Posts for: September, 2013

Mind control powers prototype bionic leg

Chicago researchers helping develop technology that could transform prostheses

September 25, 2013|By Juan Perez Jr., Chicago Tribune reporter
 

Zac Vawter's right leg weighs about 10 pounds, slightly less than his left. But it works normally; he doesn't have to do much more than think to rotate his ankle, walk or climb stairs.

Rather than tissue and bone, the 32-year-old amputee's right leg is a prosthesis made of aluminum, two motors, sensors and a powerful computer system.

 
Zac Vawter wears a thought-controlled bionic leg at the Rehabilitation Institute of Chicago. (Phil Velasquez, Chicago Tribune)
 

Vawter is wearing millions of dollars worth of emerging technology that could transform the lives of wounded veterans, accident victims and the elderly. Vawter's bionic leg can essentially read his mind.

A group of Chicago researchers is using about $8 million of the Army's money to expand the experimental field of mind-controlled prostheses, with hopes of bringing the technology to military and consumer markets in the next five years.

The Rehabilitation Institute of Chicago unveiled the latest prototype bionic device this week, in conjunction with its report on robotic leg control to be published Thursday in the New England Journal of Medicine.

The study published in the journal is a progress report on a project with a long history and years of work remaining, but it also can be seen as affirmation of progress.

"We're laying the foundation for the advances that are to come," said Levi Hargrove, head of the center's lab for neurally engineered prostheses and orthotics.

Col. John Scherer sees the technology's potential. From Fort Detrick, Md., he directs Army research intended to restore as much function as possible to veterans with traumatic injuries involving limited mobility, or vision and hearing loss.

There are more than 1,600 amputees from the Iraq and Afghanistan wars, Scherer said. About 80 percent of that population has lower-extremity amputations, he said.

Though prosthetic technology has improved since 2001, the existing technology isn't necessarily designed for a young, active population, Scherer said.

"We're trying to say, 'Hey, we have a population that needs advancements as well,'" he said. "So we're obviously funding projects in those areas to make those advancements so our injured service members can resume the life that they want to live."

Transforming Vawter into a version of the Six Million Dollar Man relied on a rather straightforward concept.

In 2009, Vawter sped a Suzuki motorcycle too quickly through a curve on a rural Washington road. The resulting crash forced doctors to amputate the lower part of his right leg.

During surgery, doctors rewired Vawter's severed nerves into surviving leg muscles, laying the groundwork for advanced prostheses. Within months, Vawter could flex his upper leg when prompted to try to plant or rotate his missing foot.

His brain was sending clear electrical signals to a body part that didn't exist. Vawter began working with the rehabilitation center in December 2010.

Researchers measured his brain signals while he tried to flex and extend the missing knee and ankle. The center's team also developed elaborate software — using tens of thousands of lines of code — to translate the neural signals into specific leg motions.

"It's a fascinating world," Vawter, a software engineer, said while testing the prosthesis inside a 14th-floor laboratory at the rehabilitation institute.

"It's neat to see the way that they're using software, algorithms and machine learning to make this work," the Washington state resident said.

The prosthesis's knee and ankle joints are powered by two small motors. Thirteen mechanical sensors are embedded along the prosthesis, including an accelerometer, gyroscope and sensors to determine how much weight Vawter puts on the leg or how fast he's moving.

Small metal electrodes attach to Vawter's remaining leg to catch his neural signals.

In the lab this week, Vawter sat and thought about bending his knee. A monitor showed a spike in neural activity. The prosthesis's motors whirred. Vawter's knee bent.

When he decided to stand he rose easily from his seat. That's when the leg's gadgets kicked in to predict and account for his movements.

"Ready to go," he said.

Vawter used an earlier prototype of the leg to climb 103 stories of the Willis Tower last year. The latest version has dramatic software improvements that allow him complete independence and a seamless range of motion directed by his thoughts.

The prosthesis used at Willis Tower last year only had modes for walking and stair climbing and required engineers to monitor the device, Hargrove said.

"This is a huge breakthrough," he said. "There isn't anything stopping him from doing that other than maybe security at the front desk."

Researchers will continue to refine the mechanics to reduce the potential for fall-inducing errors. It'll be up to the marketplace to improve the technology further and attach a price tag to it. The team, though, is thrilled with the progress.

