] Commercial video games in the rehabilitation of patients with sub-acute stroke: a pilot study

Abstract

INTRODUCTION:

Stroke generates dependence on the patients due to the various impairments associated. The use of low-cost technologies for neurological rehabilitation may be beneficial for the treatment of these patients.

AIM:

To determine whether combined treatment using a semi-immersive virtual reality protocol to an interdisciplinary rehabilitation approach, improve balance and postural control, functional independence, quality of life, motivation, self-esteem and adherence to intervention in stroke patients in subacute stage.

PATIENTS AND METHODS:

A longitudinal prospective study with pre and post-intervention evaluation was carried out. Fourteen were recruited at La Fuenfria Hospital (Spain) and completed the intervention. Experimental intervention was performed during eight weeks in combination with conventional treatment of physiotherapy and occupational therapy. Each session was increased in time and intensity, using commercial video games linked to Xbox 360° videoconsole and Kinect sensor.

RESULTS:

There were statistical significant improvements in modified Rankin scale (p = 0.04), baropodometry (load distribution, p = 0.03; support surface, p = 0.01), Barthel Index (p = 0.01), EQ-5D Questionnaire (p = 0.01), motivation (p = 0.02), self-esteem (p = 0.01) and adherence to the intervention (p = 0.02).

CONCLUSIONS:

An interdisciplinary rehabilitation approach supplemented with semi-immersive virtual reality seems to be useful for improving balance and postural control, functional independence in basic activities of daily living, quality of life, as well as motivation and self-esteem, with excellent adherence. This intervention modality could be adopted as a therapeutic tool in neurological rehabilitation of stroke patients in subacute stage.

 

via [Commercial video games in the rehabilitation of patients with sub-acute stroke: a pilot study]. – PubMed – NCBI

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[Systematic Review] Effectiveness of robotics in improving upper extremity functions among people with neurological dysfunction – Abstract

Publication CoverPurpose: the primary focus of this review was to find out the effectiveness of robotics in improving upper extremity functions among people with neurological problems in the arena of physical rehabilitation.

Material and Methods: Two reviewers independently scrutinized the included studies. The selected studies underwent quality assessment by PEDro scale. Randomized Controlled Trial (RCT) having a score of 4 or more were included in the review. A search was conducted in PUBMED, MEDLINE, CINAHL, EMBASE, PROQUEST, science direct, Cochrane Library, Physiotherapy Evidence Database (PEDro) and Google Scholar.

Results: A total of 202 studies were identified. After removal of duplication, inclusion and exclusion criteria’s n = 23 studies were included in the review process. For analysis, only the primary outcome measures of the studies were taken into account. Studies finally included in analysis were n= 21. The included studies were 19 in stroke, 1 in cerebral palsy (CP), and 1 study in multiple sclerosis (MS). No RCTs were reportedly found in spinal cord injury, Parkinson and motor neuron disease.

Conclusion: Studies related to stroke showed a clear definiteness in the improvement of upper extremity functions. Whereas on the contrary there still remains a need for quality trials in cerebral palsy, multiple sclerosis to establish the efficacy of robotics in upper extremity rehabilitation.

 

via Effectiveness of robotics in improving upper extremity functions among people with neurological dysfunction: A Systematic Review: International Journal of Neuroscience: Vol 0, No ja

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[Abstract] Wearable Movement Sensors for Rehabilitation: A Focused Review of Technological and Clinical Advances – PM&R

Abstract

Recent technologic advancements have enabled the creation of portable, low-cost, and unobtrusive sensors with tremendous potential to alter the clinical practice of rehabilitation. The application of wearable sensors to track movement has emerged as a promising paradigm to enhance the care provided to patients with neurologic or musculoskeletal conditions. These sensors enable quantification of motor behavior across disparate patient populations and emerging research shows their potential for identifying motor biomarkers, differentiating between restitution and compensation motor recovery mechanisms, remote monitoring, telerehabilitation, and robotics. Moreover, the big data recorded across these applications serve as a pathway to personalized and precision medicine. This article presents state-of-the-art and next-generation wearable movement sensors, ranging from inertial measurement units to soft sensors. An overview of clinical applications is presented across a wide spectrum of conditions that have potential to benefit from wearable sensors, including stroke, movement disorders, knee osteoarthritis, and running injuries. Complementary applications enabled by next-generation sensors that will enable point-of-care monitoring of neural activity and muscle dynamics during movement also are discussed.

 

via Wearable Movement Sensors for Rehabilitation: A Focused Review of Technological and Clinical Advances – PM&R

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[WEB SITE] What is clonus? Everything you need to know

Clonus is a neurological condition that occurs when nerve cells that control the muscles are damaged. This damage causes involuntary muscle contractions or spasms.

Clonus spasms often occur in a rhythmic pattern. Symptoms are common in a few different muscles, especially in the extremities. These include the:

  • ankles
  • knees
  • calves
  • wrists
  • jaw
  • biceps

Damaged nerves can cause muscles to misfire, leading to involuntary contractions, muscle tightness, and pain.

