NEOFECT Has Partnered with the U.S. Department of Veterans Affairs and the Rehabilitation Institute of Chicago to Bring Technological Innovations to Stroke Survivors - Rapael Smart Glove

With 53 posts on gloves and 164 posts on hand and 46 posts on fingers your therapists will know which one is most likely to bring back you hand/finger function. But I highly doubt that, so you are on your own researching rehab tools that will help you recover.
http://www.digitaljournal.com/pr/3175861
The patients of the Rehabilitation Institute of Chicago and the U.S. Department of Veterans Affairs will be able to use NEOFECT's Rapael Smart Glove to improve the efficiency of their post-stroke rehabilitation program.

NEOFECT is an international health technology startup with offices in South Korea, the U.S., and Europe. The team has designed Rapael Smart Glove, a bio-feedback system to help patients with neurological and musculoskeletal injuries regain their hand mobility. The set includes a glove-like wearable device with embedded sensors and an artificial intelligence software. The main feature of the Rapael is the therapy program based on training games.

The learning schedule algorithm analyzes data transmitted from the glove's sensors via Bluetooth and offers different games. The software adjusts games' difficulty levels to keep participants interested and alert. Doctors can monitor the progress in a real time and design custom rehabilitation programs.

NEOFECT was named a CES 2017 Innovation Award Honoree for the Rapael Smart Glove. Now, it is available for use in hospitals and at home.

The Rehabilitation Institute of Chicago (RIC) is the nation's leading provider of comprehensive physical medicine and rehabilitation care to patients from around the world. RIC has been designated the "No. 1 Rehabilitation Hospital in America" by U.S. News & World Report every year since 1991.

The organization has bought several Rapael Smart Gloves to incorporate them in their rehabilitation regimen.

The U.S. Department of Veterans Affairs (DVA) has a network of 150 hospitals around the country. After a rigid selection process, Rapael Smart Glove has been approved for use in their system. Now, any DVA patient can receive reimbursement for renting the device for at-home therapy. The rentals are available in the U.S. for $99 a month, representing significant savings compared to a conventional rehabilitation program.

One of the DVA patients, Michael E. from Anaheim, Calif., has described his experience of using Rapael: "At this point, I'm actually able to straighten up my fingers and close my fists. I can make my fingers dance. I can shake hands with confidence and pick up things using my right hand, which I thought I would never will. Rapael has put me over the top and gave me hope that my hand eventually will go back to normal. "

The new collaborations with reputable healthcare organizations will help NEOFECT to bring technological innovations to more stroke victims, giving them hope for healthy, gratifying future.

To learn more about NEOFECT, visit the company's website: www.neofect.com

Press Contact:
Anna Choi
anna.choi@NEOFECT.com
+82 70-8852-6516
US Office: 1499 Old Bayshore Hwy, Ste 243, Burlingame, CA 94010
For more information on this press release visit: http://www.sbwire.com/press-releases/neofect-has-partnered-with-the-us-department-of-veterans-affairs-and-the-rehabilitation-institute-of-chicago-to-bring-technological-innovations-to-stroke-survivors-751141.htm

Media Relations Contact

Anna Choi
NEOFECT
Telephone: +82 70-8852-6516
Email: Click to Email Anna Choi
Web: http://www.neofect.com

Read more: http://www.digitaljournal.com/pr/3175861#ixzz4SwkG9zS7

From tying shoelaces to understanding neurological disorders: New research offers a fresh perspective on motor learning

How are your doctors and therapists explaining "chunking" to you to help you in your stroke recovery? Have they incorporated it into your stroke protocols? Are your therapists able to break walking into chunks and just practice a chunk at a time? One of my therapists was terrible, he gave me the 'Walk this way' demonstration, no ability to break walking into smaller manageable pieces. And I still walk like shit, probably always will until my damned spasticity is finally removed.
http://www.mdlinx.com/neurology/top-medical-news/article/2016/07/15/1

Northwestern Medicine News

Consider an everyday action such as tying shoelaces. It consists of discrete halts in movement between continuous elemental actions, such as making a loop, or tugging at the lace. As people repeat movements, these elemental actions are merged into “chunks.” A new study, led by researchers at the Rehabilitation Institute of Chicago (RIC), makes significant advances in explaining the phenomenon of movement chunking and has important implications for the early diagnosis, treatment and rehabilitation therapy for patients with neurological disorders. The field of computational motor control focuses on how the brain ought to control movements, given its goals and resource constraints (i.e., how the brain ought to optimize the efficiency of movement). In this context, researchers have had difficulty explaining how people learn to transition from computationally simple (but inefficient) movements to those that are computationally demanding (but efficient). This study resolves the issue by demonstrating that chunking is the natural by–product of a physiologically clever strategy that minimizes learning costs. The research, published in the journal Nature Communications, presents two main findings. First, it develops a theory to explain why chunking occurs. By measuring how the nervous system in monkeys produces movement sequences over several days of practice, the authors found empirical evidence that chunks occur because of a tradeoff between efficiency and computational cost. On the one hand, the nervous system aims to produce movements as efficiently as possible. On the other, there is a computational cost to calculating efficient trajectories. Chunks are the sweet spot between these goals. Second, the study demonstrates that there are certain stages during the learning of complex movements at which it is optimally cost–effective to merge small chunks. The data show that monkeys are indeed cost–effective learners whose nervous system decides when to merge chunks in an intelligent way. Specifically, the movement sequence is divided into chunks, optimizing for efficiency within chunks, and then merging chunks only when further gains in efficiency are required.

