Showing posts with label ▷ 2015 Oct 17. Show all posts
Showing posts with label ▷ 2015 Oct 17. Show all posts

Saturday, October 17, 2015

Saturday News


Contents of This Week Saturday News ▶︎ October 17 / 2015
Robotics is the branch of mechanical engineering, electrical engineering and computer science that deals with the design, construction, operation, and application of robots, as well as computer systems for their control, sensory feedback, and information processing. These technologies deal with automated machines that can take the place of humans in dangerous environments or manufacturing processes, or resemble humans in appearance, behavior, and/or cognition. Many of today's robots are inspired by nature contributing to the field of bio-inspired robotics. SSTattler: See as well Apr/27/2013 - Lokomat Robotic Therapy and Mar/16/2013 - Powered ExoskeletonA longer definition comes from Wikipedia.
    1. Near Future
        - The Most Awesome Robots
    2. Finger, Hand and Arm
        - Hand of Hope - Robotic arm After Stroke Rehabilitation Exercise
        - Robotic Skeleton Aids Stroke Rehab
        - After Stroke | Robot Therapy | Post Stroke Arm Recovery
        - FINGER Stroke Rehabilitation Robot Demo
        - Robots Help Stroke Victims Regain Use of Arms - Hi-tech
        - There is Life After Stroke. Using Robotics to Help Rehabilitation
    3. Leg and Walking
        - Stroke Survivor Learns to Walk Again With Robotic Leg
        - Robotics Help Runner Rehabilitate After Stroke
        - New Robotics Could Help Stroke Victims Walk Again
    4. Miscellaneous but Intriguing...
        - Video: Robotics and Virtual Reality Games Improve Recovery for
          Stroke Victims
        - How a Robot Gave This Stroke Victim New Life
        - The BONES Robot for Stroke Rehabilitation Therapy (UCI)
        - Rehabilitating Stroke Patients With Stimulation and Robots
          by Dr. Matthew Fink
    Saturday News | Future Topic
    --------------+------------------------------ 

    Nov/14/2015   | 
    3D Printing
    Nov/07/2015   | 
    Blood Pressure
    Oct/31/2015   | Dr. Oliver Wolf Sacks
    Oct/24/2015   | 
    Fish Oil (i.e. Omega-3)

    Definition: Robotics for Stroke Survivors

    Robotics From Wikipedia, the free encyclopedia


    The Shadow robot hand system
    SSTattler: See as well Apr/27/2013 - Lokomat Robotic Therapy and Mar/16/2013 - Powered Exoskeleton.

    Robotics is the branch of mechanical engineering, electrical engineering and computer science that deals with the design, construction, operation, and application of robots, as well as computer systems for their control, sensory feedback, and information processing.

    These technologies deal with automated machines that can take the place of humans in dangerous environments or manufacturing processes, or resemble humans in appearance, behavior, and/or cognition. Many of today's robots are inspired by nature contributing to the field of bio-inspired robotics.

    The concept of creating machines that can operate autonomously dates back to classical times, but research into the functionality and potential uses of robots did not grow substantially until the 20th century. Throughout history, it has been frequently assumed that robots will one day be able to mimic human behavior and manage tasks in a human-like fashion. Today, robotics is a rapidly growing field, as technological advances continue; researching, designing, and building new robots serve various practical purposes, whether domestically, commercially, or militarily. Many robots do jobs that are hazardous to people such as defusing bombs, mines and exploring shipwrecks.

    Etymology


    The word robotics was derived from the word robot, which was introduced to the public by Czech writer Karel Čapek in his play R.U.R. (Rossum's Universal Robots), which was published in 1920. The word robot comes from the Slavic word robota, which means labour. The play begins in a factory that makes artificial people called robots, creatures who can be mistaken for humans – similar to the modern ideas of androids. Karel Čapek himself did not coin the word. He wrote a short letter in reference to an etymology in the Oxford English Dictionary in which he named his brother Josef Čapek as its actual originator.

