The Senate Health, Education, Labor and Pensions Committee on Wednesday approved three bills related to health care. Summaries of news coverage appear below.Brain injury: The committee by voice vote approved a bill (S 793) to reauthorize programs established by a 1996 law that allows CDC to provide state grants for patients to enter treatment and rehabilitation programs for traumatic brain injuries, CQ Today reports. The legislation also would require CDC to monitor and track brain injury cases and study techniques to improve treatment. In addition, the bill would require NIH to conduct basic research on brain injuries to improve treatment (Itkowitz [1], CQ Today, 6/27).

Information technology: The committee by voice vote approved a bill (S 1693) that would require government purchases of health care IT to meet basic standards on information exchange determined by a committee of government and private-sector experts, CQ Today reports. The legislation also would authorize $278 million in fiscal years 2008 and 2009 for competitive matching grants for regional and local health care IT networks over five years (Itkowitz [2], CQ Today, 6/27).

NIH: The committee unanimously approved a bill to change the names of several of the institutions within NIH to highlight that addiction is a disease, although the responsibilities of the institutions would remain the same, CongressDaily reports. The legislation would change the name of the National Institute on Alcohol Abuse and Alcoholism to the National Institute on Alcohol Disorders and Health and would change the name of the National Institute on Drug Abuse to the National Institute on Diseases of Addiction (Edney, CongressDaily, 6/28).

Rural Health Care Bill
In other legislative news, the bipartisan House Rural Health Care Coalition on Wednesday introduced a bill (HR 2860) to require that pharmacists in rural areas with few physicians receive reimbursement within 30 days for paper claims and 14 days for electronic claims filed with Medicare prescription drug plans,

Elsevier, the world-leading publisher of scientific, technical and medical information products and services, has announced the recipients of this year’s International Brain Mapping and Intraoperative Surgical Planning Society awards. The six awards will be presented at the 6th Annual World Congress for Brain Mapping and Image Guided Therapy, August 26-29, 2009 at Harvard Medical School, Boston, USA, organized by Elsevier and the IBMISPS.

The following awards will be presented:

The Beacon Award for Courage and Dedication is awarded for courage and dedication in increasing awareness about neurological diseases. Presented this year to:
Mr. Bob Woodruff, ABC news reporter and co-founder of the Bob Woodruff Foundation, was seriously injured in an explosion from an improvised explosive device near Taji, Iraq, while covering the Iraq War. The Bob Woodruff Foundation provides resources and support to service members, veterans and their families to successfully reintegrate into their communities so they may thrive physically, psychologically, socially and economically.
Sergeant Major Colin R. Rich (retired) is a highly decorated and trained senior enlisted soldier (Special Forces/ Ranger) with multiple deployments to “hot” spots throughout his career. SGM Rich’s combat deployments include Panama, the Gulf War, three tours the Balkans, two tours in Afghanistan and one tour in Iraq. He was part of 504th Parachute Infantry Regiment serving in Afghanistan when he was shot in the head and severely injured.

Pioneer in Medicine is awarded for excellence in research, discovery, education and pioneering work in the field of medicine and image guided therapy. Presented this year to:
Peter M. Black, MD, PhD, Franc D. Ingraham Professor of neurosurgery, Founding Chair, Dept. of Neurology, Brigham and Women’s Hospital Franc D. Ingraham, Harvard Medical School Boston, MA, USA
Keith L. Black, MD, Chairman, Dept. of Neurosurgery, Director, Maxine Dunitz Neurosurgery Institute, Cedars-Sinai Medical Center, USA

Pioneer in Healthcare Policy is presented to lawmakers who have demonstrated visionary and cross-disciplinary approaches to introducing laws that have contributed to the advancement of science, technology, education, and medicine. Presented this year to:
Senator John Kerry, his support for medical research and his tireless efforts in healthcare reform

Pioneer in Technology is awarded to companies and their CEOs for excellence in technology transfer and development. Presented this year to:
Mr. William A. Hawkins, Chairman and CEO of Medtronic, USA

Young Investigator Award is presented to senior graduate students, post doctorate fellow or junior faculty for their pioneering work in the areas of basic neuroscience. Presented this year to:
Vicky Yamamoto for her work on stem cells

Student Research Award is presented to students for contributing to the establishment of the IBMISPS-UCLA student chapter and demonstrating leadership and deep interest in neuroscience research. Presented this year to:
Josh Neman and Amir Goodarzi for establishing the UCLA student chapter and creating a multi-disciplinary research forum for UCLA undergraduate, graduate and professional students

“On behalf of the IBMISPS members and board of directors I congratulate the award recipients: SGM Colin Rich and Mr. Bob Woodruff who are true national heroes and the honorable Senator Kerry, Drs. Peter Black and Keith Black as well as President Hawkins”, commented Babak Kateb, Founding Chairman of IBMISPS. Dr. David Moore, Deputy Director of Defense Veteran Brain Injury Center (DVBIC) said “DVBIC was pleased to participate in selecting Colin, who is one of the finest and highly decorated veterans of the US Armed forces”.

Mr. Bob Woodruff also congratulated all other award recipients and added “The Brain Mapping Foundation is doing incredible work and making great strides in the treatment and research of brain injuries. I am honored to be one of the recipients of the Beacon Award and commend and support the efforts of IBMISPS.”

IBMISPS’s annual world congress aims to break boundaries in science, technology, medicine and healthcare policy with presentations and exhibitions from pioneering leaders in a range of disciplines.

