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Those with spinal cord injuries (SCI’s) know that medicine still has a long way toward a successful solution for their injury.  Spinal cord injuries often occur as a result of trauma, such as a fall or gunshot wound. The initial physical compression and loss of blood supply to the spinal cord, followed by secondary edema and swelling cause a death of the spinal nerves which control our movement. In short, this type of injury usually takes away a person’s ability to walk and stand on their own.

SCI’s are normally classified in ASIA grades from complete (A) to normal (E), with incomplete injuries in between. Complete injuries involved complete loss of movement and sensation below the level of injury, while incomplete injuries maintain some preservation of sensation or motor control. Unfortunately, the rate of spontaneous recovery for those with complete injuries is low, while incomplete injuries have a slightly better success rate of recovery.

One project working toward a solution for spinal cord injuries by combining technology and rehabilitation is the Walk Again Project. Working toward a protocol for SCI recovery, this group has recently published research combining virtual reality and robotic assistance with variable gait training. And, it has shown promise of providing some recovery even for paralyzed individuals with complete SCI’s.

In the publication, the project demonstrates a partial return of neurological function in complete SCI’s by combining several methods of treatment. As the person controlled movement via a robotic exoskeleton with their brain using virtual reality for guidance, they also received some physical feedback from their environment. This physical feedback was applied to areas such as their feet or forearms in response to certain movements.

The results of this involved, year-long training are novel and incredible. People with previous complete loss of muscle and sensory function were able to regain some motor control, sensation, and proprioception after training. This is a novel publication by the length of the study and methods of guidance which lead those with SCI’s back toward recovery. The combination of brain machine interface, robotics, and rehabilitation provides a groundwork for future treatment options.

The effectiveness of this training may partly be explained by the idea that by forcing the body to walk and waking up the part of the brain which controls movement, the motor cortex, motor function is partially restored. Additionally, the physical movement may activate CPG’s (central pattern generators) in the spinal cord, which generate rhythmic movement. There may still be a long way to go toward medicine in SCI treatment, but this project provides solutions and hope through combined methods. Watch the video below for more insight into this amazing project:

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One of the great challenges in biotechnology is interfacing synthetic materials with biological ones. Our bodies are designed with an extremely complex network of tissue, vascular, and neural structures to protect us and alarm us if there is something potentially dangerous to our system. If we sit for too long, for example, we feel discomfort and shift positions instinctively. If something is pressing against our leg and threatens to disrupt normal blood circulation, we perceive this threat with pain and pressure and respond accordingly.

Amputees and prosthetists have long been facing the issue of how to interface the residual limb with a prosthetic socket. Fitting for a prosthesis introduces a synthetic limb component to a biological one, and an improperly fitted socket can cause pain, pressure sores, and expose a residual limb to infection and tissue damage. And while there has been much improvement from the crude iron prosthetics that amputees once had to endure, there is still much room to improve to make the interface closer to a natural one.

One group at MIT has sought to address this disparity by developing a variable impedance prosthetic (VIPr) socket. Using MRI imaging and surface scanning techniques, researchers were able to find the tissue depth and where the socket was most likely to place pressure on the irregular bony areas of the residual limb. A socket was then 3D printed using this data to apply the least amount of pressure when fitted to the amputee.

After testing this socket on a below knee amputee, it was found that there was a 7-21% decrease in pressure on various bony areas of the leg compared to a regular socket during walking. While there is still no perfect socket or prosthetic interface for amputees, this is a step in the right direction to protect valuable and vulnerable human tissue.

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Regenerative medicine using biotherapy and bioprinting is providing much hope for previously irreversible conditions such as burns, muscle damage, and cancer. Cells and cellular environments are extremely difficult to reproduce once they are damaged, and much of regenerative medicine focuses on how to repair what our bodies originally made so easily.  3D cell production, versus 2D cell production, mimics the organic environment of our bodies to produce cells. In biotherapy, living organisms are used as the starter in this process.

The complexity in the specificity of our cells is part of why it is so difficult to reverse cell damage. Thus, stem cells are valuable biological material due to their ability to differentiate into any type of cell based on their environment and genetic factors. A stem cell starts out as a blank slate, and by receiving environmental and genetic signals, can become virtually anything in the human body, from a kidney to a blood cell to a muscle in the leg.

Placental stem cells are organically derived and the natural byproduct during a birth. Instead of being discarded, they can provide a very important product for placental cell therapy, which helps direct cells toward regeneration and promotes healing. In biotherapy, these placental stem cells can be very valuable for the cell production process.