Rehabilitation Institute of Chicago First to Develop Thought Controlled Robotic Leg

The main problem with this for stroke survivors is that we aren't sending decent signals down to the leg muscles. So I don't see any use for this until that is solved.
http://www.ric.org/about/mediacenter/search-press-releases/2013/first-thought-controlled-bionic-leg/
The science of bionics helped the more than 1 million Americans¹ with leg amputations take a giant step forward, as the Rehabilitation Institute of Chicago (RIC) revealed clinical applications for the world’s first thought-controlled bionic leg in the September 26, 2013 issue of The New England Journal of Medicine. This innovative technology represents a significant milestone in the rapidly growing field of bionics. Until now, only thought-controlled bionic arms were available to amputees.
Levi Hargrove, PhD, the lead scientist of this research at RIC’s Center for Bionic Medicine, developed a system to use neural signals to safely improve limb control of a bionic leg.
“This new bionic leg features incredibly intelligent engineering,” said Hargrove. “It learns and performs activities unprecedented for any leg amputee, including seamless transitions between sitting, walking, ascending and descending stairs and ramps and repositioning the leg while seated.”
This method improves upon prosthetic legs that only use robotic sensors and remote controls and do not allow for intuitive thought control of the prosthetic.
The case study focuses on RIC research subject Zac Vawter, a lower-limb amputee who underwent targeted muscle reinnervation surgery – a procedure developed at RIC and Northwestern University – in 2009 to redirect nerves from damaged muscle in his amputated limb to healthy hamstring muscle above his knee. When the redirected nerves instruct the muscles to contract, sensors on the patient’s leg detect tiny electrical signals from the muscles. A specially-designed computer program analyzes these signals and data from sensors in the robotic leg. It instantaneously decodes the type of movement the patient is trying to perform and then sends those commands to the robotic leg. Using muscle signals, instead of robotic sensors, makes the system safer and more intuitive.
“The bionic leg is a big improvement compared to my regular prosthetic leg,” stated Vawter. “The bionic leg responds quickly and more appropriately, allowing me to interact with my environment in a way that is similar to how I moved before my amputation. For the first time since my injury, the bionic leg allows me to seamlessly walk up and down stairs and even reposition the prosthetic by thinking about the movement I want to perform. This is a huge milestone for me and for all leg amputees.”

New Rehabilitation Institute of Chicago Brain Stimulation Study Reveals Breakthrough in Stroke Recovery

Ok, the RIC I guess can do good things also. Bad stuff here.
I like the fact that this was for chronic, a 5 year survivor.  This sounds like applying the earlier studies on contralateral recovery like these;

Cortical Reorganization After Stroke How Much and How Functional?

New model of how brain functions are organized may revolutionize stroke rehab

Magic for Stroke Patients: The One-Sided Workout

 So ask your therapists why this isn't available in their clinic and exactly what the protocol is.