This world class event is administered by Elsevier. The detailed program of the Congress is available at ibmisps-worldcongress/programme.asp

Source:
Shira Tabachnikoff

Elsevier

Automotive part manufacturer Dana announced on Friday it has reached a four-year agreement with United Auto Workers and United Steelworkers to transfer retiree health care and long-term disability liabilities to two health care trust funds, generally known as voluntary employer benefit associations, the New York Times reports (Maynard, New York Times, 7/7). Dana filed for Chapter 11 bankruptcy protection in March 2006.

The trust fund is expected to save Dana more than $100 million annually, according to the company (Seewer, AP/Wilmington News Journal, 7/6). Dana will contribute about $700 million in cash to the fund and an additional $80 million in stock after the company reorganizes.

The agreement gives “a glimpse of the kind of steps the UAW is willing to consider, at least in the case of companies in dire straits,” which could affect contract negotiations that start July 23 with the Big Three auto manufacturers, according to the Times. However, UAW leaders “have maintained that the deals reached at bankrupt companies should not be viewed as a road map of what might happen in the talks” in July, the Times reports (New York Times, 7/7).

Dana will present the plan in U.S. Bankruptcy Court on July 25. Dana’s United Steelworkers’ employees are scheduled to vote on the fund on July 20. UAW did not say when its Dana employees would vote (Ramsey, Bloomberg/Washington Post, 7/7).

Big Three Negotiations
The Los Angeles Times on Monday examined how “reducing health care costs is expected to be the driving issue for” General Motors, Ford Motor and Chrysler during contract negotiations in July. As of the end of 2006, the three automakers combined had around $90 billion in underfunded retiree health obligations, which the companies say need to be reduced in order to stay competitive with Asian auto manufacturers.

GM spokesperson Dan Flores said the difference between U.S. and Japanese automakers’ health costs is a “significant competitive gap.” Flores added, “Based on the magnitude of the cost, health care will continue to be a discussion point for GM and the UAW.” However, the extent of concessions UAW will be willing to grant the automakers “is unclear,” according to the Times (Zimmerman/Huffstutter, Los Angeles Times, 7/9).

“Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

All children and young people are entitled to high-quality education about sex, relationships and alcohol to help them make responsible decisions and acquire the skills and confidence to delay sex until they are ready. Evidence demonstrates that this type of education delivered as part of a planned and timetabled programme by trained and confident teachers helps children and young people better understand their own physical and emotional development. Research also suggests effective sex, relationships and alcohol education can help a child make responsible, healthy and safe choices, and improve their performance at school.

In draft guidance, issued for public consultation today (17 June), NICE recommends that children from primary school age upwards are given sex and relationships education that is appropriate to the maturity of the pupils, sensitive to diverse cultural, faith and family perspectives, and based on an understanding of their needs. For children at primary school age, this education starts with learning about the value of friendships and having respect for others.

This draft guidance also aims to ensure children and young people with particular needs, such as those with physical, learning or communication difficulties, receive good quality sex, relationships and alcohol education, consistent with the education provided in schools and colleges. Teaching should promote tolerance and inclusion and understanding diversity.

Research shows 40% of young people rated their sex and relationships education in school as poor or very poor[1] and other studies demonstrate that effective education on these topics can have a positive impact on young people’s health and wellbeing.

Good quality sex, relationships and alcohol education can help young people to understand the risks and consequences of their actions, the meaning of ‘consent’, and their rights and responsibilities. This includes learning how to resist pressure to take part in activities they are not comfortable with, such as binge drinking, and that it is wrong to put pressure on others to do something they don’t want to do. This type of education also gives them the skills and confidence to know when and how to seek advice and help from health services.

This guidance is mainly aimed at, school and college governors, school heads and teachers, college principals, lecturers and tutors, commissioners and managers in children’s trusts and children’s services, local authorities and primary care trusts. It is also for all those who have a direct or indirect role in, and responsibility for, school, college and community-based PSHE education focusing on sex and relationships and alcohol.

Key draft recommendations include:

- Ensure all children and young people are taught effectively about sex and relationships and alcohol. This should take place within a planned programme of PSHE education in schools, special schools, pupil referral units and colleges. It should start in primary school and continue through all the key stages of their educational career, until early adulthood.

- Reassure parents that sex and relationships education does not promote early sex, increase rates of sexual activity or increase the likelihood of sexual experimentation. Rather, it helps children and young people to resist pressure to get involved in activities that might damage their health. It also gives them the skills and confidence to delay sex until they are ready to enjoy a responsible and mutually loving relationship.

- Ensure education about sex and relationships and alcohol starts in primary school. Topics should be introduced and covered in a way that is appropriate to the maturity of pupils and is based on an understanding of their needs and is sensitive to diverse cultural, faith and family perspectives. The lead teacher or lecturer should coordinate the design of a scheme of work that is developmental and allows topics to be expanded and revisited in subsequent years, in secondary school and college.

- Ensure all teachers, lecturers and tutors who are willing to teach about sex and relationships and alcohol have received accredited training. They should have the skills and competence to fulfil the role and the support they need to improve their knowledge and teaching skills.

- Offer parents the opportunity to attend a course in parenting strategies and effective communication skills in relation to sex and relationships and alcohol. This should include advice on how to help their children develop communication, decision-making and negotiation skills. Provide them with ongoing support throughout the programme, and tell them where they can get support after the programme has ended.

Gillian Leng, NICE Deputy Chief Executive, said: ‘We know a planned PSHE education programme which progresses throughout a child’s time in education helps them understand the importance of valuing and having respect for others. It can also give them the ability to make sense of the world around them and make responsible decisions.

