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Brain plasticity and rehabilitation  robotic therapies
 

Brain plasticity and rehabilitation robotic therapies

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    Brain plasticity and rehabilitation  robotic therapies Brain plasticity and rehabilitation robotic therapies Presentation Transcript

    • Brain Plasticity and Rehabilitation Robotic Therapies. Cal State University, Northridge Center Of Achievement / Brown Center by DAVID KARCHEM DKARCHEM @GMAIL.COM 818-730-8756 Blog: http:// dkrehab.blogspot.com /
    • VISUALIZATION OF BODY PARTS
      • Dr. Hermano Igo Krebs, Principal Research Scientist and Lecturer – MechE Mechanical Engineering, Massachusetts Institute of Technology [Neuro-rehabilitation, functional imaging, human-machine interactions, robotics, and dynamic systems modeling & control]:
        • looking at a Powerpoint presentation, particularly related to the interaction of the brain vision processing areas "seeing" the resulting action and connecting it to the feeling of the muscles performing the action, seem to greatly improve the  imprint on the brain with the involved processes.  
      • From my own [DK] experiences, getting more than a two-dimensional screen view, seems that it would greatly enhance the learning, and resultant rehabilitation.  Considered VR-type interfaces, such that it appears to my brain that I am reaching "into" a scenario, or that " I'm picking up an object" - feeling and seeing the interaction….. [DK]
    • BRAIN PROCESSING AREAS OF FUNCTIONAL LOCALIZATION The brain differentiates processing functions in localized areas with structural connectivity between the areas FUNCTIONAL LOCALIZATION IN THE HYMAN BRAIN Brett_etal 2002 http://www.ece.uvic.ca/~bctill/papers/learning/Brett_etal_2002.pdf
    • BRAIN PROCESSING AREAS OF FUNCTIONAL LOCALIZATION The brain differentiates processing functions in localized areas with structural connectivity between the areas LOBES OF THE BRAIN WITH THEIR FUNCTION http://magdalenanordh.wordpress.com/2010/06/29/motion-learning-and-performance-chapter-i-brain/
    • BRAIN PLASTICITY AND REHABILITATION Connecting Your Brain To A Body Part.
    • HEBBIAN LEARNING Stable Hebbian Learning from Spike Timing-Dependent Plasticity M. C. W. van Rossum1, G. Q. Bi2, and G. G. Turrigiano1 The Journal Of Neuroscience http://neuro.cjb.net/content/20/23/8812.short
    • VIRTUAL REALITY The University of Southern Californi a Institute for Creative Technologies [revolutionizing learning through the development of interactive digital media] http:// ict.usc.edu / Virtual reality (VR) is a term that applies to computer-simulated environments that can simulate physical presence in places in the real world, as well as in imaginary worlds. Most current virtual reality environments are primarily visual experiences, displayed either on a computer screen or through special stereoscopic displays, but some simulations include additional sensory information, such as sound through speakers or headphones. Some advanced, haptic systems now include tactile information, generally known as force feedback, in these applications.
    • MOTOR LEARNING
    • ENHANCED LEARNING TO IMPROVE REHABILITATION Boyd,L.A., Vidoni, E.D., Daly, J.J. (2007). Answering the call: the influence of neuroimagining and electrophysiological evidence on rehabilitation . Journal of the American Physical Therapy Association, 87(6), 684-703.   Specific interventions may stimulate new neural connections, enhance cortical reorganization, and promote lasting neural networks for improved motor responses    
    • NATIONAL INSTITUTE OF HEALTH Disability and Rehabilitation Model
    • BRAIN PLASTICITY RESEARCH Nature 8 March 1969 Destroyed brain cells that control them or the bundles of nerve fibers that come out of them. The recovery of language is highly variable and can occur over years. Also amenable to rehabilitation are abstract thought, memory and emotion. On 8 March 1969, an extraordinary experiment was reported in the pages of Nature , Europe's leading science journal. It involved a group of people who took turns to sit in an old dentist's chair and describe the room around them. They commented on the presence of a phone on the table, a nearby vase, people's expressions and how they wore their hair. It was remarkable because all were completely blind.  
    • BRAIN PLASTICITY RESEARCH Nature 8 March 1969 The scientific establishment took a dim view of the work and, for the most part, dismissed it as implausible. But today it stands as one of the first, and most striking, demonstrations of neuroplasticity, the brain's ability to adapt. The blind people had learned to "see" through the sensation of touch .   Here's what happened. The back of the chair had been fitted with hundreds of tiny stimulators that were hooked up to a video camera. As the camera panned the room, those in the chair felt tiny vibrations that seemed to dance across their skin as the image moved. With practice, the blind volunteers' brains learned to turn these vibrations into a mental picture of the room. Some became so good at it that they ducked when a ball was tossed at the camera.
    • BRAIN PLASTICITY RESEARCH Nature 8 March 1969 What was regarded as fringe science 40 years ago is currently at the cutting edge of neuroscience. With the right training, scientists now know the brain can reshape itself to work around dead and damaged areas, often with dramatic benefits. Therapies that exploit the brain's power to adapt have helped people overcome damage caused by strokes, depression, anxiety and learning disabilities, and may one day replace drugs for some of these conditions. Some studies suggest therapies that tap into the brain's neuroplasticity are already making a big difference. Children with language difficulties have been shown to make significant progress using computer training tools that are the equivalent of cerebral cross-training.
    • BRIEF RESEARCH INTO STROKE REHABILITATION THERAPIES Nature 8 March 1969 Mirror-box Therapy Concepts. I used mirror box concepts to initiate my left ankle movement [3-months post stroke] [DK]. Hyperbaric Therapy Electrical Stimulus Therapy TMS - Transcranial Magnetic Stimulation . TMS Therapy uses a highly focused pulsed magnetic field to stimulate nerve cells in the area of the brain thought to control certain brain functions by altering those brain structures Stem Cell Replacement Therapy Aquatic Therapy – balance, stretching, range of motion, strength I have been coming to the COA for 1 ½ years – I learned to walk without a support about 3 months ago [25-months post stroke] [DK].
    • BRIEF RESEARCH INTO STROKE REHABILITATION THERAPIES Nature 8 March 1969 Vision Therapy - a type of physical therapy for the eyes and brain -- is a highly effective non-surgical treatment for many common visual problems such as lazy eye, crossed eyes, double vision, convergence insufficiency and some reading and learning disabilities I used several different computer programs to help with resolving peripheral vision and depth perception issues [began 3-months post stroke; depth perception improved 100% after 13 months] [DK]. Robotic Therapy - After my first robot arm & shoulder exercise [a demonstration session – I was able to raise my left leg behind me for the first time post-stroke] [DK].
    • THERAPEUTIC GOALS Nature 8 March 1969 Reduced tone – throughout the entire arm, shoulder, elbow, wrist and hand. Reduced pain – Stroke patients with loss of upper extremity movement often suffer shoulder pain, which sometimes can be exacerbated by therapy . Improved coordination – Patients treated with Reo Therapy have exhibited improvements in active range of motion and in overall coordination of arm movements.
    • THERAPEUTIC GOALS Nature 8 March 1969 Improved gait – Patients whose gait was affected by their in-ability to properly move their upper extremities showed a marked improvement in gait following therapy sessions. Functional gains – Therapists reported that following Therapy sessions, subsequent components of their patients’ therapy session were more productive, an improvement they attributed to the affects of robotic therapies.
    • PURPOSE/FUNCTION OF ROBOTICS
      • ENHANCED LEARNING TO IMPROVE REHABILITATION –
        • Brain-to-Body Connectivity = Functional gains
        • Stroke rehabilitation by muscle/brain re-education
        • Maintain or increase range of motion
        • I chose InMotion as my initial therapeutic device to
          • gain mental stimulation through visual activities, which
          • effectively improve shoulder [scapula movement] range of motion, and
          • enhance brain-to-body re-education
        • The Myomo device combines several treatment modalities into one device , and
          • can cost effectively improve range of motion,
          • enhance brain-to-body re-education through practical Clinical Progression process
          • be used as a therapeutic tool for improved motor function,
          • and be effective as an assistive device
    • PURPOSE/FUNCTION OF ROBOTICS
      • ENHANCED LEARNING TO IMPROVE REHABILITATION –
      • Rehabilitation with highly repetitive training for severely affected patients.
      • Improved therapy efficiency and patient care OR • Guided therapeutic programs
      • An extensive 3D workspace OR • Visual aids [‘seeing it”]
      • Augmented Feedback with functionally based , motivating exercises to train activities of daily living.
      • Assist-as-needed support provided by the robotic exoskeleton that automatically adapts to the patients’ capabilities.
      • Clinical research shows that patients suffering from neuromuscular dysfunction show better results when performing repetitive, intense, functionally based retraining, as part of their physical therapy program.
      • Objective analysis and documentation of the patient’s progress .
    • ROBOTICS – TAXONOMY ClassifyingHuman-RobotInteraction.pdf [ATTACHED] Human-Robot Interaction An Updated Taxonomy.doc ( A Simplified Taxonomy of Command and Control Structures for Robot Teams) [ATTACHED] 3.1 Task Type [ the task to be accomplished sets the tone for the system’s design and use] 3.2 Task Criticality [ high , medium and low .] 3.3 Robot Morphology [ Robots can take many physical forms.] 3.4 Ratio of People to Robots [ The ratio of people to robots directly affects the human-robot interaction in a system. This taxonomy classification does not measure the interaction between the operators and the robots, simply the numbers of each.    
    • ROBOTICS – TAXONOMY
      • Robotics – taxonomy and associated robotics
        • EXTRAMURAL, EXTERNAL and NON-SENSOR, NON-STIMULATION [ROBOT REACTIVE TO COMMAND PROMPTS ]- situated or occurring outside the wall of an organ or structure.
          • Toyota
          • Armeo
          • Rupert
          • Howard
        • EXTRADURAL, SENSOR, HUMAN STIMULATION [ROBOT REACTING TO HUMAN SIGNALS/ACTIONS]- outside the dura matter enveloping the spinal cord
          • REO/MOTORIKA –
          • InteractiveMotion
          • ReWalk
          • MYOMO
        • EPIDURAL- , SENSOR, ROBOT STIMULATION [ROBOT SIGNALS STIMULATING HUMAN ACTIONS] -  an agent into the epidural space of the spinal canal
      • CalTech    
      NOTE: This taxonomy is based on my personal research and is subject to evaluation. My taxonomy design is based on two factors: (1) type of human-robot interface and (2) If/How the robot stimulates or is reacting to/Is stimulated by human signals [DK].
    • Definition of Spasticity vs Recruitment Spasticity: A state of increased tone of a muscle (and an increase in the deep tendon reflexes) when there is a sudden muscle movement. For example, with spasticity of the legs (spastic paraplegia) there is an increase in tone of the leg muscles so they feel tight and rigid and the knee jerk reflex is exaggerated, when the leg is suddenly moved. Order of Recruitment As a general rule, motor units are recruited in order of their size. When the muscle is activated initially, the first motor units to fire are small in size and weak in the degree of tension they can generate. Starting with the smallest motor units, progressively larger units are recruited with increasing strength of muscle contraction. The result is an orderly addition of sequentially larger and stronger motor units resulting in a smooth increase in muscle strength.[2] This orderly recruitment of sequentially larger motor units is referred to as the "Henneman size principle", or simply "size principle."[2, 3, 4] Recording from the ventral rootlets in cats and measuring the amplitudes of motor axon spikes, Henneman et al concluded that motor axon diameter, conduction velocity and, by further inference, motor neuron cell size all increase with functional threshold.[2]
    • Definition of Spasticity vs Recruitment Order of Recruitment (continued) There are exceptions to the size-ordered activation of motor units. Motor unit recruitment patterns vary for different movement tasks, depending on many factors, including the mechanical function of the muscle, sensory feedback, and central control.[3] After nerve injury, the relationship between motoneuron size and the number and size of muscle fibers that the motoneuron reinnervates is initially lost.[4] With time, however, a size-dependent branching of axons accounts for the rematching of motor neuron size and muscle unit size, and the size-ordered organization of motor units properties is restored.[4] The 3 main types of motor units, which have different physiologic and staining properties, include the following: [Refer to ATTACHMENT: Definition of Spasticity vs Recruitment.doc]
    • ROBOTS
    • Brain Plasticity and Rehabilitation Robotic Therapies. DK personal comments identified in dark red color with [DK] ATTACHMENTS: ClassifyingHuman-RobotInteraction.pdf Human-Robot Interaction An Updated Taxonomy.doc ( A Simplified Taxonomy of Command and Control Structures for Robot Teams) Toyota Armeo Rupert REO/MOTORIKA InteractiveMotion SHOULDER/ARM ROBOT WRIST/HAND ROBOT Research notes ReWalk MYOMO CLINICAL PROGRESSION-PROG 1+2 EXERCISE LEVEL1+2 LIVE BETTER VISITS OVERVIEW CalTech
    • Toyota CSUN 11/21 6 pm Brain Plasticity and Rehabilitation Robotic Therapies. CSUN COA/Brown Center VISUALIZATION OF BODY PARTS Think of your favorite food – Close your eyes and smell the food. Is everybody hungry now? Now Think of your favorite food as a child – close eyes and smell the food. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it already? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? CONNECTING YOUR BRAIN TO A BODY PART. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? Now think of a rubber straw or clear flexible rubber tube - and CONNECT it to your brain where your toe feeling was. CONNECT the other end of the straw to your toe. Look through the straw and look at your toe. A stroke or other TBI can break the connection, or prevent this visualization. ENHANCED LEARNING TO IMPROVE REHABILITATION VIRTUAL REALITY Virtual reality (VR) is a term that applies to computer-simulated environments that can simulate physical presence in places in the real world, as well as in imaginary worlds. Most current virtual reality environments are primarily visual experiences, displayed either on a computer screen or through special stereoscopic displays, but some simulations include additional sensory information, such as sound through speakers or headphones. Some advanced, haptic systems now include tactile information, generally known as force feedback, in these applications. ----------------------------------------------------------- Enhanced Learning to Improve Rehabilitation Specific interventions may stimulate new neural connections, enhance cortical reorganization, and promote lasting neural networks for improved motor responses Boyd,L.A., Vidoni, E.D., Daly, J.J. (2007). Answering the call: the influence of neuroimagining and electrophysiological evidence on rehabilitation. Journal of the American Physical Therapy Association, 87(6), 684-703. BRAIN PLASTICITY Destroyed brain cells that control them or the bundles of nerve fibers that come out of them. The recovery of language is highly variable and can occur over years. Also amenable to rehabilitation are abstract thought, memory and emotion. On 8 March 1969, an extraordinary experiment was reported in the pages of Nature, Europe's leading science journal. It involved a group of people who took turns to sit in an old dentist's chair and describe the room around them. They commented on the presence of a phone on the table, a nearby vase, people's expressions and how they wore their hair. It was remarkable because all were completely blind. The scientific establishment took a dim view of the work and, for the most part, dismissed it as implausible. But today it stands as one of the first, and most striking, demonstrations of neuroplasticity, the brain's ability to adapt. The blind people had learned to "see" through the sensation of touch. Here's what happened. The back of the chair had been fitted with hundreds of tiny stimulators that were hooked up to a video camera. As the camera panned the room, those in the chair felt tiny vibrations that seemed to dance across their skin as the image moved. With practice, the blind volunteers' brains learned to turn these vibrations into a mental picture of the room. Some became so good at it that they ducked when a ball was tossed at the camera. What was regarded as fringe science 40 years ago is currently at the cutting edge of neuroscience. With the right training, scientists now know the brain can reshape itself to work around dead and damaged areas, often with dramatic benefits. Therapies that exploit the brain's power to adapt have helped people overcome damage caused by strokes, depression, anxiety and learning disabilities, and may one day replace drugs for some of these conditions. Some studies suggest therapies that tap into the brain's neuroplasticity are already making a big difference. Children with language difficulties have been shown to make significant progress using computer training tools that are the equivalent of cerebral cross-training. Work is underway to investigate whether it is possible to stave off a loss of brain plasticity in older age, which might help to address memory problems linked to Alzheimer's disease. Some psychoanalysts are adopting techniques to help people overcome relationship troubles, obsessions, worries and bad habits. ENHANCED LEARNING TO IMPROVE REHABILITATION Dr. Hermano Krebs - looking at the IMT Powerpoint presentation, particularly related to the interaction of the brain vision processing areas "seeing" the resulting action and tieing it to the feeling of the muscles performing the action, seem to greatly improve the   imprint on the brain with the involved processes.   From my own experiences, getting more than a two-dimensional screen view, seems that it would greatly enhance the learning, and resultant rehabilitation.   Have you considered VR-type interfaces, such that it appears to my brain that I am reaching "into" a scenario, or that " I'm picking up an object" - feeling and seeing the interaction
      • CONNECTING YOUR BRAIN TO A BODY PART.
      • BRIEF RESEARCH INTO STROKE REHABILITATION THERAPIES
      • After my first robot [arm & shoulder exercise [a demonstration session – I was able to raise my left leg behind me].
      • Mirror-box therapy concepts.
