By Natan Gendelman D.O.M.P | http://www.healthinmotionrehab.com | http://www.enabledkids.ca
Traveling can be a great opportunity to learn about and experience
new things together with your child. When the process goes smoothly, it
is also a good way to develop closer ties among family and friends.
However, this process can also be challenging, especially when traveling
with a child that has special needs. Many of the patients and families I
treat from overseas have experienced issues with arranging
transportation, finding the right food and booking the right
accommodations. All of these items need to be arranged well in advance
in order for the whole process to run smoothly. As a result, I would
like to cover a few things to keep in mind when you’re preparing to
travel with your child. Hopefully this will aid you in plans for your
own trip with your child, and also generate a discussion about what
you’d like to share and learn more about in regards to traveling and
accessibility.
Food in foreign countries
Now whether or not a child or adult has special needs, what a person
eats can have a huge impact on their health, behaviour and cognitive
function. When traveling, this becomes even more important as food
sensitivities, allergies and intolerances can all pose risks during your
child’s mealtime. As a result, it is important to pay attention to what
you and your child are eating, and to ask questions about ingredients
and preparation wherever you go. Since the regulations regarding food
production change from country to country, even foods which are familiar
to you and your family may be grown, produced and processed according
to different standards.
For this reason, offer your child items that are light and easy to
digest such as plenty of fresh (preferably organic) fruits and
vegetables throughout the first few days of your trip. As well, certain
foods may contain different ingredients than your child is used to, such
as dyes or preservatives. As always, read the labels on the products
you buy and eat, and try not to switch drastically from the kinds of
foods your child is used to eating.
Accessibility Challenges
Another aspect of travel that you will need to consider is
accessibility, especially if your child uses a wheelchair or other
specialized equipment on a regular basis. Many countries have facilities
that are said to be accessible, but this may be different from what you
actually encounter while you are there. Last year when I visited Cuba, I
found it very hard to watch an elderly couple struggle to climb a steep
flight of stairs, as the plane they were trying to board didn’t have
any other means of access. Thinking about what a person using a walker
or wheelchair might encounter, it is extremely important to check with
your travel agent whether the place you are going will meet your child’s
accommodation needs, including facilitating ramps, elevators and a
roll-in shower.
Of course, when you decide to go on a trip with your child, it is
important to speak with him and help him understand where you all will
be going, and what for. There are some great articles by about.com and
Friendship Circle I’ve linked to below that give great tips on ways to
prepare your child for traveling. By getting him used to the idea of
going on the trip ahead of time, you can reduce any anxiety he may have,
and prevent him from becoming overwhelmed and overexcited by the
experience. I think that is an important step towards a fun and
successful travelling experience.
If you have any questions, comments or experiences to share about
what worked and didn’t work for you, leave me a comment down below or join our forum discussion. Thanks everyone!
For more information:
http://specialchildren.about.com/od/travelwithspecialneeds/Travel_with_Children_with_Special_Needs.htm
Some great articles from Friendship Circle’s blog about things to prepare:
http://blog.friendshipcircle.org/2012/01/09/a-special-needs-pre-flight-checklist/
http://blog.friendshipcircle.org/2012/03/05/packing-for-the-plane-your-complete-special-needs-checklist/
Showing posts with label Stroke. Show all posts
Showing posts with label Stroke. Show all posts
22 March 2012
17 June 2011
So what’s the difference between cerebral palsy, brain injury and stroke?
By Natan Gendelman | http://www.enabledkids.ca
Cerebral palsy, traumatic brain injury and pediatric stroke are often brought together under the same treatment processes and types of rehabilitation. It is common knowledge for many people who work with kids that the approach to take is often quite similar between the three conditions. However, after working with and observing children who have cerebral palsy, brain injury or pediatric stroke, personally I would disagree with this method and viewpoint. In my opinion, there are many reasons why treatment for each condition should be distinct, and the first thing I would like to examine is what makes each condition different from the next.
Comparing terms
To start with, cerebral palsy can be generalized as a condition that a child is born with. The degree of severity of his condition will depend on how severely the brain is affected, and--by following a chain reaction--on the stages of development he has missed. This will lead to impairment as he grows older if the appropriate function is not gained. Children who have cerebral palsy cannot move through the stages of development because they are not acquiring skills in the normal developmental process. In most cases, a child is taken through his individual milestones by the nervous system. For a child with cerebral palsy however, this progression is absent and this normal development does not exist. Therefore, the skills have to be acquired first, and then repeated until they become automatic. This means that when we work with a child with CP, there is no re-gaining of skills, only learning from scratch. These are things that a child will then apply in his daily life, to become a part of his everyday function.
In contrast, traumatic brain injury and pediatric stroke can be seen as having totally different circumstances. Although it will depend on when these injuries occur, often a child with either one of these conditions would have already gone through at least some of the stages of development. This means that he would have already learned and acquired certain skills before the injury. When dealing with a child in one of these situations (and again, depending on his specific age, severity of condition and other factors), treatment will involve rehabilitation--that is, the re-gaining of movement and function which has been lost because of brain damage. This is what sets conditions such as TBI and pediatric stroke apart from cerebral palsy, and is something that should be accounted for in treatment.
Learning vs. regaining skills in treatment
When working with a child that has cerebral palsy, we need to remember that the child will not be regaining skills; he will be learning ones that he has never had before. Therefore, he has to be taught from A-Z what everything stands for, the individual body parts, the way they move, and how normal function should be. In contrast, a child with a brain injury or who has experienced pediatric stroke will need to focus on this idea of regaining skills, which means we are acquiring skills that take place before the injury has occurred. It is for these reasons that the approach to treatment will need to be completely different for a child with cerebral palsy. Rather than following the same steps that patients follow for the other conditions, the child will need to be shown how to turn, roll over, and be able to build on those skills before moving onto the next step.
As a result, a child’s treatment should differ according to how the child gains valuable life function. The methods of learning for kids with brain injury or stroke should not be the same as those for children with cerebral palsy. We take this approach in my clinic’s specialized treatment program called LIFE, and that is why we call our program an education / rehabilitation system rather than one or the other--the approach will change depending on the child’s needs. Here, we teach kids how to acquire these functions, how to do them, and why. If a child does not understand, we repeat them again and again and again under the child begins to follow. By paying attention to a child’s personality and characteristics as well as to his learning and specific condition, the treatment process becomes much more successful and fulfilling for those involved. It is for this reason that I think treatment for children under each category should be approached with regards to the condition itself. Of course, whether dealing with kids that have cerebral palsy, pediatric stroke or brain injury, the bottom line is the same: the patient must be the one to work harder than the therapist. That’s the reason why at our clinic, we try have a child do everything he has been taught by himself. In the end, the ultimate goal of treatment is to have a child learn to do things independently. By distinguishing each of these conditions, I hope that more parents, caregivers and therapists will learn from and experience success with their child as he learns and discovers the joys, wonders and surprises held by the world around him.
If you have any questions or comments, feel free to leave a comment down below or email me at natan@enabledkids.ca. Thanks everyone!
Cerebral palsy, traumatic brain injury and pediatric stroke are often brought together under the same treatment processes and types of rehabilitation. It is common knowledge for many people who work with kids that the approach to take is often quite similar between the three conditions. However, after working with and observing children who have cerebral palsy, brain injury or pediatric stroke, personally I would disagree with this method and viewpoint. In my opinion, there are many reasons why treatment for each condition should be distinct, and the first thing I would like to examine is what makes each condition different from the next.
Comparing terms
To start with, cerebral palsy can be generalized as a condition that a child is born with. The degree of severity of his condition will depend on how severely the brain is affected, and--by following a chain reaction--on the stages of development he has missed. This will lead to impairment as he grows older if the appropriate function is not gained. Children who have cerebral palsy cannot move through the stages of development because they are not acquiring skills in the normal developmental process. In most cases, a child is taken through his individual milestones by the nervous system. For a child with cerebral palsy however, this progression is absent and this normal development does not exist. Therefore, the skills have to be acquired first, and then repeated until they become automatic. This means that when we work with a child with CP, there is no re-gaining of skills, only learning from scratch. These are things that a child will then apply in his daily life, to become a part of his everyday function.
In contrast, traumatic brain injury and pediatric stroke can be seen as having totally different circumstances. Although it will depend on when these injuries occur, often a child with either one of these conditions would have already gone through at least some of the stages of development. This means that he would have already learned and acquired certain skills before the injury. When dealing with a child in one of these situations (and again, depending on his specific age, severity of condition and other factors), treatment will involve rehabilitation--that is, the re-gaining of movement and function which has been lost because of brain damage. This is what sets conditions such as TBI and pediatric stroke apart from cerebral palsy, and is something that should be accounted for in treatment.
