Stroke

U of T researcher 'reprograms' brain cells in pursuit of new therapy for stroke patients

Christopher.Sorensen — Tue, 01 Jun 2021 18:29:22 +0000

U of T researcher 'reprograms' brain cells in pursuit of new therapy for stroke patients

Christopher.Sorensen Tue, 06/01/2021 - 14:29

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Understanding the role of reprogrammed neurons, shown here in yellow, and resident neurons, shown in red, in post-stroke recovery is at the heart of research by U of T's Maryam Faiz (image courtesy of Maryam Faiz)

Blake Eligh

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Our Community

Insulin 100

Temerty Faculty of Medicine

Brain

Faculty of Arts & Science

Research & Innovation

Stroke

Could “reprogramming” the brain at a cellular level help people recover from strokes faster and better? One researcher from the ��Ƶ’s Temerty Faculty of Medicine aims to find out.

Strokes happen when blood flow to the brain is disrupted, resulting in irreversible damage to neurons, the brain cells that control behaviour and movement. For the 50,000 Canadians who will experience stroke each year, more than half will be left with lifelong impairments in the ability to move, eat or communicate.

But research by neuroscientist Maryam Faiz, a professor in the department of surgery who studies neuronal reprogramming, suggests a new kind of therapy for post-stroke recovery. She says astrocytes – a network of bushy cells Faiz likens to “a night sky” – are thought to play an important role in the brain’s circuitry. With reprogramming, she says, astrocytes can be converted into neurons to replace those cells lost to stroke damage.

Maryam Faiz

“We think of this as a new strategy for neural repair,” says Faiz, adding that, in the lab, the technique shows good results in mice with post-stroke impairments in mobility and gait.

“After reprogramming, those abilities recover to the level of an uninjured animal.”

The technique may help extend the window for the recovery process. Current stroke recovery interventions are time-sensitive, with the greatest gains taking place in the hours that follow a stroke.

In Faiz’s experiments, however, reprogrammed mice showed continued recovery, even at the nine-week mark. In these experiments, researchers administered reprogramming to the mice a week following their strokes.

“We could see functional recovery early in the reprogramming process,” Faiz says. “Animals were walking better and this extended to much later time points.”

While Faiz’s lab research focuses on tiny astrocytes and neurons, the patient outcome is never far from her mind.

Her work took a personal turn two years ago when a close family member suffered a traumatic brain injury as the result of an accident. Witnessing their ongoing recovery process highlighted the potential impact of Faiz’s research, which could be applied to stroke recovery – but also in the treatment of Parkinson’s or Alzheimer’s diseases or a traumatic brain injury.

“Knowing someone who has had a brain injury is eye-opening,” she says. “It can have a massive impact on every part of their life.”

Faiz, who joined the Temerty Faculty of Medicine in 2017, is one of three recipients of the inaugural Temerty Pathway Grant. Launched in 2020, the internal funding program supported by the Temerty family awards $100,000 each to three promising research projects that have not yet been successful in grant competitions.

The bridge funding allows researchers to keep working on a project and submit a stronger grant application in the next round.

“The Pathway Grant gave me room to breathe,” says Faiz. “When you don’t get your CIHR grant, you’re just back in the lab 24 hours a day, trying to get the next set of data.”

Faiz and fellow Pathway recipients Thierry Mallevaey and Scott Yuzwa, in the departments of immunology and laboratory medicine and pathobiology respectively, were awarded CIHR funding in the round of grants announced this spring.

"The Temerty Pathway Grant Program is designed to provide bridge funding for early career researchers like Professor Faiz to achieve CIHR funding,” says Reinhart Reithmeier, senior adviser to the vice-dean research and graduate education. “I congratulate the first three winners, Professors Faiz, Mallevaey and Yuzwa, on their success in the last CIHR Program grant competition."

While Faiz’s initial recovery results in mice are promising, little is known about how the reprogrammed neurons integrate into the circuitry of the brain.

With funding from the CIHR to Faiz and co-applicants Shreejoy Tripathy, an assistant professor of psychiatry and Melanie Woodin, dean of the Faculty of Arts & Science and a cell and systems biology professor, Faiz hopes to understand what’s happening at different periods during the stroke recovery process and how reprogramming contributes to brain recovery and repair.