      • I used mirror box concepts to initiate my left ankle movement [3-months post stroke].
      • Hyperbaric therapy
      • Electrical stimulus
      • TMS - Transcranial Magnetic Stimulation. TMS Therapy uses a highly focused pulsed magnetic field to stimulate nerve cells in the area of the brain thought to control certain brain functions by altering those brain structures
      • Stem Cell replacement
      • Aquatic therapy – balance, stretching, range of motion, strength
      • I have been coming to the COA for 1 ½ years – I learned to walk without a support about 3 months ago [25-months post stroke].
      • Vision Therapy - Vision therapy -- a type of physical therapy for the eyes and brain -- is a highly effective non-surgical treatment for many common visual problems such as lazy eye, crossed eyes, double vision, convergence insufficiency and some reading and learning disabilities
      • I used several different computer programs to help with resolving peripheral vision and depth perception issues [began 3-months post stroke; depth perception improved 100% after 13 months].
      • Therapeutic Goals:
      • Reduced tone – throughout the entire arm, shoulder, elbow, wrist and hand.
      • Reduced pain – Stroke patients with loss of upper extremity movement often suffer shoulder pain, which sometimes can be exacerbated by therapy.
      • Improved coordination – Patients treated with Reo Therapy have exhibited improvements in active range of motion (ROM) and in overall coordination of arm movements.
      • Improved gait – Patients whose gait was affected by their inability to properly move their upper extremities showed a marked improvement in gait following therapy sessions.
      • Functional gains – Therapists reported that following Therapy sessions, subsequent components of their patients ’ therapy session were more productive, an improvement they attributed to the affects of robotic therapies.
      • ENHANCED LEARNING TO IMPROVE REHABILITATION
      • 3.1 Task Type [ the task to be accomplished sets the tone for the system’s design and use]
      • 3.2 Task Criticality [ high , medium and low .]
      • 3.3 Robot Morphology [ Robots can take many physical forms.]
      • 3.4 Ratio of People to Robots [ The ratio of people to robots directly affects the
      • human-robot interaction in a system. This taxonomy classification does not measure the
      • interaction between the operators and the robots, simply the numbers of each.
      • Robotics – taxonomy:
        • EXTRAMURAL, EXTERNAL and NON-SENSOR, NON-STIMULATION - situated or occurring outside the wall of an organ or structure.
          • Toyota
          • Armeo
          • REO/MOTORIKA
          • InteractiveMotion
        • EXTRADURAL, SENSOR , HUMAN STIMULATION -outside the dura mater enveloping the spinal cord
          • MYOMO
          • ReWalk
        • EPIDURAL- , SENSOR, ROBOT STIMULATION -   an agent into the epidural space of the spinal canal
      • CalTech
      • purpose/function of Robotics:
      • ENHANCED LEARNING TO IMPROVE REHABILITATION –
        • Brain-to-Body Connectivity = Functional gains
        • Stroke rehabilitation by muscle/brain re-education
        • Maintain or increase range of motion
        • I chose InMotion as my initial therapeutic device to
      • effectively improve shoulder [scapula movement] range of motion, and
      • gain mental stimulation through visual activities, which
      • enhance brain-to-body re-education
        • The Myomo device combines several treatment modalities into one device , and
        • can cost effectively improve range of motion,
        • enhance brain-to-body re-education through practical Clinical Progression process
        • be used as a therapeutic tool for improved motor function,
        • and be effective as an assistive device
      • Rehabilitation with highly repetitive training for severely affected patients.
      • • Improved therapy efficiency and patient care. • An extensive 3D workspace. OR
      • • Guided therapeutic programs • Augmented Feedback with motivating exercises to train activities of daily living. • Assist-as-needed support provided by the robotic arm exoskeleton that automatically adapts to the patients’ capabilities.
      • • Clinical research shows that patients suffering from neuromuscular dysfunction show better results when performing repetitive, intense, functionally based retraining, as part of their physical therapy program. • Objective analysis and documentation of the patient’s progress.
      • November 8, 2011
      • Eiichi Saito/Bloomberg/Getty Images Toyota Shows Machines to Help Sick, Elderly Move
      • By YURI KAGEYAMA AP Business Writer November 2, 2011
      • Toyota unveiled its ambitions for high-tech health care Tuesday, displaying experimental robots that the auto giant says can lift disabled patients from their hospital beds or help them walk.
      • The company aims to commercialize products such as its "independent walk assist" device sometime after 2013 — seeking to position itself in an industry with great potential in Japan, one of the world's most rapidly aging nations.
      • Eiichi Saitoh, a professor in rehabilitation medicine, demonstrated the "walk assist" device on Tuesday, strapping the computerized metallic brace onto his right leg, which was paralyzed by polio.
      • He showed reporters at a Toyota facility in Tokyo how the brace could bend at the knee as needed, allowing him to walk more naturally and rise from a chair with greater ease than the walker he now uses. Wearing a backpack-like battery, Saitoh walked up and down a flight of stairs, smiling with delight.
      • Saitoh said he had tried Toyota's machines with patients and was confident they helped people recover more quickly from strokes and other ailments that curtailed movement.
      • "It may be difficult to predict the future, but the era of an aging society is definitely coming," he said. "We need partner robots to enrich our lives."
      • Toyota also demonstrated an intelligent machine with padded arms that can help health care workers lift disabled patients from their beds and then carry them around. Another mobility aid worked like a skateboard to help people relearn balance.
      • Toyota officials said technology for autos such as sensors, motors and computer software are being used in such computerized gadgets to help people get around, and what they learn about mobility for people will likely be of use in future cars.
      • Prices and overseas sales plans of all the machines are still undecided, according to Toyota.
      • General Manager Akifumi Tamaoki said more tests were needed on more people to insure safety and reliability, and gain user feedback, but the commercial products in the works were going to be smaller and lighter than the prototype versions shown.
      • "We define gentle and smart machines as partner robots," he said.
      • Toyota has previously shown human-shaped robots that played the trumpet and violin, and those that move around and talk about Toyota cars at showrooms.
      • Rival Japanese automaker Honda Motor Co. has developed a sophisticated humanoid robot called Asimo, which can run, talk and dance. But Asimo has been limited to showrooms and labs and has yet to enter any hospital or home.
      • Toyota faces competition from other manufacturers that are all working on gadgets to tap into the health care business. Honda also has demonstrated machines worn on the legs that help people move, as have some universities.
      • Hirohisa Hirukawa, a robot exert at the government-backed National Institute of Advanced Industrial Science and Technology, said more time would be needed to see the full busineses potential of the Toyota machines but was upbeat.
      • "I feel that the walk-assist device has real potential to sell to consumers," he said in an email.
      • Tamaoki said Toyota is keeping its offerings simple, compared to those from Honda, so they can enter everyday life easily.
      • ———
      • Follow Yuri Kageyama on Twitter at http://twitter.com/yurikageyama
    • Armeo CSUN 11/21 6 pm Brain Plasticity and Rehabilitation Robotic Therapies. CSUN COA/Brown Center VISUALIZATION OF BODY PARTS Think of your favorite food – Close your eyes and smell the food. Is everybody hungry now? Now Think of your favorite food as a child – close eyes and smell the food. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it already? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? CONNECTING YOUR BRAIN TO A BODY PART. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? Now think of a rubber straw or clear flexible rubber tube - and CONNECT it to your brain where your toe feeling was. CONNECT the other end of the straw to your toe. Look through the straw and look at your toe. A stroke or other TBI can break the connection, or prevent this visualization. ENHANCED LEARNING TO IMPROVE REHABILITATION VIRTUAL REALITY Virtual reality (VR) is a term that applies to computer-simulated environments that can simulate physical presence in places in the real world, as well as in imaginary worlds. Most current virtual reality environments are primarily visual experiences, displayed either on a computer screen or through special stereoscopic displays, but some simulations include additional sensory information, such as sound through speakers or headphones. Some advanced, haptic systems now include tactile information, generally known as force feedback, in these applications. ----------------------------------------------------------- Enhanced Learning to Improve Rehabilitation Specific interventions may stimulate new neural connections, enhance cortical reorganization, and promote lasting neural networks for improved motor responses Boyd,L.A., Vidoni, E.D., Daly, J.J. (2007). Answering the call: the influence of neuroimagining and electrophysiological evidence on rehabilitation. Journal of the American Physical Therapy Association, 87(6), 684-703. BRAIN PLASTICITY Destroyed brain cells that control them or the bundles of nerve fibers that come out of them. The recovery of language is highly variable and can occur over years. Also amenable to rehabilitation are abstract thought, memory and emotion. On 8 March 1969, an extraordinary experiment was reported in the pages of Nature, Europe's leading science journal. It involved a group of people who took turns to sit in an old dentist's chair and describe the room around them. They commented on the presence of a phone on the table, a nearby vase, people's expressions and how they wore their hair. It was remarkable because all were completely blind. The scientific establishment took a dim view of the work and, for the most part, dismissed it as implausible. But today it stands as one of the first, and most striking, demonstrations of neuroplasticity, the brain's ability to adapt. The blind people had learned to "see" through the sensation of touch. Here's what happened. The back of the chair had been fitted with hundreds of tiny stimulators that were hooked up to a video camera. As the camera panned the room, those in the chair felt tiny vibrations that seemed to dance across their skin as the image moved. With practice, the blind volunteers' brains learned to turn these vibrations into a mental picture of the room. Some became so good at it that they ducked when a ball was tossed at the camera. What was regarded as fringe science 40 years ago is currently at the cutting edge of neuroscience. With the right training, scientists now know the brain can reshape itself to work around dead and damaged areas, often with dramatic benefits. Therapies that exploit the brain's power to adapt have helped people overcome damage caused by strokes, depression, anxiety and learning disabilities, and may one day replace drugs for some of these conditions. Some studies suggest therapies that tap into the brain's neuroplasticity are already making a big difference. Children with language difficulties have been shown to make significant progress using computer training tools that are the equivalent of cerebral cross-training. Work is underway to investigate whether it is possible to stave off a loss of brain plasticity in older age, which might help to address memory problems linked to Alzheimer's disease. Some psychoanalysts are adopting techniques to help people overcome relationship troubles, obsessions, worries and bad habits. ENHANCED LEARNING TO IMPROVE REHABILITATION Dr. Hermano Krebs - looking at the IMT Powerpoint presentation, particularly related to the interaction of the brain vision processing areas "seeing" the resulting action and tieing it to the feeling of the muscles performing the action, seem to greatly improve the   imprint on the brain with the involved processes.   From my own experiences, getting more than a two-dimensional screen view, seems that it would greatly enhance the learning, and resultant rehabilitation.   Have you considered VR-type interfaces, such that it appears to my brain that I am reaching "into" a scenario, or that " I'm picking up an object" - feeling and seeing the interaction
      • CONNECTING YOUR BRAIN TO A BODY PART.
      • BRIEF RESEARCH INTO STROKE REHABILITATION THERAPIES
      • After my first robot [arm & shoulder exercise [a demonstration session – I was able to raise my left leg behind me].
      • Mirror-box therapy concepts.
      • I used mirror box concepts to initiate my left ankle movement [3-months post stroke].
      • Hyperbaric therapy
      • Electrical stimulus
      • TMS - Transcranial Magnetic Stimulation. TMS Therapy uses a highly focused pulsed magnetic field to stimulate nerve cells in the area of the brain thought to control certain brain functions by altering those brain structures
      • Stem Cell replacement
      • Aquatic therapy – balance, stretching, range of motion, strength
      • I have been coming to the COA for 1 ½ years – I learned to walk without a support about 3 months ago [25-months post stroke].
      • Vision Therapy - Vision therapy -- a type of physical therapy for the eyes and brain -- is a highly effective non-surgical treatment for many common visual problems such as lazy eye, crossed eyes, double vision, convergence insufficiency and some reading and learning disabilities
      • I used several different computer programs to help with resolving peripheral vision and depth perception issues [began 3-months post stroke; depth perception improved 100% after 13 months].
      • Therapeutic Goals:
      • Reduced tone – throughout the entire arm, shoulder, elbow, wrist and hand.
      • Reduced pain – Stroke patients with loss of upper extremity movement often suffer shoulder pain, which sometimes can be exacerbated by therapy.
      • Improved coordination – Patients treated with Reo Therapy have exhibited improvements in active range of motion (ROM) and in overall coordination of arm movements.
      • Improved gait – Patients whose gait was affected by their inability to properly move their upper extremities showed a marked improvement in gait following therapy sessions.
      • Functional gains – Therapists reported that following Therapy sessions, subsequent components of their patients ’ therapy session were more productive, an improvement they attributed to the affects of robotic therapies.
      • ENHANCED LEARNING TO IMPROVE REHABILITATION
      • 3.1 Task Type [ the task to be accomplished sets the tone for the system’s design and use]
      • 3.2 Task Criticality [ high , medium and low .]
      • 3.3 Robot Morphology [ Robots can take many physical forms.]
      • 3.4 Ratio of People to Robots [ The ratio of people to robots directly affects the
      • human-robot interaction in a system. This taxonomy classification does not measure the
      • interaction between the operators and the robots, simply the numbers of each.
      • Robotics – taxonomy:
        • EXTRAMURAL, EXTERNAL and NON-SENSOR, NON-STIMULATION - situated or occurring outside the wall of an organ or structure.
          • Toyota
          • Armeo
          • REO/MOTORIKA
          • InteractiveMotion
        • EXTRADURAL, SENSOR , HUMAN STIMULATION -outside the dura mater enveloping the spinal cord
          • MYOMO
          • ReWalk
        • EPIDURAL- , SENSOR, ROBOT STIMULATION -   an agent into the epidural space of the spinal canal
      • CalTech
      • purpose/function of Robotics:
      • ENHANCED LEARNING TO IMPROVE REHABILITATION –
        • Brain-to-Body Connectivity = Functional gains
        • Stroke rehabilitation by muscle/brain re-education
        • Maintain or increase range of motion
        • I chose InMotion as my initial therapeutic device to
      • effectively improve shoulder [scapula movement] range of motion, and
      • gain mental stimulation through visual activities, which
      • enhance brain-to-body re-education
        • The Myomo device combines several treatment modalities into one device , and
        • can cost effectively improve range of motion,
        • enhance brain-to-body re-education through practical Clinical Progression process
        • be used as a therapeutic tool for improved motor function,
        • and be effective as an assistive device
      • Rehabilitation with highly repetitive training for severely affected patients.
      • • Improved therapy efficiency and patient care. • An extensive 3D workspace. OR
      • • Guided therapeutic programs • Augmented Feedback with motivating exercises to train activities of daily living. • Assist-as-needed support provided by the robotic arm exoskeleton that automatically adapts to the patients’ capabilities.
      • • Clinical research shows that patients suffering from neuromuscular dysfunction show better results when performing repetitive, intense, functionally based retraining, as part of their physical therapy program. • Objective analysis and documentation of the patient’s progress.
      • November 8, 2011
      • Eiichi Saito/Bloomberg/Getty Images
      • Toyota Shows Machines to Help Sick, Elderly Move
      • By YURI KAGEYAMA AP Business Writer November 2, 2011
      • Toyota unveiled its ambitions for high-tech health care Tuesday, displaying experimental robots that the auto giant says can lift disabled patients from their hospital beds or help them walk.
      • The company aims to commercialize products such as its "independent walk assist" device sometime after 2013 — seeking to position itself in an industry with great potential in Japan, one of the world's most rapidly aging nations.
      • Eiichi Saitoh, a professor in rehabilitation medicine, demonstrated the "walk assist" device on Tuesday, strapping the computerized metallic brace onto his right leg, which was paralyzed by polio.
      • He showed reporters at a Toyota facility in Tokyo how the brace could bend at the knee as needed, allowing him to walk more naturally and rise from a chair with greater ease than the walker he now uses. Wearing a backpack-like battery, Saitoh walked up and down a flight of stairs, smiling with delight.
      • Saitoh said he had tried Toyota's machines with patients and was confident they helped people recover more quickly from strokes and other ailments that curtailed movement.
      • "It may be difficult to predict the future, but the era of an aging society is definitely coming," he said. "We need partner robots to enrich our lives."
      • Toyota also demonstrated an intelligent machine with padded arms that can help health care workers lift disabled patients from their beds and then carry them around. Another mobility aid worked like a skateboard to help people relearn balance.
      • Toyota officials said technology for autos such as sensors, motors and computer software are being used in such computerized gadgets to help people get around, and what they learn about mobility for people will likely be of use in future cars.
      • Prices and overseas sales plans of all the machines are still undecided, according to Toyota.
      • General Manager Akifumi Tamaoki said more tests were needed on more people to insure safety and reliability, and gain user feedback, but the commercial products in the works were going to be smaller and lighter than the prototype versions shown.
      • "We define gentle and smart machines as partner robots," he said.
      • Toyota has previously shown human-shaped robots that played the trumpet and violin, and those that move around and talk about Toyota cars at showrooms.
      • Rival Japanese automaker Honda Motor Co. has developed a sophisticated humanoid robot called Asimo, which can run, talk and dance. But Asimo has been limited to showrooms and labs and has yet to enter any hospital or home.