‘Starting PSHE education early can help improve a child’s ability to develop and sustain friendships, and understand the importance of valuing and having respect for others, building the foundation for later teaching about important subjects such as alcohol and sexual relationships. We also know education about sex and relationships is more effective if it is introduced before young people first have sex.’

Simon Blake, Chief Executive of the young people’s sexual health charity, Brook, and Programme Development Group member said: ‘As a member of the NICE programme development group, I helped develop this draft guidance. Sex and relationships education is vital to protect children and young people from harm and enable them to enjoy their relationships safely.

‘It’s a myth that sex and relationships education encourages children to be more promiscuous or have sex at an early age. In fact, evidence demonstrates this type of education helps children and young people resist pressures to get involved in activities that might damage their health. Importantly, it helps them develop the skills to only have the sex they choose when they are able to enjoy and take responsibility for their personal relationships and sexual health.

‘These draft recommendations are set to make a real difference by helping parents and carers feel reassured about the benefits of sex and relationships education. Our aim is to make sure all young men and women receive high quality sex and relationships education which can give them the skills and confidence to know when and how to seek advice and help from health services.”

Professor Mark Bellis, Director of the Centre for Public Health, Liverpool John Moores University, and Programme Development Group member said: ‘For most children, attitudes to alcohol start to develop long before they begin to drink. Parental drinking, advertising and sponsorship ensure that children can grow up in environments steeped in references to alcohol. Even at an early age, children require a basic understanding of alcohol, the part it plays in society and the dangers relating to its use.

‘This draft guidance identifies the importance of continually building up children’s understanding of alcohol throughout their development in ways which are sensitive to their personal needs and circumstances. It makes clear that this is something best achieved through the involvement of well prepared teachers, parents and health professionals.

‘We hope this draft guidance will provide effective delivery of quality alcohol education for children and young people, and reduce the threat to young people’s health and social development that alcohol currently represents.’

Anyone wishing to submit comments on this draft guidance is invited to do so via the NICE website until 15 July 2010. Final guidance is expected in January 2011.

About the guidance

1. The draft guidance will be available on the NICE website from Thursday 17 June 2010. Consultation will take place between 17 June and 15 July 2010.

2. Only stakeholders can comment formally on consultations, but organisations can register to be a stakeholder at anytime during this process, The criteria to become a stakeholder are available on our website.

Organisations from England and organisations with operations in England can register to comment on this draft guidance.

3. Final guidance is expected in January 2011. Although NICE public health guidance is not statutory, the NHS, local authorities and the wider public, private, voluntary and community sectors are expected to follow it.

4. This guidance complements but does not replace NICE guidance on community based interventions to reduce substance misuse; alcohol and schools; reducing sexually transmitted infections and teenage pregnancy; and social and emotional wellbeing in primary and secondary education. For more information, visit nice.

5. Personal, social, health and economic (PSHE) education is a planned programme of learning opportunities and experiences that helps children and young people grow and develop as individuals and as members of families and communities. Developing health literacy – a level of knowledge, personal skills and confidence that allows improvements to personal and community health and wellbeing – is central to this.

Source
NICE

Physical therapy or physiotherapy (UK/Ireland/Australia) is a branch of rehabilitative medicine aimed at helping patients maintain, recover or improve their physical abilities.

Physical therapists or physiotherapists (UK/Ireland/Australia) work with patients whose movements may be undermined by aging, disease, environmental factors, or sporting hazards.

Physical therapy also means the treatment of any pain, disease, or injury by physical means.

According to Medilexicon’s medical dictionary, physical therapy is:

1. The treatment of pain, disease, or injury by physical means.

2. The profession concerned with promotion of health, with prevention of physical disabilities, with evaluation and rehabilitation of persons disabled by pain, disease, or injury, and with treatment by physical therapeutic measures as opposed to medical, surgical, or radiologic measures.
A physical therapist seeks to identify and maximize quality of life and movement potential through prevention, intervention (treatment), promotion, habilitation, and rehabilitation.

Habilitation means making somebody fit or capable of doing something.

Rehabilitation means making somebody fit or capable of doing something they can no longer do properly or at all, but used to be able to – i.e. restoring an ability or abilities.

Promotion means the process of enabling people to increase control over and improve their health.
Physical therapy is a clinical health science
Physical therapy is not alternative therapy. It is a clinical health science. Physical therapists study medical science subjects, including anatomy, neuroscience and physiology in order to acquire the health education needed for prevention, diagnosis, treatment, rehabilitation, etc., of patients with physical problems.

The physical therapist works in hospitals, GP (general practice, primary care medicine) practices, and the community. In the vast majority of countries a physical therapist must be fully qualified and registered by law. In order to become registered the physical therapist must have graduated with a university degree in physical therapy or a health science university degree that included a physical therapy course.

A qualified physical therapist is an expert in the examination and treatment of people with cardiothoracic, musculoskeletal and neuromuscular diseases; focusing on conditions and problems that undermine patients’ abilities to move and function effectively.
Physical therapy is based on science
According to the Chartered Society of Physiotherapy, UK:

“Physiotherapy is science-based, committed to extending, applying, evaluating and reviewing the evidence that underpins and informs its practice and delivery. The exercise of clinical judgment and informed interpretation is at its core.”

