Rehabilitation & Physical Therapy

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A new 3-D motion detection system could help identify baseball pitchers who are at risk for shoulder injuries, according to a new study by scientists at the Loyola University Medical Center, Maywood, IL. The laptop computer-based system can be used right on the field.

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The American Orthotic & Prosthetic Association (AOPA) launched its "Coalition to Walk and Run Again," an effort to aid uninsured and under-insured victims of the April 15th Boston Marathon terror attack. The bombing killed 3 people and left more than 200 injured, several of whom lost portions of their legs as a result. Those who have or are undergoing amputations will be provided major assistance with the cost of their initial prostheses and related care, the group stated at a telephone press conference on April 30.

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When babies are deprived of oxygen before birth, brain damage and disorders such as cerebral palsy can occur. Extended cooling can help to prevent brain injuries, but, in developing nations where advanced medical care is scarce, this treatment is not always available. To address this need, undergraduates at Johns Hopkins University, Baltimore, MD, have devised a low-cost, low-tech unit to provide protective cooling for infants. The device, called the Cooling Cure, can lower a newborn’s temperature by about 6 degrees Fahrenheit for three days, which has been shown to protect the baby from brain damage if administered shortly after a loss of oxygen has occurred, such as when the umbilical cord is knotted or if there is a problem with the placenta during a difficult birth.

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Using a device that supplies humidified oxygen is more effective than a technique that reduces positive airway pressure delivered to the lungs to wean patients from a ventilator to breathe on their own, according to a study supported by the National Institutes of Health. The research compared using a tracheostomy collar placed over a breathing tube in a tracheotomy incision through which humidified oxygen is given versus simply reducing the pressure support supplied via the ventilator.

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Chalmers University of Technology, Gothenburg, Sweden
www.chalmers.se/en/pages/default.aspx

A team of researchers at Chalmers University of Technology in Gothenburg, Sweden, say that they have created the world’s first implantable robotic arm controlled by thoughts. Prosthetic leg technology has ad vanced rapidly in the past decade, but prosthetic arms have been much slower to catch up. Since the 1960s, upper limb amputees have been taught to use prostheses that are controlled by electrical impulses in the muscles. Many still have hooks for “hands.” And, the technology for controlling these prostheses really has not evolved to any great extent since then. There are, to be sure, some advanced electric hand prostheses available, but their movements must be preprogrammed. Rehabilitation is slow and frustrating. And, since there’s no sensory feedback, the sense of touch is a greatly missed.
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Digital devices can provide games, e-books, and learning apps to everyone who can operate them. But what if you can't work even the easiest of controls? Engineers at Georgia Institute of Technology, Atlanta, are working with children who have limited mobility that makes it difficult for them to perform the pinch and swipe gestures required to control touch-screen devices like tablets and smartphones. They have created Access4Kids, a wireless input device that uses a sensor system to translate physical movements into the fine-motor skills needed to control a tablet. The device, coupled with supporting open-source apps and software, allows children with fine motor impairments to access Facebook, YouTube, and custom-made apps for therapy and science education.
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A team of researchers from the University of Pittsburgh (UP) School of Medicine and UPMC (Medical Center) are working with a woman with longstanding quadriplegia to accomplish "ordinary" tasks that once seemed impossible. Together, they have demonstrated, for the first time, that a person with quadriplegia can maneuver a mind-controlled, human-like robot arm in seven dimensions (7D) to consistently perform many of the natural and complex motions of everyday life, such as feed herself, and manipulate objects. In a study published in The Lancet, the researchers described the brain-computer interface technology and training programs that allowed the patient to intentionally move an arm, turn and bend a wrist, and close a hand for the first time in nine years.
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According to the National Spinal Cord Injury Statistical Center, somewhere between 236,000 to 327,000 people in the US are living with serious spinal cord injuries. About 155,000 have paraplegia. But being able to stand and walk again is something that may someday come to be realized, say engineers at the Vanderbilt University Center for Intelligent Mechatronics, Nashville, TN. They have developed a powered exoskeleton that can enable those with severe spinal cord injuries to not only stand, but to walk, sit, and climb stairs. The robotic suit is light in weight, compact in size, and modular in design.

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A technology derived from NASA’s Robonaut 2 project could help astronauts stay fit in space and may someday aid paraplegics in walking on Earth. Working with the Florida Institute for Human and Machine Cognition, Pensacola, FL, and engineers from Oceaneering Space Systems of Houston, NASA developed a mobility assistance robotic exoskeleton called X1. The X1 device is a wearable robot that has a dual purpose; it can assist or inhibit movement in leg joints. In the inhibit mode, the device can be used for resistance exercise training for astronauts aboard the space station and possibly during future long-duration missions. But, reverse the mode, and the device may help paraplegics walk again, or perhaps walk for the first time.

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Authors, filmmakers, and television programs have given us visions of robots serving humanity for most of the past 100 years. Some of the most iconic fictional ones include the benevolent Robby in the 1956 movie “Forbidden Planet,” the chatty C-3PO from all six of the “Star Wars” films, and the humanoid Commander Data from “Star Trek: The Next Generation” – sentient beings that can freely move, converse, and even reason. Actual robot technology has not reached that level yet, but continues to make rapid advances in the military, security, manufacturing, and healthcare fields. This year alone has seen many new medical applications. This overview article will examine some of the newest uses of medical robotics alongside some now-standard uses.
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Biologists at Stanford University, Stanford, CA, pursuing a model for studying heat dissipation, have created a glove that can rapidly cool down athletes’ core temperatures and dramatically improve exercise recovery and performance. A version of the heat-extraction glove is currently nearing commercialization. It consists of a rigid plastic mitt, attached by a hose to what looks like a portable cooler. When an athlete sticks his or her hand into the airtight glove, the device creates a slight vacuum. The veins in the palm expand, drawing blood into a network of specialized heat-transfer veins, where the blood is rapidly cooled by water circulating through the glove's plastic lining. Even in prototype form, the device was enormously efficient at altering body temperature. Early on, it successfully helped to speedily warm up the core temperature of surgery patients recovering from anesthesia.