"I never, ever thought we would accomplish so much in five years. Never," Hargrove said in the lab. "I'm glad we have."

"Ditto that," Vawter replied.


13 Cute Shoes That Are Good for Your Feet

 

With these podiatrist-approved pairs, you’ll never have to choose between style and comfort again

By: Ashley Ross

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September 23, 2013
Category: Uncategorized
Tags: Untagged

Hyperbaric Oxygen Therapy: Healing Versus Hoax?

Batya Swift Yasgur | Sept 17 2013

Hyperbaric oxygen therapy (HBOT) has garnered attention both in scientific circles and in the popular press.

For example, Jacqueline Laurita, who plays in the reality show Real Housewives of NJ,uses HBOT to treat her autistic son.1 NFL players such as Tim Tebow and Hines Ward routinely use HBOT for healing bumps and bruises after practice.2 Dr. Oz enthusiastically recommends it as a "great longevity tool" that "keeps stem cells healthier so they can repair our bodies."3 HBOT is touted as a wonder chamber for diseases as varied as AIDS/HIV,neurodegenerative conditionsasthma, and autism.

But does it work? And is it safe?

It works for some conditions but not others, according to the U.S. Food and Drug Administration (FDA).4 According to the FDA, HBOT has not been clinically proven to cure or be effective in the treatment of cancer, autism, or diabetes and is not approved for these indications.4 Only 13 uses of HBOT are FDA-approved, including treatment of air or gas embolism, carbon monoxide poisoning, decompression sickness, and thermal burns.

But "patients may incorrectly believe that [HBOT] devices have been proven safe and effective for uses not cleared by FDA," according to Nayan Patel, a biomedical engineer in the FDA's anesthesiology branch.4 Additionally, HBOT has risks that range from mild (eg, sinus pain, ear pressure, painful joints) to serious (eg, paralysis).4

How Does HBOT Work?

A person being treated with HBOT breathes 100 percent O2 while exposed to increased atmospheric pressure.5 The elevated hydrostatic pressure increases partial pressure of gases and reduces the volume of gas-filled spaces.5 Gas volume reduction has "direct relevance to treating pathological conditions in which gas bubbles are present in the body, such as arterial embolism and decompression sickness."5

HBOT also increases growth factors and local wound signaling, while promoting a central stem cell release of endothelial progenitor cells from the bone marrow via nitric oxide pathways.6

HBOT: A Sampling of Research

Although the FDA has not formally approved HBOT for conditions such as autism and diabetes, HBOT has been widely researched for these and other conditions. Findings from clinical trials show HBOT to be a promising intervention in stroke and diabetic foot ulcers, but less promising in autism.

Stroke: Hyperbaric oxygen is an "approved treatment modality for ischemia-reperfusion injury."7 It "maintains the viability of the marginal tissue, reduces the mitochondrial dysfunction, metabolic penumbra, and blocks inflammatory cascades observed in acute stroke."7 Data suggest that it is a "safe and effective treatment option" in the management of acute stroke7 as well as post-stroke symptoms, even in chronic late stages.8

Diabetic Foot Ulcers: HBOT is frequently used as an adjunctive treatment for diabetic hard-to-treat ulcers, improving abnormal low tissue oxygen tension in wound areas.9 HBOT stimulates several phases of wound healing, including infection control and reduction of tissue edema.9

A recent review found the quality of many studies of HBOT in diabetic foot ulcers to be "weak," but noted that "the consistency of positive outcomes is noteworthy, not least because these findings are in concert with data from in vitro and physiological studies supporting the theoretical framework of HBOT reversing hypoxia-induced pathology." The author cited two "well-designed" randomized, double-blind, placebo controlled trials9,10 that "have in recent years put HBOT on firmer ground as treatment for diabetic patients with chronic foot ulcer."9

Autism: Use of HBOT in the treatment of autism is controversial. A small study of 10 children with autism spectrum disorder found that all children who had been treated with HBOT improved by 2 points on the clinician-rated Clinical Global Impression Improvement (CGI-I)11 But another study of 60 autistic children, which compared HBOT to sham treatment, found similar improvements between the two groups.12