    Video: Robotics for Stroke Survivors

    Contents:

    1. Near Future
    2. Finger, Hand and Arm
    3. Leg and Walking
    4. Miscellaneous but Intriguing...


    1. Near Future

    The Most Awesome Robots

    Published on Jun 5, 2014

    Will robots take over the world one day in your opinion?
    • The Next Generation of NAO Robot
    • Honda Asimo (latest version)
    • Paul the Drawing Robot
    • Boston Dynamics Robots: Wild Cat Robot, Petman Robot... 
    • Actroid
    • Nasa's Curiosity Mars Rover Robot
    • Bionic Kangaroo


    Standard YouTube License @ AppsTube


    Headline Blog: Robotics for Stroke Survivors

    Definition: Blog (noun). Add new material to or regularly update to a blog. (≃1990s: blog shortening of weblog)

    You Never Know What Will Bite You in the Ass Next

    Joyce Hoffman
    The Tales of a Stroke Patient
    Oct 21, 2013

    If I had to recall the most dominant memories of my parents, they are these: My mother who was overly plump always talked about the next meal, and my father who had a short fuse always yelled at me when I couldn't solve a math problem. That was pretty much it. But both my parents shared something in common. They never talked to me about death. So as a result, I thought I could live forever.

    My  friend always says, "You were born to die." I always say, "You were born to live." Who's right? Maybe we both are. I used to daydream that I would be the breakthrough person who be subject to cryogenics intentionally, aka frozen in time, and I would wake up to a planet that seemed more like the Jetsons, a cartoon where everything was in the future like Rosie the Robot and flying saucers. But ever since my stroke, I knew that all of us--even me--have to die. It took me 60 years to realize that.

    Many people don't know about long-term health care insurance (LTC), an insurance that kicks in once you're chronically disabled. They have exclusions, of course, and each long-term policy differs. In my case, if I had a stroke (which I did), I need skilled assistance with simple activities such as bathing and eating, so I'm covered. Chronic illnesses or other conditions requiring specific needs on a daily basis over an extended period of time are also covered. The thing about insurance is this: Consider yourself lucky if you don't use it. But that doesn't mean you don't need it. Thinking it won't happen to you, especially if you haven't experienced significant health problems in the past, is foolhardy.

    Burning Daylight

    Diana Smith
    Beyond Reality
    April 27, 2013

    It was so so so Niiiiccccceeee today, I had planned to spend time outside working on my yard. I asked my son if he wanted to paint my planters. Of course none of that was done, or even started. I did take my girl for a long walk. I walked further than we have before. I did not think I could make it back since I was already on max breathing mode and chest tightening. I did make it back, and now I know I can go a little further next time. I just hope my son is willing. I am still scared to do it alone because my dog is off leash. If we met anyone else with a dog even one on a leash it would probably be a disaster. At least on the drive back we passed some people walking some dogs and she did not shake, she just wined. She was so happy just to stick her nose out the window and not be left home alone. We left her alone two days in a row. One day she ate my bread, the next day she ate my sons bread off the table. When I went to the post office this morning she pulled a bag off the table. At least she did not tear it all apart and scatter around.

    We went to the auction last night. They had so much good stuff. Most was so good it went way over my willing to pay price. It also had some stuff no one else wanted. Bottom feeder that I am took it. I did not take all the unwanted, there was a table full that did not sell. I got a shoe shine kit (cool, but not my style) for $2 I took a chance that it won’t sit in my house forever. I bought a huge box of old Christmas stuff, more postcards, more little smalls assorted boxes no one wanted, some enamel pans that will become planters (maybe if I don’t sell them), and my son bought a huge suitcase for $1. So instead of enjoying this nice day, I took pictures while the sun shined. It is easier to take pictures with good lighting. It is still free listing days on ebay so I am trying to list as much as I can.

    This postcard is from the 60s. That is Anne Francis with Robby the Robot, from the Sci-Fi movie Forbidden Planet. I had no idea, but after a few minutes searching I do now. I wish I looked like her, but I look more like Robby except not dark at all. I glow in the dark. I need to get back to work. I have grandchildren on the way to plan for. The plan is to get in shape and move my arm and fingers more to hold the new grandbaby by November (when it is due). I also need to save more money, which seems even more impossible than getting in shape.



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    What Kind of Mother Am I?

