Brain-controlled devices may help paralyzed people

 

By Elizabeth Landau, CNN

updated 9:31 AM EDT, Wed October 17, 2012

Wheelchair driven by thoughts

STORY HIGHLIGHTS

• Melody Moore Jackson is the director of Georgia Tech's BrainLab
• About 6 million Americans live with paralysis
• Moving limbs and wheelchairs with the brain could help many people with limited mobility

(CNN) -- Wouldn't moving objects with your mind be fun? But the implications go deeper: For the millions of Americans who live with paralysis, mentally controlling artificial limbs and mobility devices would be a big step forward toward more independent living.

Melody Moore Jackson, director of the BrainLab at the Georgia Institute of Technology, is trying to make that happen.

 

Jackson started this lab in 1998 to look at methods of brain control that didn't involve surgery. At that time, she estimates, there were about five labs working on the same topic of brain-computer interfaces. Now there are about 300.

 

The BrainLab was one of the first to demonstrate that a person can control a robotic arm and a wheelchair with brain signals, Jackson said.

 

"We can literally influence the wiring of the brain, rewiring the brain, so to speak, to allow them to make new neural connections, and hopefully to restore movement to a paralyzed arm," Jackson said.

About 6 million Americans live with paralysis, according to the Christopher & Dana Reeve Foundation.

 

A smaller subset in need of such technologies consists of patients with locked-in syndrome, a rare neurological disorder. These patients feel, think, and understand language, but cannot move or speak -- they are "prisoners in their own bodies," Jackson explained.

 

A famous example is Jean-Dominique Bauby, who became locked-in after a stroke, and wrote the memoir "The Diving Bell and the Butterfly" by blinking to indicate individual letters. Jackson wants to open up possibilities for people with locked-in syndrome to communicate and move.

 

There has been a lot of activity in brain-computer interfaces to help such people.

 

Another pioneering research group in this area is the laboratory of Miguel Nicolelis at Duke University Center for Neuroengineering. Nicolelis and colleagues have shown that a rhesus monkey in North Carolina could, using only its brain, control the walking patterns of a robot in Japan. In 2011, they got a monkey to move a virtual arm and feel sensations from it.

 

This team is leading the Walk Again Project, an international consortium of research centers dedicated to creating brain-computer interfaces to restore movement.

 

One technique that Jackson and colleagues use to harness brain signals is called functional near-infrared spectroscopy. This involves shining a light into the brain to discern how much activity is there, and examining the corresponding oxygen level.

 

Light at a specific wavelength is beamed into the brain, and the oxygen present will absorb some of that light. This allows scientists to pick up on small differences in the blood's oxygenation.

For example, scientists can place a sensor over the Brocca's area, a part of the brain essential for language. This area is activated when you talk to yourself inside your head or count silently, which is called subvocal speech.

 

Scientists can use the oxygen levels associated with this to create a system of allowing a person to say "yes" and "no" just by thinking; "no" corresponds to no subvocal speech or nonsense syllables.

The original hardware for a device that utilizes this technique was developed by Hitachi, and it allows a person with locked-in syndrome to say "yes" or "no," Jackson said.

 

But Jackson wanted to make something more interesting to learn. Her group created a hot-air balloon video game, where the balloon reflects the blood oxygenation level. Multiple locked-in syndrome patients can compete with each other in this game.

 

"It's not necessarily just for fun," Jackson said. "We can actually say, 'Well, they got 70% of the obstacles correct, they were able to jump over the mountains or get through the wind.' And so it also allows us to collect data."

In the stroke rehabilitation arena, Jackson's group hopes to restore movement in people who have paralysis or partial paralysis in a limb.

 

Researchers are looking at a rehabilitation robot called an exoskeleton, a device that a person sits in to be able to move limbs that they wouldn't otherwise. The robot can detect the brain signal corresponding to a person thinking about moving an arm, and then move the arm.

 

"What we're trying to do is make new neural connections from the brain to the arm," Jackson said.

The lab has also developed a wheelchair that a person can drive by using brain signals, rather than moving a joystick or pressing buttons.

 

Such brain-computer interfaces require that the user wear an EEG cap to measure brain signals, but setting one up is very complicated. Jackson hopes to make it accessible for anyone to use in their own home.

 

"You can imagine how much faster the therapy would go if you were doing it all the time," she said.

