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A whole new ball game for stroke rehab

A device that was recently named ‘garden shed’ invention of the year is offering a new alternative to stroke survivors, as NR Times reports.

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‘Necessity is the mother of invention,’ so the old proverb goes.

For Guillem Singla Buxarrais, that necessity stemmed from his uncle; who was struggling to recover from a stroke suffered in 2010.

The Spanish inventor-turned-entrepreneur says: “I wanted to find a solution to motivate him, that was at least affordable to buy and was also fun; that was my criteria and I couldn’t find anything at the time.”

Guillem was looking for an antidote to his uncle’s upper limb problems; a device to fire up his morale and get him exercising towards recovery.

After a fruitless search, he set about creating something himself.

His background in biomedical engineering and as a sometime dabbler in neuro-technology aided his journey.

So too did the input of the device’s eventual co-founder Dimitris Athanasiou, as well as a cast of fellow technologists.

Stroke survivors, physiotherapists and patient-families also played their part, shaping the device’s inception and development.

The result was NeuroBall, which allows users to complete upper limb rehabilitation exercise by playing games; intelligently adapting to the user’s ability and becoming increasingly challenging the more they  use it.

The device, which is used with a tablet computer, also enables rehab professionals and patients to monitor engagement and performance over time to track progress.

“We know that if you had to do 400 repetitions on your hand you would get bored after a few,” says Guillem.

“So we’ve developed a set of games that make it fun to do these repetitions. For example, in one game the user controls a scuba diver in the sea, moving them and collecting items by moving your wrist.”

NeuroBall trains the key physio exercises including flexion and extension, pronation and supination, and grasp and release. Different games train a different combination of these movements. Sensors able to pick up the smallest movements enable the games to continually adapt to the current level of movement.

It is designed for a wide range of impairment levels – patients with highly limited movement can remove the device from its base and use their other hand to assist in the movement.

Demand for products that can boost post-stroke exercise time is certainly intensifying. Worldwide stroke-related illness, disability and early death is set to double from 2018 to 2035.

At the last available count in 2016 there were reportedly 14 million incidences of first-time strokes. In the UK, as reflected globally, services are stretched. Only three out of 10 stroke survivors who need a six-month assessment receive one, according to research cited in the  Stroke Association’s 2018 State of  the Nation report.

The same paper also reports that only around half of the stroke survivors in England, Wales, and Northern Ireland are discharged from hospital having been assessed for all appropriate therapies and with agreed goals for their rehabilitation.

It estimates that 65 per cent of stroke survivors leave hospital with a disability, while around three quarters of stroke survivors will have arm or leg weakness.

“Of course, we want patients to be able to train more in hospitals after their stroke and we do have survivors using NeuroBall on wards. But when they are discharged we also want them to be able to continue training at home.

“So this is the device that therapists can use with patients within [stroke care] centres and patients can also continue using the home.”

Last year, NeuroBall won the Inventor Prize – a title dubbed as the best “garden shed invention” in Britain. It beat over 200 other entrants to the £50,000 award, which is backed by the innovation foundation Nesta and the Department of Business, Energy and Industrial Strategy.

The company also recently received £650,000 in grant funding to support a clinical trial into the technology.

Watch this space for the results, which are expected to be published soon.

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Video: everyday vs specialist tech

Assistive technology Expert Andy Fell joins Irwin Mitchell law firm for an in-depth exploration of the very latest independence-boosting devices and platforms.

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Technology plays a day to day role in our lives and mobile phones, tablets, Alexa and Siri are common place.

Imagine the impact on your life if you were no longer able to interact with a touch screen or keyboard or give voice commands….

In this virtual event, Assistive Technology expert Andy Fell gives practical demonstrations of how everyday technology and specialist technology can be used to help give independence to those who need it most and why specialist technology may be needed.

During the event hosted by Lauren Haas, personal injury solicitor at Irwin Mitchell LLP, Andy goes into detail about what apps and gadgets are on the market, how everyday technology can be optimised such as the Amazon Alexa, and answered a number of questions ranging from touch screen sensitivity to smart watch reminders.

Case managers, ancillary medical professionals, as well as interested members in healthcare, social care, parents and clients may find this recording useful, as well as anyone caring for, working or living with people such as dementia sufferers or sufferers of other conditions which restrict their mobility.

Andy Fell is an independent disability and assistive technology (AT) consultant with almost twenty years’ experience working with all disabilities and age groups.

He is a qualified Rehabilitation Officer for the Visually Impaired and, since qualification, has lectured on the use of assistive technology and role of AT in the life of disabled people.

He has worked with a wide range of charitable organisations including British Dyslexia Association, was head of assistive technology for Guide Dogs for the Blind and National Disability Advisor for the Royal Yacht Association.