Learning vs. regaining skills in treatment
When working with a child that has cerebral palsy, we need to remember that the child will not be regaining skills; he will be learning ones that he has never had before. Therefore, he has to be taught from A-Z what everything stands for, the individual body parts, the way they move, and how normal function should be. In contrast, a child with a brain injury or who has experienced pediatric stroke will need to focus on this idea of regaining skills, which means we are acquiring skills that take place before the injury has occurred. It is for these reasons that the approach to treatment will need to be completely different for a child with cerebral palsy. Rather than following the same steps that patients follow for the other conditions, the child will need to be shown how to turn, roll over, and be able to build on those skills before moving onto the next step.
As a result, a child’s treatment should differ according to how the child gains valuable life function. The methods of learning for kids with brain injury or stroke should not be the same as those for children with cerebral palsy. We take this approach in my clinic’s specialized treatment program called LIFE, and that is why we call our program an education / rehabilitation system rather than one or the other--the approach will change depending on the child’s needs. Here, we teach kids how to acquire these functions, how to do them, and why. If a child does not understand, we repeat them again and again and again under the child begins to follow. By paying attention to a child’s personality and characteristics as well as to his learning and specific condition, the treatment process becomes much more successful and fulfilling for those involved. It is for this reason that I think treatment for children under each category should be approached with regards to the condition itself. Of course, whether dealing with kids that have cerebral palsy, pediatric stroke or brain injury, the bottom line is the same: the patient must be the one to work harder than the therapist. That’s the reason why at our clinic, we try have a child do everything he has been taught by himself. In the end, the ultimate goal of treatment is to have a child learn to do things independently. By distinguishing each of these conditions, I hope that more parents, caregivers and therapists will learn from and experience success with their child as he learns and discovers the joys, wonders and surprises held by the world around him.
If you have any questions or comments, feel free to leave a comment down below or email me at natan@enabledkids.ca. Thanks everyone!
20 March 2010
Promise For Improving Hand Function In Teens With Cerebral Palsy: Modified Home Video Game
Engineers at Rutgers University have modified a popular home video game system to help teenagers with cerebral palsy improve hand functions. In a pilot trial with three participants, the system improved the teens' abilities to perform a range of daily personal and household activities.
The modified system combined a Sony PlayStation 3 console and a commercial gaming glove with custom-developed software and games to provide exercise routines aimed at improving hand speed and range of finger motion.
The Rutgers engineers, who are members of the university's Tele-Rehabilitation Institute, worked with clinicians at the Indiana University School of Medicine to deploy systems in participants' homes for up to 10 months. A description of the modified system and its use in the pilot trial appeared this week in the journal, IEEE Transactions on Information Technology in Biomedicine.
"Based on early experience, the system engages the interest of teens with cerebral palsy and makes it convenient for them to perform the exercises they need to achieve results," said Grigore Burdea, professor of electrical and computer engineering and director of the Rutgers Tele-Rehabilitation Institute.
Each system communicated via the Internet to allow the Indiana and Rutgers researchers to oversee participants' exercise routines and evaluate the effectiveness of the systems. The system is an example of both virtual rehabilitation, where patients interact with computer-generated visual environments to perform exercises, and tele-rehabilitation, where patients perform exercises under remote supervision by physical or occupational therapists.
"All three teens were more than a decade out from their perinatal strokes, yet we showed that improvement was still possible ," said Meredith Golomb, associate professor of neurology at the Indiana University School of Medicine and Riley Hospital for Children pediatric neurologist in this study. "The virtual reality telerehabiltiaiton system kept them exercising by rewarding whatever movements they could make, and all three showed significant progress in hand function."
Golomb oversaw the pilot study where participants were asked to exercise their affected hand 30 minutes a day, five days a week, using games custom developed by the Rutgers engineers. The games were calibrated to the individual teen's hand functionality. An on-screen image of a hand showing normal movements guided the participants in their exercises.
After three months of therapy, two participants progressed from being unable to lift large, heavy objects to being able to do so. Participants showed varying improvement in such activities as brushing teeth, shampooing, dressing, and using a spoon. At 10 months, one participant was able to open a heavy door.
The modified PlayStation 3 is the second system based on commercial video gaming technology that Burdea and his institute have developed to investigate economical and engaging rehabilitation therapy tools. Earlier work involved modifying an older model Microsoft Xbox to help stroke victims recover hand functions.
"Systems like this have the potential for widespread deployment in outpatient clinics or the homes of people needing rehabilitation services for any number of illnesses or injuries," said Burdea, a noted inventor of virtual rehabilitation technology. "Well-designed custom games are likely to hold patients' attention and motivate them to complete their exercises, versus conventional therapy regimens, which patients may find boring or tedious."
Burdea acknowledged the popularity of gaming platforms and many newer games that physically engage their players, but noted that they generally are not suitable off-the-shelf for rehabilitation needs. Games for rehabilitation need to focus on the specific impairment, and they require professional oversight to ensure that patients exercise within therapeutic bounds while not over-exercising and risking stress or injury.
The systems that Burdea and his colleagues built combined a PlayStation 3 console with a Fifth Dimension Technologies 5 Ultra sensing glove, a flat-panel television, mouse, keyboard and digital subscriber line modem for Internet communication. They reprogrammed the game console using the open-source Linux operating system and developed games written in Java3D.
One game promoted range of finger motion by asking participants to clean up bars of "dirty" pixels on the screen to reveal an image. Another promoted finger movement speed by asking participants to flick away an on-screen butterfly. A third promoted hand opening and closing speed by asking participants to manipulate an on-screen unidentified flying object.
The developers also wrote software to manage participant scheduling and performance data and to administer subjective evaluation questionnaires.
In addition to Burdea and Golomb, the article's co-authors are Meghan Huber and Bryan Rabin, both Rutgers undergraduates during the study, and Ciprian Docan and Moustafa AbdelBaky, Rutgers graduate students. The study was funded in part by the National Institutes of Health and the Clarian Foundation.
Source:
Carl Blesch
Rutgers University
The modified system combined a Sony PlayStation 3 console and a commercial gaming glove with custom-developed software and games to provide exercise routines aimed at improving hand speed and range of finger motion.
The Rutgers engineers, who are members of the university's Tele-Rehabilitation Institute, worked with clinicians at the Indiana University School of Medicine to deploy systems in participants' homes for up to 10 months. A description of the modified system and its use in the pilot trial appeared this week in the journal, IEEE Transactions on Information Technology in Biomedicine.
"Based on early experience, the system engages the interest of teens with cerebral palsy and makes it convenient for them to perform the exercises they need to achieve results," said Grigore Burdea, professor of electrical and computer engineering and director of the Rutgers Tele-Rehabilitation Institute.
Each system communicated via the Internet to allow the Indiana and Rutgers researchers to oversee participants' exercise routines and evaluate the effectiveness of the systems. The system is an example of both virtual rehabilitation, where patients interact with computer-generated visual environments to perform exercises, and tele-rehabilitation, where patients perform exercises under remote supervision by physical or occupational therapists.
"All three teens were more than a decade out from their perinatal strokes, yet we showed that improvement was still possible ," said Meredith Golomb, associate professor of neurology at the Indiana University School of Medicine and Riley Hospital for Children pediatric neurologist in this study. "The virtual reality telerehabiltiaiton system kept them exercising by rewarding whatever movements they could make, and all three showed significant progress in hand function."
Golomb oversaw the pilot study where participants were asked to exercise their affected hand 30 minutes a day, five days a week, using games custom developed by the Rutgers engineers. The games were calibrated to the individual teen's hand functionality. An on-screen image of a hand showing normal movements guided the participants in their exercises.
After three months of therapy, two participants progressed from being unable to lift large, heavy objects to being able to do so. Participants showed varying improvement in such activities as brushing teeth, shampooing, dressing, and using a spoon. At 10 months, one participant was able to open a heavy door.
The modified PlayStation 3 is the second system based on commercial video gaming technology that Burdea and his institute have developed to investigate economical and engaging rehabilitation therapy tools. Earlier work involved modifying an older model Microsoft Xbox to help stroke victims recover hand functions.
"Systems like this have the potential for widespread deployment in outpatient clinics or the homes of people needing rehabilitation services for any number of illnesses or injuries," said Burdea, a noted inventor of virtual rehabilitation technology. "Well-designed custom games are likely to hold patients' attention and motivate them to complete their exercises, versus conventional therapy regimens, which patients may find boring or tedious."
Burdea acknowledged the popularity of gaming platforms and many newer games that physically engage their players, but noted that they generally are not suitable off-the-shelf for rehabilitation needs. Games for rehabilitation need to focus on the specific impairment, and they require professional oversight to ensure that patients exercise within therapeutic bounds while not over-exercising and risking stress or injury.
The systems that Burdea and his colleagues built combined a PlayStation 3 console with a Fifth Dimension Technologies 5 Ultra sensing glove, a flat-panel television, mouse, keyboard and digital subscriber line modem for Internet communication. They reprogrammed the game console using the open-source Linux operating system and developed games written in Java3D.
