Mind-controlled prosthetic arm moves individual fingers

Physicians and biomedical engineers from Johns Hopkins University School of Medicine, Baltimore, report what they believe is the first successful effort to wiggle fingers individually and independently of each other using a mind-controlled artificial arm to control the movement.

The proof-of-concept, described online Feb. 15 in the Journal of Neural Engineering, represents a potential advance in technologies to restore refined hand function to those who have lost arms to injury or disease, researchers said in a news release. The young man on whom the experiment was performed was not missing an arm or hand, but he was outfitted with a device that essentially took advantage of a brain-mapping procedure to bypass control of his own arm and hand.

“We believe this is the first time a person using a mind-controlled prosthesis has immediately performed individual digit movements without extensive training,” senior author Nathan Crone, MD, professor of neurology at Johns Hopkins, said in the release. “This technology goes beyond available prostheses, in which the artificial digits, or fingers, moved as a single unit to make a grabbing motion, like one used to grip a tennis ball.”

For the experiment, the research team recruited a young man with epilepsy who already was scheduled to undergo brain mapping at Johns Hopkins Hospital’s epilepsy monitoring unit to pinpoint the origin of his seizures. While the brain recordings were made using electrodes surgically implanted for clinical reasons, researchers could then use the signals to control a modular prosthetic limb developed by the Johns Hopkins University Applied Physics Laboratory.

First, the patient’s neurosurgeon placed an array of 128 electrode sensors — all on a single rectangular sheet of film the size of a credit card — on the part of the man’s brain […]

By |March 18th, 2016|Categories: News||0 Comments

Longer, intense rehab boosts recovery after brain injury in rat study

For cognitive and functional recovery after a stroke or traumatic brain injury, a longer, even more intense period of rehabilitation might improve the brain’s ability to repair and restructure itself, according to a new animal study that also confirmed the importance of intensive rehab.

Researchers at the University of California, San Diego School of Medicine found rats with cortical injury that did not receive intensive rehab did not rebuild brain structure or recover function — while also learning a longer, even more intense period of rehabilitation might amplify the benefits.

“This has implications for medical practice and medical insurance,” senior study author Mark Tuszynski, MD, PhD, said in a news release. Tuszynski is a professor in the neurosciences department and director of the Center for Neural Repair at UC San Diego School of Medicine and a neurologist with the VA San Diego Healthcare System.

“Typically, insurance supports brief periods of rehab to teach people to get good enough to go home,” he said in the release. “These findings suggest that if insurance would pay for longer and more intensive rehab, patients might actually recover more function.”

Findings were published in the Feb. 22 online early edition of Proceedings of the National Academy of Sciences. In recent years, past studies have documented the surprising plasticity or ability of the adult central nervous system to recover from injury. Researchers continue to explore how to best encourage the repair and regrowth of damaged nerve cells and connections.

To better understand what happens at the molecular and cellular levels and how rehabilitation might be made more effective after brain injury, the team studied rats relearning skills and physical abilities. They found rats that received intensive therapy for an extended period of time showed […]

By |March 15th, 2016|Categories: News||0 Comments

Study: One-on-one session before joint surgery aids patients

Patients benefit from a one-on-one education session provided by a PT and access to a custom web portal before knee or hip replacement surgery, according to a new study at the Hospital for Special Surgery in New York City.

On questionnaires, patients indicated they were more satisfied with their presurgery education and felt better prepared to leave the hospital after joint replacement, compared with those who did not participate in the session or have access to the website.

The research was presented Feb. 20 at the meeting of the American Physical Therapy Association in Anaheim, Calif.

“Controversy exists regarding the most effective means of delivering preoperative physical therapy education prior to total joint replacement,” lead investigator Rupali Joshi, PhD, PT, said in a news release. “Our study sought to evaluate the effect of a face-to-face counseling session coupled with web-based education on patient satisfaction and functional outcomes.”

The goal of the half-hour sessions, which generally took place on the patients’ presurgical screening day, was to educate them on what to expect when undergoing joint replacement.