      • Toyota faces competition from other manufacturers that are all working on gadgets to tap into the health care business. Honda also has demonstrated machines worn on the legs that help people move, as have some universities.
      • Hirohisa Hirukawa, a robot exert at the government-backed National Institute of Advanced Industrial Science and Technology, said more time would be needed to see the full busineses potential of the Toyota machines but was upbeat.
      • "I feel that the walk-assist device has real potential to sell to consumers," he said in an email.
      • Tamaoki said Toyota is keeping its offerings simple, compared to those from Honda, so they can enter everyday life easily.
      • ———
      • Follow Yuri Kageyama on Twitter at http://twitter.com/yurikageyama
    • Rupert CSUN 11/21 6 pm Brain Plasticity and Rehabilitation Robotic Therapies. CSUN COA/Brown Center VISUALIZATION OF BODY PARTS Think of your favorite food – Close your eyes and smell the food. Is everybody hungry now? Now Think of your favorite food as a child – close eyes and smell the food. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it already? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? CONNECTING YOUR BRAIN TO A BODY PART. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? Now think of a rubber straw or clear flexible rubber tube - and CONNECT it to your brain where your toe feeling was. CONNECT the other end of the straw to your toe. Look through the straw and look at your toe. A stroke or other TBI can break the connection, or prevent this visualization. ENHANCED LEARNING TO IMPROVE REHABILITATION VIRTUAL REALITY Virtual reality (VR) is a term that applies to computer-simulated environments that can simulate physical presence in places in the real world, as well as in imaginary worlds. Most current virtual reality environments are primarily visual experiences, displayed either on a computer screen or through special stereoscopic displays, but some simulations include additional sensory information, such as sound through speakers or headphones. Some advanced, haptic systems now include tactile information, generally known as force feedback, in these applications. ----------------------------------------------------------- Enhanced Learning to Improve Rehabilitation Specific interventions may stimulate new neural connections, enhance cortical reorganization, and promote lasting neural networks for improved motor responses Boyd,L.A., Vidoni, E.D., Daly, J.J. (2007). Answering the call: the influence of neuroimagining and electrophysiological evidence on rehabilitation. Journal of the American Physical Therapy Association, 87(6), 684-703. BRAIN PLASTICITY Destroyed brain cells that control them or the bundles of nerve fibers that come out of them. The recovery of language is highly variable and can occur over years. Also amenable to rehabilitation are abstract thought, memory and emotion. On 8 March 1969, an extraordinary experiment was reported in the pages of Nature, Europe's leading science journal. It involved a group of people who took turns to sit in an old dentist's chair and describe the room around them. They commented on the presence of a phone on the table, a nearby vase, people's expressions and how they wore their hair. It was remarkable because all were completely blind. The scientific establishment took a dim view of the work and, for the most part, dismissed it as implausible. But today it stands as one of the first, and most striking, demonstrations of neuroplasticity, the brain's ability to adapt. The blind people had learned to "see" through the sensation of touch. Here's what happened. The back of the chair had been fitted with hundreds of tiny stimulators that were hooked up to a video camera. As the camera panned the room, those in the chair felt tiny vibrations that seemed to dance across their skin as the image moved. With practice, the blind volunteers' brains learned to turn these vibrations into a mental picture of the room. Some became so good at it that they ducked when a ball was tossed at the camera. What was regarded as fringe science 40 years ago is currently at the cutting edge of neuroscience. With the right training, scientists now know the brain can reshape itself to work around dead and damaged areas, often with dramatic benefits. Therapies that exploit the brain's power to adapt have helped people overcome damage caused by strokes, depression, anxiety and learning disabilities, and may one day replace drugs for some of these conditions. Some studies suggest therapies that tap into the brain's neuroplasticity are already making a big difference. Children with language difficulties have been shown to make significant progress using computer training tools that are the equivalent of cerebral cross-training. Work is underway to investigate whether it is possible to stave off a loss of brain plasticity in older age, which might help to address memory problems linked to Alzheimer's disease. Some psychoanalysts are adopting techniques to help people overcome relationship troubles, obsessions, worries and bad habits. ENHANCED LEARNING TO IMPROVE REHABILITATION Dr. Hermano Krebs - looking at the IMT Powerpoint presentation, particularly related to the interaction of the brain vision processing areas "seeing" the resulting action and tieing it to the feeling of the muscles performing the action, seem to greatly improve the   imprint on the brain with the involved processes.   From my own experiences, getting more than a two-dimensional screen view, seems that it would greatly enhance the learning, and resultant rehabilitation.   Have you considered VR-type interfaces, such that it appears to my brain that I am reaching "into" a scenario, or that " I'm picking up an object" - feeling and seeing the interaction
      • CONNECTING YOUR BRAIN TO A BODY PART.
      • BRIEF RESEARCH INTO STROKE REHABILITATION THERAPIES
      • After my first robot [arm & shoulder exercise [a demonstration session – I was able to raise my left leg behind me].
      • Mirror-box therapy concepts.
      • I used mirror box concepts to initiate my left ankle movement [3-months post stroke].
      • Hyperbaric therapy
      • Electrical stimulus
      • TMS - Transcranial Magnetic Stimulation. TMS Therapy uses a highly focused pulsed magnetic field to stimulate nerve cells in the area of the brain thought to control certain brain functions by altering those brain structures
      • Stem Cell replacement
      • Aquatic therapy – balance, stretching, range of motion, strength
      • I have been coming to the COA for 1 ½ years – I learned to walk without a support about 3 months ago [25-months post stroke].
      • Vision Therapy - Vision therapy -- a type of physical therapy for the eyes and brain -- is a highly effective non-surgical treatment for many common visual problems such as lazy eye, crossed eyes, double vision, convergence insufficiency and some reading and learning disabilities
      • I used several different computer programs to help with resolving peripheral vision and depth perception issues [began 3-months post stroke; depth perception improved 100% after 13 months].
      • Therapeutic Goals:
      • Reduced tone – throughout the entire arm, shoulder, elbow, wrist and hand.
      • Reduced pain – Stroke patients with loss of upper extremity movement often suffer shoulder pain, which sometimes can be exacerbated by therapy.
      • Improved coordination – Patients treated with Reo Therapy have exhibited improvements in active range of motion (ROM) and in overall coordination of arm movements.
      • Improved gait – Patients whose gait was affected by their inability to properly move their upper extremities showed a marked improvement in gait following therapy sessions.
      • Functional gains – Therapists reported that following Therapy sessions, subsequent components of their patients ’ therapy session were more productive, an improvement they attributed to the affects of robotic therapies.
      • ENHANCED LEARNING TO IMPROVE REHABILITATION
      • 3.1 Task Type [ the task to be accomplished sets the tone for the system’s design and use]
      • 3.2 Task Criticality [ high , medium and low .]
      • 3.3 Robot Morphology [ Robots can take many physical forms.]
      • 3.4 Ratio of People to Robots [ The ratio of people to robots directly affects the
      • human-robot interaction in a system. This taxonomy classification does not measure the
      • interaction between the operators and the robots, simply the numbers of each.
      • Robotics – taxonomy:
        • EXTRAMURAL, EXTERNAL and NON-SENSOR, NON-STIMULATION - situated or occurring outside the wall of an organ or structure.
          • Toyota
          • Armeo
          • REO/MOTORIKA
          • InteractiveMotion
        • EXTRADURAL, SENSOR , HUMAN STIMULATION -outside the dura mater enveloping the spinal cord
          • MYOMO
          • ReWalk
        • EPIDURAL- , SENSOR, ROBOT STIMULATION -   an agent into the epidural space of the spinal canal
      • CalTech
      • purpose/function of Robotics:
      • ENHANCED LEARNING TO IMPROVE REHABILITATION –
        • Brain-to-Body Connectivity = Functional gains
        • Stroke rehabilitation by muscle/brain re-education
        • Maintain or increase range of motion
        • I chose InMotion as my initial therapeutic device to
      • effectively improve shoulder [scapula movement] range of motion, and
      • gain mental stimulation through visual activities, which
      • enhance brain-to-body re-education
        • The Myomo device combines several treatment modalities into one device , and
        • can cost effectively improve range of motion,
        • enhance brain-to-body re-education through practical Clinical Progression process
        • be used as a therapeutic tool for improved motor function,
        • and be effective as an assistive device
      • Rehabilitation with highly repetitive training for severely affected patients.
      • • Improved therapy efficiency and patient care. • An extensive 3D workspace. OR
      • • Guided therapeutic programs • Augmented Feedback with motivating exercises to train activities of daily living. • Assist-as-needed support provided by the robotic arm exoskeleton that automatically adapts to the patients’ capabilities.
      • • Clinical research shows that patients suffering from neuromuscular dysfunction show better results when performing repetitive, intense, functionally based retraining, as part of their physical therapy program. • Objective analysis and documentation of the patient’s progress.
      • November 8, 2011
    • Rupert CSUN 11/21 6 pm Brain Plasticity and Rehabilitation Robotic Therapies. CSUN COA/Brown Center VISUALIZATION OF BODY PARTS Think of your favorite food – Close your eyes and smell the food. Is everybody hungry now? Now Think of your favorite food as a child – close eyes and smell the food. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it already? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? CONNECTING YOUR BRAIN TO A BODY PART. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? Now think of a rubber straw or clear flexible rubber tube - and CONNECT it to your brain where your toe feeling was. CONNECT the other end of the straw to your toe. Look through the straw and look at your toe. A stroke or other TBI can break the connection, or prevent this visualization. ENHANCED LEARNING TO IMPROVE REHABILITATION VIRTUAL REALITY Virtual reality (VR) is a term that applies to computer-simulated environments that can simulate physical presence in places in the real world, as well as in imaginary worlds. Most current virtual reality environments are primarily visual experiences, displayed either on a computer screen or through special stereoscopic displays, but some simulations include additional sensory information, such as sound through speakers or headphones. Some advanced, haptic systems now include tactile information, generally known as force feedback, in these applications. ----------------------------------------------------------- Enhanced Learning to Improve Rehabilitation Specific interventions may stimulate new neural connections, enhance cortical reorganization, and promote lasting neural networks for improved motor responses Boyd,L.A., Vidoni, E.D., Daly, J.J. (2007). Answering the call: the influence of neuroimagining and electrophysiological evidence on rehabilitation. Journal of the American Physical Therapy Association, 87(6), 684-703. BRAIN PLASTICITY Destroyed brain cells that control them or the bundles of nerve fibers that come out of them. The recovery of language is highly variable and can occur over years. Also amenable to rehabilitation are abstract thought, memory and emotion. On 8 March 1969, an extraordinary experiment was reported in the pages of Nature, Europe's leading science journal. It involved a group of people who took turns to sit in an old dentist's chair and describe the room around them. They commented on the presence of a phone on the table, a nearby vase, people's expressions and how they wore their hair. It was remarkable because all were completely blind. The scientific establishment took a dim view of the work and, for the most part, dismissed it as implausible. But today it stands as one of the first, and most striking, demonstrations of neuroplasticity, the brain's ability to adapt. The blind people had learned to "see" through the sensation of touch. Here's what happened. The back of the chair had been fitted with hundreds of tiny stimulators that were hooked up to a video camera. As the camera panned the room, those in the chair felt tiny vibrations that seemed to dance across their skin as the image moved. With practice, the blind volunteers' brains learned to turn these vibrations into a mental picture of the room. Some became so good at it that they ducked when a ball was tossed at the camera. What was regarded as fringe science 40 years ago is currently at the cutting edge of neuroscience. With the right training, scientists now know the brain can reshape itself to work around dead and damaged areas, often with dramatic benefits. Therapies that exploit the brain's power to adapt have helped people overcome damage caused by strokes, depression, anxiety and learning disabilities, and may one day replace drugs for some of these conditions. Some studies suggest therapies that tap into the brain's neuroplasticity are already making a big difference. Children with language difficulties have been shown to make significant progress using computer training tools that are the equivalent of cerebral cross-training. Work is underway to investigate whether it is possible to stave off a loss of brain plasticity in older age, which might help to address memory problems linked to Alzheimer's disease. Some psychoanalysts are adopting techniques to help people overcome relationship troubles, obsessions, worries and bad habits. ENHANCED LEARNING TO IMPROVE REHABILITATION Dr. Hermano Krebs - looking at the IMT Powerpoint presentation, particularly related to the interaction of the brain vision processing areas "seeing" the resulting action and tieing it to the feeling of the muscles performing the action, seem to greatly improve the   imprint on the brain with the involved processes.   From my own experiences, getting more than a two-dimensional screen view, seems that it would greatly enhance the learning, and resultant rehabilitation.   Have you considered VR-type interfaces, such that it appears to my brain that I am reaching "into" a scenario, or that " I'm picking up an object" - feeling and seeing the interaction
      • CONNECTING YOUR BRAIN TO A BODY PART.
      • BRIEF RESEARCH INTO STROKE REHABILITATION THERAPIES
      • After my first robot [arm & shoulder exercise [a demonstration session – I was able to raise my left leg behind me].
      • Mirror-box therapy concepts.
      • I used mirror box concepts to initiate my left ankle movement [3-months post stroke].
      • Hyperbaric therapy
      • Electrical stimulus
      • TMS - Transcranial Magnetic Stimulation. TMS Therapy uses a highly focused pulsed magnetic field to stimulate nerve cells in the area of the brain thought to control certain brain functions by altering those brain structures
      • Stem Cell replacement
      • Aquatic therapy – balance, stretching, range of motion, strength
      • I have been coming to the COA for 1 ½ years – I learned to walk without a support about 3 months ago [25-months post stroke].
      • Vision Therapy - Vision therapy -- a type of physical therapy for the eyes and brain -- is a highly effective non-surgical treatment for many common visual problems such as lazy eye, crossed eyes, double vision, convergence insufficiency and some reading and learning disabilities
      • I used several different computer programs to help with resolving peripheral vision and depth perception issues [began 3-months post stroke; depth perception improved 100% after 13 months].
      • Therapeutic Goals:
      • Reduced tone – throughout the entire arm, shoulder, elbow, wrist and hand.
      • Reduced pain – Stroke patients with loss of upper extremity movement often suffer shoulder pain, which sometimes can be exacerbated by therapy.
      • Improved coordination – Patients treated with Reo Therapy have exhibited improvements in active range of motion (ROM) and in overall coordination of arm movements.
      • Improved gait – Patients whose gait was affected by their inability to properly move their upper extremities showed a marked improvement in gait following therapy sessions.
      • Functional gains – Therapists reported that following Therapy sessions, subsequent components of their patients ’ therapy session were more productive, an improvement they attributed to the affects of robotic therapies.
      • ENHANCED LEARNING TO IMPROVE REHABILITATION
      • 3.1 Task Type [ the task to be accomplished sets the tone for the system’s design and use]
      • 3.2 Task Criticality [ high , medium and low .]
      • 3.3 Robot Morphology [ Robots can take many physical forms.]
      • 3.4 Ratio of People to Robots [ The ratio of people to robots directly affects the
      • human-robot interaction in a system. This taxonomy classification does not measure the
      • interaction between the operators and the robots, simply the numbers of each.
      • Robotics – taxonomy:
        • EXTRAMURAL, EXTERNAL and NON-SENSOR, NON-STIMULATION - situated or occurring outside the wall of an organ or structure.
          • Toyota
          • Armeo
          • REO/MOTORIKA
          • InteractiveMotion
        • EXTRADURAL, SENSOR , HUMAN STIMULATION -outside the dura mater enveloping the spinal cord
          • MYOMO
          • ReWalk
        • EPIDURAL- , SENSOR, ROBOT STIMULATION -   an agent into the epidural space of the spinal canal
      • CalTech
      • purpose/function of Robotics:
      • ENHANCED LEARNING TO IMPROVE REHABILITATION –
        • Brain-to-Body Connectivity = Functional gains
        • Stroke rehabilitation by muscle/brain re-education
        • Maintain or increase range of motion
        • I chose InMotion as my initial therapeutic device to
      • effectively improve shoulder [scapula movement] range of motion, and
      • gain mental stimulation through visual activities, which
      • enhance brain-to-body re-education
        • The Myomo device combines several treatment modalities into one device , and
        • can cost effectively improve range of motion,
        • enhance brain-to-body re-education through practical Clinical Progression process
        • be used as a therapeutic tool for improved motor function,
        • and be effective as an assistive device
      • Rehabilitation with highly repetitive training for severely affected patients.
      • • Improved therapy efficiency and patient care. • An extensive 3D workspace. OR
      • • Guided therapeutic programs • Augmented Feedback with motivating exercises to train activities of daily living. • Assist-as-needed support provided by the robotic arm exoskeleton that automatically adapts to the patients’ capabilities.
      • • Clinical research shows that patients suffering from neuromuscular dysfunction show better results when performing repetitive, intense, functionally based retraining, as part of their physical therapy program. • Objective analysis and documentation of the patient’s progress.
