A man with completely paralysed from the lower trunk in robotic suit kicks off World Cup

Juliano Pinto, a 29-year-old with complete paralysis of the lower trunk performed the symbolic kick-off at the Corinthians Arena in Sao Paulo. Using his robotic suit, Mr Pinto kicked the official ball a short distance along a mat laid down by the touchline. His robotic exoskeleton was created by a Brazilian neuroscientist Dr. Miguel Nicolelis who led the team of 150 researchers on a project named "The Walk Again" which aimed to make people with paralysis abandon the wheelchair and literally walk again. The World Cup demonstration is "just the beginning" of a future for people suffering from paralysis.

It's for the first time that an exoskeleton has been controlled by brain activity and offered feedback to the patients. And also having a demonstration in a stadium is something very much outside routine in robotics. It's never been done before.

The exoskeleton uses a cap placed on the patient's head to pick up brain signals and relay them to a computer in the exoskeleton's backpack. This then decodes the signals which in return translates into commands for the robot to start moving and sends them to the legs. The robotic suit is powered by hydraulics, and a battery in the backpack allows for approximately two hours of use. Dr Cheng who led the development of a form of artificial skin for the exoskeleton. This skin consists of flexible printed circuit boards, each containing pressure, temperature and speed sensors. It is applied on the soles of the feet and allows the patient to receive tactile stimulation when walking with the exoskeleton. When the robotic suit starts to move and touches the ground, signals are transmitted to an electronic vibration device on the patient's arm, which stimulates their skin. After lots of practice, the brain starts associating the movements of the legs with the vibration in the arm. In theory, the patient should start to develop the sensation that they have legs and that they are walking.
The suit has been named Bra-Santos Dumont, which combines the three-letter designation for Brazil and Alberto Santos-Dumont, the aviation pioneer who was born in the country's southern state of Minas Gerais.

Looking at the screengrab of the kick, it’s unlikely that the Bra-Santos Dumont exoskeleton will instantly give you Cristiano Ronaldo skills, but it should certainly give some hope to soccer players who have lost the use of their legs.
 Paraplegic Performs World Cup’s Ceremonial First Kick in Mind-Controlled Robotic Suit

Measure 'Sixth Vital Sign' Using App "GaitTrack"

Bruce Schatz, lead researcher on the project GaitTrack app says it is different from other fitness apps, since it uses eight motion parameters to gather, record, and analyze critical information about a person’s gait — the overall pattern of a person’s physical movements while walking.

Schatz classifies gait as the “sixth vital sign" adding to the important vital health measurements as temperature, blood pressure, heart rate, respiratory rate, and blood oxygen level. Gait analysis can provide important information about a patient’s cardiopulmonary, muscular, and neurological health.
Routinely - actually rarely we use "6 min walk test" for checking the cardiovascular status of the client which is not ideal for detecting a new or already existing worsening condition. GaitTrack, developed by University of Illinois converts any cellphone into a sophisticated medical monitor for your heart and lungs.

The GaitTrack app runs constantly in the background of a user’s smartphone and periodically measures, records, and analyze key data related to gait. The app collects data in six minute increments tracking the user’s walking gait and analyzing it. It would then alert the patient or the patient’s doctor if the data ever indicated a dangerous change. It can be an important tool for those with congestive heart failure, chronic obstructive pulmonary disease (COPD), and asthma.

The GaitTrack app takes advantage of accelerometers and if coupled with a pulse oximeter, the app can record the gait along with the person’s heart rate and blood oxygenation for a more complete picture of health. The app have been tested in a research on 30 patients with chronic obstructive pulmonary disease (COPD) and found that the app is more accurate, and surely cheaper, than medical accelerometers already used in medicine. They discovered that the GaitTrack app was able to quite accurately predict a person’s FEV1 test (Forced Expiratory Volume in 1 Second).
The app will be publicly available sometime later this year.