What does a physical therapist do?
According to the Chartered Society of Physiotherapy, UK, physical therapists use their training and skills to treat a wide range of physical problems linked to different systems in the body, including:

Neuromuscular systems – concerned with both nerves and muscles. Nerves include the brain, spine and nerves throughout the body. Neuromuscular refers to neuromuscular junction – where nerves and muscle fibers meet, and also includes neuromuscular transmission – the transfer of information, impulses, from the nerve to the muscle.
Musculoskeletal systems – an organ system that gives us the ability to move using our muscles and bones (muscular and skeletal systems). The musculoskeletal system gives us form, movement and stability. The musculoskeletal system includes our bones, muscles, cartilage, tendons, ligaments, joints, and other connective tissue.
Cardiovascular systems – include the heart and the circulatory systems. The circulatory system carries nutrients and oxygen via blood vessels to the tissues of the body and removes waste and carbon dioxide from them.
Respiratory systems – include organs that are involved in breathing, such as the lungs, bronchi, trachea, larynx, throat, and nose.

In many countries doctors increasingly refer their patients to physical therapists, which is resulting in more and more patients going straight to the physical therapist without having first seen a doctor.

The physical therapist works autonomously, usually as part of a team with other health care and social care professionals.
Physical therapy is much more than just dealing with sports-related injuries
Below are some examples of diseases and conditions physical therapists treat, often as a result of a doctor’s referral:

Asthma – the physical therapist will interview the patient with asthma, listen to the chest with a stethoscope, monitor how the patient breathes and how the chest moves, possibly test the patient’s breathing while exercising, and liaise with other healthcare professionals who treat the patient. The physical therapist will help the patient learn how to breathe in a more relaxed way, this may include breathing exercises, advice on physical activity, strategies to overcome and manage wheezing and other symptoms linked to asthma – all of which significantly contribute towards the patient’s recovery.
Back pain – the physical therapist will examine the patient’s back, determine how it is affecting his/her life, and check some other aspects of the patient’s health. The physical therapist may perform manual therapy, help the patient learn how to manage the pain, what to do to speed up recovery and prevent recurrence. The therapist will draw up a program which probably includes exercise, tailored specifically to the patient’s health, ability and fitness level.
Cerebral palsy – the physical therapist, along with other healthcare professionals, is involved in helping the child or adult achieve his/her potential for physical independence and fitness. The therapist also liaises closely with the patients’ caregivers or parents. If the patient is a child, the physical therapist helps him/her and the parents/caregivers on how best to acquire skills which improve independence.
Incontinence – physical therapy is vital for the rapid recovery of urinary continence of women after childbirth and men after certain surgical procedures on the prostate gland. Depending on the patient’s needs and physical health, this may involve pelvic floor exercises, advice on what to eat and drink, electrical stimulation or biofeedback. Studies have shown that recovery of urinary function after a radical prostatectomy (surgical removal of the prostate) is likely to be much faster and better if the man sees a physical therapist.

Physical therapy is also very much an integral part of treatment for neck pain, whiplash, stroke, osteoarthritis, osteoporosis, and multiple sclerosis.
Five most common specialty areas of physical therapy
Orthopedic physical therapy

The orthopedic physical therapist treats injuries and disorders of the musculoskeletal system; this also includes rehabilitation for post-orthopedic surgery patients. The therapist is a specialist in the treatment of:

Post operative joints
Sports injuries
Arthritis
Disease or injuries affecting muscles, bones, ligaments or tendons
Amputations

Geriatric physical therapy

The focus here is on the older adult. The geriatric physical therapist is a specialist in the treatment of the following:

Arthritis
Osteoporosis
Cancer
Alzheimer’s disease
Hip replacement
Joint replacement
Balance problems
Incontinence

The main goal is to get the patient mobile again, pain management, and optimizing fitness levels, among others.

Neurological physical therapy

The neurological physical therapist is specialized in treating patients with a neurological disorder or disease. This may include patients with:

Alzheimer’s disease
Cerebral palsy
Multiple sclerosis
Paralysis
Parkinson’s disease
Poor balance
Spinal cord injury
Stroke
Vision impairment
Walking difficulties

Cardiovascular and pulmonary rehabilitation physical therapy

The specialist works with patients who have a disease or disorder of the heart, circulatory system, or pulmonary system. The focus here is to improve the patient’s endurance and physical independence. Patients with pulmonary problems, such as cystic fibrosis, may need manual therapy to get fluid build-up out of the lungs. The specialist commonly works with:

Patients recovering from a heart attack
Those recovering from bypass surgery
Patients with chronic obstructive pulmonary disease (COPD)
Patients with pulmonary fibrosis

Pediatric physical therapy

The pediatric physical therapist treats children with various diseases and disorders. The physical therapist is also trained to diagnose health problems early on. Examples of patients may include children with:

Spina bifida
Cerebral palsy
Torticollis

A brief breakdown of what a physical therapist does:
A physical therapist provides services that help..

restore function
improve mobility
relieve pain
prevent permanent disabilities
limit permanent disabilities

..of patients who have an injury or disease.

The physical therapist..

restores..
maintains..
promotes..

..general fitness and health.

The physical therapist..

examines the patient’s medical history
tests and measures the patient’s..

strength
range of motion
balance
coordination
posture
muscle performance
respiration
motor function

..and then develops the patient’s plan describing a treatment strategy and its targeted outcome.

The patient’s treatment typically includes..

exercise, which may focus on..

endurance
strength
flexibility

The physical therapist will encourage the patient to..

use his/her muscles to increase..

flexibility
range of motion

Some patients will be taught more advanced exercises aimed at improving..

balance
strength
coordination
endurance

..so that they are better able to go about their daily activities at home and at work.

