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.

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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.

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The bionic exoskeleton will never, ever cease to be an amazing product. It is, in every way, aligned with the evolution of man, from technology to function. We have developed as humans to walk, and not sit, and so a product that addresses the captivity of being wheelchair bound addresses the essence of what we are: bipedal creatures. The robotic exoskeleton technology has been breathtaking to observe as it evolves, from bulky and functional to increasingly light, mobile, and personalized.

The prosthetic world is undergoing a revolution, and has never seen such advances as in the last 10 years. The work behind it, the hours of labor, the intelligence of those who are painstakingly developing these products while trying to negotiate with the FDA for home and personal use may be unseen, but the finalized product’s beauty is visible. As technology advances, however, so does the cost, and many home units of motorized prosthetics are still out of financial reach for those that need it.

Phoenix by SuitX addresses these financial and functional concerns while presenting an amazing, modular, lightweight product. Weighing only 27 pounds, Phoenix allows 4 hours of continuous use between charges, and can be put on piece by piece for ease of use. Its adaptive fit also allows for a more minimalist design, which can allow for versatility and a generally more aesthetic approach.

SuitX’s mission to accept feedback from its users with constant research and development, gear the product toward versatile ambulatory use, and focus on making not only a highly functional but affordable product marks the shift toward a more approachable and attainable bionic exoskeleton for paraplegics.

Anyone that has ever observed anyone with a neurological injury that renders them paralyzed in the lower extremities understands the necessity of a device that allows them to stand and ambulate. A constant sedentary and inactive life wreaks havoc on a person’s health and is psychologically extremely difficult. For years, otherwise healthy and often young people have been given only a wheelchair as the answer to their injury, but thankfully this sentence is changing with devices such as Phoenix.

Watch the video below for a demonstration and explanation of this amazing product.