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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.

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What makes life meaningful? For me, part of the answer has always been movement. The ability to move forward through situations, to walk, to run. The understanding of the devastation with cessation of movement has allowed me to work with patients to meet their goals in physical therapy. To stop moving is to pause life, and a person shouldn’t have to pause life just because of a change in their physical status.

Cybathlon is fast approaching. It is the culmination of what is great about technology, creativity, and human adaptability: pairing assistive robotic devices with disabled competitors in what will be the first ‘Cyborg Olympics.’ Since first writing of the event 2 years ago, I’ve been eagerly awaiting which products will support the pilots in each of the six disciplines.

The website is now updated, and the event is set with the teams, which include pilots (competitors) and the respective assistive robotic technologies which they will be using for the race. I’m looking forward to exploring and writing of the different technologies which the pilots will be using.

Beyond just the competitions, however, Cybathlon aims to connect academia, industry and the general public while bringing awareness to the issues surrounding those with disabilities. The event was created by a professor of ETH Zurich to connect these realms, and prior to the event there will also be a synopsium where researchers and experts will be able to discuss the technology surrounding the event.

Truly Cybathlon is amazing, from inception to organization. The event provides a platform not only for the athletes, but also for researchers and creators. The goal here is not opportunism, but rather progress and communication. From here, there can only be further advancement of human movement for those with disabilities.

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Research, often underappreciated, is the foundation of medical decisions and the determining factor for whether devices and medications pass on to us as a population. Before we even hear about many of the amazing medical devices that are available to us, they undergo intense research to prove their safety and efficacy, and have to pass through national regulations to be distributed to the general population.

Research is the basis of the trends and decisions that we make in healthcare. In physical therapy, research is the basis of the treatments we provide. It makes for valuable, efficient treatment. Research proves the effectiveness of exercise for treating back pain, and provides the justification for why we prescribe specific exercises.

In the case of brain injury, this research is vital because subjects are not always able to describe their progress and limitations as they go through the healing process. A brain injury, especially when traumatic, leaves someone relearning to do the activities that we spent our childhood years developing: walking, talking, eating, expressing what they want and understanding commands. Time is very valuable during recovery, and it is important to begin effective treatment immediately before the results from the injury become chronic. With good research, there is more likelihood that effective treatment can be provided at an appropriate time.

KINARM Labs is a robotic platform developed for neuroscientists to conduct basic and clinical research for brain injury in the realm of cognitive, sensory, and motor deficits. This is novel and fantastic as it provides an option for both companies developing products and clinical research to learn more about their subjects. It is quite an amazing and involved research option for neuroscientists, with a multitude of research options to explore for researchers. There are two basic categories of available research platform: an Exoskeleton Lab and a hand-held bimanual End-Point Lab.

The Exoskeleton Lab helps to evaluate sensorimotor performance and voluntary motor control after a brain injury. This lab allows researchers to observe aspects of controlled movement such as joint motion. As the site states, this is a huge asset in the development of neuroprosthetics, where devices optimize the use of intact neural systems to help regain motor control of areas that have been injured.

The End-Point Lab is a graspable, hand-held robotics research platform which has sensors which helps to evaluate components important for upper limb control and coordination, visual research, and virtual reality as it relates to brain injury. One of the many great aspects of this lab is that it is bimanual, and thus the performance of an affected side can be compared to the unaffected side after injury.

It is difficult to fully describe all the aspects of this amazing platform. Go to their site to learn more. As healthcare technology expands its options and devices, it is vital for companies to remember that devices and programs available for clients must be based on research and knowledge.

Additionally, see the diagram below for a platform comparison:

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Scientific gains are in a very exciting time as we progress artificial intelligence and machine learning. AI systems are dynamic, and respond to the subject as they gain more data, which increases our database of knowledge. There are many aspects of human development that we still have limited knowledge of, and while we have insight on the amount of sleep of infants, there is much less knowledge of the quality. It has been shown that baby fatigue affects maternal sleep patterns and behavior. By gaining insight on these sleep patterns, we may find a way to modify them for maximum improvement of both infant and parental sleep behavior.

Knit health is using machine learning to better understand the sleep patterns of infants and gain insight on how these patterns may affect health and other issues. By integrating a deep learning system with a baby-cam, the company uses metrics to measure and detect sleep patterns. Some of these metrics include breathing, movement, and physical presence, all fueling the knowledge toward the quality of sleep. The camera detects the physical presence of the baby as well as motion and positional changes to provide the system with information to learn sleep patterns.

