At-Home Stroke Rehab Device Improves Upper Limb Function

 Ask your competent? doctor if this will cure spastic fingers.

You're fired for incompetence! You couldn't look up previous research on this and at least propose a protocol?

Ipsihand (6 posts to May 2017)

At-Home Stroke Rehab Device Improves Upper Limb Function

A brain-computer interface has shown encouraging results in stroke rehabilitation, helping patients with chronic stroke regain partial upper limb function through regular, device-assisted exercises performed at home.

The technology links activity in the unaffected hemisphere to a hand device that facilitates movement of the paretic limb, promoting the formation of new neural pathways to support motor recovery.

Results of a clinical trial showed patients using the new device, known as IpsiHand, showed clinically meaningful improvement in hand/arm function compared with control individuals assigned to standard at-home exercise programs.

The Ipsihand system

“This study shows that chronic stroke recovery is not biologically closed. This noninvasive brain computer interface therapy produced meaningful clinical recovery where standard therapy did not, and the effect size and response rate starts to approach accepted stroke interventions, despite occurring years after injury,” said lead study investigator, Eric Leuthardt, MD, professor with the Department of Neurological Surgery and the Department of Biomedical Engineering at Washington University, St Louis.

He added that it was particularly notable that recovery was achieved at home and noted that the therapy does not require surgery, inpatient rehabilitation, or ongoing therapist supervision because patients can perform the exercises independently at home.The results were presented at International Stroke Conference (ISC) 2026.

Harnessing Activity in the Unaffected Hemisphere

The IpsiHand device is designed to harness activity in the unaffected cerebral hemisphere during motor intention, using those signals to retrain alternative neural networks to restore control of the disabled arm.

The system includes three components: a wireless handpiece that assists with opening and closing of the affected hand, a noninvasive EEG headset that detects activity in the unaffected hemisphere and identifies neural signals associated with the intention to move the paretic hand, and a tablet interface that guides patients through daily therapy sessions and provides performance feedback.

Leuthardt said the technology is based on understanding the process of how the brain encodes information and transforms that to motor movements.

“Classically, we understand that the primary motor cortex encodes that information that is transmitted to the muscles on the opposite side of the body. But in the setting of stroke, the unaffected hemisphere still maintains some of those motor intentions, and by tapping into those signals, that provides a signal source for a brain-computer interface to work to enable neuro restoration and neuro remodeling,” he noted.

The sensors in the EEG headset detect signals from the healthy hemisphere of the brain, and computation is used to convert those signals into an output that reflects the intentions of the user — in this case movement of a robotic handpiece fitted to the disabled arm.

The IpsiHand system is FDA approved and has been available in the US since 2023.

Previous studies in which patients served as their own controls have suggested clinical benefit with this technology. In addition, electrophysiologic and connectivity changes in the brain which correspond to the magnitude of functional improvement have also been observed.

At-Home Setting

The current study evaluated the brain-computer interface system against standard exercise therapy to assess the potential for meaningful motor improvement in a home environment.

Patients performed an EEG assessment to determine if they could generate an ipsilateral motor signal from the unaffected side of the brain associated with motor imagery from the affected hand. If this was successful, they were randomly assigned to therapy with the brain-computer interface intervention or a standardized home exercise program.

Baseline evaluations were performed, both in motor and nonmotor assessments. Patients were asked to perform the exercises at home for 5 out of 7 days each week and were seen again at 12 weeks.

Patients had to be more than 6 months out from their stroke and to have upper extremity hemiparesis or hemiplegia.

The primary outcome measure was improvement of motor function as measured on the Fugl-Meyer scale.

Compliance was defined as a greater than 80% adherence to the prescribed intervention, which was monitored through use of the system. For the control group, adherence to the home exercise program was self-reported.

Of 109 patients initially assessed, 24 were excluded of these individuals, 10 were excluded because they were unable to generate a brain-computer interface signal. Leuthardt noted that the vast majority of patients are able to produce an ipsilateral motor signal sufficient for device control.