http://www.wspa.com/story/25587087/new-rehabilitation-institute-of-chicago-brain-stimulation-study-reveals-breakthrough-in-stroke-recovery#.U8OcnUKrd_0.email
Doctors at the Rehabilitation Institute of Chicago (RIC) revealed the results of a study wherein 80 percent of stroke survivor participants regained arm and hand use – 30 percent more than possible with standard therapies. The breakthrough study combines for the first time a new, non-invasive brain stimulation technique with traditional occupational therapy (OT) to improve upper limb (arm and hand) movement recovery – and give patients back the independence they lost as a result of their strokes.
Richard L. Harvey, MD, medical director at the RIC Center for Stroke Rehabilitation and lead scientist of this study, researched and developed a new approach to modulate brain healing and improve lasting arm and hand use in stroke survivors. This type of brain stimulation is the only technology that has been shown to deliver greater functional improvements when accompanied with an OT session. Typically, only about 50 percent of post-stroke patients regain full upper limb use through OT alone.¹ The results from RIC's study indicate this combined treatment could increase that success rate to 80 percent.
RIC worked with Nexstim Corporation to apply this novel type of non-invasive brain stimulation – navigated brain stimulation (NBS) – to standard stroke rehabilitation. After a stroke blocks blood to the brain, some regions of the affected brain hemisphere become less active, while some areas on the healthy side of the brain become more active. By externally and painlessly stimulating the overly active parts of the healthy brain with NBS magnetic waves, these targeted parts calm down. The RIC study indicates that when the overly active healthy brain areas quiet down, the stroke-damaged areas respond more fully and sustainably to occupational therapy. This allows the patient to have a better recovery and increased arm use.
"This study represents what could be a significant breakthrough in the treatment of strokes," said Harvey. "Our results indicate that targeting stimulation to the correct area can set up the brain to learn and retain more during traditional stroke rehabilitation. We know that stroke is a leading cause of serious disability and costs the U.S. more than $36 billion each year from lost work days and long-term health care. To these patients, regaining arm use and mobility means increasing their ability and, thus, their quality of life."
Darryl Holmes, one of the 30 stroke survivors with severe arm impairments in this pilot study, had a stroke in 2009 at age 57. After his stroke, his movement was limited. He had trouble using his left side, including his arm and hand, which prevented him from performing many of his regular activities, like driving and writing.
In 2013, Holmes participated in RIC's six-month stroke study and received treatment with NBS in combination with occupational therapy. This study used NBS to stimulate the brain with magnetic waves using a navigation system akin to a GPS map. Adding navigation to regular brain stimulation allows doctors to locate the exact area of the brain that should be inhibited, or calmed down, by this type of stimulation.
"Since the RIC study treatment, I've gone back to work," said Holmes. "I've gone into private practice. I drive a new car. Participating in this research has made me a healthier person, both physically and mentally. I have my life back, and it's good."
The Center for Stroke Rehabilitation at RIC integrates research directly into patient care and is the only federally-designated Rehabilitation Research and Training Center for Stroke, as recognized by the National Institute on Disability and Rehabilitation Research. RIC is the first hospital to run a trial with NBS as an aid to OT in stroke survivors. Now that the pilot study is complete, RIC has expanded the study and currently manages 12 other research centers in a nationwide study – the first large-scale trial of its kind to take a major step toward clinical availability of this treatment.
About The Rehabilitation Institute of Chicago
The Rehabilitation Institute of Chicago (RIC) is the nation's leading provider of comprehensive physical medicine and rehabilitation care to patients from around the world. Founded in 1954, RIC has been designated the "No. 1 Rehabilitation Hospital in America" by U.S. News & World Report every year since 1991. RIC sets the standard of care in the post-acute market through its innovative applied research and discovery programs, particularly in the areas of neuroscience, bionic medicine, musculoskeletal medicine and technology transfer. For more information, go to www.ric.org.

U.S. News and World Report Again Names the Rehabilitation Institute of Chicago America's Best hospital for physical medicine and rehabilitation

Well, well. Read this first before going there for stroke. But they list no statistics for stroke at all.
Yelp reviews:
http://www.yelp.com/biz/rehabilitation-institute-of-chicago-chicago
Dr Richard Harvey abilities here:
http://mycerebellarstrokerecovery.com/2014/07/11/ric/
http://mycerebellarstrokerecovery.com/2014/01/26/julia/

What Dr. Richard Harvey of RIC should have said to Julia

I would suggest going directly to the president of the RIC
Joanne C. Smith, MDPresident and Chief Executive Officer
to find out what exactly the goals and objectives are for Dr. Richard Harvey. They seem not to align with  survivor needs. 

U.S. News and World Report Again Names the Rehabilitation Institute of Chicago America's Best hospital for physical medicine and rehabilitation

Nexstim Initiates Multicenter Clinical Trial on the Therapeutic Effects of Navigated TMS for Stroke Rehabilitation

I'm sure this will be interesting because they are stimulating the good side.
gitaljournal.com/pr/1980763
Nexstim has launched a multicenter double-blinded, randomized, and sham-controlled trial to determine the therapeutic effects of navigated rTMS (repetitive transcranial magnetic stimulation) for stroke rehabilitation. This cutting-edge stroke therapy combines occupational therapy with nTMS (navigated transcranial magnetic stimulation). Called the NICHE trial (Navigated Inhibitory rTMS in Contralesional Hemisphere Evaluation), this two year study will be conducted at twelve of the top rehabilitation sites in the United States.
“The trial results are showing great potential for non-invasive brain modulation and the difference Nexstim is providing is the proven Navigation to enable this approach.” - Janne Huhtala, CEO, Nexstim
Dr. Richard Harvey, Medical Director, Center for Stroke Rehabilitation, Rehabilitation Institute of Chicago (RIC), developed the protocol with Nexstim and ran the single center trial. Dr. Harvey and his team at RIC presented the trial results at the American Heart Association’s International Stroke Conference in February, ‘The Contrastim Stroke Study: Improving Hand and Arm Function After Stroke with Combined Non-Invasive Brain Stimulation and Task-Oriented Therapy’ (presentation #152).
Dr. Harvey’s study approached stroke rehabilitation through a new combination of therapies which produced significantly greater gains in patients’ motor function 6 months post stroke. The combination of non-invasive navigated transcranial magnetic stimulation (nTMS) along with occupational therapy opened the door to improving the quality of life for stroke survivors. The study showed over 80% of the active group received a clinically meaningful response rate.
Researchers working at the following trial sites, will enroll up to 200 patients, and will look to replicate the initial findings.
Arizona
Mayo Clinic
California
Ranchos Los Amigos National Rehabilitation Institute
Georgia
Shepherd Center
Illinois
Rehabilitation Institute of Chicago
Indiana
Indiana University
Massachusetts
Spaulding Rehabilitation Hospital
New York
Columbia University
Burke Rehabilitation Center
North Carolina
Duke University
Ohio
Ohio State University
University of Cincinnati
Texas
TIRR Memorial Hermann Hospital
About the Technology:
The NBS System uses stereotactic MRI-guided transcranial magnetic stimulation (TMS) to non-invasively modulate precise areas of the motor cortex. The system’s e-field based targeting tool allows the therapist to accurately locate the patients exact stimulation target using technology similar to mapping the globe with a GPS. The nTMS is used to stimulate the patient’s non-injured brain hemisphere at a low frequency. This results in down-regulation of the excitability of the healthy side and restoration of the balance between the lesioned and healthy sides, allowing the lesioned side to regain function. Adding navigation to TMS is the key to finding the exact location and orientation of the e-field of the motor area that should be inhibited by stimulation. The stimulation is then accurately repeated in every session, assuring the dose is applied to the correct place.
About Nexstim:
Founded in 2000, Nexstim is committed to improving the quality of life of patients with significant unmet clinical needs. The advanced technology providing navigation to TMS has led to Nexstim being the world leader in image-guided transcranial magnetic stimulation (TMS). Nexstim has pioneered the technology for brain diagnostics and with FDA-clearance of the Navigated Brain Stimulation (NBS) System for non-invasive pre-surgical mapping. NBS is recognized as the emerging standard for pre-operative direct functional mapping. Nexstim’s NBS System enables treatment of brain injury and disease using rTMS with accurate and repeatable 3D-guidance of therapeutic electrical field.
Nexstim’s non-invasive Navigated Brain Stimulation System is not approved by the Food and Drug Administration for therapy in commercial use in the United States and is available to select physician for investigational use only.