      • November 8, 2011
    • Howard CSUN 11/21 6 pm Brain Plasticity and Rehabilitation Robotic Therapies. CSUN COA/Brown Center VISUALIZATION OF BODY PARTS Think of your favorite food – Close your eyes and smell the food. Is everybody hungry now? Now Think of your favorite food as a child – close eyes and smell the food. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it already? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? CONNECTING YOUR BRAIN TO A BODY PART. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? Now think of a rubber straw or clear flexible rubber tube - and CONNECT it to your brain where your toe feeling was. CONNECT the other end of the straw to your toe. Look through the straw and look at your toe. A stroke or other TBI can break the connection, or prevent this visualization. ENHANCED LEARNING TO IMPROVE REHABILITATION VIRTUAL REALITY Virtual reality (VR) is a term that applies to computer-simulated environments that can simulate physical presence in places in the real world, as well as in imaginary worlds. Most current virtual reality environments are primarily visual experiences, displayed either on a computer screen or through special stereoscopic displays, but some simulations include additional sensory information, such as sound through speakers or headphones. Some advanced, haptic systems now include tactile information, generally known as force feedback, in these applications. ----------------------------------------------------------- Enhanced Learning to Improve Rehabilitation Specific interventions may stimulate new neural connections, enhance cortical reorganization, and promote lasting neural networks for improved motor responses Boyd,L.A., Vidoni, E.D., Daly, J.J. (2007). Answering the call: the influence of neuroimagining and electrophysiological evidence on rehabilitation. Journal of the American Physical Therapy Association, 87(6), 684-703. BRAIN PLASTICITY Destroyed brain cells that control them or the bundles of nerve fibers that come out of them. The recovery of language is highly variable and can occur over years. Also amenable to rehabilitation are abstract thought, memory and emotion. On 8 March 1969, an extraordinary experiment was reported in the pages of Nature, Europe's leading science journal. It involved a group of people who took turns to sit in an old dentist's chair and describe the room around them. They commented on the presence of a phone on the table, a nearby vase, people's expressions and how they wore their hair. It was remarkable because all were completely blind. The scientific establishment took a dim view of the work and, for the most part, dismissed it as implausible. But today it stands as one of the first, and most striking, demonstrations of neuroplasticity, the brain's ability to adapt. The blind people had learned to "see" through the sensation of touch. Here's what happened. The back of the chair had been fitted with hundreds of tiny stimulators that were hooked up to a video camera. As the camera panned the room, those in the chair felt tiny vibrations that seemed to dance across their skin as the image moved. With practice, the blind volunteers' brains learned to turn these vibrations into a mental picture of the room. Some became so good at it that they ducked when a ball was tossed at the camera. What was regarded as fringe science 40 years ago is currently at the cutting edge of neuroscience. With the right training, scientists now know the brain can reshape itself to work around dead and damaged areas, often with dramatic benefits. Therapies that exploit the brain's power to adapt have helped people overcome damage caused by strokes, depression, anxiety and learning disabilities, and may one day replace drugs for some of these conditions. Some studies suggest therapies that tap into the brain's neuroplasticity are already making a big difference. Children with language difficulties have been shown to make significant progress using computer training tools that are the equivalent of cerebral cross-training. Work is underway to investigate whether it is possible to stave off a loss of brain plasticity in older age, which might help to address memory problems linked to Alzheimer's disease. Some psychoanalysts are adopting techniques to help people overcome relationship troubles, obsessions, worries and bad habits. ENHANCED LEARNING TO IMPROVE REHABILITATION Dr. Hermano Krebs - looking at the IMT Powerpoint presentation, particularly related to the interaction of the brain vision processing areas "seeing" the resulting action and tieing it to the feeling of the muscles performing the action, seem to greatly improve the   imprint on the brain with the involved processes.   From my own experiences, getting more than a two-dimensional screen view, seems that it would greatly enhance the learning, and resultant rehabilitation.   Have you considered VR-type interfaces, such that it appears to my brain that I am reaching "into" a scenario, or that " I'm picking up an object" - feeling and seeing the interaction
      • CONNECTING YOUR BRAIN TO A BODY PART.
      • BRIEF RESEARCH INTO STROKE REHABILITATION THERAPIES
      • After my first robot [arm & shoulder exercise [a demonstration session – I was able to raise my left leg behind me].
      • Mirror-box therapy concepts.
      • I used mirror box concepts to initiate my left ankle movement [3-months post stroke].
      • Hyperbaric therapy
      • Electrical stimulus
      • TMS - Transcranial Magnetic Stimulation. TMS Therapy uses a highly focused pulsed magnetic field to stimulate nerve cells in the area of the brain thought to control certain brain functions by altering those brain structures
      • Stem Cell replacement
      • Aquatic therapy – balance, stretching, range of motion, strength
      • I have been coming to the COA for 1 ½ years – I learned to walk without a support about 3 months ago [25-months post stroke].
      • Vision Therapy - Vision therapy -- a type of physical therapy for the eyes and brain -- is a highly effective non-surgical treatment for many common visual problems such as lazy eye, crossed eyes, double vision, convergence insufficiency and some reading and learning disabilities
      • I used several different computer programs to help with resolving peripheral vision and depth perception issues [began 3-months post stroke; depth perception improved 100% after 13 months].
      • Therapeutic Goals:
      • Reduced tone – throughout the entire arm, shoulder, elbow, wrist and hand.
      • Reduced pain – Stroke patients with loss of upper extremity movement often suffer shoulder pain, which sometimes can be exacerbated by therapy.
      • Improved coordination – Patients treated with Reo Therapy have exhibited improvements in active range of motion (ROM) and in overall coordination of arm movements.
      • Improved gait – Patients whose gait was affected by their inability to properly move their upper extremities showed a marked improvement in gait following therapy sessions.
      • Functional gains – Therapists reported that following Therapy sessions, subsequent components of their patients ’ therapy session were more productive, an improvement they attributed to the affects of robotic therapies.
      • ENHANCED LEARNING TO IMPROVE REHABILITATION
      • 3.1 Task Type [ the task to be accomplished sets the tone for the system’s design and use]
      • 3.2 Task Criticality [ high , medium and low .]
      • 3.3 Robot Morphology [ Robots can take many physical forms.]
      • 3.4 Ratio of People to Robots [ The ratio of people to robots directly affects the
      • human-robot interaction in a system. This taxonomy classification does not measure the
      • interaction between the operators and the robots, simply the numbers of each.
      • Robotics – taxonomy:
        • EXTRAMURAL, EXTERNAL and NON-SENSOR, NON-STIMULATION - situated or occurring outside the wall of an organ or structure.
          • Toyota
          • Armeo
          • REO/MOTORIKA
          • InteractiveMotion
        • EXTRADURAL, SENSOR , HUMAN STIMULATION -outside the dura mater enveloping the spinal cord
          • MYOMO
          • ReWalk
        • EPIDURAL- , SENSOR, ROBOT STIMULATION -   an agent into the epidural space of the spinal canal
      • CalTech
      • purpose/function of Robotics:
      • ENHANCED LEARNING TO IMPROVE REHABILITATION –
        • Brain-to-Body Connectivity = Functional gains
        • Stroke rehabilitation by muscle/brain re-education
        • Maintain or increase range of motion
        • I chose InMotion as my initial therapeutic device to
      • effectively improve shoulder [scapula movement] range of motion, and
      • gain mental stimulation through visual activities, which
      • enhance brain-to-body re-education
        • The Myomo device combines several treatment modalities into one device , and
        • can cost effectively improve range of motion,
        • enhance brain-to-body re-education through practical Clinical Progression process
        • be used as a therapeutic tool for improved motor function,
        • and be effective as an assistive device
      • Rehabilitation with highly repetitive training for severely affected patients.
      • • Improved therapy efficiency and patient care. • An extensive 3D workspace. OR
      • • Guided therapeutic programs • Augmented Feedback with motivating exercises to train activities of daily living. • Assist-as-needed support provided by the robotic arm exoskeleton that automatically adapts to the patients’ capabilities.
      • • Clinical research shows that patients suffering from neuromuscular dysfunction show better results when performing repetitive, intense, functionally based retraining, as part of their physical therapy program. • Objective analysis and documentation of the patient’s progress.
      • November 8, 2011
    • REO Therapy by MOTORIKA CSUN 11/21 6 pm Brain Plasticity and Rehabilitation Robotic Therapies. CSUN COA/Brown Center VISUALIZATION OF BODY PARTS Think of your favorite food – Close your eyes and smell the food. Is everybody hungry now? Now Think of your favorite food as a child – close eyes and smell the food. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it already? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? CONNECTING YOUR BRAIN TO A BODY PART. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? Now think of a rubber straw or clear flexible rubber tube - and CONNECT it to your brain where your toe feeling was. CONNECT the other end of the straw to your toe. Look through the straw and look at your toe. A stroke or other TBI can break the connection, or prevent this visualization. ENHANCED LEARNING TO IMPROVE REHABILITATION VIRTUAL REALITY Virtual reality (VR) is a term that applies to computer-simulated environments that can simulate physical presence in places in the real world, as well as in imaginary worlds. Most current virtual reality environments are primarily visual experiences, displayed either on a computer screen or through special stereoscopic displays, but some simulations include additional sensory information, such as sound through speakers or headphones. Some advanced, haptic systems now include tactile information, generally known as force feedback, in these applications. ----------------------------------------------------------- Enhanced Learning to Improve Rehabilitation Specific interventions may stimulate new neural connections, enhance cortical reorganization, and promote lasting neural networks for improved motor responses Boyd,L.A., Vidoni, E.D., Daly, J.J. (2007). Answering the call: the influence of neuroimagining and electrophysiological evidence on rehabilitation. Journal of the American Physical Therapy Association, 87(6), 684-703. BRAIN PLASTICITY Destroyed brain cells that control them or the bundles of nerve fibers that come out of them. The recovery of language is highly variable and can occur over years. Also amenable to rehabilitation are abstract thought, memory and emotion. On 8 March 1969, an extraordinary experiment was reported in the pages of Nature, Europe's leading science journal. It involved a group of people who took turns to sit in an old dentist's chair and describe the room around them. They commented on the presence of a phone on the table, a nearby vase, people's expressions and how they wore their hair. It was remarkable because all were completely blind. The scientific establishment took a dim view of the work and, for the most part, dismissed it as implausible. But today it stands as one of the first, and most striking, demonstrations of neuroplasticity, the brain's ability to adapt. The blind people had learned to "see" through the sensation of touch. Here's what happened. The back of the chair had been fitted with hundreds of tiny stimulators that were hooked up to a video camera. As the camera panned the room, those in the chair felt tiny vibrations that seemed to dance across their skin as the image moved. With practice, the blind volunteers' brains learned to turn these vibrations into a mental picture of the room. Some became so good at it that they ducked when a ball was tossed at the camera. What was regarded as fringe science 40 years ago is currently at the cutting edge of neuroscience. With the right training, scientists now know the brain can reshape itself to work around dead and damaged areas, often with dramatic benefits. Therapies that exploit the brain's power to adapt have helped people overcome damage caused by strokes, depression, anxiety and learning disabilities, and may one day replace drugs for some of these conditions. Some studies suggest therapies that tap into the brain's neuroplasticity are already making a big difference. Children with language difficulties have been shown to make significant progress using computer training tools that are the equivalent of cerebral cross-training. Work is underway to investigate whether it is possible to stave off a loss of brain plasticity in older age, which might help to address memory problems linked to Alzheimer's disease. Some psychoanalysts are adopting techniques to help people overcome relationship troubles, obsessions, worries and bad habits. ENHANCED LEARNING TO IMPROVE REHABILITATION Dr. Hermano Krebs - looking at the IMT Powerpoint presentation, particularly related to the interaction of the brain vision processing areas "seeing" the resulting action and tieing it to the feeling of the muscles performing the action, seem to greatly improve the   imprint on the brain with the involved processes.   From my own experiences, getting more than a two-dimensional screen view, seems that it would greatly enhance the learning, and resultant rehabilitation.   Have you considered VR-type interfaces, such that it appears to my brain that I am reaching "into" a scenario, or that " I'm picking up an object" - feeling and seeing the interaction
      • CONNECTING YOUR BRAIN TO A BODY PART.
      • BRIEF RESEARCH INTO STROKE REHABILITATION THERAPIES
      • After my first robot [arm & shoulder exercise [a demonstration session – I was able to raise my left leg behind me].
      • Mirror-box therapy concepts.
      • I used mirror box concepts to initiate my left ankle movement [3-months post stroke].
      • Hyperbaric therapy
      • Electrical stimulus
      • TMS - Transcranial Magnetic Stimulation. TMS Therapy uses a highly focused pulsed magnetic field to stimulate nerve cells in the area of the brain thought to control certain brain functions by altering those brain structures
      • Stem Cell replacement
      • Aquatic therapy – balance, stretching, range of motion, strength
      • I have been coming to the COA for 1 ½ years – I learned to walk without a support about 3 months ago [25-months post stroke].
      • Vision Therapy - Vision therapy -- a type of physical therapy for the eyes and brain -- is a highly effective non-surgical treatment for many common visual problems such as lazy eye, crossed eyes, double vision, convergence insufficiency and some reading and learning disabilities
      • I used several different computer programs to help with resolving peripheral vision and depth perception issues [began 3-months post stroke; depth perception improved 100% after 13 months].
      • Therapeutic Goals:
      • Reduced tone – throughout the entire arm, shoulder, elbow, wrist and hand.
      • Reduced pain – Stroke patients with loss of upper extremity movement often suffer shoulder pain, which sometimes can be exacerbated by therapy.
      • Improved coordination – Patients treated with Reo Therapy have exhibited improvements in active range of motion (ROM) and in overall coordination of arm movements.
      • Improved gait – Patients whose gait was affected by their inability to properly move their upper extremities showed a marked improvement in gait following therapy sessions.
      • Functional gains – Therapists reported that following Therapy sessions, subsequent components of their patients ’ therapy session were more productive, an improvement they attributed to the affects of robotic therapies.
      • ENHANCED LEARNING TO IMPROVE REHABILITATION
      • 3.1 Task Type [ the task to be accomplished sets the tone for the system’s design and use]
      • 3.2 Task Criticality [ high , medium and low .]
      • 3.3 Robot Morphology [ Robots can take many physical forms.]
      • 3.4 Ratio of People to Robots [ The ratio of people to robots directly affects the
      • human-robot interaction in a system. This taxonomy classification does not measure the
      • interaction between the operators and the robots, simply the numbers of each.
      • Robotics – taxonomy:
        • EXTRAMURAL, EXTERNAL and NON-SENSOR, NON-STIMULATION - situated or occurring outside the wall of an organ or structure.
          • Toyota
          • Armeo
          • REO/MOTORIKA
          • InteractiveMotion
        • EXTRADURAL, SENSOR , HUMAN STIMULATION -outside the dura mater enveloping the spinal cord
          • MYOMO
          • ReWalk
        • EPIDURAL- , SENSOR, ROBOT STIMULATION -   an agent into the epidural space of the spinal canal
      • CalTech
      • purpose/function of Robotics:
      • ENHANCED LEARNING TO IMPROVE REHABILITATION –
        • Brain-to-Body Connectivity = Functional gains
        • Stroke rehabilitation by muscle/brain re-education
        • Maintain or increase range of motion
        • I chose InMotion as my initial therapeutic device to
      • effectively improve shoulder [scapula movement] range of motion, and
      • gain mental stimulation through visual activities, which
      • enhance brain-to-body re-education
        • The Myomo device combines several treatment modalities into one device , and
        • can cost effectively improve range of motion,
        • enhance brain-to-body re-education through practical Clinical Progression process
        • be used as a therapeutic tool for improved motor function,
        • and be effective as an assistive device
      • Rehabilitation with highly repetitive training for severely affected patients.
      • • Improved therapy efficiency and patient care. • An extensive 3D workspace. OR
      • • Guided therapeutic programs • Augmented Feedback with motivating exercises to train activities of daily living. • Assist-as-needed support provided by the robotic arm exoskeleton that automatically adapts to the patients’ capabilities.
      • • Clinical research shows that patients suffering from neuromuscular dysfunction show better results when performing repetitive, intense, functionally based retraining, as part of their physical therapy program. • Objective analysis and documentation of the patient’s progress.
      • November 8, 2011
      • Eiichi Saito/Bloomberg/Getty Images
      • Toyota Shows Machines to Help Sick, Elderly Move
      • By YURI KAGEYAMA AP Business Writer November 2, 2011
      • Toyota unveiled its ambitions for high-tech health care Tuesday, displaying experimental robots that the auto giant says can lift disabled patients from their hospital beds or help them walk.
      • The company aims to commercialize products such as its "independent walk assist" device sometime after 2013 — seeking to position itself in an industry with great potential in Japan, one of the world's most rapidly aging nations.
      • Eiichi Saitoh, a professor in rehabilitation medicine, demonstrated the "walk assist" device on Tuesday, strapping the computerized metallic brace onto his right leg, which was paralyzed by polio.
      • He showed reporters at a Toyota facility in Tokyo how the brace could bend at the knee as needed, allowing him to walk more naturally and rise from a chair with greater ease than the walker he now uses. Wearing a backpack-like battery, Saitoh walked up and down a flight of stairs, smiling with delight.
      • Saitoh said he had tried Toyota's machines with patients and was confident they helped people recover more quickly from strokes and other ailments that curtailed movement.