A review of 18 studies found that while some uncontrolled and controlled studies suggested that HBO therapy is effective for the treatment of autism, these "promising effects" were not replicated across all studies. The author recommended more "sham-controlled studies with rigorous methodology" to reach evidence-based conclusions.13

The European Committee for Hyperbaric Medicine (ECHM)'s 2010 workshop titled "Controversial Issues in Hyperbaric Oxygen Therapy," which reviewed not only research evidence but also reported from the clinical experiences of specialists and hyperbaric facilities, concluded that the use of HBOT for treatment of autism could not be recommended.14

 

The field of HBOT "continues to evolve and grow."15 New indications are currently being researched in clinical trials. It is hoped that as the uses of HBOT expand, with increased evidence base, "more patients will benefit from improved techniques and protocols, broadening the scope with which HBOT is used."15



Diabet Med. 2013 Jun 12. doi: 10.1111/dme.12254. [Epub ahead of print]

 

Importance of factors determining the low health-related quality of life in people presenting with a diabetic foot ulcer: the Eurodiale study.

 

Source

 

Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.


AIM:

 

To identify the factors responsible for the low health-related quality of life associated with foot ulcers and the relative importance of these factors.

METHODS:

 

A total of 1232 patients with a new foot ulcer, who presented at one of the 14 centres in 10 European countries participating in the Eurodiale study, were included in this cross-sectional study. Patient and ulcer characteristics were obtained as well as results from the Euro-Qol-5D questionnaire, a health-related quality of life instrument with five domains (mobility, self-care, usual activities, pain/discomfort and anxiety/depression). To analyse the relative importance of comorbidities and ulcer- and patient-related factors for health-related quality of life, linear regression models were used to calculate the relative contributions of each factor to the fit (R2 ) of the model.

RESULTS:

 

Patients reported poor overall health-related quality of life, with problems primarily in the mobility and pain/discomfort domains. Among the comorbidities, the inability to stand or walk without help was the most important determinant of decreased health-related quality of life in all five domains. Among ulcer-related factors, ulcer size, limb-threatening ischaemia and elevated C-reactive protein concentration also had high importance in all domains. The clinical diagnosis of infection, peripheral arterial disease and polyneuropathy were only important in the pain/discomfort domain.

CONCLUSIONS:

 

The factors that determine health-related quality of life are diverse and to an extent not disease-specific. To improve health-related quality of life, treatment should not only be focused on ulcer healing but a multifactorial approach by a specialized multidisciplinary team is also important. This article is protected by copyright. All rights reserved.

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  • Three Most-Common Cancers on the Feet

 

  • Updated Aug. 5, 2013 @ 5:11 am 

    Learn about the types of cancers that affect the feet, and know their warning signs and symptoms. Common foot cancers include:
    Basal cell carcinoma - The least aggressive form of skin cancer, basal cell carcinoma causes local damage but rarely spreads. On the feet and lower legs, basal cell carcinoma often looks like non-cancerous skin tumors. On other parts of the body, basal cell cancers may manifest as pearly white bumps or patches that ooze or crust over, similar to an open sore.
    Squamous cell carcinoma - The most common form of skin cancer on the feet, squamous cell carcinoma usually does not spread. When advanced, however, it can become more aggressive and spread throughout the body. Squamous cell cancer often first appears as a small, scaly bump or plaque. The cancer may be itchy and resemble a plantar wart, fungal infection, eczema, ulcer or other common dermatological problem.
    Melanoma - The deadliest form of skin cancer - and the form that is gaining prevalence at an alarming rate - melanoma most often requires surgical treatment. Catching it early is vital to a good outcome for patients, as melanoma can spread throughout the body, affecting the lymphatic system and blood vessels. Melanomas may be found on the tops of the feet, on the soles and even, occasionally, beneath a toenail.
    This type of skin cancer often begins as a small brown-black spot or bump, but a third of cases may appear pink or red instead. It's easy to mistake melanoma for a harmless mole, so look for asymmetry, irregular borders, changes in color and size, or a size greater than 6 millimeters in diameter. Melanomas can look like a host of other things - including blood blisters, plantar warts, common ulcers and even bruises - so it's important to have a podiatrist, dermatologist or your family doctor take a look at anything you find suspicious.
    Brought to you by: American Profile - Inspirational Stories & American History



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