Nexstim
Jaime Bloom
+1-404-358-7440
j.bloom@nexstim.com
or
Janne Huhtala, CEO
+358 40 8615046
janne.huhtala@nexstim.com

Read more: http://www.digitaljournal.com/pr/1980763#ixzz34MzIpNLa

Therapy Pioneered In Chicago Could Be Breakthrough For Stroke Patients

Have your doctor contact Dr. Richard Harvey, Director of Stroke Rehab, for what exactly is being done. Who the hell cares if it hasn't been approved by the FDA?
http://chicago.cbslocal.com/2014/05/21/therapy-pioneered-in-chicago-could-be-breakthrough-for-stroke-patients/

Roselinde Torres: What it takes to be a great leader

If we just look at the stroke world news in the last couple of weeks we can easily point out which ones do not have a great leader.
UC Neuroscience Institute at the University of Cincinnati and UC Health
Center for Innovation & Research at Memorial Hermann-Texas Medical Center
Mayo Clinic in Jacksonville, Fla.
R








http://www.ted.com/talks/roselinde_torres_what_it_takes_to_be_a_great_leader.html?

Rethinking the Continuum of Stroke Rehabilitation

How many years before your doctor realizes that chronic rehab can and does work? Obviously the RIC head doesn't believe in it now.
http://www.sciencedirect.com/science/article/pii/S0003999313012203

• Robert W. Teasell, MD^{a, b, c, ,} ,
• Manuel Murie Fernandez, MD^d,
• Amanda McIntyre, MSc^a,
• Swati Mehta, MA^a

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http://dx.doi.org/10.1016/j.apmr.2013.11.014

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Abstract

Suffering a stroke can be a devastating and life-changing event. Although there is a large evidence base for stroke rehabilitation in the acute and subacute stages, it has been long accepted that patients with stroke reach a plateau in their rehabilitation recovery relatively early. We have recently published the results of a systematic review designed to identify all randomized controlled trials (RCTs) where a rehabilitation intervention was initiated more than 6 months after the onset of the stroke. Of the trials identified, 339 RCTs met inclusion criteria, demonstrating an evidence base for stroke rehabilitation in the chronic phase as well. This seems at odds with the assumption that further recovery is unlikely and the subsequent lack of resources devoted to chronic stroke rehabilitation and management.

Nexstim Announces New Stroke Therapy Produced Significant Gains in Motor Function Post-Stroke