“Is the cell we’re making important for recovery or does reprogramming exert an effect in the environment around the cells that could lead to change?” she asks. “Are these new cells actually responsible for recovery or might something else be happening here?

“Our study will answer these questions and help us understand if and how these newly generated neurons are responsible for the recovery in function that follows neuronal reprogramming.”

Women less likely to be diagnosed with minor stroke than men: U of T study

Christopher.Sorensen — Tue, 28 May 2019 18:05:32 +0000

Women less likely to be diagnosed with minor stroke than men: U of T study

Christopher.Sorensen Tue, 05/28/2019 - 14:05

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The study found that women were 10 per cent more likely to be given a non-stroke diagnosis – for example migraine or vertigo – even though men and women were equally likely to report atypical stroke symptoms (photo by Mayte Torres via Getty Images)

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Research & Innovation

Stroke

Sunnybrook Hospital

Women experiencing a minor stroke or transient ischemic attack (TIA) are less likely to be diagnosed with a stroke compared to men – even though they describe similar symptoms in emergency departments.

That’s according to a ��Ƶ-led study published in JAMA Neurology that was presented at the European Stroke Organisation Conference in Milan on May 22.

The study found men and women equally described atypical stroke symptoms such as dizziness, tingling or confusion, but that women were more likely than men to be diagnosed with another ailment.

“In our study, men were more likely to be diagnosed with TIA or minor stroke, and women were 10 per cent more likely to be given a non-stroke diagnosis – for example migraine or vertigo – even though men and women were equally likely to report atypical stroke symptoms,” says study lead author Dr. Amy Yu, a stroke neurologist at Sunnybrook Health Sciences Centre and assistant professor at the ��Ƶ’s department of medicine in the Faculty of Medicine.

A TIA occurs when there is temporary interruption of blood flow to the brain, and is often a warning sign of another stroke. TIAs can also be associated with permanent disability. Typical symptoms of stroke, by contrast, are sudden weakness, face drooping or speech difficulties.

“Our study also found the chance of having another stroke or heart attack within 90 days of the diagnosis was the same for women and men,” adds Dr. Shelagh Coutts, a stroke neurologist with Alberta Health Services at Foothills Medical Centre and an associate professor at the University of Calgary’s Cumming School of Medicine.

Researchers say that, while further study is needed, it’s possible patient reporting of symptoms, interpretation of symptoms by clinicians, or a combination of both, could explain the discrepancy in diagnosis among men and women.

“Our findings call attention to potential missed opportunities for prevention of stroke and other adverse vascular events such as heart attack or death in women,” says Coutts.

Previous studies on this topic have focused on patients diagnosed with stroke. Researchers in the current study included 1,648 patients with suspected TIA who were referred to a neurologist after receiving emergency care from 2013 to 2017, regardless of their final diagnosis.

Researchers note it is an important opportunity for the public and clinicians to be aware of atypical symptoms of TIA.

“What’s important to recognize in stroke is that the brain has so many different functions and when a stroke is happening, people can feel different things beyond the typical stroke symptoms,” says Yu.

“Accurately diagnosing TIA and stroke would change a patient’s treatment plan and could help prevent another stroke from happening.”

Technologies that can help end ‘hallway medicine’: U of T health-care researchers to meet with Ontario legislators

geoff.vendeville — Mon, 29 Oct 2018 13:56:32 +0000

Technologies that can help end ‘hallway medicine’: U of T health-care researchers to meet with Ontario legislators

geoff.vendeville Mon, 10/29/2018 - 09:56

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The robotic Hero Glove enables stroke survivors to open and close their hand to do all sorts of activities, from holding a fork to dressing themselves (photo by Geoffrey Vendeville)

Geoffrey Vendeville

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City & Culture

Faculty of Applied Science & Engineering

Research & Innovation

Robotics

Stroke

Video games and a robotic glove that help stroke survivors regain dexterity in their hands and arms. A robot named Casper that assists older adults with everything from fixing a tuna sandwich to communicating with loved ones.

