Topics

Brain Computer Interface (BCI) Based Robotic Rehabilitation for Stroke

2014-08-27 03:20:09 | BioPortfolio

Summary

The trial aims to test a novel rehabilitation device for subacute stroke hemiplegic upper limbs based on state-of-the-art non invasive Brain-Computer Interface (BCI) robotic rehabilitation in a clinical setting. The investigators aim to prove the clinical efficacy and safety of BCI therapy over traditional rehabilitation methods.

Description

The proposed rehabilitation device is the first neuro-rehabilitation system which combines non-invasive BCI and robotic rehabilitation for the paralysed stroke upper extremity within 6 months of stroke.Spontaneous recovery after stroke takes place over the first 6-12 months after stroke. The first 3-6 months are the most crucial periods as this is the period of maximal neurological recovery and neuroplasticity. Differential rates of recovery occur for various types of impairments post-stroke. In general, motor functions (mobility, walking, upper limb function, activities of daily living (ADL)) recover faster than cognitive or language impairments which may recover over 12 months. A number of approaches to stroke injury rehabilitation have been introduced to facilitate intrinsic recovery or aid adaptive compensation for stroke-related impairments. Generally for rehabilitative training to be effective, it must be commenced as early as possible after stroke. Current research proves that rehabilitation using traditional neuro-facilitation approaches is effective in improving neurological and functional recovery and is superior to no treatment or nursing care alone. Rehabilitated patients have shorter total hospitalization stays, lower complication rates, earlier and higher rates of discharge home than patients who do not receive rehabilitation. In addition, rehabilitation involving a multidisciplinary team approach led by rehabilitation physician or specialist result in better functional outcomes compared to acute general ward-based therapies. In order for rehabilitation to be effective in modifying cortical neuroplasticity, it must be targeted at the specific stroke impairment, task specific, exercise must be repetitive and intensive, goal directed and command the attention of the stroke patient. Some of the components of rehabilitation include physical therapy, gait and balance training, aerobic conditioning, functional Activities of Daily Living (ADL) training, physical modalities to treat pain, Functional Electrical Stimulation (FES) or Neuro-Muscular Electrical Stimulation (NMES). Other methods include specific treatments to address complications of rehabilitation such as spasticity, ataxia, contractures and bladder or bowel incontinence. Often, one-to-one and highly labour-intensive and expensive therapies with close hand-over-hand treatments are required. Limitations of current physiotherapy and occupational therapy techniques include the following:(1) Difficulties in rehabilitation for the severely paralysed arm and hand which are often treated with passive modalities such as NMES, passive ROMs and other modalities. (2) Difficulties in achieving intensive rehabilitation and high repetitions in those with moderate to severe upper extremity paralysis either due to non participation or pain which is commoner in those with severe paralysis. (3)Problems in motivating and sustaining patient interest in repetitive exercises.(4)Therapy is often perceived to be boring and due to lack of immediate biofeedback. (I) Robot Aided Rehabilitation: MIT (USA) has developed a robot, named the MIT-MANUS, to aid therapy of stroke victims. Small clinical trials have reported that the robot significantly improved patients' recovery of arm motor movement and function with sustained gains several months after cessation of treatment. This system is being clinically used as a rehabilitation training tool in over 20 centres world-wide. Advantages of robot aided rehabilitation include the ability to document and store motion and force parameters, the ability to achieve thousands of repetitions per treatment session (100 times more than conventional treatment or FES) without causing tissue injury or pain, high intensity with low friction, attention training and increased biofeedback through the incorporation of interactive video games, which can simulate trajectories, mazes, ADL tasks such as preparing a meal and spatial task simulation such as going shopping. In addition, after the initial training period, supervision of the patient by the therapist can be reduced due to the sustainability of participation of the patient from the robot or BCI based Robotic Rehabilitation. Hence, productivity of the human therapist is increased by the robot. The robot thus acts as a high technology aid to the clinician and therapist. The system is also portable, giving rise to the possibility of tele-rehabilitation options with the performance and progress of the patient being monitored by the institution remotely. (II)BCI-based BCI based Robotic Rehabilitation:This non invasive device aims to use a novel approach in robotic training, which has not been employed in the therapeutic realm before.In the MIT-MANUS and related commercially available systems, there is no direct communication between the patient's mind or thinking processes or motor volitional thinking and the robotic system. Although some sensors are used to detect the patient's weak movement, it never knows when and how the patient wants to move. The robot arm to which the patient is tethered or constrained plans the trajectory of movement for the patient and reduces its active role as the patient recovers voluntary motion. In most times, the patient can only passively follow the predefined program, which may not fully explore the patient's motor initiatives and potential or attention processes.