And once again rehabilitation departments(RIC this time) are not looking beyond their own silo. Damn, do they not have any understanding that if you stop the neuronal cascade of death you will have less dead and damaged neurons and thus your existing protocols will work much better. I'm working on a letter to the president of the RIC laying out all their failures.
http://www.fortmilltimes.com/2014/02/14/3288083/nexstim-announces-new-stroke-therapy.html
Every two seconds someone in the world suffers a stroke. A study from the Rehabilitation Institute of Chicago approached stroke rehabilitation through a new combination of therapies which produced significantly greater gains in patients’ motor function 6 months post-stroke. The combination of non-invasive navigated transcranial stimulation (nTMS) along with occupational therapy (OT) opened the door to improving the quality of life for stroke survivors. The study presented Thursday at the American Heart Association (AHA) and the American Stroke Association’s (ASA) International Stroke Conference, yielded results from the active group of improved function by 13+ points in UEFM score.
“The results obtained in the Contrastim trial provide evidence that non-invasive neurostimulation has major potential for improving motor function in stroke sufferers.” – Jarmo Laine, MD, Nexstim VP of Medical Affairs
The Study
Dr. Richard Harvey and his team at the Rehabilitation Institute of Chicago (RIC) presented their research (presentation #152) which looked at the combination of non-invasive nTMS along with OT in post-stroke patients.
“It helped me greatly. It’s just immeasurable the progress that I have made.” – Dwayne Nelson, stroke trial patient
Treatment consisted of 20 minutes of pre-functional OT, 17 minutes of nTMS, followed by 60 minutes of upper limb task-oriented OT. Patients received treatment during 3 visits per week, for 6 weeks, as the standard of care in the US. They then returned for follow-up visits at 1 week, 1 month, and 6 months. The study found that Nexstim’s non-invasive Navigated Brain Stimulation (NBS) System used as an adjunct to therapy promoted lasting improvements in patients’ motor function compared to the sham group.
“What we found is that there are areas of the brain, usually where the lesion is, that are less active than they used to be, and that there are actually areas on the brain on the opposite hemisphere, the healthy side of the brain, that are more active than they used to be.” – Lynn Rogers, PhD, Director, Neuralplasticity Laboratory, RIC

More about the technology at the link.

What Dr. Richard Harvey of RIC should have said to Julia

I put this together since this is all readily available for anyone with a modicum of stroke knowledge and smarts.  If the RIC were anything close to the #1 stroke rehabilitation hospital out there, this would be the minimum I would expect from them.  With a team of 5 people and a couple of years Dr. Harvey could have accomplished this, or just me in a couple of hours. Why didn't he?

The RIC episode fiasco as explained in a letter to them here;
http://mycerebellarstrokerecovery.com/2014/01/26/julia/
RIC failed miserably in point #2 from here. My opinion only since I'm not seeing any facts proving their competency.

How to tell you have an incompetent stroke doctor or hospital

-----------------------------------------------------------------------------

Pedro Bach-y-Rita had a stroke in 1958, it destroyed a large portion of his brain stem and yet over the last 7 years of his life he recovered most of his faculties. We have the methods he used, we should be able to modify them to help you.
http://oc1dean.blogspot.com/2011/05/brainstem-stroke-recovery.html

 If you have spasticity in your hand the only way I think its possible to stop spasticity is to exercise the spastic muscles, thus telling the brain that it has control and stop listening to those contract messages from the spinal cord. As Peter Levine talks about here;
http://physical-therapy.advanceweb.com/Article/The-Magic-Cure-for-Spasticity-Reduction.aspx
That does require the ability to grasp and close your hand

Since your control area for your fingers is probably dead, the next step is to find a new location for that control area, this is where the Good, the Bad and the Ugly come in. We really have no idea on how to accomplish that yet.

The Good, the Bad and the Ugly - neurons

The area that controlled your hand is probably dead, this means none of the standard therapies will work, but since we are #1 we have studied possibilities that show promise in bringing back those functions.
1. Mirror therapy
Mirror Therapy for Improving Motor Function After Stroke
Systematic Review on the Effectiveness of Mirror Therapy in Training Upper Limb Hemiparesis after Stroke
Regardless we have come up with some protocols to follow.

2. Action observation
From action representation to action execution: exploring the links between cognitive and biomechanical levels of motor control

Modulating the motor system by action observation: Implications for stroke rehabilitation

We have thousands of animated gifs and videos of hundreds of muscle movements.

3. Mental imagery
Motor Imagery As A Tool For Stroke Rehabilitation Improvement
 We believe this works even though some research suggests it doesn't.
4. Passive movement
Exoskeleton hand gives you robo-powered fingers
We are working on getting a prototype of this in RIC.

5. Thermal stimulation
Facilitation of Sensory and Motor Recovery by Thermal Intervention for the Hemiplegic Upper Limb in Acute Stroke Patients
Basically 15 seconds warm 30 seconds cool.

6. Lucid dreaming
Lucidity Research, Past And Future - dreaming

7. Extra sensation
According to Margaret Yekutiel  in the book, Sensory Re-Education of the Hand After Stroke in 2001 sensation is a great precursor to movement.


You have to hope that your executive control areas are strong enough to resist being taken over.

We have been studying the hundreds of neurogenesis research papers and while there is no defined standard of care for this yet we have some ideas worth trying. This is fairly far out there so we don't even have any reported successes yet.

Stem cells are not even close to any brain application.
We have the ability to get you closer to where you want to be.

Contact me RIC if you want even more innovative ideas to keep your #1 ranking.  Its obvious Dr. Harvey is not.

