CSUN

1. 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 /

3. 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

4. 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/

5. BRAIN PLASTICITY AND REHABILITATION Connecting Your Brain To A Body Part.

6. 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

7. 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.

8. MOTOR LEARNING

9. 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

10. NATIONAL INSTITUTE OF HEALTH Disability and Rehabilitation Model

11. 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.

12. 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.

13. 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.

14. 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].

15. 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].

16. 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.

17. 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.

20. 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.

22. 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]

23. 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]

24. ROBOTS

25. 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