What is really interesting is that because the company is in the early stages of data collection, the data that it gains will grow with its costumers. Parents of infants will have the opportunity to use machine learning essentially in real time to gain insight on human behavior and development, all while potentially increasing quality of family life.

With their product in early beta, the company is seeking parents of young children to participate in beta testing. This is a great opportunity to gain insight on a product before it is released.

Overhead photo of Proteus patch, device and pills in persons hand

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In light of the upcoming Digital Health CEO Summit by Rock Health on March 30th, I would like to touch on the exponentially growing sector of digital health in the healthcare technology space. As lines slowly become blurred between biotechnology, medical devices, fitness tracking, and standard healthcare, an undeniable part of this changing landscape is the presence of wearable sensors.

Most of us are by now familiar with the presence of fitness trackers such as Fitbit and the presence of Apple Health in our daily lives, tracking our steps and movement patterns. A more unknown type of wearable sensor is an ingestible one. Ingestibles are sensors contained within a pill; once swallowed, the sensor sends signals to a device. These are sensors which can be used to track medication habits and other metrics without a person constantly having to keep track.

Proteus‘s product is targeted toward those with chronic health conditions and has four components: an ingestible pill which contains a sensor, a patch which receives the signal from the pill, an app where users can look at their data, and a portal which a provider can log into and  view patient data. The ingestible pill tracks people’s medication habits, measures metrics, and provides insights for both the user and their provider. These four components offer a well-rounded system to systematically involve both the user and their provider, and give the option to also give medication reminders.

For those with chronic health conditions such as diabetes and hypertension, medication compliance is normally very low: 50%, according to Proteus’s site. Proteus was created to improve adherence, decrease healthcare costs, and also allow both healthcare professionals and patients themselves to take a more active role in their own healthcare.

From experience, I have seen that without the investment and active participation of someone in their own health, the path to stable health becomes a difficult one. This lack of participation is often multifactorial, and the patient is not necessarily to blame. Chronic health conditions become a complicated system where one must take constant medication without always understanding or being engaged with what is actually happening in their own body. Education and active participation are vital, as is understanding the significance of self care.

Particularly when dealing with chronic conditions, it is very empowering for someone to have some type of feedback which gives their health regimen significance and involvement. The added bonus of metrics such such as steps, activity, blood pressure, heart rate, and weight give a person even more insight into their own system.

As healthcare changes and people become more in control of their own well being with knowledge, research, and digital insights, we hope to see more amazing products such as the one from Proteus.

 

 

The human ability to grasp objects is an amazing feature of our bodies which we seamlessly integrate into our daily lives. Google is conducting research on how to replicate this feature, and as expected, replicating what we do easily is not so simple.

This post will not highlight a specific product but I would like to review a few important terms and concepts, as so much of robotics is currently shifting toward replicating what we can do with our hands.

Stereognosis: When you reach into your bag and look for your wallet, how do you determine, in seconds, that it is your wallet without having to look at it? Now, when you look for a coin in the wallet, how do you know that you are about to pull out a dime versus a penny? The concept of being able to recognize 3D objects with the sensory feedback from our hands is stereognosis. We know what we are holding without having to use visual cues. It’s phenomenal, and extremely difficult to reproduce due to the involved sensory and neural feedback that is required.

Weight anticipation:  Anticipation of forces is a very important concept in lifting and grasping. You may go through the same motion of lifting a heavy suitcase or a light grocery bag, but the amount of force that you recruit will be very different. Without much effort, we size objects up before we lift them and our brains tell our muscles to recruit the appropriate amount of force to move something. It is how we conserve energy; you don’t need the full force of your bicep to lift a light pencil. It is also how we move efficiently and save our body from injury.

In robots, this anticipation is difficult due to the limited experience, vision, and the possibly simple neural network of a robot.

Grasp: The human ability to use our fingers to pick something up is complicated and involved. Our precision, ability to use tactile cues, the involved sensation and neural network connected to our skin, and our quick ability to adapt and respond to objects means that a seemingly simple task is actually very difficult for a robot to replicate.

Robotics is currently in a very exciting time, with the applications for robotics growing. And as we use more products to enhance our work and daily activities, we find that we are the models and gold standard for the products being created.

 

 

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One of the most exciting aspects of current robotics is the amenability and exchange of ideas that can occur with a single product. Both the remarkable ideas and communities that are created are very exciting.  I discussed this previously, specifically for open source 3D printing in prosthetics for the 3-D Heals community.

But, what if an intelligent arm could be programmed to carry out a wide array of tasks? KATIA from Carbon Robotics is designed for just this, to be to a functional, affordable robot with an open platform to allow versatility. The company has 3D printing and a camera as functions in mind, but is opening up its creator space to the community to give the intelligent arm more functions.