      • "It may be difficult to predict the future, but the era of an aging society is definitely coming," he said. "We need partner robots to enrich our lives."
      • Toyota also demonstrated an intelligent machine with padded arms that can help health care workers lift disabled patients from their beds and then carry them around. Another mobility aid worked like a skateboard to help people relearn balance.
      • Toyota officials said technology for autos such as sensors, motors and computer software are being used in such computerized gadgets to help people get around, and what they learn about mobility for people will likely be of use in future cars.
      • Prices and overseas sales plans of all the machines are still undecided, according to Toyota.
      • General Manager Akifumi Tamaoki said more tests were needed on more people to insure safety and reliability, and gain user feedback, but the commercial products in the works were going to be smaller and lighter than the prototype versions shown.
      • "We define gentle and smart machines as partner robots," he said.
      • Toyota has previously shown human-shaped robots that played the trumpet and violin, and those that move around and talk about Toyota cars at showrooms.
      • Rival Japanese automaker Honda Motor Co. has developed a sophisticated humanoid robot called Asimo, which can run, talk and dance. But Asimo has been limited to showrooms and labs and has yet to enter any hospital or home.
      • Toyota faces competition from other manufacturers that are all working on gadgets to tap into the health care business. Honda also has demonstrated machines worn on the legs that help people move, as have some universities.
      • Hirohisa Hirukawa, a robot exert at the government-backed National Institute of Advanced Industrial Science and Technology, said more time would be needed to see the full busineses potential of the Toyota machines but was upbeat.
      • "I feel that the walk-assist device has real potential to sell to consumers," he said in an email.
      • Tamaoki said Toyota is keeping its offerings simple, compared to those from Honda, so they can enter everyday life easily.
      • ———
      • Follow Yuri Kageyama on Twitter at http://twitter.com/yurikageyama
    • InteractiveMotion CSUN 11/21 6 pm Brain Plasticity and Rehabilitation Robotic Therapies. CSUN COA/Brown Center VISUALIZATION OF BODY PARTS Think of your favorite food – Close your eyes and smell the food. Is everybody hungry now? Now Think of your favorite food as a child – close eyes and smell the food. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it already? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? CONNECTING YOUR BRAIN TO A BODY PART. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? Now think of a rubber straw or clear flexible rubber tube - and CONNECT it to your brain where your toe feeling was. CONNECT the other end of the straw to your toe. Look through the straw and look at your toe. A stroke or other TBI can break the connection, or prevent this visualization. ENHANCED LEARNING TO IMPROVE REHABILITATION VIRTUAL REALITY Virtual reality (VR) is a term that applies to computer-simulated environments that can simulate physical presence in places in the real world, as well as in imaginary worlds. Most current virtual reality environments are primarily visual experiences, displayed either on a computer screen or through special stereoscopic displays, but some simulations include additional sensory information, such as sound through speakers or headphones. Some advanced, haptic systems now include tactile information, generally known as force feedback, in these applications. ----------------------------------------------------------- Enhanced Learning to Improve Rehabilitation Specific interventions may stimulate new neural connections, enhance cortical reorganization, and promote lasting neural networks for improved motor responses Boyd,L.A., Vidoni, E.D., Daly, J.J. (2007). Answering the call: the influence of neuroimagining and electrophysiological evidence on rehabilitation. Journal of the American Physical Therapy Association, 87(6), 684-703. BRAIN PLASTICITY Destroyed brain cells that control them or the bundles of nerve fibers that come out of them. The recovery of language is highly variable and can occur over years. Also amenable to rehabilitation are abstract thought, memory and emotion. On 8 March 1969, an extraordinary experiment was reported in the pages of Nature, Europe's leading science journal. It involved a group of people who took turns to sit in an old dentist's chair and describe the room around them. They commented on the presence of a phone on the table, a nearby vase, people's expressions and how they wore their hair. It was remarkable because all were completely blind. The scientific establishment took a dim view of the work and, for the most part, dismissed it as implausible. But today it stands as one of the first, and most striking, demonstrations of neuroplasticity, the brain's ability to adapt. The blind people had learned to "see" through the sensation of touch. Here's what happened. The back of the chair had been fitted with hundreds of tiny stimulators that were hooked up to a video camera. As the camera panned the room, those in the chair felt tiny vibrations that seemed to dance across their skin as the image moved. With practice, the blind volunteers' brains learned to turn these vibrations into a mental picture of the room. Some became so good at it that they ducked when a ball was tossed at the camera. What was regarded as fringe science 40 years ago is currently at the cutting edge of neuroscience. With the right training, scientists now know the brain can reshape itself to work around dead and damaged areas, often with dramatic benefits. Therapies that exploit the brain's power to adapt have helped people overcome damage caused by strokes, depression, anxiety and learning disabilities, and may one day replace drugs for some of these conditions. Some studies suggest therapies that tap into the brain's neuroplasticity are already making a big difference. Children with language difficulties have been shown to make significant progress using computer training tools that are the equivalent of cerebral cross-training. Work is underway to investigate whether it is possible to stave off a loss of brain plasticity in older age, which might help to address memory problems linked to Alzheimer's disease. Some psychoanalysts are adopting techniques to help people overcome relationship troubles, obsessions, worries and bad habits. ENHANCED LEARNING TO IMPROVE REHABILITATION Dr. Hermano Krebs - looking at the IMT Powerpoint presentation, particularly related to the interaction of the brain vision processing areas "seeing" the resulting action and tieing it to the feeling of the muscles performing the action, seem to greatly improve the   imprint on the brain with the involved processes.   From my own experiences, getting more than a two-dimensional screen view, seems that it would greatly enhance the learning, and resultant rehabilitation.   Have you considered VR-type interfaces, such that it appears to my brain that I am reaching "into" a scenario, or that " I'm picking up an object" - feeling and seeing the interaction
      • CONNECTING YOUR BRAIN TO A BODY PART.
      • BRIEF RESEARCH INTO STROKE REHABILITATION THERAPIES
      • After my first robot [arm & shoulder exercise [a demonstration session – I was able to raise my left leg behind me].
      • Mirror-box therapy concepts.
      • I used mirror box concepts to initiate my left ankle movement [3-months post stroke].
      • Hyperbaric therapy
      • Electrical stimulus
      • TMS - Transcranial Magnetic Stimulation. TMS Therapy uses a highly focused pulsed magnetic field to stimulate nerve cells in the area of the brain thought to control certain brain functions by altering those brain structures
      • Stem Cell replacement
      • Aquatic therapy – balance, stretching, range of motion, strength
      • I have been coming to the COA for 1 ½ years – I learned to walk without a support about 3 months ago [25-months post stroke].
      • Vision Therapy - Vision therapy -- a type of physical therapy for the eyes and brain -- is a highly effective non-surgical treatment for many common visual problems such as lazy eye, crossed eyes, double vision, convergence insufficiency and some reading and learning disabilities
      • I used several different computer programs to help with resolving peripheral vision and depth perception issues [began 3-months post stroke; depth perception improved 100% after 13 months].
      • Therapeutic Goals:
      • Reduced tone – throughout the entire arm, shoulder, elbow, wrist and hand.
      • Reduced pain – Stroke patients with loss of upper extremity movement often suffer shoulder pain, which sometimes can be exacerbated by therapy.
      • Improved coordination – Patients treated with Reo Therapy have exhibited improvements in active range of motion (ROM) and in overall coordination of arm movements.
      • Improved gait – Patients whose gait was affected by their inability to properly move their upper extremities showed a marked improvement in gait following therapy sessions.
      • Functional gains – Therapists reported that following Therapy sessions, subsequent components of their patients ’ therapy session were more productive, an improvement they attributed to the affects of robotic therapies.
      • ENHANCED LEARNING TO IMPROVE REHABILITATION
      • 3.1 Task Type [ the task to be accomplished sets the tone for the system’s design and use]
      • 3.2 Task Criticality [ high , medium and low .]
      • 3.3 Robot Morphology [ Robots can take many physical forms.]
      • 3.4 Ratio of People to Robots [ The ratio of people to robots directly affects the
      • human-robot interaction in a system. This taxonomy classification does not measure the
      • interaction between the operators and the robots, simply the numbers of each.
      • Robotics – taxonomy:
        • EXTRAMURAL, EXTERNAL and NON-SENSOR, NON-STIMULATION - situated or occurring outside the wall of an organ or structure.
          • Toyota
          • Armeo
          • REO/MOTORIKA
          • InteractiveMotion
        • EXTRADURAL, SENSOR , HUMAN STIMULATION -outside the dura mater enveloping the spinal cord
          • MYOMO
          • ReWalk
        • EPIDURAL- , SENSOR, ROBOT STIMULATION -   an agent into the epidural space of the spinal canal
      • CalTech
      • purpose/function of Robotics:
      • ENHANCED LEARNING TO IMPROVE REHABILITATION –
        • Brain-to-Body Connectivity = Functional gains
        • Stroke rehabilitation by muscle/brain re-education
        • Maintain or increase range of motion
        • I chose InMotion as my initial therapeutic device to
      • effectively improve shoulder [scapula movement] range of motion, and
      • gain mental stimulation through visual activities, which
      • enhance brain-to-body re-education
        • The Myomo device combines several treatment modalities into one device , and
        • can cost effectively improve range of motion,
        • enhance brain-to-body re-education through practical Clinical Progression process
        • be used as a therapeutic tool for improved motor function,
        • and be effective as an assistive device
      • Rehabilitation with highly repetitive training for severely affected patients.
      • • Improved therapy efficiency and patient care. • An extensive 3D workspace. OR
      • • Guided therapeutic programs • Augmented Feedback with motivating exercises to train activities of daily living. • Assist-as-needed support provided by the robotic arm exoskeleton that automatically adapts to the patients’ capabilities.
      • • Clinical research shows that patients suffering from neuromuscular dysfunction show better results when performing repetitive, intense, functionally based retraining, as part of their physical therapy program. • Objective analysis and documentation of the patient’s progress.
      • November 8, 2011
      • Eiichi Saito/Bloomberg/Getty Images
      • Toyota Shows Machines to Help Sick, Elderly Move
      • By YURI KAGEYAMA AP Business Writer November 2, 2011
      • Toyota unveiled its ambitions for high-tech health care Tuesday, displaying experimental robots that the auto giant says can lift disabled patients from their hospital beds or help them walk.
      • The company aims to commercialize products such as its "independent walk assist" device sometime after 2013 — seeking to position itself in an industry with great potential in Japan, one of the world's most rapidly aging nations.
      • Eiichi Saitoh, a professor in rehabilitation medicine, demonstrated the "walk assist" device on Tuesday, strapping the computerized metallic brace onto his right leg, which was paralyzed by polio.
      • He showed reporters at a Toyota facility in Tokyo how the brace could bend at the knee as needed, allowing him to walk more naturally and rise from a chair with greater ease than the walker he now uses. Wearing a backpack-like battery, Saitoh walked up and down a flight of stairs, smiling with delight.
      • Saitoh said he had tried Toyota's machines with patients and was confident they helped people recover more quickly from strokes and other ailments that curtailed movement.
      • "It may be difficult to predict the future, but the era of an aging society is definitely coming," he said. "We need partner robots to enrich our lives."
      • Toyota also demonstrated an intelligent machine with padded arms that can help health care workers lift disabled patients from their beds and then carry them around. Another mobility aid worked like a skateboard to help people relearn balance.
      • Toyota officials said technology for autos such as sensors, motors and computer software are being used in such computerized gadgets to help people get around, and what they learn about mobility for people will likely be of use in future cars.
      • Prices and overseas sales plans of all the machines are still undecided, according to Toyota.
      • General Manager Akifumi Tamaoki said more tests were needed on more people to insure safety and reliability, and gain user feedback, but the commercial products in the works were going to be smaller and lighter than the prototype versions shown.
      • "We define gentle and smart machines as partner robots," he said.
      • Toyota has previously shown human-shaped robots that played the trumpet and violin, and those that move around and talk about Toyota cars at showrooms.
      • Rival Japanese automaker Honda Motor Co. has developed a sophisticated humanoid robot called Asimo, which can run, talk and dance. But Asimo has been limited to showrooms and labs and has yet to enter any hospital or home.
      • Toyota faces competition from other manufacturers that are all working on gadgets to tap into the health care business. Honda also has demonstrated machines worn on the legs that help people move, as have some universities.
      • Hirohisa Hirukawa, a robot exert at the government-backed National Institute of Advanced Industrial Science and Technology, said more time would be needed to see the full busineses potential of the Toyota machines but was upbeat.
      • "I feel that the walk-assist device has real potential to sell to consumers," he said in an email.
      • Tamaoki said Toyota is keeping its offerings simple, compared to those from Honda, so they can enter everyday life easily.
      • ———
      • Follow Yuri Kageyama on Twitter at http://twitter.com/yurikageyama
    • InteractiveMotion CSUN 11/21 6 pm Brain Plasticity and Rehabilitation Robotic Therapies. CSUN COA/Brown Center VISUALIZATION OF BODY PARTS Think of your favorite food – Close your eyes and smell the food. Is everybody hungry now? Now Think of your favorite food as a child – close eyes and smell the food. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it already? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? CONNECTING YOUR BRAIN TO A BODY PART. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? Now think of a rubber straw or clear flexible rubber tube - and CONNECT it to your brain where your toe feeling was. CONNECT the other end of the straw to your toe. Look through the straw and look at your toe. A stroke or other TBI can break the connection, or prevent this visualization. ENHANCED LEARNING TO IMPROVE REHABILITATION VIRTUAL REALITY Virtual reality (VR) is a term that applies to computer-simulated environments that can simulate physical presence in places in the real world, as well as in imaginary worlds. Most current virtual reality environments are primarily visual experiences, displayed either on a computer screen or through special stereoscopic displays, but some simulations include additional sensory information, such as sound through speakers or headphones. Some advanced, haptic systems now include tactile information, generally known as force feedback, in these applications. ----------------------------------------------------------- Enhanced Learning to Improve Rehabilitation Specific interventions may stimulate new neural connections, enhance cortical reorganization, and promote lasting neural networks for improved motor responses Boyd,L.A., Vidoni, E.D., Daly, J.J. (2007). Answering the call: the influence of neuroimagining and electrophysiological evidence on rehabilitation. Journal of the American Physical Therapy Association, 87(6), 684-703. BRAIN PLASTICITY Destroyed brain cells that control them or the bundles of nerve fibers that come out of them. The recovery of language is highly variable and can occur over years. Also amenable to rehabilitation are abstract thought, memory and emotion. On 8 March 1969, an extraordinary experiment was reported in the pages of Nature, Europe's leading science journal. It involved a group of people who took turns to sit in an old dentist's chair and describe the room around them. They commented on the presence of a phone on the table, a nearby vase, people's expressions and how they wore their hair. It was remarkable because all were completely blind. The scientific establishment took a dim view of the work and, for the most part, dismissed it as implausible. But today it stands as one of the first, and most striking, demonstrations of neuroplasticity, the brain's ability to adapt. The blind people had learned to "see" through the sensation of touch. Here's what happened. The back of the chair had been fitted with hundreds of tiny stimulators that were hooked up to a video camera. As the camera panned the room, those in the chair felt tiny vibrations that seemed to dance across their skin as the image moved. With practice, the blind volunteers' brains learned to turn these vibrations into a mental picture of the room. Some became so good at it that they ducked when a ball was tossed at the camera. What was regarded as fringe science 40 years ago is currently at the cutting edge of neuroscience. With the right training, scientists now know the brain can reshape itself to work around dead and damaged areas, often with dramatic benefits. Therapies that exploit the brain's power to adapt have helped people overcome damage caused by strokes, depression, anxiety and learning disabilities, and may one day replace drugs for some of these conditions. Some studies suggest therapies that tap into the brain's neuroplasticity are already making a big difference. Children with language difficulties have been shown to make significant progress using computer training tools that are the equivalent of cerebral cross-training. Work is underway to investigate whether it is possible to stave off a loss of brain plasticity in older age, which might help to address memory problems linked to Alzheimer's disease. Some psychoanalysts are adopting techniques to help people overcome relationship troubles, obsessions, worries and bad habits. ENHANCED LEARNING TO IMPROVE REHABILITATION Dr. Hermano Krebs - looking at the IMT Powerpoint presentation, particularly related to the interaction of the brain vision processing areas "seeing" the resulting action and tieing it to the feeling of the muscles performing the action, seem to greatly improve the   imprint on the brain with the involved processes.   From my own experiences, getting more than a two-dimensional screen view, seems that it would greatly enhance the learning, and resultant rehabilitation.   Have you considered VR-type interfaces, such that it appears to my brain that I am reaching "into" a scenario, or that " I'm picking up an object" - feeling and seeing the interaction
      • CONNECTING YOUR BRAIN TO A BODY PART.
      • BRIEF RESEARCH INTO STROKE REHABILITATION THERAPIES
      • After my first robot [arm & shoulder exercise [a demonstration session – I was able to raise my left leg behind me].
      • Mirror-box therapy concepts.
      • I used mirror box concepts to initiate my left ankle movement [3-months post stroke].