A Chronic Patient Population

Ultimately, 85 patients were randomized, but 17 participants assigned to the control group withdrew, largely because of dissatisfaction with being in the control group. The final study population comprised 62 patients — 37 in the intervention group and 25 in the control group.

At baseline, the mean age was 56.6 years. The average upper extremity Fugl-Meyer score was 26.5, indicating moderate-to-severe impairment, and the mean time since stroke was 5.5 years.

“These were pretty chronic stroke patients,” Leuthardt noted.

Results showed that patients receiving brain-computer interface therapy achieved greater improvement than those assigned to the home exercise program.

Leuthardt noted that although differences in Fugl-Meyer Section A, which assesses gross motor function, were modest, more substantial improvements were observed in section B (wrist), section C (hand), and section D (coordination).

On average, patients in the brain-computer interface group gained 6 points in the Fugl Meyer score compared with 1.5 points for those in the home exercise therapy group, a difference of 4.5 (P < .001).

In addition, 55.5% of those in the intervention group did better than the minimally clinically important change of 5.25 points on the Fugl-Meyer scale vs 9.6% of those in the control group.

Leuthardt noted that this represented a 5.8-fold higher response rate in the intervention group, corresponding to a number needed to treat of 2.2 to achieve a clinically meaningful benefit.

He noted that chronic stroke remains an area of substantial unmet need, with approximately 40% of patients experiencing persistent upper extremity deficits and few effective options to improve function. Access to rehabilitation services is also limited, particularly for patients in rural and underserved communities.

“These results suggest that brain computer interface technology could help bridge that gap,” he added.

An Exciting Innovation

Commenting on the findings for Medscape Medical News, Raul Nogueira, MD, director of the stroke unit at the University of Pittsburgh Medical Center, Pittsburgh, described the technology as compelling. He said it could make the rehabilitation process more accessible and manageable for patients and families and represents an important advance for those left with persistent upper extremity deficits after stroke.

Nogueira was particularly impressed that the device could be used at home. “This technology brings rehabilitation to the home, and on top of that, it seems to produce better results than regular rehab. So there are two victories here.”

He added that although the device may initially be costly, its ability to be used independently at home without daily therapist supervision could ultimately reduce overall rehabilitation expenses. He described the technology as an exciting innovation with the potential to open a new frontier in stroke rehabilitation.

This study was funded by Neurolutions, the company commercializing the IpsiHand device. Leuthardt reported being the inventor of the technology and holding the intellectual property that was licensed Neurolutions. He also reported holding equity in the company. Nogueira reported having no relevant disclosures.

A retrospective analysis of post-stroke rehabilitation with real world use of brain-computer interface

 But you COMPLETELY FAILED AT WRITING A PROTOCOL ON THIS! You're fired for incompetence! You couldn't look up previous research on this and at least propose a protocol?

Ipsihand (5 posts to May 2017)

A retrospective analysis of post-stroke rehabilitation with real world use of brain-computer interface

• Neha K. Prasad,
• Nikhita J. Perry,
• Allison L. Goldring,
• Lee A. Fleisher,
• Leo Petrossian,
• Eric C. Leuthardt,
• Lauren Souders &
• Seth J. Wilk 

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Abstract

The IpsiHand™ System is an FDA-authorized, non-invasive therapy for chronic stroke-induced upper limb motor impairment that uses a brain-computer interface (BCI) to translate intent-to-move signals into hand movement.(So, completely useless to those like me with dead brain there?) This retrospective study evaluated real-world outcomes in stroke survivors ≥ 6 months post-stroke who were prescribed IpsiHand™ and completed regular Upper Extremity Fugl-Meyer (UEFM) assessments as part of routine care. Patients were categorized as early responders (achieving the minimal clinically important difference [MCID] of 5.25 points in UEFM score by 6 weeks), intermediate responders (achieving MCID by 12 weeks but not at 6), or early non-responders (not reaching MCID by 12 weeks). Early responders showed statistically significant improvement in upper extremity function compared to early non-responders at both 18 weeks (p < 0.01) and 24 weeks (p < 0.05, Kruskal-Wallis test). Early responders also showed numerically greater improvement than intermediate responders. Overall, 70% (39/56) of participants achieved MCID over the 55-week observation period. These findings suggest that the majority of chronic stroke survivors experienced meaningful functional gains with IpsiHand™ over time, including beyond 12 weeks. While longer use may benefit some individuals who initially did not respond, further prospective research(Why? You're so incompetent you can't do research properly?) is warranted to determine optimal treatment duration and identify characteristics of responders.