To reduce swelling, physical therapists use..

ultrasound
hot packs
cold compresses
electrical stimulation

To reduce pain, and improve flexibility and circulation, physical therapists may use..

traction
deep-tissue massage

To help with mobility and dexterity, physical therapists teach patients how to use..

prostheses
crutches
wheelchairs
other adaptive devices

..and how to exercise to speed up recovery.

The physical therapist keeps notes on the patient’s progress, carries out periodic examinations, and adapts treatment along the way as required.

The physical therapist liaises with doctors, nurses, dentists, teachers, social workers, occupational therapists, speech-language pathologists, audiologists, and parents or caregivers.

Myomo,™ Inc. recently announced that the company received U.S. Food
and Drug Administration (FDA) 510(k) clearance to market the Myomo e100 NeuroRobotic™ System.
Myomo’s first product is a wearable, portable therapeutic modality designed to allow patients to self
initiate and control movement of partially paralyzed limbs using their own biological signals. By
simultaneously engaging and reinforcing both neurological and motor pathways, the device helps people
relearn how to move affected muscles.

No electrical stimulation or invasive procedures are employed. Relearning how to move hemiparetic arms after stroke is a significant challenge. Stroke is the country’s
leading cause of long-term disability, affecting 5.7 million people, according to the American Heart
Association1. Research indicates that up to 85% of stroke survivors show initial deficit in the upper limb
and recovery of upper limb function is seen in less than half of the patients2. Only 5% of survivors regain
full arm function after stroke.3

“Loss of movement after stroke is due to damage of brain tissue that controls that segment of the body,”
said Joel Stein, M.D., Chief Medical Officer and Stroke Program Director, Spaulding Rehabilitation
Hospital of Boston, MA, one of the first medical facilities to clinically treat stroke patients with the
Myomo system. “Since the neurological pathway is damaged, the patient can’t effectively control his or
her weak muscles, resulting in partial paralysis.”

Clinical studies show that intense repetitive exercise training may facilitate neural plasticity with
concomitant improved motor abilities and enhanced functional performance.4

“By providing patients the ability to complete intended movement through its ‘power assist’ function, the
Myomo device helps the feedback cycle to the brain, facilitating a patient’s ability to improve
performance through practice,” added Dr. Stein. “The theory is that by facilitating the patient’s ability to
practice tasks repeatedly, new connections are formed in the brain and existing connections are
reinforced, resulting in improved ability to move the arm.”

How the Myomo e100 NeuroRobotic System Works

Myomo’s therapeutic modality uniquely uses a person’s electrical muscle activity signal (EMG) to
automatically apply a power assist to facilitate movement of weakened muscles. Through Myomo’s
patent-pending NeuroRobotics technology, the device detects a person’s muscle signal from the skin’s
surface, and then employs proprietary system software and advanced robotics to allow patients to initiate
and continuously control movement of the hemiparetic limb. With this capability, the Myomo e100
NeuroRobotic System is designed to improve and facilitate movement through a feedback-based, closed
loop system that both amplifies and rewards a patient with motion in concert with his or her own
muscular activation. Wearable, and portable, the device is designed to enable goal-oriented therapy
exercises in seated, standing or ambulatory positions, depending on patient skill level.

“We are excited about the Myomo technology since its unique combination of EMG control and portable
robotics may improve functional upper extremity motor recovery and function after a neurologic injury,”
said Dan Parkinson, P.T., Director of Clinical Services, Braintree Rehabilitation Hospital, Braintree, MA,
and site investigator of the Myomo Functional Task Study. “By providing a tool for therapists to actively
engage patients in high dosage, repetitive, meaningful tasks, the Myomo device holds great potential in
helping neurologically impaired patients achieve better function.”

The Benefits of Patient Controlled Movement

The Myomo device is designed to provide power assist only if and while a patient’s muscles are firing as
he or she attempts movement during a therapy session. With this capability, patients have an opportunity
to stop, in real time, during execution of a targeted training task, to evaluate performance and re-adjust
positioning, as they train toward muscle re-education.

“The patient-controlled aspect of the Myomo device is unique and potentially very motivating for stroke
patients who must work hard to recover,” said Paul Petrone, O.T. Practice Leader, Stroke Program,
Spaulding Rehabilitation Hospital, and co-investigator of the Myomo inpatient pilot stroke study. “When
a patient can attempt movement, and see that they themselves can make their own arm move, their
attention and focus is so great that they have already made a huge leap forward. Directing attention to the
affected limb also holds tremendous potential for stroke patients who may suffer from “neglect,” a
common stroke syndrome where a patient may behave as through one whole side, including his or her
body, does not exist.”

An Opportunity to Improve Patient Independence

The Myomo e100 NeuroRobotic System is created to assist therapists in achieving optimal, goal-oriented
outcomes with stroke patients. Through its portability and ability to seamlessly interface into a variety of
clinical settings, the device can be used to facilitate a range of therapeutic strategies. The device can help
patients progress from basic motor training to more complex multi-plane movement patterns when used
by patients were their treating clinician.

“The Myomo device provides an opportunity for patients to be able to become more independent,” said
Steve R. Williams, M.D., Chief and Chairman, Department of Physical Medicine and Rehabilitation,
Boston Medical Center, Boston, MA. “The sophistication of its electronics picks up early muscle
movements and allows patients to activate muscles to become more functional faster. From a clinical
perspective, it is compact and relatively easy to use, eliminating the costs and complexity associated with
traditional equipment.”