      • Hyperbaric therapy
      • Electrical stimulus
      • TMS - Transcranial Magnetic Stimulation. TMS Therapy uses a highly focused pulsed magnetic field to stimulate nerve cells in the area of the brain thought to control certain brain functions by altering those brain structures
      • Stem Cell replacement
      • Aquatic therapy – balance, stretching, range of motion, strength
      • I have been coming to the COA for 1 ½ years – I learned to walk without a support about 3 months ago [25-months post stroke].
      • Vision Therapy - Vision therapy -- a type of physical therapy for the eyes and brain -- is a highly effective non-surgical treatment for many common visual problems such as lazy eye, crossed eyes, double vision, convergence insufficiency and some reading and learning disabilities
      • I used several different computer programs to help with resolving peripheral vision and depth perception issues [began 3-months post stroke; depth perception improved 100% after 13 months].
      • Therapeutic Goals:
      • Reduced tone – throughout the entire arm, shoulder, elbow, wrist and hand.
      • Reduced pain – Stroke patients with loss of upper extremity movement often suffer shoulder pain, which sometimes can be exacerbated by therapy.
      • Improved coordination – Patients treated with Reo Therapy have exhibited improvements in active range of motion (ROM) and in overall coordination of arm movements.
      • Improved gait – Patients whose gait was affected by their inability to properly move their upper extremities showed a marked improvement in gait following therapy sessions.
      • Functional gains – Therapists reported that following Therapy sessions, subsequent components of their patients ’ therapy session were more productive, an improvement they attributed to the affects of robotic therapies.
      • ENHANCED LEARNING TO IMPROVE REHABILITATION
      • 3.1 Task Type [ the task to be accomplished sets the tone for the system’s design and use]
      • 3.2 Task Criticality [ high , medium and low .]
      • 3.3 Robot Morphology [ Robots can take many physical forms.]
      • 3.4 Ratio of People to Robots [ The ratio of people to robots directly affects the
      • human-robot interaction in a system. This taxonomy classification does not measure the
      • interaction between the operators and the robots, simply the numbers of each.
      • Robotics – taxonomy:
        • EXTRAMURAL, EXTERNAL and NON-SENSOR, NON-STIMULATION - situated or occurring outside the wall of an organ or structure.
          • Toyota
          • Armeo
          • REO/MOTORIKA
          • InteractiveMotion
        • EXTRADURAL, SENSOR , HUMAN STIMULATION -outside the dura mater enveloping the spinal cord
          • MYOMO
          • ReWalk
        • EPIDURAL- , SENSOR, ROBOT STIMULATION -   an agent into the epidural space of the spinal canal
      • CalTech
      • purpose/function of Robotics:
      • ENHANCED LEARNING TO IMPROVE REHABILITATION –
        • Brain-to-Body Connectivity = Functional gains
        • Stroke rehabilitation by muscle/brain re-education
        • Maintain or increase range of motion
        • I chose InMotion as my initial therapeutic device to
      • effectively improve shoulder [scapula movement] range of motion, and
      • gain mental stimulation through visual activities, which
      • enhance brain-to-body re-education
        • The Myomo device combines several treatment modalities into one device , and
        • can cost effectively improve range of motion,
        • enhance brain-to-body re-education through practical Clinical Progression process
        • be used as a therapeutic tool for improved motor function,
        • and be effective as an assistive device
      • Rehabilitation with highly repetitive training for severely affected patients.
      • • Improved therapy efficiency and patient care. • An extensive 3D workspace. OR
      • • Guided therapeutic programs • Augmented Feedback with motivating exercises to train activities of daily living. • Assist-as-needed support provided by the robotic arm exoskeleton that automatically adapts to the patients’ capabilities.
      • • Clinical research shows that patients suffering from neuromuscular dysfunction show better results when performing repetitive, intense, functionally based retraining, as part of their physical therapy program. • Objective analysis and documentation of the patient’s progress.
      • November 8, 2011
      • Eiichi Saito/Bloomberg/Getty Images
      • Toyota Shows Machines to Help Sick, Elderly Move
      • By YURI KAGEYAMA AP Business Writer November 2, 2011
      • Toyota unveiled its ambitions for high-tech health care Tuesday, displaying experimental robots that the auto giant says can lift disabled patients from their hospital beds or help them walk.
      • The company aims to commercialize products such as its "independent walk assist" device sometime after 2013 — seeking to position itself in an industry with great potential in Japan, one of the world's most rapidly aging nations.
      • Eiichi Saitoh, a professor in rehabilitation medicine, demonstrated the "walk assist" device on Tuesday, strapping the computerized metallic brace onto his right leg, which was paralyzed by polio.
      • He showed reporters at a Toyota facility in Tokyo how the brace could bend at the knee as needed, allowing him to walk more naturally and rise from a chair with greater ease than the walker he now uses. Wearing a backpack-like battery, Saitoh walked up and down a flight of stairs, smiling with delight.
      • Saitoh said he had tried Toyota's machines with patients and was confident they helped people recover more quickly from strokes and other ailments that curtailed movement.
      • "It may be difficult to predict the future, but the era of an aging society is definitely coming," he said. "We need partner robots to enrich our lives."
      • Toyota also demonstrated an intelligent machine with padded arms that can help health care workers lift disabled patients from their beds and then carry them around. Another mobility aid worked like a skateboard to help people relearn balance.
      • Toyota officials said technology for autos such as sensors, motors and computer software are being used in such computerized gadgets to help people get around, and what they learn about mobility for people will likely be of use in future cars.
      • Prices and overseas sales plans of all the machines are still undecided, according to Toyota.
      • General Manager Akifumi Tamaoki said more tests were needed on more people to insure safety and reliability, and gain user feedback, but the commercial products in the works were going to be smaller and lighter than the prototype versions shown.
      • "We define gentle and smart machines as partner robots," he said.
      • Toyota has previously shown human-shaped robots that played the trumpet and violin, and those that move around and talk about Toyota cars at showrooms.
      • Rival Japanese automaker Honda Motor Co. has developed a sophisticated humanoid robot called Asimo, which can run, talk and dance. But Asimo has been limited to showrooms and labs and has yet to enter any hospital or home.
      • Toyota faces competition from other manufacturers that are all working on gadgets to tap into the health care business. Honda also has demonstrated machines worn on the legs that help people move, as have some universities.
      • Hirohisa Hirukawa, a robot exert at the government-backed National Institute of Advanced Industrial Science and Technology, said more time would be needed to see the full busineses potential of the Toyota machines but was upbeat.
      • "I feel that the walk-assist device has real potential to sell to consumers," he said in an email.
      • Tamaoki said Toyota is keeping its offerings simple, compared to those from Honda, so they can enter everyday life easily.
      • ———
      • Follow Yuri Kageyama on Twitter at http://twitter.com/yurikageyama
    • ReWalk CSUN 11/21 6 pm Brain Plasticity and Rehabilitation Robotic Therapies. CSUN COA/Brown Center VISUALIZATION OF BODY PARTS Think of your favorite food – Close your eyes and smell the food. Is everybody hungry now? Now Think of your favorite food as a child – close eyes and smell the food. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it already? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? CONNECTING YOUR BRAIN TO A BODY PART. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? Now think of a rubber straw or clear flexible rubber tube - and CONNECT it to your brain where your toe feeling was. CONNECT the other end of the straw to your toe. Look through the straw and look at your toe. A stroke or other TBI can break the connection, or prevent this visualization. ENHANCED LEARNING TO IMPROVE REHABILITATION VIRTUAL REALITY Virtual reality (VR) is a term that applies to computer-simulated environments that can simulate physical presence in places in the real world, as well as in imaginary worlds. Most current virtual reality environments are primarily visual experiences, displayed either on a computer screen or through special stereoscopic displays, but some simulations include additional sensory information, such as sound through speakers or headphones. Some advanced, haptic systems now include tactile information, generally known as force feedback, in these applications. ----------------------------------------------------------- Enhanced Learning to Improve Rehabilitation Specific interventions may stimulate new neural connections, enhance cortical reorganization, and promote lasting neural networks for improved motor responses Boyd,L.A., Vidoni, E.D., Daly, J.J. (2007). Answering the call: the influence of neuroimagining and electrophysiological evidence on rehabilitation. Journal of the American Physical Therapy Association, 87(6), 684-703. BRAIN PLASTICITY Destroyed brain cells that control them or the bundles of nerve fibers that come out of them. The recovery of language is highly variable and can occur over years. Also amenable to rehabilitation are abstract thought, memory and emotion. On 8 March 1969, an extraordinary experiment was reported in the pages of Nature, Europe's leading science journal. It involved a group of people who took turns to sit in an old dentist's chair and describe the room around them. They commented on the presence of a phone on the table, a nearby vase, people's expressions and how they wore their hair. It was remarkable because all were completely blind. The scientific establishment took a dim view of the work and, for the most part, dismissed it as implausible. But today it stands as one of the first, and most striking, demonstrations of neuroplasticity, the brain's ability to adapt. The blind people had learned to "see" through the sensation of touch. Here's what happened. The back of the chair had been fitted with hundreds of tiny stimulators that were hooked up to a video camera. As the camera panned the room, those in the chair felt tiny vibrations that seemed to dance across their skin as the image moved. With practice, the blind volunteers' brains learned to turn these vibrations into a mental picture of the room. Some became so good at it that they ducked when a ball was tossed at the camera. What was regarded as fringe science 40 years ago is currently at the cutting edge of neuroscience. With the right training, scientists now know the brain can reshape itself to work around dead and damaged areas, often with dramatic benefits. Therapies that exploit the brain's power to adapt have helped people overcome damage caused by strokes, depression, anxiety and learning disabilities, and may one day replace drugs for some of these conditions. Some studies suggest therapies that tap into the brain's neuroplasticity are already making a big difference. Children with language difficulties have been shown to make significant progress using computer training tools that are the equivalent of cerebral cross-training. Work is underway to investigate whether it is possible to stave off a loss of brain plasticity in older age, which might help to address memory problems linked to Alzheimer's disease. Some psychoanalysts are adopting techniques to help people overcome relationship troubles, obsessions, worries and bad habits. ENHANCED LEARNING TO IMPROVE REHABILITATION Dr. Hermano Krebs - looking at the IMT Powerpoint presentation, particularly related to the interaction of the brain vision processing areas "seeing" the resulting action and tieing it to the feeling of the muscles performing the action, seem to greatly improve the   imprint on the brain with the involved processes.   From my own experiences, getting more than a two-dimensional screen view, seems that it would greatly enhance the learning, and resultant rehabilitation.   Have you considered VR-type interfaces, such that it appears to my brain that I am reaching "into" a scenario, or that " I'm picking up an object" - feeling and seeing the interaction
      • CONNECTING YOUR BRAIN TO A BODY PART.
      • BRIEF RESEARCH INTO STROKE REHABILITATION THERAPIES
      • After my first robot [arm & shoulder exercise [a demonstration session – I was able to raise my left leg behind me].
      • Mirror-box therapy concepts.
      • I used mirror box concepts to initiate my left ankle movement [3-months post stroke].
      • Hyperbaric therapy
      • Electrical stimulus
      • TMS - Transcranial Magnetic Stimulation. TMS Therapy uses a highly focused pulsed magnetic field to stimulate nerve cells in the area of the brain thought to control certain brain functions by altering those brain structures
      • Stem Cell replacement
      • Aquatic therapy – balance, stretching, range of motion, strength
      • I have been coming to the COA for 1 ½ years – I learned to walk without a support about 3 months ago [25-months post stroke].
      • Vision Therapy - Vision therapy -- a type of physical therapy for the eyes and brain -- is a highly effective non-surgical treatment for many common visual problems such as lazy eye, crossed eyes, double vision, convergence insufficiency and some reading and learning disabilities
      • I used several different computer programs to help with resolving peripheral vision and depth perception issues [began 3-months post stroke; depth perception improved 100% after 13 months].
      • Therapeutic Goals:
      • Reduced tone – throughout the entire arm, shoulder, elbow, wrist and hand.
      • Reduced pain – Stroke patients with loss of upper extremity movement often suffer shoulder pain, which sometimes can be exacerbated by therapy.
      • Improved coordination – Patients treated with Reo Therapy have exhibited improvements in active range of motion (ROM) and in overall coordination of arm movements.
      • Improved gait – Patients whose gait was affected by their inability to properly move their upper extremities showed a marked improvement in gait following therapy sessions.
      • Functional gains – Therapists reported that following Therapy sessions, subsequent components of their patients ’ therapy session were more productive, an improvement they attributed to the affects of robotic therapies.
      • ENHANCED LEARNING TO IMPROVE REHABILITATION
      • 3.1 Task Type [ the task to be accomplished sets the tone for the system’s design and use]
      • 3.2 Task Criticality [ high , medium and low .]
      • 3.3 Robot Morphology [ Robots can take many physical forms.]
      • 3.4 Ratio of People to Robots [ The ratio of people to robots directly affects the
      • human-robot interaction in a system. This taxonomy classification does not measure the
      • interaction between the operators and the robots, simply the numbers of each.
      • Robotics – taxonomy:
        • EXTRAMURAL, EXTERNAL and NON-SENSOR, NON-STIMULATION - situated or occurring outside the wall of an organ or structure.
          • Toyota
          • Armeo
          • REO/MOTORIKA
          • InteractiveMotion
        • EXTRADURAL, SENSOR , HUMAN STIMULATION -outside the dura mater enveloping the spinal cord
          • MYOMO
          • ReWalk
        • EPIDURAL- , SENSOR, ROBOT STIMULATION -   an agent into the epidural space of the spinal canal
      • CalTech
      • purpose/function of Robotics:
      • ENHANCED LEARNING TO IMPROVE REHABILITATION –
        • Brain-to-Body Connectivity = Functional gains
        • Stroke rehabilitation by muscle/brain re-education
        • Maintain or increase range of motion
        • I chose InMotion as my initial therapeutic device to
      • effectively improve shoulder [scapula movement] range of motion, and
      • gain mental stimulation through visual activities, which
      • enhance brain-to-body re-education
        • The Myomo device combines several treatment modalities into one device , and
        • can cost effectively improve range of motion,
        • enhance brain-to-body re-education through practical Clinical Progression process
        • be used as a therapeutic tool for improved motor function,
        • and be effective as an assistive device
      • Rehabilitation with highly repetitive training for severely affected patients.
      • • Improved therapy efficiency and patient care. • An extensive 3D workspace. OR
      • • Guided therapeutic programs • Augmented Feedback with motivating exercises to train activities of daily living. • Assist-as-needed support provided by the robotic arm exoskeleton that automatically adapts to the patients’ capabilities.
      • • Clinical research shows that patients suffering from neuromuscular dysfunction show better results when performing repetitive, intense, functionally based retraining, as part of their physical therapy program. • Objective analysis and documentation of the patient’s progress.
      • November 8, 2011
    • ReWalk CSUN 11/21 6 pm Brain Plasticity and Rehabilitation Robotic Therapies. CSUN COA/Brown Center VISUALIZATION OF BODY PARTS Think of your favorite food – Close your eyes and smell the food. Is everybody hungry now? Now Think of your favorite food as a child – close eyes and smell the food. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it already? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? CONNECTING YOUR BRAIN TO A BODY PART. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? Now think of a rubber straw or clear flexible rubber tube - and CONNECT it to your brain where your toe feeling was. CONNECT the other end of the straw to your toe. Look through the straw and look at your toe. A stroke or other TBI can break the connection, or prevent this visualization. ENHANCED LEARNING TO IMPROVE REHABILITATION VIRTUAL REALITY Virtual reality (VR) is a term that applies to computer-simulated environments that can simulate physical presence in places in the real world, as well as in imaginary worlds. Most current virtual reality environments are primarily visual experiences, displayed either on a computer screen or through special stereoscopic displays, but some simulations include additional sensory information, such as sound through speakers or headphones. Some advanced, haptic systems now include tactile information, generally known as force feedback, in these applications. ----------------------------------------------------------- Enhanced Learning to Improve Rehabilitation Specific interventions may stimulate new neural connections, enhance cortical reorganization, and promote lasting neural networks for improved motor responses Boyd,L.A., Vidoni, E.D., Daly, J.J. (2007). Answering the call: the influence of neuroimagining and electrophysiological evidence on rehabilitation. Journal of the American Physical Therapy Association, 87(6), 684-703. BRAIN PLASTICITY Destroyed brain cells that control them or the bundles of nerve fibers that come out of them. The recovery of language is highly variable and can occur over years. Also amenable to rehabilitation are abstract thought, memory and emotion. On 8 March 1969, an extraordinary experiment was reported in the pages of Nature, Europe's leading science journal. It involved a group of people who took turns to sit in an old dentist's chair and describe the room around them. They commented on the presence of a phone on the table, a nearby vase, people's expressions and how they wore their hair. It was remarkable because all were completely blind. The scientific establishment took a dim view of the work and, for the most part, dismissed it as implausible. But today it stands as one of the first, and most striking, demonstrations of neuroplasticity, the brain's ability to adapt. The blind people had learned to "see" through the sensation of touch. Here's what happened. The back of the chair had been fitted with hundreds of tiny stimulators that were hooked up to a video camera. As the camera panned the room, those in the chair felt tiny vibrations that seemed to dance across their skin as the image moved. With practice, the blind volunteers' brains learned to turn these vibrations into a mental picture of the room. Some became so good at it that they ducked when a ball was tossed at the camera. What was regarded as fringe science 40 years ago is currently at the cutting edge of neuroscience. With the right training, scientists now know the brain can reshape itself to work around dead and damaged areas, often with dramatic benefits. Therapies that exploit the brain's power to adapt have helped people overcome damage caused by strokes, depression, anxiety and learning disabilities, and may one day replace drugs for some of these conditions. Some studies suggest therapies that tap into the brain's neuroplasticity are already making a big difference. Children with language difficulties have been shown to make significant progress using computer training tools that are the equivalent of cerebral cross-training. Work is underway to investigate whether it is possible to stave off a loss of brain plasticity in older age, which might help to address memory problems linked to Alzheimer's disease. Some psychoanalysts are adopting techniques to help people overcome relationship troubles, obsessions, worries and bad habits. ENHANCED LEARNING TO IMPROVE REHABILITATION Dr. Hermano Krebs - looking at the IMT Powerpoint presentation, particularly related to the interaction of the brain vision processing areas "seeing" the resulting action and tieing it to the feeling of the muscles performing the action, seem to greatly improve the   imprint on the brain with the involved processes.   From my own experiences, getting more than a two-dimensional screen view, seems that it would greatly enhance the learning, and resultant rehabilitation.   Have you considered VR-type interfaces, such that it appears to my brain that I am reaching "into" a scenario, or that " I'm picking up an object" - feeling and seeing the interaction
      • CONNECTING YOUR BRAIN TO A BODY PART.
