Surgical technique improves sensation, control of prosthetic limb

Humans can accurately sense the position, speed, and torque of their limbs, even with their eyes shut. This sense, known as proprioception, allows humans to precisely control their body movements.

Despite significant improvements to prosthetic devices in recent years, researchers have been unable to provide this essential sensation to people with artificial limbs, limiting their ability to accurately control their movements.

Researchers at the Center for Extreme Bionics at the MIT Media Lab have invented a new neural interface and communication paradigm that is able to send movement commands from the central nervous system to a robotic prosthesis, and relay proprioceptive feedback describing movement of the joint back to the central nervous system in return.

Full story at Medical Xpress

Home-based telehealth therapy program effective for stroke rehabilitation, shows study

In-home rehabilitation, using a telehealth system and supervised by licensed occupational/physical therapists, is an effective means of improving arm motor status in stroke survivors, according to findings presented by University of California, Irvine neurologist Steven C. Cramer, MD, at the recent 2018 European Stroke Organisation Conference in Gothenburg, Sweden.

“Motor deficits are a major contributor to post-stroke disability, and we know that occupational and physical therapy improve patient outcomes in a supervised rehabilitation program,” said Cramer, a professor of neurology in the UCI School of Medicine. “Since many patients receive suboptimal therapy doses for reasons that include cost, availability, and difficulty with travel, we wanted to determine whether a comprehensive in-home telehealth therapy program could be as effective as in-clinic rehabilitation.”

Full story at News Medical

Dry needling vs. acupuncture: What the research says

Dry needling and acupuncture involve puncturing the skin with thin needles for therapeutic purposes. While a shared aim is to provide relief from pain, the practices are otherwise very different.

Practitioners of dry needling attempt to release tension from knots and pressure points in muscles. Acupuncturists insert needles to release endorphins and affect the nervous system. Traditionally, acupuncture was used to align a person’s energy, or chi.

While researchers have studied acupuncture as a complementary treatment for many conditions, dry needling is a newer practice, and the evidence is less comprehensive. Also, strict guidelines are in place for acupuncturists, but dry needling is not regulated.

Full story at Medical News Today

New tech may make prosthetic hands easier for patients to use

Researchers have developed new technology for decoding neuromuscular signals to control powered, prosthetic wrists and hands. The work relies on computer models that closely mimic the behavior of the natural structures in the forearm, wrist and hand. The technology could also be used to develop new computer interface devices for applications such as gaming and computer-aided design (CAD).

The technology has worked well in early testing but has not yet entered clinical trials — making it years away from commercial availability. The work was led by researchers in the joint biomedical engineering program at North Carolina State University and the University of North Carolina at Chapel Hill.

Current state-of-the-art prosthetics rely on machine learning to create a “pattern recognition” approach to prosthesis control. This approach requires users to “teach” the device to recognize specific patterns of muscle activity and translate them into commands — such as opening or closing a prosthetic hand.

Full story at Science Daily

Exercise doesn’t slow cognitive decline

Moderate to high intensity exercise does not slow cognitive (mental) impairment in older people with dementia, according to new research.

The research team found that although exercise improved physical fitness, it cannot be recommended as a treatment option for cognitive impairment in dementia.

Nearly 47.5 million people worldwide have dementia and the view that exercise might slow cognitive decline has widespread popularity.

But recent reviews of trials of exercise training in people with dementia show conflicting results. To try and resolve the uncertainty, researchers decided to estimate the effect of a moderate to high intensity aerobic and strength exercise training program on cognitive impairment and other outcomes in people with dementia.

Full story at futurity.org

Early physical therapy benefits low-back pain patients

Patients with low-back pain are better off seeing a physical therapist first, according to a study of 150,000 insurance claims.

The study, published in Health Services Research, found that those who saw a physical therapist at the first point of care had an 89 percent lower probability of receiving an opioid prescription, a 28 percent lower probability of having advanced imaging services, and a 15 percent lower probability of an emergency department visit—but a 19 percent higher probability of hospitalization.