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Morgan Technical Ceramics (MTC) (Cleveland, OH) worked with the UK-based University of Hull to develop a new valve used to restore vocal function for patients with throat cancer. The new tracheo-esophageal fistula speech valve uses Zyranox™ bio-compatible yttria partially-stabilized zirconia, specifically developed for surgical implant devices.
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Electrical and computer engineers at Texas Tech University, Lubbock, are developing a technology to predict when a person might fall. They created a small prototype wireless sensor that analyzes posture and gait, and sends an alert when there is a break in routine. The alert could signal muscle or vision changes, or may even be due to a drug interaction. The first step involves building a database of the patient’s normal movements, including standing up and sitting. A future variation would then indicate instability, warning that a fall may be imminent. For some, even a simple fall could prove deadly.

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The Association of Southeast Asian Nations (ASEAN), a regional economic organization consisting of Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand and Vietnam is developing a combined regulatory system for medical devices to cover all member countries. The ASEAN Medical Devices Directive (AMDD) uses elements from the European Medical Devices Directive, European guidelines (MEDDEVs), and Global Harmonization Task Force (GHTF) guidelines. Medical devices, active implantable medical devices, and in vitro diagnostic devices would all fall under AMDD jurisdiction.
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Thousands of veterans return to the U.S. with limb amputations, and for many, standard prosthetics are not an option due to skin issues or short remaining-limb length. These amputees require something other than the typical socket-type attachment systems. Researchers and surgeons from the University of Utah and the George E. Wahlen Department of Veterans Affairs (VA) Medical Center in Salt Lake City have teamed up to provide an alternative via osseointegrated direct skeletal attachment of prosthetic limbs for these veterans and others with a similar condition.
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The National Space Biomedical Research Institute (NSBRI) is soliciting ground-based, analog definition and flight definition proposals. NSBRI is soliciting proposals for six of its seven research teams. Topic areas include smart medical systems and technology to refine and validate plug-and-play sensor and effector probes that integrate seamlessly with the proposed NASA Flexible Ultrasound System and address or mitigate medical conditions that are likely to be encountered during exploration missions. Other areas of research include: Sensorimotor Adaptation, Cardiovascular Alterations, Human Factors and Performance, Musculoskeletal Alterations, and Neurobehavioral and Psychosocial Factors.
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Research has shown that music has a profound effect on the human body and psyche. The practice of music therapy is based on well-researched clinical and empirical evidence. There is evidence-based proof that music can aid in many different areas, such as pain management, depression, and anxiety. Scientific studies show that music can actually stimulate the activity of the brain and that lullabies are soothing, rhythmic stimuli that help with the organization of the brain. Music has been shown to produce a calming experience for infants in the NICU, allowing them to return to quiet sleep more quickly following stressful medical procedures.
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The Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, MA, received a $2.6 million contract from the Defense Advanced Research Projects Agency (DARPA) to develop a smart suit that could improve field soldiers’ physical endurance.
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The Beach Boys sang about “Good Vibrations,” but a new wireless, musical glove, created by researchers at Georgia Tech, uses vibrations for the greater good, to help restore sensation and motor skills in people with paralyzing spinal cord injuries that resulted in limited feeling or movement in their hands, called tetraplegia.

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Medical Design Briefs kicked off 2012 with a feature on neuromodulation and its current and future applications, which range from the therapeutic benefits of deep brain stimulation, to artificial pacemakers. Take a look at the full article here, and you'll quickly see why neuromodulation offers exciting possibilities and benefits for patients who suffer from a variety of ailments. A new report from GBI Research now puts some numbers on the potential growth of this market.
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Researchers from the University of Arizona have produced a robotic set of legs that is believed to be the first to fully model walking in a biologically accurate manner. The biological accuracy of the robot could someday help researchers understand how to help spinal-cord-injury patients recover the ability to walk.
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Injuries to the peripheral nervous system (PNS) are extremely common and affect 1 in 1000 individuals every year. Axon regeneration in the PNS is possible, but typically cannot occur over distances of more than 1–2 mm.
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Molex Incorporated (Lisle, IL) has introduced the Mini-Fit® Plus HMC (High Mating Cycle) crimp terminals, suitable for medical equipment manufacturers developing commercially available products such as patient monitors, diagnostic imaging devices, therapeutic machines, and patient handling equipment. They are rated up to 1,500 mating cycles and capable of up to 13.0A per circuit. The Mini-Fit HMC is available in wire-to-wire and wire-to-board configurations and offered in three wire gauge sizes, 16 AWG, 18 to 20 AWG, and 22 to 24 AWG. The terminals can be used with existing Mini-Fit receptacle and plug housings and with existing Mini-Fit and Mini-Fit Plus HCS headers.
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Osteoarthritis, the most common form of arthritis, affects millions of Americans. Implantable sensor technology and custom-designed cartilage scaffolding systems could greatly improve quality of life for these patients. Researchers at the University of Arizona and three other universities around the world are working together to develop a device that could dramatically improve the recovery process for patients with damaged joints.

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Researchers improve the efficiency of devices that stimulate damaged nerves, reducing potential side effects.

Electrical implants that shut down excessive activity in brain cells hold great potential for treating epilepsy and chronic pain. Likewise, devices that enhance neurons’ activity may help restore function to people with nerve damage.
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