“It has been shown that preoperative education is most beneficial when provided one-on-one,” Joshi said in the release. “The sessions are customized to address a patient’s specific needs regarding preoperative preparation and what to expect in the hospital and during rehab and recovery. We also assist patients with setting realistic goals regarding outcomes, and they are able to ask any questions they may have in a private setting.”

“After surgery, patients may be dealing with issues such as fatigue, discomfort or anxiety, and it is not the most opportune time to give them information about the road ahead,” study author Amar Ranawat, MD, an orthopedic surgeon at HSS, said in the release. “With the face-to-face […]

By |March 14th, 2016|Categories: News||0 Comments

Research explores 10-year trends in pediatric inpatient rehab

Delivery of pediatric rehabilitation services has changed during the past decade — with length of stay decreasing, according to research presented at the Association for Academic Physiatrists Annual Meeting in Sacramento, Calif.

Recent studies have shown discrepancies in the structures and processes of pediatric rehab both within and among different facilities. Other studies have looked at what determines a child’s length of stay when admitted to an inpatient rehab program. Evidence from these studies suggests age, diagnosis and a child’s functional status when admitted are all factors in determining length of stay; however, no studies have addressed national trends, according to a news release.

To fill this research gap, investigators conducted a retrospective study to evaluate overall trends in pediatric inpatient rehab and how care is changing in regard to patient demographics, health and functional characteristics and the characteristics of facilities. The researchers also hoped to identify characteristics of patients and facilities that predict length of stay and effectiveness of treatment and characterize regional differences in rehab care.
The analysis
Using a standardized reporting system that reviews the operation and performance of health centers, the researchers looked at WeeFIM data — which assigns points for independence based on how well a child performs daily tasks such as walking, communicating and getting dressed — from 67 pediatric inpatient rehabilitation centers in the U.S. between 2004 and 2014. These data represent 42,702 inpatient pediatric rehabilitation admissions.

The researchers looked at the length of stay for patients, their WeeFIM scores at admission, WeeFIM functional gains and WeeFIM efficiency. They also looked at 11 different variables that could affect overall trends, including length of stay, patient age, co-existing diseases and conditions, gender, race, location of the rehab facility, insurance type (public vs. private), […]

By |March 8th, 2016|Categories: News||0 Comments

Study: Girls at risk for autism more attentive to social cues in faces than boys

Infant girls at risk for autism pay more attention to social cues in faces than infant boys, according to new research.

The study, conducted by researchers with the Yale University School of Medicine, New Haven, Conn., is the first one known to prospectively examine sex-related social differences in at-risk infants, according to a news release. Findings are published in the March 2016 issue of the Journal of the American Academy of Child & Adolescent Psychiatry.

This difference in observational skills could help protect female siblings of children with autism from developing the disorder themselves, according to lead author Katarzyna Chawarska, associate professor in the Yale Child Study Center and in the pediatrics department.

For the prospective study, Chawarska and her colleagues measured spontaneous social attention in 101 infants between the ages of 6 and 12 months who have older siblings with autism. The team also studied 61 infants with no risk of autism. High-risk siblings are about 15 to 20 times more likely to have autism than those without a history of autism in the family, Chawarska said in the release.

The infants were all shown a video of a woman smiling and cooing at them, while doing other activities like pointing to toys in different parts of the screen, and preparing a sandwich. The team tracked where the infants focused their gazes, and for how long.

“We found that the girls in the high-risk group displayed more attention to people and their faces than all other infants,” said Chawarska, who also director of the Early Social Cognition Laboratory at Yale. “This increased access to social experiences during a highly formative developmental period predicted fewer social impairments at 2 years of age. It is important to note however, that […]

By |March 7th, 2016|Categories: News||0 Comments

New exoskeleton designed to be lighter, more agile

More than a decade of work by a team with University of California Berkeley’s Robotics and Human Engineering Laboratory has paid off, as a new, lighter and more agile exoskeleton recently was unveiled, according to a news release.