    Grace Carpenter
    My Happy Stroke
    Monday, January 14, 2013

    I walk to pick up my kids at school most days. It's tricky to walk and have a conversation at the same time for me, so I go very slowly  and lean on my cane at lot. But on the weekend,  I try to squeeze in a walk alone. That way, I can concentrate completely on my gait: am I walking evenly? Can I push myself to walk faster? Am I remembering to swing my right arm?

    But even on weekends, sometimes the only way I can get a walk is to have my seven-year-old daughter tagging along. She chatters on, making me wish that my walking could be more automatic, so that I could have a real conversation with her. But instead, I'm rather stern: please don't walk right beside me, I say, because there isn't room for me, my cane, and you; please don't walk right in front of me, I say, so I won't trip.

    A few weeks ago she accompanied me, and I strongly suggested that she walk behind me on the narrow sidewalk, so I could concentrate. So she did, but she still kept a running commentary.

    "Oh Mommy," I heard her voice, " you're not using your cane much! Good job, Mommy!"

    A few steps later, she commented,

    "Mommy, you're walking almost normally!" Then she observed a little bit more.

    "Actually, Mommy, you walk a little like a robot."

    Almost normal mother. Robot mother. Watched mother.



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    Needed Stroke Care Delivered via Robot

    Jeff Porter
    Stroke of Faith
    Friday, May 13, 2011

    This is Stroke Awareness Month, and one issue is the need for stroke care offered to all who need it, no matter where. However, specially trained neurologists are, sadly, not everywhere. One way to combat that challenge is from Washington State.

    Robot helper allows for real-time communication to save stroke victims: 
    Hospitals in outlying areas, such as Ocean Beach Hospital, do not  have a neurologist on staff who could make an assessment within this critical window, and that's where the telestroke robot comes in. 
    The robot allows neurologists to beam in live to the emergency  department to perform real-time examinations and evaluations of stroke victims. With the remote-controlled robot, equipped with cameras and microphones, consulting doctors can review charts, patient records, diagnostic images such as CAT scans and talk directly to ED physicians, the patient and the patient's family. 
    "Basically, it's just like having the neurologist right in the  room," said Valerie Mays, Providence's telestroke program coordinator.



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    Eclectic Stuff

    Definition: Eclectic (noun). A person who derives ideas, style, or taste from a broad and diverse range of sources

    50 Shades of Truth

    Sas Freeman
    October 5, 2015

    The refreshing truth, even if it isn’t what we want to hear, we have to admit that the truth is always best. Having been unwell really, by that I mean more than usual, for just over twelve months now and showing signs of deteriorating further, my cardiologist brought my appointment forward by two months. Friday was the new date, I went along with Nick and feeling as I have of late I didn’t really identify anything any different. Once my blood pressure had been taken a couple of times, the usual conversation out of ear shot, I was told to lie down and not move. The ECG machine would be brought to me. You can imagine at that point I was praying silently not to be kept in. All the staff were so lovely, I only wish they were reading this, to thank them once again.

    photo
    I was asked if I would be alright to manage to walk next door with help, to see the cardiologist or if I required more assistance, truly most kind. me  being me, determined to show all was well and I would be off home in a few minutes, declined all help politely. Also in all honesty I didn’t feel anywhere near as unwell as I had when out with a friend in Bromyard this week, or even at her home on Monday. I was quite surprised but also flattered at their fussing.

    Once inside, we both sat down having been greeted individually. This is where things were explained at length, thoroughly and honestly. Refreshingly honest that we both left after about an hour quite shell shocked. Initially we were both quite quiet, yes ME quiet! I didn’t ask Nick directly about his immediate thoughts. He has since told me his understanding is exactly as mine, but mine was a mixture of admiration for his time and honesty, coupled with it really is now ‘over to me’ whether I continue to go downhill, and my health deteriorates continually until?? Or I damn well step in and try harder. This bit came as a bit of a shock to me, someone who has continually tried, even been told to stop for the time being as I am making things worse, now I have the green card to get started again. Yes I will feel ill, yes it has to be small chunks twice a day, sleep rest in between but medically they cannot help me anymore they can’t do anything else for me, regarding my heart. I have ill health, this is what happens to my blood pressure and my body, my only way forward now is to build up some muscle, and see if my body with the help of muscle can somehow step in and help to work with all this medication and stabilise things. The ball really is in my court.