Data availability

The data generated and analyzed in this study are not publicly available to protect patient information but are available from the corresponding author on reasonable request.

Neurolutions, Inc. Announces Groundbreaking CMS Decision for IpsiHand™: A Leap Forward in Stroke Rehabilitation

 Didn't your competent? doctor start using this years ago? Oh, you don't have a competent doctor, do you?

• Ipsihand (4 posts to May 2017)

Neurolutions, Inc. Announces Groundbreaking CMS Decision for IpsiHand™: A Leap Forward in Stroke Rehabilitation

VAN NUYS, Calif.--(BUSINESS WIRE)--Mar 12, 2024--

The Centers for Medicare & Medicaid Services (CMS) has established a new Healthcare Common Procedure Coding System (HCPCS) Level II code for the IpsiHand™ Upper Extremity Rehabilitation System by Neurolutions, Inc. This significant decision marks the first time a brain-computer interface (BCI) controlled therapy has been recognized with the receipt of a HCPCS code, setting a new benchmark for thought-activated controlled devices.

E0738 will be used to describe “Upper extremity rehabilitation system providing active assistance to facilitate muscle re-education, including microprocessor, all components and accessories” to describe the IpsiHand Upper Extremity Rehabilitation System.

The IpsiHand System is a breakthrough therapeutic device and the only FDA-cleared, commercially available solution that enables non-invasive, at-home rehabilitation for stroke survivors affected by chronic motor deficits. Utilizing BCI technology, the IpsiHand enables stroke survivors to engage in thought-actuated therapy, connecting movement to the intent to move signals within the brain, helping rebuild neuronal pathways.

CMS’ decision also includes a final Medicare benefit category determination, classifying the IpsiHand as Durable Medical Equipment (DME). This classification highlights the IpsiHand’s durability and appropriateness for home use, further emphasizing its role in advancing patient care and recovery outcomes. Neurolutions CEO, Leo Petrossian, expressed enthusiasm over the CMS decision, stating:

“We thank CMS for their decision and commitment to improving outcomes for stroke survivors by establishing a new HCPCS code, and for their support throughout the entire application process. This important milestone is a testament to the innovative spirit at Neurolutions, and a significant shift toward enhancing access to advanced rehabilitation technologies for stroke survivors across the nation.”

This is a step forward to establishing coverage for upper extremity rehabilitation therapies, opening the door for advancements in therapeutic BCI to generate better outcomes for patients and potentially lower the cost of care. Neurolutions is proud to partner with CMS to advance the forefront of the rapidly-growing frontier of BCI enabled post-stroke neurorehabilitation.

About Neurolutions, Inc.

Neurolutions is a medical technology company dedicated to transforming the lives of patients suffering from neurological conditions. Our mission is to develop innovative solutions that address the unmet needs of patients while advancing the field of neurorehabilitation through cutting-edge research and development.

The IpsiHand System is a breakthrough therapeutic device that uses brain-computer interface technology to help chronic stroke patients with an impaired upper extremity regain movement. The IpsiHand device has been clinically validated and has received FDA clearance for use in the United States.

https://neurolutions.com

View source version on businesswire.com:https://www.businesswire.com/news/home/20240312463012/en/

Functional plasticity induced by mirror training: the mirror as the element connecting both hands to one hemisphere

 At least they seem to have a protocol although I'd have to get a much larger mirror. I guess orthogonal( intersecting or lying at right angles), is between your legs. So I wonder, is this better than the iPsiHand?    WHOM will be doing the research to determine the best method for recovering the hand?