The robotics lab, a team of graduate students led by mechanical engineering professor Homayoon Kazerooni, PhD, developed the original technology for the Phoenix, made by SuitX. According to the release, SuitX was spun off from the robotics lab; Kazerooni is the company’s founder and CEO.

Weighing 27 pounds, the Phoenix is lightweight, has two motors at the hips and electrically controlled tension settings that tighten when the wearer is standing and swing freely when walking, according to the release. Users can control the movement of each leg and walk as fast as 1.1 mph by pushing buttons integrated into a pair of crutches. The exoskeleton is powered for as long as eight hours by a battery pack worn in a backpack.

“We can’t really fix their disease,” Kazerooni said in the release. “We can’t fix their injury. But what it would do is postpone the secondary injuries due to sitting. It gives a better quality of life.”

Over the years, Kazarooni and his team have developed a series of exoskeletons. Their work began in 2000 with a project funded by the Defense Advanced Research Projects Agency to create a device, now called the Berkeley Lower Extremity Exoskeleton or BLEEX, to help people carry heavier loads for longer. At that time, Kazerooni also realized the potential use for exoskeletons in the medical field, particularly as an alternative to wheelchairs, according to the release.

The team then started developing new devices to restore mobility for people who had become paraplegic.

In 2011, they made […]

By |February 29th, 2016|Categories: News||0 Comments

Study: Telephone therapy initiative helps ease spine patients’ pain

Spine surgery patients at risk for poor recovery can benefit from cognitive-behavioral based physical therapy, according to Vanderbilt University Medical Center research.

This potential new model of care involves PTs conducting weekly, 30-minute telephone sessions with 80 patients. A recent study compared the model with educational support only.

In the Changing Behavior through Physical Therapy program, patients were encouraged to set achievable goals, taught relaxation exercises, instructed about pain distraction techniques, given direction on replacing negative thoughts with positive thoughts and provided a self-management plan. Those patients scored significantly better on a lower back disability index six months after surgery than patients who received only educational support.

The CBPT program focused on patients who underwent lumbar laminectomies with or without fusion and who reported being fearful of movement before their surgeries.

“The fear is there before surgery because they have been in so much pain for so long they have restructured their lives so they don’t increase their pain,” Kristin Archer, PhD, DPT, the study’s lead author, said in a news release. “They have created a very small world for themselves. It might be if they go to work, they have to go home and not do anything else.”

The study, which was published in The Journal of Pain, is the first to assess the effects of a phone-based physical therapy intervention based upon cognitive behavioral therapy after spine surgery, according to the release.

Both the intervention group and the control group received the weekly, half-hour telephone sessions with a PT for six weeks. The intervention group scored 9.8 points better on the Oswestry Disability Index than the control group and 17 points better than what was reported before treatment.

Researchers deemed the scores for the intervention group clinically meaningful.

“The reason […]

By |February 26th, 2016|Categories: News||0 Comments

Caregiver perceptions of needed ASD services differ by race, ethnicity

Among families of children with autism spectrum disorder, perceived need for medical and support services differ among caregivers of different racial and ethnic groups, even after adjusting for child and family socioeconomic and other characteristics, according to a new study.

These differences in turn might affect how caregivers prioritize and seek care for their children, according to investigators with Thomas Jefferson University’s Jefferson College of Health Professions in Philadelphia. Researchers hope the study’s findings, which were published Feb. 1 in a Pediatrics supplement, will inform family-centered communications and support.

“Our team discovered a number of differences in perceived needs for medical, therapeutic and family support services,” first author Teal W. Benevides, PhD, MS, OTR/L, an assistant professor of occupational therapy in Jefferson College of Health Professions, said in a news release. “Our study suggests that future research should aim to understand how a family’s cultural beliefs and expectations impact care. Providers working with children with autism should identify caregiver beliefs about treatment to better tailor recommendations and referrals for service.”