      • BRIEF RESEARCH INTO STROKE REHABILITATION THERAPIES
      • After my first robot [arm & shoulder exercise [a demonstration session – I was able to raise my left leg behind me].
      • Mirror-box therapy concepts.
      • I used mirror box concepts to initiate my left ankle movement [3-months post stroke].
      • Hyperbaric therapy
      • Electrical stimulus
      • TMS - Transcranial Magnetic Stimulation. TMS Therapy uses a highly focused pulsed magnetic field to stimulate nerve cells in the area of the brain thought to control certain brain functions by altering those brain structures
      • Stem Cell replacement
      • Aquatic therapy – balance, stretching, range of motion, strength
      • I have been coming to the COA for 1 ½ years – I learned to walk without a support about 3 months ago [25-months post stroke].
      • Vision Therapy - Vision therapy -- a type of physical therapy for the eyes and brain -- is a highly effective non-surgical treatment for many common visual problems such as lazy eye, crossed eyes, double vision, convergence insufficiency and some reading and learning disabilities
      • I used several different computer programs to help with resolving peripheral vision and depth perception issues [began 3-months post stroke; depth perception improved 100% after 13 months].
      • Therapeutic Goals:
      • Reduced tone – throughout the entire arm, shoulder, elbow, wrist and hand.
      • Reduced pain – Stroke patients with loss of upper extremity movement often suffer shoulder pain, which sometimes can be exacerbated by therapy.
      • Improved coordination – Patients treated with Reo Therapy have exhibited improvements in active range of motion (ROM) and in overall coordination of arm movements.
      • Improved gait – Patients whose gait was affected by their inability to properly move their upper extremities showed a marked improvement in gait following therapy sessions.
      • Functional gains – Therapists reported that following Therapy sessions, subsequent components of their patients ’ therapy session were more productive, an improvement they attributed to the affects of robotic therapies.
      • ENHANCED LEARNING TO IMPROVE REHABILITATION
      • 3.1 Task Type [ the task to be accomplished sets the tone for the system’s design and use]
      • 3.2 Task Criticality [ high , medium and low .]
      • 3.3 Robot Morphology [ Robots can take many physical forms.]
      • 3.4 Ratio of People to Robots [ The ratio of people to robots directly affects the
      • human-robot interaction in a system. This taxonomy classification does not measure the
      • interaction between the operators and the robots, simply the numbers of each.
      • Robotics – taxonomy:
        • EXTRAMURAL, EXTERNAL and NON-SENSOR, NON-STIMULATION - situated or occurring outside the wall of an organ or structure.
          • Toyota
          • Armeo
          • REO/MOTORIKA
          • InteractiveMotion
        • EXTRADURAL, SENSOR , HUMAN STIMULATION -outside the dura mater enveloping the spinal cord
          • MYOMO
          • ReWalk
        • EPIDURAL- , SENSOR, ROBOT STIMULATION -   an agent into the epidural space of the spinal canal
      • CalTech
      • purpose/function of Robotics:
      • ENHANCED LEARNING TO IMPROVE REHABILITATION –
        • Brain-to-Body Connectivity = Functional gains
        • Stroke rehabilitation by muscle/brain re-education
        • Maintain or increase range of motion
        • I chose InMotion as my initial therapeutic device to
      • effectively improve shoulder [scapula movement] range of motion, and
      • gain mental stimulation through visual activities, which
      • enhance brain-to-body re-education
        • The Myomo device combines several treatment modalities into one device , and
        • can cost effectively improve range of motion,
        • enhance brain-to-body re-education through practical Clinical Progression process
        • be used as a therapeutic tool for improved motor function,
        • and be effective as an assistive device
      • Rehabilitation with highly repetitive training for severely affected patients.
      • • Improved therapy efficiency and patient care. • An extensive 3D workspace. OR
      • • Guided therapeutic programs • Augmented Feedback with motivating exercises to train activities of daily living. • Assist-as-needed support provided by the robotic arm exoskeleton that automatically adapts to the patients’ capabilities.
      • • Clinical research shows that patients suffering from neuromuscular dysfunction show better results when performing repetitive, intense, functionally based retraining, as part of their physical therapy program. • Objective analysis and documentation of the patient’s progress.
      • November 8, 2011
    • MYOMO CSUN 11/21 6 pm Brain Plasticity and Rehabilitation Robotic Therapies. CSUN COA/Brown Center VISUALIZATION OF BODY PARTS Think of your favorite food – Close your eyes and smell the food. Is everybody hungry now? Now Think of your favorite food as a child – close eyes and smell the food. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it already? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? CONNECTING YOUR BRAIN TO A BODY PART. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? Now think of a rubber straw or clear flexible rubber tube - and CONNECT it to your brain where your toe feeling was. CONNECT the other end of the straw to your toe. Look through the straw and look at your toe. A stroke or other TBI can break the connection, or prevent this visualization. ENHANCED LEARNING TO IMPROVE REHABILITATION VIRTUAL REALITY Virtual reality (VR) is a term that applies to computer-simulated environments that can simulate physical presence in places in the real world, as well as in imaginary worlds. Most current virtual reality environments are primarily visual experiences, displayed either on a computer screen or through special stereoscopic displays, but some simulations include additional sensory information, such as sound through speakers or headphones. Some advanced, haptic systems now include tactile information, generally known as force feedback, in these applications. ----------------------------------------------------------- Enhanced Learning to Improve Rehabilitation Specific interventions may stimulate new neural connections, enhance cortical reorganization, and promote lasting neural networks for improved motor responses Boyd,L.A., Vidoni, E.D., Daly, J.J. (2007). Answering the call: the influence of neuroimagining and electrophysiological evidence on rehabilitation. Journal of the American Physical Therapy Association, 87(6), 684-703. BRAIN PLASTICITY Destroyed brain cells that control them or the bundles of nerve fibers that come out of them. The recovery of language is highly variable and can occur over years. Also amenable to rehabilitation are abstract thought, memory and emotion. On 8 March 1969, an extraordinary experiment was reported in the pages of Nature, Europe's leading science journal. It involved a group of people who took turns to sit in an old dentist's chair and describe the room around them. They commented on the presence of a phone on the table, a nearby vase, people's expressions and how they wore their hair. It was remarkable because all were completely blind. The scientific establishment took a dim view of the work and, for the most part, dismissed it as implausible. But today it stands as one of the first, and most striking, demonstrations of neuroplasticity, the brain's ability to adapt. The blind people had learned to "see" through the sensation of touch. Here's what happened. The back of the chair had been fitted with hundreds of tiny stimulators that were hooked up to a video camera. As the camera panned the room, those in the chair felt tiny vibrations that seemed to dance across their skin as the image moved. With practice, the blind volunteers' brains learned to turn these vibrations into a mental picture of the room. Some became so good at it that they ducked when a ball was tossed at the camera. What was regarded as fringe science 40 years ago is currently at the cutting edge of neuroscience. With the right training, scientists now know the brain can reshape itself to work around dead and damaged areas, often with dramatic benefits. Therapies that exploit the brain's power to adapt have helped people overcome damage caused by strokes, depression, anxiety and learning disabilities, and may one day replace drugs for some of these conditions. Some studies suggest therapies that tap into the brain's neuroplasticity are already making a big difference. Children with language difficulties have been shown to make significant progress using computer training tools that are the equivalent of cerebral cross-training. Work is underway to investigate whether it is possible to stave off a loss of brain plasticity in older age, which might help to address memory problems linked to Alzheimer's disease. Some psychoanalysts are adopting techniques to help people overcome relationship troubles, obsessions, worries and bad habits. ENHANCED LEARNING TO IMPROVE REHABILITATION Dr. Hermano Krebs - looking at the IMT Powerpoint presentation, particularly related to the interaction of the brain vision processing areas "seeing" the resulting action and tieing it to the feeling of the muscles performing the action, seem to greatly improve the   imprint on the brain with the involved processes.   From my own experiences, getting more than a two-dimensional screen view, seems that it would greatly enhance the learning, and resultant rehabilitation.   Have you considered VR-type interfaces, such that it appears to my brain that I am reaching "into" a scenario, or that " I'm picking up an object" - feeling and seeing the interaction
      • CONNECTING YOUR BRAIN TO A BODY PART.
      • BRIEF RESEARCH INTO STROKE REHABILITATION THERAPIES
      • After my first robot [arm & shoulder exercise [a demonstration session – I was able to raise my left leg behind me].
      • Mirror-box therapy concepts.
      • I used mirror box concepts to initiate my left ankle movement [3-months post stroke].
      • Hyperbaric therapy
      • Electrical stimulus
      • TMS - Transcranial Magnetic Stimulation. TMS Therapy uses a highly focused pulsed magnetic field to stimulate nerve cells in the area of the brain thought to control certain brain functions by altering those brain structures
      • Stem Cell replacement
      • Aquatic therapy – balance, stretching, range of motion, strength
      • I have been coming to the COA for 1 ½ years – I learned to walk without a support about 3 months ago [25-months post stroke].
      • Vision Therapy - Vision therapy -- a type of physical therapy for the eyes and brain -- is a highly effective non-surgical treatment for many common visual problems such as lazy eye, crossed eyes, double vision, convergence insufficiency and some reading and learning disabilities
      • I used several different computer programs to help with resolving peripheral vision and depth perception issues [began 3-months post stroke; depth perception improved 100% after 13 months].
      • Therapeutic Goals:
      • Reduced tone – throughout the entire arm, shoulder, elbow, wrist and hand.
      • Reduced pain – Stroke patients with loss of upper extremity movement often suffer shoulder pain, which sometimes can be exacerbated by therapy.
      • Improved coordination – Patients treated with Reo Therapy have exhibited improvements in active range of motion (ROM) and in overall coordination of arm movements.
      • Improved gait – Patients whose gait was affected by their inability to properly move their upper extremities showed a marked improvement in gait following therapy sessions.
      • Functional gains – Therapists reported that following Therapy sessions, subsequent components of their patients ’ therapy session were more productive, an improvement they attributed to the affects of robotic therapies.
      • ENHANCED LEARNING TO IMPROVE REHABILITATION
      • 3.1 Task Type [ the task to be accomplished sets the tone for the system’s design and use]
      • 3.2 Task Criticality [ high , medium and low .]
      • 3.3 Robot Morphology [ Robots can take many physical forms.]
      • 3.4 Ratio of People to Robots [ The ratio of people to robots directly affects the
      • human-robot interaction in a system. This taxonomy classification does not measure the
      • interaction between the operators and the robots, simply the numbers of each.
      • Robotics – taxonomy:
        • EXTRAMURAL, EXTERNAL and NON-SENSOR, NON-STIMULATION - situated or occurring outside the wall of an organ or structure.
          • Toyota
          • Armeo
          • REO/MOTORIKA
          • InteractiveMotion
        • EXTRADURAL, SENSOR , HUMAN STIMULATION -outside the dura mater enveloping the spinal cord
          • MYOMO
          • ReWalk
        • EPIDURAL- , SENSOR, ROBOT STIMULATION -   an agent into the epidural space of the spinal canal
      • CalTech
      • purpose/function of Robotics:
      • ENHANCED LEARNING TO IMPROVE REHABILITATION –
        • Brain-to-Body Connectivity = Functional gains
        • Stroke rehabilitation by muscle/brain re-education
        • Maintain or increase range of motion
        • I chose InMotion as my initial therapeutic device to
      • effectively improve shoulder [scapula movement] range of motion, and
      • gain mental stimulation through visual activities, which
      • enhance brain-to-body re-education
        • The Myomo device combines several treatment modalities into one device , and
        • can cost effectively improve range of motion,
        • enhance brain-to-body re-education through practical Clinical Progression process
        • be used as a therapeutic tool for improved motor function,
        • and be effective as an assistive device
      • Rehabilitation with highly repetitive training for severely affected patients.
      • • Improved therapy efficiency and patient care. • An extensive 3D workspace. OR
      • • Guided therapeutic programs • Augmented Feedback with motivating exercises to train activities of daily living. • Assist-as-needed support provided by the robotic arm exoskeleton that automatically adapts to the patients’ capabilities.
      • • Clinical research shows that patients suffering from neuromuscular dysfunction show better results when performing repetitive, intense, functionally based retraining, as part of their physical therapy program. • Objective analysis and documentation of the patient’s progress.
      • November 8, 2011
      myomo Mobility System -- mPower 1000
    • CalTech CSUN 11/21 6 pm Brain Plasticity and Rehabilitation Robotic Therapies. CSUN COA/Brown Center VISUALIZATION OF BODY PARTS Think of your favorite food – Close your eyes and smell the food. Is everybody hungry now? Now Think of your favorite food as a child – close eyes and smell the food. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it already? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? CONNECTING YOUR BRAIN TO A BODY PART. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? Now think of a rubber straw or clear flexible rubber tube - and CONNECT it to your brain where your toe feeling was. CONNECT the other end of the straw to your toe. Look through the straw and look at your toe. A stroke or other TBI can break the connection, or prevent this visualization. ENHANCED LEARNING TO IMPROVE REHABILITATION VIRTUAL REALITY Virtual reality (VR) is a term that applies to computer-simulated environments that can simulate physical presence in places in the real world, as well as in imaginary worlds. Most current virtual reality environments are primarily visual experiences, displayed either on a computer screen or through special stereoscopic displays, but some simulations include additional sensory information, such as sound through speakers or headphones. Some advanced, haptic systems now include tactile information, generally known as force feedback, in these applications. ----------------------------------------------------------- Enhanced Learning to Improve Rehabilitation Specific interventions may stimulate new neural connections, enhance cortical reorganization, and promote lasting neural networks for improved motor responses Boyd,L.A., Vidoni, E.D., Daly, J.J. (2007). Answering the call: the influence of neuroimagining and electrophysiological evidence on rehabilitation. Journal of the American Physical Therapy Association, 87(6), 684-703. BRAIN PLASTICITY Destroyed brain cells that control them or the bundles of nerve fibers that come out of them. The recovery of language is highly variable and can occur over years. Also amenable to rehabilitation are abstract thought, memory and emotion. On 8 March 1969, an extraordinary experiment was reported in the pages of Nature, Europe's leading science journal. It involved a group of people who took turns to sit in an old dentist's chair and describe the room around them. They commented on the presence of a phone on the table, a nearby vase, people's expressions and how they wore their hair. It was remarkable because all were completely blind. The scientific establishment took a dim view of the work and, for the most part, dismissed it as implausible. But today it stands as one of the first, and most striking, demonstrations of neuroplasticity, the brain's ability to adapt. The blind people had learned to "see" through the sensation of touch. Here's what happened. The back of the chair had been fitted with hundreds of tiny stimulators that were hooked up to a video camera. As the camera panned the room, those in the chair felt tiny vibrations that seemed to dance across their skin as the image moved. With practice, the blind volunteers' brains learned to turn these vibrations into a mental picture of the room. Some became so good at it that they ducked when a ball was tossed at the camera. What was regarded as fringe science 40 years ago is currently at the cutting edge of neuroscience. With the right training, scientists now know the brain can reshape itself to work around dead and damaged areas, often with dramatic benefits. Therapies that exploit the brain's power to adapt have helped people overcome damage caused by strokes, depression, anxiety and learning disabilities, and may one day replace drugs for some of these conditions. Some studies suggest therapies that tap into the brain's neuroplasticity are already making a big difference. Children with language difficulties have been shown to make significant progress using computer training tools that are the equivalent of cerebral cross-training. Work is underway to investigate whether it is possible to stave off a loss of brain plasticity in older age, which might help to address memory problems linked to Alzheimer's disease. Some psychoanalysts are adopting techniques to help people overcome relationship troubles, obsessions, worries and bad habits. ENHANCED LEARNING TO IMPROVE REHABILITATION Dr. Hermano Krebs - looking at the IMT Powerpoint presentation, particularly related to the interaction of the brain vision processing areas "seeing" the resulting action and tieing it to the feeling of the muscles performing the action, seem to greatly improve the   imprint on the brain with the involved processes.   From my own experiences, getting more than a two-dimensional screen view, seems that it would greatly enhance the learning, and resultant rehabilitation.   Have you considered VR-type interfaces, such that it appears to my brain that I am reaching "into" a scenario, or that " I'm picking up an object" - feeling and seeing the interaction
      • CONNECTING YOUR BRAIN TO A BODY PART.
