Stroke Coach. Brodie Sakakibara, Post-doctoral Fellow.
Location: Main Lab – Area: Stroke
With Stroke Coach, we wanted to determine how effective a telehealth program could be on chronic disease self-management in people who have had a stroke. We are comparing the effects on self-management of a Lifestyle (physical activity, healthy eating, and stress management) or a Memory training program.
The results will contribute to the overall evidence on the uses of telestroke and the potential and cost-benefits of Lifestyle and Memory training.
An Exoskeleton for post-Stroke Recovery of Ambulation. Riley Louie, PhD student.
Location: Main Lab – Areas: Stroke, Assistive Technology
Individuals who do not regain walking ability after stroke live shorter lives and are more likely to go to nursing homes. However, not all patients have the opportunity for walking early after stroke when the brain experiences the most recovery, especially those requiring more physical assistance. A possible novel solution is the use of a powered robotic exoskeleton to enable early over ground walking.
Fifty individuals admitted for stroke rehabilitation in Canada, needing 2-person assistance to walk, will be randomly assigned to either the Usual Care Group or Exoskeleton Group for 4-5 days/week for 8 weeks. The Usual Care Group will receive daily one-hour physical therapy which has approximately 45 minutes of walking-related activities including muscle strengthening and standing. The Exoskeleton Group will receive the same care, except that the 45 minute walking-related activities will take place while wearing an exoskeleton to allow over ground walking from the first session.
We expect greater improvements in walking speed (10-Metre Walk Test), endurance (6-Minute Walk Test), and quality of life in the Exoskeleton Group. The outcomes will be measured at baseline, 4 weeks and 8 weeks later at discharge, and at 6 months after program ends.
The results from this study will provide evidence regarding the feasibility and efficacy of this new technology as an intervention to improve walking ability.
Assessing the determinants of the healthy life style profile of stroke survivors.
Beena Parappilly, PhD candidate.
Location: Main Lab – Area: Stroke
Stroke is a leading cause of disability and death worldwide, yet surprisingly 1 in 4 strokes occur in people who have previously had a stroke. We want to determine the extent to which knowledge of risk factors and healthy behaviours can lead to successful prevention of further stroke.
Data will be collected from 100 patients with diagnoses of either primary or secondary stroke at St. Paul’s Hospital or Vancouver General Hospital within 48-72 hours of their admission.
We hope that this new information will direct decision makers to the gaps in the secondary prevention programs, and will drive the development of new and novel interventions in the future.
The Spinal Cord Injury Research Evidence Project (SCIRE Professional).
Matthew Querée, M.App.Psych, Research Coordinator Location: Main Lab – Area: Spinal Cord Injury
The SCIRE Project brings together clinicians and scientists from all over the world to review and rate the literature in SCI care, and we put the results on the web — eliminating the need for Clinicians to search and screen individual databases to find the latest evidence-based information on SCI care.
We publish over 30 evidence-based chapters, 120 Outcome Measures, and more than 30 instructional videos on the internet, ensuring that the most up to date information on SCI care is free to access. We are currently completing the review for SCIRE Version 6.0 and our website to date has received over 2.5 million page views.
The Spinal Cord Injury Research Evidence Project (SCIRE Community). Christina Cassady, MScPT, Research Coordinator. Location: Main Lab – Area: Spinal Cord Injury
Evidence-based information should not just be for clinicians, researchers, and scientists. To increase the accessibility of evidence-based information in Spinal Cord Injury care, we are developing a version of SCIRE with simplified language that includes some general information geared towards people with SCI and their families (e.g., information specific to stage of recovery).
EPICWheelS (Enhancing Participation in the Community by improving Wheelchair Skills) Kate Keetch, PhD, Research Coordinator. Location: Wheelchair Skills Training Room –Area: Assistive Technology
Many people think that wheelchair users will be pushed around by a caregiver, so learning to use a wheelchair is not important. In fact, wheelchair users are at significant risk for further injury and social isolation if they are not taught to use their wheelchair properly or safely.
Using an affordable, touch-screen computer tablet, EPIC WheelS provides a structured manual wheelchair skills training program that can be customized for a specific user’s needs. The tablet features interactive training and practice activities as well as video-recording capabilities. Wireless Internet enables user-trainer communication as well as remote program monitoring and updating by the trainer.
This study investigates the potential (at two different locations) for using EPIC WheelS compared to a control group receiving only cognitive training. A monitored home program that is effective for older adults has the potential for wide and cost-effective application, particularly for those in rural and remote locations with limited access to rehabilitation expertise.
Evaluation of the WiiFit to enhance walking in older adults with Lower Limb Amputation. Nathalie Manuel, BSc. Location: Wheelchair Skills Training Room –Area: Assistive Technology
Commercially available virtual reality (VR) gaming software, such as the WiiFit™ by Nintendo, has the potential to be used as a valuable, practical and cost-effective physical therapy. WiiNWALK is a 4-week supervised, home-oriented program targeted to improve walking capacity in older adults with lower limb amputation (LLA).