FDA-Approved Device Will Help Stroke Victims Regain Use Of Hands

The latest here:

Functional plasticity induced by mirror training: the mirror as the element connecting both hands to one hemisphere

Show all authors

Farsin Hamzei, MD, PhD, Claus Henning Läppchen, MD, Volkmar Glauche, ...

First Published January 13, 2012 Research Article Find in PubMed 

https://doi.org/10.1177/1545968311427917

Article information

Abstract

Background. 

Mirror therapy (MT) is a promising therapeutic approach in stroke patients with severe hand paresis.  

Objective. 

The ipsilateral (contralesional) primary sensorimotor cortex (SMC) and the mirror neuron system have been suggested to play decisive roles in the MT network. The present study investigated its underlying neural plasticity.  

Methods. 

Two groups of healthy participants (n = 13 in each group) performed standardized fine motor tasks moving pegs and marbles (20 min/d for 4 days) with their right hand with either a mirror (mirror training group, MG) or a nonreflective board (control training group, CG) positioned orthogonally in front of them. The number of items moved by each hand was tested after each training session. Functional MRI (fMRI) was acquired before and after the training procedure to investigate the mirror training (MTr)-specific network by the analysis of the factors Time and Group.  

Results. 

The hand performance test of the trained right hand did not differ between the 2 groups. The untrained left hand improved significantly more in the MG compared with the CG. fMRI analysis of action observation and imitation of grasping tasks demonstrated MTr-specific activation changes within the right dorsal and left ventral premotor cortex as well as in the left SMC (SMC_left). Analysis of functional and effective connectivity showed a MTr-specific increase of functional coupling between each premotor region and the left supplementary motor area, which in turn showed an increased functional interaction with the ipsilateral SMC_left.  

Conclusions. 

MTr remodels the motor system by functionally connecting hand movement to the ipsilateral SMC. On a system level, it leads to interference of the neural circuit related to motor programming and observation of the trained hand with the illusionary movement of the untrained hand.

Keywords fMRI, mirror neurons, mirror therapy, plasticity, rehabilitation, stroke

Introduction

Effective stroke management is important as the treatment of stroke consumes a significant amount of resources.¹ Functional recovery can occur even in the chronic stage of stroke with plastic changes induced in the affected primary motor cortex (M1) by intense motor training of the paretic hand.^2,3 Additional commitment of noninvasive stimulation over the affected M1 by repetitive transcranial magnetic stimulation (TMS)⁴ or by transcranial direct current stimulation⁵ promotes functional recovery in association with plastic changes within the affected M1. However, the effectiveness of such strategies is limited to patients with mild to moderate hand paresis. Thus, an effective therapy regime for patients with severe hand paresis or loss of hand function is still lacking.

Mirror therapy (MT) is a promising therapeutic approach in stroke patients, even in those with complete loss of hand function. By using a mirror that is positioned orthogonally in front of the patient, the reflection of the right arm in the mirror provides an illusion that the left arm is being moved. MT was first described by Ramachandran and colleagues⁶ in patients with phantom pain after limb amputation and has been suggested to improve hand functional deficit in stroke patients.⁷ Ramachandran and Altschuler⁸ suggested that the ipsilateral (contralesional) corticospinal tracts from the M1 play a role while training with a mirror,⁸ but a recent functional MRI (fMRI) study reported an activation shift toward the ipsilesional sensorimotor cortex (SMC) after MT in chronic stroke patients in contrast with a control group.⁹ It has also been suggested that the mirror neuron system (MNS) plays an important role while observing one’s hand in the mirror and training via action observation (AO) and imitation (IMI).^8,10

The underlying neural plasticity of MT is currently unknown. Therefore, in the present study, fMRI was used to address this issue. We focused on training-induced plasticity by training with a mirror rather than the direct effect of observing one’s hand in the mirror, as was investigated with the use of functional imaging^11,12 or TMS.^13-15

 

 

FDA-Approved Device Will Help Stroke Victims Regain Use Of Hands

 A friend sent me this, but here is a transcript, much better to read it than listen to it. This could possibly help me.