      • BRIEF RESEARCH INTO STROKE REHABILITATION THERAPIES
      • After my first robot [arm & shoulder exercise [a demonstration session – I was able to raise my left leg behind me].
      • Mirror-box therapy concepts.
      • I used mirror box concepts to initiate my left ankle movement [3-months post stroke].
      • Hyperbaric therapy
      • Electrical stimulus
      • TMS - Transcranial Magnetic Stimulation. TMS Therapy uses a highly focused pulsed magnetic field to stimulate nerve cells in the area of the brain thought to control certain brain functions by altering those brain structures
      • Stem Cell replacement
      • Aquatic therapy – balance, stretching, range of motion, strength
      • I have been coming to the COA for 1 ½ years – I learned to walk without a support about 3 months ago [25-months post stroke].
      • Vision Therapy - Vision therapy -- a type of physical therapy for the eyes and brain -- is a highly effective non-surgical treatment for many common visual problems such as lazy eye, crossed eyes, double vision, convergence insufficiency and some reading and learning disabilities
      • I used several different computer programs to help with resolving peripheral vision and depth perception issues [began 3-months post stroke; depth perception improved 100% after 13 months].
      • Therapeutic Goals:
      • Reduced tone – throughout the entire arm, shoulder, elbow, wrist and hand.
      • Reduced pain – Stroke patients with loss of upper extremity movement often suffer shoulder pain, which sometimes can be exacerbated by therapy.
      • Improved coordination – Patients treated with Reo Therapy have exhibited improvements in active range of motion (ROM) and in overall coordination of arm movements.
      • Improved gait – Patients whose gait was affected by their inability to properly move their upper extremities showed a marked improvement in gait following therapy sessions.
      • Functional gains – Therapists reported that following Therapy sessions, subsequent components of their patients ’ therapy session were more productive, an improvement they attributed to the affects of robotic therapies.
      • ENHANCED LEARNING TO IMPROVE REHABILITATION
      • 3.1 Task Type [ the task to be accomplished sets the tone for the system’s design and use]
      • 3.2 Task Criticality [ high , medium and low .]
      • 3.3 Robot Morphology [ Robots can take many physical forms.]
      • 3.4 Ratio of People to Robots [ The ratio of people to robots directly affects the
      • human-robot interaction in a system. This taxonomy classification does not measure the
      • interaction between the operators and the robots, simply the numbers of each.
      • Robotics – taxonomy:
        • EXTRAMURAL, EXTERNAL and NON-SENSOR, NON-STIMULATION - situated or occurring outside the wall of an organ or structure.
          • Toyota
          • Armeo
          • REO/MOTORIKA
          • InteractiveMotion
        • EXTRADURAL, SENSOR , HUMAN STIMULATION -outside the dura mater enveloping the spinal cord
          • MYOMO
          • ReWalk
        • EPIDURAL- , SENSOR, ROBOT STIMULATION -   an agent into the epidural space of the spinal canal
      • CalTech
      • purpose/function of Robotics:
      • ENHANCED LEARNING TO IMPROVE REHABILITATION –
        • Brain-to-Body Connectivity = Functional gains
        • Stroke rehabilitation by muscle/brain re-education
        • Maintain or increase range of motion
        • I chose InMotion as my initial therapeutic device to
      • effectively improve shoulder [scapula movement] range of motion, and
      • gain mental stimulation through visual activities, which
      • enhance brain-to-body re-education
        • The Myomo device combines several treatment modalities into one device , and
        • can cost effectively improve range of motion,
        • enhance brain-to-body re-education through practical Clinical Progression process
        • be used as a therapeutic tool for improved motor function,
        • and be effective as an assistive device
      • Rehabilitation with highly repetitive training for severely affected patients.
      • • Improved therapy efficiency and patient care. • An extensive 3D workspace. OR
      • • Guided therapeutic programs • Augmented Feedback with motivating exercises to train activities of daily living. • Assist-as-needed support provided by the robotic arm exoskeleton that automatically adapts to the patients’ capabilities.
      • • Clinical research shows that patients suffering from neuromuscular dysfunction show better results when performing repetitive, intense, functionally based retraining, as part of their physical therapy program. • Objective analysis and documentation of the patient’s progress.
      • November 8, 2011
    • FUTURE OF REHABILITATION ROBOTS CSUN 11/21 6 pm Brain Plasticity and Rehabilitation Robotic Therapies. CSUN COA/Brown Center VISUALIZATION OF BODY PARTS Think of your favorite food – Close your eyes and smell the food. Is everybody hungry now? Now Think of your favorite food as a child – close eyes and smell the food. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it already? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? CONNECTING YOUR BRAIN TO A BODY PART. Next, I ’ m going to mention a part of your body – do not think of it. Do not wiggle or move it – until I tell you to do so. Now, think of your left foot, your big toe – Raise your hand if you wiggled it? Visualize how it feels – inside your toe. Where in your brain do you feel or see your toe? Now think of a rubber straw or clear flexible rubber tube - and CONNECT it to your brain where your toe feeling was. CONNECT the other end of the straw to your toe. Look through the straw and look at your toe. A stroke or other TBI can break the connection, or prevent this visualization. ENHANCED LEARNING TO IMPROVE REHABILITATION VIRTUAL REALITY Virtual reality (VR) is a term that applies to computer-simulated environments that can simulate physical presence in places in the real world, as well as in imaginary worlds. Most current virtual reality environments are primarily visual experiences, displayed either on a computer screen or through special stereoscopic displays, but some simulations include additional sensory information, such as sound through speakers or headphones. Some advanced, haptic systems now include tactile information, generally known as force feedback, in these applications. ----------------------------------------------------------- Enhanced Learning to Improve Rehabilitation Specific interventions may stimulate new neural connections, enhance cortical reorganization, and promote lasting neural networks for improved motor responses Boyd,L.A., Vidoni, E.D., Daly, J.J. (2007). Answering the call: the influence of neuroimagining and electrophysiological evidence on rehabilitation. Journal of the American Physical Therapy Association, 87(6), 684-703. BRAIN PLASTICITY Destroyed brain cells that control them or the bundles of nerve fibers that come out of them. The recovery of language is highly variable and can occur over years. Also amenable to rehabilitation are abstract thought, memory and emotion. On 8 March 1969, an extraordinary experiment was reported in the pages of Nature, Europe's leading science journal. It involved a group of people who took turns to sit in an old dentist's chair and describe the room around them. They commented on the presence of a phone on the table, a nearby vase, people's expressions and how they wore their hair. It was remarkable because all were completely blind. The scientific establishment took a dim view of the work and, for the most part, dismissed it as implausible. But today it stands as one of the first, and most striking, demonstrations of neuroplasticity, the brain's ability to adapt. The blind people had learned to "see" through the sensation of touch. Here's what happened. The back of the chair had been fitted with hundreds of tiny stimulators that were hooked up to a video camera. As the camera panned the room, those in the chair felt tiny vibrations that seemed to dance across their skin as the image moved. With practice, the blind volunteers' brains learned to turn these vibrations into a mental picture of the room. Some became so good at it that they ducked when a ball was tossed at the camera. What was regarded as fringe science 40 years ago is currently at the cutting edge of neuroscience. With the right training, scientists now know the brain can reshape itself to work around dead and damaged areas, often with dramatic benefits. Therapies that exploit the brain's power to adapt have helped people overcome damage caused by strokes, depression, anxiety and learning disabilities, and may one day replace drugs for some of these conditions. Some studies suggest therapies that tap into the brain's neuroplasticity are already making a big difference. Children with language difficulties have been shown to make significant progress using computer training tools that are the equivalent of cerebral cross-training. Work is underway to investigate whether it is possible to stave off a loss of brain plasticity in older age, which might help to address memory problems linked to Alzheimer's disease. Some psychoanalysts are adopting techniques to help people overcome relationship troubles, obsessions, worries and bad habits. ENHANCED LEARNING TO IMPROVE REHABILITATION Dr. Hermano Krebs - looking at the IMT Powerpoint presentation, particularly related to the interaction of the brain vision processing areas "seeing" the resulting action and tieing it to the feeling of the muscles performing the action, seem to greatly improve the   imprint on the brain with the involved processes.   From my own experiences, getting more than a two-dimensional screen view, seems that it would greatly enhance the learning, and resultant rehabilitation.   Have you considered VR-type interfaces, such that it appears to my brain that I am reaching "into" a scenario, or that " I'm picking up an object" - feeling and seeing the interaction
      • CONNECTING YOUR BRAIN TO A BODY PART.
      • BRIEF RESEARCH INTO STROKE REHABILITATION THERAPIES
      • After my first robot [arm & shoulder exercise [a demonstration session – I was able to raise my left leg behind me].
      • Mirror-box therapy concepts.
      • I used mirror box concepts to initiate my left ankle movement [3-months post stroke].
      • Hyperbaric therapy
      • Electrical stimulus
      • TMS - Transcranial Magnetic Stimulation. TMS Therapy uses a highly focused pulsed magnetic field to stimulate nerve cells in the area of the brain thought to control certain brain functions by altering those brain structures
      • Stem Cell replacement
      • Aquatic therapy – balance, stretching, range of motion, strength
      • I have been coming to the COA for 1 ½ years – I learned to walk without a support about 3 months ago [25-months post stroke].
      • Vision Therapy - Vision therapy -- a type of physical therapy for the eyes and brain -- is a highly effective non-surgical treatment for many common visual problems such as lazy eye, crossed eyes, double vision, convergence insufficiency and some reading and learning disabilities
      • I used several different computer programs to help with resolving peripheral vision and depth perception issues [began 3-months post stroke; depth perception improved 100% after 13 months].
      • Therapeutic Goals:
      • Reduced tone – throughout the entire arm, shoulder, elbow, wrist and hand.
      • Reduced pain – Stroke patients with loss of upper extremity movement often suffer shoulder pain, which sometimes can be exacerbated by therapy.
      • Improved coordination – Patients treated with Reo Therapy have exhibited improvements in active range of motion (ROM) and in overall coordination of arm movements.
      • Improved gait – Patients whose gait was affected by their inability to properly move their upper extremities showed a marked improvement in gait following therapy sessions.
      • Functional gains – Therapists reported that following Therapy sessions, subsequent components of their patients ’ therapy session were more productive, an improvement they attributed to the affects of robotic therapies.
      • ENHANCED LEARNING TO IMPROVE REHABILITATION
      • 3.1 Task Type [ the task to be accomplished sets the tone for the system’s design and use]
      • 3.2 Task Criticality [ high , medium and low .]
      • 3.3 Robot Morphology [ Robots can take many physical forms.]
      • 3.4 Ratio of People to Robots [ The ratio of people to robots directly affects the
      • human-robot interaction in a system. This taxonomy classification does not measure the
      • interaction between the operators and the robots, simply the numbers of each.
      • Robotics – taxonomy:
        • EXTRAMURAL, EXTERNAL and NON-SENSOR, NON-STIMULATION - situated or occurring outside the wall of an organ or structure.
          • Toyota
          • Armeo
          • REO/MOTORIKA
          • InteractiveMotion
        • EXTRADURAL, SENSOR , HUMAN STIMULATION -outside the dura mater enveloping the spinal cord
          • MYOMO
          • ReWalk
        • EPIDURAL- , SENSOR, ROBOT STIMULATION -   an agent into the epidural space of the spinal canal
      • CalTech
      • purpose/function of Robotics:
      • ENHANCED LEARNING TO IMPROVE REHABILITATION –
        • Brain-to-Body Connectivity = Functional gains
        • Stroke rehabilitation by muscle/brain re-education
        • Maintain or increase range of motion
        • I chose InMotion as my initial therapeutic device to
      • effectively improve shoulder [scapula movement] range of motion, and
      • gain mental stimulation through visual activities, which
      • enhance brain-to-body re-education
        • The Myomo device combines several treatment modalities into one device , and
        • can cost effectively improve range of motion,
        • enhance brain-to-body re-education through practical Clinical Progression process
        • be used as a therapeutic tool for improved motor function,
        • and be effective as an assistive device
      • Rehabilitation with highly repetitive training for severely affected patients.
      • • Improved therapy efficiency and patient care. • An extensive 3D workspace. OR
      • • Guided therapeutic programs • Augmented Feedback with motivating exercises to train activities of daily living. • Assist-as-needed support provided by the robotic arm exoskeleton that automatically adapts to the patients’ capabilities.
      • • Clinical research shows that patients suffering from neuromuscular dysfunction show better results when performing repetitive, intense, functionally based retraining, as part of their physical therapy program. • Objective analysis and documentation of the patient’s progress.
      • November 8, 2011
      WRIST / HAND and FINGER robots InMOTION – wrist and hand robot MYOMO – 3-year NIH research study InMOTION – 5-year NIH research study Howard – hand robot KNEE robot InMOTION – “KNEE-bot”
    • Citations NOTE: Citations hidden behind every page. Functional Localization In The Human Brain Brett_etal 2002 http://www.ece.uvic.ca/~bctill/papers/learning/Brett_etal_2002.pdf Boyd,L.A., Vidoni, E.D., Daly, J.J. (2007). Answering the call: the influence of neuroimagining and electrophysiological evidence on rehabilitation. Journal of the American Physical Therapy Association, 87(6), 684-703. Jaeger, R.J. (2006) Rehabilitation robotics research of the National Institute on Disability and Rehabilitation research. Journal of Rehabilitation Research and Development , 43[Editorial], xx Stable Hebbian Learning from Spike Timing-Dependent Plasticity M. C. W. van Rossum1, G. Q. Bi2, and G. G. Turrigiano1 The Journal Of Neuroscience http://neuro.cjb.net/content/20/23/8812.short The University of Southern California Institute for Creative Technologies [revolutionizing learning through the development of interactive digital media] http:// ict.usc.edu / Shumway-Cook A.Woolacott, M.H. (2001) Motor Control and Practical Applications 2nd edition, Baltimore: Lippincott Williams & Williams ClassifyingHuman-RobotInteraction.pdf [ATTACHED] Human-Robot Interaction An Updated Taxonomy.doc ( A Simplified Taxonomy of Command and Control Structures for Robot Teams) [ATTACHED] Nature, 8 March 1969 .
    • Citations NOTE: Citations hidden behind every page. Toyota Toyota Shows Machines to Help Sick, Elderly Move By YURI KAGEYAMA AP Business Writer November 2, 2011 Follow Yuri Kageyama on Twitter at http:// twitter.com/yurikageyama Armeo http://vimeo.com/couchmode/hocoma/videos/sort:newest/26050709 REO/MOTORIKA http:// www.motorika.com/?categoryId =65709 http:// www.motorika.com/?categoryId =66291 InteractiveMotion http://interactive- motion.com / Rehabilitation Robotics | Interactive Motion Technologies Robotic rehabilitation for stroke and other neurological conditions. ... In Motion Robot's featured in the National Stroke Association video : Brain Attack ... interactive- motion .com/news.htm ReWalk http:// www.argomedtec.com/products.asp Rupert http://www.ncbi.nlm.nih.gov/pubmed/17281846 Neural Systems and Rehabilitation Engineering, IEEE Transactions Issue Date: Sept. 2007, Volume: 15 Issue:3 , page(s): 336 - 346 MYOMO http:// www.myomo.com / Howard http://www.technovelgy.com/ct/Science-Fiction-News.asp?NewsNum =937 CalTech  http://thesis.library.caltech.edu/3666/ http:// robotics.caltech.edu/wiki/index.php/Main_Page
    • Attachments
      • DK personal comments identified in dark red color with [DK]
      • ATTACHMENTS:
      • ClassifyingHuman-RobotInteraction.pdf
      • Human-Robot Interaction An Updated Taxonomy.doc ( A Simplified Taxonomy of Command and Control Structures for Robot
      • Teams)
      • ClassifyingHuman-RobotInteraction.pdf
      • Definition of Spasticity vs Recruitment.doc
          • Toyota
          • Armeo
          • REO/MOTORIKA
          • InteractiveMotion
          • ReWalk
          • RUPERT
          • MYOMO
          • CalTech
    • Brain Plasticity and Rehabilitation Robotic Therapies. by DAVID KARCHEM DKARCHEM @GMAIL.COM Blog: http:// dkrehab.blogspot.com / 818-730-8756   with SEAN SORNBORGER sean@sornborger.com, [email_address]
    • Questions ? ? ?