Ekso Bionics Announces a New Generation of Robotic Exoskeleton

I don't know what this looks like. RIC can compare this to the Honda Walking Assist Device which is also being tested there.

http://www.eksobionics.com/pressrelease
Ekso Bionics™ today announced the first delivery of Ekso GT™, a robotic exoskeleton which enables individuals with lower extremity paralysis or weakness to stand and walk. Ekso GT introduces new advancements designed to make it easier for clinicians to provide therapy to a wide variety of patients, as well as provides new opportunities to explore therapeutic interventions, particularly for patients with some preservation of motor ability such as those who have experienced a stroke. The first device was delivered to US News’ #1 ranked hospital in rehabilitation, the Rehabilitation Institute of Chicago (RIC).
Ekso GT is the next generation of Ekso™; a wearable bionic suit which enables individuals with lower extremity paralysis to walk over ground with a fully weight bearing, reciprocal gait. Battery-powered motors drive the legs and replace deficient neuromuscular function to either or both legs. Technological advancements in the newest model of Ekso further optimize the device as a functional-based, rehabilitative tool for hospitals and clinics serving patients with various forms of paralysis due to neurological conditions such as stroke, spinal cord injury or disease, traumatic brain injury and more.
“This is our fourth product in the evolution of Ekso technology in less than two years, demonstrating not only how quickly the technology is advancing, but how rapidly the clinical community is adopting it into their rehab programs,” said Ekso Bionics chief executive officer, Nathan Harding. “We’re witnessing an exciting new approach to neurorehabilitation.”
The first Ekso GT was delivered to RIC and this is their second Ekso. It will be used to study post-stroke gait training and rehabilitation under a National Institute on Disability and Rehabilitation Research (NIDRR) funded grant. RIC and Ekso Bionics will collaborate and share data under a newly signed research agreement.
“The results we’ve seen using the previous Ekso among our stroke and spinal cord injured patients have demonstrated we have every reason to embrace and explore this technology further,” said RIC’s vice president, research, W. Zev Rymer, MD, PhD. “ This is an exciting opportunity to be at the forefront of this incredibly innovative technology helping to improve outcomes for our patients.”
Mechanical advancements in Ekso GT include; easier, faster adjustment capability between patients, releasable hip abduction and thigh rotation to provide patients with appropriate strength and motor function more freedom, adjustable foot ankle stiffness and angle enable a more stable gait, and the new composite foot design encourages improved weight shifts. In addition, the Ekso GT’s software hosts several new advancements, such as a feature for turning in place, and the ability to adjust software settings while patients are walking.

New Survey Reveals Impact Of Spasticity On Stroke Survivors And Their Caregivers

60 percent of survivors have spasticity. Doctors really have no  protocols to cure spaticity.   I still swear at  William M. Landau that spasticity research should not occur after stroke.
Dr. Landau states,"'the perseverative preoccupation of professional neurologists and therapists with the purpose of overpowering the spasticity ogre seems to be an endemic, intractably-taught delusion that afflicts both academic scholars and clinicians."
http://www.napsnet.com/articles/70026.html
The American Heart Association estimates that there are nearly seven million stroke survivors in the United States. Sixty percent (n=504) of stroke survivors live with a debilitating condition known as spasticity.
National Stroke Association and Allergan, Inc. recently conducted a survey to understand the true impact of this condition on stroke survivors and their caregivers. According to the findings, 70 percent (n=300) of stroke survivors living with spasticity and their caregivers rank spasticity as one of the top three symptoms impacting their life post-stroke, ranking second only to paralysis. Yet, close to 50 percent of stroke survivors and their caregivers are unaware of the available treatment options.
Spasticity is a debilitating condition in which the muscles contract and spasm, causing stiffness and pain. Many stroke survivors who live with the condition may have upper limb spasticity, which affects the elbow, wrist and fingers, presenting as a bent wrist with fingers pointing downward, a fist that stays clenched or a flexed elbow that stays twisted against the chest.
“Spasticity is a disabling condition, but, oftentimes, patients are either uncomfortable or too overwhelmed to discuss it with their physician. The focus after someone has experienced a stroke is so commonly on preventing a second stroke that rehabilitation goals are covered in broad terms. This can leave patients and their caregivers feeling unprepared for a larger discussion about the post-stroke symptoms they may be experiencing, including spasticity. It’s critical that patients and caregivers understand that even if a person has been experiencing spasticity for years, in many cases, there are ways to help manage the condition,” said Dr. Elliot J. Roth, Medical Director of the Patient Recovery Unit and Attending Physician, Rehabilitation Institute of Chicago; Professor & Chairman, PM&R, Northwestern University Feinberg School of Medicine.
Spasticity can occur weeks, months or even years after a stroke, possibly after a patient has stopped seeing a physician for follow-up care. Spasticity continues to be underrecognized and inadequately managed.
Although 95 percent (n=780) of physicians surveyed believe spasticity has a moderate to severe impact on their patients’ lives, approximately 31 percent of neurologists and 27 percent of primary care physicians who treat stroke survivors focus their efforts on preventing a secondary stroke versus discussing physical complications like spasticity.

U.S. Research Begins on Honda Walking Assist Device

I'm not sure which of the two pictures below is the device, ask your doctor or call the RIC.





The one below is the SMA, or stride management assist device
This is the one being tested at the RIC.