Pluristem, a company quickly gaining international presence, produces 3D cultured placental stem cell therapies for various conditions. The company uses a 3D platform to produce their line of PLX products, mimicking the environment of the human body for cell production. This cell therapy is developed to provide cell therapy which is easy to use and does not require genetic or tissue matching. Once the therapy is administered, it promotes the body to heal itself in the target area.

Pluristem products provided regenerative therapy for a variety previously potentially irreversible conditions. Among these is acute radiation syndrome (ARS), which involves irreversible damage to organs and bone marrrow from radiation exposure. Pluristem also aims to provide therapy for vascular conditions such as critical limb ischemia, intermittent claudication, and pulmonary arterial hypertension, all which are dangerous and can lead to decreased life span or surgery.

Pluristem is currently in its clinical trial phase, with collaborations with several universities and industry partners, including the NIH.

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Anyone that follows robotics, artificial intelligence, and 3D printing has likely at least brainstormed a project of their own, eyeing the possibility that one day we may provide a contribution to this world. Innovative devices, however, require a solid technical foundation to be functional, and at the source of every new robotic device and artificial intelligence machine is the platform on which it runs. While we are accustomed to seeing the outcome of a project, the founders at krtkl have developed a palm-sized computer that is an all-in-one embedded platform to support the inventive process.

With intelligent connected systems such as drones, self-guided robots, 3D printers, and artificial vision in mind, krtkl’s snickerdoodle provides a springboard for creation at a price of only $65. Included in the hardware set is support for open-source software, built-in Bluetooth, WiFi, and a mobile app to support the development process. All of the technical components are outlined on the site, including extra components which are available for more processing power and other options.  Using an Android or iOS device, you can connect to snickerdoodle’s WiFi immediately to begin working on a project.

The implications of a small, integrated and portable computer designed for robotics and other intelligent systems are promising, realistic, and positive.The exciting aspect of every new project is the notion that an innovative idea has come to fruition, and something has been created which tests the limits of what we know as possible. Not having to commit to an expensive, bulky computer to attempt to build a system may open the door for many developers to attempt projects which may flourish into a brilliant product.

Funded on crowd supply with new shipments planned to ship out this October, watch the video below for more insight:

VR and no VR treatments compared using fMRI

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What if we could minimize the amount of deleterious painkillers and risky anesthetic procedures simply by providing someone with a distraction? Many people have at some time experienced how distraction can minimize pain, and now virtual reality products are emerging for practical use in healthcare.

Pain is a major reason people seek medical treatment, and one of the main factors that we want to minimize during medical procedures. Like most ‘feelings’ it is also an incredibly difficult concept to objectively measure, and is almost entirely subjective based on the individual. Previous experience, sensitivity, and psycho-social factors all play into our perception of what we perceive as an unpleasant, protective response.

Though it is difficult to tell someone that the pain they are experiencing is ‘all in their head,’ this is the most basic explanation of what is behind the sensation. The way that our brain interprets the signals we receive dictates what we feel.

Firsthand is a virtual reality company which is using the individual interpretation of pain experience to create a product which provides an alternate treatment to manage pain levels. With animation playing for a subject undergoing a medical procedure, early trials have shown a decrease in reported pain for those using the Firsthand virtual reality masks. Subjects wearing the mask can engage in a game such as ‘SnowWorld,’throwing snowballs at objects while they virtually navigate an icy terrain.

A great aspect of Firsthand’s trial is the ability to specify parameters used during the VR experience: a wide field of view above 60 degrees, visual flow, and engaging interaction.This provides a framework toward future use, with the hope that VR can become standardized for pain control.

Numerous studies in medicine and dentistry have begun to turn toward virtual reality as an analgesic. In one study, subjects undergoing a burn wound debridement reported significantly decreased pain when using VR as a distraction. Burn wound debridements are incredibly painful, and it is amazing that numerous subjects would report decreased pain during this procedure without medication.

For those dealing with chronic pain whose only medical option is often medication after failing numerous other treatments, Firsthand could offer some hope to help break the pain cycle. And for those undergoing medical procedures, Firsthand could provide an alternate experience to minimize the recovery and side effects of anesthesia and strong pain medications.