Clinical Research

Research studies at MIT and Spaulding Rehabilitation Hospital showed significant gains in motor control
and clinically relevant decreases in muscle hypertonicity when the Myomo device was used by severely
impaired chronic stroke patients (1.5-10 years post CVA). The size of improvement found in the upper
extremity component of the Fugl Meyer scale represented a 23% increase in the severely impaired patient
sample (from a mean of 15.5 before treatment to a mean of 19 at the end of treatment).

Based on these results, some clinical experts have suggested that the Myomo device may serve as a
therapy gateway for severe chronic patients who are so impaired that they currently are ineligible for
other upper extremity stroke treatments.

“As a company, we are dedicated to providing a new category of NeuroRobotic devices, like the Myomo
e100, to help improve mobility in persons who suffer from muscle weakness or partial paralysis,” said
Steve Kelly, Chairman and CEO of Myomo. “Our first product represents the culmination of years of
research and development pioneered at the Massachusetts Institute of Technology in collaboration with
prominent medical experts affiliated with Harvard University and Boston area hospitals. With FDA
clearance, we are thrilled to be able to expand the use of the product to a broader population.”

About Myomo

Myomo is a medical device company with the mission of restoring independence for individuals who
suffer from loss of neurological function or debilitating muscle weakness. Through the company’s
patent-pending NeuroRobotics platform technology, Myomo devices facilitate and improve movement by
enabling individuals to initiate and control affected muscles using their own biological signals. No
electrical stimulation or invasive procedures of any kind are required. Myomo, which is the acronym for
“My-Own-Motion,” has been developing NeuroRobotics technology since 2002 based on research
pioneered at MIT by Myomo co-founders. Myomo is a privately held medical device technology
company and is headquartered in Boston, MA.

For more information, visit myomo.

Caution:
Federal (USA) law restricts this device to sale by or on the order of a physician or physical therapist.

The Myomo e100 System is intended for clinical use by patients with their treating medical professional. The device has not been shown to be safe or effective as a functional aid for use in the home.

Clinical studies to date have not demonstrated any known side effects or risks associated with the use of the device by stroke patients in therapy.

1 American Heart Association. Heart Disease and Stroke Statistics – 2007 Update
2 Chen J.C., et al. Stroke 2005;36:2665-2669
3 Gowland C., et al. Phys Ther. 1992; 72:624-633
4 Liepert J., et al. Stroke 2000;31:1210-6.

While younger people can easily get in and out of bed or sit on a couch, older people can have a much harder time of it, with conditions such as arthritis or rheumatism considerably limiting their movements. Czech and German partners, involved in the EUREKA E! 3210 SPECIFURN project, have developed a new line of furniture aimed at making life and leisure easier for the elderly and infirm. Their designs are suitable for use in old people’s homes, public urban spaces, swimming pools and railway stations.

“There is a lot to consider when designing furniture for senior citizens,” says SPECIFURN coordinator Josef Bartak of Form, in the Czech Republic. “We need to closely consider elderly people’s special needs, particularly their reduced mobility, but also other differences compared to younger members of the population.” The new designs were based on in-depth research and considerable accumulated experience among the partners.

Form, along with partners Addesign Furniture, also from the Czech Republic, and Germany’s Fidura Capital Consult, aimed to design a complete set of furniture, including wardrobe and other storage furniture, chairs and couches of varying comfort levels, bedroom furniture, a table and kitchen furniture. Chairs fell into three categories, including standard chairs and semi-armchairs, chairs with changeable positions, and armchairs with extensive features. Special features include better availability and visibility of stored items, rubberised or elastic handholds on lower furniture and wardrobes, insuring maximum safety when moving as well as passive protection against possible falls. New designs include removable upholstery for easy cleaning, suitable shaping of arm handles, and innovative mechanisms for changing furniture configuration.

An expanding market

By all accounts, populations in developed Central and Western European countries are growing older, says Bartak, due to decreasing birth rates and increasing life spans. This, he explains, can only increase the demand for specialised products and services for the elderly. Moreover, governments in all European countries are now continuously increasing spending on facilities for the aged. “We see our new designs giving rise to an even wider range of original and attractive wood-based furniture,” says Bartak, “furniture that is fully compliant with both ergonomic and ecological requirements and resistant to heavy use.”

“A firm of our size could not have afforded such an extensive programme of research and development without the help of EUREKA,” says Bartak. “We have achieved some remarkable results thanks to the important support we received.” Bartak says the new SPECIFURN designs have already been well received, making a big impact at MOBITEX 2007, a major trade fair that took place this year in Brno, in the Czech Republic. “The new furniture is unique in terms of its coherent approach to a complex series of problems associated with the aged.”

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Source: Sally Horspool

EUREKA

Anyone with an MP3 device — just about every man, woman and child on the planet today, it seems — has a notion of the majesty of music, of the primal place it holds in the human imagination.

But musical training should not be seen simply as stuff of the soul — a frill that has to go when school budgets dry up, according to a new Northwestern University study.

The study shows that musicians — trained to hear sounds embedded in a rich network of melodies and harmonies — are primed to understand speech in a noisy background, say in a restaurant, classroom or plane.

It is the first demonstration of musical training offsetting the deleterious effects of background noise, and the implications are provocative.

“The study points to a highly pragmatic side of music’s magic,” said Nina Kraus, Hugh Knowles Professor of Communication Sciences and Neurobiology and director of Northwestern’s Auditory Neuroscience Laboratory, where the research was done.

The findings strongly support the potential therapeutic and rehabilitation use of musical training to address auditory processing and communication disorders throughout the life span.