A SMA, or stride management assist device

 http://hondanews.com/channels/corporate-headlines/releases/u-s-research-begins-on-honda-walking-assist-device
Honda announced today that a clinical research study of its Walking Assist Device has begun at the Rehabilitation Institute of Chicago (RIC).
At RIC, physical therapists and researchers will perform a scientific assessment of the ability of the Honda Walking Assist Device or Stride Management Assist (SMA) to improve the mobility of patients who have experienced a stroke. This will serve as the first large scale clinical research study on the Honda Walking Assist Device to take place in the U.S.
The Honda Walking Assist Device is worn outside of clothing and consists of a stylish frame and battery-powered compact motors designed to assist people with reduced walking ability due to injury, illness or other causes. The device was developed by Honda R&D Co., Ltd.
"We are excited about bringing the Honda Walking Assist Device to the Rehabilitation Institute of Chicago for research with the hope of helping adults in America recover from stroke and improve over-ground mobility," said Ryan Harty, manager of the Environmental Business Development Office of American Honda Motor Co., Inc. "As a mobility company, Honda envisions a society where all people can experience the joy and freedom of personal mobility."
Stroke is the leading cause of the adult-onset of disability, affecting about 795,000 people in the U.S. each year^i,ii. A large proportion of these stroke survivors (up to 80%) experience considerable problems with walking, including reduced walking speeds and asymmetrical walking patterns, limiting their ability to walk.ⁱⁱⁱ
"The goal of post-stroke rehabilitation is to reintegrate individuals back to their highest level of function for employment, social and community participation. The return of mobility and walking is a crucial part of this return to function," said Arun Jayaraman, PT PhD, of the Department of Physical Medicine & Rehabilitation and Physical Therapy, Northwestern University and the Rehabilitation Institute of Chicago, and Principal Investigator in the clinical research study.
Honda began research and development of the Walking Assist Device in 1999. As with ASIMO, Honda’s humanoid robot, the Walking Assist Device adopts cooperative control technology^iv that was developed based on Honda’s cumulative study of human walking. The control computer activates motors based on information obtained from hip angle sensors while walking to improve the symmetry of the timing of each leg lifting from the ground and extending forward and backward, and to promote a longer stride for easier walking. The compact design of the device was achieved through the adoption of thin motors and a control system developed by Honda, as well as a simple design with adjustable belts that enables the device to be worn by people of varied body size.
"We are committed to leveraging our research into humanoid robotics to improve people’s lives," said Harty.
From the early stages of the research and development of the Walking Assist Device, Honda has worked with research institutions and other organizations in Japan. Through this process, Honda has received encouraging feedback from patients who underwent walking training, physical therapists, medical doctors, and researchers, all of whom acknowledge certain effectiveness and compatibility of the device in the rehabilitation process.
* A total of 9 sets of devices will be tested in the clinical research at RIC.

World's First Thought-Controlled Bionic Leg Unveiled by Rehabilitation Institute of Chicago