Many older Canadians are living with artificial limbs, and the prevalence of LLA is projected to double by 2050 primarily due to diseases that are common with aging (e.g., diabetes). Walking capacity is the strongest determinant of quality of life in individuals with LLA. Improvements in walking capacity will not only enhance the individual’s quality of life but also lead to increased participation in physical and social activities.
CoPILOT: Shared control for powered mobility training. Emma Smith, PhD candidate. Location: Wheelchair Skills Training Room –Area: Assistive Technology
Learning to drive a powered wheelchair can be difficult for older adults with cognitive or memory impairments. In consultation with clinicians and wheelchair users, we developed a remote tele-operation device (CoPILOT) and training program to address the needs of this population. CoPILOT allows a trainer to share control of the wheelchair with the learner to provide demonstration, error-correction, and graded learning activities. This allows the training to be individualized to the person’s learning needs, promoting safety, and potentially reducing anxiety associated with learning. In this session, we will provide a demonstration of the CoPILOT remote control on a powered wheelchair.
Systematic, Comprehensive, One-to-One Training for Scooter Skills Study (SCOOT). Sharon Jang, MSc candidate.
Location: Courtyard/SCI Gym –Area: Assistive Technology
Systematic, Comprehensive, One-to-One Training (SCOOT) for Scooter Skills is a novel Scooter skills training program that takes place in the participant’s own environment. A qualified trainer offers problem solving and helps the user participate in activities of their choosing while learning to use their Scooter properly and safely. Customary scooter training (if offered at all) is often very limited and focuses on learning discrete skills in a lab environment.
We hope that the results will be strong enough to roll the program out to multiple sites and with a sufficient sample size, enabling us to quantify definitive outcomes such as adverse events (e.g., injuries and abandonment).
dEMAND. Amna Khan, Work Learn RA.
Location: Main Lab – Hallway. Area: Assistive Technology
Accessibility information is important for identifying barriers in the community that limit the participation of people with disabilities (PwDs). In order to benefit PwDs and shape the structure of the built and natural environment, accessibility information must be useful (provide breadth, depth, and be applicable to the person and context) and reliable (accurate and current). The purpose of this study is to examine how web and mobile applications have been developed to collect and disseminate useful and reliable accessibility information.
We identified accessible information applications from Google, iTunes and the Google Play store, including only those that were scalable beyond a single location or purpose.
Overall, applications provided limited depth and breadth. Information reliability was also limited by the use of ambiguous and subjective criteria that failed to illustrate how features were connected to each other. Although accessibility information provision is in its early stages, the applications reviewed are struggling to find a feasible approach for providing useful and reliable data.
The Development and Usability of a Self-Management Mobile App for Use Following Spinal Cord Injury. Megan Magillivray, PhD Candidate and Gurkaran Singh, MSc student
Location: Main Lab –Area: Assistive Technology; Spinal Cord Injury
Inpatient rehabilitation can be a challenging time following spinal cord injury (SCI). Clients need to learn a variety of self-management skills to prevent secondary conditions during increasingly shorter rehabilitation stays. The purpose of this study was to develop and evaluate the usability of the ‘SCI Health Storylines’ self-management mobile application (app) among people with SCI. The app aims to enhance SCI self-management through goal setting, and tracking self-management confidence and related behaviours (e.g., tending to bowel, bladder, and skin).
Overall, 20 participants, most with tetraplegia, took part in the study. On average, participants were involved in the study for 67 days and completed 8 training/ follow-up sessions lasting 30 minutes each. Participants entered and saved an average of 78 entries in the app with an average of 1.71±2.12 entries per day while enrolled in the study between admission and discharge. Even participants with no hand function were able to operate the app either with a stylus (via hand or mouth) or with a caregiver, suggesting that the app could be a useful part of inpatient rehabilitation following SCI.
A Tremor Suppression Orthosis for the Elbow. Gil Herrnstadt, MENRVA lab, Simon Fraser University, Engineering Science Department, Burnaby, BC, Canada
Location: Wheelchair Skills Training Room –Area: Assistive Technology
A tremor is an involuntary rhythmic oscillation of a body part. Despite not being considered life threatening, pathological tremor can be a debilitating condition that significantly affects activities of daily living and social participation. Two common conditions associated with pathologic tremor are Essential Tremor (ET) and Parkinson’s disease (PD). Tremor often affects the arms as well as other body parts.
Treatment is typically medication (sometimes ineffective), and in severe cases, surgery (involving significant risk). Instead, tremor suppression by an external device can potentially be safe and a fully reversible treatment.