One game promoted range of finger motion by asking participants to clean up bars of "dirty" pixels on the screen to reveal an image. Another promoted finger movement speed by asking participants to flick away an on-screen butterfly. A third promoted hand opening and closing speed by asking participants to manipulate an on-screen unidentified flying object.
The developers also wrote software to manage participant scheduling and performance data and to administer subjective evaluation questionnaires.
In addition to Burdea and Golomb, the article's co-authors are Meghan Huber and Bryan Rabin, both Rutgers undergraduates during the study, and Ciprian Docan and Moustafa AbdelBaky, Rutgers graduate students. The study was funded in part by the National Institutes of Health and the Clarian Foundation.
Source:
Carl Blesch
Rutgers University
11 February 2010
Phone App To Improved Stroke Rehab
Led by Professor Linda Worrall from UQ's Clinical Centre for Research Excellence (CCRE) in Aphasia Rehabilitation, the study will be the first of its kind to use the technology in combining two complementary approaches to aphasia rehabilitation into one optimal treatment outcome.
Aphasia, a language difficulty attributed to injury of the brain, usually from stroke, is estimated to affect 80,000 Australians. It can vary from mild difficulties with finding words, or reading text, to not being able to understand what people are saying and being unable to speak.
As part of the study, 50 participants with aphasia will wear voice-activated recorders for four weeks to record the amount of time they talk each day.
The small device, to be incorporated into their mobile phone, will function in a similar way as a pedometer is used in the 10,000 steps program, by keeping track of the users "communicative fitness".
Professor Worrall said that participants would then be allocated to appropriate speech pathology programs based on their communicative fitness, which will help them gradually communicate more often.
"Our study aims to examine whether people with aphasia can improve their language and life participation by increasing the amount of time they talk during their everyday lives," she said.
"The benefits of this program for people with aphasia and their families is that it not only aims to improve language function but also to prevent or overcome the effects of social isolation that come from not being able to understand or communicate clearly with others.
"We envisage that this study will lead to better communication outcomes, less social isolation, and better quality of life for people with aphasia and their families."
Professor Worrall said that the CCRE has recruited all known available researchers associated with aphasia in Australia and relevant international experts to achieve this goal, and anticipates that the size of the team will double during the program.
The major outcome from research within the CCRE will be the development of the Australian Aphasia Clinical Pathway in close collaboration with speech pathologists and consumers.
Source
University of Queensland
Aphasia, a language difficulty attributed to injury of the brain, usually from stroke, is estimated to affect 80,000 Australians. It can vary from mild difficulties with finding words, or reading text, to not being able to understand what people are saying and being unable to speak.
As part of the study, 50 participants with aphasia will wear voice-activated recorders for four weeks to record the amount of time they talk each day.
The small device, to be incorporated into their mobile phone, will function in a similar way as a pedometer is used in the 10,000 steps program, by keeping track of the users "communicative fitness".
Professor Worrall said that participants would then be allocated to appropriate speech pathology programs based on their communicative fitness, which will help them gradually communicate more often.
"Our study aims to examine whether people with aphasia can improve their language and life participation by increasing the amount of time they talk during their everyday lives," she said.
"The benefits of this program for people with aphasia and their families is that it not only aims to improve language function but also to prevent or overcome the effects of social isolation that come from not being able to understand or communicate clearly with others.
"We envisage that this study will lead to better communication outcomes, less social isolation, and better quality of life for people with aphasia and their families."
Professor Worrall said that the CCRE has recruited all known available researchers associated with aphasia in Australia and relevant international experts to achieve this goal, and anticipates that the size of the team will double during the program.
The major outcome from research within the CCRE will be the development of the Australian Aphasia Clinical Pathway in close collaboration with speech pathologists and consumers.
Source
University of Queensland
13 August 2009
New Ultra-Portable Speech Device Marries Comprehensive Communication with Mainstream Technology
PITTSBURGH, Aug. 10 /PRNewswire/ -- DynaVox Mayer-Johnson, the world's leading provider of communication and education solutions for individuals with speech, language and learning disabilities, today announced the DynaVox Xpress. The Xpress sets a new standard for hand-held speech solutions by bringing together comprehensive augmentative and alternative communication (AAC) tools with a variety of mainstream communication features.
An innovative, sleek and extremely portable device, the Xpress delivers powerful communication capabilities for individuals living with stroke, autism, Down syndrome, traumatic brain injury, aphasia, ALS, and apraxia of speech.
This integration allows for robust communication in virtually any situation, and:
Enables mobility and creates confidence. The Xpress is so small it can be held in one hand or two, and can easily be carried in a pocket or purse. With its discreet design, the Xpress allows augmented communicators to blend in with the crowd and still speak their minds. Touch screen technology never before available in a speech device creates a compelling visual experience, and allows touching or "sweeping" to access more content quickly with fingers or thumbs.
Takes AAC technology to new heights. With multiple connectivity options such as Wi-Fi for internet and email access, Bluetooth, and infrared remote control, the Xpress offers unparalleled opportunities for communication. Multimedia tools such as MP3 and video players allow Xpress users to share their personalities in new ways.
Stands up to the demands of daily life. The Xpress is made of rugged magnesium and uses Flash memory to withstand the stresses of life. Swappable batteries, or an extended battery, ensure that Xpress users have the power they need to keep the conversation going all day.
Makes every voice - and every emotion - heard. Twin front-firing speakers allow Xpress users to be heard in virtually any environment. The new voices included with the Xpress are natural-sounding and take communication to the next level by adding emotion - laughter, crying, shouting and whispers.
Preserves familiar content. Existing DynaVox customers and their care teams will recognize the powerful InterAACT language framework designed to meet the communication needs of individuals regardless of age or ability level. Thousands of pre-programmed pages minimize the need for programming.
Includes comprehensive DynaVox Mayer-Johnson support. Xpress users and their care teams will have access to the full-range of DynaVox Mayer-Johnson's pre- and post-purchase support services including funding assistance, sales support, and technical support. The Xpress also gives the user one-touch access to technical support, where DynaVox personnel can remotely access the device and assist the user.
"Our clients told us they wanted a highly portable solution without sacrificing communication functionality," said Ed Donnelly, CEO of DynaVox Mayer-Johnson. "The Xpress accomplishes this objective, and delivers a quantum technological step forward, in a device that looks and feels like mainstream technology. We are excited to be introducing the most transformative speech device ever to the AAC community."
The Xpress will begin shipping to customers in late August 2009. Funding is available through Medicare, Medicaid and private health insurance providers.
About DynaVox Mayer-Johnson
DynaVox Mayer-Johnson develops a range of speech communication and education solutions designed to help children and adults challenged by significant speech, language and learning disabilities make meaningful connections and participate in the home, classroom and the community. The company's DynaVox line of speech communication devices gives a voice to the millions of people who are unable to use speech as their primary means of communication due to the effects of conditions such as amyotrophic lateral sclerosis (ALS or Lou Gehrig's Disease), stroke, traumatic brain injury, cerebral palsy, Parkinson's Disease, autism and mental retardation. The Mayer-Johnson line of print-based and on-screen education products engage students in the learning process and support academic achievement. Driven by a strong entrepreneurial culture, the company develops technology-based products and offers an extensive customer support program to assist individuals as well as their families and support professionals. For more information about DynaVox Mayer-Johnson, visit www.dynavoxtech.com.
SOURCE DynaVox Mayer-Johnson
An innovative, sleek and extremely portable device, the Xpress delivers powerful communication capabilities for individuals living with stroke, autism, Down syndrome, traumatic brain injury, aphasia, ALS, and apraxia of speech.
This integration allows for robust communication in virtually any situation, and:
Enables mobility and creates confidence. The Xpress is so small it can be held in one hand or two, and can easily be carried in a pocket or purse. With its discreet design, the Xpress allows augmented communicators to blend in with the crowd and still speak their minds. Touch screen technology never before available in a speech device creates a compelling visual experience, and allows touching or "sweeping" to access more content quickly with fingers or thumbs.
Takes AAC technology to new heights. With multiple connectivity options such as Wi-Fi for internet and email access, Bluetooth, and infrared remote control, the Xpress offers unparalleled opportunities for communication. Multimedia tools such as MP3 and video players allow Xpress users to share their personalities in new ways.
Stands up to the demands of daily life. The Xpress is made of rugged magnesium and uses Flash memory to withstand the stresses of life. Swappable batteries, or an extended battery, ensure that Xpress users have the power they need to keep the conversation going all day.
Makes every voice - and every emotion - heard. Twin front-firing speakers allow Xpress users to be heard in virtually any environment. The new voices included with the Xpress are natural-sounding and take communication to the next level by adding emotion - laughter, crying, shouting and whispers.
Preserves familiar content. Existing DynaVox customers and their care teams will recognize the powerful InterAACT language framework designed to meet the communication needs of individuals regardless of age or ability level. Thousands of pre-programmed pages minimize the need for programming.