FDA-Approved Device Will Help Stroke Victims Regain Use Of Hands

May 27, 20215:11 AM ET

Heard on Morning Edition

Jon Hamilton

Stroke patients who are struggling to regain the use of a hand will soon have access to a new FDA-cleared device that uses signals from the undamaged part of the brain to retrain the injured limb.

RACHEL MARTIN, HOST:

The Food and Drug Administration has authorized a device that can help stroke patients regain the use of a disabled hand. The device uses signals from the uninjured side of a patient's brain. NPR's Jon Hamilton has more.

JON HAMILTON, BYLINE: On a winter night in 2015, Mark Forrest started feeling bad. He thought it was his blood sugar. His wife, Patti, realized he was having a stroke.

MARK FORREST: So we called 911, and off to the hospital I went. And by the time I got there, most of my right side was paralyzed.

HAMILTON: Including his right hand. And more than six months after his stroke, Forrest was still struggling to pull on his socks and button his shirts. What he missed the most, though, was fishing for bass in the rivers and lakes near St. Louis.

M FORREST: I mean, I'm a die-hard fisherman, so that really hurt for me not to be able to do that.

HAMILTON: Forrest even tried cutting down a fishing pole so he could hold it with his left hand, but his right hand wouldn't reel in the line. So he kept working with a physical therapist, month after month, until he got really frustrated.

M FORREST: I said, how much more am I going to improve? She says, I don't think you're going to improve hardly at all.

PATTI FORREST: That was tough.

M FORREST: And that was hard for me to take.

HAMILTON: Around that time, Forrest started talking to Dr. Eric Leuthardt, a brain surgeon at Washington University in St. Louis. For many years, Leuthardt had been puzzled by something he often heard from patients.

ERIC LEUTHARDT: If you talk to a stroke patient, they can imagine moving their hand, they can try to move their hand, but they just can't actually move it.

HAMILTON: So Leuthardt had been looking for the source of those thoughts and he found them in a surprising place - the side of the brain that had not been injured by the stroke.

LEUTHARDT: So now we're starting to look at signals being generated on the opposite side of the brain, where there's still kind of the intent to move and it's present.

HAMILTON: Leuthardt and his team were able to build a device that used those signals to control a robotic exoskeleton. The device could open and close a patient's disabled hand for them. But a mechanical hand wasn't Leuthardt's ultimate goal. He wanted to help his patients regain the ability to move their own hand, and that meant answering a question.

LEUTHARDT: If somebody can generate a brain signal that's associated with their desire to move, and the exoskeleton moves it so they're getting feedback, can we use this device that controls their affected limb to essentially encourage the brain to rewire?

HAMILTON: Early experiments suggested the approach worked. Leuthardt says video of one man showed him initially trying and failing to grasp a marble and place it on a shelf.

LEUTHARDT: Then, after six weeks of training, you see his hand - it's not perfect, but he's more dexterous. He can pick up that marble and he can move it on top of the shelf.

HAMILTON: Leuthardt had founded a company called Neurolutions to develop the technology. Its CEO is Leo Petrossian, a brain scientist with a business degree.

LEO PETROSSIAN: I got involved specifically to help take something that was great in clinical studies and figure out how we can now bring this out to the million-plus people in the United States living with disability post-stroke.

HAMILTON: Petrossian says the conventional wisdom is that most recovery from a stroke takes place in the first 90 days or so.

PETROSSIAN: So if it's day 100 and a person can't move their arm very well, that's how their arm's going to be for the rest of their life.

HAMILTON: The company began developing a system to challenge that sort of thinking. It included a headset that analyzes brain signals, a tablet computer and a robotic exoskeleton worn over the patient's wrist and hand. Petrossian says they began trying prototypes on patients who got better.

PETROSSIAN: If you spend an hour a day doing this exercise of thinking and visualizing opening and closing a hand, five days a week for 12 weeks, you retrain a different part of the brain to drive that previously disabled appendage.