For the study, the researchers examined 5,178 records in the 2005-06 and 2009-10 National Survey of Children with Special Health Care Needs datasets to look for associations between racial and ethnic group and perceived service needs while controlling for certain factors.

After adjusting for child and family characteristics, the team’s analyses found:

Caregivers of Hispanic children reported less need for prescription medications compared with caregivers of white, non-Hispanic children with ASD.
Caregivers of black, non-Hispanic children with ASD reported less need for prescription medications and for child and family mental health services than caregivers of white, non-Hispanic children.
Both English-speaking Hispanic caregivers and black, non-Hispanic caregivers reported greater need for occupational therapy, speech therapy and physical therapy than white, non-Hispanic caregivers.

“I […]

By |February 23rd, 2016|Categories: News||0 Comments

Cognitive, physical function go downhill when seniors stop driving

Driving cessation nearly doubled the risk of depressive symptoms, while also contributing to diminished cognitive abilities and physical functioning for older adults, according to a new study.

Researchers at Columbia University’s Mailman School of Public Health in New York City examined the health and well-being of older adults after they stopped driving. Findings, which showed their health worsened in several ways, were published Jan. 19 on the website of the Journal of the American Geriatrics Society.

For older adults, driving a car is an important aspect of having control over one’s life. While 81% of the 29.5 million U.S. adults ages 65 and older continue to hold a license and get behind the wheel, age-related declines in cognition and physical function make driving more difficult, and many seniors reduce or eventually stop driving altogether.

“For many older adults, driving is more than a privilege; it is instrumental to their daily living and is a strong indicator of self-control, personal freedom and independence,” study senior author Guohua Li, MD, DrPH, professor of epidemiology at Mailman, said in a news release. “Unfortunately, it is almost inevitable to face the decision to stop driving during the process of aging as cognitive and physical functions continue to decline.”

Li, founding director of the Center for Injury Epidemiology and Prevention at Columbia, and a team of researchers reviewed and analyzed quantitative health-related data for drivers ages 55 and older from 16 studies that met eligibility criteria. They then compared results with data from current drivers. The study updates and builds on earlier findings with more than 10 additional years of empirical research.

Data showed older adults experienced faster declines in cognitive function and physical health after stopping driving. Driving cessation also was associated with […]

By |February 22nd, 2016|Categories: News||0 Comments

Books honored for portrayal of people with disabilities

Four books for children and teens have won the American Library Association’s 2016 Schneider Family Book Awards, which honor an author or illustrator for the artistic expression of the disability experience, according to a news release.

The awards were announced Jan. 11 during the ALA Midwinter Meeting & Exhibits in Boston.

Recipients are selected in three categories: birth through grade school (ages 8 and younger), middle grade (ages 9-13) and teens (ages 14-18). Winners will receive $5,000 and a framed plaque, which will be presented in June during the ALA Annual Conference & Exhibition in Orlando, Fla.

The winner in the young children category is “Emmanuel’s dream: The true story of Emmanuel Ofosu Yeboah,” written by Laurie Ann Thompson and illustrated by Sean Qualls.

In the story, Emmanuel Ofosu Yeboah, born with only one strong leg, sets out to ride a bike 400 miles across Ghana to raise awareness for the disabled. With the message of “being disabled does not mean unable,” the stunning mixed media art supports this uplifting and inspiring story, according to the release.

“Thompson and Qualls’ biographical picture book proves that ‘One leg is enough to do great things — and one person is enough to change the world,’” award chairwoman Alyson Beecher said in the release.

The book is published by Schwartz & Wade Books, an imprint of Random House Children’s Books, a division of Random House LLC, a Penguin Random House Company, New York City.

“Fish in a Tree,” written by Lynda Mullaly Hunt and published by Nancy Paulsen Books, published by the Penguin Group, was one of two books that won the award for best middle grade title.

The book’s main character, Ally, moves through multiple elementary schools without learning to read by using her […]

By |February 19th, 2016|Categories: News||0 Comments