Includes comprehensive DynaVox Mayer-Johnson support. Xpress users and their care teams will have access to the full-range of DynaVox Mayer-Johnson's pre- and post-purchase support services including funding assistance, sales support, and technical support. The Xpress also gives the user one-touch access to technical support, where DynaVox personnel can remotely access the device and assist the user.
"Our clients told us they wanted a highly portable solution without sacrificing communication functionality," said Ed Donnelly, CEO of DynaVox Mayer-Johnson. "The Xpress accomplishes this objective, and delivers a quantum technological step forward, in a device that looks and feels like mainstream technology. We are excited to be introducing the most transformative speech device ever to the AAC community."
The Xpress will begin shipping to customers in late August 2009. Funding is available through Medicare, Medicaid and private health insurance providers.
About DynaVox Mayer-Johnson
DynaVox Mayer-Johnson develops a range of speech communication and education solutions designed to help children and adults challenged by significant speech, language and learning disabilities make meaningful connections and participate in the home, classroom and the community. The company's DynaVox line of speech communication devices gives a voice to the millions of people who are unable to use speech as their primary means of communication due to the effects of conditions such as amyotrophic lateral sclerosis (ALS or Lou Gehrig's Disease), stroke, traumatic brain injury, cerebral palsy, Parkinson's Disease, autism and mental retardation. The Mayer-Johnson line of print-based and on-screen education products engage students in the learning process and support academic achievement. Driven by a strong entrepreneurial culture, the company develops technology-based products and offers an extensive customer support program to assist individuals as well as their families and support professionals. For more information about DynaVox Mayer-Johnson, visit www.dynavoxtech.com.
SOURCE DynaVox Mayer-Johnson
05 June 2009
Neurological disorder can take control over victims
By Peggy Ussery
Published: June 3, 2009
It started with stiffness in her neck. Over time, Jane Murphy noticed her chin was hanging low to her chest.
Doctors put her on arthritis medicines and recommended heat treatment. The pain spread and she began using her hand to keep her head up straight. The symptoms spread from her neck to her eyelids and then to her face.
“I was on so much medicine, I wanted to sleep all the time,” Murphy said.
The ball of Tim Hornsby’s foot began to swell. He noticed his toe was falling asleep regularly. He began dragging his foot. Hornsby thought it might be related to an old back injury. Doctors ruled out stroke and Parkinson’s disease.
Today, the once active engineer uses a walker for support. His toes curl up under the constant muscle contraction. His legs lock up without warning, causing Hornsby to fall on more than one occasion — he even broke his nose once on a night stand.
“You lose a lot of dignity,” Hornsby said. “I’ve always been one that’s done anything, and to have to ask people to do things for you ...”
The pain near the front of Chrissi Brannon’s ears spread to her teeth. For five years she saw dentists, oral surgeons, neurologists and ear, nose and throat specialists. She had root canals on all her back teeth. There were doctors and others who thought the 31-year-old was drug-seeking. Her chin started to pucker out uncontrollably.
Brannon’s left shoulder began to hurt; then, her right shoulder. The pain, fatigue and depression consumed her. Last year, the wife and mother of two gave up a career she loved as a pharmaceutical representative.
“I was a go-getter,” Brannon said. “I worked all the time.”
Murphy, Hornsby and Brannon each have a neurological movement disorder called dystonia. It’s the third most common neurological disorder in the U.S., but most people have never heard of it.
Dystonia is in the same family of neurological disorders as Parkinson’s disease. While Parkinson’s eventually destroys its victim’s brain, dystonia takes the body. It’s a debilitating condition that, while not fatal, forces muscles into a constant and painful contraction, sometimes disabling patients. The muscle contraction is so intense it’s compared to 18 hours of working out. It may hit one area of the body — legs, arms, neck, face, eyes — or attack the entire body, known as generalized dystonia. It can even effect hearing and speech, and severe cases of dystonia in the neck or vocal cords can actually impair breathing.
Hornsby, who lives in Headland, attends support group meetings in Birmingham. But he, Murphy and Brannon — who both live in Newville — hope to get enough interest to establish a Wiregrass support group. They figure there are others locally also dealing with the condition.
“I just know there are so many people out there with pain,” Brannon said.
Why and how dystonia happens is unknown. There are theories. It could be genetic. It may come on after a trauma, especially a physical trauma. Some people may be predisposed to it. Stress can aggravate symptoms.
Some people have only mild symptoms, while others live in agony. There is no cure.
A common treatment for dystonia is botox injections given every few months to paralyze the muscles and stop the involuntary movements. Medications can help, and in severe cases deep brain stimulation surgery can relieve symptoms.
“I had problems and didn’t know what the problems were,” Hornsby said. “They weren’t consistent.”
Unlike many people who spend years trying to get a diagnosis, Hornsby received a diagnosis within only a few months of seeking help in 2006. However, he saw eight doctors first. Within a year of his diagnosis, his symptoms had spread from one foot to the other.
When he and his wife, Virginia, received the news, they turned to the Internet for information. What they read was disheartening.
“Emotions for me and Virginia went from rock bottom to everywhere,” Hornsby said.
He was able to walk his daughter, Rebecca, down the aisle when she got married, but he can’t get out and walk with his grandson. He’s able to keep his job with the Alabama Department of Transportation in Troy because Virginia works in the same office and drives them both. But he’s no longer able to do field work.
“I have to depend on people I trust to get out and do things work-related,” he said. “But I’ve got some good people.”
Murphy saw 21 doctors before her diagnosis in the 1980s at the age of 48. Now 70 years old, Murphy has lived with dystonia for 22 years.
“We went to doctor after doctor ...,” Murphy said. “Nobody had heard of my ailment.”
Murphy has three kinds of dystonia in her neck, eyes and face. Her facial dystonia has gone into remission. She uses a back support to help her sit up straight in church and wears dark glasses to protect her sensitive eyes.
Brannon was 31 when her symptoms first occurred in 2001. She was diagnosed in 2006. Her dystonia affects her neck, face, back and hands. The pain and the fatigue has caused her to miss a lot with her children, ages 12 and 3. But her husband, Tom, has been supportive.
“If I have a day that’s pain-free, it’s few and far between,” she said.
Brannon now worries about the numbness she’s starting to feel in her toes.
“It’s getting worse, I can tell ...,” she said. “I’m hoping for the best, hoping to keep mine under control. Mine is moving, and that’s scary.”
Brannon is not alone in her fear.
“There’s that little bit of uncertainty,” Hornsby said. “Where is it going next and when?”——————————-Want to know more?If you or someone you know is interested in starting a local dystonia support group, e-mail DothanDystoniaSupportGroup@gmail.com
Understanding DystoniaThis week is Dystonia Awareness Week. Alabama Gov. Bob Riley signed a proclamation to support raising awareness about the condition. Here is some information about the different forms of the condition from the Dystonia Medical Research Foundation:
Laryngeal dystonia/spasmodic dystonia - Affects muscles of the vocal cords, making it difficult to speak.
Blepharospasm - Affects the eyelids, causing them to blink uncontrollably or remain closed.
Cranial dystonia - Affects face, jaw and tongue. Causes grimacing, tongue protrusion and jaw closure or opening.
Cervical dystonia/spasmodic torticollis - Affects neck and shoulder muscles, turning the head to the side or forcing the head back or forward. A tremor may be present.
Hand dystonia/writer’s cramp - Causes fingers to curl and the hand and forearm to cramp. Occurs when a person attempts to use the hand for writing, playing a musical instrument or other activities.
Generalized dystonia - Affects many parts of the body simultaneously. Causes cramping and twisting in the feet, limbs and torso.
Published: June 3, 2009
It started with stiffness in her neck. Over time, Jane Murphy noticed her chin was hanging low to her chest.
Doctors put her on arthritis medicines and recommended heat treatment. The pain spread and she began using her hand to keep her head up straight. The symptoms spread from her neck to her eyelids and then to her face.
“I was on so much medicine, I wanted to sleep all the time,” Murphy said.
The ball of Tim Hornsby’s foot began to swell. He noticed his toe was falling asleep regularly. He began dragging his foot. Hornsby thought it might be related to an old back injury. Doctors ruled out stroke and Parkinson’s disease.
Today, the once active engineer uses a walker for support. His toes curl up under the constant muscle contraction. His legs lock up without warning, causing Hornsby to fall on more than one occasion — he even broke his nose once on a night stand.
“You lose a lot of dignity,” Hornsby said. “I’ve always been one that’s done anything, and to have to ask people to do things for you ...”
The pain near the front of Chrissi Brannon’s ears spread to her teeth. For five years she saw dentists, oral surgeons, neurologists and ear, nose and throat specialists. She had root canals on all her back teeth. There were doctors and others who thought the 31-year-old was drug-seeking. Her chin started to pucker out uncontrollably.
Brannon’s left shoulder began to hurt; then, her right shoulder. The pain, fatigue and depression consumed her. Last year, the wife and mother of two gave up a career she loved as a pharmaceutical representative.