HAMILTON: Mark Forrest, the die-hard fisherman, tested several different versions of the device called IpsiHand. He often spent several hours a day working to open and close his hand with the exoskeleton's help. His wife, Patti Forrest, says by this time, more than a year had passed since the stroke and other therapies had stopped helping.

P FORREST: But with this, he was making great strides. Like, all of a sudden, he could touch his index finger with his thumb and he would be like, whoa. And so it was much bigger gains in a shorter period of time.

HAMILTON: Mark Forrest decided to test his new dexterity by building a fishing boat. Dealing with the tiny screws was still a challenge, and his friends kept joking that the homemade boat was going to sink.

M FORREST: It didn't. I built a really nice one; it's got wheels on the bottom of it, so it rolls in and out of the water.

HAMILTON: Forrest put the boat in the water for the first time in March, and he discovered that he had regained the ability to reel in a fishing line with his right hand.

M FORREST: We sat and fished for five hours on that boat and probably every cast, every other cast, we were catching fish.

HAMILTON: In April, the FDA OK'd the IpsiHand for people recovering from a stroke, even if it occurred years earlier. Neurolutions is gearing up to manufacture the device and expects it to be on the market in a matter of months.

Jon Hamilton, NPR News.

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Empowering the Mind to Heal the Brain for Stroke

The picture of Dr. Eric Leuthardt hovering over someones' head with a drill and drill bit does not make me want to try this although it might be the only way I'll ever recover my left hand function. That picture is inaccurate since no surgery is required for this.

Empowering the Mind to Heal the Brain for Stroke

MIT Technology Review picture of Dr Eric Leuthardt

The capability to “decode the brain” now makes thought-controlled machines a reality. Even more fundamentally theses brain computer interfaces empower the mind to now heal the physical substance of the brain after stroke. The Neurolution laboratory has created brain computer interfaces that enable a person with a chronically paralyzed had to recover function by using brain signals from the uninjured side of their brain. With continued practice, while the patient’s machine-empowered thoughts enable them to move their paralyzed hand, something extraordinary happens — the patients begin to recover function.

Dr. Eric Leuthardt is an Associate Professor of Neurological Surgery and Biomedical Engineering at Washington University School of Medicine, where he specializes in brain-mapping for patients with brain tumors and epilepsy; Director of Washington University’s Center for Innovation in Neuroscience and Technology, a collaborative collective for developing new technologies to improve neurosurgery; and a published author of the hit psychological thriller RedDevil_4.

He has a 17 minute TEDx video at the link.

Mind-controlled device helps stroke patients retrain brains to move paralyzed hands

What other devices is your stroke hospital comparing this to to see which is the best? ANYTHING AT ALL? Or are they sitting on their asses waiting for SOMEONE ELSE TO SOLVE THE PROBLEM? The answer to that question tells you how fucking incompetent your stroke hospital is. There is no excuse that can justify such incompetence.
Mind-controlled device helps stroke patients retrain brains to move paralyzed hands 

 

May 26, 2017

Medical resident Jarod Roland, MD, tries out a device that detects electrical activity in his brain and causes his hand to open and close in response to brain signals. A new study shows that this device can help chronic stroke patients …more

Stroke patients who learned to use their minds to open and close a device fitted over their paralyzed hands gained some control over their hands, according to a new study from Washington University School of Medicine in St. Louis.