KATIA is, according to the site, ‘Kickass, Trainable, and Intelligent.’ The trainability is a very unique feature, as it appears that once the arm is guided through a motion, it can recall the same motion with ease. Designed with motion sensors and attachments in mind, the possibilities of KATIA are great, with possibly huge implications for those needing extra assistance in daily tasks.

Go to the site for updates with this project, and contribute ideas if you are a developer that would like to take part of its growth.

More details in the video below:

 

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Anyone that has been witness to a person with Parkinson’s knows the debilitation that the physical effects of the disease can bring. As the disease progresses, individuals with Parkinson’s Disease  develop tremors, repetitive involuntary movements in the hands caused by declining circuitry between the brain and muscles. These tremors are not only physically uncomfortable, but make it extremely difficult to use the hands to perform regular gross and fine motor tasks such as eating, writing, grooming, and dressing. A type of tremor particularly characteristic to the disease is a “pill-rolling” tremor, a constant involuntary rubbing between the index finger and thumb as if one was rolling a pill..

Unfortunately, the physical manifestations of the neurological disease only worsen with time.

A brilliant product named GyroGlove, however, has been created to help offset the constant involuntary movements. Gyrogear has created a glove which uses gyrotonics to stabilize shaky hands by countering the force ‘instantaneously’ and ‘proportionately.” This is simple and amazing. Like a spinning top that wants to stay upright, the gyroscope within the glove works constantly to balance out the unnecessary movements of the tremors as they occur, stabilizing the hand.

Though the product has not yet launched, GyroGlove is certain to improve the life of those so handicapped by tremors. Those that are interested in volunteering to test the product or subscribing for updates should visit the site.

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Anyone that has ever seen the effects of a stroke knows that they can be physically devastating. Within a day, a physically functional person can lose strength to an entire side of their body and face; leaving them dependent on caretakers or suddenly forced to spend a long period in the hospital. Though a stroke is an injury to the brain, whichever part of the brain it affects means that part of the body’s command center has been injured. In effect this severs the signal to the body, leaving muscles without direction.

Due to disuse after a stroke, the muscles will atrophy and fail to function properly, aligning with the common knowledge of “use it or lose it.”

However, if there is something to intervene early, and assist with rehabilitation and movement, it could possibly accelerate the recovery process.

The Rapael Smart Glove by Neofect is a brilliant way to engage stroke patients in movement and monitor progress. By assigning tasks to the user and simultaneously assisting them with the appropriate movements, the Smart Glove retrains the body in proper movement patterns. Through a mathematical analysis, these ‘task-training games’ are also adjusted for the user’s stroke level, ranging from mild to severe.

Though still in the prototype phase, the product is a brilliant solution to assist with the challenges of retraining stroke patients. Oftentimes, though a person wants to carry out a certain movement, they are unable. A product such as this assists with carrying out the planned movement, helping to bridge the injured signal between the mind and body. The system assists with 3 vital movements in upper body mobility: rotation of the forearm, upward and downward bending of the wrist, and opening and closing the hand.

 

 

Image result for liftware

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Tremor is an involuntary movement of the hands, normally caused by some type neurological dysfunction. This can be seen in diseases such as Parkinson’s disease or stemming from unknown causes, such as with essential tremor. When this involves intentional tremor, the more focused your activity is, the worse the tremor can become. and it can feel like the curse of movement. For those with Parkinsonian or essential tremor, difficulty performing simple daily tasks such as eating are a constant challenge as a person struggles to complete a simple task such as keep food on a fork.  While we don’t think about it usually, the act of balancing food on a utensil and bringing that food to your mouth requires accuracy and precision that is difficult to achieve when your hand is increasingly shaking. Recently acquired by Google, Liftware has created a spoon with a motor and sensors which addresses this problem by steadying the spoon as it is brought to the mouth. Designed for helping in holding, eating, and transferring tasks, Liftware has shown to decrease tremor amplitude by up to 76%. This is huge for someone whose hand shakes so badly when they are eating that they are unable to place food in their mouth, and allows for a smoother transition of both bringing food from plat to mouth, as well as transferring the food from utensil to mouth. Liftware works by activating the sensors in the spoon and using them to turn on a motor which helps the spoon counteract the movement of the tremor. Essentially, the spoon detects unnecessary movement, and tries to cancel it out by moving in the opposite direction. Simple, and amazing. Best fit for mild to moderate tremors, Liftware is available for purchase through their website. The entire kit comes with a handle, soup spoon attachment, charger and pouch. Other attachments are available for purchase as well through the site. Watch the video below for a demonstration.