These are just some of the technologies being developed by ��Ƶ researchers to help people live comfortably in old age, easing the burden on caregivers and the health-care system as a whole. And, tomorrow, some of those researchers will have an opportunity to meet with legislators at the first in a series of MPP Public Policy Breakfasts.

The event at Queen's Park, hosted by the Council of Ontario Universities, will focus on how university experts are helping to end “hallway medicine” – a term that refers to hospital overcrowding and the practice of treating patients on stretchers in hallways while they wait for a bed.

“By working together, universities, health-system partners, the private sector and government can address the medical challenges facing us today and in the future,” said Vivek Goel, U of T’s vice-president of research and innovation.

A key challenge is Canada's aging population. As of 2017, Canadian seniors outnumbered children under age 14 for the first time ever, while Statistics Canada expects seniors to make up between 23 and 25 per cent of the population by 2036.

Keeping Canadians healthy at home for as long as possible is among the goals of research being conducted at U of T and its nine partner hospitals, which, together, form one of the most vibrant life sciences and human health clusters in the world. That, in turn, helps to free up valuable hospital and other health-care resources for those who need it most.

“The ��Ƶ is a leader in developing technologies that improve patients’ quality of life and reduce pressure on the health-care system,” Goel said.

Rosalie Wang, an assistant professor of occupational science and occupational therapy, will introduce lawmakers to projects by the Intelligent Assistive Technology and Systems Lab, which helps stroke survivors recover use of their upper limbs. About 50,000 Canadians suffer a stroke each year, and 14,000 die immediately. Those who survive often experience various degrees of impaired movement, vision or thinking.

With rehabilitation, however, some survivors can regain function in their affected limbs. Wang and PhD student Aaron Yurkewich have been designing technologies to complement a stroke survivor’s treatment program. One such technology is a robotic arm and video games that give a stroke survivor more opportunities to receive intense upper limb movement therapy. Patients often work toward a specific goal such as throwing a tennis ball or holding their grandchild.

With Wang's device, the patient grips a clear plastic cone, about the size of a waffle cone, which is connected to a robotic arm that applies assistive or resistive force. The patient can then, for example, play a video game that simulates an air hockey game, moving the cone around to control a player who guards the net. In another game, the patient is a snowball, rolling through a wintry maze to rescue other snowballs trapped in ice crystals.

It might look like entertainment, but patients are actually improving their strength, range of motion and the smoothness of their movement. The games also gather data that can be used as feedback to encourage patients to continue therapy. For therapists and researchers, the data can later be used to adjust the patient’s program.

Rosalie Wang demonstrates a robotic device for upper limb stroke recovery in the Rocket Family Upper Extremity Clinic at the Toronto Rehabilitation Institute (photo by Geoffrey Vendeville)

The device, aimed at improving the arm’s movement, is meant to free up an occupational therapists’ time so they can focus on other, more complicated aspects of a patient’s recovery, including transferring these mobility gains to functional, daily activity goals and community re-integration. “The opportunity really is not to replace what therapists do, but to optimize the way they practice by making the best use of therapy time,” Wang says.

The robot is designed for stroke survivors undertaking what's described as a moderate recovery stage. The device and games are being designed and evaluated with outpatients at the Toronto Rehabilitation Institute's Rocket Family Upper Extremity Clinic.

Wang says the device has given new confidence to stroke survivors who had lost hope of ever regaining movement. “Those who had a stroke years ago don’t realize there is still a lot of potential to gain” outside the initial recovery window of three to six months, she says. “There is still a window for recovery, but beyond that there is still more that can be done.”

Down the hall at Toronto Rehab, PhD student Yurkewich is working on the prototype of a robotic glove to help stroke and spinal cord injury survivors regain their movement and independence. The Hero Glove helps clench and unclench fingers so stroke survivors can do everyday tasks like grip a toothbrush or fork.

The device also collects data and provides feedback to improve a patient’s treatment plan. Yurkewich has anonymized videos of clinical feedback sessions showing how the glove has helped patients hold a water bottle again. “This person’s actually turning around to his wife to say, ‘Look I can use my hand again,’” Yurkewich says.