Technology: a gaitway to life

 

Prof Tim O'Brien, who has motor neuron disease, uses software that tracks his eye movements to communicate.Photograph: Alan Betson

Prof Tim O’Brien is a co-founder of one of the first gait laboratories in the world, writes JUNE SHANNON

PROF TIM O’BRIEN, consultant orthopaedic surgeon and director of the gait analysis laboratory at the Central Remedial Clinic (CRC) in Dublin, was the first professor of orthopaedics to be appointed in Ireland.

Over the past 37 years he has been at the forefront of education, clinical research and innovation in his chosen specialty. During this time he was also diagnosed with motor neuron disease (MND).
While MND cruelly robs sufferers of the use of their body it does not affect the mind. Diagnosed in 1993 it is testament to O’Brien’s strength of character that he continues to work full-time despite being paralysed and reliant on a portable ventilator.

He communicates using special software, which enables a sensor to follow his eye movements allowing him to pick out letters on a specially adapted laptop, which then transmits the words he types into speech.

In 2005 O’Brien was awarded the prestigious Lifetime Achievement Award at the Irish Journal of Medical Science (IJMS) Doctor Awards for his life-long clinical interest and research achievements in orthopaedics, including research on the development of the immature hip joint in babies and the assessment of gait patterns in children.

In 1990, together with physiotherapist Anne Jenkinson, O’Brien established one of the world’s first gait laboratories in the CRC which remains the only clinical gait laboratory in the State.
Gait analysis is the scientific study of how somebody walks. Using technology, O’Brien and his team assess, diagnose and recommend treatment for patients with a variety of gait disorders.
“When we started it was a big investment and we did not know how it would develop as there were only a few other clinical laboratories in the world,” O’Brien explains.

The majority of patients seen at the gait lab are children with neurological disorders such as cerebral palsy. Caused by an abnormality in the brain that controls muscle movement, children with cerebral palsy suffer a range of physical disabilities that affect their ability to walk, such as a lack of muscle co-ordination and tightness or stiffness in the muscles.

Gait analysis can make a huge difference to these children particularly where it picks up issues that may stop a child from walking altogether.

The gait lab in the CRC sees about 360 patients a year and the numbers are increasing every year. Approximately 50 per cent of the patients attending the lab live outside Dublin and in an effort to reduce the amount of travelling his patients had to endure, O’Brien and the manager of the gait lab, Mike Walsh, pioneered the world’s first mobile gait analysis unit in 2004.

A mobile gait lab now travels to Limerick and Waterford a number of times a year.

The gait lab uses an impressive range of technology to assess a patient, including video to record how they walk. Computer markers are placed on specific points such as the ankle, knee and hip joints and motion analysers then replicate an accurate 3D computerised model of how the person walks. Force plates built into the floor of the lab measure the amount of force a person puts on their joints when walking and a system called electromyography (EMG) is used to measure the electrical activity in the muscles which can show if a muscle is over or underactive.

O’Brien explains that the gait lab was initially established as a means of recording walking patterns to see how children at the CRC responded to therapy and surgery.

“As a result of the gait laboratory, surgery has changed and some procedures are no longer advised while some others are seen to make a big difference to walking.

“As we became more experienced we identified patterns of walks that would respond to surgery and we adopted an advisory role. Now 10 per cent of our clients are referred for diagnostic reasons. This is because certain neurological disorders or injuries have characteristic patterns of movement which we can see but are too hard to observe clinically,” he added.

Alongside pioneering technology in the development of gait analysis, O’Brien also uses technology that allows him to continue working and to share his expertise.

On the day of my visit to the CRC I sat in on a meeting where members of the team presented cases to O’Brien that they had assessed the previous week in the lab.

I watched in amazement as O’Brien studied the videos of patients walking, analysed graphs and read the results of complex tests, all of which were projected onto a large screen.

Having completed his expert review he then wrote and emailed the results of his assessment along with recommendations for further treatment, such as surgery where necessary, back to the referring doctor. He did all of this with his eyes.

“There is no doubt that technology has made a big difference for me personally and professionally,” O’Brien says. “When I first saw gait analysis in Boston in 1984 the staff were tracing out limb movement from photographs. It was a start but in two dimensions.

“Now we have automated three-dimensional gait analysis using improved technology. This also extends to our office management and record-keeping in a Sharepoint application where all records are digital and instantly available.