“I was a go-getter,” Brannon said. “I worked all the time.”
Murphy, Hornsby and Brannon each have a neurological movement disorder called dystonia. It’s the third most common neurological disorder in the U.S., but most people have never heard of it.
Dystonia is in the same family of neurological disorders as Parkinson’s disease. While Parkinson’s eventually destroys its victim’s brain, dystonia takes the body. It’s a debilitating condition that, while not fatal, forces muscles into a constant and painful contraction, sometimes disabling patients. The muscle contraction is so intense it’s compared to 18 hours of working out. It may hit one area of the body — legs, arms, neck, face, eyes — or attack the entire body, known as generalized dystonia. It can even effect hearing and speech, and severe cases of dystonia in the neck or vocal cords can actually impair breathing.
Hornsby, who lives in Headland, attends support group meetings in Birmingham. But he, Murphy and Brannon — who both live in Newville — hope to get enough interest to establish a Wiregrass support group. They figure there are others locally also dealing with the condition.
“I just know there are so many people out there with pain,” Brannon said.
Why and how dystonia happens is unknown. There are theories. It could be genetic. It may come on after a trauma, especially a physical trauma. Some people may be predisposed to it. Stress can aggravate symptoms.
Some people have only mild symptoms, while others live in agony. There is no cure.
A common treatment for dystonia is botox injections given every few months to paralyze the muscles and stop the involuntary movements. Medications can help, and in severe cases deep brain stimulation surgery can relieve symptoms.
“I had problems and didn’t know what the problems were,” Hornsby said. “They weren’t consistent.”
Unlike many people who spend years trying to get a diagnosis, Hornsby received a diagnosis within only a few months of seeking help in 2006. However, he saw eight doctors first. Within a year of his diagnosis, his symptoms had spread from one foot to the other.
When he and his wife, Virginia, received the news, they turned to the Internet for information. What they read was disheartening.
“Emotions for me and Virginia went from rock bottom to everywhere,” Hornsby said.
He was able to walk his daughter, Rebecca, down the aisle when she got married, but he can’t get out and walk with his grandson. He’s able to keep his job with the Alabama Department of Transportation in Troy because Virginia works in the same office and drives them both. But he’s no longer able to do field work.
“I have to depend on people I trust to get out and do things work-related,” he said. “But I’ve got some good people.”
Murphy saw 21 doctors before her diagnosis in the 1980s at the age of 48. Now 70 years old, Murphy has lived with dystonia for 22 years.
“We went to doctor after doctor ...,” Murphy said. “Nobody had heard of my ailment.”
Murphy has three kinds of dystonia in her neck, eyes and face. Her facial dystonia has gone into remission. She uses a back support to help her sit up straight in church and wears dark glasses to protect her sensitive eyes.
Brannon was 31 when her symptoms first occurred in 2001. She was diagnosed in 2006. Her dystonia affects her neck, face, back and hands. The pain and the fatigue has caused her to miss a lot with her children, ages 12 and 3. But her husband, Tom, has been supportive.
“If I have a day that’s pain-free, it’s few and far between,” she said.
Brannon now worries about the numbness she’s starting to feel in her toes.
“It’s getting worse, I can tell ...,” she said. “I’m hoping for the best, hoping to keep mine under control. Mine is moving, and that’s scary.”
Brannon is not alone in her fear.
“There’s that little bit of uncertainty,” Hornsby said. “Where is it going next and when?”——————————-Want to know more?If you or someone you know is interested in starting a local dystonia support group, e-mail DothanDystoniaSupportGroup@gmail.com
Understanding DystoniaThis week is Dystonia Awareness Week. Alabama Gov. Bob Riley signed a proclamation to support raising awareness about the condition. Here is some information about the different forms of the condition from the Dystonia Medical Research Foundation:
Laryngeal dystonia/spasmodic dystonia - Affects muscles of the vocal cords, making it difficult to speak.
Blepharospasm - Affects the eyelids, causing them to blink uncontrollably or remain closed.
Cranial dystonia - Affects face, jaw and tongue. Causes grimacing, tongue protrusion and jaw closure or opening.
Cervical dystonia/spasmodic torticollis - Affects neck and shoulder muscles, turning the head to the side or forcing the head back or forward. A tremor may be present.
Hand dystonia/writer’s cramp - Causes fingers to curl and the hand and forearm to cramp. Occurs when a person attempts to use the hand for writing, playing a musical instrument or other activities.
Generalized dystonia - Affects many parts of the body simultaneously. Causes cramping and twisting in the feet, limbs and torso.
31 May 2009
Miracle of the paralysed patients freed from their silent prison
By Isla Whitcroft
At 23, Richard Gregory had a bright future. He'd just graduated from King's College in London and had won a coveted place at Sandhurst to start officer training.
Then, in November 2003, he was a passenger in a van that was almost completely crushed by a truck. He was pulled from the wreckage alive but had ruptured several organs and, as he arrived at hospital, suffered a major stroke.
'By the time we reached him, Richard was in a coma and doctors were unsure as to whether he would wake up,' remembers his mother Vivienne. 'It was six months before he was taken off a ventilator and started to breathe for himself.
Trapped: Richard Gregory was diagnosed with 'Locked-In Syndrome' after being paralysed in a traffic accident
'Although we never gave up hope, it was almost another year before we really believed he was still conscious and alive inside his paralysed body.
'The first sign was a sort of lopsided smile which doctors said was just an involuntary movement. Then we could see his right eye was moving, which they said was reflex.'
His parents Vivienne and Errol, along with other family and friends, began to ask him questions: to their delight, he responded by twitching his eyebrow. Encouraged by this, doctors sent Richard for tests.
'The results were conclusive - his brain was fully functioning,' says Vivienne. 'He was alert, aware of everything that had happened but unable to talk. The doctors called it Locked-In Syndrome. We called it an absolute tragedy.'
Locked-In Syndrome (LIS) can occur as the result of a stroke, a progressive neurological disorder such as Motor Neurone Disease or, as in Richard's case, a trauma in the brain stem which has irreparably damaged the nerves that control the head and body movement. The stroke he suffered may have also contributed to the damage.
As a result, the patient is paralysed but fully conscious, with normal brain function.
They can breathe unaided but are unable to speak, with their only method of communication through vertical eye movements. It is a dreadful fate, exacerbated by the inability of the patient to communicate their consciousness to the outside world.
There is plenty of anecdotal evidence of patients being written off by medics as being in a vegetative state or a coma; even of hearing doctors discussing switching off their life-support machine before someone notices that they are trying to communicate that they are very much alive.
'We could tell by the look in his eyes that Richard was trying to communicate with us,' says his godmother Dawn, who's been closely involved in his care. 'He just didn't have the means to do so.'
Mind-reading miracle: Richard is pictured here with Dr Paul Gnanayathum, who developed a device which interprets the brainwaves of paralysed patients, enabling them to communicate
After his accident, Richard spent the next three years in an NHS specialist head injuries unit until it became clear that his medical condition was not going to improve. Today, he lives in a dedicated care home in Birmingham.
His inability to communicate was extremely disheartening, says Dawn. 'Richard had always been chatty, with a big smile on his face, and we knew that he wanted to communicate with us.'
Computer program that 'reads' their minds
Then, last year, she read about a computer program which offered the family fresh hope. It effectively 'reads' the patient's mind to help them communicate. Using electrodes attached to the forehead, the program picks up electrical signals in the brain and from any muscles around the forehead which are not paralysed.
These electrical signals are then fed into a 'de-scrambler' which converts them into a command to move a cursor on a computer screen - for instance, to point at words such as yes or no.
The system was designed specifically for locked-in patients by Dr Paul Gnanayutham, a lecturer in computing at Portsmouth University.
This is not the first time scientists have found a way of using a person's brain waves to navigate a cursor, but Dr Gnanayutham is one of the first to use the technology on real people with serious brain injuries.
Furthermore, he has made a real breakthrough. One of the main barriers to the expansion of this technology had been that as well as the cursor-moving brain waves, there are lots of other brain waves creating background 'noise' which can confuse the computer.
It took him three years, but Dr Gnanayutham managed to write a sophisticated computer program which cuts out this 'noise'.
Since building the machine in 2001, he has worked with more than 30 patients.
'We use any signals we can to help patients to communicate,' he says. 'Some, like Richard, can frown a bit, which means his forehead muscles are not paralysed - so he can use those muscles to help along the cursor. He can also move his eyes.
'Some people can't move anything, and in that case we just work with brain waves.'
Dawn got in touch with Dr Gnanayutham, who went to see Richard last September.
Skateboarding computer game test
'He chatted to Richard and explained what he wanted him to do,' says Dawn. 'He put six pads on Richard's forehead, which were wired up to a box and a screen. We all waited with bated breath to see what would happen.'
Dr Gnanayutham had loaded up a computer game based on skateboarding. As the family watched, Richard concentrated hard and suddenly the skateboarder began moving - jumping obstacles and sliding up and down cliffs.