The tech-heavy projects don’t stop there. On the same floor at Toronto Rehab is the Home Lab, a replica apartment complete with bedroom, kitchen and even a front door with a welcome mat and working doorbell. The lab is a mock environment for researchers seeking to test their gadgets, including a ceiling-mounted machine that calls for help in the event of a fall. In one corner, there’s a robot designed by Goldie Nejat, an associate professor of mechanical engineering and Canada Research Chair in Robots for Society.

For over a decade, Nejat has worked on robots to stimulate older adults and assist with daily tasks. They perform a range of tasks, from initiating a game of bingo to reminding someone it’s lunchtime and guiding them through the steps in making scrambled eggs or spaghetti. The goal is to help older people with dementia or other types of cognitive impairment live safely and independently.

A demonstration of the robot, Casper, in the Home Lab at the Toronto Rehabilitation Institute.

After more than 100 hours of testing human-robot interaction, Nejat says the results are positive. People engage with the robot, ask it questions, joke around – almost as if it were human. “If they’re eating a meal, they would say ‘Are you going to eat too?’” she says.

She and her team of co-researchers are preparing for a longer-term study involving robots in 2019, a prelude to commercialization. Already she says she receives letters from children with older parents, long-term care homes and even seniors themselves who are interested in trying a robot.

As the average Canadian gets older, there’s an even greater need for solutions to support older adults, she says. “A lot of our health-care professionals are retiring too, and with the growing population [of elderly people] we don’t necessarily have the staff to support them,” she says.

Much of Dr. Robert Wu's work focuses on improving another aspect of medicine: communication. It’s been more than 10 years since Wu, an associate professor in U of T’s Faculty of Medicine and general internist at the University Health Network, had a pager clipped around his waist, but some of his colleagues still do. His research evaluates communication technology to make improvements to workflow and quality of care.

“It’s about making sure that the team knows what’s going on with the patient,” he says. “Medicine is much more fast-paced now than it was 10 or 15 years ago. There is more pressure, complexity and more people involved.”

Wu has helped develop a web app that is used for non-urgent communication between nurses and doctors in four services at Toronto General Hospital and Toronto Western Hospital. The app tracks when a message was sent and read.

He says his research is part of a team effort to end hallway medicine by improving efficiency in hospitals.

“Lots that we’re doing in internal medicine, but within the emergency department as well, is to improve flow and make sure we have the right number of beds,” he says.

U of T expert on knowing the signs of a stroke – and acting quickly

rasbachn — Mon, 11 Dec 2017 18:10:44 +0000

U of T expert on knowing the signs of a stroke – and acting quickly

rasbachn Mon, 12/11/2017 - 13:10

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The sooner you get help, the better your outcomes will be, writes U of T's Dr. Gurpreet Jaswal (photo by BSIP/UIG via Getty Images)

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It is crucial to know the signs of a stroke and get help right away when symptoms suddenly strike, says ��Ƶ’s Dr. Gurpreet Jaswal.

That means calling 911 immediately.

The sooner you get help, the better your outcomes will be, Jaswal writes in this week's edition of Doctors' Notes, the Toronto Star's weekly column created by U of T medical experts.

“As a general internal medicine physician, I see how the passage of time can affect patient outcomes after a stroke," Jaswal writes. "More often than we’d like, my colleagues and I see people who have waited to get help, or gone to an urgent care or walk-in clinic before coming in to the hospital. They might not have realized they were having a stroke or how serious their symptoms were. The problem is, this delays our ability to help tremendously.”

Read the full Doctors' Notes column

The benefit of prolonged heart monitoring after unexplained strokes: New England Journal of Medicine

sgupta — Thu, 26 Jun 2014 12:45:00 +0000

The benefit of prolonged heart monitoring after unexplained strokes: New England Journal of Medicine sgupta Thu, 06/26/2014 - 08:45

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Dr. David Gladstone led the EMBRACE trial (photo by Doug Nicholson/Media Source)

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Global Lens

Caregivers happier when they can continue to enjoy hobbies and interests

sgupta — Thu, 27 Mar 2014 11:37:37 +0000

Caregivers happier when they can continue to enjoy hobbies and interests sgupta Thu, 03/27/2014 - 07:37

Topic

Stroke caregivers are happier when they are able to continue enjoying their own hobbies and interests – and when their family member has suffered a more severe stroke, according to newly released research led by Jill Cameron of the ��Ƶ.

