Issue link: https://viewer.e-digitaledition.com/i/783222
Brain-computer Interface Breakthrough IN A DDITION TO researching the potential benefits of Indego and transcranial magnetic stimulation for stroke patients, Jennifer Semel, MD, physiatrist, Medical Director of Physical Medicine and Rehabilitation at St. Charles Hospital, has begun investigating the capabilities of brain-computer interface (BCI) technology in children with dyskinetic cerebral palsy, an area which she says has seen little research. BCIs receive and interpret patients' brain signals and translate them into directives that are communicated to output devices, which then execute patients' desired actions. The primary objective of BCI technology is to replace function in people living with life-limiting physical disabilities, such as cerebral palsy, stroke or spinal cord injury. "Overall, we hope this technology will be one of several that will help our patients gain better control of their daily activities, and, ultimately, their lives," Dr. Semel says. analyst from Stony Brook, who is para- lyzed from the chest down after suering a spinal cord injury while sledding down a mountain on New Year's Day in 2009, is St. Charles Hospita l's first patient to use Indego. Following the accident, Mr. Durso had a spinal cord fusion and completed acute care rehabilitation shortly thereafter. He continued his rehabilitation at St. Charles Hospital's outpatient rehabilitation network loca- tion in Port Jeerson. "St. Charles Hospital has an excellent reputation for spina l cord injury reha- bilitation, and it was close to home — it was a perfect fit," Mr. Durso says. "I've a lways enjoyed being active — skiing, cycling, sw imming, wa keboa rding, b oa t i n g a nd c omp e t i n g i n t r i a t h- lons — a nd I wa nt to compete in the Pa ra lympics. For tunately, through a number of rehabi litative therapies, Dr. Semel a nd her tea m have helped me remain active, as well as sustain a high level of independence. "I've only used Indego for a few weeks, but it has been an incredible opportunity and experience," Mr. Durso continues. "Until Indego, I hadn't walked in almost eight years. There's great hope knowing there's now technology available to help me wa lk again." W hi le Indego ha s been indicated primarily for patients with spinal cord injuries, the novel device a lso holds great promise for those who have suf- fered a stroke. "St. Charles Hospita l is the largest acute inpatient rehabilitation facility on Long Isla nd, ser v i ng more t ha n 1,000 patients annua lly, the majority of whom are stroke patients and those living with lower limb disabilities. We a lso provide 100,000 patients visits annua lly through our eight outpatient rehabilitation centers," Dr. Semel says. "This new clinica l tria l gives the mak- ers of Indego an opportunity to have a large population eva luate their device while a lso providing hope to patients recovering from both spinal cord injury and stroke patients." Though Dr. Semel is pleased with the early success of this technolog y, she is most excited about the next generation of Indego, which will employ functional electrica l stimulation (FES). "Right now, the device drives itself," Dr. Semel ex pla i n s. " However, t he electrica l stimu lation capabi lit y in the upcoming design will stimulate the patient's leg muscles and enable him or her to drive the machine. The electrodes will attach to the quadriceps muscles, causing the patient 's legs to ex tend, and giving the impulse required for the muscles to ma ke the machine move. "Aside from g iving the patient the power and ability to move the machine instead of vice versa, we theorize that the electrical stimulation will also help keep muscles active, thereby preventing muscle atrophy, which is very common in patients with spina l cord injuries or strokes," Dr. Semel adds. Parker Hannifin Corporation expects research trials for Indego with FES will begin fa ll 2017. TAPPING INTO TMS In addition to seeing promising benefits from Indego, stroke patients receiving Mark Schmalzle, PT, St. Charles Hospital (right) helps Greg Durso (left), maintain his balance as he walks while wearing St. Charles Hospital's exoskeleton. The exoskeleton completes the walking motions for the individual who wears it. Greg Durso, a St. Charles Hospital patient, competes in a bike race following a 2009 sledding accident which left him completely paralyzed from T4 down. PHOTO: RYAN C. WALSH 0 9 M D N E W S . C O M /// M D N E W S L O N G I S L A N D ■ 2 017