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Smartphones use in biomedical research is becoming more prevalent in different clinical settings. We performed a pilot study to obtain information on smartphone use by patients with essential tremor (ET) and healthy controls, with a view to determining whether performance of touchscreen tasks is different between these groups and describing touchscreen interaction factors., This study was funded by the Spanish Ministry of Economy and Competitiveness (grant no. RTC-2015-3967-1, “NetMD-Plataforma para el seguimiento de Trastornos del Movimiento”).

Severe traumatic brain injury residual cognitive impairments significantly impact the quality of life. EEG-based neurofeedback is a technique successfully used in traumatic brain injury and stroke to rehabilitate cognitive and motor sequelae. There are not individualized comparisons of the effects of EEG-based neurofeedback versus conventional neuropsychological rehabilitation. We present a case study of a traumatic brain injury subject in whom eight sessions of a neuropsychological rehabilitation protocol targeting attention, executive functions, and working memory as compared with a personalized EEG-based neurofeedback protocol focused on the electrodes and bands that differed from healthy subjects (F3, F1, Fz, FC3, FC1, and FCz), targeting the inhibition of theta frequency band (3 Hz−7 Hz) in the same number of sessions. Quantitative EEG and neuropsychological testing were performed. Clear benefits of EEG-based neurofeedback were found in divided and sustained attention and several aspects related to visuospatial skills and the processing speed of motor-dependent tasks. Correlative quantitative EEG changes justify the results. EEG-based neurofeedback is probably an excellent complementary technique to be considered to enhance conventional neuropsychological rehabilitation. post-print 1462 KB

Background: Brain’s is stimulated by Vojta Therapy through selected body areas activating stored innate motor programs which are exported as coordinate movement and muscle contractions to trunk and limbs. The aim of this pilot study is to know the responses at cortical level to a specific tactile input, assessed by electroencephalography (EEG), compared to a sham stimulation, in healthy subjects. Methods: A randomized-controlled trial was conducted. Participants were randomly distributed into two groups: a non-specific tactile input-group (non-STI-group) (n = 20) and a Vojta specific tactile input-group (V-STI-group) (n = 20). The non-STI-group was stimulated in a non specific area (quadriceps distal area) and V-STI-group was stimulated in a specific area (intercostal space, at the mammillary line between the 7th and 8th ribs) according to the Vojta therapy. Recording was performed with EEG for 10 min considering a first minute of rest, 8 min during the stimulus and 1 min after the stimulus. EEG activity was recorded from 32 positions with active Ag/AgCl scalp electrodes following the 10–20 system. The continuous EEG signal was split into consecutive segments of one minute. Results: The V-STI-group showed statistically significant differences in the theta, low alpha and high alpha bands, bilaterally in the supplementary motor (SMA) and premotor (PMA) areas (BA6 and BA8), superior parietal cortex (BA5, BA7) and the posterior cingulate cortex (BA23, BA31). For the V-STI-group, all frequency bands presented an initial bilateral activation of the superior and medial SMA (BA6) during the first minute. This activation was maintained until the fourth minute. During the fourth minute, the activation decreased in the three frequency bands. From the fifth minute, the activation in the superior and medial SMA rose again in the three frequency bands Conclusions: Our findings highlight that the specific stimulation area at intercostal space, on the mammillary line between 7 and 8th ribs according to Vojta therapy differentially increased bilateral activation in SMA (BA6) and Pre-SMA (BA8), BA5, BA7, BA23 and BA31 in the theta, low and high alpha bands in healthy subjects. These results could indicate the activation of innate locomotor circuits during stimulation of the pectoral area according to the Vojta therapy., The authors would like to thank the volunteers for participating in this study.

The term Cerebral Palsy (CP) is a set of neurological disorders that appear in infancy or early childhood and permanently affect body movement and muscle coordination. The prevalence of CP is two–three per 1000 births. Emerging rehabilitation therapies through new strategies are needed to diminish the assistance required for these patients, promoting their functional capability. This paper presents a new robotic platform called CPWalker for gait rehabilitation in patients with CP, which allows them to start experiencing autonomous locomotion through novel robot-based therapies. The platform (smart walker + exoskeleton) is controlled by a multimodal interface that gives high versatility. The therapeutic approach, as well as the details of the interactions may be defined through this interface. CPWalker concept aims to promote the earlier incorporation of patients with CP to the rehabilitation treatment and increases the level of intensity and frequency of the exercises. This will enable the maintenance of therapeutic methods on a daily basis, with the intention of leading to significant improvements in the treatment outcomes., El término Parálisis Cerebral (PC) es un conjunto de trastornos neurológicos que aparecen en la infancia o en la niñez temprana y que afectan permanentemente al movimiento del cuerpo y a la coordinación muscular. La prevalencia de la PC es de dos-tres por cada 1000 nacimientos. Se necesitan nuevas terapias de rehabilitación a través de nuevas estrategias para disminuir la asistencia requerida por estos pacientes, promoviendo su capacidad funcional. Este trabajo presenta una nueva plataforma robótica llamada CPWalker para la rehabilitación de la marcha en pacientes con parálisis cerebral, que les permite comenzar a experimentar la locomoción autónoma a través de novedosas terapias basadas en robots. La plataforma (andador inteligente + exoesqueleto) está controlada por una interfaz multimodal que proporciona una gran versatilidad. El enfoque terapéutico, así como los detalles de las interacciones, pueden definirse a través de esta interfaz. El concepto CPWalker pretende promover la incorporación más temprana de los pacientes con parálisis cerebral al tratamiento de rehabilitación y aumenta el nivel de intensidad y frecuencia de los ejercicios. Esto permitirá el mantenimiento de los métodos terapéuticos a diario, con la intención de que se produzcan mejoras significativas en los resultados del tratamiento.