"I was most surprised that caregivers were happier when caring for a family member who survived a more severe stroke," said Dr. Cameron, an associate professor with the Department of Occupational Science and Occupational Therapy and the Graduate Department of Rehabilitation Science at U of T's Faculty of Medicine and adjunct scientist, UHN-Toronto Rehabilitation Institute.

"But when a stroke is labelled mild, expectations are high and the issues are more subtle. That can cause more frustration because survivors of a mild stroke still have problems."

Researchers interviewed approximately 400 family members who provide informal care to their loved one who suffered a stroke. The caregivers were mostly women, caring for a spouse.

They found that the happiest family caregivers were older and in better physical health. But caregivers were less happy if they were caring for a stroke survivor who had memory loss, depression and other mood, cognitive or behavioural issues.

That may be because health systems tend to offer more resources to help caregivers handle physical disability than problems with thinking, memory, behavior and mood, said Cameron.

The study only looked at people caring for stroke survivors who came home from the hospital after their first stroke, not those who were sent to nursing facilities.

Researchers found caregivers were happiest if they felt they could handle the challenge of caring for a family member and were able to continue taking part in activities they enjoyed – perhaps because they were retired and did not have to juggle the responsibilities of a job or child care, said Cameron (pictured right).

The hope is that these findings will help inform how the health-care system can make adjustments to improve the support for stroke survivors and their loved ones, she said.

"If the family is doing better, that helps the patient do better."

Read the media release. The Canadian Stroke Network, Social Sciences and Humanities Research Council and Canadian Institutes of Health Research New Investigator Award funded the study.

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Parental divorce linked to stroke in males

sgupta — Wed, 12 Sep 2012 15:08:38 +0000

Parental divorce linked to stroke in males sgupta Wed, 09/12/2012 - 11:08

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Men who experienced parental divorce before they turned 18 face a higher risk of stroke, U of T researchers say (Photo by Caz Zyvatkauskas)

Michael Kennedy

Author legacy

Michael Kennedy

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Men with divorced parents are significantly more likely to suffer a stroke than men from intact families, shows a new study from the ��Ƶ.

The study, to be published this month in the International Journal of Stroke, shows that adult men who had experienced parental divorce before they turned 18 are three times more likely to suffer a stroke than men whose parents did not divorce. Women from divorced families did not have a higher risk of stroke than women from intact families.

“The strong association we found for males between parental divorce and stroke is extremely concerning,” says lead author Esme Fuller-Thomson, Sandra Rotman Chair at U of T’s Factor-Inwentash Faculty of Social Work and Department of Family and Community Medicine.

It’s the latest in a series of studies by Fuller-Thomson that indicate the lingering effects of childhood trauma. A study published last month in the journal Child Abuse & Neglect found that men who experienced childhood sexual abuse were three times more likely to have a heart attack than all other men – while women had no increased likelihood of heart attack. (You can read about those findings here.)

As with the previous study, researchers took into account other risk factors that could affect the health of adult men.

“It is particularly perplexing in light of the fact we excluded from our study individuals who had been exposed to any form of family violence or parental addictions. We had anticipated that the association between the childhood experience of parental divorce and stroke may have been due to other factors such as riskier health behaviors or lower socioeconomic status among men whose parents had divorced,” says recent U of T graduate and co-author Angela Dalton. “However, we controlled statistically for most of the known risk factors for stroke, including age, race, income and education, adult health behaviors (smoking, exercise, obesity, and alcohol use) social support, mental health status and health care coverage.

“Even after these adjustments, parental divorce was still associated with a threefold risk of stroke among males.”

Researchers cannot say with certainty why men from divorced families had triple the risk of stroke, but one possibility lies in the body’s regulation of cortisol, a hormone associated with stress.

The elevated rate of stroke could be linked to a process known as biological embedding, says Fuller-Thomson.