Special Implication for PTs -
When we talk about therapy to improve gait, PTs know all the troubles to get effective results. Especially if we are dealing with Cardiopulmonary patients we have to be very precautious. This app will be a boon for PTs as it not only gives the parameters important for gait but also checks for the vitals related to heart as well as lungs which can help us to set the goals.

GaitTrack Smartphone App, a Medical Device for Automatic Gait Assessment

iHealth Align - The world’s smallest, most portable mobile glucometer

On June 12, 2014, Health Lab Inc. announced the launch of the iHealth Align, the world's smallest, FDA-approved mobile blood glucose monitor.

Simply plug in the iHealth Align into a smart phone and use it with the companion iHealth Gluco-Smart app in order to take a reading. Align has to be fully inserted into the audio port. iHealth Align comes with two CR1620 batteries. The battery needs to be installed before use.

The free iHealth Gluco-Smart app automatically keeps a history of your data and gives you the option to share your information with your doctor or caregiver. The devices work with both Apple and Android devices.

By displaying readings directly on the phone screen, iHealth was able to shrink the device size to just slightly larger than the circumference of a quarter. The compact size and mobile sync capability make iHealth Align a small and powerful new tool for diabetes management.

iHealth Align is the next generation of mobile solutions to diabetes management.

The budget friendly device is priced just $16.95 which comes with a lancing device and four colorful protective cases. Consumers can pre-order the iHealth Align beginning today at iHealthlabs.com. 

iHealth test strips are now available at the new low price of $12.50 per vial of 50 strips and can be found at iHealthlabs.com and Walgreens.com. The companion iHealth Gluco-Smart App is available for free from the Apple App Store for iPhone from Google Play for Android devices.

iHealth Align, World’s Smallest FDA Cleared Glucometer, Now Available in U.S. 

Special Implications for PTs
Physiotherapy plays a huge role in Diabetes management. Keeping track of the Blood Glucose level helps us decide our goals for patients. The exercise prescription is made on the basis of Blood Glucose level when it comes to Diabetic patients in order to prevent exercise induced hypoglycemia. If Glucometer like the one designed by iHealth is handy, testing levels become easier and safer too.

Health Kit app by Apple iOS 8 - Revolution in Health?

The Apple Worldwide Developers Conference (WWDC) 2014 event on June 2-6 in San Francisco certainly did not disappoint with the official announcement with news of HealthKit.

The new Health app gives you an easy-to-read dashboard of your health and fitness data. HealthKit which allows all the incredible health and fitness apps to work together might be the beginning of a health revolution.

Heart rate, calories burned, blood sugar, cholesterol; a complete health and fitness apps are great at collecting all that data.

The new Health app puts that data in one place, accessible with a tap, giving you a clear and current overview of your health. You can also create an emergency card with important health information — for example, your blood type or allergies — that’s available right from your Lock screen.

With HealthKit, developers can make their apps even more useful by allowing them to access your health data, too. And you choose what you want shared. For example, you can allow the data from your blood pressure app to be automatically shared with your doctor. Or allow your nutrition app to tell your fitness apps how many calories you consume each day. When your health and fitness apps work together, they become more powerful. And you might, too.

This time, it looks like population at large will be the main beneficiary.

Health tracking built in with your new smartphone: a new revolution?

Special Implications for PTs -

Documentation is very important when it comes to healthcare. This Health app will save time when we are dealing with patients especially in critical care. History is the most important part of documentation and when we ask patients about it, there may be times when important piece of information can get skipped. This app will fill in the gap of memory as well as will be time saving.

You wouldn't miss a murmur with Thinklabs One Digital Stethoscope

Thinklabs Medical devised a high end electronic stethoscope "Thinklabs One" with Advanced Audio Features.

It has changed the icon of medical practice where we tried to hear the human body using a hollow tube.



This new reinvented digital stethoscope is the smallest and the most powerful stethoscope in the world which fits in your palm and amplifies 100 times the vital sounds using audio headphones.
The device can be connected to tablets and smartphones to visually display the waveform of the audio using a matching app, which can also record and zoom for further clarification.