    Has Stroke Suppressed Your Self-expression?
          There *is* Hope . . .

    Pamela Hsieh
    StrokedUP
    10 October, 2015

    A year after the stroke, when I was 20, I ventured out to Florence for a year of study abroad. Since I was freshly out from under the watchful eyes of my parents and beloved medical practitioners, I was in a place where I desperately needed to be: independent, yet supported. In a foreign land living with several roommates in an apartment, where I’d learn the basics of living on my own.

    I was really open with my flatmates about my physical condition, since I knew that I would need their support with certain activities, like tying my shoes or learning to prepare food for the first time. Or, because we were on foot all the time, simply slowing down their pace so I could keep up.

    All three of my flatmates told me they understood, but one in particular had a lot of difficulty with me. (We’ll call her Sally.) She would often antagonize me, whether directly or passive aggressively, while initially pretending to accept me as I was.

    One day, I was walking around town, window shopping. To my surprise and delight, I saw that legwarmers had come into style.

    Holy. Moly.

    YESSSS.

    I was ecstatic!

    Peer-Reviewed

    Amy Shissler
    MyCerebellarStrokeRecovery
    October 6, 2015

    This makes me so sad. Figure out stuff for yourself because no one will do it for you. No one figured out anything for me and I’ve learned to only depend on myself. Evidence-based medicine sure as hell doesn’t mean what it used to, if it in fact ever meant anything. Once again my heart aches for humanity.  Thanks, Dean, for finding this. And for finding the most research on stroke that exists anywhere in the world.  And the internet.

    Editor In Chief Of World’s Best Known Medical Journal: Half Of All The Literature Is False

    Well shit, now more than ever we need stroke survivors directing and running the strategy for solving all the problems in stroke.

    http://www.healthfreedoms.org/editor-in-chief-of-worlds-best-known-medical-journal-half-of-all-the-literature-is-false/

    In the past few years more professionals have come forward to share a truth that, for many people, proves difficult to swallow. One such authority is Dr. Richard Horton, the current editor-in-chief of the Lancet – considered to be one of the most well-respected peer-reviewed medical journals in the world.

    Dr. Horton recently published a statement declaring that a lot of published research is in fact unreliable at best, if not completely false.

    The case against science is straightforward: much of the scientific literature, perhaps half, may simply be untrue. Afflicted by studies with small sample sizes, tiny effects, invalid exploratory analyses, and flagrant conflicts of interest, together with an obsession for pursuing fashionable trends of dubious importance, science has taken a turn towards darkness.” (source) This is quite disturbing, given the fact that all of these studies (which are industry sponsored) are used to develop drugs/vaccines to supposedly help people, train medical staff, educate medical students and more.

    Caregivers & Therapists Learning To Think - Aphasia Speech Therapy

    Mark A. Ittleman
    The Teaching of Talking
    Oct 8 / 2015

    We are teaching graduate students in speech language pathology and working with their clients who have aphasia. It has been a real pleasure and challenge to work with students and caregivers, while teaching them how to stimulate speech and language.  Their professor invited us to California to pursue student training and research to compare the results of the Teaching of Talking Approach to Conventional Speech Therapy.

    This is an interesting experience for us, being at a major University and teaching graduate students and caregivers, simultaneously, in speech language therapy the fundamental principals and methods to stimulate speech and language without photos, pictures, flash cards, apps, or homework sheets. They are learning The Teaching of Talking Method which is a way to talk in a conversation while simultaneously improving the speaking of those with aphasia. (The skills that took a whole career of over 40 years to master.)

    One of the first things we have been teaching the students is how to:

    I.  Observe


    How to initially in the evaluative process get away from the Standardized Tests they are so fearful of, and enter into a conversation with the person who has difficulty talking.  They are learning how to develop rapport, since the first principal is not only to observe, but also to engage the person and keep in mind that they are becoming our next best friend.  