“It is possible that exposure to the stress of parental divorce may have biological implications that change the way these boys react to stress for the rest of their lives” says Fuller-Thomson.

As with all scientific research, it is essential for many researchers to replicate findings from this study in prospective studies before it is safe to draw any conclusions about causality, Fuller-Thomson says.

“If these findings are replicated in other studies,” says Fuller Thomson, “then perhaps health professionals will include information on a patient’s parental divorce status to improve targeting of stroke prevention education.”

Internationally, stroke and other cerebrovascular diseases account for 10 per cent of deaths, making stroke the second leading cause of death.

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Health versus Wealth

sgupta — Mon, 28 May 2012 10:14:10 +0000

Health versus Wealth sgupta Mon, 05/28/2012 - 06:14

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U of T News)

Shibu Thomas

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In 1776, Adam Smith in The Wealth of Nations theorized that the free market economy was the solution to increase the wealth of a country. Almost 250 years later, health professionals, policy makers and Professor Gustavo Saposnik, a neurologist with interests in global health and population-based studies are asking another, arguably more important question:

"How does one best allocate wealth to increase the health of a nation?”

Saposnik is an Associate Professor in the Department of Medicine and the Institute of Health Policy, Management and Evaluation at the ��Ƶ, and Director of the Stroke Outcomes Research Unit at St. Michael’s Hospital. He recently explored the relationship among socioeconomic status, access to care and stroke outcomes.

In a study published in the journal Stroke, he sought to uncover the correlation between a country’s health expenditure, gross domestic product (GDP) and unemployment rate, and its incidences of hemorrhagic stroke, stroke mortality and onset of stroke. That research was a first because, instead of relying on one subset or population, it sourced 28 population-based studies conducted across 25 countries and surveying 480,000 people. The final sample included 7,703 cases of individuals with stroke.

Saposnik’s findings were eye-opening: low GDP was associated with a 30 percent increase in stroke incidence, more than a 40 percent increase in mortality, a 40 percent increase in hemorrhagic strokes and an increase in premature cardiovascular risk. Lower health expenditure resulted in a 45 percent increase in stroke mortality at 30 days.

“What’s significant about these studies,” says Saposnik, “is that they throw light on ways in which a country’s resources can be more effectively utilized by investing more energy and health resources in prevention. Investment dollars are multiplied by many times when they are allocated to preventive treatments and measures.”

Recent studies have shown that proven, inexpensive, preventative medications are less likely to be prescribed after stroke in low- and middle-income countries. Moreover, recent data from the World Bank revealed significantly higher out-of-pocket expenditures in treatment and services among such countries.

Saposnik can offer some evidence-based suggestions: “As Confucius said, ‘When it is obvious that the goals cannot be reached, don’t adjust the goals, adjust the action steps.’ Similarly, initiatives that target reducing and managing high blood pressure, for example, are much less expensive and more effective than treating the related heart attack or stroke.”

He adds that smoking cessation programs, and effectively managing diabetes and obesity also provide an exponential return on investment.

One of Saposnik’s main goals is to identify innovative strategies to improve access to care and stroke prevention, and reduce disability in stroke survivors. He is exploring virtual reality technology to assist the rehabilitation of patients after stroke, and has formed and now leads a working group on stroke outcomes research called SORCan (Stroke Outcomes Research Canada, www.sorcan.ca).

Working with U of T Department of Medicine cardiologist Professor Chi-Ming Chow, he has also developed cost-effective technological tools to assist clinicians in understanding a patient’s prognosis after acute stroke, such as the Ischemic Stroke Predictive Risk Score application (IScore). This tool can estimate death, disability and risk of intracerebral hemorrhage after thrombolysis for an acute stroke.

Available at the website www.sorcan.ca/iscore and as a smart-phone application, IScore is accessible at no cost to any clinician in any part of the world.

Raising the standards of global health is an issue dear to Saposnik, who originally hails from Buenos Aires and has consulted in countries including Argentina, Brazil and Thailand on measuring the effectiveness of stroke care.