Thinklabs provides a library of pre-recorded heart sounds with the iMurmur app that can be used to learn and maybe even compare against one’s own patients. The standard package comes with a set of in-ear headphones. For the stylish physician there’s also the Beats Package that comes with Dr. Dre’s Executive headphones that feature noise canceling technology.

Its beyond "Bell" and "Diaphragm" to multiple filter choices where the frequencies can be set for low, midrange or higher frequencies. You wouldn't miss any of the sounds be it S3, valves and murmurs, and lung sounds. It will also filter out ambient noise frequencies. The Rechargeable Lithium Ion Battery requires only one or two charges a week with a typical workload, designed for 100 - 125 patient exams per charge. Battery indicator mode indicates the battery capacity.

It has open up a world of possibilities for Telemedicine, Education, Research and Electronic Medical Records (EMR).

Special Implications for PTs -
Being a health profession it is very important to keep track of vitals of patients. Thinklabs One Digital Stethoscope will be of gr8 help to PTs for practicing not only in the emergency care but in regular practice too. It will also help in academics and research.

Time to put your old stethoscope aside and switch to Thinklabs One 

Permanent Joint implants - Yes its without an expiry date!

Artificial joints presently come with a limited lifespan.  With wear and tear of these implants after few years from transplant many hip and knee joints have to be replaced. The situations become more complex when we talk about wear and tear of intervertebral disc implants, which cannot easily be replaced after their "expiry date". This restricts the patient's freedom of movement considerably.
Dr. Kerstin Thorwarth and team at Nanoscale Materials Science at Empa technology have devised a coating made of DLC ("diamond-like carbon") on mobile intervertebral disc implants so that they show no wear and will now last for a lifetime.

Normally a standard procedure of artificial joint replacements can be repeated up to three times with most implants.  As bone material is lost each time an implant is explanted, the new joint has to replace more bone and is therefore larger. In the case of intervertebral discs, this is virtually impossible. They are too close to spinal nerves and tissue structures that could be damaged by another operation. Currently available product implants carry the risk of triggering allergies or rejection reactions due to material abrasion.

These abrasions are actually caused by the corrosion behaviour of the bonding agent between the DLC layer and the metal body. This layer was made of silicon which corroded over the years, causing it to flake, which led to increased abrasion and, as a result, bone loss.

Empa researcher finally found and tantalum to be used as the bonding agent.  This coating was tested in a so-called total disc replacement - a mobile disc implant. They simulated 100 million cycles, i.e. about 100 years of movement in a specially designed joint simulator.  The small intervertebral disc implant held out, remaining fully operational with no abrasion or corrosion. The new bonding agent will be used in combination with DLC coatings for other joints too in near future.

Specific Implications for PTs -

Physiotherapist plays a major role in rehabilitation post joint transplant, where we see patients dealing with a new joint. Some patients recover within weeks, some take months to years.
If the same process of joint transplant is repeated after five to ten years, the patient may find it difficult to rehabilitate fully as aging leave its mark on body. The healing capacity as well as functioning reduces with age, hence this permanent joints will help patients to recover once from the agony of transplant. Knowledge about provision of such implants is essential for the benefit of the patients.

Joint implants without an expiry date from Empa technology

New Coating May Finally Help Make Artificial Joints Last a Lifetime.

Mirrors are miraculous

"Twice a day, ten minutes per session, for five weeks and the phantom pain will go away" - Stephen Sumner's recipe for mirror therapy.

That was Vilayanur S. Ramachandran who invented mirror box to help alleviate phantom limb pain, in which patients feel they still have a limb after having it amputated. Albeit research and researchers have their ongoing debate, there are people who feel benefited to alleviate the phantom pain with help of mirror therapy.