Several robotic platforms were recently developed aimed at improving the locomotion capacity of people with gait impairment. Most of these gait trainers are limited to treadmill training, which is not a motivating condition for children with cerebral palsy (CP). This paper presents a pilot study done with two children with spastic CP, who trained with a new robotic platform called CPWalker during five weeks. This experimental device is a novel over ground prototype for gait rehabilitation with body weight support for children with CP. After rehabilitation training, both patients improved the mean velocity, cadence and step length. Moreover, the comparison between pre and post-kinematics analysis without the robot shows specific developments for each subject depending on the focus of the therapy (mainly trunk or hip flexion-extension).

Cerebral Palsy (CP) is a disorder of posture and movement due to an imperfection or lesion in the immature brain. CP is often associated to sensory deficits, cognition impairments, communication and motor disabilities, behaviour issues, seizure disorder, pain and secondary musculoskeletal problems. New strategies are needed to help to promote, maintain, and rehabilitate the functional capacity, and thereby diminish the dedication and assistance required and the economical demands that this condition represents for the patient, the caregivers and the whole society. This paper describes the conceptualization and development of the integrated CPWalker robotic platform to support novel therapies for CP rehabilitation. This platform (Smart Walker + exoskeleton) is controlled by a multimodal interface to establish the interaction of CP children with robot-based therapies. The objective of these therapies is to improve the physical skills of children with CP and similar disorders. CPWalker concept will promote the earlier incorporation of CP patients to the rehabilitation therapy and increase the level of intensity and frequency of the exercises according to the task, which will enable the maintenance of therapeutic methods in daily basis, with the intention to lead to significant improvements in the treatment outcome.

[Objective] Characterizing the intention to move by means of electroencephalographic activity can be used in rehabilitation protocols with patients’ cortical activity taking an active role during the intervention. In such applications, the reliability of the intention estimation is critical both in terms of specificity ‘number of misclassifications’ and temporal accuracy. Here, a detector of the onset of voluntary upper-limb reaching movements based on the cortical rhythms and the slow cortical potentials is proposed. The improvement in detections due to the combination of these two cortical patterns is also studied., [Approach] Upper-limb movements and cortical activity were recorded in healthy subjects and stroke patients performing self-paced reaching movements. A logistic regression combined the output of two classifiers: (i) a naïve Bayes classifier trained to detect the event-related desynchronization preceding the movement onset and (ii) a matched filter detecting the bereitschaftspotential. The proposed detector was compared with the detectors by using each one of these cortical patterns separately. In addition, differences between the patients and healthy subjects were analysed., [Main results] On average, 74.5 ± 13.8% and 82.2 ± 10.4% of the movements were detected with 1.32 ± 0.87 and 1.50 ± 1.09 false detections generated per minute in the healthy subjects and the patients, respectively. A significantly better performance was achieved by the combined detector (as compared to the detectors of the two cortical patterns separately) in terms of true detections (p = 0.099) and false positives (p = 0.0083)., [Significance] A rationale is provided for combining information from cortical rhythms and slow cortical potentials to detect the onsets of voluntary upper-limb movements. It is demonstrated that the two cortical processes supply complementary information that can be summed up to boost the performance of the detector. Successful results have been also obtained with stroke patients, which supports the use of the proposed system in brain–computer interface applications with this group of patients., This work has been funded by grant from the Spanish Ministry of Science and Innovation CONSOLIDER INGENIO, project HYPER (Hybrid NeuroProsthetic and NeuroRobotic Devices for Functional Compensation and Rehabilitation of Motor Disorders, CSD2009-00067), from Proyectos Cero of FGCSIC, Obra Social la Caixa, CSIC, and from the project PIE 201050E087.