    You heard me right!  Best friends talk and joke with each other, and tell one another interesting tidbits of what has been learned and experienced in living.  And it does not matter if the conversation is at a single word, two word, or even phrases or sentence levels.  While conversing and finding out about the other person, the therapist or caregiver learns to observe speaking, and listens to the processes involved in talking while obtaining recordings of the language spoken that can then be compared later with other recordings that often show considerable increase in the number of words spoken as well as improved grammatical, phonological and syntactical abilities.

    II.  The ability to Stop, Look, and Listen


    The Wrong Question

    Peter G. Levine
    Stronger After Stroke
    Saturday, October 10, 2015

    "What is the single most important thing you should know about stroke rehab treatments?"

    That's easy: Your asking the wrong question.

    If you are talking about rehabilitation treatments you are talking clinical stuff. You are talking a clinic and a clinician- usually a therapist. And they are great but they are not enough during two time periods:

    1. Every day
    2. Once your discharged from therapy.

    Let's consider why clinical stuff "every day" is not enough. How much therapy might you get? An hour-- two-- three? Recovery is a full time job during the first few months after stroke and it is the first few months after stroke that you're still seeing therapists. So even when therapists are there, there almost always not there enough.

    OK, now lets take "Once your discharged from therapy." Discharged from therapy is in and of itself the very definition of not enough therapy, because you've been discharged. Discharged like a bullet from a gun, off you go! So once you are discharged you are definitely not getting enough clinical stuff.

    So maybe the question ("What is the single most important thing you should know about stroke rehab treatments?") is wrong. What if instead the question was "What is the single most important thing you should know about stroke recovery options?"

    Isn't that freeing? You are no longer under the rules of managed care because managed care does not care if you try, on your own, to take on your recovery using whatever options you can find. You can spend as much time as you want. And even if recovery options are an adjunct to rehabilitation treatments, they expand the opportunities for recovery.

    So, "What is the single most important thing you should know about stroke recovery options?"

    Sweat equity. That's it. The more you put in, the more you make your brain uncomfortable and force it to change, the more repetitions, the more focus- the more recovery.



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    My Stroke Story

    Beth Sinfield
    Beth's Story
    Sunday, 11 October 2015

    Imagine waking up, not being able to move a single muscle? Well that's what it was like on Septemmber 16th 2012. Earlier that morning, around 1am, I had woken with an almighty migraine. I attempted to drink some water but instead it just dribbled out of my mouth, I couldn't swallow at all. Panic set in and I tried walking to my parents bedroom next to mine. I stumbled and nearly collapsed, my legs didn't work anymore. My dad came in and asked what was wrong but my words jumbled inside my head and stuck at the back of my throat- nothing would come out.

    My mum called an 'out of hours' doctor and he came and took my blood pressure and blood sugar- everything was fine but seeing my condition and ambulance was called and I was taken to A&E. By now I was incapable of walking and talking, not even my hand would move properly to write down that I wasn't drunk or had taken drugs that night.

    A&E was awful. No one knew what was wrong with me. My parents watched helplessly as the mystery illness told hold of my body further. I slipped in and out of consciousness, my hearing becoming more muffled.

    And then everything went white.

    I woke in a strange little room. I tried scratching my face but my hand didn't move. Nothing moved. My breathing was shallow and my hearing sounded distant, and echoed, like I was underwater. I was suffocating in this shell of a body.
    It was 5am.

    Then I was taken to Addenbrooks' Hospital and there I received an MRI confirming the worst. I'd had a stroke. Not just any stroke. A huge brain stem stroke. I was lucky to even be alive.

    I was now 'locked-in'; a condition where not a single muscle moves. My eyes rolled around in my head and my hearing was still muffled; what was happening?! This is unreal, it's a dream. Things like this don't happen to me. I'm not meant to be here.



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    Delving into Mindfulness

    Leslie
    Living After Stroke
    I’ve always believed that meditation and mindfulness are extremely useful tools for finding peace in a crazy world. I’ve randomly practiced both. In other words, I’ve practiced half-assed, without any type of commitment. Honestly, I’ve only turned to it during my most desperate moments. In rehab, I repeatedly listened to Bernie Siegel’s Guided Healing Meditations.

    I’ve decided to make a commitment to learning more about both meditation and mindfulness. I want to make it a permanent part of my life, not just when I’m beyond low.