We carried out simulations of a new suppression approach and orthosis for people who have tremor. An external Driving Motor (DM) and a Suppression Motor (SM) were connected to the orthosis, to simulate both voluntary movement and the tremor. Though it is challenging to remove the tremor without obstructing the intentional motion, our results demonstrate a significant reduction (above 99%) of tremorous motions in frequencies above 2 Hz, with a minor effect (below 1%) to the voluntary motion below 2 Hz frequencies. We are currently running a larger study testing the suppression orthosis with participants who are affected by tremor, and plan to publish the obtained results.
Towards Natural Control of a Bionic Hand. Lukas-Karim Merhi or Chakaveh Ahmadizadeh, MSc student.
Location: Main Lab –Area: Assistive Technology
A research team lead by Carlo Menon of Engineering Science at SFU originally developed wearable sensors to rehabilitate stroke patients. Dr. Menon has used these sensors to create a robotic prosthesis that is a futuristic bionic hand. The breakthrough technology being developed at Simon Fraser University is an advanced control system to naturally control a bionic hand using computer algorithms to decode signals from pressure sensors embedded in the socket. This breakthrough technology will benefit adaptive (disabled) people and our ageing society by providing a more intuitive experience for upper-limb amputees and replacing pincer-like hooks in use today. Videos, poster and a prototype bionic hand demonstration will be used to show how the technology works on tasks that are challenging, or even impossible, today for those with limited use of their arms. The team, which includes Vancouver-based Barber Prosthetics Clinic and Paralympic skier Danny Letain, competed with the technology at the world’s first Cyborg Olympics, Cybathlon, in Zurich on October 8th 2016, representing British Colombia and Canada.
Management of Lower Extremity Edema Using a Novel Smart Compression System. Mahan Rahimi.
Location: Main Lab –Area: Assistive Technology
Excessive swelling of the legs is prevalent in the elderly, spinal cord injury patients, and pregnant women. This condition can be associated with varicose veins and orthostatic hypotension, and may lead to stroke volume (SV) decline, fainting or worse.
We developed an adaptive compression system (ACS) for prevention of lower leg edema during stasis or ambulation. The device is a motorized compression garment which is capable of delivering pressure in continuous or intermittent modes and adapts to physiological changes based on the interface pressure feedback from flexible Force Sensing Resistors® (FSRs).
Previous studies have shown that there is a positive correlation between left ventricular ejection time (LVET) and SV. We used this concept to conduct a study on 12 healthy participants and investigate the performance of the ACS in pumping blood back to the heart by monitoring its capability of preventing LVET fall, hence SV decline. We created the needed shift in blood volume by graded lower body negative pressure (LBNP) and throughout testing continuously monitored beat-to-beat blood pressure, and electrical and mechanical activities of the heart via electrocardiography (ECG) and seismocardiography (SCG), respectively. Each subject completed two sets of experiments with and without ACS application.
Our results indicate less cardiovascular stress and a significant reduction in the mean cardiovascular changes to LBNP including LVET and heart rate (HR) with the ACS. Facilitating blood circulation through the compression of lower extremities may be a low-cost and easy to apply solution for preventing lower leg edema.
EEG controlled Exoskeleton for Upper Extremity Rehabilitation: Feasibility Research on both Healthy and Stroke Participants. Xin Zhang.
Location: Main Lab –Area: Assistive Technology
Literature suggests that stroke survivors should actively engage in exercises and practice daily tasks repetitively for the recovery of the function. We developed an elbow exoskeleton controlled by electroencephalography (EEG) to perform preprogramed simple daily activities, for example, reaching out for drinking, picking up and placing etc. While performing these activities, participants engage in kinaesthetic imagination of the activity, the EEG system assesses the participant’s intentions (move vs. rest motor command) and the load cell judges the movement direction. To date, four healthy individuals (average age 28.75±6.30) and one individual with stroke (68 years old, 5 years post-stroke) have participated in the study.
Both healthy and stroke participants were able to control the exoskeleton via EEG and load cell. Healthy participants were able to finish at least 9 trials of the training tasks in one hour whereas stroke participant was able to complete 15 trials in an hour. Results suggest that the proposed exoskeleton can be used by chronic stroke survivors, with potential for active rehabilitation in clinics and hospitals.
Assessing Cognition in Traumatic Brain Injury Research. Sabrina Khan, BSc. MPH Candidate, Rehab Research Project Assistant. Location: Main Lab – Area: Brain Injury
Cognitive abilities (thinking skills) such as memory and concentration are often affected following a traumatic brain injury, stroke, or other brain health condition. The United States government recently developed a 30-minute computerized assessment comprised of seven tests that measure various cognitive abilities – known as the National Institutes of Health (NIH) Toolbox Cognition Battery. The tests generally start out easy enough for young children or people with severe brain damage, and get progressively harder, so that even healthy smart people cannot get perfect scores.
Rehabilitation Research Program investigators are using NIH Toolbox Cognition Battery in multiple studies. If all researchers use the same battery of tests, results can be directly compared across studies and insight into cognitive training post-brain injury will be developed more quickly.
Come try the NIH Toolbox Cognition Battery and give your brain a work-out!