Hearing speech in noise is difficult for everyone. But the difficulty is particularly acute for older adults, who are likely to have hearing and memory loss, and for poor readers who have normal hearing but whose nervous systems poorly transcribe sounds that ultimately are critical to good reading skills.

“Many older adults will say, ‘I can hear what you’re saying, but I don’t understand you,’” Kraus said. “So they might have a little bit of a hearing loss, but often not enough to warrant the difficulty that a lot of older adults report.”

Such populations could benefit from the reordering of the nervous system that occurs with musical training, according to the study. Because the brain changes with experience, musicians have better-tuned circuitry — the pitch, timing and spectral elements of sound are represented more strongly and with greater precision in their nervous systems.

“Musical training makes musicians really good at picking out melodies, the bass line, the sound of their own instruments from complex sounds,” Kraus said. Now, for the first time, this study has confirmed that such fine tuning of the nervous system also makes musicians highly adept at translating speech in noise.

The finding has particular implications for hearing certain consonants which are vulnerable to misinterpretation by the brain and are a big problem for some poor readers in a noisy environment. The brain’s unconscious faulty interpretation of sounds makes a big difference in how words ultimately will be read.

Thirty-one study participants, with normal hearing and a mean age of 23, were divided into one group with music experience and another without it. They had to listen to sentences presented in increasingly noisy conditions and repeat back what they heard.

Better perception in noise was linked with better working memory and tone discrimination ability. The results imply that musical training enhances the ability to hear speech in challenging listening environments by strengthening auditory memory and the representation of important acoustic features.

In one of the tests, for example, participants had to repeat back “The square peg will settle in the round hole.” Such longer sentences that are syntactically correct but lack familiar cues measure working memory as well as the ability to distinguish sounds in noise.

The Auditory Neuroscience Lab at Northwestern has helped establish the relationship between sound encoding in the brain and linguistic abilities by showing that the very neural sound transcription processes that are deficient in children with dyslexia are enhanced in people with musical experience. Based on this collective work, poor readers may show greater benefits from training programs that include music as well as speech sounds.

By reinforcing the pervasive effects that musical experience has on sound-processing abilities, Kraus stressed, this study underscores the importance of music education being more accessible to the general population.

“Musician Enhancement for Speech-in-Noise” was published online in Ear and Hearing, the official journal of the American Auditory Society. The study’s investigators are Alexandra Parbery-Clark, Erika Skoe, Carrie Lam and Nina Kraus. The National Science Foundation supported the study.

Source:
Pat Vaughan Tremmel

Northwestern University

The Davis Phinney Foundation, a non-profit organization dedicated to improving the lives of people with Parkinson’s disease (PD), has announced that it has awarded four Parkinson’s disease research centers with support to conduct a landmark study on the long-term changes in quality of life and mobility that occur in people with PD. The results of this research will help to advance the understanding of how interventions, such as exercise, impact changes in quality of life and mobility over the course of the disease.

The study, funded by the Davis Phinney Foundation in partnership with the Parkinson’s Disease Foundation, will follow 200 people with PD for at least two years using a series of performance-based measures and patient-based self-report questionnaires to examine walking ability, balance, disease-specific impairments and quality of life. Study sites include: the University of Utah, Boston University, University of Alabama at Birmingham, and Washington University in St. Louis. Interim study findings will be available in 2010.

While much is known about how neurological symptoms change over the course of the disease in people with PD, very little is known about the impact that disease progression has on day-to-day function and quality of life. “This study addresses the critical need to understand the ways in which mobility and quality of life decline for people with PD over a long period of time,” said Lee Dibble, Ph.D., PT, lead study investigator and assistant professor at the University of Utah Department of Physical Therapy. “There is a growing body of research evidence that demonstrates the benefits of exercise in improving walking, strength, flexibility and quality of life in people with PD. In order to appreciate the potential impact that exercise may have on improving mobility and quality of life, we need to understand more about the natural changes that occur in mobility and quality of life over time.”

A recent survey conducted by the Davis Phinney Foundation found that communication about quality of life between people with PD and their treatment providers is lacking. Among findings, while 81 percent of people with PD surveyed said they believed that exercise can slow disease progression, less than half of those surveyed (40 percent) reported discussing their exercise with their physician (i.e., neurologist or movement disorder specialist) within six months of diagnosis, and almost one in five (19 percent) said they never discussed exercise with their physician. Further, while almost all respondents (99 percent) reported discussing medication with their physician, just over half discussed depression (52 percent), and only 33 percent discussed nutrition. Full survey findings are available at davisphinneyfoundation.

“The goal of the Davis Phinney Foundation is to provide information and tools that people living with Parkinson’s can use to live well with Parkinson’s disease today and in the future,” said Amy Howard, Executive Director of the Davis Phinney Foundation. “This study will provide a much needed and comprehensive look at what happens to people with PD over time so that we can understand the impact of exercise and other programs and treatments on improving the quality of their lives. today.”

As the worldwide life expectancy increases, the number of individuals with PD over age 50 in the world’s most 10 populous countries is expected to double from approximately 4.5 million in 2005 to 9 million by 2030. These numbers highlight the importance of including programs and activities such as exercise, to improve movement, function and quality of life.

“The Parkinson’s Disease Foundation is delighted to join the Davis Phinney Foundation in funding this study,” said Robin Anthony Elliott, Executive Director of the PDF. “The study will provide welcome information on the natural history of PD, and the PD community will widely benefit from the results.”

Information about study enrollment is available by contacting pdtrials.