    They’ve pulled me through the nightmares so I can only imagine what regular practice can do for me, maybe prevent the nightmares?

    People who regularly practice both appear more grounded, peaceful, and all around happier. I want to be like them.

    When the student is ready, the teacher will appear.

    Maybe? 31 days of free training sounds like the teacher appearing to me.

    For the past 9 days, I’ve been participating in The Mindfulness Summit. Every day for the month of October, a new speaker provides mindfulness training.

    I’m really looking forward to Day 14: Mindfulness for Pain & Chronic Suffering.

    This is running from October 1- 31st, 2015. If you have a minute, check it out – it’s free. So far, I’m loving it!

    After you check it out, come back & let’s compare notes!



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    It is Hurricane Season Again

    Rebecca Dutton
    Home After a Stroke
    October 5, 2015

    September was beautiful but my thoughts go to 2011 and 2012 when New Jersey was hit by Hurricanes Irene and Sandy.  Here is my consolidated list of bolded To-Do items just in case.

    Shop.  Put gas in my car and get cash because gas pumps and ATM machines do not work without electricity.  I have three flashlights and a lantern, but never remember how old the batteries are.  Buy seven D batteries before they all gone.  I cannot walk in the dark so if my flashlight batteries die I have to crawl.  Aiming a flashlight at a task is difficult so I need a lantern.

    Buy ice.  I can put food in a cooler when the electricity goes out.  Buy bottled water, peanut butter, bread, cereal, and milk.  Buy canned food.  I can use an Oxo Goodgrips can opener when the electricity goes out.  My sound hand squeezes the two handles to lock them shut on the can, turns the crank, and pushes the grey button to release the can opener.  My hemiplegic hand lightly holds the closed handles to keep the can from sliding around.  The magnet in the can opener lifts the lid.

    Prep Home.  Charge my cell phone.  Charge my iPod so I will have a radio to get the news.  Put new batteries in flashlights and lantern.  Fill empty containers with water and place them in my bathtub so I can flush my toilet in case the water is cut off.  Run the dishwasher and do laundry while I still have electricity.  Put garbage cans in the shed so the wind will not blow them away.

    If I Need to Evacuate.  Pack a rolling suitcase with medicine, soap, a small towel, clothes, toothpaste, and toothbrush.  Put my flash drive, checkbook, safety deposit box key, and contact information for my home owners insurance in my purse.  Pack stamps, return labels, envelopes, and business addresses so I can pay bills by mail (no Internet).  Bring a blanket to the shelter.  A blanket takes up half my suitcase so pack carefully.  I can carry a pillow under my hemiplegic arm, but a blanket that keeps sliding is too much for this arm to handle.

    Put adapted equipment that will be hard to replace in trunk of my car.  Pack the camera I use for this blog which I can operate one-handed, my Saebo splints, an Asus notebook that is small enough for me to handle during Power Point presentations, and rain and winter coats I can zip.  My friends do not have a handicapped bathroom so put my folding shower stool in a garment bag.  Find a better way to transport software CDs (e.g. Word) that I cannot afford to replace if I lose my computer.



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    A Map of the Brain:
          Notes on TED Talk Allan Jones of Allen Institute

    Bill Yates
    Brain Posts
    Oct 10, 2015

    Here are my notes on the above TED where Allen Jones CEO of the Allen Brain Institute reviews what type of research procedures are used on their human brain back brains.


    A Map of the Brain: My Notes


    Humans have long been fascinated by the human brain

    We now have a transformation in brain mapping for various brain structures
    * Rear brain contains cerebellum for posture, balance
    * Mid-brain temporal lobe controls language
    * Frontal cortex key in thought and decision making

    Historically, brain staining aids in understanding brain microstructure distribution
    Neuron distribution is linked to brain function
    Genes control brain proteins and neurons
    We want to know what genes out of 25,000 candidates are turned on in the brain

    We find human brains to study after death
    * 20 to 60 year olds
    * No psychiatric or drug abuse history
    * Males oversampled due to higher rates of accidental death

    Our process for brain study
    * Magnetic resonance imaging (MR)
    * Diffustion tensor imaging (DTI)
    * Brain slices for RNA purification
    * Brain slices for gene activation reference map

    1000 samples taken from each brain with 50,000 datapoints per brain=1,000,000 datapoints per brain

    Data made publicly available to scientists around the world

    We map where genes are turned on in specific brain regions

    What have we learned?
    * CNS drugs like fluoxetine (Prozac) modulate serotonin gene function
    * We can scan brain for drug effects for new drug development

    What makes us individuals is important but we are 99% genetically the same.