'It was an amazing moment,' says Dawn. 'We were nearly in tears. I remember sitting there watching with shivers running down my spine. At last Richard was able to break out of his prison, if only for a few minutes.
'I could tell Richard was really pleased. What the doctor didn't know was that Richard had been a really good snowboarder. He couldn't have picked a better game for him.'
Dr Gnanayutham, too, was astounded. 'I had never seen anything like it. To see someone playing a computer game using just brain waves, and playing it so well, was amazing.
'To do something like that takes a huge amount of effort and concentration, and people with head injuries tend to tire easily anyway. Richard is clearly a very clever man.'
Dr Gnanayutham first conceived the idea of the programme when singing in a choir which toured hospitals around London.
He says: 'We visited a neurological hospital in Putney and I saw people who were locked in. It seemed so unfair that they couldn't tell us if they were sad, happy, or wanted to go to bed late. I kept wondering if there was something I could do to help them to communicate.
'I knew the computer technology to use brain waves was out there, but my challenge was to adapt that so it was suitable for people with that condition.'
Cause? Richard suffered a major stroke as he arrived at hospital, which may have contributed to his brain damage
'What he has done is quite remarkable,' says Professor Gilbert Cockton, head of research into human and computer interaction at the University of Sunderland.
'He has solved a very complex problem and chosen to apply it to a worthwhile and moving cause.'
Indeed, Dr Gnanayutham could probably sell this programme to the computer gaming industry and make a fortune. Instead, as a committed Christian, he has chosen to devote what little spare time he has to visiting as many locked-in patients as possible and using the machine on them.
'Learning how to navigate using eye movement and brain waves isn't easy,' says Dr Gnanayutham. 'I worked for eight months with one young man whose mother knew he was "there" - but nothing happened until he started using the brain wave system. Finally, he could "talk" to her again.'
Dr Gnanayutham doesn't-always bring good news: there are times when people's loved ones are no longer conscious, and he cannot work with patients who are heavily sedated.
Wherever possible, he tries to have a medical doctor witnessing his work. 'I can't just walk into a hospital and start treating patients,' he says. 'While most care homes are sympathetic, hospitals are less so. My dream is to use my system within the NHS, so this is something I need to address.
Dr Gnanayutham has two machines, each containing a laptop, screen and head pads.
'I would like to create one single unit with all the component parts in it which could be operated by a carer, as there are so many dozens of people who want to see me and I can't be everywhere.
'Sadly, I'm not a businessman and have no idea about raising funds.'
Richard's mother says: 'We are just so grateful to Dr Gnanayutham. It's like a miracle. The next step is for us to purchase a machine just for Richard, so he can communicate all the time.'
• For more information, or if you would like to make a donation to help Dr Gnanayutham's work, email Paul.Gnanayutham@port.ac.uk
At 23, Richard Gregory had a bright future. He'd just graduated from King's College in London and had won a coveted place at Sandhurst to start officer training.
Then, in November 2003, he was a passenger in a van that was almost completely crushed by a truck. He was pulled from the wreckage alive but had ruptured several organs and, as he arrived at hospital, suffered a major stroke.
'By the time we reached him, Richard was in a coma and doctors were unsure as to whether he would wake up,' remembers his mother Vivienne. 'It was six months before he was taken off a ventilator and started to breathe for himself.
Trapped: Richard Gregory was diagnosed with 'Locked-In Syndrome' after being paralysed in a traffic accident
'Although we never gave up hope, it was almost another year before we really believed he was still conscious and alive inside his paralysed body.
'The first sign was a sort of lopsided smile which doctors said was just an involuntary movement. Then we could see his right eye was moving, which they said was reflex.'
His parents Vivienne and Errol, along with other family and friends, began to ask him questions: to their delight, he responded by twitching his eyebrow. Encouraged by this, doctors sent Richard for tests.
'The results were conclusive - his brain was fully functioning,' says Vivienne. 'He was alert, aware of everything that had happened but unable to talk. The doctors called it Locked-In Syndrome. We called it an absolute tragedy.'
Locked-In Syndrome (LIS) can occur as the result of a stroke, a progressive neurological disorder such as Motor Neurone Disease or, as in Richard's case, a trauma in the brain stem which has irreparably damaged the nerves that control the head and body movement. The stroke he suffered may have also contributed to the damage.
As a result, the patient is paralysed but fully conscious, with normal brain function.
They can breathe unaided but are unable to speak, with their only method of communication through vertical eye movements. It is a dreadful fate, exacerbated by the inability of the patient to communicate their consciousness to the outside world.
There is plenty of anecdotal evidence of patients being written off by medics as being in a vegetative state or a coma; even of hearing doctors discussing switching off their life-support machine before someone notices that they are trying to communicate that they are very much alive.
'We could tell by the look in his eyes that Richard was trying to communicate with us,' says his godmother Dawn, who's been closely involved in his care. 'He just didn't have the means to do so.'
Mind-reading miracle: Richard is pictured here with Dr Paul Gnanayathum, who developed a device which interprets the brainwaves of paralysed patients, enabling them to communicate
After his accident, Richard spent the next three years in an NHS specialist head injuries unit until it became clear that his medical condition was not going to improve. Today, he lives in a dedicated care home in Birmingham.
His inability to communicate was extremely disheartening, says Dawn. 'Richard had always been chatty, with a big smile on his face, and we knew that he wanted to communicate with us.'
Computer program that 'reads' their minds
Then, last year, she read about a computer program which offered the family fresh hope. It effectively 'reads' the patient's mind to help them communicate. Using electrodes attached to the forehead, the program picks up electrical signals in the brain and from any muscles around the forehead which are not paralysed.
These electrical signals are then fed into a 'de-scrambler' which converts them into a command to move a cursor on a computer screen - for instance, to point at words such as yes or no.
The system was designed specifically for locked-in patients by Dr Paul Gnanayutham, a lecturer in computing at Portsmouth University.
This is not the first time scientists have found a way of using a person's brain waves to navigate a cursor, but Dr Gnanayutham is one of the first to use the technology on real people with serious brain injuries.
Furthermore, he has made a real breakthrough. One of the main barriers to the expansion of this technology had been that as well as the cursor-moving brain waves, there are lots of other brain waves creating background 'noise' which can confuse the computer.
It took him three years, but Dr Gnanayutham managed to write a sophisticated computer program which cuts out this 'noise'.
Since building the machine in 2001, he has worked with more than 30 patients.
'We use any signals we can to help patients to communicate,' he says. 'Some, like Richard, can frown a bit, which means his forehead muscles are not paralysed - so he can use those muscles to help along the cursor. He can also move his eyes.
'Some people can't move anything, and in that case we just work with brain waves.'
Dawn got in touch with Dr Gnanayutham, who went to see Richard last September.
Skateboarding computer game test
'He chatted to Richard and explained what he wanted him to do,' says Dawn. 'He put six pads on Richard's forehead, which were wired up to a box and a screen. We all waited with bated breath to see what would happen.'
Dr Gnanayutham had loaded up a computer game based on skateboarding. As the family watched, Richard concentrated hard and suddenly the skateboarder began moving - jumping obstacles and sliding up and down cliffs.
'It was an amazing moment,' says Dawn. 'We were nearly in tears. I remember sitting there watching with shivers running down my spine. At last Richard was able to break out of his prison, if only for a few minutes.
'I could tell Richard was really pleased. What the doctor didn't know was that Richard had been a really good snowboarder. He couldn't have picked a better game for him.'
Dr Gnanayutham, too, was astounded. 'I had never seen anything like it. To see someone playing a computer game using just brain waves, and playing it so well, was amazing.
'To do something like that takes a huge amount of effort and concentration, and people with head injuries tend to tire easily anyway. Richard is clearly a very clever man.'
Dr Gnanayutham first conceived the idea of the programme when singing in a choir which toured hospitals around London.
He says: 'We visited a neurological hospital in Putney and I saw people who were locked in. It seemed so unfair that they couldn't tell us if they were sad, happy, or wanted to go to bed late. I kept wondering if there was something I could do to help them to communicate.
'I knew the computer technology to use brain waves was out there, but my challenge was to adapt that so it was suitable for people with that condition.'
Cause? Richard suffered a major stroke as he arrived at hospital, which may have contributed to his brain damage
'What he has done is quite remarkable,' says Professor Gilbert Cockton, head of research into human and computer interaction at the University of Sunderland.
'He has solved a very complex problem and chosen to apply it to a worthwhile and moving cause.'
Indeed, Dr Gnanayutham could probably sell this programme to the computer gaming industry and make a fortune. Instead, as a committed Christian, he has chosen to devote what little spare time he has to visiting as many locked-in patients as possible and using the machine on them.
'Learning how to navigate using eye movement and brain waves isn't easy,' says Dr Gnanayutham. 'I worked for eight months with one young man whose mother knew he was "there" - but nothing happened until he started using the brain wave system. Finally, he could "talk" to her again.'