Source:
Wendy Emanuel

Davis Phinney Foundation

Touch Bionics, developer of the world’s first commercially available bionic hand, today announced that its i-LIMB Hand and ProDigits partial hand prostheses are now generally available and have been successfully fitted to a significant number of patients across the United States and in Europe.

Touch Bionics’ i-LIMB Hand looks and acts like a real human hand and is the world’s first widely available prosthetic device with five individually powered digits. In another industry first, Touch Bionics’ ProDigits product is adapted for patients who have a partial hand, due either to congenitally missing fingers or fingers lost through an accident. Partial hand is an area of prosthetics that has been without suitable powered products in the past.

The i-LIMB Hand and ProDigits will be formally unveiled later this month at the 12th World Congress of the International Society for Prosthetics and Orthotics in Vancouver, Canada. But Touch Bionics’ technology is already changing the lives of patients with its prosthetic products, working with leading U.S. clinical partners including Advanced Arm Dynamics, Benchmark Orthotics and Prosthetics, Hanger Prosthetics and Orthotics, LIVINGSKIN and Scott Sabolich Prosthetics and Research.

Sergeant U.S. Army (ret’d.) Juan Arredondo of Universal City, TX, who lost his hand in Iraq in 2004 after his patrol vehicle was struck by an improvised explosive device, is one patient who today is living a different life after being fitted with the i-LIMB Hand.

“Everyday that I have the hand, it surprises me,” said Sgt. Arredondo, who was with the 2nd Infantry Division, 1/506th Destroyer Company. “Now I can pick up a Styrofoam cup without crushing it. With my other myoelectric hand, I would really have to concentrate on how much pressure I was putting on the cup. The i-LIMB hand does things naturally. I can just grab the cup like a regular person.”

John German, a 40-year old medical salesman and clinical technician from Altoona, PA, who lost his hand in 1987, was recently fitted with the i-LIMB Hand. He is excited about the i-LIMB Hand’s “extensive, real-world capabilities,” compared to other prostheses he has used over the past 20 years.

“My previous hand was no better than a wireless mechanical hook, whereas the i-LIMB Hand is a dynamic hand,” Mr. German said. “Instead of a c-shaped pincher, with the i-LIMB hand, I have a full range of grips that allow me to do everything I want to do with the hand.”

Lindsay Block of Oklahoma City, OK, has had a lifetime of experience with prosthetics. Born missing the lower part of her left arm as the result of a birth defect, Ms. Block, now 26, has used almost every new generation of prosthetic technology since being fitted with her first one when only six months old. She is particularly impressed both by the life-like look of the i-LIMB and by its extensive range of motion.

“When I’m wearing the i-LIMB Hand, I’m pretty sure that someone who doesn’t know me wouldn’t even guess that it wasn’t my own hand,” she said. “It’s cool how it can adjust to whatever it is grabbing on to. With this new hand, you don’t have to strategize so much about what you do with it because you realize it’s not limited and will adjust depending on what it’s gripping on to.”

The technology behind the i-LIMB Hand has come of age after many years of research and development at Touch Bionics.

“We are delighted to be the company that moves bionic hand technology from the research and development phase into the real world, and to lead a generational advance in bionics and patient care,” said Touch Bionics CEO Stuart Mead. “We have always existed to change the lives of patients with severe injuries and disabilities, and it is thrilling to feel that we are now able to accomplish that goal.”

The i-LIMB Hand offers a unique, highly intuitive control system that uses a traditional myoelectric signal input to open and close the hand’s life-like fingers. Myoelectric controls utilize the electrical signal generated by muscles in the remaining portion of a patient’s limb. This signal is picked up by electrodes that sit on the surface of the skin. Users of existing, basic myoelectric prosthetic hands are able to quickly adapt to the system and can master the device’s new functionality within minutes. For new patients, the i-LIMB Hand offers a multi-function prosthetic solution that has never before been available.

“I was amazed by how quickly I could learn to do things with the i-LIMB Hand, even only an hour after being fitted with the hand,” said Donald McKillop of Kilmarnock, Scotland, one of the first patients to be fitted with the i-LIMB Hand. “The most important thing is the movement of the fingers, that’s what really makes the difference. It’s truly incredible to see the fingers moving and gripping around objects that I haven’t been able to pick up before. The hand does feel like a real replacement for my missing hand and it is now very natural for me to pick up all sorts of objects. It makes everyday activities much easier.”

Touch Bionics has developed a custom cosmesis, or covering, for its products. i-LIMB Skin is a thin layer of semi-transparent material that has been computer-modeled to accurately wrap to every contour of the hand.

“Cosmesis is a hugely important area in prosthetics, both for appearance and for durability reasons. It is a vital component of our solution and brings an added dimension of personal comfort and satisfaction to our patients,” said Mead. “Some patients, especially soldiers, love the more robotic look of the i-LIMB Skin, but others like their device to blend anatomically with the rest of their body, and prefer to have a life-like covering for the i-LIMB Hand and ProDigits.”

For those patients who desire a more life-like appearance for the hand, Touch Bionics has partnered with some leading companies in the development of cosmesis for its products. ARTech Laboratories and LIVINGSKIN work at the forefront of high-definition cosmesis – these companies are collaborating with Touch Bionics to offer patients a life-like solution to compliment the life-like motions and performance of the hand.

The i-LIMB Hand and ProDigits products are being shipped and patients are being fitted at all of the clinics mentioned above in addition to other US clinics, as well as at Touch Bionics’ new state-of-the-art facility in Livingston, Scotland.

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