And with just a little bit more research it should be easily able to be adapted to send signals to stop the spastic muscles and fire the correct ones in sequence. But don't expect any of our ineffective stroke organizations to take on that challenge. That would require brains, innovation and hard work.
http://www.sacbee.com/2013/09/25/5768318/worlds-first-thought-controlled.html
The science of bionics helped the more than 1 million Americans¹ with leg amputations take a giant step forward, as the Rehabilitation Institute of Chicago (RIC) revealed clinical applications for the world's first thought-controlled bionic leg in this week's New England Journal of Medicine. This innovative technology represents a significant milestone in the rapidly-growing field of bionics. Until now, only thought-controlled bionic arms were available to amputees.
To view the multimedia assets associated with this release, please click: http://www.multivu.com/mnr/63339-rehabilitation-institute-of-chicago-first-thought-controlled-bionic-leg
(Photo: http://photos.prnewswire.com/prnh/20130925/MM85148)
Levi Hargrove, PhD, the lead scientist of this research at RIC's Center for Bionic Medicine, developed a system to use neural signals to safely improve limb control of a bionic leg.
"This new bionic leg features incredibly intelligent engineering," said Hargrove. "It learns and performs activities unprecedented for any leg amputee, including seamless transitions between sitting, walking, ascending and descending stairs and ramps and repositioning the leg while seated."
This method improves upon prosthetic legs that only use robotic sensors and remote controls and do not allow for intuitive thought control of the prosthetic.
The case study focuses on RIC research subject Zac Vawter, a lower-limb amputee who underwent targeted muscle reinnervation surgery – a procedure developed at RIC and Northwestern University – in 2009 to redirect nerves from damaged muscle in his amputated limb to healthy hamstring muscle above his knee. When the redirected nerves instruct the muscles to contract, sensors on the patient's leg detect tiny electrical signals from the muscles. A specially-designed computer program analyzes these signals and data from sensors in the robotic leg. It instantaneously decodes the type of movement the patient is trying to perform and then sends those commands to the robotic leg. Using muscle signals, instead of robotic sensors, makes the system safer and more intuitive.
"The bionic leg is a big improvement compared to my regular prosthetic leg," stated Vawter. "The bionic leg responds quickly and more appropriately, allowing me to interact with my environment in a way that is similar to how I moved before my amputation. For the first time since my injury, the bionic leg allows me to seamlessly walk up and down stairs and even reposition the prosthetic by thinking about the movement I want to perform. This is a huge milestone for me and for all leg amputees."
Army Funding More than 1,200 leg amputees in the United States are recently injured servicemen and women.²
The US Army's Telemedicine and Advanced Technology Research Center (TATRC) funded the RIC study with an $8 million grant to improve the control of advanced robotic leg prostheses by adding neural information to the control system. Due to this unusually large TATRC grant for the rehabilitation field and a multi-disciplinary team, RIC was able to accomplish these breakthrough innovations in only four years.
"We are pleased to partner with the RIC Center for Bionic Medicine in the development of user intent controlled bionic limbs," said Col. John Scherer, director of the Clinical and Rehabilitative Medicine Program at the U.S. Army Medical Research and Materiel Command.  "We appreciate the opportunity to sponsor this life-changing effort to provide military amputees with as much physical functionality as possible, as soon as possible."
This partnership aims to make these bionic legs available for in-home testing for both the military and civilian populations within the next five years.
About The Rehabilitation Institute of Chicago The Rehabilitation Institute of Chicago (RIC) is the nation's leading provider of comprehensive physical medicine and rehabilitation care to patients from around the world. Ranked No. 1 by both U.S. News and World Report and the U.S. National Institutes of Health, RIC holds an unparalleled market distinction.
With a record six multi-year, multi-million dollar federal research designations awarded and funded by the National Institutes of Health and the Department of Education's National Institute of Disability and Rehabilitation Research in the areas of spinal cord injury, brain injury, stroke, neurological rehabilitation, outcomes research, bionic medicine/rehabilitation engineering research, and pediatric orthopedics, RIC operates the largest rehabilitation research enterprise in the world. RIC also operates its 182-bed, flagship hospital in downtown Chicago, as well as a network of more than 40 sites of care distributed throughout the Midwest, through which it delivers inpatient, day rehabilitation, and outpatient services.
The Center for Bionic Medicine at RIC is one of the world's largest prosthetics and orthotic research centers; it focuses on developing bionic legs, bionic arms, and other innovative rehabilitation technologies.
Founded in 1954, RIC has been designated the "No. 1 Rehabilitation Hospital in America" by U.S. News & World Report every year since 1991. RIC sets the standard of care in the post-acute market through its innovative applied research and discovery programs, particularly in the areas of neuroscience, bionic medicine, musculoskeletal medicine and technology transfer. For more information, go to www.ric.org.
About the Telemedicine and Advanced Technology Research Center The Telemedicine and Advanced Technology Research Center (TATRC) explores, innovates and manages medical technologies that advance military medicine. TATRC serves as the primary execution manager for Defense Health Programs research while exploring science and engineering technologies leveraging other programs to maximize benefits to military health care.
TATRC's vision is to be the Department of Defense (DoD) model for enablement of transformational medical research. TATRC is the science and technology scout for military medicine and the center of gravity for Army telemedicine initiatives. TATRC initiates, sponsors, promotes, and oversees programs and partnerships in medical science and engineering that support military medical programs. With the strategic application of funding from small business innovation research/small business technology transfer, Army Medical Department advanced medical technology initiatives, and other sources, TATRC accelerates the implementation of novel science and engineering technology applications through validation studies, translational research, and demonstration projects. As a result, TATRC is a network of experts and capabilities positioned to rapidly address urgent DoD needs. For more information about TATRC, please visit:  www.tatrc.org

Read more here: http://www.sacbee.com/2013/09/25/5768318/worlds-first-thought-controlled.html#storylink=cpy

A Revolutionary Approach to Advancing Human Ability™ After a Stroke

A puff press release piece from RIC. You will notice no factual statistics on recovery.  Unless your rehabilitation place gives out facts they are just trying to appeal to your hopes. And the term is even trademarked. Big Whoopee.
http://www.ric.org/conditions/stroke-recovery/
RIC sets the standard for care by our novel approach to after-stroke treatment. An expert, integrated team of clinicians and researchers work together to set individual patient goals, tackle challenges, and innovate solutions that improve patient recovery.

Our quality is unrivaled. Our care is top ranked for more than two decades.

This is a tremendously exciting time for neuroscience and physical medicine. We’re learning how plastic the brain is, and how we can impact its ability to rewire itself through targeted therapies. We’re standing on the doorstep of brain-based therapies that offer recovery where it was never possible before.
A research study published by the National Institutes of Health confirms that comprehensive inpatient rehabilitation care is most effective in achieving the best recovery after stroke. Choose RIC and you’re choosing the best. As the #1 ranked rehabilitation hospital in the nation for more than two decades, we define quality by how successful we are at getting every patient to lead the most independent and fulfilling life possible. (numbers?)
We are proud to discharge more patients back home (vs. to another care facility) than anywhere else in the region. We have the most state-of-the-art technology and tools at our fingertips and the most accomplished, leading experts in the field.
On behalf of the entire RIC team, we are honored you are considering us and we look forward to working together on a successful recovery.
Richard L. Harvey, MD
Medical Director, RIC’s Stroke Rehabilitation and Recovery Center