He has also worked for blue chip companies, the emergency services and various government departments including Department for Work and Pensions.

Andy is a fellow of the Royal Society of Arts, chairman and founding trustee of the Wetwheels Foundation and sat on the British Dyslexia Association – Workplace Assessors Professional Review Panel.

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The relationship between music and running

By Daniel Thomas, joint managing director of Chroma Therapies.

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By Daniel Thomas, joint managing director of Chroma Therapies

With its ability to produce new neural pathways, Neurologic Music Therapy is able to encourage movement, co-ordination, improve speech and language, and improve the ability to read/feel emotions, reactions and more, in people living with catastrophic injuries.

This is because music automatically connects to the brain. And this automaticity is what makes music so powerful.

Music also has to ability to push your training capabilities farther and faster especially in running.

This is why a running playlist is the ideal accompaniment to any runner.

Each songs tempo stimulates the brain, evoking a running response of either a faster pace or a steady rhythm depending on what you want to achieve.

For a faster pace, a good running playlist should contain songs with 150-180bpm.

Unfortunately, with not many songs out there using that speed (unless you enjoy rock, metal or speed garage for running) than the other option is to choose songs with 75-90bpm, as this tempo is perfect for a steady rhythm and maximising efficiency.

Do you recall an earlier blog where we discussed cadence and stride length using NMT for preventing falls in the elderly?

We suggested music with a high bpm count promotes movement, good cadence and walking speed, so songs like Nancy Sinatra’s ‘These Boots are Made for Walkin’, which has 85 bpm, is ideal.

BPM strongly correlates to step cadence.

Rhythmic Auditory Stimulation (RAS) is an important aspect of NMT.

Predictable rhythmic structure allows the sensori-motor system to move in sync with the beat.

This is, in essence, why music is important to runners, as it has the ability to communicate with the brain in order to help maintain a steady pace or increase speed depending on the bpm.

When it comes to mental wellbeing, we will always discuss music’s ability to improve mental wellbeing, and its effect can also be attributed to runners.

Music’s ability to improve stride, cadence and style, to produce better and better runs, and enable runners to achieve personal goals also have a positive effect upon mental wellbeing.

A sense of accomplishment. And with the right playlist, runners can end each run on a high.

We also like to discuss how NMT is more effective when it is personalised to that individual.

The same can be said in the case of a runner. A playlist that includes, not only songs with the ideal tempo for them, but also have some personal meaning, have the greatest positive effect upon runners.

The more enjoyable the run, the less fatigue is experienced. This may be due to the fact that music is able to interfere with the parts of the brain that communicate fatigue, essentially causing a distraction, so less fatigue is experienced.

For runners, the relationship between music and running can be seen to be just as effective and important as the relationship between music and recovering from a brain injury.

Its ability to improve running capability, speed, motivation, and promote mental wellbeing is what makes the difference between a run just being a run and reaching ‘Flow State’ – the mental state where the runner is in the moment of running – no distractions, and the run becomes…euphoric.

Read more: Running in the name of mental health

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Concussion could lead to depression, ADHD, dementia and Parkinson’s – study

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A new study has revealed a link between concussion and the risk of being diagnosed with attention-deficit hyperactivity disorder, mood and anxiety disorders, dementia and Parkinson’s disease later in life.

Despite ‘clinical recovery’ from concussion typically lasting one week, a team of researchers from the University of Manitoba suspected there may be longer term effects. They used 25 years of population-based health data between 1990 and 2015, involving almost 50,000 cases of concussion from people living in Manitoba, Canada.

They found that concussion was associated with an increased risk of being diagnosed with attention-deficit hyperactivity disorder (ADHD), mood and anxiety disorders (MADs), dementia and Parkinson’s disease.

After analysing the population data, they found that concussion was linked to an increased risk of diagnosis of ADHD, dementia and Parkinson’s.

Women who had a concussion were at greater risk of developing ADHD and MADs, but there were no differences between men and women for the risk of developing dementia or Parkinson’s.

Multiple concussions didn’t affect the risk of later being diagnosed with ADHD, but a second concussion increased the risk of dementia, while exposure to more than three concussions increased the risk of being diagnosed with MADs.

While previous studies have found links between concussion and ADHD, dementia, Parkinson’s and MADs, most have relied on patients self-reporting their symptoms, the researchers write.

However, this study can only show an association, not cause and effect.

The mechanism behind this increased risk is unknown, but the researchers state it’s possible that the pathways of some biomarkers that are dysregulated in ADHD, Mads, dementia and Parkinson’s, namely, cortisol, are also affected after a concussion.

The paper, published in the BMJ journal, states that future research is needed to explore the relationships between concussion and ADHD, MADs, dementia and Parkinson’s in other populations.

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