“Efficiency and labour saving are the big advantages of this system. Personally new technology allows me to work efficiently,” he said.

Seeing how technology can make a massive difference to both his life and that of his patients, O’Brien says that the public health service appeared slow to adopt new technology.
“Here in our laboratory through private funding we developed a Sharepoint application that allows us to retrieve all patient data including documents, X-rays and gait analysis with one click. Such systems should be widely available in the health service as they save so much time.”

O’Brien is also an accomplished researcher and writer and has a huge interest in the great megalithic sites of Newgrange and Loughcrew.

Asked about how he felt on being diagnosed with motor neuron disease O’Brien says that by the time he received the diagnosis he had “a fair idea” and was not shocked by the news.

He also pays tribute to his wife and constant companion Mary, who is one of the State’s leading experts in domiciliary ventilation.

“I concentrated more time on those aspects of my practice that were easier for me such as teaching, research and the gait laboratory.

“With great support from the CRC and the children’s hospital [Temple Street] it has been possible for me to continue in full-time work. Technology and my wife make up for my lack of mobility,” he said.

The Joy Factory’s Charis Wheelchair Mount For iPad Is Awesome

 

3:15 PM EDT, Oct. 15th, 2012 · Nancy Gravley · Quick Look Review

The Charis Wheelchair Mount for iPad 2 and iPad 3 from The Joy Factory is an adaptation that can be swiftly and easily added to any wheelchair to hold the iPad in a place that is both comfortable and easy to reach for the individual who relies on the chair for transportation. It works with both electric and standard wheelchairs.

Charis Wheelchair Mount

The Charis mounts are built of high-quality carbon fiber arms. The material that is used is surprisingly lightweight yet incredibly strong. There is a double arm design and special joint designs that also contributes to the strength.

Chair Wheelchair Mount arm component

The clamp mount will clamp to any flat surface as would be expected, but it is also grooved, thus allowing it to clamp to the round spokes of any wheelchair. The clamp mount will clamp around any flat or round object up to two inches (5.08 cm). Like the other joints that are a part of the product, the joint that connects to the clamp rotates.

Clamp mount with groves

Part of the Charis Mount is a custom case for the iPad that attaches to the arms with a unique magnet system. Although the review unit is for the iPad 2 and 3, there is also a custom case available for the original iPad. The iPad must be inserted into the case for the magnet system, called the MagConnect™ to work. Once the magnet in the case and the magnet in the arm connect, a precision screw tightens for a secure fit. Once securely in the case, the iPad can be rotated 360 degrees. The iPad can remain in the case and be removed from the mount by unscrewing the case so it can be used away from the wheelchair. There is a button cover on the back of the case that protects the magnet on the back of the case.

Custom iPad case attached to arm

Using the product
As noted, there are two part to the Charis. The arm component and the iPad case. The case is compatible with the Apple Smart Cover. The first step of installation is installing the arms. This involves identifying the appropriate place on the chair to attach the arms. This will take some trial and error on the part of both the installer and the consumer. (This is particularly true if the installer doesn’t know her right from her left, but we won’t go there.)
Once the ideal location has been identified, then it is a simple process to adjust the different portions of the arms and case to have the iPad at the exact place the consumer wants it to be.

Charis Mount in use

The adjustable arm design allow the arms to be loosened by turning one lever and moving the arms out of the way without changing the basic setup of the Charis. The same is true when the Charis needs to be moved back in place.
The Joy Factory, Inc. warrants to the original purchaser against defects in materials and workmanship for the period of one year unless specified. In addition the company provides a free service to customers who register for it. It includes an extended three year warranty and special customer support should special needs require modifications.
Do I recommend it?

I do. This product is well designed and well constructed and anyone, even me, can install it in under half an hour. I have 30 years experience working with people with various disabilities and I think this product is a marvelous enhancement for anyone who wants their iPad at hand.

Company: The Joy Factory

List Price: US$179.95

Pros: Well built, strong, well designed mount allows individuals in wheelchairs to have independent access to their iPads.

Cons: None noted.

Nancy Gravley

Nancy retired from a position in human services after 30 years and is spending her retirement years spreading the joy of the Mac. She teaches beginner skills, writes a blog, and serves as president of a large Mac User Group (MUG) in addition to writing and reviewing products for TMO. She has three children, three grandchildren, and two great grandchildren. Life is good.