Clonus can cause a muscle to pulse for an extended period. This pulsing can lead to muscle fatigue, which may make it difficult for a person to use the muscle later.

Clonus can make everyday activities strenuous and can even be debilitating. In this article, learn more about the causes and treatment.

Causes

Nerve cells in muscles causing clonus

Damaged nerve cells cause clonus.

While researchers do not understand the exact cause of clonus, it appears to be due to damaged nerve passageways in the brain.

A number of chronic conditions are associated with clonus. As these conditions require specialized treatment, the outcome may vary in each case.

Conditions associated with clonus include:

Multiple sclerosis (MS) is an autoimmune disorder that attacks the protective sheath around the nerves. The resulting damage disrupts the nerve signals in the brain.

A stroke starves a part of the brain of oxygen, usually due to a blood clot. A stroke may cause clonus if it damages the area in the brain that controls movement.

Infections, such as meningitis or encephalitis, can damage brain cells or nerves if they become severe.

Major injuries, such as head trauma from a major accident, may also damage the nerves in the brain or spinal cord.

Serotonin syndrome is a potentially dangerous reaction that occurs if too much serotonin builds up in the body. This buildup could be due to drug abuse, but it may also be caused by taking high doses of medications or mixing certain medical drugs.

A brain tumor that pushes against the motor neurons in the brain or causes these areas to swell may lead to clonus.

Other causes of clonus include anything that has the potential to affect the nerves or brain cells, including:

  • cerebral palsy
  • Lou Gehrig’s disease
  • anoxic brain injury
  • hereditary spastic paraparesis
  • kidney or liver failure
  • overdoses of drugs such as Tramadol, which is a strong painkiller

Clonus tests

Clonus may be diagnosed using an MRI scan.

An MRI scan may be used to diagnose clonus.

To diagnose clonus, doctors may first physically examine the area that is most affected. If a muscle contracts while a person is in the doctor’s office, they may monitor the contraction to see how fast the muscle is pulsing and how many times it contracts before stopping.

Doctors will then order a specific series of tests to help them confirm the diagnosis. They may use magnetic resonance imaging (MRI) to check for damage to the cells or nerves.

Blood tests may also help identify markers for various conditions associated with clonus.

A physical test may also help doctors identify clonus. During this test, they will ask the person to quickly flex their foot, so their toes are pointing upward and then hold the muscle there.

This may cause a sustained pulsing in the ankle. A series of these pulses may indicate clonus. Doctors do not rely on this test to diagnose clonus, but it can help point them in the right direction during the diagnostic process.

Treatment

Treatment for clonus varies depending on the underlying cause. Doctors may try many different treatment methods before finding the one that works best for each person.

Medications

Sedative medications and muscle relaxers help reduce clonus symptoms. Doctors often recommend these drugs in the first instance for people experiencing clonus.

Medications that may help with clonus contractions include:

  • baclofen (Lioresal)
  • dantrolene (Dantrium)
  • tizanidine (Zanaflex)
  • gabapentin (Neurotonin)
  • diazepam (Valium)
  • clonazepam (Klonopin)

Sedatives and anti-spasticity medications can cause drowsiness or sleepiness. People taking these medications should not drive a car or operate heavy machinery.

Other side effects may include mental confusion, lightheadedness, or even trouble walking. A person should discuss these side effects with a doctor, especially if they are likely to disrupt a person’s work or everyday activities.

Other treatments

Clonus may be treated with physical therapy.

Physical therapy may help treat clonus.

Other than medication, treatments that may help reduce clonus include:

Physical therapy

Working with a physical therapist to stretch or exercise the muscles may help increase the range of motion in the damaged area. Some therapists may recommend wrist or ankle splints for some people as they can provide structure and improve stability, reducing the risk of accidents.

Botox injections

Some people with clonus respond well to Botox injections. Botox therapy involves injecting specific toxins to paralyze muscles in the area. The effects of Botox injections wear off over time so a person will require repeat injections on a regular basis.

Surgery

Surgery is often the last resort. During a procedure to treat clonus, surgeons will cut away parts of the nerve that are causing abnormal muscle movements, which should relieve symptoms.

Home remedies

While medical treatments for clonus are important, home remedies can be valuable in supporting these efforts.

Using heat packs or taking warm baths may relieve pain, while applying cold packs may help reduce muscle aches. Stretching and yoga may help promote an increased range of motion.

Some people may also find a magnesium supplement or magnesium salt bath helps relax the muscles. People should speak to a doctor before trying magnesium, as it may interact with other medications.

Outlook

The outlook for clonus may vary according to the underlying cause. Where a sudden injury or illness causes clonus and muscle spasms, the symptoms will likely go away over time or respond well to physical therapy.

Chronic conditions such as multiple sclerosis, meningitis, or a stroke may require long-term treatments for symptom management.

Clonus may sometimes get worse if the underlying condition progresses. Many people find they can manage symptoms by working closely with a doctor and physical therapist.

via Clonus: Definition, causes, tests, and treatment

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