By mentally controlling the device with the help of a brain-computer interface, participants trained the uninjured parts of their brains to take over functions previously performed by injured areas of the brain, the researchers said.
"We have shown that a brain-computer interface using the uninjured hemisphere can achieve meaningful recovery in chronic stroke patients," said Eric Leuthardt, MD, a professor of neurosurgery, of neuroscience, of biomedical engineering, and of mechanical engineering & applied science, and the study's co-senior author.
The study is published May 26 in the journal Stroke.
Stroke is the leading cause of acquired disability among adults. About 700,000 people in the United States experience a stroke every year, and 7 million are living with the aftermath.
In the first weeks after a stroke, people rapidly recover some abilities, but their progress typically plateaus after about three months.
"We chose to evaluate the device in patients who had their first stroke six months or more in the past because not a lot of gains are happening by that point," said co-senior author Thy Huskey, MD, an associate professor of neurology at the School of Medicine and program director of the Stroke Rehabilitation Center of Excellence at The Rehabilitation Institute of St. Louis. "Some lose motivation. But we need to continue working on finding technology to help this neglected patient population."
David Bundy, PhD, the study's first author and a former graduate student in Leuthardt's lab, worked to take advantage of a quirk in how the brain controls movement of the limbs. In general, areas of the brain that control movement are on the opposite side of the body from the limbs they control. But about a decade ago, Leuthardt and Bundy, who is now a postdoctoral researcher at University of Kansas Medical Center, discovered that a small area of the brain played a role in planning movement on the same side of the body.

To move the left hand, they realized, specific electrical signals indicating movement planning first appear in a motor area on the left side of the brain. Within milliseconds, the right-sided motor areas become active, and the movement intention is translated into actual contraction of muscles in the hand.
A person whose left hand and arm are paralyzed has sustained damage to the motor areas on the right side of the brain. But the left side of the person's brain is frequently intact, meaning many stroke patients can still generate the electrical signal that indicates an intention to move. The signal, however, goes nowhere since the area that executes the movement plan is out of commission.

The Ipsihand detects electrical signals in the uninjured part of the brain (green), and opens and closes a plastic brace fitted onto the paralyzed hand (green). By doing so, it helps train the uninjured brain areas to take over functions …more

"The idea is that if you can couple those motor signals that are associated with moving the same-sided limb with the actual movements of the hand, new connections will be made in your brain that allow the uninjured areas of your brain to take over control of the paralyzed hand," Leuthardt said.
That's where the Ipsihand, a device developed by Washington University scientists, comes in. The Ipsihand comprises a cap that contains electrodes to detect electrical signals in the brain, a computer that amplifies the signals, and a movable brace that fits over the paralyzed hand. The device detects the wearer's intention to open or close the paralyzed hand, and moves the hand in a pincer-like grip, with the second and third fingers bending to meet the thumb.
"Of course, there's a lot more to using your arms and hands than this, but being able to grasp and use your opposable thumb is very valuable," Huskey said. "Just because your arm isn't moving exactly as it was before, it's not worthless. We can still interact with the world with the weakened arm."
Leuthardt played a key role in elucidating the basic science and developing the technology behind the Ipsihand. He co-founded the company Neurolutions Inc. to continue developing the Ipsihand and serves on the company's board of directors. Neurolutions funded this study.
To test the Ipsihand, Huskey recruited moderately to severely impaired stroke patients and trained them to use the device at home. The participants were encouraged to use the device at least five days a week, for 10 minutes to two hours a day. Thirteen patients began therapy, but three dropped out due to unrelated health issues, poor fit of the device or inability to comply with the time commitment. Ten patients completed the study.
Participants underwent a standard motor skills evaluation at the start of the study and every two weeks throughout. The test measured their ability to grasp, grip and pinch with their hands, and to make large motions with their arms. Among other things, participants were asked to pick up a block and place it atop a tower, fit a tube around a smaller tube, and move their hands to their mouths. Higher scores indicated better function.
After 12 weeks of using the device, the patients' scores increased an average of 6.2 points on a 57-point scale.
"An increase of six points represents a meaningful improvement in quality of life," Leuthardt said. "For some people, this represents the difference between being unable to put on their pants by themselves and being able to do so."
Each participant also rated his or her ability to use the affected arm and his or her satisfaction with the skills. Self-reported abilities and satisfaction significantly improved over the course of the study.
How much each patient improved varied, and the degree of improvement did not correlate with time spent using the device. Rather, it correlated with how well the device read brain signals and converted them into hand movements.
"As the technology to pick up brain signals gets better, I'm sure the device will be even more effective at helping stroke patients recover some function," Huskey said.

Explore further: Stroke patients take the lead in their rehabilitation

Journal reference: Stroke
Provided by: Washington University School of Medicine