Study Design

Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Conditions

Stroke

Intervention

Rehabilitation technique

Location

National Neuroscience Institute
Singapore
Singapore
308433

Status

Recruiting

Source

National Neuroscience Institute

Results (where available)

View Results

Links

Published on BioPortfolio: 2014-08-27T03:20:09-0400

Clinical Trials [3348 Associated Clinical Trials listed on BioPortfolio]

Exoneuromusculoskeleton for Upper Limb Rehabilitation After Stroke

A new clothing robotic arm was developed for multi-joint coordinated upper limb rehabilitation after stroke. Patients after stroke will be recruited to evaluate the rehabilitation effectiv...

Study on the Effectiveness and Safety of Early Rehabilitation After Ischemic Stroke

There are about 2.5 million new stroke patients in China each year, and 70%-80% of stroke patients cannot live independently because of their disability. Stroke has the characteristics of ...

Stratification of Stroke Rehabilitation: 5-year Profiles of Functional Outcomes

Objective: To make use of admission Modified Functional Ambulation Category (MFAC) as a stratification tool to reveal profiles of functional outcomes of patients with stroke in inpatient r...

Effectiveness of Commercial Video Games in Subacute Stroke Rehabilitation

Stroke creats dependancy of patients due to various associated impairments. The use of low-cost technologies for neurological rehabilitation may be beneficial for the treatment of these pa...

TCM Clinical Practice Rehabilitation of Post-stroke Spasticity

The purpose of this study is to determine the effectiveness,safety and Input-output ratio of chinese traditional treatment in spasm after stroke,both in massage and herbal medicine bathing...

PubMed Articles [7417 Associated PubMed Articles listed on BioPortfolio]

How much rehabilitation are our patients with stroke receiving?

Stroke rehabilitation often needs to continue following discharge from hospital. The New Zealand Stroke Network recommends community team review within seven calendar days of discharge and a minimum o...

Stroke survivors' experiences of team support along their recovery continuum.

A coordinated stroke rehabilitation care team is considered optimal for supporting stroke survivors from diagnosis to recovery. Despite this recognition, many stroke survivors cannot access essential ...

Advances and challenges in stroke rehabilitation.

Stroke remains a leading cause of adult disability and the demand for stroke rehabilitation services is growing. Substantial advances are yet to be made in stroke rehabilitation practice to meet this ...

Cognition in Stroke Rehabilitation and Recovery Research: Consensus-Based Core Recommendations From the Second Stroke Recovery and Rehabilitation Roundtable.

Cognitive impairment is an important target for rehabilitation as it is common following stroke, is associated with reduced quality of life and interferes with motor and other types of recovery interv...

Factors related to met needs for rehabilitation 6 years after stroke.

Research on stroke rehabilitation mainly concerns the first year of recovery, and there is a lack of knowledge regarding long-term rehabilitation needs and associated factors.

Medical and Biotech [MESH] Definitions

Restoration of functions to the maximum degree possible in a person or persons suffering from a stroke.

The diagnosis and treatment of human responses of individuals and groups to actual or potential health problems with the characteristics of altered functional ability and altered life-style. (American Nurses Association & Association of Rehabilitation Nurses. Standards of Rehabilitation Nursing Practice, 1986, p.2)

Psychotherapeutic technique which emphasizes socioenvironmental and interpersonal influences in the resocialization and rehabilitation of the patient. The setting is usually a hospital unit or ward in which professional and nonprofessional staff interact with the patients.

Studies and research concerning the psychological, educational, social, vocational, industrial, and economic aspects of REHABILITATION.

Stroke caused by lacunar infarction or other small vessel diseases of the brain. It features hemiparesis (see PARESIS), hemisensory, or hemisensory motor loss.

More From BioPortfolio on "Brain Computer Interface (BCI) Based Robotic Rehabilitation for Stroke"

Quick Search

Relevant Topics

Neurology - Central Nervous System (CNS)
Alzheimer's Disease Anesthesia Anxiety Disorders Autism Bipolar Disorders Dementia Epilepsy Multiple Sclerosis (MS) Neurology Pain Parkinson's Disease Sleep Disorders Neurology is the branch of me...

Alzheimer's Disease
Of all the types of Dementia, Alzheimer's disease is the most common, affecting around 465,000 people in the UK. Neurons in the brain die, becuase  'plaques' and 'tangles' (mis-folded proteins) form in the brain. People with Al...

Stroke - Cerebrovascular Disease (CVA)
A stroke is a serious medical condition that occurs when the blood supply to part of the brain is cut off. Strokes are a medical emergency and prompt treatment is essential because the sooner a person receives treatment for a stroke, the less damage is ...


Searches Linking to this Trial