New wearable sensor for people with incomplete paraplegia

A new electromyography biofeedback device that is wearable and connects to novel smartphone games may offer people with incomplete paraplegia a more affordable, self-controllable therapy to enhance their recovery, according to a new study presented this week at the Association of Academic Physiatrists Annual Meeting in Puerto Rico.

Megan Washburn, Shirley Ryan AbilityLab, Northwestern University February 19, 2019

Electromyography (recording electrical activity of muscles) biofeedback has been shown to enhance recovery of muscle control in people with incomplete spinal cord injury. However, existing biofeedback therapy devices are expensive and can be operated only by trained personnel in a laboratory environment. These factors prevent many people — up to 50,000 in the United States — from accessing the biofeedback therapy that could benefit their recoveries.

To help overcome these barriers, a team of researchers — led by R. James Cotton MD PhD, at Shirley Ryan AbilityLab (formerly the Rehabilitation Institute of Chicago) and John Rogers PhD, at Northwestern University — developed an affordable, wearable-sensor biofeedback platform that allows people with incomplete paraplegia to self-dose this type of therapy.

Although many research systems can record muscle activity, very few are portable and can be worn comfortably over a span of days. Critically, none of these systems provide real-time access to the data via smartphones. The innovative system provides this functionality, allowing biofeedback via games, which can be played outside of the lab.

Shirley Ryan AbilityLab and Northwestern researchers deployed recent advances in flexible, stretchable electronics to design a wearable electromyography sensor. The device allows subjects to use movement and muscle activation to control novel smartphone games — which were also developed by the researchers — making biofeedback easily and constantly available. Data from the new platform, including muscle activity and game performance, is transparently synchronized to a secure cloud database, allowing monitoring by clinicians and researchers.

The device is adhered to the skin with conductive tape and uses integrated electrodes to record muscle activity. The low-profile sensor has wireless charging, Bluetooth connectivity and a nine-axis inertial measurement unit. The battery runs for several days and may be charged wirelessly using inexpensive commercial units.

Data the research team has collected from intact subjects has shown stable measurements over time. Pilot data from subjects with spinal cord injuries demonstrate that the device has sufficient sensitivity to detect muscle activation and to control the biofeedback games.

The developers believe that their new system for electromyography biofeedback overcomes many of the barriers to wider use of this therapeutic modality. Study of the device is ongoing to determine if self-dosed biofeedback can enhance recovery of electromyography activity and other functional outcome measures. At present, the device does not have FDA approval.

This new wearable sensor may cut costs and improve access to biofeedback for people with incomplete paraplegia. The device connects to novel smartphone games, allowing users to self-treat with biofeedback therapy and tracking improvements in muscle activity with use. Shirley Ryan AbilityLab, Northwestern University. Published on Youtube Feb 19, 2019
This research is generously supported by the Craig H. Neilsen Foundation.

The Association of Academic Physiatrists (AAP) is a professional society with a mission to create the future of academic physiatry through mentorship, leadership, and discovery. The only academic association dedicated to the specialty of physiatry, its members are leading physicians, researchers, in-training physiatrists, and professionals in 21 countries and 44 U.S. states. With a keen focus on research and education, the AAP holds an Annual Meeting, produces a leading medical journal in rehabilitation: AJPM&R, and leads a variety of programs and activities that support and enhance academic physiatry. To learn more about the Association and specialty of physiatry, visit physiatry.org and follow us on Twitter at @AAPhysiatrists.

Source Shirley Ryan AbilityLab
via Medical Express

  References
Wearable Electronics for Electromyography Biofeedback in Incomplete Paraplegia, presented by Ronald J. Cotton MD PhD. Scientific Paper Presentations-Spinal Cord Injury. Association of Academic Physiatrists’ (AAP) Annual Meeting — Physiatry ’19. Puerto Rico
  Further reading
A wireless closed-loop system for optogenetic peripheral neuromodulation, Aaron D. Mickle, Sang Min Won, Kyung Nim Noh, Jangyeol Yoon, Kathleen W. Meacham, Yeguang Xue, Lisa A. McIlvried, Bryan A. Copits, Vijay K. Samineni, Kaitlyn E. Crawford, Do Hoon Kim, Paulome Srivastava, Bong Hoon Kim, Seunghwan Min, Young Shiuan, Yeojeong Yun, Maria A. Payne, Jianpeng Zhang, Hokyung Jang, Yuhang Li, H. Henry Lai, Yonggang Huang, Sung-Il Park, Robert W. Gereau IV & John A. Rogers. Nature 565, pages 361–365 (2019) DOI: 10.1038/s41586-018-0823-6

Bioresorbable pressure sensors protected with thermally grown silicon dioxide for the monitoring of chronic diseases and healing processes, Jiho Shin, Ying Yan, Wubin Bai, Yeguang Xue, Paul Gamble, Limei Tian, Irawati Kandela, Chad R. Haney, William Spees, Yechan Lee, Minseok Choi, Jonathan Ko, Hangyu Ryu, Jan-Kai Chang, Maryam Pezhouh, Seung-Kyun Kang, Sang Min Won, Ki Jun Yu, Jianing Zhao, Yoon Kyeung Lee, Matthew R. MacEwan, Sheng-Kwei Song, Yonggang Huang, Wilson Z. Ray & John A. Rogers. Nature Biomedical Engineering volume 3, pages 37–46 (2019) DOI: 10.1038/s41551-018-0300-4

Bio-Integrated Wearable Systems: A Comprehensive Review, Tyler R. Ray, Jungil Choi, Amay J. Bandodkar, Siddharth Krishnan, Philipp Gutruf, Limei Tian, Roozbeh Ghaffari, and John A. Rogers. Chem. Rev. Article ASAP DOI: 10.1021/acs.chemrev.8b00573 Publication Date (Web): January 28, 2019

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