Dr Gnanayutham doesn't-always bring good news: there are times when people's loved ones are no longer conscious, and he cannot work with patients who are heavily sedated.
Wherever possible, he tries to have a medical doctor witnessing his work. 'I can't just walk into a hospital and start treating patients,' he says. 'While most care homes are sympathetic, hospitals are less so. My dream is to use my system within the NHS, so this is something I need to address.
Dr Gnanayutham has two machines, each containing a laptop, screen and head pads.
'I would like to create one single unit with all the component parts in it which could be operated by a carer, as there are so many dozens of people who want to see me and I can't be everywhere.
'Sadly, I'm not a businessman and have no idea about raising funds.'
Richard's mother says: 'We are just so grateful to Dr Gnanayutham. It's like a miracle. The next step is for us to purchase a machine just for Richard, so he can communicate all the time.'
• For more information, or if you would like to make a donation to help Dr Gnanayutham's work, email Paul.Gnanayutham@port.ac.uk
15 May 2009
Rehabilitative Benefits of the Nintendo Wii
by Holly McCarthy on May 14, 2009
This is a guest post on the EasyStand Blog, contributed by Holly McCarthy, who writes on the subject of the sports management degree programs at an accredited university. She invites your feedback at hollymccarthy12 at gmail dot com.
The Nintendo Wii has been one of the most popular game systems this decade and has even been used in rehabilitative applications for people coping with a variety of ailments. A little over a year ago doctors in Canada thought of using the system, which had been used as entertainment for young spinal cord injury recovering patients, and as therapy for patients after strokes.
What they began to realize is that this system, the Nintendo Wii, could be just what is needed to help with rehabilitation because of its ease of use and friendly interface. There are several benefits of using the Wii in rehabilitative treatments (commonly termed at Wii-hab), a few of which will be explored below.
Balance - Whether the patient is standing or sitting in a wheelchair, the controllers used to play the Wii console require balance and proper form for the best results. Using a standing frame while playing Wii can promote movement while standing, which research has shown to improve bone mineral density and strengthening.
Hand-Eye Coordination - Over time, hand-eye coordination improves through the use of video games. This is especially true of the Wii since the players’ movements are mimicked on the screen.
Entertainment - Therapy becomes more enjoyable when put in the context of a game. People who use a standing frame for Physical or Occupational Therapy can prolong their standing time by “multi-tasking” by playing Wii.
Competitive Spirit - The competitive spirit in patients who may not otherwise be able to compete is awakened. This can be great for increasing social skills as well as self-esteem.
Extension of Therapy to Home - While many things that are found in a therapists office are far too cost-prohibitive to be kept at home, the Wii is an affordable method of treatment that can be taken beyond the office and into the home for around $250. Additionally, friends and family can play along and join in the fun.
Helps With Memory, Problem Solving, and Decision Making Skills - All of these skills are honed through the use of video games according to studies, which may or may not be good news for parents. Playing sophisticated games helps with short-term, long-term, and muscle memory. Strategic games require problem solving and decision making skills, all of which help to enhance the experience.
The Nintendo Wii is finding enthusiasts of many abilities these days. Games and hardware have made participating in many activities from the comfort of your own home possible with a small price tag that can bring benefits to those in and out of rehabilitation care.
Have you used the Nintendo Wii for rehab or fun? What games have you enjoyed the most?
16 April 2009
Nordic Walking Poles Are Helping Many with Balance and Stability Issues - Including Many of Our Recovering War Heroes
When a thank you letter arrived from The American Red Cross for the one-piece Nordic Walking Poles that were donated to Walter Reed Veterans Hospital by SkiWalking.com and The American Nordic Walking System it was one of hundreds of confirmations that one-piece Nordic Walking poles prove to be safer, lighter and much more durable than twist-locking adjustable length/telescoping/collapsible poles.
Glen Arbor, MI, April 15, 2009 ---- Nordic Walking instructor, running and ski coach, Pete Edwards, discovered five years ago that Nordic Walking Poles were not just for expert skiers deprived of snow, but doubled as an aid for those with balance and stability issues. He started volunteering to host free Nordic Walking Clinics at Multiple Sclerosis (MS), Parkinson's (PD) and Diabetes support group meetings. A couple years later he donated dozens of pairs of durable one-piece Nordic Walking poles to Walter Reed Veterans Hospital in Washington, DC. He has also shipped free Nordic Walking poles directly to injured soldiers returning from Iraq and Afghanistan after talking to their spouses and/or parents. Family members, doctors and physical therapists have been amazed by the improvement in posture, balance, stability and gate thanks to the use of Nordic Walking Poles in the correct lengths.For over 25 years Edwards has been coaching runners and skiers. His skiers have been ski walking and hill bounding with poles during the warmer months when snow could not be found.
After a knee injury ended his marathon running career, his Nordic Walking Poles saved the day – allowing Edwards to Nordic Walk and even Nordic Run (running with poles) pain free.Using the perfect length Nordic Walking Poles helps us to automatically walk with a super straight back - better walking posture is biomechanically a good thing. This improved walking posture when combined with the unique 4-Wheel-Drive type action of walking with poles radically reduces the stress to the shins, knees, hips and back. Nordic Walking is low impact and yet provides a highly effective workout - burning more calories and working more muscle groups than regular walking.Nordic Walking has been the fastest growing fitness activity in Europe for several years. Over seven million Europeans are walking with poles - in the city, in the country and up in the mountains. Walking with poles helps to burn more calories than regular walking, improves balance/stability, radically reduces the stress to the weight bearing joints and provides a workout for your upper body by engaging your arms and legs – a lot like cross country skiing.Nordic Walking’s winning combination of improved posture, a unique 4-Wheel-Drive type action and shock absorbing benefits are helping many individuals to walk comfortably again.
Nordic Walking Poles are helping individuals with balance issues, knee issues or new knees, hip issues or new hips, back issues (including those with rods in their back), weight issues, multiple sclerosis (MS), parkinson’s disease (PD), neuropathy, arthritis, bursitis, scoliosis, lumbar stenosis, fibromyalgia, post polio, osteoporosis, stroke recovery, cancer recovery and other limitations to walking. Nordic Walking poles are helping thousands of Americans get off the couch, successfully get outside, start walking safely and effectively launch much needed walking campaigns.Individuals that use canes and/or walkers often find that Nordic Walking Poles are much more comfortable and stable than their canes or walkers. Individuals that find pushing a shopping cart comfortable find that Nordic Walking poles provide even more support and much improved balance, stability and versatility. The feedback from amputees, individuals with head trauma and others with balance issues is consistent – the poles really do improve balance and stability.From a fitness standpoint, walking with the correct length poles and proper technique can burn up to 40% more calories than regular walking. Walking with Nordic Walking Poles can turbo charge any walking campaign.Real Nordic Walking Poles are equipped with comfortable fingerless glove type straps, durable metal tips (for use on trails, the beach, snow and ice) and special rubber tips/paws that are removable and designed for use on pavement and other hard surfaces. All poles from http://www.skiwalking.com/ and The American Nordic Walking System are also equipped with patented straps (patented by the Salomon Ski Company).Thanks to the efforts of Pete Edwards, SkiWalking.com and The American Nordic Walking System, individuals of All ages and All fitness levels, are safely unlocking the calorie burning and aerobic benefits of walking, hiking, trekking and running with poles. These durable one-piece poles prove to be safer, lighter and much more durable than cheap twist-locking adjustable length/telescoping/collapsible poles. Nordic Walking Poles from SkiWalking.com and The American Nordic Walking System also includes a free Nordic Walking DVD and there are a variety of exertion options to choose from regardless of age, balance and/or fitness level.
Glen Arbor, MI, April 15, 2009 ---- Nordic Walking instructor, running and ski coach, Pete Edwards, discovered five years ago that Nordic Walking Poles were not just for expert skiers deprived of snow, but doubled as an aid for those with balance and stability issues. He started volunteering to host free Nordic Walking Clinics at Multiple Sclerosis (MS), Parkinson's (PD) and Diabetes support group meetings. A couple years later he donated dozens of pairs of durable one-piece Nordic Walking poles to Walter Reed Veterans Hospital in Washington, DC. He has also shipped free Nordic Walking poles directly to injured soldiers returning from Iraq and Afghanistan after talking to their spouses and/or parents. Family members, doctors and physical therapists have been amazed by the improvement in posture, balance, stability and gate thanks to the use of Nordic Walking Poles in the correct lengths.For over 25 years Edwards has been coaching runners and skiers. His skiers have been ski walking and hill bounding with poles during the warmer months when snow could not be found.