The authors noted that a higher probability of hospitalization is not necessarily a bad outcome if physical therapists are appropriately referring patients to specialized care when low back pain does not resolve by addressing potential musculoskeletal causes first.

Full story at Medical Xpress

Prior TBI Diagnosis Increases Risk of Parkinson’s Disease

Recently, there has been attention on the association of traumatic brain injury (TBI) with progressive neurodegenerative diseases; such as, Parkinson’s disease. However, the association between mild TBI and Parkinson’s remains unclear. Therefore, the authors used 3 nationwide Veterans Health Administration databases (Comprehensive TBI Evaluation, National Patient Care Databases, Vital Status File Database) of inpatients and outpatients seen between 2002-2014 to determine the risk of developing Parkinson’s disease following a TBI. Authors age-matched 162,935 patients (~48 years of age) with TBI diagnosis without dementia, Parkinson’s disease, or secondary parkinsonism at baseline to a random sample of patients without any of the aforementioned conditions. The authors defined TBI exposure as a diagnosis of TBI after a comprehensive neurological assessment or by at least one inpatient or outpatient TBI diagnosis from a list of ICD-9 codes. Parkinson’s disease was defined as any inpatient or outpatient diagnosis of ICD-9 332.0 at least 1 year after TBI. The average follow-up was ~5 years. The authors found that a veteran with a prior TBI (0.6%) is >56% more likely to develop Parkinson’s disease than a veteran without a prior TBI (0.3%). This finding was consistent even after accounting for factors such as medical comorbidities (diabetes, hypertension, cerebrovascular disease) and psychiatric disorders (anxiety, post-traumatic stress, drug/alcohol use). Furthermore, this finding was consistent among people with mild or moderate-severe TBI.

Full story at Sports Medicine Research

Patients with low-back pain benefit from early physical therapy

Patients with low-back pain are better off seeing a physical therapist first, according to a study of 150,000 insurance claims.

The study, published in Health Services Research, found that those who saw a physical therapist at the first point of care had an 89 percent lower probability of receiving an opioid prescription, a 28 percent lower probability of having advanced imaging services, and a 15 percent lower probability of an emergency department visit – but a 19 percent higher probability of hospitalization.

The authors noted that a higher probability of hospitalization is not necessarily a bad outcome if physical therapists are appropriately referring patients to specialized care when low back pain does not resolve by addressing potential musculoskeletal causes first.

Full story at news-medical.net

Advanced Cancer Patients Can Benefit From Structured Exercise, Say Researchers

Incorporating structured exercise into supportive care can help improve the lives of patients with advanced cancer, say researchers in an article e-published ahead of print in the Archives of Physical Medicine and Rehabilitation. In an analysis of previous studies, authors found that both aerobic exercise and resistance training improved many cancer side effects.

Authors evaluated 25 studies, for a total of 1,188 participants, that measured the efficacy of exercise interventions on physical function, quality of life, fatigue, body composition, psychosocial function, sleep quality, pain, and survival. All studies used more than 1 session of structured exercise as the primary intervention and specified the “frequency, intensity, time, or type” of exercise. More than 80% of participants in each study had been diagnosed with “advanced cancer that is unlikely to be cured.” Some studies used control groups, and some did not.

Full story at APTA

Physical Therapy Helps Recover Arm Function in Chronic Stroke

Physical therapy promotes the recovery of arm function and neuroplasticity in all chronic stroke patients, according to a study published online April 25 in the Journal of Evaluation in Clinical Practice.

Raquel Carvalho, P.T., from the University of Minho in Braga, Portugal, and colleagues assessed the effect of physical therapy based on problem-solving in recovering arm function in three chronic stroke patients. Functional magnetic resonance imaging (during motor imagery and performance), the action research arm test, the motor assessment scale, and the Fugl-Meyer assessment scale were used to evaluate neuroplasticity and function.

Full story at the Cardiology Advisor