Technology in Neuro PT

T/F: its important to balance innovation with patient-centered care?

true

what are some examples of non-invasive/wearable sensors? (tons)

- ECG/EEG

- glucose sensor

- pulse ox

- temp

- BP

what are some examples of invasive/implantable sensors? (tons)

- pacemaker

- cochlear implant

- electro pill for drug delivery

- deep brain stimulator

what are the 2 components of neuro rehab tech?

- stimulation (neural physiology)

- intervention with motor learning

T/F: both invasive and noninvasive stimulation stimulate both the brain and spinal cord?

true

T/F: tech can provide higher repetitions and intensity?

true

T/F: tech can enhance engagement?

true

what can tech help with in terms of objective measures?

- can provide better objective data

what are some downsides to tech?

- cost

- training (is cost included?)

- maintenance/updates (warranty)

what is gizmo idolatry?

- term that describes the general, implicit conviction that a more technological approach is intrinsically better than one that is less technological

is gizmo idolatry research based?

- beliefs are regardless of evidence

what is novelty blindness?

- risk of integrating new digital innovations and wearable devices into clinical practice before they have been properly validated or demonstrated clear clinical value

T/F: neurotechnology may help to treat impairments?

true

what is virtual reality?

- immerses users in fully simulated closed environment

what is augmented reality?

- enhances the real world by overlaying digital information

what did 2021 review of VR find?

- low quality evidence

- benefits for improving ambulation in children with CP

what are benefits of an exoskeleton/robot? (4)

- standing, walking

- LE loading for bone density

- helps with circulation

- early mobility

what are barriers to exoskeleton/robot? (5)

- cost

- only good for flat surfaces

- slow moving

- not hands-free

- falls/wounds

what level of injury is required for an exoskeleton? why?

- C7 and below for clinical training

> must have tricep strength

- may be T3 and below for personal use

> full UE use if independently using

are there height requirements for exoskeleton?

- between 5'3 and 6'2

- under 220lbs

ESTIM PARAMETERS

T/F: estim should be paired with function?

true

should you activate only desired muscles with estim? or all?

only desired

how does estim change rate and number of motor units firing?

- increases rate

- increases number of motor units firing

what type of fibers are recruited first by estim?

- fast fibers recruited first (more fatiguing)

what 4 ways can estim be used for spasticity management?

- reciprocal inhibition

- fatigue or temporary weakening

- sensory level stimulation

- FES

what are neural prosthetics?

- bracing combined with estim

what is transcutaneous spinal stimulator?

- wide pulsed stim

why is epidural stim initially used?

for pain

what did study find epidural stim was able to help with?

- rhythmic stepping like pattern

- recovered volitional control over LE motor functions

when would vagus nerve stimulation be used?

- chronic ischemic stroke patients with mod to severe UE impairments

what is vagus nerve stim paired with in therapy?

- UE rehab therapy

what are 2 non-invasive brain stimulations?

- transcranial magnetic stimulation

- transcranial direct current stimulation

what is transcranial magnetic stimulation? what is it approved for?

- electromagnetic field to induce small electric currents to targeted brain areas

- depression and OCD

what is transcranial direct current stimulation?

- low direct current to alter resting membrane potentials to enhance or suppress brain activity

T/F: transcranial direct current stimulation can help physical performance? what is the term?

- true

- neuro-doping

PoNS

- portable neuromodulation stimulator

what is PoNS?

- noninvasive neuromodulation via CN V and VII

- rests on tongue

- on label for MS

how does PoNS work?

- excitation with tongue --> BS --> cerebellum and other brain regions

what are neuroprosthetics?

- replace or enhance function (cochlear implants)

what is brain computer interfaces (BCI)?

- systems that allow people to control devices using brain signals

what is IpsiHand?

- first FDA cleared device with BCI

- assists in chronic stroke rehab

what theory