Watch the video below for more insight of how virtual reality can provide an alternative to painkillers for those dealing with chronic pain:

 

Why do we seek external advice for our health? In part, we expect providers to know more than us. This is partially through the experience of treating other patients that have had similar struggles, and also by having the background knowledge and mental data storage to make decisions that will guide us toward our goals. So, what if there was an external system that could help guide the decisions that providers make to improve our health?

Artificial intelligence is going to change the way that clinicians diagnose and treat, for the better. Any human work has the risk of error and knowledge can be variable between practitioners. Patients oftentimes don’t expect to find their providers searching their conditions or related questions on Google, but the truth is that this is common practice. Seeing a condition for the first time, with a client expecting you to provide guidance for them and keep them safe is difficult and sometimes external resources are necessary. In my first years of practice, Google Scholar and the search engine became my close alliances while I navigated many new diagnoses and patient questions.

IBM Watson seeks to provide an external network of both data and experience. It is growing to become an amazing resource for answering questions, compiling data, and helping drive logical decisions in medicine. A large cloud of data storage that learns as it compiles more data, this promises to be a close resource for clinicians by making our decisions more precise and valuable for patients. Watson’s storage allows for a diverse amount of data storage, including personal data along with genomic and clinical research. When searching for information, it will be extremely valuable and efficient to have all this information stored in one known resource.

Quality care is a combination of data and experience. Both are extremely valuable, and the combination is what makes medical decisions supreme. Without research we are unable to learn as a society and defend the decisions that we make. And it is through experience, working with thousands of people, that we begin to see patterns and apply them to our practice. People often ask, ‘have you seen this before?’ It comforts them when the answer is yes, and this is because experience gives us the power of efficiency. With a resource such as IBM Watson, providers will have the benefits of current research and data to pair with our experience.

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In the past, having a neurological injury which left someone with quadriplegia was a life sentence. With research and developing technology has emerged new hope for people left with minimal use of their arms and legs after an event such as severe stroke or spinal cord injury. Current applications are combining the use of virtual reality and electrical signals from the brain to increase people’s function and potential through brain-computer interface (BCI).

In light of the upcoming Cybathlon as well as BCI Meeting 2016, I would like to highlight a company creating much opportunity through research and development. g.tec is a biomedical engineering company that both creates products and conducts research for BCI. While many of the company’s products are inspiring and impressive, it is their BCI research system which is brilliant.

In a BCI system, a person is able to control a target by thinking, and thus using the electrical signals from their brain which are converted into electrical signals which a computer can detect and use to perform tasks. This task can either be something on a computer screen such as a game or computer application, or a robotic device which is able to pick up these signals and move in response. Much like our bodies can use our brain as the command center to tell us to pick up a pen using our left hand, a BCI system can potentially do the same, replacing a biological hand with a robotic limb.

In order for someone to control a target with their brain, there must be multiple working components. A person wears a cap with electroencephalography (EEG) electrodes, and can use motor imagery to plan a task. The electrical signals in the brain which occur while the person is planning this activity are picked up up by the EEG electrodes, amplified, and converted to electrical signals which the computer system uses to carry out the task. It is an incredibly complex and amazing feat to connect biological and computer systems seamlessly to carry out a task.

As the g.tec website elaborates, the electrical conversion from human brain to computer leads to a number of amazing applications. There is, for example, a motor rehabilitation system where a system is controlled by thought directing virtual hand activity, allowing users to control a prosthesis, wheelchair, or virtual reality environment with their mind. In essence, a person can think that they are using their right hand to spell out a word, and the computer spells out this word in response.

Another application of BCI which g.tec is working toward researching is motor rehabilitation through virtual limbs. In this system, a user imagines a limb moving, and is able to visualize this limb in virtual form on a screen. In essence, this system would allow someone with left sided paralysis after a stroke to visualize moving their left arm on a screen. This is incredibly valuable for recovery from a neurological event such as stroke, where decreased activity in the brain of controlling a limb can lead to permanent difficulty of extremity control. “Use it or lose it” unfortunately can prove to be an accurate description of limb use after a debilitating stroke.

While this technology is still emerging and by no means has reached its full potential, g.tec presents us with a diverse platform for research and development of products which will have a huge impact on those who are affected by stroke and other neurological injuries. Anyone who has observed someone with such an injury understands the frustration, disappointment, and loss of independence that such an event brings.

The BCI research system is just one of many groundbreaking products that g.tec is developing. Their site outlines many more products which perform a variety of functions, from cortical mapping to assisting people with communication limitations.