After a knee injury ended his marathon running career, his Nordic Walking Poles saved the day – allowing Edwards to Nordic Walk and even Nordic Run (running with poles) pain free.Using the perfect length Nordic Walking Poles helps us to automatically walk with a super straight back - better walking posture is biomechanically a good thing. This improved walking posture when combined with the unique 4-Wheel-Drive type action of walking with poles radically reduces the stress to the shins, knees, hips and back. Nordic Walking is low impact and yet provides a highly effective workout - burning more calories and working more muscle groups than regular walking.Nordic Walking has been the fastest growing fitness activity in Europe for several years. Over seven million Europeans are walking with poles - in the city, in the country and up in the mountains. Walking with poles helps to burn more calories than regular walking, improves balance/stability, radically reduces the stress to the weight bearing joints and provides a workout for your upper body by engaging your arms and legs – a lot like cross country skiing.Nordic Walking’s winning combination of improved posture, a unique 4-Wheel-Drive type action and shock absorbing benefits are helping many individuals to walk comfortably again.
Nordic Walking Poles are helping individuals with balance issues, knee issues or new knees, hip issues or new hips, back issues (including those with rods in their back), weight issues, multiple sclerosis (MS), parkinson’s disease (PD), neuropathy, arthritis, bursitis, scoliosis, lumbar stenosis, fibromyalgia, post polio, osteoporosis, stroke recovery, cancer recovery and other limitations to walking. Nordic Walking poles are helping thousands of Americans get off the couch, successfully get outside, start walking safely and effectively launch much needed walking campaigns.Individuals that use canes and/or walkers often find that Nordic Walking Poles are much more comfortable and stable than their canes or walkers. Individuals that find pushing a shopping cart comfortable find that Nordic Walking poles provide even more support and much improved balance, stability and versatility. The feedback from amputees, individuals with head trauma and others with balance issues is consistent – the poles really do improve balance and stability.From a fitness standpoint, walking with the correct length poles and proper technique can burn up to 40% more calories than regular walking. Walking with Nordic Walking Poles can turbo charge any walking campaign.Real Nordic Walking Poles are equipped with comfortable fingerless glove type straps, durable metal tips (for use on trails, the beach, snow and ice) and special rubber tips/paws that are removable and designed for use on pavement and other hard surfaces. All poles from http://www.skiwalking.com/ and The American Nordic Walking System are also equipped with patented straps (patented by the Salomon Ski Company).Thanks to the efforts of Pete Edwards, SkiWalking.com and The American Nordic Walking System, individuals of All ages and All fitness levels, are safely unlocking the calorie burning and aerobic benefits of walking, hiking, trekking and running with poles. These durable one-piece poles prove to be safer, lighter and much more durable than cheap twist-locking adjustable length/telescoping/collapsible poles. Nordic Walking Poles from SkiWalking.com and The American Nordic Walking System also includes a free Nordic Walking DVD and there are a variety of exertion options to choose from regardless of age, balance and/or fitness level.
08 February 2009
Stem cells repair stroke patient's brain
A stroke victim has become the first in the world to have his brain damage successfully treated by stem cell therapy.
The International Neuroscience Institute (INI) in Hanover revealed yesterday that the 49-year-old man was treated with experimental stem cell therapy in Germany and has shown no side-effects following the procedure.
He was the first of 20 people to be treated in the trial aimed at showing the therapy is safe for men and women who have had severe strokes.
Prior to surgery, he was suffering from severe paralysis of the right arm and had difficulties in speech and comprehension. Following the surgery, there have been clear signs of improvement from his condition and he has since been discharged from hospital.
Peter Stratford, chief scientific officer for Biocompatibles, the company behind the treatment, said the trial was an important step forward for stroke victims.
"From a patient's perspective this is a very positive development," he said. "We hope that the patients who recover from this surgical procedure will lead as normal a life as possible following treatment and if we can maintain as much of the healthy brain as possible, this is achievable."
Researchers have long been looking for ways to repair the brain damage from strokes, which can cause permanent disability. Studies have shown that transplanting brain cells produced from human embryonic stem cells has helped fix such damage in rats' brains.
In this case, researchers used a type of adult stem cells obtained from a healthy donor which were programmed to deliver a naturally occurring protein called GLP-1, known to protect against brain cell death that follows a stroke.
The man was admitted to hospital in October and diagnosed with a haemorrhagic stroke. He then underwent surgery to relieve the pressure on his brain. At the same time, he was treated with the stem cell therapy, CellBeads.
CellBeads were transplanted within a retrievable mesh device into the brain after the clot was removed. CellBeads protect against lasting neurological damage and are taken out completely after a treatment period of 14 days.
Last month, an artificial airway created from stem cells was used to save a woman's left lung. Mother-of-two Claudia Castillo, 30, was the first person in the world to be given a whole laboratory-engineered airway.
Researchers from the UK, Italy and Spain worked together to grow tissue from Ms Castillo's own bone marrow stem cells, use them to fashion a new bronchus - a branch of the windpipe - and carry out the transplant.
The stroke patient in Germany is under the care of Professor Thomas Brinker from the INI, who said the results were "encouraging".
He said: "We see a path of recovery as good as this only in the minority of patients, so it is an encouraging start.
"It is most important that we found definitively no side-effects from the treatment."
Stroke is one of the leading causes of death among the elderly population in the developed world, with an incidence rate of 145 per 100,000.
Haemorrhagic stroke is responsible for approximately 15% to 20% of all strokes and it is the least treatable form. It is associated with the highest morbidity and mortality rate of all strokes, with only 44% of affected patients surviving the first 30 days.
If the safety trial meets its goal, Biocompatibles hopes to have a larger, international trial under way in 2010 with potential regulatory approval coming as early as 2012.
Mr Stratford said that following the continuation of the trials in Germany, he hopes surgeons in the UK will sign up to participate in experimental stem cell therapy.
Crispin Simon, chief executive of Biocompatibles, said: "We are delighted with the response of the first patient to the CellBeads treatment.
"Stem cell therapy is now advancing across a broad range of medical indications; but as with all ground breaking technology safety is key and it is encouraging that the trial appears to have made a good start in this respect."
The International Neuroscience Institute (INI) in Hanover revealed yesterday that the 49-year-old man was treated with experimental stem cell therapy in Germany and has shown no side-effects following the procedure.
He was the first of 20 people to be treated in the trial aimed at showing the therapy is safe for men and women who have had severe strokes.
Prior to surgery, he was suffering from severe paralysis of the right arm and had difficulties in speech and comprehension. Following the surgery, there have been clear signs of improvement from his condition and he has since been discharged from hospital.
Peter Stratford, chief scientific officer for Biocompatibles, the company behind the treatment, said the trial was an important step forward for stroke victims.
"From a patient's perspective this is a very positive development," he said. "We hope that the patients who recover from this surgical procedure will lead as normal a life as possible following treatment and if we can maintain as much of the healthy brain as possible, this is achievable."
Researchers have long been looking for ways to repair the brain damage from strokes, which can cause permanent disability. Studies have shown that transplanting brain cells produced from human embryonic stem cells has helped fix such damage in rats' brains.
In this case, researchers used a type of adult stem cells obtained from a healthy donor which were programmed to deliver a naturally occurring protein called GLP-1, known to protect against brain cell death that follows a stroke.
The man was admitted to hospital in October and diagnosed with a haemorrhagic stroke. He then underwent surgery to relieve the pressure on his brain. At the same time, he was treated with the stem cell therapy, CellBeads.
CellBeads were transplanted within a retrievable mesh device into the brain after the clot was removed. CellBeads protect against lasting neurological damage and are taken out completely after a treatment period of 14 days.
Last month, an artificial airway created from stem cells was used to save a woman's left lung. Mother-of-two Claudia Castillo, 30, was the first person in the world to be given a whole laboratory-engineered airway.
Researchers from the UK, Italy and Spain worked together to grow tissue from Ms Castillo's own bone marrow stem cells, use them to fashion a new bronchus - a branch of the windpipe - and carry out the transplant.
The stroke patient in Germany is under the care of Professor Thomas Brinker from the INI, who said the results were "encouraging".
He said: "We see a path of recovery as good as this only in the minority of patients, so it is an encouraging start.
"It is most important that we found definitively no side-effects from the treatment."
Stroke is one of the leading causes of death among the elderly population in the developed world, with an incidence rate of 145 per 100,000.
Haemorrhagic stroke is responsible for approximately 15% to 20% of all strokes and it is the least treatable form. It is associated with the highest morbidity and mortality rate of all strokes, with only 44% of affected patients surviving the first 30 days.
If the safety trial meets its goal, Biocompatibles hopes to have a larger, international trial under way in 2010 with potential regulatory approval coming as early as 2012.
Mr Stratford said that following the continuation of the trials in Germany, he hopes surgeons in the UK will sign up to participate in experimental stem cell therapy.
Crispin Simon, chief executive of Biocompatibles, said: "We are delighted with the response of the first patient to the CellBeads treatment.
"Stem cell therapy is now advancing across a broad range of medical indications; but as with all ground breaking technology safety is key and it is encouraging that the trial appears to have made a good start in this respect."
Subscribe to:
Posts (Atom)