This story is of Stephen Sumner who lost his left leg that had been amputated six inches above the knee and his phantom pain. Stephen used the mirror for two weeks, then stopped because the pain had not returned. About a year and a half later, he felt the pain again, and this time he stayed the course for the full five weeks. He hasn’t had phantom pain for over four years. “It’s gone now,” he says. “It’s gone because I treated myself with a mirror.”

This man have done many magnificent jobs past the event and now he is on a mission to alleviate pain of people suffering from Phantom pain using mirrors. He meets people with amputation, learns about their story and shares his too. With people who have phantom pain he gives a mirror, teaches them the use of it and thereby alleviates their pain. He is "Mirror Man"; a mirror therapist who first targetted Cambodia, place where landmines and unexploded ordnance killed around 20,000 people and injured 44,000 more between 1979 and 2011.

Stephen thoughts about phantom pain is that “It’s not in the head, it’s in the limb.” He have travelled around Asia with mirrors on the back of his bicycle to help amputees who were suffering from phantom pain but now he is exhausted. He says "Mirrors are supereffective".

Stephen offers a simplified explanation of the brain reorganisation theory. Pointing to his head, he says, “You have a commander here that controls the body. The commander has a map of the whole body. When the map doesn’t match the body, the commander panics and you feel pain. This mirror is to trick the commander into thinking the leg still exists, so he stops panicking and the pain goes away.”

He is dedicated towards helping people to overcome from phantom pain using mirrors, read his full story by clicking the link below.

Specific Implications for Physiotherapists -
Mirror therapy is a part of Graded Motor Imagery which consist of three steps.
1st. Left Right Discrimination
2nd. Explicit Motor Imagery
3rd. Mirror Therapy
In order to get effective results we need to know the technique properly. Only use of mirror wouldn't give effective results.
See these videos from David Butler

Mirror Box Therapy with David Butler

GaitTrack Smartphone App, a Medical Device for Automatic Gait Assessment 

Its Is Not Just Big Tobacco Anymore

Hence WHO's Global NCD (Non Communicable diseases) Action Plan accepts the road to 25 × 25.
The UN high-level meeting on NCDs in September 2011 accepted the recommendation of Pearce and colleagues to include the 25×25 strategy to tackle the global epidemic of NCD. Margaret Chan, Director General of WHO stated that “It is not just Big Tobacco anymore. Public health must also contend with Big Food, Big Soda, and Big Alcohol. All of these industries fear regulation, and protect themselves by using the same tactics”.

The increasing burden of NCDs poses an enormous threat to populations and health systems across the globe. The 25×25 strategy seeks to reduce preventable mortality. The WHO Global NCD Action Plan 2013—2020 includes many disorders, the four disorders specified in the 25 ×25 strategy (cardiovascular disease, diabetes, cancer, and chronic respiratory disease) account for 87% of all deaths from NCDs. This plan lists nine voluntary national targets i.e. diabetes, obesity, reduced alcohol consumption, increased physical activity, reduced dietary salt, reduced smoking, improved blood pressure control, and enhanced treatment of those at risk are the major NCDs. The plan will acknowledge social, economic as well as political determinants of disease. However, making changes into the policy is less clear.

“The 25×25 strategy needs to be implemented in existing health systems in low-income and middle-income countries (LMICs), particularly in primary care. This approach would address NCDs in broader social, economic, and health-care contexts, adaptable to local circumstances.”

Special Implications for PTs
In the past decade energy expenditure has decreased markedly because of changes in the livelihood, including urban design, safety concerns, the rise of the car, and the near demise of public transport.
The dire need is environmental change so that physical exercise becomes part of daily life again, rather than being a lifestyle choice. If exercise were a pill, it would be one of the most cost-effective drugs ever invented. People can get lot of benefit from being more physically active.
Of all the health professionals dealing with NCDs, PTs have a big role in prevention as well as management of NCDs.
Thumb rule is increasing Physical Activity in order to meet up the 25×25 strategy success.

The road to 25×25: how can the five-target strategy reach its goal?

25×25 strategy for the burden of non-communicable diseases