“Global collaboration enriches everyone. This is a two-way process,” he says. “There are a lot of opportunities for the so-called ‘developed’ countries to learn from practices in other parts of the world. It is a win-win for everyone.”

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Intelligent, affordable rehab robot to help stroke patients

sgupta — Mon, 26 Mar 2012 11:00:38 +0000

Intelligent, affordable rehab robot to help stroke patients sgupta Mon, 03/26/2012 - 07:00

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Associate Professor Alex Mihailidis (Photo courtesy of Professor Mihailidis )

Erin Vollick

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Erin Vollick

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U of T's Alex Mihailidis designs table-top technology

Rehabilitation is crucial after a stroke. Yet patients don’t always do their exercises because they’re boring or difficult to do at home.

But what if you could make them easy and fun?

Enter ��Ƶ Associate Professor Alex Mihailidis of the Department of Occupational Science and Occupational Therapy at the Faculty of Medicine and his intelligent, table-top robot.

"This new robot will help to advance the use of robotics in stroke rehab," said Mihailidis, “as it will provide an affordable and accessible technology that can be used in hospitals, clinics, and in the home.”

Mihailidis, of U of T’s Institute of Biomaterials and Biomedical Engineering (IBBME) knows the speed and intensity by which stroke patients begin rehabilitation exercises greatly increases patients' neuroplasticity—the brain's ability to reorganize itself around damaged areas by forming new neural connections—and mobility. But rehab exercises are often neglected in a home environment, either because those exercises are repetitive and boring, or because attendants and rehab machines are needed to oversee or complete the exercises.

With his team of researchers, Mihailidis, the Barbara G. Stymiest Research Chair in Rehabilitation Technology at the Toronto Rehabilitation Institute, used interviews with focus groups and therapists, along with questionnaires from more 200 respondents to design a new, more cost-effective rehabilitation robot. Working with industrial partner Quanser Consulting Inc., they developed a lightweight, portable robot. Approximately one-tenth the cost of rehab robots currently available, the robot is designed to go home with patients.

And it’s intelligent.

"The fact that it can automatically learn about a user and adapt its exercises accordingly makes this robot unique," Mihailidis said.

Patients interact with games and other visual stimuli displayed on a computer screen as part of their exercises, making these repetitive movements fun and interactive. Meanwhile, the robot's artificial intelligence, an integral part of its design, allows the robot to operate independently, tracking a patient's progress and recalling how the patient did during previous sessions. It adjusts the difficulty of the exercises according to the user's needs and fatigue-level, while a camera system—also a unique characteristic—records patients' posture and movements. (See photo, left, by Rajibul Huq)

IBBME post-doctoral researcher Rajibul Huq, designer of the robotic intelligence, explained that "the system can record video or any other data" that attendants can then access remotely.

The rehab robot technology may also help patients suffering from spinal cord and brain injuries, osteoarthritis, or address other types of upper body rehabilitation needs. A second round of clinical trials of the robot is scheduled to begin next month, with the goal of distributing the technology by early autumn.

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Study finds delirium after stroke linked to poorer outcomes for patients

sgupta — Thu, 19 Jan 2012 16:56:58 +0000

Study finds delirium after stroke linked to poorer outcomes for patients sgupta Thu, 01/19/2012 - 11:56

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New U of T research shows the importance of preventing delirium in stroke patients. (Bigstock photo)

Kate Taylor

Author legacy

Kate Taylor

Topic

Breaking Research

Stroke

U of T researcher 'reprograms' brain cells in pursuit of new therapy for stroke patients

Women less likely to be diagnosed with minor stroke than men: U of T study

Technologies that can help end ‘hallway medicine’: U of T health-care researchers to meet with Ontario legislators

U of T expert on knowing the signs of a stroke – and acting quickly

Read more Toronto Star Doctors' Notes columns by U of T experts

Read the full Doctors' Notes column

The benefit of prolonged heart monitoring after unexplained strokes: New England Journal of Medicine

Caregivers happier when they can continue to enjoy hobbies and interests

Parental divorce linked to stroke in males

Health versus Wealth

Intelligent, affordable rehab robot to help stroke patients

Study finds delirium after stroke linked to poorer outcomes for patients