    Follow the author on Twitter WRY999.

    Photo of sunrise in St. Peterburg, FL from the authors files.


    TED.com Terms of Use



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    Weekly Columnists

    Definition: Columnist |ˈkäləmnist| (noun). A blogger or a journalist contributing regularly to a blog or newspaper

    Musing: Effects of Robot-Assisted Therapy on Upper Limb
          Recovery After Stroke - A Systematic Review

    Dean Reinke
    Deans’ Stroke Musing
    Wednesday, December 31, 2014

    My god, this was written in 2007. Where is the written protocol explaining exactly how this should be used for your recovery? Demand an answer from your doctor. More failures from our stroke organizations that should be doing something as simple as monitoring research and applying it to help survivors - Effects of Robot-Assisted Therapy on Upper Limb Recovery After Stroke: A Systematic Review.

    1. Gert Kwakkel, PhD Department Rehabilitation Medicine and Research Institute MOVE, VU University Medical Center Amsterdam, The Netherlands, Department Rehabilitation Medicine, Rudolf Magnus Institute of NeuroScience, University Medical Center Utrecht, The Netherlands, g.kwakkel@vumc.nl
    2. Boudewijn J. Kollen, PhD Research Bureau, Isala Klinieken Zwolle, The Netherlands
    3. Hermano I. Krebs, PhD Mechanical Engineering Department, Massachusetts Institute of Technology, Cambridge, Massachusetts, Department of Neurology and Neuroscience, Burke Institute of Medical Research, Weill Medical College, Cornell University, White Plains, New York, Department of Neurology, University of Maryland, School of Medicine, Baltimore, Maryland

    ABSTRACT


    Objective. The aim of the study was to present a systematic review of studies that investigate the effects of robot-assisted therapy on motor and functional recovery in patients with stroke.

    Methods. A database of articles published up to October 2006 was compiled using the following Medline key words: cerebral vascular accident, cerebral vascular disorders, stroke, paresis, hemiplegia, upper extremity, arm, and robot. References listed in relevant publications were also screened. Studies that satisfied the following selection criteria were included: (1) patients were diagnosed with cerebral vascular accident; (2) effects of robot-assisted therapy for the upper limb were investigated; (3) the outcome was measured in terms of motor and/or functional recovery of the upper paretic limb; and (4) the study was a randomized clinical trial (RCT). For each outcome measure, the estimated effect size (ES) and the summary effect size (SES) expressed in standard deviation units (SDU) were calculated for motor recovery and functional ability (activities of daily living [ADLs]) using fixed and random effect models. Ten studies, involving 218 patients, were included in the synthesis. Their methodological quality ranged from 4 to 8 on a (maximum) 10-point scale.

    Results. Meta-analysis showed a nonsignificant heterogeneous SES in terms of upper limb motor recovery. Sensitivity analysis of studies involving only shoulder-elbow robotics subsequently demonstrated a significant homogeneous SES for motor recovery of the upper paretic limb. No significant SES was observed for functional ability (ADL).

    Conclusion. As a result of marked heterogeneity in studies between distal and proximal arm robotics, no overall significant effect in favor of robot-assisted therapy was found in the present meta-analysis. However, subsequent sensitivity analysis showed a significant improvement in upper limb motor function after stroke for upper arm robotics. No significant improvement was found in ADL function. However, the administered ADL scales in the reviewed studies fail to adequately reflect recovery of the paretic upper limb, whereas valid instruments that measure outcome of dexterity of the paretic arm and hand are mostly absent in selected studies. Future research into the effects of robot-assisted therapy should therefore distinguish between upper and lower robotics arm training and concentrate on kinematical analysis to differentiate between genuine upper limb motor recovery and functional recovery due to compensation strategies by proximal control of the trunk and upper limb.



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